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Following a visit to Reggio Emilia settings, Anne O'Connor discusses their practice and provision and inspiration for our own settings

The Perinatal Integrated Psychosocial Assessment (PIPA) tool screens for anxiety, depression, and psychosocial factors in pregnancy. We aimed to assess the association between PIPA-determined psychosocial risk and obstetric and neonatal outcomes.Cohort study of all pregnant women who gave birth at ≥20 weeks of gestation in 2017-2019 at a tertiary maternity hospital in, Sydney, Australia. Women completed PIPA at their first antenatal visit and were assigned a PIPA risk category. At-risk women were reviewed and referred for support. The association between PIPA risk category and obstetric and neonatal outcomes was evaluated using multivariable logistic regression adjusting for sociodemographic and pregnancy factors.In all, 5969 women completed PIPA; 71.4% were assessed no/low risk, 17.5% medium risk, and 11.1% medium-high/high risk. Compared with no/low-risk women, medium-high/high-risk women were more likely to remain in hospital forgt;72 hours (aOR 1.47 [95% CI 1.33-1.64]); to not be breastfeeding at discharge (aOR 1.77 [95% CI 1.20-2.61]); to have their infants experience birth complications (aOR 1.24 [95% CI 1.03-1.50]); and to be admitted to the NICU (aOR 1.63 [95% CI 1.26-2.11]). There was a modest increase in odds of cesarean birth (aOR 1.12 [95% CI 1.00-1.27]), and no association with preterm birth or low birthweight. The risk of adverse outcomes disappeared for medium-high/high-risk women referred for support.The PIPA tool identified one in 10 women at high psychosocial risk with increased risk of adverse obstetric and neonatal outcomes. Adverse outcomes were attenuated for high-risk women who were referred for extra support, suggesting that psychosocial review and referral for high-risk women may reduce the risk of adverse obstetric and neonatal outcomes.

Background Feedback, if effectively provided by the teacher and utilised by the learner, enables improvement in academic performance. It is clear from current literature that the provision of feedback by teachers is not sufficient on its own to guarantee improvements as early university entrants may not be sufficiently equipped to effectively engage with feedback. Nonetheless, it is critical for health professional students to develop feedback literacy early, in order to prepare them for a professional career of lifelong learning and critical thinking. The overarching aim of this study was to identify a feasible, sustainable approach to improve feedback literacy among students on pre-qualifying health professional programmes. Methods The study was divided into two phases. A mixed-methods approach grounded in constructivism was employed. Participants included teachers and learners from the School of Allied Health at X University, and two internationally acclaimed educationalists. In phase 1, first year students were encouraged to use an established online platform to upload modular feedback and develop personal learning action plans aimed at improving academic performance. A follow-up survey highlighted poor engagement with this method. Thus, the second phase focused on the co-construction of a suite of modules to develop these skills, supported by academic staff. Interviews were conducted with participants to review and refine this initiative. Results Learners’ engagement with the first phase of the study was poor. Thus, the second phase provided all stakeholders with the opportunity to feed into the development of a suite of modules, designed to encourage teachers and learners to work in partnership to nurture these skills. All stakeholder groups reported short- and long-term benefits with this approach, but also highlighted challenges towards its implementation. Conclusion The development of feedback literacy among health professional learners is essential. The transferability of such skills has been highlighted in the literature and by all stakeholder groups involved in this study. Finding a balance between introducing these skills at a time early enough to highlight their importance among university entrants is challenging. Further balance must be achieved between the workload required to achieve these skills and current programme demands for both teachers and learners.

This article argues that the study of religious translation can greatly benefit from a material turn, that attention needs to be paid to the carriers and forms of religious translations, and that s...

How the prime area of PD should be approached to best meet the needs of all children, as the countdown to the revised EYFS begins. By Anne O'Connor

Talking about death with young children is necessary when there has been a bereavement. Anne O'Connor explains the best ways to tackle this difficult subject

