Health And Care Professions Council Research Articles

What might an interactive music therapy service bring to the adult intensive care unit? A suggested service based on data from a scoping review

Individual music listening in intensive care units (ICU) has more frequently reported benefits for reducing anxiety and pain. There may be benefits in reducing heart rate and respiratory rate. There is a lack of research in the ICU setting that examines the effects of active music-based interventions, for example, where patients play instruments as part of structured exercises for cognitive or physical rehabilitation or improvise music with a Health and Care Professions Council (HCPC) registered Music Therapist in ways that may benefit emotional well-being in addition to physical and cognitive function, including management of deconditioning. The search string of the present scoping review was used on 25 January 2022 and then again for PubMed on 24 June 2023 and brought up any research using music or music therapy in the intensive care setting. Out of 139 titles, 45 full texts were included, with a total of 3,441 participants. Forty-three studies meeting the inclusion criteria used pre-recorded music, ranging from cassette to CDs, audio files, and MP3, most often delivered using headphones, some with audio pillows. All interventions were passive (listening) except for one, which delivered music played live. More research is needed into the workings of active and receptive music therapy in the adult ICU.

Measuring the Impact of Incorporating Case Study Presentations Into Applied Biomedical Science Placement Workshops for Trainee Biomedical Scientists.

Introduction: Successfully completing the Institute of Biomedical Science (IBMS) registration portfolio is essential to becoming a Health and Care Professions Council (HCPC) registered Biomedical Scientist. In the West Midlands, a unique collaboration between four universities (Aston, Wolverhampton, Coventry, and Keele) and local NHS Trusts supports student placements and portfolio development. The universities support Training Officers in delivering components of the registration portfolio through the delivery of eight combined placement workshops. These have been designed to align to the IBMS registration portfolio and help students meet the HCPC Standards of Proficiency. This study aimed to evaluate the effectiveness of a redesigned workshop where students generated and presented medical case studies to peers, academics, and training leads. Materials and Methods: The three phases of the case study intervention included a pre-intervention survey, academic-led sessions focussing on medical case presentations and delivery of the presentation followed by a post-intervention survey. Results: Analysing survey responses pre- and post-intervention, students demonstrated enhanced confidence in their understanding of clinical conditions (p<0.0001), connecting lab findings to diseases, and in delivering a case presentation to their peers (p<0.001). Students reported an increased confidence in structuring case presentations and their critical thinking ability (p<0.0001). All students agreed engaging with the case study workshop improved their ability to communicate knowledge of scientific concepts orally. Thematic analysis revealed that the case presentation deepened students' understanding of multidisciplinary teams. 98% of respondents agreed patient communication should be integrated into Biomedical Sciences courses and 85% would like to see case study presentations embedded into the curriculum. Discussion: Combined placement workshops are an integral part of the Applied Biomedical Science placement journey. Case study presentations are clearly a valuable teaching and learning tool to nurture and develop key transferable skills and competencies in conjunction with Biomedical Science expertise. The collaborative approach in the West Midlands effectively prepares graduates with essential pathology knowledge, skills, and a completed IBMS registration portfolio. This study highlights a successful framework for a collaborative partnership with local NHS trusts that has allowed the completion of numerous pathology placements and could be adopted by other universities delivering accredited Biomedical Science courses.

“Surprisingly helpful”: An exploration of trainee and registered music therapists’ perspectives on the current role of personal therapy in music therapy training in the United Kingdom

Music therapy training programmes in the United Kingdom are accredited by the Health and Care Professions Council (HCPC). The HCPC requires registered music therapists to have experience and understanding of the value of therapy for developing insight and self-awareness. In practice, this currently translates into a requirement for personal therapy during training – working therapeutically and confidentially with a suitably qualified and registered therapist for a minimum number of hours – although the amount and type of therapy required varies between course providers. The aim of this study was to explore the perceived value and impact of mandatory personal therapy from the perspectives of trainee and HCPC-registered music therapists. Data were collected through a qualitative survey with open-ended questions exploring participants’ personal therapy experiences. Thirty-nine participants were recruited from across the various music therapy training institutions in the UK at the time of the research and from within the pool of registered music therapists. Thematic analysis was used to develop three themes from the data: “personal therapy is costly, but ultimately beneficial”; “personal therapy provides a supportive space separate from training”; and “personal therapy is part of becoming a music therapist.” We conclude with recommendations about how personal therapy can be most usefully incorporated into training programmes based on our interpretation of the participants’ responses.

