The small molecule raptinal can simultaneously induce apoptosis and inhibit PANX1 activity.

Discovery of new small molecules that can activate distinct programmed cell death pathway is of significant interest as a research tool and for the development of novel therapeutics for pathological conditions such as cancer and infectious diseases. The small molecule raptinal was discovered as a pro-apoptotic compound that can rapidly trigger apoptosis by promoting the release of cytochrome c from the mitochondria and subsequently activating the intrinsic apoptotic pathway. As raptinal is very effective at inducing apoptosis in a variety of different cell types in vitro and in vivo, it has been used in many studies investigating cell death as well as the clearance of dying cells. While examining raptinal as an apoptosis inducer, we unexpectedly identified that in addition to its pro-apoptotic activities, raptinal can also inhibit the activity of caspase-activated Pannexin 1 (PANX1), a ubiquitously expressed transmembrane channel that regulates many cell death-associated processes. By implementing numerous biochemical, cell biological and electrophysiological approaches, we discovered that raptinal can simultaneously induce apoptosis and inhibit PANX1 activity. Surprisingly, raptinal was found to inhibit cleavage-activated PANX1 via a mechanism distinct to other well-described PANX1 inhibitors such as carbenoxolone and trovafloxacin. Furthermore, raptinal also interfered with PANX1-regulated apoptotic processes including the release of the 'find-me' signal ATP, the formation of apoptotic cell-derived extracellular vesicles, as well as NLRP3 inflammasome activation. Taken together, these data identify raptinal as the first compound that can simultaneously induce apoptosis and inhibit PANX1 channels. This has broad implications for the use of raptinal in cell death studies as well as in the development new PANX1 inhibitors.

Investigating the Role of Heparanase in Breast Cancer Development Utilising the MMTV-PyMT Murine Model of Mammary Carcinoma.

Breast cancer is the second most common human malignancy and is a major global health burden. Heparanase (HPSE) has been widely implicated in enhancing the development and progression of solid tumours, including breast cancer. In this study, the well-established spontaneous mammary tumour-developing MMTV-PyMT murine model was utilised to examine the role of HPSE in breast cancer establishment, progression, and metastasis. The use of HPSE-deficient MMTV-PyMT (MMTV-PyMTxHPSE-/-) mice addressed the lack of genetic ablation models to investigate the role of HPSE in mammary tumours. It was demonstrated that even though HPSE regulated mammary tumour angiogenesis, mammary tumour progression and metastasis were HPSE-independent. Furthermore, there was no evidence of compensatory action by matrix metalloproteinases (MMPs) in response to the lack of HPSE expression in the mammary tumours. These findings suggest that HPSE may not play a significant role in the mammary tumour development of MMTV-PyMT animals. Collectively, these observations may have implications in the clinical setting of breast cancer and therapy using HPSE inhibitors.

DMPC/Chol liposomal copper CX5461 is therapeutically superior to a DSPC/Chol formulation.

CX5461, a compound initially identified as an RNA polymerase inhibitor and more recently as a G-quadruplex binder, binds copper to form a complex. Our previous publication showed that the complexation reaction can be leveraged to formulate copper-CX5461 inside liposomes, improving the apparent solubility of CX5461 by over 500-fold and reducing the elimination of CX5461 from the plasma compartment following intravenous administration. In mouse models of acute myeloid leukemia, the resulting formulation was more effective than the free drug solution of CX5461 (pH 3.5) currently used in clinical trials. However, the gains observed with the liposomal formulation were minimal, despite significant increases in circulation half-life. Since the formulation technology used relied on liposomes and the fate of most compounds associated with liposomes is dependent on liposomal lipid composition, the studies described here were designed to evaluate how simple changes in lipid composition could affect therapeutic activity. The previously reported formulation method was simplified to ensure an easy scale-up process. In the modified method, pre-measured solid CX5461 was added to copper-containing liposomes prior to an incubation at 60 °C, which enabled copper-CX5461 complexation inside DSPC/Chol or DMPC/Chol liposomes. Efficacy was determined in BRCA-normal (BxPC3) and BRCA-deficient (Capan-1) models of pancreatic cancer. Both liposomal formulations enhanced the circulation lifetime of CX5461 compared to the free drug solution (pH 3.5). Unlike most compounds that are loaded using a transmembrane pH-gradient, the dissociation of CX5461 from liposomes prepared using the copper complexation method were comparable for DSPC/Chol and DMPC/Chol liposomes, in vitro and in vivo. Nonetheless, copper CX5461 prepared using DMPC/Chol liposomes exhibited superior efficacy. The reason for the improved activity of DMPC/Chol copper-CX5461 was not readily explained by the release data and may be due to the fact that DMPC/Chol liposomes are less stable following localization in the tumor. The results indicate that the therapeutic effects of copper-CX5461 will be dependent on liposomal lipid composition and that liposomal CX5461 should exhibit superior benefits when used to treat BRCA-deficient cancers.