This qualitative study examines the reasons why animal shelter workers choose this occupation, and why they remain, despite the sorrows and travails inherent in this work. This thesis makes an original contribution to knowledge in three domains. While the Human-Animal Studies (HAS) literature explains shelter entry as counter-hegemonic and based on loving animals, my data provides evidence that these antecedents to occupational choice are insufficient. Instead, I find that my respondents’ occupational choice is processual; multiple pathways, false starts, and changes in the life course combine to precede entry. Rich insights into the role of process in occupational choice exist in the gendering literature. However, although it is a gendered occupation, shelter work does not appear to be simply a culturally, gender-based choice. I have found evidence of similar processes leading to this choice amongst both male and female respondents, although the few males in my sample (which is reflective of shelter work more broadly) suggests that further research on this point would be valuable. Second, the HAS literature on staying in shelter work focuses on emotion management strategies. While coping strategies are indubitably necessary in order to persist, to this insight I add a moral economy lens and the notion of sanctuary to explain why my respondents stay in this occupation. My respondents feel their occupation is part of a project of wider significance, and they are supported by some members of the public in this belief, by the ‘moral economy of the crowd’. My respondents have found an alternative experience of the economy, one which is not isolated from, but embedded in their values and moral rationalities. Shelter work also offers sanctuary from the market economy and in animal care. Third, I make an empirical contribution by producing unique data on shelter work in the Republic of Ireland, based on two years of ethnographic observations in seven shelters and one veterinary surgery, 24 semi-structured interviews, and an analysis of shelter social media. This study advances sociological theory in the area of occupational choice and promotes a re-visioning of the meaning and purposes of work under conditions of 21st century capitalism. The findings in these pages also bring us a small step closer to understanding our complex, messy, and contradictory relationships with other animals

Background: Performance-based assessment (PBA) is a complex process undertaken in the workplace by healthcare practitioners known as clinical educators, who assist universities in determining health professional students’ readiness for independent practice. Preparing healthcare professionals for PBA is considered essential to ensuring the quality of the assessment process in the clinical learning environment. A preliminary search of the literature indicated a paucity of research guiding the development of education programmes that support practice educators to understand and implement PBA. Objective: The aim of this scoping review is to investigate and describe education programmes delivered to allied health and nursing clinical educators, to develop PBA knowledge and skills. Methods: This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Electronic databases relevant to this research topic will be searched including, EMBASE, ERIC, MEDLINE (Ovid), Web of Science and CINAHL and other targeted databases for grey literature. Studies that include PBA as the main focus or a component of the education programmes, of any format, delivered to clinical educators in allied health and nursing will be included. Studies may report the design and/or implementation and/or evaluation of PBA education programmes. Relevant English language publications will be sought from January 2000 to October 2022. Two reviewers will screen all titles and abstracts against the inclusion/exclusion criteria, and publications deemed relevant will be eligible for full text screening, confirming appropriateness for inclusion in the scoping review. Data will be charted to create a table of the results, supported by narrative summary of findings in line with the review objectives.

725 Background: Immune checkpoint blockade (ICB) has a modest signal in the treatment of patients with genomically unselected pancreatic cancer (PDAC). Synergistic effects of combined radiotherapy and ICB are postulated. Preliminary results of a phase 1/2 trial of anti-PD-L1 antibody durvalumab (D) and SABR in locally advanced (LA) and borderline resectable PDAC (Tuli, AACR; 2019; Abstr B58), noted SABR and D to be safe and tolerable following induction chemotherapy. We sought to further evaluate the tolerability and efficacy of D and SABR, in LA PDAC. Methods: A single-arm, open-label phase 2 trial was conducted at Memorial Sloan Kettering (MSK). Key eligibility: histologically confirmed LA unresectable PDAC, with stable or responding disease following 4-6 months (m) of FOLFIRINOX (FFX), ECOG 0-2. Therapy: D and SABR; D dosed on day 1 750mg x 4 doses Q14 days, and subsequently 1500mg Q 28 days x 11 doses (1 year total), or until progression of disease (POD), or limiting toxicity. All patients received MRI adaptive ablative radiation, 50Gy in 5 fractions between doses 1 and 2 of D. Primary endpoint: 6-m progression free survival (6 m PFS) by RECIST v1.1. Secondary endpoints were Duration of Response, Overall Response Rate (ORR), CA 19-9 response, rates of downstaging/resection, and survival outcomes (overall survival (OS) and progression-free survival (PFS)) calculated from date of enrolment. OS and PFS were estimated using Kaplan-Meier method. Pre- and on-treatment tissue, blood and microbiome samples were collected to evaluate tumor-intrinsic and peripheral immunogenomic correlates of response. Results: Between 09/2020 and 05/2022, N = 18 enrolled. Median age 67.5 years (IQR; 62.5, 71.5), 28% (5/18) female. Baseline Performance Status: N = 8 (44%) ECOG 0; N = 10 (56%) ECOG 1. Tumor location: Head/uncinate N = 9 (50%), body N = 7 (39%), neck N = 2 (11%). Median # doses FFX prior to enrolment: 8.5 (IQR; 8.0- 11.0). At median follow-up of 13.8 m, 6-m PFS: 62% (95% CI 43%, 91%). Median PFS: 10.2 m (95% CI; 5.03, NA) and median OS 17.2 m (95% CI; 12.98, NA). Disease progression (any time) N = 12, of which local POD in N = 7 (58%). N = 3 completed maintenance D; N = 5 on active treatment. ORR: N = 17 (94.4%) stable disease (95% CI; 64.6%, 99.4%). Toxicity endpoints of special interest: Grade 3 ICB-related: in N = 4 patients; diarrhea N = 2; elevated AST/ALT N = 2; G3 lipase elevation N = 1; attribution uncertain. Conclusions: D and SABR following FFX in LA PDAC had an encouraging 6-m PFS of 62% (43-91%) and a tolerable safety profile. Immuno-genomic analyses of correlative biospecimens is underway. Funding support AstraZeneca. Clinical trial information: NCT03245541 .

