Royal College of Surgeons of Edinburgh

Introduction Advising is essential for student success in graduate health professions education (HPE). Advising does not happen in a vacuum, yet most research focuses narrowly on advisor-advisee relationships. To address this gap, this study examines how institutional structures, policies, and programmatic dynamics influence the effectiveness of advising in graduate HPE. Methods We conducted semi-structured interviews with 15 HPE program leaders across six WHO regions. Using framework analysis guided by Activity Theory and the concept of knotworking, we analyzed how institutional systems shape advising practices. Results Five institutional factors were identified: (1) strategic advisor recruitment, (2) supportive advising cultures, (3) bureaucratic and resource constraints, (4) advisor training and evaluation, and (5) recognition and support for advisors. Leaders described advising as an adaptive, cross-system process shaped by institutional complexity and evolving student needs. Discussion Advising in graduate HPE operates beyond dyadic relationships. It is embedded within institutional activity systems and requires ongoing negotiation across structural boundaries. Programs must adopt systemic strategies, such as faculty development, workload alignment, and policy reform, to support effective advising networks.

ABSTRACTAimThis study explores the initial impact of the 2021 Military coup on Myanmar's nursing profession, clinical practice and clinical education.BackgroundMyanmar is a country historically riven by conflict; however, between 2010 and 2021, there was democratic reform and partial peace, prompting improvements in nursing practice and health outcomes. This study examines the impact of the 2021 coup, which effectively halted this progress, on Myanmar's nursing. It contributes to the limited literature exploring the effects of civil unrest and governmental coups on nursing, particularly in closed societies such as Myanmar.MethodsWe present a qualitative synthesis of semi‐structured interviews, undertaken with seventeen nurses in Myanmar via secure video link.ResultsNurses describe the challenges to nursing practice before the coup, the relative progress that Myanmar's nurses made in the short years of quasi‐civilian government and, following the coup, the significant deterioration in working locations, conditions and personal safety for nurses who refused to work in Junta‐controlled hospitals.DiscussionThe coup has damaged all aspects of nursing in Myanmar. These results document a rapid unravelling of progress, accentuated by long‐standing underlying weaknesses in systems and leadership, with additional threats to personal safety. This trend has been previously reported in other conflicts but rarely directly from nurses and never from Myanmar.Implications for nursingThe coup has been catastrophic for nursing in Myanmar. Participants describe widespread health system collapse, deliberate targeting by the junta and a need for international support.

A curriculum map is a visual representation of key components in a medical curriculum, designed to address the challenge of navigating a dense and complex curriculum. Conventional curriculum maps are often fragmented, as they are developed incrementally by faculty members at different times. Over time, this can make them difficult to navigate, irrelevant and incoherent to faculty and student end-users. To address these issues, we developed an in-house curriculum map, MEduCompass, featuring an easy-to-navigate interface. MEduCompass was created through a participatory approach involving students and faculty to ensure it met their needs. Guided by Design Thinking principles, the platform has a structured and cohesive design, incorporating a continuous feedback system for iterative, user-centred feature updates. This was piloted with an undergraduate module on the topic of gastrointestinal systems. Initial feedback from faculty members was that it allowed them to view the curriculum holistically and helped bridge the gap between clinical and pre-clinical years to meet learners’ need. This adaptable, feedback-driven approach ensures that stakeholders’ needs are addressed, keeping the platform relevant to evolving educational demands and learning outcomes, while also adapting to both technical and pedagogical requirements.

Programmatic Assessment (PA) relies on the integration of diverse data sources to deliver holistic feedback that supports student learning. However, the complexity and volume of assessment data can hinder efficient tracking and interpretation, challenging the implementation of PA’s principles. To address these challenges, we developed the Learning Progress Dashboard (LPD) – a bespoke technological-enhanced solution and infrastructure designed for medical students. Built with an user-centric approach, the dashboard integrates previously siloed data systems, offering tailored interfaces for both students and faculty to facilitate data-informed learning strategies. Key lessons were the importance of breaking down data silos, fostering interdisciplinary collaboration, and employing gradual change management strategies to balance innovation with user acceptance.

Moringa oleifera (MO) has been explored for anticancer drug development. However, conventional extract formulations face limitations in drug delivery. Nanoparticles offer a promising alternative due to their small size, enhancing drug selectivity, efficacy, and safety. Therefore, this study aimed to characterize polyvinyl alcohol-based MO nanoparticles (NpMO) and assess their cytotoxicity and anticancer potential. Moreover, NpMO was synthesized using ultrasonication and characterized by its size, functional groups, and surface morphology. Then, an MTT assay was conducted in Vero and HeLa cells, each divided into a control group and five treatment groups (PV1–5 and PL1–5). The treatment groups received NpMO with various doses: 12.5 µg/mL, 25 µg/mL, 50 µg/mL, 100 µg/mL, and 200 µg/mL. The results were represented as OD values and percentage of viable cells, with statistical analysis performed using SPSS version 27. We found that Vero cell viability remained high at 96%, 95%, 93%, 90%, and 82.3% in PV groups, indicating no significant difference between control and PV1–PV4 groups with statistical analysis. Meanwhile, HeLa cell viability decreased to 98%, 92%, 78%, 69%, and 50.2%, with PL5 showing the lowest viability percentage. Statistical analysis confirmed a significant difference between PL5 and the other PL groups. In conclusion, NpMO showed minimal toxicity to Vero cells (>50% viability up to 200 µg/mL) but significantly reduced HeLa cell viability at 50–200 µg/mL, with the strongest effect at 200 µg/mL, indicating a potential anticancer activity.

