Using a meta-ethnographic approach to explore the nature of facilitation and teaching approaches employed in interprofessional education

Background: Interprofessional facilitators and teachers are regarded as central to the effective delivery of interprofessional education (IPE). As the IPE literature continues to expand, most studies have focused on reporting learner outcomes, with little attention paid to IPE facilitation. However, a number of studies have recently emerged reporting on this phenomenon.

Aim: To present a synthesis of qualitative evidence on the facilitation of IPE, using a meta-ethnographic approach.

Methods: Electronic databases and journals were searched for the past 10 years. Of the 2164 abstracts initially found, 94 full papers were reviewed and subsequently 12 papers were included. Teams of two reviewers independently completed each step in the review process. The quality of these papers was assessed using a modified critical appraisal checklist.

Results: Seven key concepts embedded in the included studies were synthesized into three main factors which provided an insight into the nature of IPE facilitation. Specifically, the synthesis found that IPE facilitation is influenced by “contextual characteristics”; “facilitator experiences”; and the “use of different facilitation strategies”.

Conclusions: IPE facilitation is a complex activity affected by contextual, experiential and pedagogical factors. Further research is needed to explore the effects of these factors on the delivery of IPE.     

Residual skin injury after repeated irradiation: differences observed using healing, macrocolony, and microcolony endpoints

Following three repeated tolerance doses to mouse tail skin, residual injury was characterized by a 35% reduction in the iso-effective dose compared to age-matched controls, using healing or macrocolony endpoints. In contrast, the reduction was only 9%, measured using microcolony formation. The colony data showed that the reduction was a constant dose, not a dose-modifying effect. The residual injury is interpreted as due to a reduced density of microcolony-forming cells in the epidermis, and these are less capable of macrocolony formation and hence of re-epithelialization in the repeatedly-irradiated epidermis.     

Re-irradiation of mouse skin: similarity of dose reductions for healing and macrocolony endpoints

The amount of residual injury in mouse tail skin, assessed by the decrease in re-irradiation dose for equal effect, was similar whether assessed using healing or colony endpoints (17-21% after single priming doses). There were tendencies towards an increased sensitivity of the colony-forming cells by a factor of about 2, and less residual injury after multifractionated priming doses. These observations are compatible with a lower alpha/beta ratio characterising the response to dose fractionation for residual injury than for the acute healing response.     

Lack of protection by oestrogen from radiation-induced testicular damage in the rat

The influence of pretreatment with oestradiol dipropionate (E) on the response of the rat testis to radiation has been studied. Treatment of rats for 3 weeks with E (100 mg/kg per week) induced severe atrophy of the testis. At this time, the testes were locally irradiated to doses of 0, 4 or 15 Gy, E treatment was continued for a further week and the rats were killed 24 or 36 weeks later. Radiation alone had a marked effect on spermatogenesis as assessed by testicular weight and counts of regenerating tubule cross-sections. At 24 weeks, 8% of cross-sections were found to possess spermatogenic cells after 4 Gy and this had increased to 15% at 36 weeks. No significant regeneration was observed after 15 Gy. Similar results were obtained in those rats pretreated with E. Following irradiation alone, decreases in interstitial cell numbers and testicular luteinizing hormone (LH) receptors reflected Leydig cell damage. Again, pretreatment with oestrogen did not appear to reduce Leydig cell damage. The results of the present study suggest that pretreatment with oestrogen is not able to reduce the testicular damage induced by moderate to high single doses of radiation.     

Expression of glutamic acid decarboxylase mRNA in normal and monocularly deprived cat visual cortex

Neurons expressing glutamic acid decarboxylase (GAD) mRNA were localized by in situ hybridization in normal and monocularly deprived cat visual cortex by using single-stranded RNA probes transcribed from cDNAs cloned in vectors with the T3 and T7 RNA polymerase promoters. In Northern blot analyses, these RNA probes identified 2 forms of GAD mRNA, one of which is approximately 200 bases longer than the other which has previously been identified. The distribution of neurons containing GAD mRNA was compared with the distribution of immunocytochemically identified GABA neurons and in both cases the highest density of labeled neurons was found in layers II, III, and upper VI. All other cellular layers contained a homogeneous, but lower density of labeled cells. Cells expressing GAD mRNA outnumbered GABA immunostained neurons by approximately 10%, but colocalization of GAD mRNA with GABA immunocytochemistry revealed that the two methodologies were detecting the same neuronal population. To determine whether decreased retinal activity affected the levels of GAD mRNA in adult cats, neurons containing GAD mRNA were counted in normal and monocularly deprived visual cortex. However, the number of cells expressing GAD mRNA did not change following monocular deprivation.     

整合素β4结合蛋白与P311在人胚肾293细胞中的表达及共定位

目的:利用激光共聚焦显微镜共定位检测整合素β4结合蛋白与P311蛋白在细胞内的分布,进一步证实它们在细胞内产生相互作用的可能性。方法:实验于2006-03/12在解放军第三军医大学西南医院全军烧伤研究所,创伤、烧伤与复合伤国家重点实验室完成。先分别构建能在哺乳动物细胞中表达整合素β4结合蛋白的绿色荧光融合蛋白和表达P311的红色荧光融合蛋白的重组载体,经酶切鉴定正确后,利用脂质体介导法共转染人胚肾293细胞后,激光共聚焦显微镜进行共定位观察。结果:表达整合素β4结合蛋白的绿色荧光融合蛋白和表达P311的红色荧光融合蛋白的重组载体经双酶切鉴定正确,转染293细胞后,荧光显微镜下能观察到绿色和红色荧光。激光共聚焦显微镜下观察两者主要分布在293细胞的胞浆和胞核中,并且存在着共定位现象。结论:表达整合素β4结合蛋白的绿色荧光融合蛋白和表达P311的红色荧光融合蛋白的重组载体在空间分布上两者存在相互作用的物质基础。     

A reliability study of biomechanical foot function in psoriatic arthritis based on a novel multi-segmented foot model

The objective of this study was to determine the within-and between-day reliability of spatio-temporal, plantar pressure, kinematic and kinetic measurements based on a novel, seven segment foot model applied in patients with Psoriatic Arthritis (PsA). Nine PsA patients and matched healthy adult controls underwent three-dimensional gait analysis on two occasions, one week apart using a seven segment foot model. A core-set of functional variables including inter-segment kinematics, kinetics, spatio-temporal and plantar pressure distribution were analysed using the coefficient of multiple correlation (CMC), Bland-Altman plots, intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). Results showed excellent within- and between-day reliability for intersegment kinematic and kinetic data patterns with CMC values typically greater than 0.950 in a clinically stable cohort of PsA patients. Between-day reliability ranged from poor to excellent for absolute CMC values. Corrected CMC values were consistently higher across all variables ranging from fair-to-good to excellent. ICC values indicated excellent reliability for discrete spatio-temporal, plantar pressure, and ankle moment and power variables for both groups. Reliability for ground reaction forces and kinematic discrete variables ranged from fair-to-good to excellent. Standard error of measurement values ranged from 0.7° to 3.0° for discrete kinematic variables across both groups with greater variability in the PsA patients. In conclusion, intersegment kinematics and kinetics as well as spatio-temporal and plantar pressure can be reliably measured in PsA patients using a novel seven segment foot model. Some discrete kinematic variables have poor reliability and should not be used in prospective cohort and intervention studies.