Humanistic counselling plus pastoral care as usual versus pastoral care as usual for the treatment of psychological distress in adolescents in UK state schools (ETHOS): a randomised controlled trial.

BACKGROUND: About one in seven adolescents have a mental health disorder in England, UK. School counselling is one of the most common means of trying to address such a problem. We aimed to determine the effectiveness and cost-effectiveness of school-based humanistic counselling (SBHC) for the treatment of psychological distress in young people in England, UK. METHODS: We did a two-arm, individually randomised trial in 18 secondary state-funded schools across the Greater London area of the UK. Participants were randomly assigned (1:1) using a centrally secure randomisation procedure with random permuted blocks to either SBHC plus schools' pastoral care as usual (PCAU), or PCAU alone. Participants were pupils aged 13-16 years who had moderate-to-severe levels of emotional symptoms (measured by a score of ≥5 on the Strengths and Difficulties Questionnaire Emotional Symptoms scale) and were assessed as competent to consent to participate in the trial. Participants, providers, and assessors (who initially assessed and enrolled participants) were not masked but testers (who measured outcomes) were masked to treatment allocation. The primary outcome was psychological distress at 12 weeks (Young Person's Clinical Outcomes in Routine Evaluation measure [YP-CORE]; range 0-40), analysed on an intention-to-treat basis (with missing data imputed). Costs were assessed at 24 weeks (Client Service Receipt Inventory and service logs). The trial was registered with ISRCTN, number ISRCTN10460622. FINDINGS: 329 participants were recruited between Sept 29, 2016, and Feb 8, 2018, with 167 (51%) randomly assigned to SBHC plus PCAU and 162 (49%) to PCAU. 315 (96%) of 329 participants provided data at 12 weeks and scores were imputed for 14 participants (4%). At baseline, the mean YP-CORE scores were 20·86 (SD 6·38) for the SBHC plus PCAU group and 20·98 (6·41) for the PCAU group. Mean YP-CORE scores at 12 weeks were 16·41 (SD 7·59) for the SBHC plus PCAU group and 18·34 (7·84) for the PCAU group (difference 1·87, 95% CI 0·37-3·36; p=0·015), with a small effect size (0·25, 0·03-0·47). Overall costs at 24 weeks were £995·20 (SD 769·86) per pupil for the SBHC plus PCAU group and £612·89 (1224·56) for the PCAU group (unadjusted difference £382·31, 95% CI £148·18-616·44; p=0·0015). The probability of SBHC being more cost-effective reached 80% at a willingness to pay of £390 for a 1-point improvement on the YP-CORE. Five serious adverse events occurred for four participants in the SBHC plus PCAU group, all involving suicidal intent. Two serious adverse events occurred for two participants in the PCAU group, one involving suicidal intent. INTERPRETATION: The addition of SBHC to PCAU leads to small reductions in psychological distress, but at an additional economic cost. SBHC is a viable treatment option but there is a need for equally rigorous evaluation of alternative interventions. FUNDING: This work was supported by the Economic and Social Research Council (grant reference ES/M011933/1).

Who Attends Couples Counseling in the UK and Why?

In England, publicly funded couples therapy is reserved for couples where one or both partners present with psychological disorders, rather than relationship distress, despite evidence of a bidirectional relationship between the two. Demographics and presenting issues for 14,726 couples who received counseling through a third-sector counseling organization in England and Wales were investigated. Clients were often White, aged 25-54, and presented with interpersonal issues. "Mental health problems" were identified as an issue by about a quarter of all clients. This suggests that many couples seeking relationship counseling wish to address relational versus psychological distress, which has implications for publicly funded services.