What do the revised UK standards of proficiency mean for diagnostic radiography training? A regional radiographer focus group study

IntroductionRevisions to the UK Health and Care Professions Council (HCPC) standards of proficiency for diagnostic radiographers came into effect on September 1st 2023. Changes include an increase of proficiencies in CT and extended to MRI imaging. As workforce support the development of learners to meet stage outcomes in practice, this study aimed to understand the radiographers' expectations of future learners' training to meet the new standards of proficiency. MethodsSnowball sampling was used to invite practice educators/student supervisors and department leads within the 21 NHS Trusts in the North East and Yorkshire region providing diagnostic radiography practice placements. Online focus groups used a semi structured topic guide to explore the expectations of student performance during different stages of their training, and on different types of pre-registration programmes. Participants views were sought on considerations for appropriate assessment. Thematic analysis was supported by NVivo software. ResultsFifteen diagnostic radiographers across 11 NHS trusts participated in 5 focus groups in November 2022. The findings showed consistency in expectations of student performance in projectional radiography, patient care and communication. Participants felt some standards of proficiency were beyond threshold competency, or current practices were a barrier in supporting learning. Participants felt assessment over a period and range of examinations in the clinical environment gave a fairer picture of student performance. ConclusionThere is uncertainty and perceived barriers in supporting future diagnostic radiography training in the practice setting. Implications for practiceFurther work will be needed to identify and support appropriate learning opportunities and stage outcomes if learners are to meet the breadth of HCPC standards of proficiency with some consistency.

A Cytomegalovirus (CMV) Case Study to Promote Interprofessional Learning (IPL) Between Audiology and Biomedical Science Students in Higher Education

Modern and effective patient care requires specialist healthcare professionals working together. Interprofessional learning (IPL) seeks to provide opportunities for different healthcare disciplines to learn with, from and about each other. This study focused on the delivery and evaluation of a cytomegalovirus (CMV) case study workshop to facilitate IPL between two Health and Care Professions Council (HCPC) regulated courses: Biomedical Science and Audiology. The 2 h online workshop consisted of 1) defining the roles, responsibilities and skills of the two healthcare professions, 2) the structure of the Biomedical Science and Audiology departments, 3) routes to HCPC registration, 4) core curriculum of both degree programmes and 5) interpreting interdisciplinary data related to a CMV patient case. The workshop was interactive, with the virtual learning environment promoting peer discussions and the use of online polling. Student responses were collected through an online questionnaire. A total of 108 respondents completed a post-event survey and Mann-Whitney U tests revealed there were no significant differences in the responses between the two student cohorts in response to each of the survey statements (p &amp;gt; 0.05). A total of 82.4% of students agreed that they need to know the role of other healthcare professionals for their future practice, whilst 84.2% agreed that the CMV case study was a good format to facilitate effective IPL. A total of 93.5% of respondents recognised the importance of both professions in diagnosing a patient with CMV. Thematic analysis identified four common themes, including appreciation of shared roles, recognition of similarities in registration pathways, working together to provide holistic patient care and the role of clinicians in the patient journey. This novel collaboration between Biomedical Science and Audiology facilitated effective IPL whilst meeting the interprofessional education HCPC requirements. Collaborative working is an essential component of delivering effective patient care and allied healthcare degrees need to provide opportunities within their curriculum to foster this. We hope this study encourages other higher education institutes to expand and develop their current IPL activities to include a broader spectrum of healthcare courses.

Carrying out research, critical appraisal, ethics and stakeholder involvement

Research skills are a requirement under the Health and Care Professions Council (HCPC) standards for paramedic registration. Paramedics must ‘recognise the value of research to the critical evaluation of practice’. Research in the medical field is important in order to improve the knowledge of clinicians and inform evidence-based practice. The purpose of this article is to demonstrate the key components of the research process, use of a PICO [population, intervention, comparison, outcome] tool to search relevant databases and explain the critical appraisal of research in order to establish if research is valid before implementing results into paramedic practice.

Questions of Identity in Sport Psychology Scholar-Practitioners.

As with other academic disciplines, sport psychology academics working in higher education (HE) in the United Kingdom (UK) in lecturer and senior lecturer positions are typically required to hold a PhD in sport psychology or a related discipline. To work in applied practice with athletes, coaches, National Governing Bodies (NGBs), and sporting organisations, practitioners are required to acquire a qualification that affords registration with the Health and Care Professions Council (HCPC) through either the British Psychology Society (BPS) or the British Association of Sport and Exercise Sciences (BASES). Accordingly, scholar-practitioners, who have "a foot in both worlds" (Tenkasi and Hay, 2008), are required to have two related but distinct qualifications, each of which requires considerable resources (i.e., time, finances, and commitment) to achieve. This paper addresses some of the dilemmas and conflicts that these individuals may encounter in their primary workplace, which typically does not provide for applied practice (either in time or financial incentives). Specifically, issues around the knowledge-transfer gap will be addressed. Real-world examples will be in the form of reflections from the author's own experiences. I am a senior lecturer in sport and exercise psychology at Cardiff Metropolitan University and the programme director of the MSc Sport Psychology. The role requires me to be HCPC registered, as well as have a PhD in sport psychology. I am also an HCPC Practitioner Psychologist, registered following completion of the BPS Qualification in Sport and Exercise Psychology (QSEP). My practice is limited to minimal private work and the supervision of trainee sport psychologists (BPS). At the end of the paper, I leave the reader with three questions to prompt reflection on what being a sport psychologist means and what contributions scholar-practitioners may offer to academic institutions and the clients we work with.

An Innovative Workshop Embedding Pathology Service Users into the Undergraduate Biomedical Science Curriculum.

