Motivations for choosing an allied health profession career: findings from a scoping review

Fourteen professions are recognised as AHPs in England representing the third largest workforce in health and care. Although there is a need to significantly grow the AHP workforce in England, recruitment to many AHP courses is an issue. To increase course applications and encourage individuals to choose AHP careers, we need to understand the decision-making process in choosing an AHP career. The aim of this scoping review was to examine the nature and breadth of evidence internationally regarding the motivations for choosing an AHP career as well as any sources of influence and barriers. A comprehensive search identified 61 relevant studies. Findings revealed inconsistency in the evidence base and the literature focused on a select number of professions and countries. No relevant studies were found for three professions. Whilst many motivations and sources of influence were identified, barriers to entering an AHP career were explored less. The opportunity to help people was a key motivation with financially based motivations less important. Personal influences, such as a relative working in healthcare, were the most influential source to choosing this career pathway, media was the least. The main barrier to choosing an AHP career identified was a lack of awareness of the profession. There is a need to further investigate career choice motivations, sources of influence and barriers for all AHPs; gaining this knowledge will help tailor future healthcare career promotion and advice for each profession and assist with overall AHP recruitment

Low grade Ductal Carcinoma in situ (DCIS): how best to describe it?

BACKGROUND: In the absence of definitive data about the natural history of DCIS the appropriateness of describing DCIS as cancer is controversial. METHODS: We conducted a survey amongst British Breast Group (BBG) members, to determine which descriptions of DCIS were deemed most accurate and appropriate. RESULTS: 54/73 (74%) attendees completed the survey: A majority (34/54; 63%) said they would be comfortable using the description that explained DCIS as abnormal cells in the milk ducts that had not spread into other breast tissue and which did not need urgent treatment as if it was breast cancer and this description was overall the most preferred (24/54; 44%). CONCLUSIONS: Little consensus exists regarding how best to explain low grade DCIS to patients

Gated cardiac blood pool studies in atrial fibrillation: role of cycle length windowing

Cycle length windowing is gaining increasing acceptance in gated blood pool imaging of patients with atrial fibrillation (AF). The goals of this study were: to assess differences of ejection fraction (EF) in AF with and without windowing and to determine how EF varied with cycle length in patients with AF. Twenty patients with AF were prospectively studied by gated blood pool imaging, with simultaneous collection in each patient of 5–7 studies with cycle length windows spanning the cycle length histogram. Each window accepted beats of only a narrow range of cycle lengths. EF was determined for each of the narrow cycle length windows as well as for the entire gated blood pool study without cycle length windowing. For every patient an average of the windowed EFs was compared with the non-windowed EF. EF values were similar (mean windowed: 46.6; non-windowed: 45.5; P =0.16), and there was a good correlation between the two techniques ( r =0.97). The data were then examined for a relationship of EF with cycle length. The difference from average windowed EF (ΔEF) was calculated for each window and plotted vs. the cycle length of the center of each window. No predictable linear or nonlinear relationship of ΔEF with window position was observed. Lack of predictable variation of EF with cycle length is likely due to lack of a predictable amount of ventricular filling for a given cycle length, as the amount of diastolic filling in AF depends on the random cycle length of the preceding beat. In summary, windowing in AF does not provide a clinically significant difference in EF determination. If cycle length windowing is used, the exact location of the window is not critical.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46830/1/259_2004_Article_BF00177680.pd

An ecological study to evaluate the association of Bacillus Calmette-Guerin (BCG) vaccination on cases of SARS-CoV2 infection and mortality from COVID-19

As the SARS-CoV2 pandemic has progressed, there have been marked geographical differences in the pace and extent of its spread. We evaluated the association of BCG vaccination on morbidity and mortality of SARS-CoV2, adjusted for country-specific responses to the epidemic, demographics and health. SARS-CoV2 cases and deaths as reported by 31 May 2020 in the World Health Organization situation reports were used. Countries with at least 28 days following the first 100 cases, and available information on BCG were included. We used log-linear regression models to explore associations of cases and deaths with the BCG vaccination policy in each country, adjusted for population size, gross domestic product, proportion aged over 65 years, stringency level measures, testing levels, smoking proportion, and the time difference from date of reporting the 100th case to 31 May 2020. We further looked at the association that might have been found if the analyses were done at earlier time points. The study included 97 countries with 73 having a policy of current BCG vaccination, 13 having previously had BCG vaccination, and 11 having never had BCG vaccination. In a log-linear regression model there was no effect of country-level BCG status on SARS-CoV2 cases or deaths. Univariable log-linear regression models showed a trend towards a weakening of the association over time. We found no statistical evidence for an association between BCG vaccination policy and either SARS-CoV2 morbidity or mortality. We urge countries to rather consider alternative tools with evidence supporting their effectiveness for controlling SARS-CoV2 morbidity and mortality

Surface Zeta Potential and Diamond Seeding on Gallium Nitride Films.

