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McLornan DP, Hargreaves R, Hernández-Boluda JC, Harrison CN. How I manage myeloproliferative neoplasm-unclassifiable: Practical approaches for 2022 and beyond. Br J Haematol 2022; 197:407-416. [PMID: 35191542 DOI: 10.1111/bjh.18087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 12/15/2022]
Abstract
Myeloproliferative neoplasm (MPN)-unclassifiable (MPN-U) or not otherwise specified represents a rare, poorly defined and heterogeneous group of MPNs. Disease incidence is difficult to define but likely represents close to 5% of all MPNs when strict World Health Organisation (WHO) criteria are applied. Dynamic review over time is required to assess if the disease can be re-classified into another MPN entity. A diagnosis of MPN-U leads to many challenges for both the patient and physician alike including lack of agreed monitoring and therapeutic guidelines, validated prognostic markers and licenced therapies coupled with exclusion from clinical trials. MPN-U has an inherent risk of an aggressive clinical course and transformation in some but who, and when to treat in the chronic phase, including identifying who may require more aggressive therapy at an earlier stage, remains elusive. Moreover, despite the significant thrombotic risk, there is no agreement on systematic primary thromboprophylaxis. We hereby provide a contemporary overview of MPN-U in addition to four illustrative cases providing our collective suggested approaches to clinical challenges.
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Affiliation(s)
- Donal P McLornan
- Department of Haematology, 4th Floor Southwark Wing, Guy's and St. Thomas' NHS Foundation Trust, Great Maze Pond, London, UK.,Department of Haematology, University College London Hospitals, London, UK
| | - Rupen Hargreaves
- Department of Haematology, University College London Hospitals, London, UK
| | | | - Claire N Harrison
- Department of Haematology, 4th Floor Southwark Wing, Guy's and St. Thomas' NHS Foundation Trust, Great Maze Pond, London, UK
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Appel JM. Name Dropping: Toward a Uniform Best Practice on Historical Commemoration in Medicine. Camb Q Healthc Ethics 2022; 31:16-22. [PMID: 35049460 DOI: 10.1017/S0963180121000438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The removal of controversial names and monuments from the public sphere in the United States has gained traction in the context of efforts to achieve social justice for historically mistreated and marginalized communities. Such debates are increasingly raising issues in the healthcare setting as hospitals and medical schools grapple with the legacies of figures whose scientific contributions are clouded with ethical transgressions. Present efforts to address these challenges have largely occurred at the institutional level. The results have been guidelines that are complex, highly inconsistent across institutions, and largely downplay the symbolic importance of such historical redress. This paper proposes a simpler three-part test for name and monument removal in the medical and hospital settings that places greater weight on the symbolic importance of the renaming process itself instead of only considering the outcomes.
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53
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Houser SH, Flite CA, Foster SL, Hunt TJ, Morey A, Palmer MN, Peterson J, Pope RD, Sorensen L. Building Best Practices for Telehealth Record Documentation in the COVID-19 Pandemic. Perspect Health Inf Manag 2022; 19:1e. [PMID: 35440922 PMCID: PMC9013218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Telehealth services for patient visits have substantially surged during the COVID-19 pandemic. Thus, there is increased importance and demand for high-quality telehealth clinical documentation. However, little is known about how clinical data documentation is collected and the quality of data items included. This study aimed to identify the current state of and gaps in documentation and develop a best practice strategy for telehealth record documentation. Data were collected from January to February 2021 via a self-designed questionnaire for administrators and managers from physicians' offices and mental health facilities, resulting in 76 valid responses. Survey items included health organization demographic information, use of telehealth policies and procedures, and clinical documentation for telehealth patient visits. Findings from this study can be used to assist government, policymakers, and healthcare organizations in developing best practices in telehealth usage and clinical documentation improvement strategies.
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Zhang Y, Fung JF, Johnson KJ, Sattar S. Review of Seismic Risk Mitigation Policies in Earthquake-Prone Countries: Lessons for Earthquake Resilience in the United States. J Earthq Eng 2022; 26:10.1080/13632469.2021.1911889. [PMID: 36967727 PMCID: PMC10037557 DOI: 10.1080/13632469.2021.1911889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/29/2021] [Indexed: 06/18/2023]
Abstract
This article reviews the current state of practice in seismic risk mitigation, focusing on policies in ten of the most earthquake-prone countries around the world. In particular, the review compares policies to retrofit existing buildings and mechanisms for financing seismic risk mitigation, within the context of seismic risk and design standards for each country. The goal of the review is to identify policy best practices that may be useful for national and local governments that are interested in improving their earthquake resilience. The result is a set of best practice recommendations that are organized conceptually around key stages of the seismic retrofit process: (1) risk assessment; (2) knowledge transfer; (3) setting targets; (4) implementation; and (5) monitoring. While these lessons may be valuable to any earthquake-prone country, the recommendations are framed with particular attention to the United States where seismic risk mitigation is primarily the responsibility of local governments.
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Affiliation(s)
- Yating Zhang
- Applied Economics Office, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Juan F. Fung
- Applied Economics Office, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Katherine J. Johnson
- Earthquake Engineering Group, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Siamak Sattar
- Earthquake Engineering Group, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
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55
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Miller KC, McDermott BP, Yeargin SW, Fiol A, Schwellnus MP. An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps. J Athl Train 2022; 57:5-15. [PMID: 34185846 PMCID: PMC8775277 DOI: 10.4085/1062-6050-0696.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Exercise-associated muscle cramps (EAMCs) are common and frustrating for athletes and the physically active. We critically appraised the EAMC literature to provide evidence-based treatment and prevention recommendations. Although the pathophysiology of EAMCs appears controversial, recent evidence suggests that EAMCs are due to a confluence of unique intrinsic and extrinsic factors rather than a singular cause. The treatment of acute EAMCs continues to include self-applied or clinician-guided gentle static stretching until symptoms abate. Once the painful EAMCs are alleviated, the clinician can continue treatment on the sidelines by focusing on patient-specific risk factors that may have contributed to the onset of EAMCs. For EAMC prevention, clinicians should obtain a thorough medical history and then identify any unique risk factors. Individualizing EAMC prevention strategies will likely be more effective than generalized advice (eg, drink more fluids).
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Affiliation(s)
- Kevin C. Miller
- School of Rehabilitation and Medical Sciences, Central Michigan University, Mount Pleasant
| | - Brendon P. McDermott
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Susan W. Yeargin
- Exercise Science Department, University of South Carolina, Columbia
| | - Aidan Fiol
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Martin P. Schwellnus
- Institute for Sport, Exercise Medicine and Lifestyle Research, University of Pretoria, South Africa
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56
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Røsvik J, Michelet M, Engedal K, Bergh S, Bieber A, Gonçalves-Pereira M, Portolani DM, Hopper L, Irving K, Jelley H, Kerpershoek L, Meyer G, Marques MJ, Sjølund BM, Sköldunger A, Stephan A, Verhey F, de Vugt M, Woods B, Wolfs C, Zanetti O, Selbaek G. Development of best practice recommendations to enhance access to and use of formal community care services for people with dementia in Europe: a Delphi process conducted by the Actifcare project. Aging Ment Health 2021; 25:2298-2309. [PMID: 33030026 DOI: 10.1080/13607863.2020.1822286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Home-dwelling people with dementia and their informal carers experience barriers impeding access to community care services. This study is a part of the Actifcare project where eight countries participated. The aim was to achieve consensus on best practice recommendations for enhancing access to and use of formal community care services. METHOD A Delphi consensus process was conducted. A total of 48 professional experts, 14 people with dementia and 20 informal carers rated the importance of 72 statements on a 7-point Likert scale. Consensus was based on the median and level of dispersion. RESULTS Sixty-two statements reached consensus, resulting in three categories of recommendations. An appointed contact person was central in Recommendations to enhance access. Coordination and flexibility in setting and type of services were among the Recommendations to enhance use. Training of health care personnel and person-centred care were central Recommendations that can facilitate access or use indirectly. CONCLUSION The Actifcare Best Practice Recommendations suggest practical measures that can be taken by decision makers to enhance access and use of community care services, and thereby enhance quality of care and quality of life for home dwelling people with dementia and their informal carers.
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Affiliation(s)
- Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University, Halle-Wittenberg, Halle (Saale), Germany
| | - Manuel Gonçalves-Pereira
- Comprehensive Health Research Center/ CEDOC, Nova Medical School-Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Louise Hopper
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre Wales, Bangor University, Bangor, UK
| | - Liselot Kerpershoek
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University, Halle-Wittenberg, Halle (Saale), Germany
| | - Maria J Marques
- Comprehensive Health Research Center/ CEDOC, Nova Medical School-Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Britt-Marie Sjølund
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Anders Sköldunger
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University, Halle-Wittenberg, Halle (Saale), Germany
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, UK
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Yadav BK, Vu H, Fachiroh J, Tsuruyama T, Ng W, Furuta K. Preparation of the "Lexique" for ISBER Best Practices 4th Edition for Biobankers in Indo-Pacific Rim Region. Biopreserv Biobank 2021; 20:260-270. [PMID: 34756094 DOI: 10.1089/bio.2021.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Statement of the Problem: Several standards and guidelines for biobanks or biorepositories have been published by various parties (e.g., the International Society for Biological and Environmental Repositore [ISBER] and the International Organization for Standardization [ISO]). These documents are invaluable for improving the routine practices of the biobanks but the implementation has proven to be challenging for those biobanks from the non-English regions because these resources are mostly written in English. Proposed Solution: The World Health Organization (WHO) has recently published the International Classification of Diseases 11th Revision (ICD-11) along with a translation tool (lexique) for potential users. This has inspired us to make a similar contribution in the biobanking field. All the regional ambassadors (RAs) and director-at-large (DAL) in the Indo-Pacific Rim (IPR) region worked together to produce a similar lexique for potential users of ISBER's Best Practices (BPs) 4th edition. A lexique with languages of Hindi, Indonesian, Vietnamese, and Japanese has been prepared. Conclusions: This lexique is a comparison table between various languages and is expandable to other languages. In addition, this lexique will be a good tool for understanding the ISBER BPs 4th edition.
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Affiliation(s)
| | - Hanh Vu
- Clinical Laboratories, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Jajah Fachiroh
- Department of Histology and Cell Biology/Biobank Development Team, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tatsuaki Tsuruyama
- Kitano Medical Institute, Osaka, Japan.,Kyoto University Hospital, Kyoto, Japan
| | - Wayne Ng
- Victorian Cancer Biobank, Melbourne, Australia
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Simpson A, Ramagopalan SV. R WE ready for reimbursement? A round up of developments in real-world evidence relating to health technology assessment: part 4. J Comp Eff Res 2021; 11:11-12. [PMID: 34702048 DOI: 10.2217/cer-2021-0243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In this month's round up, we discuss a number of recent publications and guidelines addressing the use of real-world evidence to evaluate the clinical benefit of health technology assessments and what the publications mean practically for manufacturers.
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Affiliation(s)
- Alex Simpson
- Global Access, F Hoffmann-La Roche, Basel, 4070, Switzerland
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Jeyakumar T, Ambata-Villanueva S, McClure S, Henderson C, Wiljer D. Best Practices for the Implementation and Sustainment of Virtual Health Information System Training: Qualitative Study. JMIR Med Educ 2021; 7:e30613. [PMID: 34449402 PMCID: PMC8544731 DOI: 10.2196/30613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/05/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic has necessitated the adoption and implementation of digital technologies to help transform the educational ecosystem and the delivery of care. OBJECTIVE We sought to understand instructors' and learners' perceptions of the challenges and opportunities faced in implementing health information system virtual training amid the COVID-19 pandemic. METHODS Semistructured interviews were conducted with education specialists and health care staff who provided or had taken part in a virtual instructor-led training at a large Canadian academic health sciences center. Guided by the Technology Acceptance Model and the Community of Inquiry framework, we analyzed interview transcript themes deductively and inductively. RESULTS Of the 18 individuals participating in the study, 9 were education specialists, 5 were learners, 3 were program coordinators, and 1 was a senior manager at the Centre for Learning, Innovation, and Simulation. We found 3 predominant themes: adopting a learner-centered approach for a meaningful learning experience, embracing the advances in educational technologies to maximize the transfer of learning, and enhancing the virtual user experience. CONCLUSIONS This study adds to the literature on designing and implementing virtual training in health care organizations by highlighting the importance of recognizing learners' needs and maximizing the transfer of learning. Findings from this study can be used to help inform the design and development of training strategies to support learners across an organization during the current climate and to ensure changes are sustainable.