Exploring public perspectives of e-professionalism in nursing.

BACKGROUND: E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses' e-professionalism. AIM: To explain what, how and why the public make decisions about the acceptability of nurses' online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. METHOD: This was a mixed-method critical realist study. Participants in a survey ( n =53) and two focus groups ( n =8) discussed and rated the acceptability of five vignettes related to nurses' online behaviours based on real-life examples. FINDINGS: The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. CONCLUSION: The public make decisions on the acceptability of nurses' online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can 'tag' and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based.

Correction to: The 2018 UK NHS Digital annual report on the Improving Access to Psychological Therapies programme: a brief commentary.

Following publication of the original article [1], we have been notified that one of the authors' names is spelled incorrectly. In this Correction the incorrect and correct author name are shown.

Philosophy and quality? TAPUPASM as an approach to rigour in critical realist research.

BACKGROUND: Philosophical principles should guide how research is designed, conducted and appraised. The more traditional and commonly used approaches to positivist (validity and generalisability) or interpretivist (trustworthiness) research do not necessarily complement the philosophical principles of post-positivist critical realism. AIMS: To discuss an approach to ensuring scientific rigour in post-positivist critical realist research using an enhanced version of the quality assurance model, TAPUPAS, that has an additional criterion: modified objectivity. DISCUSSION: The authors present examples of the quality framework TAPUPASM in the planning, design, conduct and dissemination of a realist research study. These strategies include choices about the collection and analysis of data, as well as how to disseminate findings using methods other than traditional academic approaches. They also provide a practical example of how they used TAPUPASM to ensure rigour in a critical realist ethnographic study in pre-registration nurse education. CONCLUSION: TAPUPASM provides a framework for quality in post-positivist critical realist research. IMPLICATIONS FOR PRACTICE: Nurse researchers can use the strategies provided to plan, design, conduct and disseminate critical realist research.

Postpositivist critical realism: philosophy, methodology and method for nursing research.

BACKGROUND: Healthcare research acknowledges a range of paradigms, including postpositivism and critical realist methodologies. However, there are few examples of such studies, which may discourage nurses from considering it to be a viable option. AIM: To provide a detailed overview of Bhaskar's critical realism and illustrate its methods with published examples. DISCUSSION: Bhaskar's critical realist methodology is explained and three main research methods are illustrated: critical realist evaluation, action research and ethnography. CONCLUSION: Postpositivism negotiates some of the conflict and differences between positivism and interpretivism. It offers a variety of methodological choices for nurses who do not wish to align themselves only with facts, cause and effect, proving hypotheses, or the perspectives and experiences of participants. IMPLICATIONS FOR PRACTICE: Researchers can use Bhaskar's critical realist principles to study complex and open systems, such as those of teams and organisations, public health interventions, and social situations, but particularly the complexities of nursing practice, service delivery and service design.

The 2018 UK NHS Digital annual report on the Improving Access to Psychological Therapies programme: a brief commentary.

This commentary examines publicly available information on 2017-2018 outcomes in the UK government's Improving Access to Psychological Therapies (IAPT) programme, a National Health Service (NHS) primary care mental health programme in England. In that year there were 1.4 million referrals into IAPT and over 500,000 people completed a course of treatment. The IAPT database collects routine session-by-session outcome monitoring data for this population, including outcomes for depression and anxiety in a stepped care model which includes a range of psychological therapies, among them Cognitive Behavioural Therapy (CBT) and Person-centred Experiential Therapy, known in the IAPT programme as Counselling for Depression (CfD).In 2017-18, 32% of all referrals were for anxiety and stress disorders, 26% for depression, and 35% were unspecified. The definition of treatment completion is receipt of 2 sessions or more and on this basis 60% of all referrals in 2017-18 did not complete treatment, predominantly because they failed to attend the initial appointment, or ended after only one session. Four years of data on outcomes for CBT and CfD suggests these therapies are broadly comparable in terms of both recovery rate and average number of sessions, though the number of referrals to each therapy varied widely. Data on treatment choice and satisfaction was favourable but there were issues with low return rates and invalid data. Information on outcomes for ethnicity, sexual orientation, disability and religion, as well as a measure of local economic deprivation, indicate lower outcomes for a number of patient groups. Data on employment status outcomes suggest little overall change, including for the category of those on benefits payments.The data published alongside the annual IAPT reports mean there is an increasing amount of information in the public domain about IAPT performance, but it is time consuming to extract and evaluate. This report highlights a number of points of concern which suggest the need for improvement on multiple axes. We suggest that improved researcher access to the huge IAPT dataset can allow for more detailed evaluations of IAPT that can inform policy/decision-making to improve outcomes for clients.