BACKGROUND: Limited evidence exists regarding practice educators’ and practice tutors’ experience of, and training in, student supervision in the physiotherapy workplace. This knowledge would inform universities of their learning needs and help to enhance the practice-based experience for physiotherapy students. OBJECTIVE: The aim of this study was to create a profile of physiotherapy practice educators’ and practice tutors’ student supervision experience, university support available to them during practice placement and training undertaken by them. This study was undertaken in the Republic of Ireland. METHODS: An online survey was designed and circulated via the Irish Society of Chartered Physiotherapists’ database of physiotherapy members. RESULTS: One hundred and ninety-two practice educators and 71 practice tutors participated. Findings indicate that the 1:1 model of practice education is the predominant model of practice education employed in the Republic of Ireland. 70% of practice educators currently receive support from a practice tutor. Fifty-five percent of practice educators undertake student supervision 2-3 times per year. However, 56% of practice educators and 48% of practice tutors had not undertaken training in student supervision in the year prior to the study. A decline was also noted in the uptake of student supervision among clinicians with 16–25 years clinical experience. CONCLUSION: This study provides an insightful profile of physiotherapy practice education in the Republic of Ireland. Findings are encouraging, with data highlighting that most practice educators are supported by practice tutors. Recommendations include the need for further investigation of the apparent decline in student supervision among experienced clinicians. Consideration of the learning needs of practice educators and practice tutors is encouraged as well as a review of the accessibility and flexibility of training resources provided.

Anne O'Connor explains why visiting local spaces is important – and how to navigate doing so in the wake of lockdown

Background/Aims Oropharyngeal dysphagia is a common condition following stroke, with adverse consequences including aspiration pneumonia. Internationally, aspiration risk is typically managed using thickened liquids, an intervention with limited empirical support and associated treatment adherence issues. This study explores speech and language therapists' perceptions of and reasons for employing this intervention. Methods A total of 22 speech and language therapists working with people with dysphagia post-stroke in hospital settings participated in three focus groups. Participants were recruited through gatekeeper managers and data were analysed using inductive thematic analysis. Results Three themes were identified: primary justifications for treatment use, acute implementation issues, and having doubts. Use of thickened liquids is pivoted on safety-first reasoning, employed as a first step on the treatment ladder and in the context of limited perceived alternatives. Both clarity and contradictions are revealed by therapists, who acknowledge multiple factors that impact treatment effectiveness, including hospital, patient and product issues. Conclusions The findings from this study provide a basis for understanding clinical decision making for a widely-used gateway treatment that requires further empirical support. The data suggest that, similar to other professions, safety-first reasoning is paramount for speech and language therapists. The dominance of thickened liquids in treating aspiration is reflected internationally and warrants ongoing discussion.