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Affiliation(s)
| | | | | | | | - David Wiljer
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- University of Toronto, Faculty of Medicine, Toronto, ON, Canada
- CAMH Education, Centre for Addictions and Mental Health, Toronto, ON, Canada
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Scarneo-Miller SE, Eason CM, Adams WM, Stearns RL, Casa DJ. State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within High Schools: An Update. Am J Sports Med 2021; 49:3372-3378. [PMID: 34398720 DOI: 10.1177/03635465211031849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Mandated sports safety policies that incorporate evidence-based best practices have been shown to mitigate the risk of mortality and morbidity in sports. In 2017, a review of the state-level implementation of health and safety policies within high schools was released. PURPOSE To provide an update on the assessment of the implementation of health and safety policies pertaining to the leading causes of death and catastrophic injuries in sports within high school athletics in the United States. STUDY DESIGN Cross-sectional study. METHODS A rubric composed of 5 equally weighted sections for sudden cardiac arrest, traumatic head injuries, exertional heatstroke, appropriate health care coverage, and emergency preparedness was utilized to assess an individual state's policies. State high school athletic/activities association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia between academic year (AY) 2016-2017 (AY16/17) and 2019-2020 (AY19/20). To meet the specific rubric criteria and be awarded credit, policies needed to be mandated by all SHSAA member schools. Weighted scores were tabulated to calculate an aggregate score with a minimum of 0 and a maximum of 100. RESULTS A total of 38 states had increased their rubric scores since AY16/17, with a mean increase of 5.57 ± 6.41 points. In AY19/20, scores ranged from 30.80 to 85.00 points compared with 23.00 to 78.75 points in AY16/17. Policies related to exertional heatstroke had the greatest change in scores (AY16/17 mean, 6.62 points; AY19/20 mean, 8.90 points; Δ = 2.28 points [11.40%]), followed by emergency preparedness (AY16/17 mean, 8.41 points; AY19/20 mean, 10.29 points; Δ = 1.88 points [9.40%]). CONCLUSION A longitudinal review of state high school sports safety policies showed progress since AY16/17. A wide range in scores indicates that continued advocacy for the development and implementation of policies at the high school level is warranted.
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Affiliation(s)
- Samantha E Scarneo-Miller
- Division of Athletic Training, School of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Christianne M Eason
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - William M Adams
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA.,Division of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
| | - Rebecca L Stearns
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
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61
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Yeung AWK, Wong NSM. The non-transparent usage and reporting of the Edinburgh Handedness Inventory in functional magnetic resonance imaging literature: a survey of studies published since 2013. Laterality 2021; 27:221-231. [PMID: 34583612 DOI: 10.1080/1357650x.2021.1984497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Subject handedness is an important parameter to be evaluated and accounted for in neuroscience studies dealing with laterality. The aim of this study was to survey for the details of how researchers administered the Edinburgh handedness inventory (EHI) to assess subject handedness. Web of Science and PubMed databases was searched on 3 August 2021 to identify functional magnetic resonance imaging (fMRI) articles published since 2013 using the EHI or citing Oldfield, the original paper that introduced the EHI. Articles not actually using the EHI and/or its variants were excluded. Two reviewers performed the screening independently and disagreements were solved by mutual consensus. Most of the 406 studies using the EHI did not report details regarding the number of items (94.1%), identity of items (96.1%), response format (97.0%), and cutoff score for right-handedness (87.2%). Items were found dropped or replaced, with response format and cutoff score changed without citing references that justified the modifications. A clearer reporting of the details of the EHI as an assessment tool for determining subject handedness should be encouraged.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China
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Flenady V, Gardener G, Ellwood D, Coory M, Weller M, Warrilow KA, Middleton PF, Wojcieszek AM, Groom KM, Boyle FM, East C, Lawford H, Callander E, Said JM, Walker SP, Mahomed K, Andrews C, Gordon A, Norman JE, Crowther C. My Baby's Movements: a stepped-wedge cluster-randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths. BJOG 2021; 129:29-41. [PMID: 34555257 DOI: 10.1111/1471-0528.16944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The My Baby's Movements (MBM) trial aimed to evaluate the impact on stillbirth rates of a multifaceted awareness package (the MBM intervention). DESIGN Stepped-wedge cluster-randomised controlled trial. SETTING Twenty-seven maternity hospitals in Australia and New Zealand. POPULATION Women with a singleton pregnancy without major fetal anomaly at ≥28 weeks of gestation from August 2016 to May 2019. METHODS The MBM intervention was implemented at randomly assigned time points, with the sequential introduction of eight groups of between three and five hospitals at 4-monthly intervals. Using generalised linear mixed models, the stillbirth rate was compared in the control and the intervention periods, adjusting for calendar time, study population characteristics and hospital effects. MAIN OUTCOME MEASURES Stillbirth at ≥28 weeks of gestation. RESULTS There were 304 850 births with 290 105 births meeting the inclusion criteria: 150 053 in the control and 140 052 in the intervention periods. The stillbirth rate was lower (although not statistically significantly so) during the intervention compared with the control period (2.2/1000 versus 2.4/1000 births; aOR 1.18, 95% CI 0.93-1.50; P = 0.18). The decrease in stillbirth rate was greater across calendar time: 2.7/1000 in the first versus 2.0/1000 in the last 18 months. No increase in secondary outcomes, including obstetric intervention or adverse neonatal outcome, was evident. CONCLUSIONS The MBM intervention did not reduce stillbirths beyond the downward trend over time. As a result of low uptake, the role of the intervention remains unclear, although the downward trend across time suggests some benefit in lowering the stillbirth rate. In this study setting, an awareness of the importance of fetal movements may have reached pregnant women and clinicians prior to the implementation of the intervention. TWEETABLE ABSTRACT The My Baby's Movements intervention to raise awareness of decreased fetal movement did not significantly reduce stillbirth rates.
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Affiliation(s)
- V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - G Gardener
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Department of Maternal Fetal Medicine, Mater Misericordiae Limited, Brisbane, Queensland, Australia
| | - D Ellwood
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - M Coory
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - M Weller
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K A Warrilow
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - P F Middleton
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - A M Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K M Groom
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - F M Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - C East
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Hls Lawford
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - E Callander
- Monash University, Melbourne, Victoria, Australia
| | - J M Said
- University of Melbourne, Melbourne, Victoria, Australia.,Sunshine Hospital, Western Health, St Albans, Victoria, Australia
| | - S P Walker
- University of Melbourne, Melbourne, Victoria, Australia
| | - K Mahomed
- Ipswich Hospital, Ipswich, Queensland, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - J E Norman
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - C Crowther
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Nguyen TH, Chambers CG, Dada M. Crowdsourcing anaesthesia care. Comment on Br J Anaesth 2016; 117: 276-279. Br J Anaesth 2021; 127:e176-e177. [PMID: 34419242 DOI: 10.1016/j.bja.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/25/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- The-Hung Nguyen
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, MD, USA.
| | | | - Maqbool Dada
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
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Abstract
Minimizing false positives is a critical issue when variant calling as no method is without error. It is common practice to post-process a variant-call file (VCF) using hard filter criteria intended to discriminate true-positive (TP) from false-positive (FP) calls. These are applied on the simple principle that certain characteristics are disproportionately represented among the set of FP calls and that a user-chosen threshold can maximize the number detected. To provide guidance on this issue, this study empirically characterized all false SNP and indel calls made using real Illumina sequencing data from six disparate species and 166 variant-calling pipelines (the combination of 14 read aligners with up to 13 different variant callers, plus four ‘all-in-one’ pipelines). We did not seek to optimize filter thresholds but instead to draw attention to those filters of greatest efficacy and the pipelines to which they may most usefully be applied. In this respect, this study acts as a coda to our previous benchmarking evaluation of bacterial variant callers, and provides general recommendations for effective practice. The results suggest that, of the pipelines analysed in this study, the most straightforward way of minimizing false positives would simply be to use Snippy. We also find that a disproportionate number of false calls, irrespective of the variant-calling pipeline, are located in the vicinity of indels, and highlight this as an issue for future development.
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Affiliation(s)
- Stephen J Bush
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Abstract
Objectives Supervised exercise programmes (SEPs) are a vital treatment for people with intermittent claudication, leading improvements in walking distance and quality of life and are recommended in multiple national and international guidelines. We aimed to evaluate the use and structure of SEPs in the United Kingdom (UK). Design We conducted an anonymous online survey using the Jisc platform comprising of 40 questions. The survey was designed to address key areas such as access, provision, uptake and delivery of SEPs in the United Kingdom. Ethical approval was obtained from Coventry University (P108729). Methods The list of trusts providing vascular services was obtained from the National Vascular Registry (NVR) report. The survey was disseminated via social media, The Vascular Society of Great Britain and Ireland and the Society for Vascular Technology. Data were exported to a Microsoft Excel document and analysed using simple descriptive statistics. Results Of 93 vascular units identified, we received response from 48. Of these, 23 had access to an exercise programme (48%). The majority of SEPs were exclusively for PAD patients (77%), with 21% using integrated services. 67% of respondents were providing a circuit-based programme, and 5 out of 23 were meeting the dose recommendations in the UK National Institute for Health and Care Excellence (NICE) guidelines. Respondents felt that programmes were moderately to extremely important to patients, slightly to very important to clinicians and not at all important to slightly important to commissioning/funding bodies. Conclusion SEPs are a well-established first-line treatment for patients with IC and they are recommended by NICE guidelines. Despite this, many patients still do not have access to an exercise programme, and clinicians do not feel that they have support from commissioning/funding bodies to develop them. There is an urgent need for funding, development and delivery of SEPs in the United Kingdom.
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Affiliation(s)
- Amy E Harwood
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, RinggoldID:120958Coventry University, Coventry, UK
| | - Sean Pymer
- Academic Vascular Surgical Unit, 12195Hull York Medical School, Hull, UK
| | - Said Ibeggazene
- College of Health, Wellbeing and Life Sciences, 7314Sheffield Hallam University, Sheffield, UK
| | - Lee Ingle
- Department of Sport, Health and Exercise Sciences, Faculty of Health Sciences, 4019University of Hull, Hull, UK
| | - Eddie Caldow
- School of Health and Society, 7046University of Salford, Salford, UK
| | - Stefan T Birkett
- School of Sport and Health Sciences, 6723University of Central Lancashire, Preston, UK
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Lorey K, Fegert JM. Increasing Mental Health Literacy in Law Enforcement to Improve Best Practices in Policing-Introduction of an Empirically Derived, Modular, Differentiated, and End-User Driven Training Design. Front Psychiatry 2021; 12:706587. [PMID: 34408683 PMCID: PMC8365022 DOI: 10.3389/fpsyt.2021.706587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: Law enforcement officers often have contact to persons who show symptoms of mental disorders. Adequately designed training is necessary for developing the best possible practices in policing when coming into contact with mentally ill people, and may help to expand their general knowledge on mental disorders. To achieve a sustainable implementation of training content in daily policing work, the acceptance and proactive integration of methods by the training participants is essential. Method: This study investigates an exemplary modular training curriculum based on a survey with 2,228 German police officers (28.2% female, 71.8% male) concerning their needs and challenges when coming into contact with persons with mental disorders. This empirical end-user driven approach was used to adapt existing training concepts to the current needs and interests of law enforcement personnel in order to maximize compliance. Results: The training program draft includes basic modules which are intended to be of direct interest to all police officers, such as mental disorders with high policing relevance, encountering suicidal patients, (non-directive) communication and de-escalation skills, and mental hygiene in policing. They are arranged in more specialized modules that address specific target group audiences within police forces and the training curriculum provides information about genuine risks and self-protection, trauma sensitivity, and interaction with children and victims among other contents. The self-selectable, modular, and empirically-based continued training program also includes an introduction to local mental health service professionals and networks, trialogue sequences, and situational role play scenarios. Conclusion: Due to frequent contact law enforcement officers have to mentally ill people, improved training designed to maximize knowledge and the integration of trained methods is necessary. Gaining acceptance and proactive support by trainees is ensured through end-user driven implementation of specialized and differentiated up-to-date training programs. Our results showcase how police officers' perspectives on persons with mental illnesses is a main aspect that can and should be used to encourage training course designs.
