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Most Widening Participation (WP) research is focused on medical school recruitment; there is a paucity of research examining whether the experience of medical school itself is an equal experience for both 'traditional' and WP students. This qualitative systematic review used the Joanna Briggs Institute meta-aggregative approach to characterise the experience of undergraduate medical education in the UK from the perspective of WP students. Seven databases were searched, 27 studies were critically appraised, and 208 findings were grouped into 12 categories and 4 synthesised findings. The majority of the research found relates to ethnic minority groups, with reports of other WP groups being less frequent. Whilst WP programmes attempt to alleviate disadvantages prior to entering university, our findings suggest that difficulties follow WP students into medical school. Unfamiliarity with higher education and lack of representation of WP staff in faculty can deter help-seeking behaviour and result in lack of trust. Furthermore, students from different backgrounds can find their identity conflicted upon entering medical school. Despite difficulties in establishing social networks with 'traditional' medical student peers, WP students form strong relationships with students from similar backgrounds. Ultimately, these students find that the uniqueness of their experience is a useful tool for communicating with diverse patients which they come across and are able to overcome adversity with the help of a supportive institution.

Objective: The objective of this review is to characterize the experiences of Widening Participation students in undergraduate medical education in the United Kingdom (UK).Introduction: Most Widening Participation research in the UK is focused on medical school recruitment. Although this is important, there is a paucity of research examining whether the experience of medical school itself is an equal experience for both traditional and Widening Participation students. The aim of this review is to explore and to characterize the experiences of Widening Participation students within medical education during their studies in the UK.Inclusion criteria: This review will include qualitative research conducted in the UK examining any aspect of the lived experience of undergraduate medical education according to Widening Participation students, including identity formation, learning experience in pre-clinical environments and clinical placements, and the relation to social, cultural, and financial capital.Methods: The study will consider articles found through searching the databases MEDLINE, PubMed, Web of Science, CINAHL, EMBASE, PsycINFO, and ERIC, as well as gray literature. Studies published from 2000 onwards in the English language will be included. Studies will be assessed against the inclusion criteria at all stages by two independent reviewers. Eligible studies will be critically appraised for methodological quality. Regardless of methodological quality, all studies retrieved will be included in the review. The final synthesized findings will be graded according to the ConQual approach.

This thesis project reconsiders the purpose and effectiveness of public, free-to-use outdoor gyms, resulting in the Health Loop nine-station outdoor gym. The project identifies three key areas of failings in existing gyms: intimidation, lack of understanding, and lack of enjoyment.The design solution creates a gym which focuses firstly on providing a comfortable, appealing, approachable space and equipment. This is achieved through simplicity, a non-sporting atmosphere, and targeting the workout to relatively inactive people. The second key focus is on quick-to-understand, engaging, enjoyable workout routines for each station. This aspect is delivered through an interactive digital display and sensors to provide gamified routines and feedback.

The human endometrium is the site of embryo implantation and is therefore responsible for providing a suitable environment for an embryo to grow and develop. This is achieved by the endometrium undergoing cyclical changes, under the control of steroid hormones. However, it is clear that steroid hormones are not the final effectors, but rather initiate a downstream cascade of molecular events through local autocrine and paracrine factors, such as cytokines. The role of cytokines in the human endometrium still remains to be determined, but they are thought to play an important role in the implantation process. This study has therefore focused on the expression of pro-inflammatory cytokines in the human endometrium and effects of these cytokines on endometrial function. Immunocytochemistry was used to determine the expression of leukaemia inhibitory factor (LIF), interleukin-6 (IL-6), interleukin-1alpha (IL-1alpha), interleukin-1beta (IL-1beta) and tumour necrosis factor alpha (TNFalpha) in the human endometrium of normal fertile women throughout the menstrual cycle. The results showed that staining intensity for LIF and IL-6 increased in epithelial cells at the time of implantation. IL-1alpha and IL-1beta remained relatively constant throughout the cycle, with a slight increase in epithelial IL-1B at the time of implantation. The expression of TNFalpha could not be determined. Staining for LIF, IL-6, IL-1alpha and IL-1beta was then repeated on endometrial sections from biopsies obtained from women who suffer recurrent miscarriage at the time of implantation and compared to the staining obtained in biopsies from normal fertile women. For all four cytokines, there were some biopsies from women who suffer recurrent miscarriage, where staining was significantly weaker than that seen in normal fertile women at the same time in the menstrual cycle. These results suggest that LIF, IL-6, IL-1alpha and IL-1beta may therefore be important for successful implantation and subsequently successful pregnancy outcome.Matrix metalloproteinases (MMPs) are postulated to be involved in the implantation process, as they are capable of digesting the components of the extracellular matrix. Recent studies have shown that cytokines may be involved in the regulation of MMPs in both the endometrium and the invading trophoblast cells. The effects of LIF, IL-6, IL-1beta and TNFalpha on endometrial MMP production in vitro were thereforeinvestigated. MMP-2 was produced by both cultured epithelial and stromal cells, MMP-9 was produced mainly by epithelial cells and MMP-7 was only produced by epithelial cells. Although LIF and IL-6 had no significant effect on endometrial MMP production, IL-1alpha and TNFalpha did alter MMP-2, MMP-9 and MMP-7 production from both epithelial and stromal cells.More recent studies have suggested the possible role of interleukin-11 (IL-11) in endometrial function, particularly decidualisation. Therefore the expression of both IL-11 and its receptor, IL-11R, was investigated in endometrial biopsies obtained from normal fertile women throughout the menstrual cycle. The results showed that both IL-11 and IL-11R were expressed throughout the menstrual cycle, predominantly by epithelial cells, however, stromal expression did increase slightly towards the end of the cycle. The effects of cytokines on IL-11 production by cultured endometrial cells were also investigated. IL-1alpha, TNFalpha and TGFbeta caused a significant increase in IL-11 production from both stromal and epithelial cells. Finally the effects of IL-11 on MMP-2, MMP-9, MMP-7, IL-1beta and TNFalpha produced by cultured endometrial cells were studied. No effect of IL-11 on MMP production was seen by either stromal or epithelial cells, but IL-11 did cause a concentration dependent decrease in TNFalpha production from cultured epithelial cells.The results have increased our knowledge on the expression and function of endometrial pro-inflammatory cytokines and suggested that although endometrial LIF and IL-6 expression is greatest at the time of implantation and is decreased in women who suffer recurrent miscarriage, IL-1 and TNFalpha have a greater effect on endometrial function. IL-11 is also expressed by the endometrium and is affected by other cytokines. Its positioning within the cytokine networks, which could control endometrial function, requires further study.