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Best practice

Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Elianny Domínguez-Tejo, Graciela Metternicht, Emma L Johnston, Luke Hedge
Sandy beaches are unique ecosystems increasingly exposed to human-induced pressures. Consistent with emerging frameworks promoting this holistic approach towards beach management, is the need to improve the integration of social data into management practices. This paper aims to increase understanding of links between demographics and community values and preferred beach activities, as key components of the social dimension of the beach environment. A mixed method approach was adopted to elucidate users' opinions on beach preferences and community values through a survey carried out in Manly Local Government Area in Sydney Harbour, Australia...
March 13, 2018: Journal of Environmental Management
Grace S Chng, Dongdong Li, Chi Meng Chu, Tabitha Ong, Felicia Lim
Children who enter the child protection system often have complex family problems and have experienced early adverse experiences. Using latent class analysis, this study aimed to identify family classes of child protection cases in Singapore, to ascertain the prevalence of these family classes, and to test the association of family class membership to subsequent recurrence of harm. A sample of 440 cases who entered the Child Protective Service in Singapore was analyzed based on eight familial factors on the household and caregiver levels...
March 13, 2018: Child Abuse & Neglect
Gillian A Ryan, Sarah M Nicholson, John J Morrison
Vaginal birth after caesarean (VBAC) delivery remains a controversial topic, and one for which there is a lack of robust data to guide clinicians and parturients regarding their best option for mode of delivery in a subsequent pregnancy. In many developed countries the trend observed in recent years is that of progressively reduced VBAC rates, and hence increased use of elective repeat caesarean section (ERCS). This factor has contributed, more than any other, to the disproportionately high caesarean section (CS) rates in many countries...
March 7, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Barbara J Wilson, Laura J Zitella, Colleen H Erb, Jackie Foster, Mary Peterson, Sylvia K Wood
BACKGROUND: Cancer-related infections lead to increases in mortality, antibiotic use, and hospital stays. Other adverse outcomes include dose delays and reductions, which can result in suboptimal treatment outcomes. OBJECTIVES: Effective implementation of risk assessment and evidence-based interventions for the prevention and treatment of infection are essential to improve care and reduce costs related to infections in patients with cancer receiving immunosuppressive therapy...
April 1, 2018: Clinical Journal of Oncology Nursing
Elizabeth A Duffy, Wendy Fitzgerald, Kelley Boyle, Radha Rohatgi
BACKGROUND: Cisplatin has been used as a chemotherapeutic agent to treat many different cancers. A well-known side effect of cisplatin is nephrotoxicity, which is the primary dose-limiting toxicity. Hydration in conjunction with appropriate diuresis can decrease the incidence of nephrotoxicity. OBJECTIVES: This article aims to identify best practices in supportive therapy for patients receiving cisplatin therapy. METHODS: A team was assembled to review research-based evidence and summarize recommendations to address appropriate hydration regimens and forced diuresis for patients receiving cisplatin chemotherapy...
April 1, 2018: Clinical Journal of Oncology Nursing
Caitlin M Davis, Martin Gruebele
Qualitative imaging of biomolecular localization and distribution inside cells has revolutionized cell biology. Most of these powerful techniques require modifications to the target biomolecule. Over the past 10 years, these techniques have been extended to quantitative measurements, from in-cell protein folding rates, to complex dissociation constants, to RNA lifetimes. Such measurements can be affected even when a target molecules is just mildly perturbed by its labels. Here, the impact of labeling on protein (and RNA) structure, stability, and function in cells are discussed via practical examples from recent literature...
March 16, 2018: Biochemistry
Julia Twichell, Richard Pollnac, Patrick Christie
International interest in increasing marine protected area (MPA) coverage reflects broad recognition of the MPA as a key tool for marine ecosystems and fisheries management. Nevertheless, effective management remains a significant challenge. The present study contributes to enriching an understanding of best practices for MPA management through analysis of archived community survey data collected in the Philippines by the Learning Project (LP), a collaboration with United States Coral Triangle Initiative (USCTI), United States Agency for International Development (USAID), and partners...
March 15, 2018: Environmental Management
Rosanne M Kho, Marina Paula Andres, Giuliano Moysés Borrelli, Joao Siufi Neto, Alan Zanluchi, Mauricio Simões Abrão
Treatment options for patients with different types of endometriosis - superficial, ovarian, or deep - vary depending on the clinical presentation. New findings in the recent years regarding the role of preoperative imaging, efficacy of medical therapy, and effect of surgery on ovarian reserve have changed the way we understand the disease and subsequently the way we treat our patients. Practicing clinicians frequently refer to published recommendations from major societies for treatment guidelines. This paper aims to present and compare the varying major society guidelines on the indications and best surgical treatment approach for the management of the different types of endometriosis...
February 16, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Laura M Wagner, Mary A Dolansky, Robert Englander
BACKGROUND: Further efforts are warranted to identify innovative approaches to best implement competencies in nursing education. To bridge the gap between competency-based education, practice, and implementation of knowledge, skills, and attitudes, one emerging approach is entrustable professional activities (EPAs). PURPOSE: The objective of this study was to introduce the concept of EPAs as a framework for curriculum and assessment in graduate nursing education and training...
