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1. This meta-analysis investigated the impact of LPS and covariates (serotype, rearing period and administration route) on the productivity parameters of broiler chickens (average daily feed intake (ADFI), average daily gain (ADG) and feed conversion ratio (FCR)). 2. Thirty-two eligible studies were included. Hedges' g effect size was determined using a random-effects model at 95% confidence interval. 3. Results showed that LPS significantly decreased average daily feed intake (ADFI; p < 0.0001) and average daily gain (ADG; p < 0.0001) and increased FCR (p < 0.0001). The serotypes Escherichia coli 055: B5 (EC055: B5) and Escherichia coli 0127: B8 (EC 0127: B8) significantly reduced ADFI and ADG, and the serotype EC 055: B5 significantly increased the FCR (p < 0.05). 4. The intraperitoneal administration of the LPS significantly reduced the productivity of broiler chickens (p < 0.05), but other administration routes did not show such effects. The reduction in ADFI and ADG was found in all rearing periods (p < 0.05), and the increase in FCR was observed in the starter (p = 0.0302) and grower periods (p = 0.0031). 5. Exposure to LPS significantly reduced the productivity of broiler chickens (p < 0.05). However, no relationship was observed between LPS dosage and productivity as indicated by the meta-regression study. 6. The findings indicated that LPS has detrimental effects on broiler chickens' ADFI, ADG and FCR across various LPS serotypes and rearing periods. These detrimental impacts of LPS remain consistent regardless of the administered dosage. [ABSTRACT FROM AUTHOR]

The current research on deliberative-participatory democratic innovations conducted by state administration agencies exhibits empirical eclecticism and is dominated by a deliberative paradigm. However, this paradigm tends to conflate normative prescription with analytical description. In contrast, this article proposes a comprehensive re-conceptualization of such innovations, drawing from Niklas Luhmann's systems theory. It outlines the specific problem these innovations address (function), how they operate in tackling this problem (functioning) and the problems they inevitably raise (dysfunctions). In addition, my re-conceptualization retains the possibility to critically compare these (and other) experiments regarding their capability to address emerging challenges within the modern democratic political system. [ABSTRACT FROM AUTHOR]

This introductory piece for the research cluster 'The Economic Power of European Queens: Sources, Resources and Expenditure both delineates the content of the cluster and places it in the context of wider research. The article highlights common themes among the four articles in the cluster and common issues with the survival of sources which document the economic activity of royal women. It also highlights the importance of new research which is beginning to illuminate the financial element of queenship and helping us to understand this vital, yet understudied, part of the queen's office. [ABSTRACT FROM AUTHOR]

Background: Unnecessary group and screens (G&S) can lead to unnecessary antibody investigations, use of technologist time, and laboratory resources. Local Problem: A baseline audit at our institution identified that 25% of G&S from the cancer center were unnecessary. We aimed to reduce the ratio of monthly G&S to CBC samples processed from the cancer center by 10% (from 0.034 to 0.031) by January 2024. Methods: This represents an interrupted time series design from November 2022 to January 2024. Using Plan Do Study Act (PDSA) cycles, we aimed to increase the use of an existing reflex testing system, termed "do not test." When this option is selected, the blood bank will only process the G&S sample if specific CBC criteria are met (e.g., hemoglobin <9.0 g/dL). Educational sessions increased awareness of this feature and sought feedback from end‐users on its usability. With feedback, the design was updated to include a modifiable hemoglobin threshold for G&S testing, automatic re‐selection of the "do not test" feature for future G&S orders, and aesthetic changes to make the feature more visible. Results: The percentage of samples with "do not test" selected increased from 7.2% to 63.0% (p <.0001) and the ratio of G&S to CBC specimens improved from 0.034 to 0.028, exceeding the target of 0.031. We noted an improvement in the appropriateness of G&S orders from 75% at baseline (n = 20) to 97.5% (n = 80) post intervention (p =.003). Conclusions: We describe an effective strategy to improve G&S utilization at our institution's cancer center using a reflex testing system. [ABSTRACT FROM AUTHOR]