Objectives Physiotherapy lacks the significant body of evidence that underpins performance-based assessments in disciplines such as medicine and nursing. In particular, very few studies have examined stakeholder perspectives of the process. This study set out to explore the perceptions of clinicians who undertake student assessment in the workplace in order to inform further development of performance-based assessment in physiotherapy. Design A qualitative, descriptive design was employed where focus group interviews were utilised for data collection. Inductive thematic analysis was used to analyse the data. Participants Clinical educator and practice tutor volunteers affiliated with three Irish universities participated in one of seven focus groups (n = 46). Results Two themes were identified; 1) Tensions in the clinical learning environment, 2) An optimal PBA process. The first theme describes clinical educators’ struggle with juggling multiple roles and highlights the challenges of sustaining a balance between student mentoring and patient care. The second theme outlines factors perceived to contribute to an optimal performance-based assessment process; these include maintaining aspects of the current process and expanding the employment of dedicated educational roles in the workplace. Conclusion Our findings illustrate a complex working environment for clinicians involved in student supervision and assessment. A dedicated educational role was perceived to provide a more standardised and rigorous approach to performance-based assessment. These findings provide critical stakeholder-centred insights, which may inform development of this process by addressing critical aspects deemed to facilitate and challenge clinical educator’s roles as assessors.

How can we ensure that children's Personal, Social and Emotional Development needs are being met, asks Anne O'Connor

This article examines the circulation of popular religious translations in the 19th century, illustrating how the intersection of religion, print and popular culture fostered greater orthod...

How sight and hearing work, their effects on children's development, and spotting problems. By Anne O'Connor and Dr Kath Dickinson

How the tactile sense develops in young children, and its purpose in relation to physical and emotional health. By Anne O'Connor and Dr Kath Dickinson

Proprioception – our sense of our body in relation to the world – how it develops and what happens when problems arise. By Anne O'Connor and Dr Kath Dickinson

Sensory experiences are vital to healthy brain development, explain Anne O'Connor and Dr Kath Dickinson in part one of a new series

We present LipidFinder 2.0, incorporating four new modules that apply artefact filters, remove lipid and contaminant stacks, in-source fragments and salt clusters, and a new isotope deletion method which is significantly more sensitive than available open-access alternatives. We also incorporate a novel false discovery rate (FDR) method, utilizing a target-decoy strategy, which allows users to assess data quality. A renewed lipid profiling method is introduced which searches three different databases from LIPID MAPS and returns bulk lipid structures only, and a lipid category scatter plot with color blind friendly pallet. An API interface with XCMS Online is made available on LipidFinder’s online version. We show using real data that LipidFinder 2.0 provides a significant improvement over non-lipid metabolite filtering and lipid profiling, compared to available tools.AvailabilityLipidFinder 2.0 is freely available at https://github.com/ODonnell-Lipidomics/LipidFinder and http://lipidmaps.org/resources/tools/lipidfinder.Contactlipidfinder@cardiff.ac.ukSupplementary informationSupplementary data are available at Bioinformatics online.

peer-reviewed The full text of this article will not be available in ULIR until the embargo expires on the 16/08/2021 Performance-based assessment evaluates a health professional student's performance as they integrate their knowledge and skills into clinical practice. Performance-based assessment grades, however, are reported to be highly variable due to the complexity of decision-making in the clinical environment. The aim of this study was to evaluate the impact of a training workshop based on frame-of-reference principles on grading of student performance by physiotherapy practice educators. This was a prospective cross-sectional study which used a single group pre-test, post-test design. Fifty-three practice educators rated two video vignettes depicting a poor and very good student performance, using a subsection of a physiotherapy performance-based assessment tool before and after training. Overall, results showed that participants amended their scores on approximately half of all scoring occasions following training, with the majority decreasing the scores awarded. This impacted positively on scoring for the poor performance video, bringing scores more in line with the true score. This study provides evidence of the benefit of a training workshop to influence decision-making in performance-based assessment as part of a wider education program for practice educators. ACCEPTED peer-reviewed