The integration of pathology service users into the biomedical science curriculum has been driven by the refinement of the Health and Care Professions Council (HCPC) Standards of Proficiency. This study aimed to design and implement a novel and innovative service user event with a reflective assessment to enhance students' knowledge and understanding of the impact of pathology laboratory results on the patient pathway. The 4-h workshop consisted of a series of service users. Patients discussed how pathology services had contributed to their diagnosis and treatment, while service providers-a Microbiology Consultant, a director of primary care, and the patient referral optimisation officer-discussed their roles and their interactions with pathology services. Post-event, students completed a 750-word reflective assessment, highlighting challenges experienced by service users and providing suggestions for improving the delivery of pathology services. In total, 57.5% of respondents (57/99) completed a post-reflection survey, which included open- and closed-ended questions. Quantitative analysis of the survey data revealed that over 87.7% of respondents had increased knowledge and understanding of the revised HCPC standards. Following the assessment, students reported a significant increase in their confidence with respect to reflective writing (p < 0.001), with over 90% of respondents agreeing that the reflective assessment had increased their knowledge and understanding of the limitations that may negatively impact service users and patient care. Moreover, respondents highlighted how advancements in point-of-care testing (POCT) and improvements in communication can improve patient experiences. Thematic analysis revealed that respondents agreed that embedding patients into the curriculum reinforced the importance of there being a patient behind every sample. Respondents reported that reflecting upon service user experiences enabled them to identify improvements to the delivery of pathology services while recognising the essential role that Biomedical Scientists play in the patient pathway. This successful workshop has created a platform encompassing a range of pathology service users in the undergraduate curriculum. We recommend that other accredited biomedical science programmes adopt and embed this innovative workshop and reflective assessment into their programmes to help them meet these standards relating to service users while fostering important transferable skills in their students.

Editorial introductions.

Current Opinion in Clinical Nutrition and Metabolic Care was launched in 1998. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of clinical nutrition and metabolic care are divided into 15 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Anastasia Z. KaleaAnastasia Z. KaleaDr Anastasia Z. Kalea is an Associate Professor in Teaching Nutrition and Dietetics at the UCL Division of Medicine, UK, and an honorary Associate Professor at the UCL Institute of Cardiovascular Science, UK. She has over 20 years of research and teaching experience in academic institutions in the US and the UK. She is an external examiner and reviewer for undergraduate nutrition and dietetics programmes in the US, UK, and Greece. Dr Kalea is a Registered Dietitian with the Health and Care Professions Council (HCPC) and a Senior Fellow of the Higher Education Academy in the UK. Her research interests focus on metabolic inflammation and associated molecular nutrition pathways, on trace mineral metabolism, on nutrigenetics, precision nutrition and public health, and she has presented her work in numerous national and international conferences. Dr Kalea leads teaching for the MSc in Clinical and Public Health Nutrition, MSc in Eating Disorders and Clinical Nutrition, and the BSc in Nutrition and Medical Sciences. She is the Programme Director for the MSc course in Obesity and Clinical Nutrition at UCL. Dorothy Klimis-ZacasDorothy Klimis-ZacasDr Klimis-Zacas is professor of clinical nutrition, cooperating professor at the Graduate School of Biomedical Sciences and Engineering and Associate Faculty of the Institute of Medicine at the University of Maine, USA. As a Fulbright Senior Fellow, she aided in the establishment and curricular development of the Human Nutrition and Dietetics Program at Harokopio University, Greece, where she is a cooperating professor. She is also cooperating professor at DeFENs-Department of Food, Environmental and Nutritional Sciences at the University of Milan, Italy. Dr Klimis-Zacas is external reviewer and examiner for undergraduate and graduate Nutrition and Dietetics programs in the US, Italy and Greece. Her research and teaching have focused on lipid and trace mineral nutrition and metabolism associated with cardiovascular disease. Additionally, she has explored the role of berry bioactive compounds and berry-enriched diets on endothelial function, inflammation, and lipid metabolism as it relates to cardiovascular disease and the metabolic syndrome in pre-clinical and clinical studies. She is currently researching the molecular mechanisms and genomic effects of polyphenols on endothelial cell migration and angiogenesis as it relates to diabetes mellitus, ischemic disorders and wound healing. For the development and preclinical testing of a biomedical product that aids in wound healing she received the Inaugural Foster Innovation Award from the University of Maine. A Fulbright Senior Specialist and Cariplo Fellow, Dr Klimis-Zacas is the author of over 130 peer reviewed publications, editor of books and a patent. She is an editorial board member for The Journal of Nutritional Biochemistry and editor and guest editor for Antioxidants, Nutrients (MDPI) and others. Bettina MittendorferBettina MittendorferBettina Mittendorfer graduated from the University of Vienna in Austria with a MSc in Human Nutrition, and from the University of Texas Medical Branch in Galveston, USA, with a PhD in Nutritional Biochemistry. In 1999 she came to Washington University School of Medicine in St. Louis, USA, for a postdoctoral research fellowship. Currently she is Associate Professor of Medicine and Nutritional Sciences and the Director of the Nutrition and Obesity Research Center Clinical Science Research Core Laboratory at Washington University in St. Louis. Her research interests focus on the regulation of muscle protein and lipid metabolism with special emphasis on obesity, aging and sexual dimorphism, which she studies in vivo in human subjects by using stable isotope labelled tracer techniques. Faidon MagkosFaidon MagkosFaidon Magkos holds a BSc degree in Clinical Nutrition and Dietetics (2000), a MSc degree in Nutrition and Exercise (2004) and a PhD degree in Human Metabolism (2008). He completed post-doctoral training at Harokopio University in Athens, Greece, and Harvard Medical School in Boston, Massachusetts. In 2011, Magkos was appointed Assistant Professor of Medicine at the Center for Human Nutrition, Division of Geriatrics & Nutritional Science, at Washington University School of Medicine in St. Louis, Missouri. He moved to Singapore in 2015 and served as Assistant Professor of Physiology at the Clinical Nutrition Research Centre, Yong Loo Lin School of Medicine, at the National University of Singapore. Since 2018, he is Associate Professor in Obesity Research at the Department of Nutrition, Exercise and Sports, at the University of Copenhagen, Denmark. The study of human metabolism lies at the core of his research interests and activity. During the course of his career, Magkos has been involved in research projects examining the effects of diet, exercise, obesity and weight gain or weight loss, sex differences, and fatty liver on energy and substrate metabolism, lipid and lipoprotein kinetics, and insulin sensitivity in skeletal muscle, liver, and adipose tissue. He is a “metabolist” at heart. Since 2003, he has published 154 peer-reviewed publications and his work has been cited more than 7200 times (h-index 46).