The superintendent is one of the most important positions within public school districts because they have the capacity to influence policies, practices, and perceptions among school staff while simultaneously holding sway over the public. Yet, few Latinx administrators are hired into the superintendency – even fewer are Latinas. Consequently, districts are never gaining access to talented leaders that can help foster improved educational experiences and outcomes for all students. In this essay, we briefly outline the important role of the superintendent. Then, we provide a set of unique insights on the racial and gender demographics of Texas superintendents as well as how Latinas move through the educator workforce from principal to superintendent. We conclude with implications to further diversify the superintendency and ensure Latinas are effectively mentored, supported, and hired into district leadership positions. [ABSTRACT FROM AUTHOR]

The improvement of teaching quality within secondary schooling has been a core focus within Rwandan educational reforms. Despite this emphasis, efforts towards defining this construct have been minimal, particularly amongst head teachers and government officials who often hold responsibilities in monitoring, evaluating and guiding teaching improvements. To address this gap, this study aimed to shed light on these stakeholders' perceptions of teaching quality, the extent of alignment between their views and the degree to which they reflected earlier teacher conceptions. Data from this study drew upon semi-structured interviews with 5 head teachers and 11 government officials from three Rwandan districts. Using constant comparison analysis, findings revealed that strong agreement exists between perceptions of stakeholder groups, as evidenced by a shared recognition that teaching inputs, processes and outcomes are vital components of the teaching quality construct. Key differences that emerged included recognition of the impact of external factors on teaching quality and their greater focus on the importance of inclusion compared with teachers. The results suggest a need for greater emphasis on these factors within initiatives focused on improving teaching to better align the expectations of stakeholders concerning teaching quality. These results have implications for policy and for the evaluation and professional development of teachers. [ABSTRACT FROM AUTHOR]

Background Fosfomycin is an antibiotic extensively used to treat uncomplicated urinary tract infections in women, and it is available in different salts and formulations. The European Medicines Agency (EMA) recommends further studies to characterize the pharmacokinetics of fosfomycin calcium for oral administration and to justify its dosage recommendation. Objectives A population pharmacokinetic model of fosfomycin calcium was developed after oral administration to healthy women. Methods A clinical trial (a randomized, open-label, bioavailability study of single and multiple doses of 1000 mg capsules, single dose of 500 mg capsule and single dose of 250 mg/5 mL suspension of oral fosfomycin calcium under fasted conditions in healthy women volunteers, Code: PD7522.22, EudraCT: 2020-001664-28) was carried out at the Clinical Trial Unit, Araba University Hospital (Vitoria-Gasteiz, Spain). Twenty-four healthy women were included in the study, and plasma samples were collected at different times over a period of 24 h. The concentration–time data of fosfomycin in plasma were modelled by a population approach using a nonlinear mixed-effects modelling implemented by NONMEM 7.4 (ICON Clinical Research LLC, North Wales, PA, USA). Results The pharmacokinetics of fosfomycin was best described by a two-compartment model. Creatinine clearance and body weight were identified as covariates for fosfomycin clearance and volume of distribution, respectively. Conclusions This study provides relevant information on the pharmacokinetic profile of fosfomycin in women after oral administration as calcium salt. This population model may be very useful for establishing dosage recommendations of fosfomycin calcium to treat urinary tract infections in women. [ABSTRACT FROM AUTHOR]

Omaveloxolone (SKYCLARYS®) is approved for the treatment of Friedreich ataxia (FA) in patients aged ≥16 years in the United States and European Union (EU). The recommended dosage is 150 mg administered orally once daily as three 50‐mg capsules. However, some patients with FA may have oropharyngeal dysphagia or difficulty swallowing whole capsules; therefore, alternate method(s) of administration are needed. A Phase 1 clinical study in 32 healthy volunteers evaluated the relative bioavailability, safety, and tolerability of a single dose of omaveloxolone when capsule contents were sprinkled on and mixed in applesauce compared to when taken as intact capsules. Palatability when sprinkled on and mixed in applesauce was assessed with a questionnaire. After a single 150‐mg dose, the peak and overall exposures of omaveloxolone were similar irrespective of administration method, with the 90% CIs of the geometric least squares mean ratio (%) for maximum plasma concentration (Cmax), AUC0‐t, and AUC0‐∞ within the 80% to 125% reference intervals. Omaveloxolone was absorbed more slowly as intact capsules (median tmax, 10 h) compared with sprinkled capsule contents over applesauce (median tmax, 6 h). With chronic daily administration of omaveloxolone to treat FA, the 4‐h difference in tmax is not considered clinically relevant. Sprinkled omaveloxolone capsule contents on applesauce were well tolerated, with acceptable palatability and no serious adverse events. Given the similar systemic exposure when capsules were swallowed whole, sprinkling omaveloxolone capsule contents on and mixing in applesauce is a feasible alternative method of administering omaveloxolone and has been included in both the United States and EU prescribing information. [ABSTRACT FROM AUTHOR]

