Search

Patient involvement in health and social care education lacks theoretical underpinning, despite increasing calls for rigour. Theories help explain how learning is advanced and offer guidance for how faculty work with patients who become involved in curriculum delivery. We conducted a systematic review to synthesise how theory shapes our understanding of patient involvement in health and social care education. Three databases were systematically searched. Studies demonstrating explicit and high-quality application of theory to patient involvement in teaching and learning or involvement within a community of health and social care educators, were included. A narrative synthesis was undertaken using Activity Theory as an analytical lens to highlight the multifaceted components of patient involvement in professional education. Seven high-quality, theoretically underpinned studies were included. Four studies applied theory to pedagogy, showing how deep learning from patient involvement occurred. Despite a growing body of studies which attempt to use theory to explain learning, many were descriptive, lacked theoretical quality and were therefore excluded. Three studies applied theory to illuminate the complexity of involving patients in the educational system, showing how patients can be supported and valued in teaching roles. This review highlights that more work is required to identify the mechanisms through which patient involvement enhances learning and, to explore what involvement within the education community means for faculty and patients. Our understandings of patient-educator partnerships for learning could be progressed by further high-quality theory driven studies, which include the patient voice.

Almond [Prunus dulcis (Mill.) D.A. Webb] is an economically important nut crop susceptible to the genetic disorder, Non-infectious Bud Failure (NBF). Despite the severity of exhibition in several prominent almond cultivars, no causal mechanism has been identified underlying NBF development. The disorder is hypothesized to be associated with differential DNA methylation patterns based on patterns of inheritance (i.e., via sexual reproduction and clonal propagation) and previous work profiling methylation in affected trees. Peach (Prunus persica L. Batsch) is a closely related species that readily hybridizes with almond; however, peach is not known to exhibit NBF. A cross between an NBF-exhibiting 'Carmel' cultivar and early flowering peach ('40A17') produced an F1 where ∼50% of progeny showed signs of NBF, including canopy die-back, erratic branching patterns (known as "crazy-top"), and rough bark. In this study, whole-genome DNA methylation profiles were generated for three F1 progenies exhibiting NBF and three progenies considered NBF-free. Subsequent alignment to both the almond and peach reference genomes showed an increase in genome-wide methylation levels in NBF hybrids in CG and CHG contexts compared to no-NBF hybrids when aligned to the almond genome but no difference in methylation levels when aligned to the peach genome. Significantly differentially methylated regions (DMRs) were identified by comparing methylation levels across the genome between NBF- and no-NBF hybrids in each methylation context. In total, 115,635 DMRs were identified based on alignment to the almond reference genome, and 126,800 DMRs were identified based on alignment to the peach reference genome. Nearby genes were identified as associated with the 39 most significant DMRs occurring either in the almond or peach alignments alone or occurring in both the almond and peach alignments. These DMR-associated genes include several uncharacterized proteins and transposable elements. Quantitative PCR was also performed to analyze the gene expression patterns of these identified gene targets to determine patterns of differential expression associated with differential DNA methylation. These DMR-associated genes, particularly those showing corresponding patterns of differential gene expression, represent key targets for almond breeding for future cultivars and mitigating the effects of NBF-exhibition in currently affected cultivars.

While all organisms age, our understanding of how aging occurs varies among species. The aging process in perennial plants is not well-defined, yet can have implications on production and yield of valuable fruit and nut crops. Almond exhibits an age-related disorder known as non-infectious bud failure (BF) that affects vegetative bud development, indirectly affecting kernel yield. This species and disorder present an opportunity to address aging in a commercially relevant and vegetatively propagated perennial crop. The hypothesis tested in this study was that relative telomere length and/or telomerase reverse transcriptase (TERT) expression can serve as biomarkers of aging in almond. Relative telomere lengths and expression of TERT, a subunit of the enzyme telomerase, were measured via qPCR methods using bud and leaf samples collected from distinct age cohorts over a two-year period. Results from this work show a marginal but significant association between both relative telomere length and TERT expression, and age, suggesting that as almonds age, telomeres shorten and TERT expression decreases. This work provides information on potential biomarkers of perennial plant aging, contributing to our knowledge of this process. In addition, these results provide opportunities to address BF in almond breeding and nursery propagation.

Background: Medical students become members of the clinical team through participation in their activities, as described by Lave and Wenger's situated learning theory. While there is research into how medical students cognitively engage in clinical learning, there is limited work on clinical experiences using a social theoretical lens such as situated learning theory. Method: This study explored third year medical students' lived experience as newcomers to clinical teams using a qualitative phenomenological approach. Medical students completed in‐depth, semi‐structured interviews in 2021. Interpretive phenomenological analysis (IPA) using Lave and Wenger's theory of situated learning was applied to understand students' experiences. Results: Seven students discussed their variable placement experiences. Learning related to three elements: conditions for participation, modes of participation and products of participation. When certain conditions were met relating to student, clinician and activity, students learned. This drove identity and relationship formation. The findings related and led to a self‐perpetuating cycle with potential to advance student learning. When the conditions for participation were not met, the cycle stopped, leading to student disengagement. Conclusion: Passivity in students is a result of modifiable factors in the workplace. To encourage proactivity, clinicians must enable students to move from observation to participation as their competence increases. Participation should be supervised, challenging and should contribute to patient care. Time pressures can make this difficult; one solution is to nominate a clinician to direct students and account for this in their workload or to employ a clinical fellow to assist with student training. [ABSTRACT FROM AUTHOR]