166 Sequential Simulation as Replacement for Standard 4-Week Practice-Based Learning (PBL) for First-Year Undergraduate Physiotherapy Students

Practice-based learning (PBL) via clinical placement is a core part of a physiotherapy degree with the Chartered Society of Physiotherapy (CSP) requiring completion of 1000 placement hours. The COVID-19 pandemic resulted in cancellation of placements on top of an already saturated geographical placement provision in certain regions with many Higher Education Institutes (HEI) reporting a backlog of placements. Inability to meet requisite placement hours impacts on student progression, reducing the flow of physiotherapists into the workforce at a time when Allied Heath Professions (AHP) growth has been planned. The CSP and Health and Care Professions Council (HCPC) have both encouraged HEIs to be innovative in placement provision in response. Simulation is widely utilized in healthcare training but remains an emerging concept in terms of placement replacement The aim was to develop a fully simulated placement that replicated the learning objectives achievable through standard PBL.Development of a novel placement model to deliver a fully simulated placement as replacement for a standard 4-week clinical placement scheduled for 15 (20% cohort) first-year physiotherapy students.The placement was split across clinical specialities within cardiorespiratory and musculoskeletal physiotherapy. Key objectives were set weekly: week 1, focussing on communication/patient-centred care (scaffolded across subsequent 4 weeks); week 2, focussing on assessment, patient management and clinical reasoning; week 3, consolidation of clinical reasoning; week 4, case presentation. Sequential simulation was utilized to best replicate clinical practice, following simulated patients from pre-admission/injury, through to admission, deterioration, rehabilitation and long-term management. This approach enabled learners to experience a full patient journey, unachievable through standard placement timelines. Simulation using a mixed approach to facilitation and PEARLS debrief, handover tasks, multi-disciplinary team meetings, discharge planning and smaller vignette scenarios to develop specific clinical skills were simulated utilizing actor role players, high-fidelity manikins and peer enhanced e-learning. The placement modelled a CLiP (collaborative learning in practice) delivery, an approach promoted across standard placements by HEE, with students autonomously setting objectives, utilizing across level learning, recording of daily learning logs, reflections and peer assessments. Pre- and post-placement data have been gathered exploring the students’ experiences, expectations, and attitudes towards simulated placement, competence and confidence in both communication and clinical skills using focus group interviews and questionnaires.

Living life in limbo: experiences of healthcare professionals during the HCPC fitness to practice investigation process in the UK

BackgroundIt is the responsibility of healthcare regulators to ensure healthcare professionals remain fit for practice in healthcare settings. If there are concerns about an individual healthcare professional they may undergo a fitness to practice investigation. This process is known to be hugely stressful for doctors and social workers, but little is known about the impact of this experience on other professions. This study explores the experiences of registrants going through the process of being reported to the UK’s Health and Care Professions Council (HCPC) and attending fitness to practice (FTP) hearings. We discuss the implications of this process on registrants’ wellbeing and, from our findings, present recommendations based on registrants experiences. In doing so we articulate the structural processes of the HCPC FTP process and the impact this has on individuals.MethodsThis study uses semi-structured interviews and framework analysis to explore the experiences of 15 registrants who had completed the FTP process. Participants were sampled for maximum variation and were selected to reflect the range of possible processes and outcomes through the FTP process.ResultsThe psychological impact of undergoing a FTP process was significant for the majority of participants. Their stories described influences on their wellbeing at both a macro (institutional/organisational) and micro (individual) level. A lack of information, long length of time for the process and poor support avenues were macro factors impacting on the ability of registrants to cope with their experiences (theme 1). These macro factors led to feelings of powerlessness, vulnerability and threat of ruin for many registrants (theme 2). Suggested improvements (theme 3) included better psychological support (e.g. signposting or provision); proportional processes to the incident (e.g. mediation instead of hearings); and taking context into account.ConclusionsFindings suggest that improvements to both the structure and conduct of the FTP process are warranted. Implementation of better signposting for support both during and after a FTP process may improve psychological wellbeing. There may also be value in considering alternative ways of organising the FTP process to enable greater consideration of and flexibility for registrants’ context and how they are investigated.