Purpose This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2022 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following components: prescribing/transcribing, dispensing, administration, and monitoring. Articles evaluating at least one step of the MUP were assessed for their usefulness toward practice improvement. Summary A PubMed search was conducted in January 2023 for articles published in calendar year 2022 using targeted Medical Subject Headings (MeSH) keywords, and searches of the table of contents of selected pharmacy journals were conducted, providing a total of 6,213 articles. A thorough review identified 69 potentially practice-enhancing articles: 13 for prescribing/transcribing, 13 for dispensing, 5 for administration, and 38 for monitoring. Practice trends discussed in the articles are briefly summarized, with a mention of their importance within health-system pharmacy. The articles are listed and summarized in tables for further review and evaluation. Conclusion It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article assists in identifying and summarizing the most impactful publications. Health-system pharmacists have an active role in improving the MUP in their institution, and awareness of the significant published studies can assist in changing practice at the institutional level. [ABSTRACT FROM AUTHOR]

Student evaluation of teaching (SET) involves numerous conceptual and methodological problems. This paper focuses on a specific methodological dilemma: whether to conduct SET surveys before or after the final examination. This decision is a critical administrative and practical issue that can affect the level and quality of SET results. To address this problem, a systematic literature search was initially performed. However, it found only 17 studies and inconclusive results. In the empirical component, a replication survey (n = 5,077) was conducted. It posed seven course-related questions to the same students before and after their final examination. A slightly higher but statistically significant (p < 0.001) average score was obtained in the after-examination survey (a 0.06 difference on a 1–5 scale). This increase was partly attributed to a positive examination experience. The overall test–retest correlation (r = 0.61) indicated relatively low reliability, suggesting that the before-examination survey better reflected students' attitudes. The data quality was also higher in the before-examination survey, although the before-examination survey could not properly assess the examination-related aspects of the course. From a methodological perspective, the most comprehensive insight seems to be derived from conducting SET surveys before the examination and following up with a brief after-examination survey. [ABSTRACT FROM AUTHOR]

Leadership in administration does not operate in a vacuum. Every decision comes with consequences for those tasked to make them, and foreseen career consequences, which often materialize during performance evaluations, may support or constrain administrators' leadership. This article explores how and why administrators factor in foreseen evaluation career outcomes when making leadership decisions, drawing from the qualitative investigation of 14 Canadian university decanal reappointments. The study asked 13 reappointed and one non-reappointed deans how they experienced and made sense of their reappointments. The study found that performance evaluations allow organizational agents to bypass normal role negotiation and that foreseen career consequences associated with evaluations play a role in leadership decisions. The effect of performance evaluations is contingent on personal, role, and evaluation characteristics. In the case of decanal reappointments, the short-term effect on individual leadership was modest. However, by limiting deans' effective in-role time, reappointments had an important long-term constraining effect on their consecutive and collective leadership. [ABSTRACT FROM AUTHOR]