BACKGROUND AND AIMS Clinician engagement in research has the potential to improve healthcare processes and facilitate evidence-based practice. As a means to encourage clinician research engagement and links between speech-language pathology (SLP) clinicians in practice and researchers in higher education institutions, a national SLP clinician-academic research community of practice was established. The first steps for this newly formed research community was to determine stakeholder aims, to prioritize those aims and specify actions which would help respond to the stated priorities. METHODS The study was conducted in Ireland and the Irish Association of Speech and Language Therapists acted as a gatekeeper who forwarded a study information sheet and expression of interest form to its membership. A World Cafe methodology was utilized to gather data and conducted as part of the inaugural meeting where consent was retrieved. As part of this methodology, the participants created and managed their own data with the help of group facilitators. RESULTS Thirty six members replied expressing interest and 15 participants attended the inaugural meeting. Participants represented both clinical and research communities and identified and prioritized aims for the research community of practice. The aims were, in order of prioritization: Dissemination, Education, Enablers, Networking and Advocacy. Participants agreed that what they labelled as Dissemination was the number one priority for the newly formed research community of practice. In this context Dissemination referred to the identification of research already being conducted by participants and the sharing of that research both within the group and the larger SLP community nationally and internationally. Various actions were proposed to achieve agreed aims and these reflected a variety of targeted (e.g. development of a research database) and generic (e.g. to act as advocates) activities as well as local and national strategies including lobbying for clinical-research posts. CONCLUSION Clear aims, priorities and actions were identified by SLP clinical and research participants to facilitate the development of a research community of practice. This article presents the results of that exercise and outlines the priorities of participants who identified five aims in total. Dissemination was the number one priority for the newly formed research group and manifested a desire to share information about participants' research activities. The prioritized aims reflect assured thinking and form a solid co-constructed footing for the research community to develop and grow.

Purpose: The purpose of this study was to implement and evaluate a novel internship model that incorporates a practice tutor in physiotherapy clinical education during an acute care cardiorespiratory internship at a large acute tertiary care teaching hospital in Canada. Method: A prospective evaluation of this model was conducted by means of a mixed-methods approach using surveys and focus groups. The participants were students and clinical instructors (CIs) who were taking part in the internship. Results: Half of the CIs agreed that the practice tutor model gave them more time to manage their caseload and work with the student than did the traditional model, and 63% would recommend the model for future internships. In reviewing the focus group and open-ended data, we identified four themes: benefits, tensions, critical logistics, and unforeseen blind spots. There was a trend for patient attendance to increase with the practice tutor model compared with the previous year’s internship session and with the 5 weeks immediately preceding the internship. Conclusions: On the basis of CIs’ and students’ self-reports, the piloted practice tutor model was perceived to facilitate students’ clinical reasoning and collaborative learning skills. In addition, during the 5-week internship, the number of patients seen each day by the individual CIs and their students was not reduced, with a trend toward increased patient attendance. There was also a trend toward CIs having the same or more time to manage their caseload and work with the students compared with a non–practice tutor internship model. Recommendations to improve this model in future implementations are made.

Supplemental Digital Content is available in the text., Background: Common chromosome 9p21 single nucleotide polymorphisms (SNPs) increase coronary heart disease risk, independent of traditional lipid risk factors. However, lipids comprise large numbers of structurally related molecules not measured in traditional risk measurements, and many have inflammatory bioactivities. Here, we applied lipidomic and genomic approaches to 3 model systems to characterize lipid metabolic changes in common Chr9p21 SNPs, which confer ≈30% elevated coronary heart disease risk associated with altered expression of ANRIL, a long ncRNA. Methods: Untargeted and targeted lipidomics was applied to plasma from NPHSII (Northwick Park Heart Study II) homozygotes for AA or GG in rs10757274, followed by correlation and network analysis. To identify candidate genes, transcriptomic data from shRNA downregulation of ANRIL in HEK-293 cells was mined. Transcriptional data from vascular smooth muscle cells differentiated from induced pluripotent stem cells of individuals with/without Chr9p21 risk, nonrisk alleles, and corresponding knockout isogenic lines were next examined. Last, an in-silico analysis of miRNAs was conducted to identify how ANRIL might control lysoPL (lysophosphospholipid)/lysoPA (lysophosphatidic acid) genes. Results: Elevated risk GG correlated with reduced lysoPLs, lysoPA, and ATX (autotaxin). Five other risk SNPs did not show this phenotype. LysoPL-lysoPA interconversion was uncoupled from ATX in GG plasma, suggesting metabolic dysregulation. Significantly altered expression of several lysoPL/lysoPA metabolizing enzymes was found in HEK cells lacking ANRIL. In the vascular smooth muscle cells data set, the presence of risk alleles associated with altered expression of several lysoPL/lysoPA enzymes. Deletion of the risk locus reversed the expression of several lysoPL/lysoPA genes to nonrisk haplotype levels. Genes that were altered across both cell data sets were DGKA, MBOAT2, PLPP1, and LPL. The in-silico analysis identified 4 ANRIL-regulated miRNAs that control lysoPL genes as miR-186-3p, miR-34a-3p, miR-122-5p, and miR-34a-5p. Conclusions: A Chr9p21 risk SNP associates with complex alterations in immune-bioactive phospholipids and their metabolism. Lipid metabolites and genomic pathways associated with coronary heart disease pathogenesis in Chr9p21 and ANRIL-associated disease are demonstrated.

