Australia's first Allied Health Prescribing Program - enabling new models of patient care and practice scope for allied health professionals

Background - Non-medical prescribing provides patients with timely access to medicines and health services. A framework for allied health professional (AHP) prescribing trials within Queensland Health (Allied Health Professions’ Office of Queensland) enabled endorsed credentialed physiotherapists and pharmacists working in the public health system to enrol in the Queensland University of Technology (QUT) Allied Health Prescribing Training Program. The principles underpinning this framework incorporated those identified in the Health Professionals Prescribing Pathway. Aim - To design and deliver an allied health prescribing training program that would ultimately enable a new model of patient care across multiple Queensland public health practice settings, focusing on best practice via the Quality Use of Medicines and the NPS MedicineWise Prescribing Competencies Framework (the nationally available standard for health professional prescribing in Australia). Methods - A remote, interprofessional AHP prescribing training program was developed with enrolment offered to appropriately credentialed Queensland Health physiotherapists and pharmacists. The QUT program design included an extended period of supervised practice with an authorised prescriber within specific practice settings and with support by the local facility. Results and Discussion - Twenty participants (12 physiotherapists and 8 pharmacists) have undertaken the QUT prescribing training program to date. Following training completion, participants reported an increase in degree of confidence and understanding regarding various prescribing learning objectives (including safe and effective prescribing, professional, legal and ethical aspects, communicating medication orders, prescribing safely within their select area of practice, prescribing safely for complex patients in their area of practice). The training provided will enable implementation of a new model of patient care within public hospitals by AHPs within an approved prescribing trial framework. Future prescribing programs may include more diverse allied health cohorts targeting patient populations in different practice settings but still focusing on enabling safe, effective, appropriate and judicious prescribing under agreed processes and within a legislative framework

Australia's first Allied Health Prescribing Program - exploring participants understanding and confidence in clinical therapy choices for patient management

BACKGROUND Globally there are emerging trends for non-medical health professionals to expand their scope of practice into prescribing. The NPS Prescribing Competencies Framework and the Health Professionals Prescribing Pathway Program are recent initiatives to assist with implementation of prescribing for allied health professionals (AHPs). For AHPs to become prescribers, training programmes must be designed to extend their knowledge of medicines information and medicine management principles with the aim of optimising medicines related outcomes for patients. AIM To explore the understanding and confidence in clinical therapeutic choices for patient management of those AHPs enrolled in the Allied Health Prescribing Training Program Module One: Introduction to clinical therapeutics for prescribers, delivered by Queensland University of Technology, Brisbane. METHOD A pre-post survey was developed to explore key themes around understanding and confidence in selecting therapeutic choices for patients with varying complexities of conditions. Data were collected from participants in week one and 13 of the module via an online survey using a five-point Likert scale (1 = Strongly Agree (SA) to 5 = Strongly Disagree (SD)). RESULTS In the pre-Module survey the AHPs had a limited degree (D/SD) of understanding and confidence regarding the safe and effective use of medicines and appropriate therapeutic choices for managing patients, particularly with complex patients. This improved significantly in the post Module survey (A/SA)

Australia's first Allied Health Prescribing Program - development of a teaching tool to competently prescribe medicines