• Hyperthermia-assisted chemotherapy offers a promising approach for NMIBC treatment. • COMBAT and BR-TRG-I show potential in reducing recurrence in NMIBC patients. • Unithermia's efficacy appears inferior to BCG in high-risk NMIBC. • Conduction hyperthermia devices present varied outcomes in NMIBC treatment. • Further research with standardized protocols is essential for conclusive results. Intravesical treatment for non-muscle invasive bladder cancer (NMIBC) aims to reduce recurrences and stop progression. Hyperthermia-enhanced chemotherapy with devices like COMBAT BRS, Unithermia, and BR-TRG-I is a promising alternative to conventional Bacillus de Calmette Guerin (BCG) therapy. To systematically review the efficacy of hyperthermia generated by conduction devices in the treatment of NMIBC. The review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. A search was performed in the PubMed, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Two reviewers independently assessed the eligibility of candidate studies and abstracted data from studies that met the inclusion criteria. The primary endpoint was assessment of recurrence. Secondary objectives included evaluation of treatment progression and safety. Thirty studies meeting inclusion criteria underwent data extraction. In intermediate-risk NMIBC patients, COMBAT versus mitomycin C (MMC) in normothermia revealed no superiority in reducing recurrence or progression. High-risk NMIBC patients using COMBAT achieved similar or superior outcomes to BCG. BR-TRG-I demonstrated superior results over normothermia in intermediate- and high-risk NMIBC patients. Unithermia proved less effective than BCG in high-risk NMIBC. Progression outcomes were promising with COMBAT and BR-TRG-I, but comprehensive analysis was limited due to inconsistent assessment across studies. Adverse events were primarily mild-moderate, with some device-specific differences. Studies on conduction hyperthermia present great variability, which do not allow us to determine the superiority of 1 device over another in terms of recurrence, progression, and/or adverse effects. Further research with consistent administration protocols is crucial for definitive conclusions [ABSTRACT FROM AUTHOR]

Purpose: Delay in initiating adjuvant chemotherapy (AC) after curative resection of colorectal cancer (CRC) has been reported to lead to poor prognosis, but few studies have looked at associated factors. This study aimed to identify risk factors for delay in initiating AC. Methods: Data from 200 consecutive patients who underwent curative resection and AC for stage III CRC between 2013 and 2018 were retrospectively collected and analyzed. Results: AC was initiated more than 8 weeks after surgery in 12.5% of patients (the delay group). Compared to those with no delay (the non-delay group), patients in the delay group had significantly higher rates of synchronous double cancers (2.3% vs. 16.0%, p = 0.001), preoperative bowel obstruction (10.3% vs. 32.0%, p = 0.003), laparotomy (56.0% vs. 80.0%, p = 0.02), concomitant resection (2.9% vs. 24.0%, p < 0.001), and postoperative complications (32.0% vs. 56.0%, p = 0.02), and a significantly longer length of hospital stay (median 12 vs. 30 days, p < 0.001). In multivariate analysis, synchronous double cancers (odds ratio 10.2, p = 0.008), preoperative bowel obstruction (odds ratio 4.6, p = 0.01), concomitant resection (odds ratio 5.2, p = 0.03), and postoperative complications of Clavien–Dindo grade ≥ IIIa (odds ratio 4.0, p = 0.03) were identified as independent risk factors for delay in initiating AC. Conclusion: Careful preoperative treatment planning for CRC patients with synchronous double cancers, preoperative bowel obstruction, and concomitant resection, and management for postoperative complication are necessary to avoid delay in initiating AC. [ABSTRACT FROM AUTHOR]

Purpose This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2021 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following components: prescribing/transcribing, dispensing, administration, and monitoring, and monitoring/medication reconciliation. Articles evaluating at least one step of the MUP were assessed for their usefulness toward practice improvement. Summary A PubMed search was conducted in January 2022 for articles published in calendar year 2021 using targeted Medical Subject Headings (MeSH) keywords, and searches of the table of contents of selected pharmacy journals were conducted, providing a total of 7,178 articles. A thorough review identified 79 potentially practice-enhancing articles: 15 for prescribing/transcribing, 17 for dispensing, 4 for administration, 21 for monitoring, and 22 for monitoring/medication reconciliation. Ranking of the articles for importance by peers led to the selection of key articles from each category. The highest-ranked articles are briefly summarized, with a mention of their importance within health-system pharmacy. The other articles are listed for further review and evaluation. Conclusion It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article assists in identifying and summarizing the most impactful publications. Health-system pharmacists have an active role in improving the MUP in their institution, and awareness of the significant published studies can assist in changing practice at the institutional level. [ABSTRACT FROM AUTHOR]

National climate policies have generated a considerable body of research in academic literature. Focusing on the little-studied case of France, this article examines the way in which, in this country, the State has drafted its latest low-carbon strategy (SNBC). Drawing on approaches such as ‘bureaucratic politics’ and ‘administrative capacity’, it questions the ability of the administration responsible for writing this document (and thus defending the climate cause) to make its voice heard within the political-administrative arena. Based on an in-depth sociological study, this article shows that this administration found itself in a position of ‘powerlessness’, due to three main factors: instrumental (the limited scope of the tool, reflecting an initial will to reduce its impact), organizational (the subordinate position of this administration within the bureaucratic hierarchy) and political (weak support from government). The result is a contested strategy, unlikely to bring about a credible roadmap to implement the necessary changes. [ABSTRACT FROM AUTHOR]