An evaluation of the experiences of academics and practice educators who supported radiography students working on the temporary HCPC register during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has had a profound impact on all those residing in the United Kingdom, resulting in unprecedented changes being made to the education and training of healthcare students. Universities and practice partners had to respond quickly and work in close collaboration with Health Education England, to ensure the changes brought in by the Health and Care Professions Council (HCPC) emergency measures were implemented.The aim of this study was to explore the experiences of staff supporting final year diagnostic and therapeutic radiography students who joined the HCPC register early during phase one of the COVID-19 pandemic. MethodsThis study was informed by a phenomenological approach, in which a purposeful sample of eight participants comprising of six practice educators (PEs) and two academics. Semi-structured interviews and focus groups were conducted to collect the data via a virtual platform. ResultsThe results highlighted three themes, Competence and the transition to registration, Support mechanisms and Communication. Both academics and PEs described how they observed the new registrants gaining confidence and competence during their time on the temporary register and suggested that professional bodies could consider curriculum changes to encompass a final transitional placement similar to their experience. They suggested that having robust support mechanisms and communication in place are essential for the success of this initiative. ConclusionThe results provide insight into how PEs and academics supported new registrants to meet the necessary requirements of the HCPC register whilst working during the first phase of the COVID-19 pandemic. They highlight the importance of having robust support mechanisms and good communication in place to achieve this. Implications for practiceSome consideration could be made to changing the curriculum in the future to allow for early temporary registration and paid Band 4 final placements for students working as assistant practitioners.

Editorial introductions.

Current Opinion in Clinical Nutrition and Metabolic Care was launched in 1998. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of clinical nutrition and metabolic care are divided into 15 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Anastasia Z. KaleaAnastasia Z. KaleaDr Anastasia Z. Kalea is an Associate Professor in Teaching Nutrition and Dietetics at the UCL Division of Medicine, UK, and an honorary Associate Professor at the UCL Institute of Cardiovascular Science, UK. She has over 20 years of research and teaching experience in academic institutions in the US and the UK. She is an external examiner and reviewer for undergraduate nutrition and dietetics programmes in the US, UK, and Greece. Dr Kalea is a Registered Dietitian with the Health and Care Professions Council (HCPC) and a Senior Fellow of the Higher Education Academy in the UK. Her research interests focus on metabolic inflammation and associated molecular nutrition pathways, on trace mineral metabolism, on nutrigenetics, precision nutrition and public health, and she has presented her work in numerous national and international conferences. Dr Kalea leads teaching for the MSc in Clinical and Public Health Nutrition, MSc in Eating Disorders and Clinical Nutrition, and the BSc in Nutrition and Medical Sciences. She is the Programme Director for the MSc course in Obesity and Clinical Nutrition at UCL. Dorothy Klimis-ZacasDorothy Klimis-ZacasDr Klimis-Zacas is professor of clinical nutrition and cooperating professor of the Graduate School of Biomedical Sciences and Engineering at the University of Maine, USA. As a Fulbright Senior Fellow, she aided in the establishment and curricular development of the Human Nutrition and Dietetics Program at Harokopio University, Greece, where she is a cooperating professor. She is also cooperating professor at DeFENs-Department of Food, Environmental and Nutritional Sciences at the University of Milan, Italy. Dr Klimis-Zacas is external reviewer and examiner for undergraduate and graduate programs, on promotion and tenure committees in the US, Italy and Greece, and grant reviewer for the Ministry of Health and Religion in Greece. Her research and teaching have focused on lipid and trace mineral nutrition and metabolism associated with cardiovascular disease. Additionally, she has explored the role of signalling pathways and gene expression of berry bioactive compounds and berry-enriched diets on endothelial function, inflammation, and lipid metabolism as it relates to cardiovascular disease and the metabolic syndrome in pre-clinical and clinical studies. Her applied research investigations utilized nutritional interventions to reduce cardiovascular disease risk in adolescents both in the United States and in the Mediterranean region. Recently, she is researching the molecular mechanisms and genomic effects of polyphenols on endothelial cell migration and angiogenesis as it relates to diabetes mellitus, ischemic disorders and wound healing. A Fulbright Senior Specialist and Cariplo Fellow, Dr Klimis-Zacas is the author of over 130 peer-reviewed publications, editor of books, series volumes and one patent. She is an editorial board member for The Journal of Nutritional Biochemistry, editor and guest editor for Antioxidants, Nutrients (MDPI) and others. Bettina MittendorferBettina MittendorferBettina Mittendorfer graduated from the University of Vienna in Austria with a MSc in Human Nutrition, and from the University of Texas Medical Branch in Galveston, USA, with a PhD in Nutritional Biochemistry. In 1999 she came to Washington University School of Medicine in St. Louis, USA, for a postdoctoral research fellowship. Currently she is Associate Professor of Medicine and Nutritional Sciences and the Director of the Nutrition and Obesity Research Center Clinical Science Research Core Laboratory at Washington University in St. Louis. Her research interests focus on the regulation of muscle protein and lipid metabolism with special emphasis on obesity, aging and sexual dimorphism, which she studies in vivo in human subjects by using stable isotope labelled tracer techniques. Faidon MagkosFaidon MagkosFaidon Magkos holds a BSc degree in Clinical Nutrition and Dietetics (2000), a MSc degree in Nutrition and Exercise (2004) and a PhD degree in Human Metabolism (2008). He completed post-doctoral training at Harokopio University in Athens, Greece, and Harvard Medical School in Boston, Massachusetts. In 2011, Magkos was appointed Assistant Professor of Medicine at the Center for Human Nutrition, Division of Geriatrics & Nutritional Science, at Washington University School of Medicine in St. Louis, Missouri. He moved to Singapore in 2015 and served as Assistant Professor of Physiology at the Clinical Nutrition Research Centre, Yong Loo Lin School of Medicine, at the National University of Singapore. Since 2018, he is Associate Professor in Obesity Research at the Department of Nutrition, Exercise and Sports, at the University of Copenhagen, Denmark. The study of human metabolism lies at the core of his research interests and activity. During the course of his career, Magkos has been involved in research projects examining the effects of diet, exercise, obesity and weight gain or weight loss, sex differences, and fatty liver on energy and substrate metabolism, lipid and lipoprotein kinetics, and insulin sensitivity in skeletal muscle, liver, and adipose tissue. He is a “metabolist” at heart. Since 2003, he has published 154 peer-reviewed publications and his work has been cited more than 7200 times (h-index 46).