Background - In Australia, an allied health prescribing training program was developed based on collaborative agreement between the Queensland University of Technology (QUT) and the state government (Allied Health Professions’ Office of Queensland) to extend the scope of practice of allied health professionals.1 An initial hospital cohort of physiotherapists enrolled in the first module of the program, with the overall aim to competently prescribe medicines within their practice setting. Objectives - To develop and design a teaching tool to provide a starting point for awareness of safe and effective prescribing. A primary focus would be on incorporation of Quality Use of Medicines2 principles and the NPS Prescribing Competencies Framework.3 Methodology - A teaching tool embedded with the NPS Prescribing Competencies Framework was modelled as a template to enable collaborative student creation of patient case studies. Each case was made available online for group discussion and facilitation by the pharmacist coordinators. Results - Student feedback was sought via an online anonymous survey. The teaching tool assisted with increasing knowledge and confidence regarding safe and effective use of medicines and appropriate therapeutic choices for managing patients, especially complex patients. Discussion - A teaching tool was designed, developed and implemented to enable a process for safe and effective prescribing for the initial cohort of physiotherapists, who are currently engaged in the second module of the prescribing training program alongside hospital pharmacists. In addition, the modified tool is also utilised for other post-graduate nurse practitioner and podiatrist programs at QUT. Further refinement and improvement will be made for future cohorts. Reference 1. State of Queensland (Queensland Health) Allied Health Professions’ Office of Queensland. A framework for allied health professional prescribing trials within Queensland Health. Revised Dec 2014. 2. Australian Government Department of Health. The National Strategy for Quality Use of Medicines. Canberra: Commonwealth of Australia; 2002. 3. NPS: Better choices, better health. Competencies required to prescribe medicines: putting quality use of medicines into practice. Sydney: National Prescribing Service Limited, 2012

Pharmacist coordination, facilitation and remodelling of a nurse practitioner prescribing training program

Background - Education using blended learning concepts is encouraged by the Queensland University of Technology (QUT), Australia. Initiatives in the pharmacology and therapeutics program for nurse practitioner students were to be implemented, coordinated, and facilitated by pharmacists. Objectives - To remodel the program to enable blended and flexible learning. The key objective was to develop student knowledge, skills and attributes to competently prescribe medicines within their scope of practice. The principles of Quality Use of Medicines1 and the NPS Prescribing Competencies Framework2 were integral to the redesign of the teaching and learning. Methodology - Using flexible blended learning concepts, the redesigned program supported and delivered remote learning. Program changes included: • addition of a 2 day residential intensive; • remote online activities and presentation recordings; • recorded teleconference seminars involving patient case studies, facilitated by pharmacists; and • remote assessment to enable flexibility for students across Australia. Surveys were developed to explore the students’ perspectives of the remodelled program. Results - Overall, implementation of the new concepts was successful based on initial student feedback from an anonymous online survey; the program is in its final stages of delivery and perspectives are currently being sought. Discussion - A remote and blended learning format enabled flexibility for student participation with the majority of the program accessed from their workplace3 and home. Efficiencies were gained using online assessments. Possible future improvements to the remodelled prescribing training program include the use of a student discussion forum, development of vodcasts, and assessment of student communication and prescribing competencies via online mediums such as Skype. Reference 1. Australian Government Department of Health. The National Strategy for Quality Use of Medicines. Canberra: Commonwealth of Australia; 2002. 2. NPS: Better choices Better health. Competencies required to prescribe medicines: putting quality use of medicines into practice. Sydney: National Prescribing Service Limited 2012. 3. Shaw JP, Print SA and Duffull SB. Development of a Postgraduate Educational Program for Pharmacist Prescribers in New Zealand. Journal of Pharmacy Practice and Research. Vol 43 (2):2013

Australia's first Allied Health prescribing program - exploring participants' perspectives on the study program's learning objectives

BACKGROUND The Queensland University of Technology in collaboration with Queensland Health pioneered development of the Allied Health Prescribing Training Program to assist allied health professionals (AHPs) to competently prescribe medicines within their scope of practice. The study program consisted of two modules: Introduction to Clinical Therapeutics for Prescribers and Prescribing and Quality Use of Medicines. METHODS Pre- and post- surveys were developed for both modules. Key themes explored were understanding and confidence in selecting therapeutic choices for patients. For module 2 the learning objectives for safe and effective prescribing were investigated. Data were collected from participants in weeks one and thirteen of the modules via online surveys. RESULTS In the pre-module survey for the first module, participants had a limited degree of understanding and confidence regarding safe and effective use of medicines and appropriate therapeutic choices for managing patients, particularly for complex patients. This improved significantly in the post-module survey. In the pre-module survey for module 2, participants had a moderate degree of understanding and confidence regarding various prescribing learning objectives (including safe and effective prescribing, professional, legal and ethical aspects, communicating medication orders, prescribing safely in their select areas of practice, prescribing safely for complex patients in their area of practice). This increased significantly in the post-module survey. DISCUSSION This training program was implemented to develop a framework of knowledge and skills for AHPs to undertake a prescribing role. The program delivered an increase in participants’ knowledge in the key prescribing areas; and increased participants’ confidence in prescribing safely for patients and for complex patients in their select practice areas. An important aspect of this program was inclusion of prescribing–related activities under supervision of a designated medical practitioner. In conclusion, this educational program for Queensland Health AHP prescribers was successfully developed and is in the final stages of delivery