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the various aspects of starting and running an endoscopy unit. Some of the areas considered are referral and recruitment systems, determination of the need and site selection, layout and regulations, aspects related to drugs, equipment, medical emergencies, and emergency room transfers, discharge criteria, post-discharge follow-up, and finally, we have addressed issues related to avoiding and managing cancelations. It is assumed that a majority of the procedures are performed with predominantly propofol-induced deep sedation. [ABSTRACT FROM AUTHOR]

Purpose: Iron deficiency anemia is common in people with inflammatory bowel disease (IBD), causing deterioration in quality of life, which can be reversed by treatment that increases iron stores and hemoglobin levels. The present post hoc analyses estimate health state utility values for patients with IBD after treatment with ferric derisomaltose or ferric carboxymaltose and evaluate the health domains driving the changes. Methods: SF-36v2 responses were recorded at baseline and day 14, 35, 49, and 70 from 97 patients enrolled in the randomized, double-blind, PHOSPHARE-IBD trial (ClinicalTrials.gov ID: NCT03466983), in which patients with IBD across five European countries were randomly allocated to either ferric derisomaltose or ferric carboxymaltose. Changes in SF-36v2 scale scores and SF-6Dv2 health utility values were analyzed by mixed models. Results: In both treatment arms, SF-6Dv2 utility values and all SF-36v2 scale scores, except Bodily Pain, improved significantly (p = < 0.0001). The improvement in SF-6Dv2 utility values showed no significant treatment group difference. The improvement in utility values was completely explained by improvement in Vitality scores. Vitality scores showed significantly larger improvement with ferric derisomaltose versus ferric carboxymaltose (p = 0.026). Patients with the smallest decrease in phosphate had significantly larger improvements in Vitality scores at each time point (p = < 0.05 for all comparisons) and overall (p = 0.0006). Conclusions: Utility values improved significantly with intravenous iron treatment. Improvement in utility values was primarily driven by Vitality scores, which showed significantly greater improvement in the ferric derisomaltose arm. Smaller decreases in phosphate were associated with significantly higher Vitality scores, suggesting that quality of life improvement is attenuated by hypophosphatemia. The utility values can inform future cost-utility analysis. [ABSTRACT FROM AUTHOR]

To determine the prevalence and characteristics of food insecurity among female collegiate athletes. NCAA Division I female athletes attending a public university located in East Texas in 2018. A prospective cross-sectional online survey was employed to gather quantitative and qualitative data regarding food security status. Participants were instructed to complete the 26-item questionnaire, including the six-item USFSSM. Participants (N = 78) were 18–22 years of age, largely white (75%). Despite most (89.74%) receiving some form of scholarship and 80% reporting provision of some meals, 32.10% were classified as food insecure. Barriers to food intake were two-fold higher among the food insecure (88% vs 43%, p <.001); limited time (43.6%) and finances (23.1%) were the most frequently reported barriers. Despite university support, food insecurity exists in female collegiate athletes. Outcomes warrant screening for food insecurity, referral to support resources throughout matriculation, and tailored intervention programs. [ABSTRACT FROM AUTHOR]

This paper considers the ways that publicly funded developmental services for adults with developmental disabilities in southern Ontario are limited in how they support clients. This paper is informed by field research conducted in the summer of 2019, which was composed of semi-structured interviews, focus groups, and a policy review. Informed by parent advocates who are the main caregivers of their adult children labelled with intellectual and developmental disabilities, this paper claims that the administrative processes of the Ontario ministry that manages and funds adult disability services relate to broader exclusionary patterns among adults with developmental disabilities. I explore this claim by reviewing how common ableist assumptions of people with developmental disabilities are ingrained in the policies and administrative processes of these services. I contribute to ongoing discussions among Critical Disability Scholars of the ways that disability as a social category can be articulated outside of ableist assumptions. Informed by parent caregiver perspectives, this article outlines how the limitations of provincially funded disability services in Ontario, Canada cause significant challenge in the lives of those labelled with intellectual and developmental disabilities. One possible explanation for these limitations is that there is a disconnect between how the provincial government classifies who should receive immediate services and how many services, versus the actual need of those labelled with intellectual and developmental disabilities. The criteria for high supports, such as monthly funding, placement into a living facility, and the provincial assessment for determining a person's 'adaptive functioning' are rooted in problematic assumptions made of people labelled with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

