Journal articles
Jenkins HE, Boddy K, Bull SA (2023). The patient voice: More than a tick box exercise?.
Clin TeachAbstract:
The patient voice: More than a tick box exercise?
BACKGROUND: Patient and public involvement (PPI) in healthcare professional education is important, yet publications often provide insufficient detail about the types of involvement patients undertake and the level of autonomy that they have. This study details the factors that promote or hinder PPI within a university healthcare professional education setting and the types of activities members conducted. METHODS: PPI activities were described and mapped against a framework for PPI in healthcare professional education. Semi-structured interviews with PPI group members explored the motivators, enablers and barriers that influence involvement. FINDINGS: the framework highlighted that the PPI group were involved in a range of activities, yet they received limited training for their role and were infrequently involved in planning the activities. When interviewed, PPI members did not consider that these factors were the important promoters or barriers to involvement, instead emphasising five themes: (1) their individual characteristics, (2) factors relating to the university organisation, (3) relationships between themselves, faculty and students, (4) time in their role and (5) evidence of their impact. DISCUSSION AND CONCLUSION: Supporting PPI members whilst working, rather than provision of formal training was considered most empowering for group members. This was mediated through having enough time in their role to develop supportive relationships with faculty, which in turn promoted self-confidence and increased autonomy. This should be considered when making PPI appointments. Small changes in processes during education planning can make it easier for PPI members to bring their own agenda forward and promote equity during education decision making.
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Couchman D, Donnachie D, Tarr J, Bull S (2022). Clinical Teaching Fellows, the new norm?—Experiences of fellows and education faculty. The Clinical Teacher, 19(4), 299-307.
Neve H, Bull S, Lloyd H, Gilbert K, Mattick K (2018). Evaluation of an innovative, evidence-guided, PBL approach.
Clin Teach,
15(2), 156-162.
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Evaluation of an innovative, evidence-guided, PBL approach.
AIM: to understand the experiences of students and problem-based learning (PBL) facilitators during an evidence-based curriculum change to a PBL programme within an undergraduate medical course in South West England. METHODS: Four novel PBL cases were designed and implemented, based on educational theory and evidence. Eight focus groups were undertaken with Year-1 and -2 students (n = 18) and PBL facilitators (n = 14) to explore the experiences of participants. Thematic analysis and conceptual abstraction led to insights into the intended and unintended consequences of the change. RESULTS: Participant responses to the change process were influenced by the perceived relevance and value of the change (e.g. benefit to student learning), which was shaped by individual beliefs and preferences (e.g. presumed purpose of PBL, relative value placed on different curriculum topics, and desire for uniform educational experience), and the wider education context (e.g. expectations of assessment). It appears that the three distinct elements must align for the changes to be received positively. We updated our PBL curriculum in response to new evidence DISCUSSION: This study describes how we updated our PBL curriculum in response to new evidence, and demonstrates the importance of communicating the pedagogic rationale behind changes, and meticulous planning, preparation and alignment, even in distant parts of the curriculum. Engaging with existing views and attitudes is an essential requirement for successful curriculum change.
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Bull S, Mattick K, Postlethwaite KC (2013). “Junior doctor decision making: isn’t that an oxymoron?” a qualitative analysis of junior doctors’ ward-based decision making. Journal of Vocational Education and Training
Jorgensen F, Ellis-Iversen J, Rushton S, Bull SA, Harris SA, Bryan SJ, Gonzalez A, Humphrey TJ (2011). Influence of season and geography on Campylobacter jejuni and C. coli subtypes in housed broiler flocks reared in Great Britain.
Appl Environ Microbiol,
77(11), 3741-3748.
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Influence of season and geography on Campylobacter jejuni and C. coli subtypes in housed broiler flocks reared in Great Britain.
Geographical and seasonal variation in the incidence and prevalence of Campylobacter jejuni and C. coli in housed broiler flocks reared in Great Britain in 2004 to 2006 was investigated in this study. Ceca (30) from 797 flocks, not subject to prior partial depopulation and reared on 211 farms, were examined individually for the presence of Campylobacter spp. The best-fitting climatic factors explained approximately 46% of the prevalence of Campylobacter-colonized flocks at slaughter and consisted of a combination of temperature at slaughter, number of sunshine hours in placement month, and millimeters of rainfall in placement month. Positive flocks were more likely to be slaughtered between June and November than during the rest of the year and to be reared in northern Great Britain than in central or southern Great Britain. C. jejuni was identified in approximately 90% of flocks, and C. coli was present in 10% of flocks. The most common clonal complexes identified in 226 isolates typed by multilocus sequence typing (MLST) were ST-45, ST-21, ST-574, ST-443, and ST-828. Flocks slaughtered at the same time were more likely to have similar complexes, and ST-45 had a seasonal pattern, with the highest prevalence in June, and was also more likely to be present in flocks reared in northern Great Britain.
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Bull S, Mattick K (2010). What biomedical science should be included in undergraduate medical courses and how is this decided?.
Med Teach,
32(5), 360-367.
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What biomedical science should be included in undergraduate medical courses and how is this decided?
