Understanding the Allied Health Professions Student Experience of Practice Placements during the First Wave of the Coronavirus Pandemic

In England, a national lockdown came into effect on 23 March 2020 in response to the rapid spread of the Coronavirus. Healthcare services were quickly redesigned or scaled back to meet the significant and rising demands. Many practice placements were discontinued, which resulted in large numbers of Allied Health Professions (AHPs) pre-registration students requiring placements to meet the required practice hours. The challenge for placement providers, who were experiencing increased demand and uncertainty, was to continue providing quality placements. At the local trust, 58 AHP students had a placement between April and July 2020. Some clinical areas offered traditional placements. However due to social distancing rules many placements utilised blended practice; using aspects of both direct face-to-face and remote practice. It is important to understand the student experience in anticipation of future surges of Coronavirus. In total, 36 students responded to a placement survey. Results showed the majority of the students reported positive placement experiences overall. Despite the ever-changing placement landscape and the need for flexibility, it is important to ensure that placements are well planned and that students are well informed about the safety measures in place. It is vital that student’s feel welcomed and valued in order to learn and reach their full potential whilst on placement. The use of a blended placement model provided valuable learning experiences, however consideration needs to be given to ensure that students feel part of the team and have confidence that their learning needs are met

Managing pertussis in adults

Pertussis or whooping cough is typically characterised by paroxysms of coughing with a whooping sound during inhalation. It is thought to be under-diagnosed generally. Whooping cough is caused by Bordetella pertussis and is highly contagious. Although childhood immunisation has been effective in preventing the disease, outbreaks in Australia have been associated with waning immunity in older children and adolescents. The peak incidence of infection now occurs in people aged 15 or older. When given early in the illness, antibiotics can decrease the infectious period, but have no effect on the duration or severity of disease. Symptomatic treatment of cough has shown no clear benefit. Antibiotic prophylaxis of contacts is recommended for certain high-risk groups, but there is limited evidence of its effectiveness. Although infants remain the most at risk for severe, life-threatening disease, it is adolescent and adult booster immunisation which remains critical for prevention programs

Drug treatments of childhood coughs

Appropriate management of cough in children depends upon accurate assessment. The diagnosis is often unclear at the initial presentation. Acute cough is frequently caused by a viral infection, and often no specific therapy is indicated. Urgent treatment may be needed if history suggests a more serious disorder such as a foreign body or pneumonia. When treating children with chronic cough, paediatric-specific algorithms should be used. Empirical use of medicines without looking for a specific cause should be avoided. In the absence of an alternative specific cause of cough, chronic wet cough (lasting at least four weeks) is most frequently due to protracted bacterial bronchitis. Antibiotics are indicated

Spin orientation and magnetostriction of Tb1−xDyxFe2 from first principles

The optimal amount of dysprosium in the highly magnetostrictive rare-earth compounds Tb1−xDyxFe2 for room-temperature applications has long been known to be x=0.73 (Terfenol-D). Here, we derive this value from first principles by calculating the easy magnetization direction and magnetostriction as a function of composition and temperature. We use crystal-field coefficients obtained within density-functional theory to construct phenomenological anisotropy and magnetoelastic constants. The temperature dependence of these constants is obtained from disordered-local-moment calculations of the rare-earth magnetic order parameter. Our calculations find the critical Dy concentration required to switch the magnetization direction at room temperature to be xc=0.78, with magnetostrictions λ111=2700 and λ100=−430 ppm, close to the Terfenol-D values

Codeine versus placebo for chronic cough in children (Review)

Background: Cough in children is a commonly experienced symptom that is associated with increased health service utilisation and burden to parents. The presence of chronic (equal to or more than four weeks) cough in children may indicate a serious underlying condition such as inhaled foreign body or bronchiectasis. Codeine (and derivative)-based medications are sometimes used to treat cough due to their antitussive properties. However, there are inherent risks associated with the use of these medications such as respiratory drive suppression, anaesthetic-induced anaphylaxis, and addiction. Metabolic response and dosage variability place children at increased risk of experiencing such side effects. A systematic review evaluating the quality of the available literature would be useful to inform management practices. Objectives: To evaluate the safety and efficacy of codeine (and derivatives) in the treatment of chronic cough in children. Search methods: We searched the Cochrane Airways Group Register of Trials, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1946 to 8 June 2016), EMBASE (1974 to 8 June 2016), the online trials registries of the World Health Organization and ClinicalTrials.gov, and the bibliographic references of publications. We imposed no language restrictions. Selection criteria: We considered studies eligible for analysis when: the participant population included children aged less than 18 years with chronic cough (duration equal to or more than four weeks at the time of intervention); and the study design evaluated codeine or codeine-based derivatives against placebo through a randomised controlled trial. Data collection and analysis: Two review authors independently screened the search results to determine eligibility against a standardised criteria, and we had a pre-planned method for analysis. Main results: We identified a total of 556 records, of which 486 records were excluded on the basis of title and abstract. We retrieved the remaining 70 references in full to determine eligibility. No studies fulfilled the inclusion criteria of this review, and thus we found no evidence to support or oppose the use of codeine or derivatives as antitussive agents for chronic cough in children. While chronic cough is not the same as acute cough, systematic reviews on the use of codeine efficacy for acute cough in children conclude an overall lack of evidence to support or oppose the use of over-the-counter cough and cold medications containing codeine (or derivatives) for treatment of acute cough in children. The lack of sufficient evidence to support the use of these medications has been consistently reaffirmed by medical experts in international chronic cough guidelines and by governing medical and pharmaceutical authorities in the USA, Europe, Canada, New Zealand, and Australia. Due to the lack of sufficient evidence to support efficacy, and the known risks associated with use - in particular the increased risks for children - these medications are now not recommended for children less than 12 years of age and children between 12 to 18 years with respiratory conditions. Authors' conclusions: This review has highlighted the absence of any randomised controlled trials evaluating codeine-based medications in the treatment of childhood chronic cough. Given the potential adverse events of respiratory suppression and opioid toxicity, national therapeutic regulatory authorities recommend the contraindication of access to codeine in children less than 12 years of age. We suggest that clinical practice adhere to clinical practice guidelines and thus refrain from using codeine or its derivatives to treat cough in children. Aetiological-based management practices continue to be advocated for children with chronic cough