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Affiliation(s)
- Katharina Lorey
- Ministry of the Interior, Digitalisation and Local Government of Baden-Wuerttemberg, Stuttgart, Germany
- Child and Adolescent Psychiatry and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Jörg M. Fegert
- Child and Adolescent Psychiatry and Psychotherapy, Ulm University Medical Center, Ulm, Germany
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O'Connell J, Abbas M, Beecham S, Buckley J, Chochlov M, Fitzgerald B, Glynn L, Johnson K, Laffey J, McNicholas B, Nuseibeh B, O'Callaghan M, O'Keeffe I, Razzaq A, Rekanar K, Richardson I, Simpkin A, Storni C, Tsvyatkova D, Walsh J, Welsh T, O'Keeffe D. Best Practice Guidance for Digital Contact Tracing Apps: A Cross-disciplinary Review of the Literature. JMIR Mhealth Uhealth 2021; 9:e27753. [PMID: 34003764 PMCID: PMC8189288 DOI: 10.2196/27753] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/17/2021] [Accepted: 04/05/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Digital contact tracing apps have the potential to augment contact tracing systems and disrupt COVID-19 transmission by rapidly identifying secondary cases prior to the onset of infectiousness and linking them into a system of quarantine, testing, and health care worker case management. The international experience of digital contact tracing apps during the COVID-19 pandemic demonstrates how challenging their design and deployment are. OBJECTIVE This study aims to derive and summarize best practice guidance for the design of the ideal digital contact tracing app. METHODS A collaborative cross-disciplinary approach was used to derive best practice guidance for designing the ideal digital contact tracing app. A search of the indexed and gray literature was conducted to identify articles describing or evaluating digital contact tracing apps. MEDLINE was searched using a combination of free-text terms and Medical Subject Headings search terms. Gray literature sources searched were the World Health Organization Institutional Repository for Information Sharing, the European Centre for Disease Prevention and Control publications library, and Google, including the websites of many health protection authorities. Articles that were acceptable for inclusion in this evidence synthesis were peer-reviewed publications, cohort studies, randomized trials, modeling studies, technical reports, white papers, and media reports related to digital contact tracing. RESULTS Ethical, user experience, privacy and data protection, technical, clinical and societal, and evaluation considerations were identified from the literature. The ideal digital contact tracing app should be voluntary and should be equitably available and accessible. User engagement could be enhanced by small financial incentives, enabling users to tailor aspects of the app to their particular needs and integrating digital contact tracing apps into the wider public health information campaign. Adherence to the principles of good data protection and privacy by design is important to convince target populations to download and use digital contact tracing apps. Bluetooth Low Energy is recommended for a digital contact tracing app's contact event detection, but combining it with ultrasound technology may improve a digital contact tracing app's accuracy. A decentralized privacy-preserving protocol should be followed to enable digital contact tracing app users to exchange and record temporary contact numbers during contact events. The ideal digital contact tracing app should define and risk-stratify contact events according to proximity, duration of contact, and the infectiousness of the case at the time of contact. Evaluating digital contact tracing apps requires data to quantify app downloads, use among COVID-19 cases, successful contact alert generation, contact alert receivers, contact alert receivers that adhere to quarantine and testing recommendations, and the number of contact alert receivers who subsequently are tested positive for COVID-19. The outcomes of digital contact tracing apps' evaluations should be openly reported to allow for the wider public to review the evaluation of the app. CONCLUSIONS In conclusion, key considerations and best practice guidance for the design of the ideal digital contact tracing app were derived from the literature.
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Affiliation(s)
- James O'Connell
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Manzar Abbas
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Sarah Beecham
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Jim Buckley
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Muslim Chochlov
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Brian Fitzgerald
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Kevin Johnson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - John Laffey
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- University Hospital Galway, Saolta, Health Services Executive, Galway, Ireland
| | - Bairbre McNicholas
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- University Hospital Galway, Saolta, Health Services Executive, Galway, Ireland
| | - Bashar Nuseibeh
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
- School of Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | | | - Ian O'Keeffe
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Abdul Razzaq
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Kaavya Rekanar
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Ita Richardson
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Andrew Simpkin
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Cristiano Storni
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Damyanka Tsvyatkova
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Jane Walsh
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Thomas Welsh
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Derek O'Keeffe
- Lero, Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- University Hospital Galway, Saolta, Health Services Executive, Galway, Ireland
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Miller KC, Casa DJ, Adams WM, Hosokawa Y, Cates J, Emrich C, Fitzpatrick T, Hopper M, Jardine JF, LaBotz M, Lopez RM, O'Connor F, Smith MS. Roundtable on Preseason Heat Safety in Secondary School Athletics: Prehospital Care of Patients With Exertional Heat Stroke. J Athl Train 2021; 56:372-382. [PMID: 33290540 PMCID: PMC8063668 DOI: 10.4085/1062-6050-0173.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE First, we will update recommendations for the prehospital management and care of patients with exertional heat stroke (EHS) in the secondary school setting. Second, we provide action items to aid clinicians in developing best-practice documents and policies for EHS. Third, we supply practical strategies clinicians can use to implement best practice for EHS in the secondary school setting. DATA SOURCES An interdisciplinary working group of scientists, physicians, and athletic trainers evaluated the current literature regarding the prehospital care of EHS patients in secondary schools and developed this narrative review. When published research was nonexistent, expert opinion and experience guided the development of recommendations for implementing life-saving strategies. The group evaluated and further refined the action-oriented recommendations using the Delphi method. CONCLUSIONS Exertional heat stroke continues to be a leading cause of sudden death in young athletes and the physically active. This may be partly due to the numerous barriers and misconceptions about the best practice for diagnosing and treating patients with EHS. Exertional heat stroke is survivable if it is recognized early and appropriate measures are taken before patients are transported to hospitals for advanced medical care. Specifically, best practice for EHS evaluation and treatment includes early recognition of athletes with potential EHS, a rectal temperature measurement to confirm EHS, and cold-water immersion before transport to a hospital. With planning, communication, and persistence, clinicians can adopt these best-practice recommendations to aid in the recognition and treatment of patients with EHS in the secondary school setting.
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Affiliation(s)
- Kevin C. Miller
- School of Rehabilitation and Medical Sciences, Central Michigan University, Mount Pleasant
| | - Douglas J. Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | - William M. Adams
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | | | | | | | | | - John F. Jardine
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | | | - Rebecca M. Lopez
- Department of Orthopaedics and Sports Medicine, University of South Florida, Tampa
| | - Francis O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD
| | - M. Seth Smith
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville
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Blanchette V, Patry J, Brousseau-Foley M. Adequacy Between Canadian Clinical Guidelines and Recommendations Compared With International Guidelines for the Management of Diabetic Foot Ulcers. Can J Diabetes 2021; 45:761-767.e12. [PMID: 34052133 DOI: 10.1016/j.jcjd.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/21/2021] [Accepted: 03/19/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Although quality of care in the prevention and management of diabetic foot ulceration (DFU) has improved with the use of comprehensive evidence-based clinical practice guidelines, disparities between national and international guidelines have been demonstrated in one study conducted in Western Pacific regions. Although there are challenges of systematic implementation of evidence-based care in some clinical settings, their applications have demonstrated positive outcomes on DFU-associated burdens in many countries. The aim of this study was to review and evaluate 3 Canadian clinical practice guidelines and recommendations (CPGRs) in comparison with the 2019 International Working Group on the Diabetic Foot (IWGDF) guidelines. METHODS Extraction of all 85 recommendations from the IWGDF guidelines was performed and 3 independent investigators used a rating recommendations adequacy method with descriptive statistics. The Appraisal of Guidelines REsearch & Evaluation (AGREE) II instrument was used for quality appraisal and reliability scores were noted using intraclass correlation coefficients. RESULTS The Wounds Canada CPGR had the higher adequacy with the IWGDF guidelines. However, its development method was poor to fair. The Registered Nurses' Association of Ontario CPGR was superior for its development and implementation strategies, but major gaps were found in all chapters. The Diabetes Canada CPGR obtained a good quality appraisal evaluation, but was not dedicated exclusively to DFU and some important recommendations were absent. Reliability scores of AGREE II were good between investigators (p<0.0001). Some disparities were noted between Canadian and international recommendations. CONCLUSIONS Some disparities were noted, future orientations for development should include various health-care professionals involved in the team approach, patient-oriented research, recommendations published along with their level of evidence and strength of recommendations (such as with the Grading of Recommendations, Assessment, Development and Evaluations system) and implementation strategies to enhance evidence-based practice in Canada.
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Affiliation(s)
- Virginie Blanchette
- Department of Physical Activity Sciences and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Centre de recherche du Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada.
| | - Jérôme Patry
- Department of Physical Activity Sciences and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Centre de recherche du Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Faculty of Medicine, Family Medicine and Emergency Medicine Department, Université Laval, Québec, Canada
| | - Magali Brousseau-Foley
- Department of Physical Activity Sciences and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; Faculty of Medicine, Centre intégré universitaire de santé et de services sociaux de la Mauricie et du Centre-du-Québec affiliated with Université de Montréal, Trois-Rivières Family Medicine University Clinic, Trois-Rivières, Québec, Canada
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Lopez-Beltran A, López-Rios F, Montironi R, Wildsmith S, Eckstein M. Immune Checkpoint Inhibitors in Urothelial Carcinoma: Recommendations for Practical Approaches to PD-L1 and Other Potential Predictive Biomarker Testing. Cancers (Basel) 2021; 13:cancers13061424. [PMID: 33804698 PMCID: PMC8003923 DOI: 10.3390/cancers13061424] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 01/22/2023] Open
Abstract
Simple Summary The predominant histologic type of bladder cancer is urothelial carcinoma (UC). Programmed cell death-ligand 1 (PD-L1) expression levels in UC tumors help clinicians determine which patients are more likely to respond to immuno-oncology (IO) therapies; as such, the harmonization of PD-L1 testing in evaluating patients is increasingly important. A series of international workshops, involving renowned pathologists and oncologists, were held to develop best practice approaches to PD-L1 testing in UC. It was agreed that robust control of analytical standards is required to obtain quality PD-L1 results and that interpretation and reporting of PD-L1 require clear inter-clinician communication. Recommendations for the best practices for PD-L1 testing in UC are provided. A PD-L1 test request form for pathology laboratories was also developed and included here, encouraging communication between clinicians and pathologists, and ensuring fast and high-quality test results. Novel biomarkers being evaluated for immuno-oncology agents in UC are also briefly discussed. Abstract Immuno-oncology (IO) agents (anti–programmed cell death 1 (PD-1) and anti–programmed cell death-ligand 1 (PD-L1)) are approved as first- and second-line treatments for metastatic UC. PD-L1 expression levels in UC tumors help clinicians determine which patients are more likely to respond to IO therapies. Assays for approved IO agents use different antibodies, immunohistochemical protocols, cutoffs (defining “high” vs. “low” PD-L1 expression), and scoring algorithms. The robust control of pre-analytical and analytical standards is needed to obtain high-quality PD-L1 results. To better understand the status and perspectives of biomarker-guided patient selection for anti–PD-1 and anti–PD-L1 agents in UC, three workshops were held from December 2018 to December 2019 in Italy, Malaysia, and Spain. The primary goal was to develop recommendations for best practice approaches to PD-L1 testing in UC. Recommendations pertaining to the interpretation and reporting of the results of PD-L1 assays from experienced pathologists and oncologists from around the globe are included. A test request form for pathology laboratories was developed as a critical first step for oncologists/urologists to encourage communication between clinicians and pathologists, ensuring fast and high-quality test results. In this era of personalized medicine, we briefly discuss novel biomarkers being evaluated for IO agents in UC.