An evaluation of the experiences of radiography students working on the temporary HCPC register during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has changed the world's perspective and had a profound impact on all those residing in the United Kingdom, resulting in unprecedented changes being made to the education and training of healthcare students. Universities and practice partners had to respond quickly and work in close collaboration with their wider system partners, Health Education England and the Department of Health, to ensure the changes made within the Health and Care Professions Council (HCPC) emergency measures were implemented.The aim was to explore the experiences of final year diagnostic and therapeutic radiography students who joined the HCPC temporary register during phase one of the COVID-19 pandemic. MethodsThis study was informed by a phenomenological approach, in which a purposeful sample of seventeen participants comprising of nine students, six practice educators and two academics were chosen to participate. Semi-structured interviews and focus groups were conducted to collect the data via a virtual platform. ResultsThe results highlighted three themes, professionalism and transition to registration, benefits and challenges of working through a pandemic, and emotional impact. Students described how they gained confidence and competence during their time on the temporary register and suggested that professional bodies could consider curriculum changes to encompass a final transitional placement similar to their experience. They said they had been well supported but felt a sense of loss having been denied the normal rite of passage associated with completion of their course and graduation. ConclusionThe results provide insight into how students, practice educators and academics transformed their practice to meet the necessary requirements whilst working during the first phase of the COVID-19 pandemic. They highlight the importance of having good support mechanisms in place and the rewards and challenges for students joining their professional register early. Implications for practiceSome consideration could be made to changing the curriculum in the future to allow for early temporary registration and paid Band 4 final placements for students working as assistant practitioners.

An exploration of UK paramedics' experiences of cardiopulmonary resuscitation-induced consciousness.

Introduction:Consciousness may occur during cardiopulmonary resuscitation despite the absence of a palpable pulse. This phenomenon, known as CPR-Induced Consciousness (CPR-IC), was first described over three decades ago and there has been an increase in case reports describing it. However, there remains limited evidence in relation to the incidence of CPR-IC and to practitioners’ experiences of it.Methods:A mixed-methods, cross-sectional survey of paramedics who were registered with the Health and Care Professions Council (HCPC) and working in the United Kingdom (UK) at the time of the survey. Participants who had experienced CPR-IC were asked to provide details about the number of episodes, a description of how consciousness was manifested and whether or not it interfered with resuscitation.Results:293 eligible participants completed the study and 167 (57%) said that they had witnessed CPR-IC. Of those, over 56% reported that they had experienced it on at least two occasions. CPR-IC was deemed to interfere with resuscitation in nearly 50% of first experiences but this fell to around 31% by the third experience. The most common reasons for CPR-IC to interfere with resuscitation were: patient resisting clinical interventions, increased rhythm and pulse checks, distress, confusion and reluctance to perform CPR.Conclusions:The prevalence of CPR-IC in our study was similar to that in earlier studies; however, unlike the other studies, we did not define what constituted interfering CPR-IC. Our findings suggest that interference may be related as much to the exposure of the clinician to CPR-IC as to any specific characteristic of the phenomenon itself.