Validación en español de las propiedades psicométricas de la Generic Multifaceted Automaticity Scale (GMAS) para actividades físicas

Esta investigación presenta la validación al español de la Generic Multifaceted Automaticity Scale (GMAS) elaborada y validada en francés por Boiché et al. (2016). Esta escala mide tres propiedades de la automaticidad aplicadas a las actividades físicas: (a) la falta de intencionalidad para activar un comportamiento; (b) la eficiencia en su ejecución; y (c) la dificultad para controlarlo una vez adoptado. Dos estudios evaluaron sus propiedades psicométricas. En el primer estudio (N= 245) se realizaron un análisis factorial, una estimación de la coherencia interna a través del alpha de Cronbach y de validez convergente. Se confirmó un modelo en tres factores: (a) falta de intencionalidad, (b) la eficiencia y (c) el control (χ²/df = 2,24; TLI = .96; CFI = .97; SRMR=.08 RMSEA = .08; 90 [.05 - .10]). La GMAS presentó una consistencia interna satisfactoria (α =.89). Asimismo, los resultados mostraron que cuanto mayor sea la automaticidad, mayores serán los niveles de actividad física. Un segundo estudio (N=151) mostró que la automaticidad predijo significativamente la adopción de los transportes activos (β =.29; p < .05) independientemente de las intenciones. La GMAS es un instrumento válido en español para evaluar las propiedades automáticas de las actividades físicas.This research presents the Spanish validation of the Generic Multifaceted Automaticity Scale (GMAS) developed and validated in French by Boiché et al. (2016). This scale measures three properties of automaticity applied to physical activities: (a) the intentionality to activate a behaviour; (b) the efficiency of its execution; and (c) the difficulty to control it once adopted. Two studies evaluated its psychometric properties. Two studies evaluate the GMAS psychometric properties. In the first study (N= 245), a factorial analysis, reliability estimation by Cronbach's alpha, and convergent validity analysis were performed. A three-factor model was confirmed: (a) lack of intentionality, (b) efficiency and (c) control (χ²/df = 2,24; TLI = .96; CFI = .97; SRMR=.08 RMSEA = .08; 90 [.05 - .10]) with a good internal consistency (α =.89). The results show that high levels of automaticity are related to high levels of physical activity. The second study (N=151) shows that automaticity predicts the adoption of active modes of transportation, over and beyond intentions (β = .29; p < .05). These results suggest that the Spanish version of the GMAS is a valid instrument to evaluate the automatic properties of physical activity behaviours.Esta estudo apresenta a validação em espanhol da Generic Multifaceted Automaticity Scale (GMAS) elaborada e validada em francês por Boiché et al. (2016). Esta escala mede três propriedades de automaticidade aplicadas às atividades físicas: (a) a intencionalidade de ativar um comportamento; (b) a eficiência de sua execução; e (c) a dificuldade de controlá-lo uma vez adotado. Dois estudos avaliaram as propriedades psicométricas do GMAS. No primeiro estudo (N = 245) foi realizado análise fatorial, estimação de fiabilidade pelo alpha de Cronbach e validação de convergência. Um modelo de três fatores foi confirmado: a) falta de intencionalidade, b) eficiência e c) controlo (χ²/df = 2,24; TLI = .96; CFI = .97; SRMR=.08 RMSEA = .08; 90 [.05 - .10]) e uma boa consistência interna (α =.89). Conjuntamente, altos níveis de automaticidade foram correlacionados com altos níveis de atividade física. O segundo estudo (N = 151) revelou que a automaticidade previu a adoção de modos ativos de transporte, para além das intenções (β =.29; p < .05). A versão em espanhol do GMAS é um instrumento válido para avaliar as propriedades automáticas dos comportamentos relacionados a atividade física