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Affiliation(s)
- Antonio Lopez-Beltran
- Department of Pathology and Surgery, Faculty of Medicine, Cordoba University, 14004 Cordoba, Spain
- Faculty of Medicine, Champalimaud Clinical Center, 1400-038 Lisbon, Portugal
- Correspondence: or
| | - Fernando López-Rios
- Pathology-Targeted Therapies Laboratory, HM Hospitales, 28050 Madrid, Spain;
| | - Rodolfo Montironi
- School of Medicine, Polytechnic University of the Marche Region (Ancona), 60126 Ancona, Italy;
| | | | - Markus Eckstein
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
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Scheibein F, Stowe MJ, Arya S, Morgan N, Shirasaka T, Grandinetti P, Saad NA, Ghosh A, Vadivel R, Ratta-apha W, Pant SB, Ransing R, Ramalho R, Bruschi A, Maiti T, HA AY, Delic M, Jain S, Peyron E, Siste K, Onoria J, Boujraf S, Dannatt L, Schellekens A, Calvey T. Responding to COVID-19: Emerging Practices in Addiction Medicine in 17 Countries. Front Psychiatry 2021; 12:634309. [PMID: 33796034 PMCID: PMC8009036 DOI: 10.3389/fpsyt.2021.634309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/15/2021] [Indexed: 01/23/2023] Open
Affiliation(s)
- Florian Scheibein
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - M. J. Stowe
- Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sidharth Arya
- State Drug Dependence Treatment Centre, Institute of Mental Health, Pt Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Nirvana Morgan
- University of the Witwatersrand, Johannesburg, South Africa
| | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Paolo Grandinetti
- Addiction Services (SerD), Department of Territorial Services, ASL Teramo, Teramo, Italy
| | - Noha Ahmed Saad
- Department of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Abhishek Ghosh
- Drug Deaddiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Sagun Ballav Pant
- Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, India
| | - Rodrigo Ramalho
- Department of Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Angelo Bruschi
- Department of Mental Health, ASL Viterbo, Viterbo, Italy
| | - Tanay Maiti
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Anne Yee HA
- Department of Psychological Medicine, University Malaya Centre of Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mirjana Delic
- Center for Treatment of Drug Addiction, University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Shobhit Jain
- Department of Psychiatry, Heritage Institute of Medical Sciences (HIMS), Varanasi, India
| | | | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia-Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Joy Onoria
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Saïd Boujraf
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University of Fez, Fes, Morocco
| | - Lisa Dannatt
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Tanya Calvey
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Raphael J, Winter R, Berry K. Adapting practice in mental healthcare settings during the COVID-19 pandemic and other contagions: systematic review. BJPsych Open 2021; 7:e62. [PMID: 33632372 PMCID: PMC8027557 DOI: 10.1192/bjo.2021.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND During the global COVID-19 pandemic, there has been guidance concerning adaptations that physical healthcare services can implement to aid containment, but there is relatively little guidance for how mental healthcare services should adapt service provision to better support staff and patients, and minimise contagion spread. AIMS This systematic review explores service adaptations in mental health services during the COVID-19 pandemic and other contagions. METHOD The Allied and Complementary Medicine database (AMED), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Medline, PsycINFO and Web of Science were systematically searched for published studies from database inception to April 2020. Data were extracted focusing on changes to mental health services during contagion outbreaks. Data were analysed with thematic analysis. RESULTS Nineteen papers were included: six correspondence/point-of-view papers, five research papers, five reflection papers, two healthcare guideline documents and one government document. Analysis highlighted four main areas for mental health services to consider during contagion outbreaks: infection control measures to minimise contagion spread, including procedural and practical solutions across different mental health settings; service delivery, including service changes, operational planning and continuity of care; staff well-being (psychological and practical support); and information and communication. CONCLUSIONS Mental health services need to consider infection control measures and implement service changes to support continuity of care, and patient and staff well-being. Services also need to ensure they are communicating important information in a clear and accessible manner with their staff and patients, regarding service delivery, contagion symptoms, government guidelines and well-being.
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Affiliation(s)
- Jessica Raphael
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, UK; and Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, University of Manchester, UK
| | - Rachel Winter
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, UK; and Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, University of Manchester, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, University of Manchester, UK
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Ciquier G, Azzi M, Hébert C, Watkins-Martin K, Drapeau M. Assessing the quality of seven clinical practice guidelines from four professional regulatory bodies in Quebec: What's the verdict? J Eval Clin Pract 2021; 27:25-33. [PMID: 32083781 DOI: 10.1111/jep.13374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Clinical practice guidelines (CPGs) have become a common feature in the health and social care fields, as they promote evidence-based practice and aim to improve quality of care and patient outcome. However, the benefits of the recommendations reported in CPGs are only as good as the quality of the CPGs themselves. Indeed, rigorous development and strategies for reporting are significant precursors to successful implementation of the recommendations that are proposed. Unfortunately, research has demonstrated that there is much variability in their level of quality. Furthermore, the quality of many CPGs has yet to be examined. The aim of the present study was to assess the quality of seven CPGs from four Quebec professional regulatory bodies pertaining to clinical evaluations in the fields of medicine, psychoeducation, psychotherapy, and social work. METHODS The seven Quebec CPGs were assessed by four trained appraisers using the Appraisal of Guidelines for Research and Evaluation II guideline evaluation tool. RESULTS Results suggest that while some quality criteria were met, most were not, denoting that these CPGs are of sub-optimal quality. CONCLUSION Our findings highlight that there is still a lot to be done in order to improve the rigour and transparency with which scientific evidence is assessed and applied when developing CPGs. Impacts regarding the implementation of these CPGs are discussed in light of their use in clinical practice.
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Affiliation(s)
- Gabrielle Ciquier
- Department of Counselling Psychology, McGill University, Montreal, Canada
| | - Michelle Azzi
- Department of Counselling Psychology, McGill University, Montreal, Canada
| | - Catherine Hébert
- Department of Counselling Psychology, McGill University, Montreal, Canada
| | - Kia Watkins-Martin
- Department of Counselling Psychology, McGill University, Montreal, Canada
| | - Martin Drapeau
- Department of Counselling Psychology, McGill University, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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74
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Shea KD, Towers V, Koon M, Silva G. Development of an Intentional Telehealth Viewing Guide for Home-Based Patient Assessment. Telemed Rep 2021; 2:32-38. [PMID: 35720747 PMCID: PMC9049814 DOI: 10.1089/tmr.2020.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 06/15/2023]
Abstract
BACKGROUND The increased use of telehealth to visit patients in their home permits greater access to care, and also increases the opportunity for whole-person assessments that improve individualized care. The videoconferencing camera is a proxy for home visit provider's eyes. However, cameras limit views, thereby reducing environmental cues. The Novice to Expert Theory of skill acquisition supports the use of an intentional viewing guide to assure a comprehensive patient assessment using telehealth in the home (CPATH). This study advances the development of a CPATH framework to guide providers to be intentional when using televideo technology. METHODS A quantitative content validity approach was used to determine the validity of a priori items within domains that were in the original protocol framework. A content validity determination requires 5-10 experts to rate agreement (range 1-5) on items within domains. Our sample was composed of seven expert home health providers. More than five experts had to agree to achieve statistical significance (p < 0.05) for validity. RESULTS Of the 15 items in the protocol, only 8 items had significant agreement for the sample size. These items were breathing, nonverbal gesturing, positioning, oxygen, safety, and types, dosages, and administration guidance of medication. Other items were added within the existing domains of Patient Characteristics, Treatment and Equipment Functioning, Medications and Environmental Quality, with the exception of Caregivers. CONCLUSION The domains triggered considerations for existing or additional items that require assessment, thereby developing the intentional guide framework that permits individualization of a telehealth home-based visit.
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Affiliation(s)
| | - Victoria Towers
- College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Melissa Koon
- Casa de la Luz Hospice and Palliative Care, Tucson, Arizona, USA
| | - Graciela Silva
- College of Nursing, University of Arizona, Tucson, Arizona, USA
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75
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Tyler N, Planner C, Byrne M, Blakeman T, Keers RN, Wright O, Pascall Jones P, Giles S, Keyworth C, Hodkinson A, Taylor CDJ, Armitage CJ, Campbell S, Panagioti M. Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method. Front Psychiatry 2021; 12:789418. [PMID: 34925112 PMCID: PMC8680088 DOI: 10.3389/fpsyt.2021.789418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Discharge from acute mental health inpatient units is often a vulnerable period for patients. Multiple professionals and agencies are involved and processes and procedures are not standardized, often resulting in communication delays and co-ordination failures. Early and appropriate discharge planning and standardization of procedures could make inpatient care safer. Aim: To inform the development of a multi-component best practice guidance for discharge planning (including the 6 component SAFER patient flow bundle) to support safer patient transition from mental health hospitals to the community. Methods: Using the RAND/UCLA Appropriateness method, a panel of 10 professional stakeholders (psychiatrists, psychiatric nurses, clinical psychologists, pharmacists, academics, and policy makers) rated evidence-based statements. Six hundred and sixty-eight statements corresponding to 10 potential components of discharge planning best practice were rated on a 9-point integer scale for clarity, appropriateness and feasibility (median ≥ 7-9) using an online questionnaire then remote online face-to-face meetings. Results: Five of the six "SAFER" patient flow bundle components were appropriate and feasible for inpatient mental health. One component, "Early Flow," was rated inappropriate as mental health settings require more flexibility. Overall, 285 statements were rated as appropriate and feasible. Forty-four statements were considered appropriate but not feasible to implement. Discussion: This consensus study has identified components of a best practice guidance/intervention for discharge planning for UK mental health settings. Although some components describe processes that already happen in everyday clinical interactions (i.e., review by a senior clinician), standardizing such processes could have important safety benefits alongside a tailored and timely approach to post-discharge care.
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Affiliation(s)
- Natasha Tyler
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,National Institute for Health Research, School for Primary Care Research, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Claire Planner
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Matthew Byrne
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Thomas Blakeman
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Richard N Keers
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Oliver Wright
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, United Kingdom
| | - Paul Pascall Jones
- Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, United Kingdom
| | - Sally Giles
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Chris Keyworth
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Alexander Hodkinson
- National Institute for Health Research, School for Primary Care Research, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Christopher D J Taylor
- Secondary Care Psychological Therapies Service, Pennine Care National Health Service (NHS) Foundation Trust, Bury, United Kingdom.,Division of Psychology and Mental Health, Manchester Academic Health Science Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Christopher J Armitage
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom.,University National Health Service (NHS) Foundation Trust Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,National Institute of Health Research (NIHR) Manchester Biomedical Research Council, Manchester, United Kingdom
| | - Stephen Campbell
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,National Institute for Health Research, School for Primary Care Research, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Maria Panagioti
- National Institute of Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,National Institute for Health Research, School for Primary Care Research, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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Stoeger H, Balestrini DP, Ziegler A. Key issues in professionalizing mentoring practices. Ann N Y Acad Sci 2020; 1483:5-18. [PMID: 33258118 DOI: 10.1111/nyas.14537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 01/03/2023]
Abstract
Mentoring has experienced a tremendous upswing over the past decades, which has only recently slowed down somewhat. One possible factor explaining mentoring's popularity are numerous case studies suggesting that it is one of the most effective ways of helping individuals to develop. Meta-analyses indicating effect sizes for mentoring that are below what would theoretically be possible appear to contradict the success stories, however. This circumstance raises questions about the professionalization of mentoring practices. We focus on seven key issues for future efforts at professionalizing mentoring. Key issues 1 and 2 address observation of the state of the art within formal mentoring when programs are planned and implemented: the consideration of recent research and of best practices. While both areas can overlap, they provide complementary sources of pertinent information for the professionalization of mentoring. Key issues 3-6 address the need to align mentoring activities to the specific context and goals of individual mentoring programs by observing idiographic program characteristics, mentoring dynamics, the orchestration of mentoring goals, and the provision of mentoring resources. Finally, key issue 7 highlights ongoing evaluation as the basis of the effective, continuous improvement of mentoring programs.