This review aimed to determine the availability of core curricula for the biomedical sciences in the published literature and the approach taken to determining learning objectives. A systematic review was conducted searching three databases for articles containing the terms 'core curriculum', 'undergraduate' and 'medic*'. Fifty seven papers were read in full, of which 40 listed learning objectives. The authors used a consensus process to categorize the learning objectives according to the level of detail (high / medium / low) and the approach taken (either a top down approach using experts or a bottom up approach using key stakeholders). This paper directs the reader to publications that describe core curricula for the biomedical sciences. The review revealed that topic coverage was patchy and there was a variable level of detail of learning outcomes presented. Documents published by professional bodies tended to provide more detailed learning outcomes than those derived by experts associated with medical schools. Two thirds of the 40 publications used a top down approach and there was a temporal trend towards involving non-expert groups in some stage of the process of defining the learning objectives, regardless of whether a top down or bottom up approach was taken.
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Bull SA, Thomas A, Humphrey T, Ellis-Iversen J, Cook AJ, Lovell R, Jorgensen F (2008). Flock health indicators and Campylobacter spp. in commercial housed broilers reared in Great Britain.
Appl Environ Microbiol,
74(17), 5408-5413.
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Flock health indicators and Campylobacter spp. in commercial housed broilers reared in Great Britain.
This study investigated the relationship between flock health and Campylobacter infection of housed commercial broilers in Great Britain. Thirty ceca were collected at slaughter from batches of broilers from 789 flocks, at either full or partial depopulation, between December 2003 and March 2006 and examined individually for Campylobacter by direct plating onto selective media. Management and health data were collected from each flock and included information on mortality or culling during rearing, the number of birds rejected for infectious or noninfectious causes at slaughter, the proportion of birds with digital dermatitis (also termed hock burn), and other general characteristics of the flock. Campylobacter spp. were isolated from 280 (35%) flocks. The relationship between bird health and welfare and Campylobacter status of flocks was assessed using random-effects logistic regression models, adjusting for region, month, year, and rearing regime. Campylobacter-positive batches of ceca were associated with higher levels of rejection due to infection (odds ratio [OR], 1.5; 95% confidence interval [CI(95%)], 0.98 to 2.30) and digital dermatitis (OR, 2.08; CI(95%), 1.20 to 3.61). Furthermore, higher levels of these conditions were also associated with the highest-level category of within-flock Campylobacter prevalence (70 to 100%). These results could indicate that improving health and welfare may also reduce Campylobacter in broilers.
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Allen VM, Bull SA, Corry JEL, Domingue G, Jørgensen F, Frost JA, Whyte R, Gonzalez A, Elviss N, Humphrey TJ, et al (2007). Campylobacter spp. contamination of chicken carcasses during processing in relation to flock colonisation.
Int J Food Microbiol,
113(1), 54-61.
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Campylobacter spp. contamination of chicken carcasses during processing in relation to flock colonisation.
The presence and numbers of campylobacters on chicken carcasses from 26 slaughter groups, originating from 22 single-house flocks and processed in four UK plants, were studied in relation to the level of flock colonisation determined by examining the caecal contents of at least ten birds per group. The prevalence of campylobacters on carcasses from five campylobacter-negative flocks processed just after other negative flocks was low (
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Bull SA, Allen VM, Domingue G, Jørgensen F, Frost JA, Ure R, Whyte R, Tinker D, Corry JEL, Gillard-King J, et al (2006). Sources of Campylobacter spp. colonizing housed broiler flocks during rearing.
Appl Environ Microbiol,
72(1), 645-652.
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Sources of Campylobacter spp. colonizing housed broiler flocks during rearing.
The study aimed to identify sources of campylobacter in 10 housed broiler flocks from three United Kingdom poultry companies. Samples from (i) the breeder flocks, which supplied the broilers, (ii) cleaned and disinfected houses prior to chick placement, (iii) the chickens, and (iv) the environments inside and outside the broiler houses during rearing were examined. Samples were collected at frequent intervals and examined for Campylobacter spp. Characterization of the isolates using multilocus sequence typing (MLST), serotyping, phage typing, and flaA restriction fragment length polymorphism typing was performed. Seven flocks became colonized during the growing period. Campylobacter spp. were detected in the environment surrounding the broiler house, prior to as well as during flock colonization, for six of these flocks. On two occasions, isolates detected in a puddle just prior to the birds being placed were indistinguishable from those colonizing the birds. Once flocks were colonized, indistinguishable strains of campylobacter were found in the feed and water and in the air of the broiler house. Campylobacter spp. were also detected in the air up to 30 m downstream of the broiler house, which raises the issue of the role of airborne transmission in the spread of campylobacter. At any time during rearing, broiler flocks were colonized by only one or two types determined by MLST but these changed, with some strains superseding others. In conclusion, the study provided strong evidence for the environment as a source of campylobacters colonizing housed broiler flocks. It also demonstrated colonization by successive campylobacter types determined by MLST during the life of a flock.
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Sturdee AP, Chalmers RM, Bull SA (1999). Detection of Cryptosporidium oocysts in wild mammals of mainland Britain.
Vet Parasitol,
80(4), 273-280.