Editorial introductions

Current Opinion in Clinical Nutrition and Metabolic Care was launched in 1998. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of clinical nutrition and metabolic care are divided into 15 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Anastasia Z. KaleaAnastasia Z. KaleaDr Anastasia Z. Kalea is Senior Teaching Fellow in Nutrition Education at the UCL Division of Medicine, UK, and an honorary Senior Associate Professor at the UCL Institute of Cardiovascular Science, UK. She has over 15 years of research and teaching experience in academic institutions in the US and the UK. She is an external examiner and reviewer for undergraduate nutrition and dietetics programmes in the US, UK, and Greece. Dr Kalea is a registered dietitian with the Health and Care Professions Council (HCPC) and has received a fellowship from the Higher Education Academy in the UK. She joined UCL in 2011 and researched the epigenetic effects of miRNAs in inflammatory diseases, cardiovascular disease and obesity. Prior to her joining UCL, Dr Kalea had been awarded a JDRF Fellowship to study vascular complications in diabetes while at Columbia University, USA, and continued her research at Northwestern University, USA. She held also a post-doctoral position at University of Maine, USA. Her research interests focus on metabolic inflammation and their associated comorbidities, on trace mineral metabolism, and on nutrigenetics and presented her work in numerous national and international conferences. Recent research publications explored the effects of diet on autoimmune diseases (lupus, rheumatoid arthritis), and on management of obesity. Her teaching interests lie on molecular nutrition pathways, personalised nutrition and public health. Dr Kalea leads teaching for the MSc in Clinical and Public Health Nutrition, MSc in Eating Disorders and Clinical Nutrition, and the BSc in Nutrition and Medical Sciences. She is the Programme Director for a new MSc course in Obesity and Clinical Nutrition at UCL. Dorothy Klimis-ZacasDorothy Klimis-ZacasDr Klimis-Zacas is professor of clinical nutrition and cooperating professor of the Graduate School of Biomedical Sciences and Engineering at the University of Maine, USA. As a Fulbright Senior Fellow, she aided in the establishment and curricular development of the Human Nutrition and Dietetics Program at Harokopio University, Greece, where she is a cooperating professor. She is also cooperating professor at DeFENs-Department of Food, Environmental and Nutritional Sciences at the University of Milan, Italy. Dr Klimis-Zacas is external reviewer and examiner for undergraduate and graduate programs, on promotion and tenure committees in the US, Italy and Greece, and grant reviewer for the Ministry of Health and Religion in Greece. Her research and teaching have focused on lipid and trace mineral nutrition and metabolism associated with cardiovascular disease. Additionally, she has explored the role of signalling pathways and gene expression of berry bioactive compounds and berry-enriched diets on endothelial function, inflammation, and lipid metabolism as it relates to cardiovascular disease and the metabolic syndrome in pre-clinical and clinical studies. Her applied research investigations utilized nutritional interventions to reduce cardiovascular disease risk in adolescents both in the United States and in the Mediterranean region. Recently, she is researching the molecular mechanisms and genomic effects of polyphenols on endothelial cell migration and angiogenesis as it relates to diabetes mellitus, ischemic disorders and wound healing. A Fulbright Senior Specialist and Cariplo Fellow, Dr Klimis-Zacas is the author of over 130 peer-reviewed publications, editor of books, series volumes and one patent. She is an editorial board member for The Journal of Nutritional Biochemistry, editor and guest editor for Antioxidants, Nutrients (MDPI) and others. Bettina MittendorferBettina MittendorferBettina Mittendorfer graduated from the University of Vienna in Austria with a MSc in Human Nutrition, and from the University of Texas Medical Branch in Galveston, USA, with a PhD in Nutritional Biochemistry. In 1999 she came to Washington University School of Medicine in St. Louis, USA, for a postdoctoral research fellowship. Currently she is Associate Professor of Medicine and Nutritional Sciences and the Director of the Nutrition and Obesity Research Center Clinical Science Research Core Laboratory at Washington University in St. Louis. Her research interests focus on the regulation of muscle protein and lipid metabolism with special emphasis on obesity, aging and sexual dimorphism, which she studies in vivo in human subjects by using stable isotope labelled tracer techniques. Olle LjungqvistOlle LjungqvistOlle Ljungqvist received his MD, PhD and surgical training from the Karolinska Institutet and Hospital in Sweden where he held several clinical positions in gastrointestinal surgery before being appointed Professor of Surgery Nutrition and Metabolism in 2005 at the Karolinska Insitutet. He chaired the Center for Gastrointestinal Disease at Ersta hospital 1999–2008, Stockholm before taking up his current position as Professor of Surgery at Örebro University, Sweden in 2009. Dr Ljungqvist has served as Chair of ESPEN, IASMEN as part of the International Surgical Society. He co-founded the ERAS® Society 2010 and serves as the Executive Chairman. He proposed the use of preoperative carbohydrates instead of overnight fasting, guideline recommend world-wide. His research interests are surgical stress, metabolism and nutrition and outcomes focusing on ERAS. He has published more than 200 original contributions, textbook chapter, edited textbooks, and has a current H index above 60.