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Affiliation(s)
- Heidrun Stoeger
- Department of Educational Sciences, Universtiy of Regensburg, Regensburg, Germany
| | | | - Albert Ziegler
- Department of Educational Psychology, University of Erlangen-Nuremberg, Nuremberg, Germany
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77
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Lenihan D, Carver J, Porter C, Liu JE, Dent S, Thavendiranathan P, Mitchell JD, Nohria A, Fradley MG, Pusic I, Stockerl-Goldstein K, Blaes A, Lyon AR, Ganatra S, López-Fernández T, O’Quinn R, Minotti G, Szmit S, Cardinale D, Alvarez-Cardona J, Curigliano G, Neilan TG, Herrmann J. Cardio-oncology care in the era of the coronavirus disease 2019 (COVID-19) pandemic: An International Cardio-Oncology Society (ICOS) statement. CA Cancer J Clin 2020; 70:480-504. [PMID: 32910493 PMCID: PMC7934086 DOI: 10.3322/caac.21635] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has given rise to a pandemic of unprecedented proportions in the modern era because of its highly contagious nature and impact on human health and society: coronavirus disease 2019 (COVID-19). Patients with cardiovascular (CV) risk factors and established CV disease (CVD) are among those initially identified at the highest risk for serious complications, including death. Subsequent studies have pointed out that patients with cancer are also at high risk for a critical disease course. Therefore, the most vulnerable patients are seemingly those with both cancer and CVD, and a careful, unified approach in the evaluation and management of this patient population is especially needed in times of the COVID-19 pandemic. This review provides an overview of the unique implications of the viral outbreak for the field of cardio-oncology and outlines key modifications in the approach to this ever-increasing patient population. These modifications include a shift toward greater utilization of cardiac biomarkers and a more focused CV imaging approach in the broader context of modifications to typical practice pathways. The goal of this strategic adjustment is to minimize the risk of SARS-CoV-2 infection (or other future viral outbreaks) while not becoming negligent of CVD and its important impact on the overall outcomes of patients who are being treated for cancer.
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Affiliation(s)
- Daniel Lenihan
- Cardio-Oncology Center of Excellence, Washington University in St Louis, St Louis, Missouri
| | - Joseph Carver
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Charles Porter
- Cardiovascular Medicine, Cardio-Oncology Unit, University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer E. Liu
- Department of Medicine/Cardiology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan Dent
- Department of Medicine, Duke Cancer Institute, Duke University, Durham, North Carolina
| | - Paaladinesh Thavendiranathan
- Department of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, University Health Network, University of Toronto, Toronto, Ontario Canada
| | - Joshua D. Mitchell
- Cardio-Oncology Center of Excellence, Washington University in St Louis, St Louis, Missouri
| | - Anju Nohria
- Cardio-Oncology Program, Brigham and Women’s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Michael G. Fradley
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Iskra Pusic
- Division of Oncology, Washington University School of Medicine, St Louis, Missouri
| | | | - Anne Blaes
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Alexander R. Lyon
- Cardio-Oncology Service, Royal Brompton Hospital and Imperial College London, London, United Kingdom
| | - Sarju Ganatra
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Teresa López-Fernández
- Cardiac Imaging and Cardio-Oncology Unit, Division of Cardiology, La Paz University Hospital, La Paz Hospital Institute for Health Research, Network Research Center for Cardiovascular Diseases, Madrid, Spain
| | - Rupal O’Quinn
- Division of Cardiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Giorgio Minotti
- Department of Medicine, University Campus Bio-Medico, Rome, Italy
| | - Sebastian Szmit
- Department of Pulmonary Circulation, Thromboembolic Diseases, and Cardiology, Center of Postgraduate Medical Education, European Health Center, Otwock, Poland
| | - Daniela Cardinale
- Cardio-Oncology Unit, European Institute of Oncology, IRCCS, Milan Italy
| | - Jose Alvarez-Cardona
- Cardio-Oncology Center of Excellence, Washington University in St Louis, St Louis, Missouri
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Tomas G. Neilan
- Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joerg Herrmann
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
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Abstract
BACKGROUND Prevention strategies help to teach what individuals can do to potentially offset cancer risks. Screenings can detect cancer at earlier stages, allowing for earlier treatments and better outcomes. OBJECTIVES This article seeks to identify best practices in cancer prevention and screening. METHODS This article presents exemplars in oncology nursing that illustrate implementation of best practices for cancer prevention and screening. FINDINGS Oncology nurses are well situated to not only provide education about prevention activities, but also to encourage participation in recommended screenings. Implementation of evidence-based practice, along with the nurses' clinical knowledge and patient preferences, allows for the best outcomes for patients. The use of exemplars is an ideal way of telling nurses' stories to share their experiences and how they affected patient outcomes.
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Affiliation(s)
- Colleen O'Leary
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University in Columbus
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79
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Scarneo-Miller SE, Saltzman B, Adams WM, Casa DJ. Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools. ACTA ACUST UNITED AC 2020; 56:E488. [PMID: 32977447 DOI: 10.3390/medicina56100488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 12/20/2022]
Abstract
Background and objectives: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school policy adoption in the United States (US). Materials and Methods: Athletic trainers (ATs) from high schools across the US participated in an online survey (n = 365). This survey inquired about their compliance with nine components of an EHS policy which was then compared to their state requirements for the policies. Evaluation of the number of components adopted between states with a requirement versus states without a requirement was conducted with a Wilcoxon Sign Rank test. Finally, an ordinal logistic regression with proportional odds ratios (OR) with 95% confidence intervals (CI) were run to determine the effect of a state requirement and regional differences on the number of components adopted. Results: ATs working in states with a requirement reported adoption of more components in their heat modification policy compared to states that did not require schools to develop a heat modification policy (with requirement mean = 5.34 ± 3.68, median = 7.0; without requirement mean = 4.23 ± 3.59, median = 5.0; Z = -14.88, p < 0.001). ATs working in region 3 (e.g., hotter regions) reported adopting more components than those in region 1 (e.g., cooler regions) (OR = 2.25, 95% CI: 1.215-4.201, p = 0.010). Conclusions: Our results demonstrate a positive association between state policy requirements and subsequently increased local policy adoption for EHS policies. Additionally, the results demonstrate that regional differences exist, calling for the need for reducing disparities across the US. These findings may imply that policy adoption is a multifactorial process; furthermore, additional regional specific investigations must be conducted to determine the true determinants of high school policy adoption rates for EHS policies.
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80
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Miyokawa R, Kivler C, Louie S, Godor D, Tan L, Kenyon N. Self-Administered Mepolizumab in the Management of Severe Asthma: Usability and Patient Acceptance. Patient Prefer Adherence 2020; 14:1669-1682. [PMID: 33061310 PMCID: PMC7520541 DOI: 10.2147/ppa.s227465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/28/2020] [Indexed: 11/23/2022] Open
Abstract
The increasing use of advanced biologic therapies for patients with severe asthma is transforming the standard of care, clinic workflow, and the clinic business model. Expanded patient access to at-home injection treatment possibilities with some biologics has the potential to improve patient adherence and outcomes. Simultaneously, transition to the home setting can address the escalating costs that limit access for certain patients and healthcare facilities. Such moves come with recognized risks. Garnering input from physicians and other healthcare specialists as well as scrutinizing best practice position statements are vital to implementing truly patient-safe and cost-effective strategies in medicine. Mepolizumab is the first anti-IL-5 inhibitor to receive FDA approval in late 2015. We focus on this injectable medication and discuss the specific indications and contraindications for transitioning patients to at-home injection with mepolizumab. In doing so, we review our recent real-world experiences in the University of California, Davis and Loma Linda University severe asthma clinics, which can provide the foundation for building a comprehensive clinic and home-based biologics asthma program. In addition, we offer insight into the barriers to implementing a successful program and strategies for overcoming them.
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Affiliation(s)
- Reika Miyokawa
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California Davis, Sacramento, CA95817, USA
| | - Celeste Kivler
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California Davis, Sacramento, CA95817, USA
| | - Samuel Louie
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California Davis, Sacramento, CA95817, USA
| | - Dorottya Godor
- Northwick Park Hospital London North West University Healthcare NHS Trust Watford Road, LondonHA1 3UJ, UK
| | - Laren Tan
- Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, School of Medicine Loma Linda University, Loma Linda, CA92354, USA
| | - Nicholas Kenyon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California Davis, Sacramento, CA95817, USA
- VA Northern California Health Care System, Mather, CA95655, USA
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81
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Burke A, Jones A, Hughes R, Player E. From evidence to practice: Developing best practice guidelines for the delivery of activities to people living with moderate to advanced dementia using a pragmatic observational study. Dementia (London) 2020; 20:1604-1616. [PMID: 32893679 PMCID: PMC8216305 DOI: 10.1177/1471301220957805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The benefits of physical activities for those living with moderate to advanced dementia are well documented and include improved well-being and quality of life. What is less well known is how best to deliver such activities to make them meaningful for those taking part and, more generally, how to develop good practice guidance for working with this group. This article reports on an observational study of a physical activity programme in a residential care setting, Mobile Me, and on the process used to develop good practice guidance from it, which included input from a range of stakeholders. Learnings from this study conclude that changes in delivery and setting can contribute to a difference in the quality of the experience for participants and their levels of well-being during sessions. The findings from the study were consolidated into four themes for disseminating best practice: promoting the right atmosphere, environment, communication, and adaptations. These form part of a new multimedia best practice guide for delivering physical activities to those living with moderate to advanced dementia.
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Affiliation(s)
- Amanda Burke
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Andy Jones
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Ryan Hughes
- Active Norfolk, Easton Tennis Centre, Easton & Otley College, Norwich, UK
| | - Emily Player
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
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82
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Firnhaber GC, Roberson DW, Kolasa KM. Nursing staff participation in end-of-life nutrition and hydration decision-making in a nursing home: A qualitative study. J Adv Nurs 2020; 76:3059-3068. [PMID: 32820543 DOI: 10.1111/jan.14491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/04/2020] [Accepted: 06/19/2020] [Indexed: 01/25/2023]
Abstract
AIM To better understand the participation of nursing staff in end-of-life nutrition and hydration decision-making in an American nursing home. DESIGN A qualitative exploration with ethnographic focus. METHODS In April 2017, in-person, semi-structured interviews were performed with 19 nursing staff members in a nursing home located in the south-eastern United States. Additional information was gathered through participant observation during interviews and review of organizational and regulatory policies. Transcripts were coded and analysed using qualitative methods described by Roper and Shapira (2000). RESULTS Three primary themes relating to nursing staff participation in end-of-life nutrition and hydration decision-making were identified: (a) Formal decision-making: decisions made and implemented by persons with the authority to make legal and binding care decisions in the nursing home setting; (b) Informal decision-making: decisions not requiring medical orders; and (c) Influential factors: factors that influence actions of nursing staff. CONCLUSION A variety of factors have an impact on nursing staff participation in end-of-life nutrition and hydration decision-making. Participation is closely aligned with the type of decision, whether formal or informal, and role, whether Certified Nursing Assistant/Aide, Licensed Practical/Vocational Nurse, or Registered Nurse. IMPACT End-of-life nutrition and hydration decision-making in nursing homes differs from decision-making in other care settings and presents a challenge globally. Interventions that support the participation of nursing staff in end-of-life nutrition and hydration decision-making have the potential to positively impact the experiences of residents and family members faced with these issues in the nursing home setting.