Structural and functional characterization of the membrane-permeabilizing activity of Nicotiana occidentalis defensin NoD173 and protein engineering to enhance oncolysis.

Defensins are an extensive family of host defense peptides found ubiquitously across plant and animal species. In addition to protecting against infection by pathogenic microorganisms, some defensins are selectively cytotoxic toward tumor cells. As such, defensins have attracted interest as potential antimicrobial and anticancer therapeutics. The mechanism of defensin action against microbes and tumor cells appears to be conserved and involves the targeting and disruption of cellular membranes. This has been best defined for plant defensins, which upon binding specific phospholipids, such as phosphatidylinositol 4,5-bisphosphate (PIP2) and phosphatidic acid, form defensin-lipid oligomeric complexes that destabilize membranes, leading to cell lysis. In this study, to further define the anticancer and therapeutic properties of plant defensins, we have characterized a novel plant defensin, Nicotiana occidentalis defensin 173 (NoD173), from N. occidentalis. NoD173 at low micromolar concentrations selectively killed a panel of tumor cell lines over normal primary cells. To improve the anticancer activity of NoD173, we explored increasing cationicity by mutation, with NoD173 with the substitution of Q22 with lysine [NoD173(Q22K)], increasing the antitumor cell activity by 2-fold. NoD173 and the NoD173(Q22K) mutant exhibited only low levels of hemolytic activity, and both maintained activity against tumor cells in serum. The ability of NoD173 to inhibit solid tumor growth in vivo was tested in a mouse B16-F1 model, whereby injection of NoD173 into established subcutaneous tumors significantly inhibited tumor growth. Finally, we showed that NoD173 specifically targets PIP2 and determined by X-ray crystallography that a high-resolution structure of NoD173, which forms a conserved family-defining cysteine-stabilized-αß motif with a dimeric lipid-binding conformation, configured into an arch-shaped oligomer of 4 dimers. These data provide insights into the mechanism of how defensins target membranes to kill tumor cells and provide proof of concept that defensins are able to inhibit tumor growth in vivo.-Lay, F. T., Ryan, G. F., Caria, S., Phan, T. K., Veneer, P. K., White, J. A., Kvansakul, M., Hulett M. D. Structural and functional characterization of the membrane-permeabilizing activity of Nicotiana occidentalis defensin NoD173 and protein engineering to enhance oncolysis.

Liposomal Formulations to Modulate the Tumour Microenvironment and Antitumour Immune Response.

Tumours are complex systems of genetically diverse malignant cells that proliferate in the presence of a heterogeneous microenvironment consisting of host derived microvasculature, stromal, and immune cells. The components of the tumour microenvironment (TME) communicate with each other and with cancer cells, to regulate cellular processes that can inhibit, as well as enhance, tumour growth. Therapeutic strategies have been developed to modulate the TME and cancer-associated immune response. However, modulating compounds are often insoluble (aqueous solubility of less than 1 mg/mL) and have suboptimal pharmacokinetics that prevent therapeutically relevant drug concentrations from reaching the appropriate sites within the tumour. Nanomedicines and, in particular, liposomal formulations of relevant drug candidates, define clinically meaningful drug delivery systems that have the potential to ensure that the right drug candidate is delivered to the right area within tumours at the right time. Following encapsulation in liposomes, drug candidates often display extended plasma half-lives, higher plasma concentrations and may accumulate directly in the tumour tissue. Liposomes can normalise the tumour blood vessel structure and enhance the immunogenicity of tumour cell death; relatively unrecognised impacts associated with using liposomal formulations. This review describes liposomal formulations that affect components of the TME. A focus is placed on formulations which are approved for use in the clinic. The concept of tumour immunogenicity, and how liposomes may enhance radiation and chemotherapy-induced immunogenic cell death (ICD), is discussed. Liposomes are currently an indispensable tool in the treatment of cancer, and their contribution to cancer therapy may gain even further importance by incorporating modulators of the TME and the cancer-associated immune response.