This article concludes the interprofessional education series published by the Centre for the Advancement of Interprofessional Education Research Subgroup, and considers the lessons that can be learned from experiences of emergency remote teaching during the COVID-19 pandemic. Consideration is given to the practicalities of emergency remote teaching, including its preparation, delivery and proposed outcomes of using online platforms for interprofessional education. The article is written as a guide for others to draw on and includes considerations for future delivery and sustainability of interprofessional education in midwifery practice and other fields of health and social care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to demonstrate improved precision of word recognition scores (WRSs) by increasing list length and analyzing phonemic errors. Method: Pure-tone thresholds (frequencies between 0.25 and 8.0 kHz) and WRSs were measured in 3 levels of speech-shaped noise (50, 52, and 54 dB HL) for 24 listeners with normal hearing. WRSs were obtained for half-lists and full lists of Northwestern University Test No. 6 (Tillman & Carhart, 1966) words presented at 48 dB HL. A resampling procedure was used to derive dimensionless effect sizes for identifying a change in hearing using the data. This allowed the direct comparison of the magnitude of shifts in WRS (%) and in the average pure-tone threshold (dB), which provided a context for interpreting the WRS. Results: WRSs based on a 50-word list analyzed by the percentage of correct phonemes were significantly more sensitive for identifying a change in hearing than the WRSs based on 25-word lists analyzed by percentage of correct words. Conclusion: Increasing the number of items that contribute to a WRS significantly increased the test's ability to identify a change in hearing. Clinical and research applications could potentially benefit from a more precise word recognition test, the only basic audiologic measure that estimates directly the distortion component of hearing loss and its effect on communication.

Purpose: The purpose of this study was to demonstrate improved precision of word recognition scores (WRSs) by increasing list length and analyzing phonemic errors. Method: Pure-tone thresholds (frequencies between 0.25 and 8.0 kHz) and WRSs were measured in 3 levels of speech-shaped noise (50, 52, and 54 dB HL) for 24 listeners with normal hearing. WRSs were obtained for half-lists and full lists of Northwestern University Test No. 6 (Tillman & Carhart, 1966) words presented at 48 dB HL. A resampling procedure was used to derive dimensionless effect sizes for identifying a change in hearing using the data. This allowed the direct comparison of the magnitude of shifts in WRS (%) and in the average pure-tone threshold (dB), which provided a context for interpreting the WRS. Results: WRSs based on a 50-word list analyzed by the percentage of correct phonemes were significantly more sensitive for identifying a change in hearing than the WRSs based on 25-word lists analyzed by percentage of correct words. Conclusion: Increasing the number of items that contribute to a WRS significantly increased the test's ability to identify a change in hearing. Clinical and research applications could potentially benefit from a more precise word recognition test, the only basic audiologic measure that estimates directly the distortion component of hearing loss and its effect on communication. Key Words: audiology, diagnostics, speech recognition, pure-tone thresholds, Nearly every audiologic diagnostic workup includes results from suprathreshold word recognition testing. The preferred stimulus is a list of monosyllabic words. The most commonly used word lists for adults are [...]

Almond [ Prunus dulcis (Mill.) D.A. Webb] is an economically important nut crop susceptible to the genetic disorder, Non-infectious Bud Failure (NBF). Despite the severity of exhibition in several prominent almond cultivars, no causal mechanism has been identified underlying NBF development. The disorder is hypothesized to be associated with differential DNA methylation patterns based on patterns of inheritance (i.e., via sexual reproduction and clonal propagation) and previous work profiling methylation in affected trees. Peach (Prunus persica L. Batsch) is a closely related species that readily hybridizes with almond; however, peach is not known to exhibit NBF. A cross between an NBF-exhibiting 'Carmel' cultivar and early flowering peach ('40A17') produced an F1 where ∼50% of progeny showed signs of NBF, including canopy die-back, erratic branching patterns (known as "crazy-top"), and rough bark. In this study, whole-genome DNA methylation profiles were generated for three F1 progenies exhibiting NBF and three progenies considered NBF-free. Subsequent alignment to both the almond and peach reference genomes showed an increase in genome-wide methylation levels in NBF hybrids in CG and CHG contexts compared to no-NBF hybrids when aligned to the almond genome but no difference in methylation levels when aligned to the peach genome. Significantly differentially methylated regions (DMRs) were identified by comparing methylation levels across the genome between NBF- and no-NBF hybrids in each methylation context. In total, 115,635 DMRs were identified based on alignment to the almond reference genome, and 126,800 DMRs were identified based on alignment to the peach reference genome. Nearby genes were identified as associated with the 39 most significant DMRs occurring either in the almond or peach alignments alone or occurring in both the almond and peach alignments. These DMR-associated genes include several uncharacterized proteins and transposable elements. Quantitative PCR was also performed to analyze the gene expression patterns of these identified gene targets to determine patterns of differential expression associated with differential DNA methylation. These DMR-associated genes, particularly those showing corresponding patterns of differential gene expression, represent key targets for almond breeding for future cultivars and mitigating the effects of NBF-exhibition in currently affected cultivars. [ABSTRACT FROM AUTHOR]

Individuals in capitalist societies are increasingly exposed to market risks. Luck egalitarian theories, which advocate neutralizing the influence of luck on distribution, fail to cope with this problem, because they [...]

Affirmative action is mainly seen as a remedy to past wrongs. Rather than this, it should be seen as the means to accomplish the just and moral goal of integration. The Supreme Court should examine affirmative action policies with a view to whether they are promoting violations of equal protection.