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Affiliation(s)
- Gina C Firnhaber
- College of Nursing at East, Carolina University, Greenville, NC, USA
| | - Donna W Roberson
- College of Nursing at East, Carolina University, Greenville, NC, USA
| | - Kathryn M Kolasa
- Brody School of Medicine at East, Carolina University, Greenville, NC, USA
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Vignolo-González HA, Laha S, Jiménez-Solano A, Oshima T, Duppel V, Schützendübe P, Lotsch BV. Toward Standardized Photocatalytic Oxygen Evolution Rates Using RuO 2@TiO 2 as a Benchmark. Matter 2020; 3:464-486. [PMID: 32803152 PMCID: PMC7418450 DOI: 10.1016/j.matt.2020.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 05/29/2023]
Abstract
Quantitative comparison of photocatalytic performances across different photocatalysis setups is technically challenging. Here, we combine the concepts of relative and optimal photonic efficiencies to normalize activities with an internal benchmark material, RuO2 photodeposited on a P25-TiO2 photocatalyst, which was optimized for reproducibility of the oxygen evolution reaction (OER). Additionally, a general set of good practices was identified to ensure reliable quantification of photocatalytic OER, including photoreactor design, photocatalyst dispersion, and control of parasitic reactions caused by the sacrificial electron acceptor. Moreover, a method combining optical modeling and measurements was proposed to quantify the benchmark absorbed and scattered light (7.6% and 81.2%, respectively, of λ = 300-500 nm incident photons), rather than just incident light (≈AM 1.5G), to estimate its internal quantum efficiency (16%). We advocate the adoption of the instrumental and theoretical framework provided here to facilitate material standardization and comparison in the field of artificial photosynthesis.
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Affiliation(s)
- Hugo A. Vignolo-González
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
- Department of Chemistry, University of Munich (LMU), Butenandtstraße 5–13, 81377 München, Germany
| | - Sourav Laha
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - Alberto Jiménez-Solano
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - Takayoshi Oshima
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - Viola Duppel
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - Peter Schützendübe
- Max Planck Institute for Intelligent Systems, Heisenbergstraße 3, 70569 Stuttgart, Germany
| | - Bettina V. Lotsch
- Max Planck Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
- Department of Chemistry, University of Munich (LMU), Butenandtstraße 5–13, 81377 München, Germany
- Cluster of Excellence e-conversion, Lichtenbergstrasse 4a, 85748 Garching, Germany
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Nelissen I, Haase A, Anguissola S, Rocks L, Jacobs A, Willems H, Riebeling C, Luch A, Piret JP, Toussaint O, Trouiller B, Lacroix G, Gutleb AC, Contal S, Diabaté S, Weiss C, Lozano-Fernández T, González-Fernández Á, Dusinska M, Huk A, Stone V, Kanase N, Nocuń M, Stępnik M, Meschini S, Ammendolia MG, Lewinski N, Riediker M, Venturini M, Benetti F, Topinka J, Brzicova T, Milani S, Rädler J, Salvati A, Dawson KA. Improving Quality in Nanoparticle-Induced Cytotoxicity Testing by a Tiered Inter-Laboratory Comparison Study. Nanomaterials (Basel) 2020; 10:nano10081430. [PMID: 32707981 PMCID: PMC7466672 DOI: 10.3390/nano10081430] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/28/2022]
Abstract
The quality and relevance of nanosafety studies constitute major challenges to ensure their key role as a supporting tool in sustainable innovation, and subsequent competitive economic advantage. However, the number of apparently contradictory and inconclusive research results has increased in the past few years, indicating the need to introduce harmonized protocols and good practices in the nanosafety research community. Therefore, we aimed to evaluate if best-practice training and inter-laboratory comparison (ILC) of performance of the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay for the cytotoxicity assessment of nanomaterials among 15 European laboratories can improve quality in nanosafety testing. We used two well-described model nanoparticles, 40-nm carboxylated polystyrene (PS-COOH) and 50-nm amino-modified polystyrene (PS-NH2). We followed a tiered approach using well-developed standard operating procedures (SOPs) and sharing the same cells, serum and nanoparticles. We started with determination of the cell growth rate (tier 1), followed by a method transfer phase, in which all laboratories performed the first ILC on the MTS assay (tier 2). Based on the outcome of tier 2 and a survey of laboratory practices, specific training was organized, and the MTS assay SOP was refined. This led to largely improved intra- and inter-laboratory reproducibility in tier 3. In addition, we confirmed that PS-COOH and PS-NH2 are suitable negative and positive control nanoparticles, respectively, to evaluate impact of nanomaterials on cell viability using the MTS assay. Overall, we have demonstrated that the tiered process followed here, with the use of SOPs and representative control nanomaterials, is necessary and makes it possible to achieve good inter-laboratory reproducibility, and therefore high-quality nanotoxicological data.
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Affiliation(s)
- Inge Nelissen
- Health Department, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (A.J.); (H.W.)
- Correspondence: ; Tel.: +32-14-335107
| | - Andrea Haase
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany; (A.H.); (C.R.); (A.L.)
| | - Sergio Anguissola
- Centre for BioNano Interactions, University College Dublin (UCD), Belfield, Dublin 4, Ireland; (S.A.); (L.R.); (A.S.); (K.A.D.)
- Charles River Laboratories, Carrowntreila, Ballina, Co. Mayo, Ireland
| | - Louise Rocks
- Centre for BioNano Interactions, University College Dublin (UCD), Belfield, Dublin 4, Ireland; (S.A.); (L.R.); (A.S.); (K.A.D.)
- Science Foundation Ireland, Three Park Place, Hatch Street Upper, Dublin 2, Ireland
| | - An Jacobs
- Health Department, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (A.J.); (H.W.)
| | - Hanny Willems
- Health Department, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (A.J.); (H.W.)
| | - Christian Riebeling
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany; (A.H.); (C.R.); (A.L.)
| | - Andreas Luch
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany; (A.H.); (C.R.); (A.L.)
| | - Jean-Pascal Piret
- Research Unit in Cellular Biology (URBC), Namur Nanosafety Center (NNC), Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), rue de Bruxelles 61, 5000 Namur, Belgium;
| | - Olivier Toussaint
- Research Unit in Cellular Biology (URBC), Namur Nanosafety Center (NNC), Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), rue de Bruxelles 61, 5000 Namur, Belgium;
| | - Bénédicte Trouiller
- Experimental Toxicology Unit, Institut National de l’Environnement Industriel et des Risques (INERIS), Parc Alata, BP2, 60550 Verneuil-en-Halatte, France; (B.T.); (G.L.)
| | - Ghislaine Lacroix
- Experimental Toxicology Unit, Institut National de l’Environnement Industriel et des Risques (INERIS), Parc Alata, BP2, 60550 Verneuil-en-Halatte, France; (B.T.); (G.L.)
| | - Arno C. Gutleb
- Environmental Research and Innovation (ERIN) Department, Luxembourg Institute of Science and Technology (LIST), 41, rue du Brill, L-4422 Belvaux, Luxembourg; (A.C.G.); (S.C.)
| | - Servane Contal
- Environmental Research and Innovation (ERIN) Department, Luxembourg Institute of Science and Technology (LIST), 41, rue du Brill, L-4422 Belvaux, Luxembourg; (A.C.G.); (S.C.)
| | - Silvia Diabaté
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany; (S.D.); (C.W.)
| | - Carsten Weiss
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany; (S.D.); (C.W.)
| | - Tamara Lozano-Fernández
- Biomedical Research Center (CINBIO), University of Vigo, Campus Lagoas Marcosende, 36310 Vigo, Spain; (T.L.-F.); (Ã.G.-F.)
- Nanoimmunotech SL, Edificio CITEXVI Fonte das Abelleiras s/n, Campus Universitario de Vigo, 36310 Vigo, Pontevedra, Spain
| | - África González-Fernández
- Biomedical Research Center (CINBIO), University of Vigo, Campus Lagoas Marcosende, 36310 Vigo, Spain; (T.L.-F.); (Ã.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IISGS), Hospital Álvaro Cunqueiro, Estrada Clara Campoamor 341, Babio – Beade, 36312 Vigo, Spain
| | - Maria Dusinska
- Health Effects Laboratory, Department of Environmental Chemistry, Norwegian Institute for Air Research (NILU), Instituttveien 18, 2007 Kjeller, Norway; (M.D.); (A.H.)
| | - Anna Huk
- Health Effects Laboratory, Department of Environmental Chemistry, Norwegian Institute for Air Research (NILU), Instituttveien 18, 2007 Kjeller, Norway; (M.D.); (A.H.)
- Gentian Diagnostics AS, Bjørnåsveien 5, 1596 Moss, Norway
| | - Vicki Stone
- School of Life Sciences, Heriot-Watt University (HWU), Riccarton Campus, Edinburgh EH14 4AS, UK; (V.S.); (N.K.)
| | - Nilesh Kanase
- School of Life Sciences, Heriot-Watt University (HWU), Riccarton Campus, Edinburgh EH14 4AS, UK; (V.S.); (N.K.)
| | - Marek Nocuń
- Department of Toxicology and Carcinogenesis, Nofer Institute of Occupational Medicine (NIOM), 91-348 Łódź, Poland; (M.N.); (M.S.)
- SEQme s.r.o., Dlouha 176, 26301 Dobris, Czech Republic
| | - Maciej Stępnik
- Department of Toxicology and Carcinogenesis, Nofer Institute of Occupational Medicine (NIOM), 91-348 Łódź, Poland; (M.N.); (M.S.)
| | - Stefania Meschini
- National Center for Drug Research and Evaluation and National Center of Innovative Technologies for Public Health, Istituto Superiore di Sanità (ISS), Viale Regina Elena, 299 Rome, Italy; (S.M.); (M.G.A.)
| | - Maria Grazia Ammendolia
- National Center for Drug Research and Evaluation and National Center of Innovative Technologies for Public Health, Istituto Superiore di Sanità (ISS), Viale Regina Elena, 299 Rome, Italy; (S.M.); (M.G.A.)
| | - Nastassja Lewinski
- Institute for Work and Health (IST), University of Lausanne and University of Geneva, Route de la Corniche 2, 1066 Epalinges-Lausanne, Switzerland; (N.L.); (M.R.)
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Michael Riediker
- Institute for Work and Health (IST), University of Lausanne and University of Geneva, Route de la Corniche 2, 1066 Epalinges-Lausanne, Switzerland; (N.L.); (M.R.)
- Swiss Centre for Occupational and Environmental Health (SCOEH), Binzhofstrasse 87, 8404 Winterthur, Switzerland
- School of Materials Science & Engineering, Nanyang Technological University, Block N4.1, Nanyang Avenue, Singapore 639798, Singapore
| | - Marco Venturini
- ECAMRICERT SRL, European Center for the Sustainable Impact of Nanotechnology (ECSIN), Corso Stati Uniti 4, 35127 Padova, Italy; (M.V.); (F.B.)
| | - Federico Benetti
- ECAMRICERT SRL, European Center for the Sustainable Impact of Nanotechnology (ECSIN), Corso Stati Uniti 4, 35127 Padova, Italy; (M.V.); (F.B.)
| | - Jan Topinka
- Institute of Experimental Medicine (IEM), Czech Academy of Sciences, Videnska 1083, 14220 Prague 4, Czech Republic; (J.T.); (T.B.)
| | - Tana Brzicova
- Institute of Experimental Medicine (IEM), Czech Academy of Sciences, Videnska 1083, 14220 Prague 4, Czech Republic; (J.T.); (T.B.)
- Faculty of Safety Engineering, VSB-Technical University of Ostrava, Lumirova 13, 70030 Ostrava-Vyskovice, Czech Republic
| | - Silvia Milani
- Faculty of Physics and Center for NanoScience, Ludwig-Maximilians-Universität, Geshwister-Scholl-Platz 1, 80539 Munich, Germany; (S.M.); (J.R.)
| | - Joachim Rädler
- Faculty of Physics and Center for NanoScience, Ludwig-Maximilians-Universität, Geshwister-Scholl-Platz 1, 80539 Munich, Germany; (S.M.); (J.R.)
| | - Anna Salvati
- Centre for BioNano Interactions, University College Dublin (UCD), Belfield, Dublin 4, Ireland; (S.A.); (L.R.); (A.S.); (K.A.D.)
