Implementation of the national antimicrobial stewardship competencies for UK undergraduate healthcare professional education within undergraduate pharmacy programmes: a survey of UK schools of pharmacy.

Background: Pharmacists play a key role in antimicrobial stewardship (AMS). Consensus-based national AMS competencies for undergraduate healthcare professionals in the UK reflect the increasing emphasis on competency-based healthcare professional education. However, the extent to which these are included within undergraduate pharmacy education programmes in the UK is unknown. Objectives: To explore which of the AMS competencies are delivered, including when and at which level, within UK undergraduate MPharm programmes. Methods: A cross-sectional online questionnaire captured the level of study of the MPharm programme in which each competency was taught, the method of delivery and assessment of AMS education, and examples of student feedback. Results: Ten institutions completed the survey (33% response rate). No institution reported covering all 54 AMS competencies and 5 of these were taught at half or fewer of the institutions. Key gaps were identified around taking samples, communication, outpatient parenteral antimicrobial therapy and surgical prophylaxis. The minimum time dedicated to AMS teaching differed between institutions (range 9-119 h), teaching was generally through didactic methods, and assessment was generally through knowledge recall and objective structured clinical examinations. Feedback from students suggests they find AMS and antimicrobial resistance (AMR) to be complex yet important topics. Conclusions: UK schools of pharmacy should utilize the competency framework to identify gaps in their AMS, AMR and infection teaching. To prepare newly qualified pharmacists to be effective at delivering AMS and prescribing antimicrobials, schools of pharmacy should utilize more simulated environments and clinical placements for education and assessment of AMS.

Effects of Sleep Extension on Inhibitory Control in Children With ADHD: A Pilot Study.

Objective: Children with ADHD often have sleep complaints and cognitive deficits. The aim of this pilot study was to determine whether sleep extension improves inhibitory control, a primary cognitive deficit in ADHD. Method: Children with (n = 11) and without (n = 15) ADHD participated in a within-subject sleep extension intervention that targeted nocturnal sleep duration. Sleep was assessed with actigraphy and polysomnography. Inhibitory control was assessed with a Go/No-Go task. Results: For children without ADHD, there was a significant main effect of time, such that morning inhibitory control was 10% greater than evening inhibitory control. However, inhibitory control did not differ between the baseline and extension conditions in this group. For children with ADHD, although morning inhibitory control did not differ from evening inhibitory control, sleep extension improved inhibitory control by 13% overall. Conclusion: These results suggest that a sleep extension intervention improves inhibitory control in children with ADHD.

Sleep and behavior of preschool children under typical and nap-promoted conditions.

BACKGROUND: Children transition out of naps in early childhood. However, there is disagreement about when this transition should occur. AIMS: We compared measures of sleep and behavior in children divided into Frequent, Sometimes, and Rarely nappers to determine what factors predict when napping should cease. We then examined the effect of an experimenter-promoted nap on measures of sleep and behavior. METHODS: We studied 133 children (50.4% female; mean=52.77months) over 16 days. Parents completed questionnaires, whereas children wore actigraphs. On 1 study day, children were nap-promoted. RESULTS: Overnight sleep duration was significantly less for children who napped frequently than those who rarely napped, yet total 24-hour sleep and other sleep parameters did not differ across napping groups. Effortful control was marginally greater in those who rarely napped. Nap promotion was 91% successful across nap groups. When typical sleep was compared with sleep following a promoted nap, frequent nappers slept more on the nap-promoted night. Total 24-hour sleep increased in all children following the promoted nap, and other sleep parameters did not differ between groups. CONCLUSIONS: The emergence of self-regulatory behaviors may predict when children should cease napping, consistent with the hypothesis that transitioning out of naps may be related to brain maturation. Given previously reported benefits of sleep on cognition and the observed increase in 24-hour sleep following nap promotion, nap promotion may benefit early education. Further research should explore maturational cues that illuminate when children are ready to transition out of napping.