Disseminating research information through Facebook and Twitter (DRIFT): presenting an evidence-based framework.

BACKGROUND: The social media platform Facebook boasts of having more than 1,284 million daily active users globally. A large proportion of adults use the internet to seek health-related information. AIM: To critically analyse the use of social media to engage parents of children with attention deficit hyperactivity disorder (ADHD) with the findings of clinical research. DISCUSSION: Observation and qualitative content analysis combined with Facebook Audience Insights were used to evaluate the levels of engagement and interaction with different types of research information. More than 1,100 people from 41 nations engaged with the group. Sharing information through a range of Facebook functions was found to successfully achieve engagement and reach this demographic nationally and internationally. CONCLUSION: Lay research users are eager to engage and understand clinical research. Social media platforms are an appropriate way to disseminate research. IMPLICATIONS FOR PRACTICE: This paper presents a much-needed evidence-based framework that nursing and health researchers can use for effective communication.

Introduction to positivism, interpretivism and critical theory.

BACKGROUND: There are three commonly known philosophical research paradigms used to guide research methods and analysis: positivism, interpretivism and critical theory. Being able to justify the decision to adopt or reject a philosophy should be part of the basis of research. It is therefore important to understand these paradigms, their origins and principles, and to decide which is appropriate for a study and inform its design, methodology and analysis. AIM: To help those new to research philosophy by explaining positivism, interpretivism and critical theory. DISCUSSION: Positivism resulted from foundationalism and empiricism; positivists value objectivity and proving or disproving hypotheses. Interpretivism is in direct opposition to positivism; it originated from principles developed by Kant and values subjectivity. Critical theory originated in the Frankfurt School and considers the wider oppressive nature of politics or societal influences, and often includes feminist research. CONCLUSION: This paper introduces the historical context of three well-referenced research philosophies and explains the common principles and values of each. IMPLICATIONS FOR PRACTICE: The paper enables nurse researchers to make informed and rational decisions when embarking on research.

Lymphatic transport and lymph node targeting of methotrexate-conjugated PEGylated dendrimers are enhanced by reducing the length of the drug linker or masking interactions with the injection site.

Drug conjugation to dendrimer-based delivery systems has been shown to enhance delivery to the lymphatic system after subcutaneous administration. Dendrimer interaction with components of the interstitium at the injection site, however, may prevent drainage from the injection site. The current study sought to vary the length of a linker employed to conjugate methotrexate (MTX) to a PEGylated dendrimer, in an attempt to reduce MTX interaction with interstitial binding sites and enhance lymphatic drainage. Dendrimers with shorter linkers resulted in higher lymphatic drainage, presumably via shielding of interaction sites by the PEG mantle, but were not retained in lymph nodes. Improved drainage of dendrimers with longer linkers was achieved through coadministration with dextran to mask interactions at the injection site while maintaining retention within the node. Enhanced drug exposure to the lymph node has the potential to enhance the treatment of lymph-node resident cancer metastases.

Copper (II) complexes of bidentate ligands exhibit potent anti-cancer activity regardless of platinum sensitivity status.

Insensitivity to platinum, either through inherent or acquired resistance, is a major clinical problem in the treatment of many solid tumors. Here, we explored the therapeutic potential of diethyldithiocarbamate (DDC), pyrithione (Pyr), plumbagin (Plum), 8-hydroxyquinoline (8-HQ), clioquinol (CQ) copper complexes in a panel of cancer cell lines that differ in their sensitivity to platins (cisplatin/carboplatin) using a high-content imaging system. Our data suggest that the copper complexes were effective against both platinum sensitive (IC50 ~ 1 µM platinum) and insensitive (IC50 > 5 µM platinum) cell lines. Furthermore, copper complexes of DDC, Pyr and 8-HQ had greater therapeutic activity compared to the copper-free ligands in all cell lines; whereas the copper-dependent activities of Plum and CQ were cell-line specific. Four of the copper complexes (Cu(DDC)2, Cu(Pyr)2, Cu(Plum)2 and Cu(8-HQ)2) showed IC50 values less than that of cisplatin in all tested cell lines. The complex copper DDC (Cu(DDC)2) was selected for in vivo evaluation due to its low nano-molar range activity in vitro and the availability of an injectable liposomal formulation. Liposomal (Cu(DDC)2) was tested in a fast-growing platinum-resistant A2780-CP ovarian xenograft model and was found to achieve a statistically significant reduction (50%; p < 0.05) in tumour size. This work supports the potential use of copper-based therapeutics to treat cancers that are insensitive to platinum drugs.