Background The PAPHIO study; a randomized controlled trial with 2X2 crossover design will implement a self-directed physical activity program in which participants will engage in self-monitoring and receive motivational interviewing to enhance physical activity adherence. The study aims to determine the effects of 24 weeks self-directed activity combined with motivational interviewing (MI) on (i) psychological health, (ii) quality of life (QoL) and (iii) immune function in female breast cancer survivors. Methods The study will recruit 64 female breast cancer survivors within 3 years of diagnosis and at least 6 months post primary treatments at Western Health Sunshine Hospital, Melbourne, Australia. They will be randomly allocated to immediate intervention (IIG group) or delayed intervention groups (DIG group) in a 1:1 ratio. All participants will be given a wearable device (Fitbit Alta HR) and undertake self-directed physical activity for 24 weeks and will receive MI for 12 weeks (IIG; during week 0 to week 12 and DIG; during week 13 to week 24). Participants’ daily step count and the changes of immune cell functionality will be assessed at the beginning (week 1: T1), week 12 (T2) and week 24 (T3) of the program. Physical activity adherence will be assessed at T2 and T3. Participants will also complete four questionnaires assessing exercise self-regulation (BREQ2), exercise barrier and task self-efficacy, mental health (DASS-21) and QoL (FACT-B) at three time points (T1 to T3). Linear-mixed models will be used to assess the relationship between physical activity volume by step counting and mental health (DASS-21), QoL (FACT-B), immune biomarkers, self-regulation (BREQ2) and self-efficacy at T1, T2 and T3;between 2 groups. Discussion We expect this physical activity intervention to be acceptable and beneficial to the participants in terms of psychological and immunological well-being with the potential outcomes to be implemented more widely at relatively low cost to these or other patient populations. Trial registration Australian New Zealand Clinical trials Registry- ACTRN12619001271190. Prospectively registered on 13 September 2019.

Leigh Anne shares the story not only of Chloe's birth but of the birth of her first daughter, Phoebe, and the loss of her second baby. She describes waiting for labor to start, and her frustration when arriving at the hospital to find, to her surprise, that she was not ready to push. With the support of her midwife, her husband, and her friend, Leigh Anne manages a hard labor, made long and difficult because of a compound presentation, and gives birth to her sweet baby girl.

peer-reviewed The full text of this article will not be available in ULIR until the embargo expires on the 01/05/2021 Objectives Discrete choice experiments (DCEs) are used in healthcare to measure the relative importance that stakeholders give to different features (or attributes) of medical treatments or services. They may also help to address research questions in health professional education. Several challenges exist regarding the performance-based assessment process (PBA) employed in physiotherapy practice-based education, a process which determines students’ readiness for independent practice. Evidence highlights many commonalities among these challenges, but it is unknown which factors are the most important to stakeholders. The use of DCE methodology may provide answers and help to prioritise areas for development. Thus, this study employed DCE to identify clinical educators’, practice tutors and physiotherapy students’ preferences for developing the PBA process in physiotherapy. Design Attributes (aspects of the PBA process known to be important to stakeholders) were derived from focus group interviews conducted with three groups; physiotherapy students, clinical educators (practising clinicians) and practice tutors (dedicated educational roles in the workplace). These attributes included the PBA tool, grading mechanisms, assessors involved, and, feedback mechanisms. Preferences for each group were calculated using a logistic regression model. Results Seventy-two students, 124 clinical educators and 49 practice tutors (n = 245) participated. Priorities identified centred primarily on the mandatory inclusion of two assessors in the PBA process and on refinement of the PBA tool. Conclusion Employment of DCE enabled the prioritisation of stakeholder-informed challenges related to PBA in physiotherapy practice-based education. This corroborates findings from previous qualitative work and facilitates a prioritised pathway for development of this process. ACCEPTED peer-reviewed