Objective & ApproachRoutine optometry examinations, which may include retinal images, have been free to everyone in Scotland since 2006. Images and patient data are stored locally on non-interoperable systems, usually without unique identifiers. The Scottish Collaborative Optometry-Ophthalmology Network for e-research (SCONe) aimed to create a secure, longitudinal repository collating community-acquired images linked to national, routinely-collected healthcare data. We developed bulk export processes to retrieve images and patient data from current and archived systems and a series of deterministic and probabilistic algorithms to match images to patients. ResultsWe successfully exported images and patient data from several commonly used systems. Exact matching of available data between image and clinical systems within practices linked 78% of images (IQR 71.2-84.1). Our algorithms increased match rate to 90% (IQR 83.5-98.6) of images, efficiently reducing risk of systemic bias in the cohort. Match method is included in the repository metadata to facilitate quality assurance checks after national linkage and pseudonymisation. To date over 600k images have been processed and delivered to the National Safe Haven for linkage to healthcare data. Conclusions & ImplicationsBreakthrough research into early detection and pre-symptomatic disease can be facilitated by harnessing community-acquired retinal images which capture normal ageing and disease progression. Rather than await interoperability and widespread use of unique identifiers, this has been achieved through innovative solutions to real-world issues around time-pressured clinical data entry and non-standardised data storage. The SCONe repository continues to grow. It is currently supporting ocular disease prediction research and offers the potential for much more.

Coffee is a kind of daily beverage, and its correlation with cardiovascular disease and atherosclerosis is still debatable. The aim of this study is to investigate the effects of Amstirdam coffee extract (ACE) on lipoprotein-associated phospholipase A2 (Lp-PLA2) and the inflammatory response in atherosclerosis mouse models. The study used 25 Swiss male mice for five groups (n = 5): healthy mice fed a normal diet (N); mice fed a high-fat, high-fructose diet (HFFD); mice fed HFFD and treated with ACE at doses of 104 (D1), 520 (D2), and 5200 mg/kg BW (D3). The levels of Lp-PLA2, regulatory T cells (Tregs) (CD4+CD25+CD62L+, CD4+CD25+IL-10+, CD4+CD25+TGF-+), IL-10 (CD4+IL-10+), and TGF-B (CD4+TGF+) were analyzed using a flow cytometer. Histological analysis of the mouse aorta was done by hematoxylin and eosin (HE) staining. This study indicated a significant increase in total cholesterol (TC), triglyceride (TG), LDL, and Lp-PLA2 levels in the HFFD group. HFFD also reduced HDL, IL-10, and TGF produced by CD4 and Tregs compared with the normal group. ACE at all doses significantly reduced Lp-PLA2 levels compared with the HFFD group (p < 0.05). Interestingly, the administration of 520 mg/kg BW ACE (D2) increased the production of IL-10 significantly compared to other doses (p < 0.05). The D3 group possessed a high TGF- production and Treg expression level significantly different between groups (p < 0.05). Foam cells were mostly found in the aorta of the HFFD group compared to the normal and ACE treatment groups. This study suggested that ACE could reduce Lp-PLA2 enzyme activity and foam cell formation through the immunosuppressive activity of IL-10 and TGF cytokines.

The series covers the circumstances that promote health or illness, the ways in which people experience and explain such conditions, and what, practically, they do about them. Practitioners of all approaches to health and healing come within its scope, as do their ideas, beliefs and practices, and the social, economic and cultural contexts in which they operate. Methodologically, the series welcomes relevant studies in social, economic, cultural and intellectual history, as well as approaches derived from other disciplines in the arts, sciences, social sciences and humanities. The series is a collaboration between Manchester University Press and the Society for the Social History of Medicine. Introduction: Sir Lancelot Spratt and the myth of the modern surgeon 1 1 Self-made myths 27 2 Surgeons in film, fiction, and on TV screens 59 3 Surgical conduct and surgical communities 83 4 Gender in surgery 5 Race and ethnicity in surgery 6 Surgical time 7 Military myths and metaphors Conclusion: moving myths Bibliography Index This book was researched and part-written while I was Research and Engagement Fellow on the Wellcome Trust Investigator Award, Surgery & Emotion (108667/ Z/ 15/ B), and I am first and foremost indebted to the Trust for its funding, to the project's Principal Investigator Michael Brown, and to my colleagues Alison Moulds, James Kennaway, and Lauren Ryall-Waite. Due to the nature of academic precarity, I completed the book while working on a series of other postdoctoral projects and I am grateful to my various PIs and line managers for their generosity, intellectual support, and patience. My thanks to