This article explores the advancements in blood transfusion practices for resuscitating bleeding patients, which have been influenced by experiences on the battlefield and later adopted in civilian settings. These changes, such as using balanced ratios of blood products and prepositioning blood in emergency departments, have improved outcomes for trauma patients and those with hemorrhagic shock. However, there are still three major changes needed for wider implementation: adopting a walking blood bank, correcting reimbursement practices for prehospital blood transfusion, and ensuring military personnel are trained in transfusion practices. The article also addresses the issue of blood shortages in the United States and suggests implementing a whole blood-based resuscitation strategy as a potential solution. The authors emphasize the importance of military-civilian partnerships and call for policy changes to support the routine use of prehospital blood products and the implementation of the whole blood-based resuscitation strategy in civilian trauma systems. [Extracted from the article]

Background: Studies have described poor transfusion medicine (TM) knowledge in postgraduate trainees. The impact of undergraduate medical TM education on postgraduate knowledge is unclear. Methods: Canadian medical schools were surveyed on the number of hours dedicated to TM teaching and topics covered by curricula during 2016–2020. Postgraduate trainees attending Transfusion Camp in 2021 completed a pretest of 20 multiple‐choice questions. The survey results and pretest scores were compared to evaluate the association between undergraduate medical TM education and pretest scores. Results: The survey was completed by 16 of 17 Canadian medical schools. The number of hours (h) of TM teaching were <2 h (25%), 3–4 h (25%), and >4 h (50%). Twelve of 19 Transfusion Camp topics were covered in ≥50% of schools. Eleven medical schools provided ethics approvals/waivers to include trainee pretest scores in the analysis (N = 200). The median pretest scores by medical school ranged from 48% to 70%. No association was found between number of TM teaching hours and average pretest scores (p =.60). There was an association between higher postgraduate year level and individual pretest score (p <.0001). The analysis by topic demonstrated questions where trainees from different schools performed uniformly well or poorly; other topics showed considerable variation. Conclusion: Variation in quantity and content of undergraduate TM teaching exists across Canadian medical schools. In this limited assessment, the number of TM teaching hours was not associated with performance on the pretest. This study raises the opportunity to re‐evaluate the delivery (content, timing, consistency) of TM education in undergraduate medical schools. [ABSTRACT FROM AUTHOR]

Background: Nontraumatic brain injury encompasses various pathological processes and medical conditions that result in brain dysfunction and neurological impairment without direct physical trauma. The study aimed to assess the efficacy of intravenous administration of 20% mannitol and 3% hypertonic saline to reduce intracranial pressure in nontraumatic brain injury. Materials and methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed for study selection and data extraction. The search was conducted in the PubMed, Embase, and Scopus databases, including articles published in English from January 2003 to December 2023. Our study included randomized controlled trials, comparative studies, prospective analyses, and retrospective cohort studies. We extracted data on baseline characteristics of patients, intervention details, major outcomes, and complications. Quality assessment was performed using the Jadad scale and the Robvis assessment tool for risk of bias. Results: A total of 14 studies involving 1,536 patients were included in the analysis. Seven studies reported hypertonic saline as more effective in reducing intracranial pressure, while three studies found similar effectiveness for both interventions. Adverse events were reported in only three studies. The studies that reported complication rates ranged from 21 to 79%. A meta-analysis was conducted on five studies, showing varying rates of adverse events associated with mannitol and hypertonic saline. Conclusion: Both hypertonic saline solution and mannitol have been explored as treatment options for decreasing intracranial pressure in nontraumatic brain injuries. While some studies indicate the superiority of hypertonic saline, others report similar effectiveness between the two interventions. [ABSTRACT FROM AUTHOR]

