Betty Exintaris

Description:Vascular smooth muscle cell (SMC) relaxation by guanylyl cyclases (GCs) and cGMP is mediated by NO and its receptor soluble GC (sGC) or natriuretic peptides (NPs) ANP/BNP and CNP with the receptors GC-A and GC-B, respectively. It is commonly accepted that cultured SMCs differ from those in intact vessels. Nevertheless, cell culture often remains the first step for signaling investigations and drug testing. Previously, we showed that even popular reference genes changed dramatically after SMC isolation from aorta. Regarding NP receptors, a substantial amount of data relies on cell culture. We hypothesize that the NP/cGMP system in intact aortic tunica media differs from isolated and cultured aortic SMCs. Therefore, we studied isolation and culturing effects on the expression of NP receptors GC-A, GC-B, and NP clearance receptor (NPRC) compared to sGC. We investigated intact tunica media and primary SMCs from the longitudinal halves of the same rat aorta. GC activity was monitored by cyclic guanosine monophosphate (cGMP). In addition, we hypothesize that there are sex-dependent differences in the NP/cGMP cascade in both intact tissue and cultured cells. We, therefore, analyzed a male and female cohort. Expression was quantified by RT-qPCR comparing aortic media and SMCs with our recently validated reference gene (RG) small nuclear ribonucleoprotein 2 (U2). Only GC-A was stably expressed. In intact media, GC-A exceeded GC-B and NPRC. However, GC-B, NPRC, and sGC were dramatically upregulated in cultured SMCs of the same aortae different from the stable GC-A. The expression was mirrored by NP-induced GC activity. In cultured cells, changes in GC activity were delayed compared to receptor expression. Minor differences between both sexes could also be revealed. Thus, isolation and culture fundamentally alter the cGMP system in vascular SMCs with potential impact on drug testing and scRNAseq. Especially, the dramatic increase in the clearance receptor NPRC in culture might distort all physiological ANP, BNP, and CNP effects.

Description:Background: Generative Artificial Intelligence (GenAI) is increasingly integrated into health professions education (HPE), offering new opportunities for student learning. However, current research lacks a comprehensive understanding of how HPE students actually use GenAI in practice. Laurillard's Conversational Framework outlines six learning types-acquisition, inquiry, practice, production, discussion and collaboration-commonly used to categorise learning activities supported by conventional and digital technologies. Gaining insight into how GenAI aligns with these six learning types could assist HPE academics in integrating it more thoughtfully and effectively into teaching and learning. Objective: This systematic review investigates how HPE students utilise GenAI and examines how these uses align with Laurillard's six learning types compared to conventional and digital technologies. Methods: A systematic review searching five major databases-ERIC, Education Database, Ovid Medline, Ovid Embase and Scopus including articles on HPE students' use of GenAI until 15th September 2024. Studies were included if they were conducted within formal HPE training programs in HPE and specifically mentioned how students interact with GenAI. Data were mapped to the six learning modes of the Laurillard's Framework. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Results: Thirty-three studies met inclusion criteria. GenAI supported learning most frequently in practice (73%), inquiry (70%), production (67%) and acquisition (55%). These studies highlight GenAI's varied educational applications, from clarifying complex concepts to simulating clinical scenarios and generating practice materials. Discussion and collaboration were less represented (12% each), suggesting a shift toward more individualised learning with GenAI. The findings highlight benefits such as efficiency and accessibility, alongside concerns about critical thinking, academic integrity and reduced peer interaction. Conclusions: This review has provided insights into HPE students' learning aligned with Laurillard's existing six learning types. Although GenAI supports personalised and self-directed learning, its role in collaborative modes is under-explored.