- Groningen Research Institute of Pharmacy, University of Groningen, A. Deusinglaan 1, 9713AV Groningen, The Netherlands
| | - Kenneth A. Dawson
- Centre for BioNano Interactions, University College Dublin (UCD), Belfield, Dublin 4, Ireland; (S.A.); (L.R.); (A.S.); (K.A.D.)
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85
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Gabbianelli R, Bordoni L, Morano S, Calleja-Agius J, Lalor JG. Nutri-Epigenetics and Gut Microbiota: How Birth Care, Bonding and Breastfeeding Can Influence and Be Influenced? Int J Mol Sci 2020; 21:E5032. [PMID: 32708742 DOI: 10.3390/ijms21145032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/12/2022] Open
Abstract
Maternal lifestyle is an important factor in the programming of an infant's epigenome, in particular when considered alongside the mode of birth and choice of feeding method (i.e., breastfeeding or formula feeding). Beginning in utero, and during the first two years of an infant's life, cells acquire an epigenetic memory of the neonatal exposome which can be influential across the entire lifespan. Parental lifestyle (e.g., malnutrition, alcohol intake, smoke, stress, exposure to xenobiotics and/or drugs) can modify both the maternal and paternal epigenome, leading to epigenetic inheritance in their offspring. This review aims to outline the origin of early life modulation of the epigenome, and to share this fundamental concept with all the health care professionals involved in the development and provision of care during childbirth in order to inform future parents and clinicians of the importance of the this process and the key role it plays in the programming of a child's health.
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86
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Nakayama T, Fujisawa F. Therapy options after CDK4/6 inhibitors for HR+, HER2- postmenopausal metastatic/recurrent breast cancer in Japan: a role for mammalian target of rapamycin inhibitors? Future Oncol 2020; 16:1851-1862. [PMID: 32614252 DOI: 10.2217/fon-2020-0326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Despite advances in the treatment of hormone receptor-positive, HER2- metastatic breast cancer, the disease is rarely curable. In this review, we focus on the use of CDK4/6 inhibitors, examining clinical experience and the mechanisms underlying the development of resistance, and evaluating treatment options after failure to respond to CDK4/6 inhibitors. Current basic research supports the use of mammalian target of rapamycin inhibitors after CDK4/6 inhibitor failure; however, more data are needed, particularly regarding treatment sequencing. Real-world data studies may help to fill the current knowledge gap, particularly where large-scale randomized controlled studies are not feasible.
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Affiliation(s)
- Takahiro Nakayama
- Breast & Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Fumie Fujisawa
- Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
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87
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Abstract
When analyzing data, researchers may have multiple reasonable options for the many decisions they must make about the data-for example, how to code a variable or which participants to exclude. Therefore, there exists a multiverse of possible data sets. A classic multiverse analysis involves performing a given analysis on every potential data set in this multiverse to examine how each data decision affects the results. However, a limitation of the multiverse analysis is that it addresses only data cleaning and analytic decisions, yet researcher decisions that affect results also happen at the data-collection stage. I propose an adaptation of the multiverse method in which the multiverse of data sets is composed of real data sets from studies varying in data-collection methods of interest. I walk through an example analysis applying the approach to 19 studies on shooting decisions to demonstrate the usefulness of this approach and conclude with a further discussion of the limitations and applications of this method.
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88
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Isles M. Patient safety issues associated with the use of compounded medicines as alternatives to approved pharmaceutical products in Europe and how best practice can improve outcomes. Int J Risk Saf Med 2020; 31:133-144. [PMID: 32538874 DOI: 10.3233/jrs-200002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Pharmaceutical compounding allows individuals with special requirements access to medicines. Compounding can also be used to provide cheaper alternatives to commercially produced medicines which may be less strictly regulated than those commercially produced as they do not require marketing authorisation. OBJECTIVE This review describes the issues and potential risks associated with compounded medicines and equally importantly identifies best practices. METHODS To establish reports about lack of effectiveness, adverse events and medication errors occurring with compounded pharmaceuticals, a literature search was conducted of PubMed, Embase and MEDLINE databases for relevant cases in European countries which were published between 2003 and 2018. Case reports/series that described instances of successful use of compounded medicines over the same period were also identified. RESULTS Overall, 12 case reports/case series describing problems associated with compounded medicines in Europe have been identified. Sources of patient risk associated with compounded medicines include lack of quality, safety and efficacy data, preparation and labelling errors, and improper storage and handling practices. CONCLUSIONS Several case reports/series describing instances of overdose, medication errors and adverse events associated with compounded medications were reviewed. The number of affected patients was relatively small, but many were children and two adult patients experienced permanent sequelae. The number of incidents associated with compounded medicines is unknown, and so these numbers should be interpreted with caution. When licensed medicines are available, the use of compounded medicines can put patients at unnecessary risk which should be avoided. Stricter regulation is necessary to prevent similar cases from occurring in the future as the European market for compounded medications grows. Pharmacists can promote best practices in compounding through professional organisations. Future recommended actions are: 1. Stricter regulation is necessary to prevent similar cases from occurring in the future as the European market for compounded medications grows. 2. A comprehensive pan-European survey to gain a greater understanding of compounding procedures and techniques. This would provide valuable information to the benefit of hospital systems and their patients. 3. The results of the survey can then be used to improve the knowledge and quality control of compounded medicines for the good of patient safety.
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Affiliation(s)
- Mike Isles
- The European Alliance for Access to Safe Medicines, 20 Madeira Park, Tunbridge Wells, Kent, UK
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89
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Maugeri G, Musumeci G. Research and Publication Ethics in Journal of Functional Morphology and Kinesiology. J Funct Morphol Kinesiol 2020; 5. [PMID: 33467258 DOI: 10.3390/jfmk5020042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/16/2022] Open
Abstract
Research is required to minimize uncertainty and to be reproducible, that is, the design, implementation, evaluation, interpretation, and reporting of the presented data, must follow a good practice. An appropriate experimental design, an accurate execution of the study, a strict criticism of the obtained data while avoiding overestimation, as well as a suitable interpretation of main outcomes, represent key aspects in reporting and disseminating research to the scientific community. Furthermore, author contribution, responsibility, funding, acknowledgement, and adequately declaring any conflict of interest play important roles in science. The Journal of Functional Morphology and Kinesiology (JFMK), a member of the Committee on Publication Ethics (COPE), is committed to the highest scientific and ethical standards and encourages all authors to take into account and to comply, as much as possible, with the contents and issues reported in this technical note. This could be useful to improve the quality of the manuscripts and avoid misconduct, as well as to stimulate interest and debate, reflecting upon uses and misuses within our disciplines belonging to the medicine area (sports medicine and movement sciences) categories: anatomy, histology, orthopedics and sports medicine, rheumatology, sports sciences, physical therapy, sports therapy, and rehabilitation.
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90
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Liu S, Wang WC, Zhang H, Tong J, Zhang X, Chen P, Hu C. Best Practices for Human Biobank Ethics Review in China. Biopreserv Biobank 2020; 18:274-282. [PMID: 32429687 DOI: 10.1089/bio.2019.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The ethical practices for human biobanks in China are intended to safeguard the interests of all the participants, to standardize the construction, management, and resource sharing of human biobanks, to promote the development of medical research, and to improve public health and well-being. The practices contain several chapters: General Principles; Ethics Review; Informed Consent; Privacy Protection; Benefits of Sharing; and Conflict of Interest.
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Affiliation(s)
- Shijian Liu
- Department of Biobank, Clinical Research Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiye Charles Wang
- MOE-Shanghai Key Lab of Children's Environmental Health Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongxia Zhang
- Shanghai Ethics Committee for Clinical Research, Shanghai Clinical Research Center, Shanghai, China
| | | | - Xiaoyi Zhang
- Shanghai Ethics Committee for Clinical Research, Shanghai Clinical Research Center, Shanghai, China
| | - Pei Chen
- Shanghai Ethics Committee for Clinical Research, Shanghai Clinical Research Center, Shanghai, China
| | - Chingli Hu
- Shanghai Ethics Committee for Clinical Research, Shanghai Clinical Research Center, Shanghai, China
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91
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Ferry SL, Cook KR. Local Anesthetic Systemic Toxicity (LAST): Increasing Awareness Through Education. J Perianesth Nurs 2020; 35:365-367. [PMID: 32334931 DOI: 10.1016/j.jopan.2020.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Local anesthetics are used for procedures in various settings. Although complications related to local anesthetic use is rare, adverse events do occur. A significant knowledge deficit was identified regarding local anesthetic systemic toxicity (LAST) signs, symptoms, and treatment. DESIGN A learning needs assessment was performed at a local hospital to determine the nurses' baseline knowledge of LAST signs, symptoms, and treatment. METHODS A self-paced web-based learning module was developed and completed by clinical nurses with an immediate post survey and 6-month follow-up survey. FINDINGS The repeat learning needs assessment immediately after education resulted in more than 50% improvement in nurses' knowledge of LAST. A 6-month follow-up survey indicated that the gain in knowledge, signs, symptoms, and treatment of LAST was maintained. CONCLUSIONS An educational gap was identified regarding clinical nurses' knowledge of LAST. An educational program was designed to improve baseline knowledge. The program goal was successfully met with more than half of nurses being able to identify signs, symptoms, and treatment of LAST.
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Affiliation(s)
- Sherri L Ferry
- Institute of Learning, Leadership and Development (iLEAD), ChristianaCare, Newark, DE.
| | - Kay R Cook
- Institute of Learning, Leadership and Development (iLEAD), ChristianaCare, Newark, DE
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92
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Holst JE, Bargen GA, Holmes CE. Providing the Best Audiological Care and Creating Sustainability in Peru. Semin Hear 2020; 41:110-123. [PMID: 32269415 DOI: 10.1055/s-0040-1708508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
International humanitarian programs are one way for individuals within low-income countries to access hearing health care. Faculty and students from the Idaho State University (ISU) Audiology Program have traveled to several locations within less developed countries over the past 15 years. Most recently, the ISU Audiology Program has partnered with Idaho Condor Humanitarian to provide hearing health care services to Peruvian indigenous people. The humanitarian expedition provides medical, dental, and audiology services to rural villages surrounding Cusco, Peru. Each year the ISU Audiology team gathers data on the hearing health care needs of the Peruvian people and fits donated hearing aids. The ISU Audiology team navigates a variety of barriers associated with limited resources to provide quality hearing health care focused on best practice guidelines for the people of Peru. This article highlights the specific needs of the people served, which the team identified and prioritized, as well as initiated a plan for continuing to develop follow-up care and sustainability.
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Affiliation(s)
- Jennifer E Holst
- Department of Communication Sciences and Disorders, Idaho State University, Pocatello, Idaho
| | - Gabriel A Bargen
- Department of Communication Sciences and Disorders, Idaho State University, Meridian, Idaho
| | - Corrie E Holmes
- Department of Communication Sciences and Disorders, Idaho State University, Pocatello, Idaho
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93
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Myles EM, O'Leary ME, Romkey ID, Piano A, de Carvalho V, Tompkins TA, Perrot TS. Guidelines for best practice in placebo-controlled experimental studies on probiotics in rodent animal models. Benef Microbes 2020; 11:245-254. [PMID: 32216469 DOI: 10.3920/bm2019.0144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the absence of established best practice standards in the probiotic field for reducing the risk of bacterial transfer between experimental groups, we developed protocols and methods to ensure the highest quality and interpretability of results from animal studies, even when performed in non-conventional animal care facilities. We describe easily implementable methods for reducing cross-contamination during animal housing, behavioural testing, and euthanasia, along with highlighting protocols for contamination detection in experimental subjects and laboratory areas using qPCR. In light of the high cross-contamination risks between animals during experiments involving probiotics, constant vigilance in animal care and research protocols is critical to ensure valid and reliable research findings.