Helium identification with LHCb

International audienceThe identification of helium nuclei at LHCb is achieved using a method based on measurements of ionisation losses in the silicon sensors and timing measurements in the Outer Tracker drift tubes. The background from photon conversions is reduced using the RICH detectors and an isolation requirement. The method is developed using $pp$ collision data at $\sqrt{s}=13\,{\rm TeV}$ recorded by the LHCb experiment in the years 2016 to 2018, corresponding to an integrated luminosity of $5.5\,{\rm fb}^{-1}$. A total of around $10^5$ helium and antihelium candidates are identified with negligible background contamination. The helium identification efficiency is estimated to be approximately $50\%$ with a corresponding background rejection rate of up to $\mathcal O(10^{12})$. These results demonstrate the feasibility of a rich programme of measurements of QCD and astrophysics interest involving light nuclei

Observation of Cabibbo-suppressed two-body hadronic decays and precision mass measurement of the Ωc0\Omega_{c}^{0} baryon

International audienceThe first observation of the singly Cabibbo-suppressed $\Omega_{c}^{0}\to\Omega^{-}K^{+}$ and $\Omega_{c}^{0}\to\Xi^{-}\pi^{+}$ decays is reported, using proton-proton collision data at a centre-of-mass energy of $13\,{\rm TeV}$, corresponding to an integrated luminosity of $5.4\,{\rm fb}^{-1}$, collected with the LHCb detector between 2016 and 2018. The branching fraction ratios are measured to be $\frac{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}K^{+})}{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}\pi^{+})}=0.0608\pm0.0051({\rm stat})\pm 0.0040({\rm syst})$, $\frac{\mathcal{B}(\Omega_{c}^{0}\to\Xi^{-}\pi^{+})}{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}\pi^{+})}=0.1581\pm0.0087({\rm stat})\pm0.0043({\rm syst})\pm0.0016({\rm ext})$. In addition, using the $\Omega_{c}^{0}\to\Omega^{-}\pi^{+}$ decay channel, the $\Omega_{c}^{0}$ baryon mass is measured to be $M(\Omega_{c}^{0})=2695.28\pm0.07({\rm stat})\pm0.27({\rm syst})\pm0.30({\rm ext})\,{\rm MeV}/c^{2}$, improving the precision of the previous world average by a factor of four

Measurement of CP violation in B0→ψ(→ℓ+ℓ−)KS0(→π+π−)decaysB^0\to \psi(\to\ell^+\ell^-)K^0_\mathrm{S}(\to \pi^+\pi^-)decays