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Detection of Cryptosporidium oocysts in wild mammals of mainland Britain.
This paper combines the results from a preliminary survey of occurrence of Cryptosporidium species in faecal samples from a range of wild mammal species inhabiting mainland Britain with a tabulated literature review of world-wide reports of the parasite in those British mammals. In the literature, C. parvum was reported from 11 wild mammals found in Britain and elsewhere, mainly in rodents but also in insectivores, lagomorphs and ungulates. C. muris has been reported only in wild rodents. The sample survey detected C. parvum in seven additional British species, including carnivores. Overall, 12% of 184 faecal samples tested with a genus-specific monoclonal antibody contained oocysts of C. parvum. The results further emphasise the widespread distribution of Cryptosporidium amongst wild mammals in Britain, highlight the potential for transmission between host species and warn of the possibility of direct exposure for anybody using the countryside for professional or recreational purposes (e.g. farmers and ramblers) to previously unregarded sources of infection. It seems increasingly likely that most, if not all, mammalian species can be infected with C. parvum.
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Quy RJ, Cowan DP, Haynes PJ, Sturdee AP, Chalmers RM, Bodley-Tickell AT, Bull SA (1999). The Norway rat as a reservoir host of Cryptosporidium parvum.
JOURNAL OF WILDLIFE DISEASES,
35(4), 660-670.
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Quy RJ, Cowan DP, Haynes PJ, Sturdee AP, Chalmers RM, Bodley-Tickell AT, Bull SA (1999). The Norway rat as a reservoir host of Cryptosporidium parvum.
J Wildl Dis,
35(4), 660-670.
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The Norway rat as a reservoir host of Cryptosporidium parvum.
The potential of Norway rats (Rattus norvegicus) to spread the parasite Cryptosporidium parvum was investigated by examining parasite prevalence in relation to the structure and movements of three permanent rat populations living on farmland in Warwickshire (UK) from October 1994 to March 1997. One population lived among a group of farm buildings housing cattle, while the other two had no contact with livestock, one living around a pond and its outflowing stream and the other on a rubbish tip. Overall, parasite occurrence was 24% (n = 438), but it varied according to body weight (age) with 40% of juveniles (< or =100 g) infected decreasing to 12% for adults >400 g, suggesting that actively breeding populations are potentially more likely to spread the parasite than non-breeding populations. There was no difference in prevalence between the three populations. The parasite was detected in more males (29%) than females (19%). Seasonally, on the livestock farm, prevalence was significantly lower in autumn (10%), but varied little (31-36%) from winter to summer. In contrast, on the arable farm, prevalence peaked in summer (50%) with a trough in winter (6%). Infection in rats appeared to last
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Bull SA, Chalmers RM, Sturdee AP, Healing TD (1998). A survey of Cryptosporidium species in Skomer bank voles (Clethrionomys glareolus skomerensis).
Journal of Zoology,
244(1), 119-122.
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A survey of Cryptosporidium species in Skomer bank voles (Clethrionomys glareolus skomerensis)
A survey of Skomer voles (Clethrionomys glareolus skomerensis) conducted in August of 1994 and 1995 discovered that 51% of live-trapped animals were positive for Cryptosporidium species (Coccidia). of the positive animals, 85% were shedding C. muris in their faeces, 5% C. parvum and 10% apparently both parasite species. On the U.K. mainland, the prevalence of Cryptosporidium in the bank vole (Clethrionomys glareolus) is a quarter of that on Skomer and the species normally found is C parvum. Interest in C. parvum stems from the often severe diarrhoeal disease cryptosporidiosis which it can cause in humans and livestock. The parasite occupies the gastro-intestinal tract and is transmitted between hosts by the faecal-oral route. It has been suggested that wild rodents may be an important reservoir of infection by C parvum for livestock. However, on Skomer island, C. muris, which is rarely found in livestock, is the dominant species infecting voles.
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Chalmers RM, Sturdee AP, Bull SA, Miller A, Wright SE (1997). The prevalence of Cryptosporidium parvum and C. muris in Mus domesticus, Apodemus sylvaticus and Clethrionomys glareolus in an agricultural system.
Parasitol Res,
83(5), 478-482.
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The prevalence of Cryptosporidium parvum and C. muris in Mus domesticus, Apodemus sylvaticus and Clethrionomys glareolus in an agricultural system.
Wild mice and voles were tested for Cryptosporidium during a 2-year survey at an agricultural site in Warwickshire, United Kingdom. C. parvum and C. muris, the two cryptosporidial species known to infect mammals, were detected. Prevalence figures of 22%, 21% and 13% noted for C. parvum for Mus domesticus, Apodemus sylvaticus and Clethrionomys glareolus, respectively, were higher than those recorded for C. muris at 10%, 6% and 2%. C. parvum causes the sometimes severe diarrhoeal disease cryptosporidiosis in many hosts, but the wild rodents were asymptomatic. The discovery of C. muris in A. sylvaticus and C. glareolus confirms a wider distribution in wild rodents than has previously been reported. Rodents may represent a significant reservoir of Cryptosporidium with a high potential for infection of man and livestock due to cohabitation.
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