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Affiliation(s)
- E M Myles
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St., Halifax NS, B3M 4R2, Canada
| | - M E O'Leary
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St., Halifax NS, B3M 4R2, Canada
| | - I D Romkey
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St., Halifax NS, B3M 4R2, Canada
| | - A Piano
- Rosell® Institute for Microbiome and Probiotics, 6100 Ave. Royalmount, Montreal, QC, H4P 2R2, Canada
| | - V de Carvalho
- Rosell® Institute for Microbiome and Probiotics, 6100 Ave. Royalmount, Montreal, QC, H4P 2R2, Canada
| | - T A Tompkins
- Rosell® Institute for Microbiome and Probiotics, 6100 Ave. Royalmount, Montreal, QC, H4P 2R2, Canada
| | - T S Perrot
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St., Halifax NS, B3M 4R2, Canada
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Van Gestel D, Dragan T, Grégoire V, Evans M, Budach V. Radiotherapy Quality Assurance for Head and Neck Squamous Cell Carcinoma. Front Oncol 2020; 10:282. [PMID: 32226773 PMCID: PMC7081058 DOI: 10.3389/fonc.2020.00282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/18/2020] [Indexed: 12/03/2022] Open
Abstract
The impact of radiotherapy (RT) quality assurance (QA) has been demonstrated by numerous studies and is particularly important for head and neck cancer (HNC) treatment due to the complexity of RT target volumes in this region and the multiple adjacent organs at risk. The RT planning process includes many critical steps including interpretation of diagnostic imaging, image fusion, target volume delineation (tumor, lymph nodes, and organs at risk), and planning. Each step has become highly complex, and precise and rigorous QA throughout the planning process is essential. The ultimate aim is to precisely deliver radiation dose to the target, maximizing the tumor dose and minimizing the dose to surrounding organs at risk, in order to improve the therapeutic index. It is imperative that RT QA programs should systematically control all aspects of the RT planning pathway and include regular end-to-end tests and external audits. However, comprehensive QA should not be limited to RT and should, where possible, also be implemented for surgery, systemic therapy, pathology, as well as other aspects involved in the interdisciplinary treatment of HNC.
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Affiliation(s)
- Dirk Van Gestel
- Department of Radiation Oncology Head and Neck Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Tatiana Dragan
- Department of Radiation Oncology Head and Neck Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Vincent Grégoire
- Radiation Oncology Departement, Léon Bérard Cancer Center, Lyon, France
| | - Mererid Evans
- Department of Clinical Oncology, Velindre University NHS Trust, Cardiff, United Kingdom
| | - Volker Budach
- Departments of Radiation Oncology, Charité University Medicine Berlin, Berlin, Germany
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Simon C, Nicolai P, Paderno A, Dietz A. Best Practice in Surgical Treatment of Malignant Head and Neck Tumors. Front Oncol 2020; 10:140. [PMID: 32117778 PMCID: PMC7028740 DOI: 10.3389/fonc.2020.00140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/27/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose of review: Defining the best practice of surgical care for patients affected by malignant head and neck tumors is of great importance. In this review we aim to describe the evolution of “best practice” guidelines in the context of quality-of-care measures and discuss current evidence on “best practice” for the surgical treatment of cancers of the sino-nasal tract, skull base, aero-digestive tract, and the neck. Recent findings: Current evidence based on certain structure and outcome indicators, but mostly based on process indicators already helps defining the framework of “Best practice” for head and neck cancer surgery. However, many aspects of surgical treatment still require in-depth research. Summary: While a framework of “Best practice” strategies already exists for the conduction of the surgical treatment of head and neck cancers, many questions still require additional research in particular in case of rare histologies in the head and neck region.
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Affiliation(s)
- Christian Simon
- Service d'Oto-rhino-laryngologie - Chirurgie cervico-faciale, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne (UNIL), Lausanne, Switzerland
| | - Piero Nicolai
- Department of Otolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Alberto Paderno
- Department of Otolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
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96
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Singer RA, Ellis S, Page LM. Awareness and use of biodiversity collections by fish biologists. J Fish Biol 2020; 96:297-306. [PMID: 31621077 DOI: 10.1111/jfb.14167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
A survey of 280 fish biologists from a diverse pool of disciplines was conducted in order to assess the use made of biodiversity collections and how collections can better collect, curate and share the data they have. From the responses, data for how fish biologists use collections, what data they find the most useful, what factors influence the decisions to use collections, how they access the data and explore why some fish biologists make the decision to not use biodiversity collections is collated and reported. The results of which could be used to formulate sustainability plans for collections administrators and staff who curate fish biodiversity collections, while also highlighting the diversity of data and uses to researchers.
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Affiliation(s)
- Randal A Singer
- University of Michigan Museum of Zoology, University of Michigan, Ann Arbor, Michigan, USA
| | - Shari Ellis
- Florida Museum of Natural History, University of Florida, Gainesville, Florida, USA
| | - Lawrence M Page
- Florida Museum of Natural History, University of Florida, Gainesville, Florida, USA
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97
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Bissett SM, Rapley T, Preshaw PM, Presseau J. Uptake of best practice recommendations in the management of patients with diabetes and periodontitis: a cross-sectional survey of healthcare professionals in primary care. BMJ Open 2020; 10:e032369. [PMID: 32005779 PMCID: PMC7045148 DOI: 10.1136/bmjopen-2019-032369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the practices of healthcare professionals in relation to best practice recommendations for the multidisciplinary management of people with diabetes and periodontitis, focusing on two clinical behaviours: informing patients about the links between diabetes and periodontitis, and suggesting patients with poorly controlled diabetes go for a dental check-up. DESIGN Cross-sectional design utilising online questionnaires to assess self-reported performance and constructs from Social Cognitive Theory (SCT) and Normalisation Process Theory. SETTING Primary care medical practices (n=37) in North East, North Cumbria and South West of England Clinical Research Networks. PARTICIPANTS 96 general practitioners (GPs), 48 nurses and 21 healthcare assistants (HCAs). RESULTS Participants reported little to no informing patients about the links between diabetes and periodontitis or suggesting that they go for a dental check-up. Regarding future intent, both GPs (7.60±3.38) and nurses (7.94±3.69) scored significantly higher than HCAs (4.29±5.07) for SCT proximal goals (intention) in relation to informing patients about the links (p<0.01); and nurses (8.56±3.12) scored significantly higher than HCAs (5.14±5.04) for suggesting patients go for a dental check-up (p<0.001). All professional groups agreed on the potential value of both behaviours, and nurses scored significantly higher than GPs for legitimation (conforms to perception of job role) in relation to informing (nurses 4.16±0.71; GPs 3.77±0.76) and suggesting (nurses 4.13±0.66; GPs 3.75±0.83) (both p<0.01). The covariate background information (OR=2.81; p=0.03) was statistically significant for informing patients about the links. CONCLUSIONS Despite evidence-informed best practice recommendations, healthcare professionals currently report low levels of informing patients with diabetes about the links between diabetes and periodontitis and suggesting patients go for a dental check-up. However, healthcare professionals, particularly nurses, value these behaviours and consider them appropriate to their role. While knowledge of the evidence is important, future guidelines should consider different strategies to enable implementation of the delivery of healthcare interventions.
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Affiliation(s)
- Susan M Bissett
- School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Tim Rapley
- Social Work, Education and Community Wellbeing, Northumbria University Department of Social Work and Communities, Newcastle upon Tyne, UK
| | - Philip M Preshaw
- National University Centre for Oral Health, National University of Singapore, Singapore
| | - Justin Presseau
- School of Epidemiology and Public Health, and the School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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98
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Cartledge S, Thomas E, Hollier K, Maddison R. Development of standardised programme content for phase II cardiac rehabilitation programmes in Australia using a modified Delphi process. BMJ Open 2019; 9:e032279. [PMID: 31796485 PMCID: PMC7003389 DOI: 10.1136/bmjopen-2019-032279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/16/2019] [Accepted: 11/06/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To develop standardised programme content for Australian phase II cardiac rehabilitation (CR) programme. DESIGN Using the RAND/UCLA appropriateness method (RAM), a two-phase process including a comprehensive literature review and a two round modified Delphi process was undertaken to develop and validate content of a standardised CR programmes. PARTICIPANTS An invited multidisciplinary expert advisory group (EAG; n=16), including CR health professionals (nurses, allied health professionals, cardiologist), academics, policy makers, representation from the Australian Cardiovascular Health and Rehabilitation Association and consumers, provided oversight of the literature review and assisted with development of best practice statements. Twelve members of the EAG went onto participate in the modified Delphi process rating the necessity of statements in two rounds on a scale of 1 (not necessary) to 9 (essential). MAIN OUTCOME MEASURE Best practice statements that achieved a median score of ≥8 on a nine-point scale were categorised as 'essential'; statements that achieved a median score of ≥6 were categorised as 'desirable' and statements with a median score of <6 were omitted. RESULTS 49 best practice statements were developed from the literature across ten areas of care within four module domains (CR foundations, developing heart health knowledge, psychosocial health and life beyond CR). At the end of a two-round validation process a total of 47 best practice statements were finalised; 29 statements were rated as essential, 18 as desirable and 2 statements were omitted. CONCLUSIONS For the first time in Australia, an evidence-based and consensus-led standardised programme content for phase II CR has been developed that can be provided to CR coordinators.
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Affiliation(s)
- Susie Cartledge
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Emma Thomas
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Kerry Hollier
- National Heart Foundation of Australia, Melbourne, Victoria, Australia
| | - R Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
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99
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Vaughan G, Dawson A, Peek MJ, Carapetis JR, Sullivan EA. Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis. Birth 2019; 46:560-573. [PMID: 31150150 DOI: 10.1111/birt.12435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Rheumatic heart disease (RHD) is a preventable cardiac condition that escalates risk in pregnancy. Models of care informed by evidence-based clinical guidelines are essential to optimal health outcomes. There are no published reviews that systematically explore approaches to care provision for pregnant women with RHD and examine reported measures. The review objective was to improve understanding of how attributes of care for these women are reported and how they align with guidelines. METHODS A search of 13 databases was supported by hand-searching. Papers that met inclusion criteria were appraised using CASP/JBI checklists. A content analysis of extracted data from the findings sections of included papers was undertaken, informed by attributes of quality care identified previously from existing guidelines. RESULTS The 43 included studies were predominantly conducted in tertiary care centers of low-income and middle-income countries. Cardiac guidelines were referred to in 25 of 43 studies. Poorer outcomes were associated with higher risk scores (detailed in 36 of 41 quantitative studies). Indicators associated with increased risk include anticoagulation during pregnancy (28 of 41 reported) and late booking (gestation documented in 15 of 41 studies). Limited access to cardiac interventions was discussed (19 of 43) in the context of poorer outcomes. Conversely, early assessment and access to regular multidisciplinary care were emphasized in promoting optimal outcomes for women and their babies. CONCLUSIONS Despite often complex care requirements in challenging environments, pregnancy provides an opportunity to strengthen health system responses and address whole-of-life health for women with RHD. A standard set of core indicators is proposed to more accurately benchmark care pathways, outcomes, and burden.
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Affiliation(s)
- Geraldine Vaughan
- Faculty of Health, Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Angela Dawson
- Faculty of Health, Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Michael J Peek
- The Australian National University and Centenary Hospital for Women and Children, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Jonathan R Carapetis
- Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.,Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Elizabeth A Sullivan
- Faculty of Health, Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, New South Wales, Australia.,Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
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100
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Abstract
Inter-professional education (IPE) can support professionals in developing their ability to work collaboratively. This position paper from the European Forum for Primary Care considers the design and implementation of IPE within primary care. This paper is based on workshops and is an evidence review of good practice. Enablers of IPE programmes are involving patients in the design and delivery, providing a holistic focus, focussing on practical actions, deploying multi-modal learning formats and activities, including more than two professions, evaluating formative and summative aspects, and encouraging team-based working. Guidance for the successful implementation of IPE is set out with examples from qualifying and continuing professional development programmes.
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