Evaluation of a drop-in clinic for young people with attention deficit hyperactivity disorder.

Aims To implement and evaluate a nurse-led, multi-agency drop-in clinic for young people with attention deficit hyperactivity disorder (ADHD). Method A repeated measures observational study over 12 months exploring clinic attendance and user satisfaction, crisis management and did not attend (DNA) rates, consultant time spent with patients, benefits to quality of care, and service flexibility. Results A total of 62 service users participated. A significant improvement in service user experience was observed (P=0.001). Crisis management attendances significantly increased (P=0.005). DNA rates did not reduce significantly (P=0.057). Service users attended for their medication review before or on their due date (P=0.011). Those who needed to were able to spend more time with the staff (P=0.001). Conclusion The clinic improved service accessibility and flexibility. It allowed adherence to clinical guidance, including uptake of psychosocial interventions. There was an overwhelmingly positive improvement in service user experience. Importantly, as contact with the ADHD nurse specialists increased, this significantly reduced the amount of time consultant community paediatricians spent with service users. Further research should examine the cost-effectiveness and longitudinal effect of the drop-in model.

An introduction to the origins, history and principles of ethnography.

Background Ethnography is embedded in the history of research and has been considered a methodology in its own right. Its long history means those new to ethnography may find it complex to navigate the differing perspectives and its historical context. Philosophical perspectives further compound the complexities of understanding and making decisions about method. Aim To introduce the historical context of ethnography and its wide-ranging and differing perspectives. Discussion This paper provides an overview of the historical context of ethnography and discusses the different approaches to ethnography based on philosophical paradigms. Examples of ethnographic research in nursing literature are used to illustrate how these different approaches and types of ethnography can be used in nursing. Conclusion Ethnographic research has much to contribute to nursing knowledge. However, it is important to understand the philosophical influences when making decisions about research approach. Implications for practice This article provides an overview of the historic context of ethnography and may improve the knowledge of nurses wishing to employ ethnographic approaches in their own post-graduate and doctoral research.

International perspectives on social media guidance for nurses: a content analysis.

Aim This article reports the results of an analysis of the content of national and international professional guidance on social media for the nursing profession. The aim was to consolidate good practice examples of social media guidelines, and inform the development of comprehensive guidance. Method A scoping search of professional nursing bodies' and organisations' social media guidance documents was undertaken using google search. Results 34 guidance documents were located, and a content analysis of these was conducted. Conclusion The results, combined with a review of competency hearings and literature, indicate that guidance should cover the context of social media, and support nurses to navigate and negotiate the differences between the real and online domains to help them translate awareness into actions.

Development and evaluation of an online, interactive information and advice tool for pre-registration nursing students.

Attrition rates for student nurses on academic programmes is a challenge for UK Higher Education Institutions. Reasons for leaving a programme of study include personal, financial issues or practice placement experiences. Research has shown systematic and integrated support mechanisms may improve attrition rates and student experience. This project explored the sources of, and support needs of nursing and allied health students, develop and evaluate and interactive online tool: 'SignpOSt'. Enabling students to access 'the right support, at the right time, from the right place'. Focus groups were carried out with 14, 3rd year students and 8 academic staff including personal tutors, programme/module leaders. Thematic analysis of transcribed data under four key themes for support and advice: 1. Financial 2. Programme 3. Personal 4. Study/academic, found poor student knowledge and little clarity of responsibilities of academic staff and services leads to students sourcing support from the wrong place at the wrong time. Students valued the speed and accessibility of information from informal, programme specific Facebook groups. Conversely, there were also concerns about the accuracy of these. Further research into the use of informal Facebook groups may be useful along with additional evaluation of the SOS tool.