The measurement of ζ potential of Ga-face and N-face gallium nitride has been carried out as a function of pH. Both of the faces show negative ζ potential in the pH range 5.5-9. The Ga-face has an isoelectric point at pH 5.5. The N-face shows a more negative ζ potential due to larger concentration of adsorbed oxygen. The ζ potential data clearly showed that H-terminated diamond seed solution at pH 8 will be optimal for the self-assembly of a monolayer of diamond nanoparticles on the GaN surface. The subsequent growth of thin diamond films on GaN seeded with H-terminated diamond seeds produced fully coalesced films, confirming a seeding density in excess of 1011 cm-2. This technique removes the requirement for a low thermal conduction seeding layer like silicon nitride on GaN

Impact of N-Acetyl Cysteine (NAC) on Tuberculosis (TB) Patients—A Systematic Review

This research article was published by MDPI in 2022Sustained TB infection overproduces reactive oxygen species (ROS) as a host defense mechanism. Research shows ROS is destructive to lung tissue. Glutathione (GSH) neutralizes ROS, although it is consumed. NAC is a precursor of GSH synthesis, and administering an appropriate dose of NAC to patients with respiratory conditions may enhance lung recovery and replenish GSH. The present review searched for articles reporting on the effects of NAC in TB treatment from 1960 to 31 May 2022. The PICO search strategy was used in Google Scholar, PubMed, SciFinder, and Wiley online library databases. The COVIDENCE tool was used to delete inappropriate content. We eventually discovered five clinical trials, one case report, seven reviews, in vitro research, and four experimental animal studies from the twenty-four accepted articles. The use of NAC resulted in increased GSH levels, decreased treatment time, and was safe with minimal adverse events. However, the evidence is currently insufficient to estimate the overall effects of NAC, thus the study warrants more NAC clinical trials to demonstrate its effects in TB treatment

Addressing overtreatment of screen detected DCIS; the LORIS trial

Abstract Overdiagnosis, and thus overtreatment, are inevitable consequences of most screening programmes; identification of ways of minimising the impact of overdiagnosis demands new prospective research, in particular the need to separate clinically relevant lesions that require active treatment from those that can be safely left alone or monitored and only need treated if they change characteristics. Breast cancer screening has led to a large increase in ductal carcinoma in situ (DCIS) diagnoses. This is a widely heterogeneous disease and most DCIS detected through screening is of high cytonuclear grade and therefore likely to be important clinically. However, the historic practice of surgical treatment for all DCIS is unlikely to be optimal for lower risk patients. A clearer understanding of how to manage DCIS is required. This article describes the background and development of ‘The low risk’ DCIS trial (LORIS), a phase III trial of surgery versus active monitoring. LORIS will determine if it is appropriate to manage women with screen detected or asymptomatic, low grade and intermediate grade DCIS with low grade features, by active monitoring rather than by surgical treatment

Pulmonary function deficits in newborn screened infants with cystic fibrosis managed with standard UK care are mild and transient

With the advent of novel designer molecules for cystic fibrosis (CF) treatment, there is huge need for early-life clinical trial outcomes, such as infant lung function (ILF). We investigated the degree and tracking of ILF abnormality during the first 2 years of life in CF newborn screened infants. Forced expiratory volume in 0.5 s (FEV₀.₅), lung clearance index (LCI) and plethysmographic functional residual capacity were measured at ∼3 months, 1 year and 2 years in 62 infants with CF and 34 controls. By 2 years there was no significant difference in FEV₀.₅ z-score between CF and controls, whereas mean LCI z-score was 0.81 (95% CI 0.45–1.17) higher in CF. However, there was no significant association between LCI z-score at 2 years with either 3-month or 1-year results. Despite minimal average group changes in any ILF outcome during the second year of life, marked within-subject changes occurred. No child had abnormal LCI or FEV₀.₅ on all test occasions, precluding the ability to identify “high-risk” infants in early life. In conclusion, changes in lung function are mild and transient during the first 2 years of life in newborn screened infants with CF when managed according to a standardised UK treatment protocol. Their potential role in tracking disease to later childhood will be ascertained by ongoing follow-up