A measurement of time-dependent $C\!P$ violation in the decays of $B^0$ and $\overline{B}^0$ mesons to the final states ${J\!/\!\psi(\to\mu^+\mu^-)K^0_\mathrm{S}}$, $\psi(2S)(\to\mu^+\mu^-)K^0_\mathrm{S}$ and $J\!/\!\psi(\to e^+e^-)K^0_\mathrm{S}$ with $K^0_\mathrm{S}\pi^+\pi^-$ is presented. The data correspond to an integrated luminosity of $6\,\mathrm{fb}^{-1}$ collected at a centre-of-mass energy of $\sqrt{s}=13\,\mathrm{TeV}$ with the LHCb detector. The $C\!P$-violation parameters are measured to be \begin{align*} S_{\psi K^0_\mathrm{S}} &= 0.717 \pm 0.013\,(\text{stat}) \pm 0.008\,(\text{syst}), \\ C_{\psi K^0_\mathrm{S}} &= 0.008 \pm 0.012\,(\text{stat}) \pm 0.003\,(\text{syst}). \end{align*} This measurement of $S_{\psi K^0_\mathrm{S}}$ represents the most precise single measurement of the CKM angle $\beta$ to date and is more precise than the current world average. In addition, measurements of the $C\!P$-violation parameters of the individual channels are reported and a combination with the LHCb Run 1 measurements is performed.A measurement of time-dependent CP violation in the decays of $B^0$ and $\overline{B}^0$ mesons to the final states $J/\psi(\to\mu^+\mu^-)K^0_S$, $\psi(2S)(\to\mu^+\mu^-)K^0_S$ and $J/\psi(\to e^+e^-)K^0_S$ with $K^0_S\to\pi^+\pi^-$ is presented. The data correspond to an integrated luminosity of 6 fb${}^{-1}$ collected at a centre-of-mass energy of $\sqrt{s}=13$ TeV with the LHCb detector. The CP-violation parameters are measured to be \begin{align*} S_{\psi K^0_S} &= 0.717 \pm 0.013 (\text{stat}) \pm 0.008 (\text{syst}), \\ C_{\psi K^0_S} &= 0.008 \pm 0.012 (\text{stat}) \pm 0.003 (\text{syst}). \end{align*} This measurement of $S_{\psi K^0_S}$ represents the most precise single measurement of the CKM angle $\beta$ to date and is more precise than the current world average. In addition, measurements of the CP-violation parameters of the individual channels are reported and a combination with the LHCb Run 1 measurements is performed

Enhanced production of Λb0\Lambda_{b}^{0} baryons in high-multiplicity pppp collisions at s=13\sqrt{s} = 13 TeV

International audienceThe production rate of $\Lambda_{b}^{0}$ baryons relative to $B^{0}$ mesons in $pp$ collisions at a center-of-mass energy $\sqrt{s} = 13$ TeV is measured by the LHCb experiment. The ratio of $\Lambda_{b}^{0}$ to $B^{0}$ production cross-sections shows a significant dependence on both the transverse momentum and the measured charged-particle multiplicity. At low multiplicity, the ratio measured at LHCb is consistent with the value measured in $e^{+}e^{-}$ collisions, and increases by a factor of $\sim2$ with increasing multiplicity. At relatively low transverse momentum, the ratio of $\Lambda_{b}^{0}$ to $B^{0}$ cross-sections is higher than what is measured in $e^{+}e^{-}$ collisions, but converges with the $e^{+}e^{-}$ ratio as the momentum increases. These results imply that the evolution of heavy $b$ quarks into final-state hadrons is influenced by the density of the hadronic environment produced in the collision. Comparisons with a statistical hadronization model and implications for the mechanisms enforcing quark confinement are discussed

Charge-dependent curvature-bias corrections using a pseudomass method

International audienceMomentum measurements for very high momentum charged particles, such as muons from electroweak vector boson decays, are particularly susceptible to charge-dependent curvature biases that arise from misalignments of tracking detectors. Low momentum charged particles used in alignment procedures have limited sensitivity to coherent displacements of such detectors, and therefore are unable to fully constrain these misalignments to the precision necessary for studies of electroweak physics. Additional approaches are therefore required to understand and correct for these effects. In this paper the curvature biases present at the LHCb detector are studied using the pseudomass method in proton-proton collision data recorded at centre of mass energy $\sqrt{s}=13$ TeV during 2016, 2017 and 2018. The biases are determined using $Z\to\mu^+\mu^-$ decays in intervals defined by the data-taking period, magnet polarity and muon direction. Correcting for these biases, which are typically at the $10^{-4}$ GeV$^{-1}$ level, improves the $Z\to\mu^+\mu^-$ mass resolution by roughly 20% and eliminates several pathological trends in the kinematic-dependence of the mean dimuon invariant mass