Dietetic Students’ Attitudes to and Knowledge of Working with Older People

Across the world, people are living longer but not necessarily healthier lives. Healthcare professionals will need to be prepared to work with older people, recognising that, at all stages of the lifespan, attention to nutrition and other health behaviours can impact positively on wellbeing. This study examined the attitudes, knowledge and future career preferences of pre-registration dietetic students in the United Kingdom towards working with older people. A questionnaire, based on the validated Palmore Facts on Aging Quiz and adapted to a UK population, was sent to the fifteen universities which provide dietetic courses in the UK approved by the Health and Care Professions Council (HCPC). Responses were received from thirteen universities, and, of the estimated 1250 students, 285 questionnaires were completed (response rate 23%) with the predominant demographic being 91% female, and 86% undergraduate degree type. The mean knowledge score was higher in postgraduate vs. undergraduate students (69.6% vs. 65.2%; p [less than] 0.011). A weak positive correlation (rs = 0.155) was found between number of placement weeks carried out and knowledge score (p [less than] 0.01). Care of the elderly was the least preferred of five specialities, and 65-plus was the fourth preferred age group out of five. A greater focus should be placed on the delivery of aging education and placement experiences in dietetic courses to increase the number of graduate dietetic students who have positive work preferences towards older adults.

Facing our shadows: understanding harm in the arts therapies

ABSTRACT This paper examines what harm reveals about psychoactive power in the arts therapies. A 20-year sample of fitness-to-practise cases brought to the UK statutory regulator (the Health and Care and Professions Council) was examined to establish the prevalence of practitioners who cause harm which was low (0.165%). Transcripts of sanctioned cases were used to construct a grounded theory of how harm is mediated in arts therapies practice. This revealed service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. In arts therapies practice, the arts create powerfully emotionally salient elements to aid therapy which can affect both service user and arts therapists’ attachment systems to fulfil this task. Harm was enacted when the arts therapist used the power of that trust to isolate the relationship and introduce their own needs through arts therapies practices. This increased service user dependency on the arts therapist and further decreased their self-trust resulting in harm. Harm was only possible where the arts therapist’s self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary. Plain language summary This paper examines harm in the arts therapies (art, drama and music therapies as regulated by the Health and Care Professions Council (HCPC)). Harm is understudied but important because it tells us how things can go wrong and also indicates where areas of strong psychoactive power may operate in therapy which can also help people. Arts therapies have been regulated by the HCPC for 20 years and we found there were 77 cases brought against arts therapies practitioners with a total of 16 cases that led to HCPC sanction. We used a grounded theory method of analysis to try to understand how harm was mediated in those harmful arts therapy practices because it is an established form of qualitative research used to construct a theory of social action using examples drawn from real-world examples. We found that service users enter arts therapies with damaged self-trust in the expectation that they can trust the professional. In non-harmful therapy, trust in the professional is then used to boost self-trust in the service user. Within arts therapies, the arts support access to powerful emotions which underpins the building of trust, an element essential to good therapy. However, harm happened when the arts therapist used the power of that trust to isolate the relationship, introduced personal issues and used the service user for their own needs. This increased service user dependency on the arts therapist, detrimentally affecting their sense of self-trust and resulting in harm. Harm was only possible where the arts therapists’ self-reflection failed and they distorted theory to self-justify their actions and refute all feedback to the contrary.

Clinical exam: an introduction

The clinical examination is an important part of any patient consultation. After the primary survey and patient history, a more in-depth examination of the patient is required in order to aid the working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient condition and may not be possible in time-critical circumstances. However, it is becoming an increasing part of paramedic practice due to continued expansion of the scope of the paramedic role, both in urgent and emergency care. Educational delivery of clinical examinations of each of the main body systems is now an integral part of undergraduate paramedic curricula. The forthcoming Clinical Examination series will provide a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians in order to maintain and demonstrate currency and advancement within their roles (Health and Care Professions Council (HCPC) 2018). This series will therefore provide an overview of each examination to support students, newly qualified paramedics, and paramedics wishing to utilise these as a CPD development activity and an aide-memoire for clinical practice. This article will provide an introduction to the series, a guide to the intended use and an overview of initial examination considerations, including first impressions.

Social Workers under the Spotlight: An Analysis of Fitness to Practise Referrals to the Regulatory Body in England, 2014–2016

Abstract This article examines the nature of, and reasons for, the disproportionately high rates of fitness to practise referrals of social workers in England to the Health and Care Professions Council (HCPC), compared with other professions regulated by HCPC during 2014–2016. In 2014–2015, the rate of referrals for social workers was 1.42 per cent of registrants, compared with an average for the sixteen professions regulated by HCPC of 0.66 per cent. Drawing on published statistics and unique analysis of a sample of 232 case files undertaken as part of a research project in 2016–2017, the article highlights relatively high rates of inappropriate referrals from ‘members of the public’ (mainly service users) particularly in relation to child placements and contact. A detailed picture is offered of the variety of referrals dealt with at each stage of the fitness to practise process (from initial triage to final hearings), with recommendations for how to prevent inappropriate referrals, whilst focusing concern on the most serious cases of incompetence and misconduct. This research is of significance at a time of increasing pressure for social workers, social services and service users under conditions of austerity and managerialism; on-going concerns about standards in social work; and recent changes in social work regulation.