peer-reviewed Background: Clinical performance assessment tools (CPATs) used in physiotherapy practice education need to be psychometrically sound and appropriate for use in all clinical settings in order to provide an accurate reflection of a student's readiness for clinical practice. Current evidence to support the use of existing assessment tools is inconsistent. Objectives: To conduct a systematic review synthesising evidence relating to the psychometric and edumetric properties of CPATS used in physiotherapy practice education. Data Sources: An electronic search of Web of Science, SCOPUS, Academic Search Complete, AMED, Biomedical Reference Collection, British Education Index, CINAHL plus, Education Full Text, ERIC, General Science Full Text, Google Scholar, MEDLINE, UK and Ireland Reference Centre databases was conducted identifying English language papers published in this subject area from 1985 to 2015. Study selection: Twenty papers were identified representing fourteen assessment tools. Data Extraction and Synthesis: Two reviewers evaluated selected papers using a validated framework (Swing et al., 2009). Results: Evidence of psychometric testing was inconsistent and varied in quality. Reporting of edumetric properties was unpredictable in spite of its importance in busy clinical environments. No Class 1 recommendation was made for any of the CPATs, and no CPAT scored higher than Level C evidence. Conclusions: Findings demonstrate poor reporting of psychometric and edumetric properties of CPATs reviewed. A more robust approach is required when designing CPATs. Collaborative endeavour within the physiotherapy profession and interprofessionally may be key to further developments in this area and may help strengthen the rigour of such assessment processes. ACCEPTED peer-reviewed

Performance-based assessment (PBA) is an integral component of health professional education as it determines students' readiness for independent practice. Stakeholder input can provide valuable insight regarding its challenges, facilitators, and impact on student learning, which may further its evolution. Currently, evidence of stakeholder opinion is limited. Thus, we aimed to explore physiotherapy students' perceptions of performance-based assessment in their capacity as its central stakeholders.A qualitative interpretive constructivist approach was employed using focus group interviews for data collection. Six focus groups were completed (n = 33). Inductive thematic analysis was used to explore the data.Two themes were identified. The first outlined perceived inconsistencies within the process, and how these impacted on student learning. The second described how students used their experiential knowledge to identify strategies to manage these challenges thus identifying key areas for improvement.Inconsistencies outlined within the current physiotherapy performance-based assessment process encourage an emphasis on grades rather than on learning. It is timely that the physiotherapy academic and clinical communities consider these findings alongside evidence from other health professions to improve assessment procedures and assure public confidence and patient safety.

Children are often labelled as being ‘so resilient’, but real resilience is built on nurturing relationships and should not be taken for granted, explains Anne O'Connor

How does the ability to form and retrieve memories develop in children, why is it important to early learning, and how can adults help to stimulate it? Anne O'Connor reports

This article addresses the translation of Petrarch's work on the Western fringes of Europe demonstrating how the appropriation and transformation of the European literary canon served domestic ends in Ireland in the nineteenth century. The afterlives of Petrarch's texts contribute to understanding how translation can introduce novel material to a target culture which in turn transforms the literature in a new social and cultural context. These translations chart the spread of Petrarch's influence throughout Europe and illustrate how cultures absorb traditions through translations and reworkings. Although the Irish translations of Petrarch (into English) bear some similarities to the British translation tradition, the differences that are highlighted in this study illustrate how translation responds to differing cultural contexts even when dealing with the same linguistic group and time frame. This case study of translations of Petrarch's poetry in Ireland discusses the reach and influence of the Italian writer, while also examining the ability of translation to refashion the poet according to distinct local trends. peer-reviewed 2019-03-08

Increasing numbers of children are now traveling to high-altitude destinations, and pediatricians often see these children prior to and immediately following their travels. Thus, pediatricians have the opportunity to provide guidance for the prevention of altitude illness and must treat high-altitude illness (HAI) in some circumstances. This review will examine guidelines for prevention and management of HAI in the pediatric population.Recent research has examined children's short-term cardiorespiratory adaptation to high altitude, incidence of acute mountain sickness, hypoxic ventilator response, and maximal exercise capacity. Overall, studies indicate that children and adults are largely similar in these variables. Furthermore, studies suggest that heritability seems to be a component of response to altitude and development of altitude illness - a finding that may have implications for family vacation planning.Increasing numbers of children are visiting high altitude destinations. Whereas most of these child travelers will only experience mild to moderate symptoms of HAI, a small percentage, particularly those with predisposing health conditions, may experience severe disease. Pediatricians should encourage preventive measures with an emphasis on gradual ascent and vigilance for onset of symptoms that should prompt immediate transport to medical care.