November 22, 2017: Nursing Outlook
Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Charlotte E Teunissen, Markus Otto, Sebastiaan Engelborghs, Sanna-Kaisa Herukka, Sylvain Lehmann, Piotr Lewczuk, Alberto Lleó, Armand Perret-Liaudet, Hayrettin Tumani, Martin R Turner, Marcel M Verbeek, Jens Wiltfang, Henrik Zetterberg, Lucilla Parnetti, Kaj Blennow
Body fluid biomarkers have great potential for different clinical purposes, including diagnosis, prognosis, patient stratification and treatment effect monitoring. This is exemplified by current use of several excellent biomarkers, such as the Alzheimer's disease cerebrospinal fluid (CSF) biomarkers, anti-neuromyelitis optica antibodies and blood neurofilament light. We still, however, have a strong need for additional biomarkers and several gaps in their development and implementation should be filled. Examples of such gaps are i) limited knowledge of the causes of neurological diseases, and thus hypotheses about the best biomarkers to detect subclinical stages of these diseases; ii) the limited success translating discoveries obtained by e...
March 15, 2018: Alzheimer's Research & Therapy
Chiara Anna Parente, Domenico Salvatore, Giampiero Maria Gallo, Fabrizio Cipollini
BACKGROUND: In almost all healthcare systems, no-shows (scheduled appointments missed without any notice from patients) have a negative impact on waiting lists, costs and resource utilization, impairing the quality and quantity of cares that could be provided, as well as the revenues from the corresponding activity. Overbooking is a tool healthcare providers can resort to reduce the impact of no-shows. METHODS: We develop an overbooking algorithm, and we assess its effectiveness using two methods: an analysis of the data coming from a practical implementation in an healthcare center; a simulation experiment to check the robustness and the potential of the strategy under different conditions...
March 15, 2018: BMC Health Services Research
Genevieve N Thompson, Susan E McClement, Nina Labun, Kathleen Klaasen
BACKGROUND: Nursing home (NH) administrators need tools to measure the effectiveness of care delivered at the end of life so that they have objective data on which to evaluate current practices, and identify areas of resident care in need of improvement. METHODS: A three-phase mixed methods study was used to develop and test an empirically derived chart audit tool aimed at assessing the care delivered along the entire dying trajectory. RESULTS: The Auditing Care at the End of Life (ACE) instrument contains 27 questions captured across 6 domains, which are indicative of quality end-of-life care for nursing home residents...
March 15, 2018: BMC Palliative Care
Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
Ekaterina M Savelieva, Vladimir E Oslovsky, Dmitry S Karlov, Nikolay N Kurochkin, Irina A Getman, Sergey N Lomin, Georgy V Sidorov, Sergey N Mikhailov, Dmitry I Osolodkin, Georgy A Romanov
Biological effects of hormones in both plants and animals are based on high-affinity interaction with cognate receptors resulting in their activation. The signal of cytokinins, classical plant hormones, is perceived in Arabidopsis by three homologous membrane receptors: AHK2, AHK3, and CRE1/AHK4. To study the cytokinin-receptor interaction, we used 25 derivatives of potent cytokinin N6 -benzyladenine (BA) with substituents in the purine heterocycle and/or in the side chain. The study was focused primarily on individual cytokinin receptors from Arabidopsis...
March 12, 2018: Phytochemistry
Peng Li, Chandan Karmakar, John Yearwood, Svetha Venkatesh, Marimuthu Palaniswami, Changchun Liu
Entropy measures that assess signals' complexity have drawn increasing attention recently in biomedical field, as they have shown the ability of capturing unique features that are intrinsic and physiologically meaningful. In this study, we applied entropy analysis to electroencephalogram (EEG) data to examine its performance in epilepsy detection based on short-term EEG, aiming at establishing a short-term analysis protocol with optimal seizure detection performance. Two classification problems were considered, i...
2018: PloS One
Nathalie M Berninger, Gill A Ten Hoor, Guy Plasqui
Sedentary behavior (SB) has detrimental consequences and cannot be compensated for through moderate-to-vigorous physical activity (PA). In order to understand and mitigate SB, tools for measuring and monitoring SB are essential. While current direct-to-customer wearables focus on PA, the VitaBit validated in this study was developed to focus on SB. It was tested in a laboratory and in a free-living condition, comparing it to direct observation and to a current best-practice device, the ActiGraph, on a minute-by-minute basis...
March 15, 2018: Sensors
Michelle Wong, Esther Bejarano, Graeme Carvlin, Katie Fellows, Galatea King, Humberto Lugo, Michael Jerrett, Dan Meltzer, Amanda Northcross, Luis Olmedo, Edmund Seto, Alexa Wilkie, Paul English
Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities...
March 15, 2018: International Journal of Environmental Research and Public Health
Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
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