Description:Background: Inappropriate use of antimicrobials can push the environment out of balance, and cause unnecessary waste that can contaminate our soil, animals and waterways. Health professional education is committed to preparing students for antimicrobial stewardship (AMS) and supporting planetary health, but a more multidisciplinary action is needed to curb the expansion of antimicrobial resistance (AMR). The aim of this scoping review is to showcase the current antimicrobial knowledge of undergraduate students across the disciplines of medicine, pharmacy, nursing, dentistry and veterinary. This will consequently showcase the gaps and trends across the different disciplines and countries to help inform planetary health multidisciplinary undergraduate curriculums. Methods: A search of the existing literature published prior to December 2023 was conducted using CINAHL, EMBASE, MEDLINE, SCOPUS, and ERIC databases. Studies were excluded if they included postgraduate students or discussed the knowledge, attitude and practice (KAP) of students towards antimicrobial prescribing, AMR and AMS related to a specific learning activity. Results: A total of 144 articles were included. The most represented countries were India and Pakistan accounting for 17% and 8% of the studies, respectively. Single-disciplinary research accounted for approximately 80% of the studies. Medicine was the most represented discipline in both single-disciplinary and multidisciplinary research, appearing in approximately 62% of the studies, followed by pharmacy appearing in approximately 30% of the studies and dentistry appearing in approximately 18% of the studies. Three major priority themes were identified: students are more familiar with the term AMR compared to AMS; inappropriate use of antimicrobials is seen as the main driver of AMR; and the need for more training and education in the field of appropriate antimicrobial prescribing, AMR and AMS. Conclusions: This review has highlighted that there is a need for more AMS interprofessional education (IPE) activities in all five disciplines, and especially within the disciplines of nursing, veterinary and dentistry, as shown by a lack of multidisciplinary research in this area. Most of the knowledge assessments have just touched the surface of AMS and focused on inappropriate antimicrobial use alone. Interdisciplinary planetary health education needs to go beyond these skills and broaden the understanding of other factors that can contribute to AMR such as inappropriate disposal, environmental contamination, monitoring and surveillance, one health, false allergies, and more importantly, how each health professional can contribute to a team.

Description:Background: Resilience is an essential psychological trait that empowers individuals to adapt and thrive in the face of challenges. Although it is acknowledged that health professionals need to possess high levels of resilience, there has been limited research comparing how different groups of health students, particularly school leaver undergraduates and mature age graduate entry students, develop resilience in their coursework. Methods: This study combines both objective (academic grades with validated survey results) and subjective data (interviews) to compare how resilience is related to academic coursework performance for two groups of pharmacy students: the mature age graduate entry (GE, N = 64) learners and school leaver undergraduate (UG, N = 208) learners. We employed a sequential explanatory mixed methods design using surveys, academic performance data and semi-structured interviews. The survey tapped constructs related to resilience (burnout, stressors and coping methods) while the interviews elicited a more nuanced understanding of individual and environmental factors. Results: Although there was no statistical difference in burnout experience between the two groups, GE students exhibited more positive resilience attitudes than UG when selecting resilience statements on the survey. Both cohorts indicated in the survey that engaging in distraction activities (physical exercise, sleeping, listening to music, anything other than the stressor) was their most preferred method of relieving stress. Within UG student survey responses, those who indicated support from partners, friends and family had better academic performance, while those who did not report coping methods did worse academically. The three key environmental factors we identified that contributed to both undergraduate and graduate entry resilience were workload, feedback provision and psychosocial support. Conclusions: Currently, there is still a need for resilience programs geared at academic success to be implemented in higher education. This study provides objective evidence of academic success coupled with exploration into the nuances of resilience amongst different student groups. It not only highlights the differing resilience development strategies and burnout coping mechanisms in emerging health professionals, but showcases the juxtaposition of two different learner groups (UG and GE students) within a discipline. The cross-cohort facilitation of learning as in the discipline-specific strategies identified can help both groups develop resilience and inform future innovations. By comparing mature-age graduate students and younger-in-age undergraduate students, we identified a wider range of strategies and more positive attitudes to burnout in mature-age students. Health and clinical educators in university health degrees, clinical placements and clinical workplaces can develop effective training materials based on findings from this study to 1) assist undergraduate younger-age health students with developing resilience and 2) further refine mature-age health students' and practicing health professionals' resilience in today's fast-paced clinical workplaces.

Description:What was the educational challenge?: A major challenge in health professions education is to equip graduates with essential teamwork skills, addressing cognitive, motivational, and emotional barriers that hinder effective collaboration among students from diverse backgrounds. What was the solution and how was this implemented?: The Teamwork Baseline Assessment Tool (TBAT) was developed as an innovative solution to teach collaboration and teamwork, focusing on growth mindsets, reactions to challenging scenarios, and ideal team player attributes. Implemented during the orientation for new first-year students, TBAT facilitated early engagement in teamwork discussions, with students receiving personalised reports to aid in self-reflection and development. What lessons were learned?: Key lessons included the importance of initiating teamwork conversations early, the value of personalised feedback in promoting self-awareness and peer understanding, and the effectiveness of TBAT in providing instructors with insights into students' teamwork aptitudes. What are the next steps?: Expanding TBAT across various student populations and integrating it into the curriculum aims to provide continuous opportunities for applying and reinforcing teamwork and collaboration skills. This strategy will support the development of targeted instructional approaches, fostering a collaborative learning environment and preparing students for the teamwork challenges in healthcare settings.