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Practical Behaviour Management for Primary School Teachers will provide you with practical strategies at every part of your teaching journey, enabling you to create an inclusive environment in your own classroom.

Background Intramuscular (IM) injection of epinephrine (adrenaline) at the mid-anterolateral (AL) thigh is the international standard therapy for acute anaphylaxis. Concerns exist regarding implications of epinephrine auto-injector needles not penetrating the muscle in patients with greater skin-to-muscle-distances (STMD). Methods This open-label, randomized, crossover study investigated pharmacokinetics and pharmacodynamics following injection of epinephrine in healthy volunteers. Individuals were stratified by maximally compressed STMD (low, < 15 mm; moderate, 15–20 mm; high, > 20 mm). Participants received epinephrine injections via EpiPen ® Auto-Injector (EpiPen; 0.3 mg/0.3 mL) or IM syringe (0.3 mg/0.3 mL) at mid-AL thigh or received saline by IM syringe in a randomized order. Eligible participants received a fourth treatment (EpiPen [0.3 mg/0.3 mL] at distal-AL thigh). Model-independent pharmacokinetic parameters and pharmacodynamics were assessed. Results There were numerical trends toward higher peak epinephrine concentrations (0.52 vs 0.35 ng/mL; geometric mean ratio, 1.40; 90% CI 117.6–164.6%) and more rapid exposure (time to peak concentration, 20 vs 50 min) for EpiPen vs IM syringe at mid-AL thigh across STMD groups. Absorption was faster over the first 30 min for EpiPen vs IM syringe (partial area under curve [AUC] over first 30 min: geometric mean ratio, 2.13; 90% CI 159.0–285.0%). Overall exposure based on AUC to the last measurable concentration was similar for EpiPen vs IM syringe (geometric mean ratio, 1.13; 90% CI 98.8–129.8%). Epinephrine pharmacokinetics after EpiPen injection were similar across STMD groups. Treatments were well tolerated. Conclusions Epinephrine delivery via EpiPen resulted in greater early systemic exposure to epinephrine vs IM syringe as assessed by epinephrine plasma levels. Delivery via EpiPen was consistent across participants with a wide range of STMD, even when the needle may not have penetrated the muscle. Trial registrations This trial was registered with the German Clinical Trials Register (DRKS-ID: DRKS00011263; secondary ID, EudraCT 2016-000104-29) on 23 March 2017.

Purpose Pegfilgrastim is a long-acting granulocyte colony-stimulating factor indicated for prevention of febrile neutropenia in patients receiving myelosuppressive chemotherapy by promoting neutrophil recovery. Methods This phase 1, randomized, double-blind, three-way crossover trial in healthy volunteers evaluated the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of the proposed biosimilar, comparing MYL-1401H, reference pegfilgrastim (Neulasta ® , Amgen Inc, Thousand Oaks, CA, USA) sourced from the European Union, and reference pegfilgrastim sourced from the USA. Primary PK end points were peak plasma concentration of pegfilgrastim ( C max ) and area under the plasma concentration–time curve from the time of dosing to infinity (AUC 0−inf ). Primary PD end points were area under the curve above baseline for absolute neutrophil counts (ANC AUC 0− t ) and maximum change from baseline for ANC (ANC C max ). Adverse events were also recorded. Results The primary PK and PD end points were similar across all groups. For the PK parameters, the 90% confidence intervals (CIs) of the ratios of geometric means ranged between 0.91 and 1.18, which were within the predefined bioequivalence interval of 0.8000 to 1.2500 for all comparisons. For the PD parameters, the 95% CIs of the ratios of geometric means ranged between 0.94 and 1.06 for all comparisons, which were within the predefined PD equivalence interval of 0.8500 to 1.1765. The safety profiles were similar, with the most common adverse events being back pain and headache. Conclusions MYL-1401H demonstrated similar PK, PD, and safety to reference pegfilgrastim in healthy volunteers and may be an equivalent option for the prevention of febrile neutropenia.

[...]next' boards offer a visual cue to silence the continually asked question, 'What's happening next?' What is important here is finding a way to manage the child's needs, while also being able to teach, support others and utilise yourself in the best way to the benefit of all. Tracey Lawrence...

Tracey Lawrence is assistant headteacher and specialist leader of education in social, emotional and mental health at Danemill Primary School in Leicester @behaviourteach References 1. Deliberate Practice and Performance in Music, Games, Sports, Education, and Professions, Psychological Science, 25: 8, bit.ly/DelibPrac 2. Challenges for the Estimation of an Upper-Bound on Relations between Accumulated Deliberate Practice and the Associated Performance of Novices and Experts (draft), bit.ly/EricssonComments 3.

[...]identify the outcome: what are you aiming to achieve by using this resource? [...]measure the impact that this has on the child's ability to self-regulate and share your findings.

Exercise is always a winner Not only does it promote teamwork and self-discipline but it also provides a much-needed opportunity to burn some energy. Tracey Lawrence is assistant headteacher and specialist leader of education in social, emotional and mental health at Danemill Primary School in Leicester Want to ask a...

There has been a rapid rise in referrals for gender dysphoria to the NHS, as well as more teachers reaching out for the right ways to support children as early as primary school. 1 Be understanding Understanding is your best means of support. Tracey Lawrence is assistant headteacher and specialist...

The more that this becomes a part of daily life, the more ingrained it will become and the more effect it will have on children's attitudes to learning. Tracey Lawrence is assistant headteacher and specialist leader of education in social, emotional and mental health at Danemill Primary School in Leicester...

Assign monitors to check the pens to make sure they all work and have lids. 3 Provide an activity At transition times, have an activity ready for the children to complete within a set time. In a lesson, be aware of the clock and ensure children have time to pack...