Among the various forms of quality control of the provision of medical care, self-control and internal control of the quality of medical services are the most effective and significant. Currently, there is no comprehensive information technology and algorithm for recording data on the provision of medical services and determining their quality. The goal is to develop and analyze the effectiveness of business processes and an algorithm for quality control of the performance of medical services in a surgical health care institution by establishing their daily accounting in the information system, control of indicators characterizing the safety and quality of their performance, as well as an opportunity to assess the dynamics changes in indicators for making management decisions. In the study, an analysis of literary sources was carried out, business processes were formulated, and on the materials of a retrospective analysis algorithms for the use of information technologies were developed based on the methods of generalization, comparison, content analysis, system-analytical and logical analysis, a graphic analysis was performed to increase the clarity of the presentation of the material. The research was approved by the Biomedical Ethics Committee. For the first time, as a result of the work of the internal quality commission, daily and summarized forms of reports on the work of the medical center, which have five sections are obtained. The statistical indicators of the operation of the surgical unit for any period are fixed, formed in an automated mode and analyzed. Clinical data characterizing all prescribed procedures applied are subject to analysis, and the results provide an opportunity to isolate from the records the disorders and complications reflected in the reports. The quality control of the use of antibiotics, the frequency of their use for preventive and therapeutic purposes is also carried out. The section that contains multivariate epidemiological control of the work of the treatment facility, as well as the section that shows the quality of medical record keeping and patient care is important. Together with the inpatient chart, e-mails of medical appointments are analyzed, patient falls are recorded, appointments and monitoring of patient care, pain assessment after surgery, allergic reactions are recorded, as well as a retrospective audit of the charts regarding the justification of the appointment of antimicrobial therapy. Control of patient safety and the quality of the provided medical services requires constant verification of their implementation and paying attention to be up to standards, the occurrence of deviations and complications. The application of a specially developed algorithm based on information technologies, aimed at daily accounting of medical services and obtaining data on deviations in their application, makes it possible to make urgent management decisions and influence the improvement of the qualifications of personnel who provide such services. [ABSTRACT FROM AUTHOR]

Local governments are public legal entities that both form their own administrative structure to serve the nation and benefit from administrative autonomy while establishing relations with the central government. Audit is an understanding that deals with the methods applied by political and administrative units in fulfilling their objectives, what kind of methods they apply and the measures they need. At the same time, in national legislation, the subject of audit is included in the Law on Court of Accounts, Law on Local Authorities, Law on Municipalities, Law on Special Provincial Administration, Law on Basic Principles and Restructuring of Public Administration, Law on Public Financial Management and Control. In international legislation, the European Charter of Local Self-Government guarantees the issue of audit. The supervision of local governments is necessary for the protection of national unity and integrity, the protection of the integrity of the administration and the protection of the rights of citizens. When auditing local governments, two different methods are applied either according to the content of the audit or according to the criteria to be applied in the audit. Along with the public audit, local governments are subjected to legal compliance audit, subsidiarity audit, financial audit and performance audit. Performance audit is a process that examines the way an institution, organisation, activity or programme is managed in terms of the principles of efficiency, effectiveness and frugality and evaluates to what extent the requirements of accountability are fulfilled. In public administration, the main factor that constitutes the diversity of auditing is the auditing methods of local governments. These are political audit, judicial audit, administrative (managerial) audit, ombudsman audit and public audit. [ABSTRACT FROM AUTHOR]

SUMMARY: This article offers a review of John Conolly's book of 1847 concerning the construction and administration of asylums for the mentally ill, which gives detailed advice on the selection and management of staff and remarks on the role of the medical superintendent. [ABSTRACT FROM AUTHOR]

This study's purpose is to extend our understanding of school leadership for student learning by identifying high-leverage teacher evaluation practices that improve teaching. A partnership with a state education agency administered a teacher questionnaire regarding evaluation practices multiple times in one semester, then linked teacher responses to their next within-semester observation score. Broadly, teachers reported on scoring practices, the facilitation of post-observation conferences, feedback characteristics, and post-conference supports for evaluation-informed professional learning. Fixed effect regressions effectively compare observation scores and teacher-reported evaluation practices within the same teacher or teacher-by-evaluator pairing over four months while controlling for month-to-month influences on performance. The methods remove several serious confounders plausibly affecting related estimates in prior work. The analysis identifies six high-leverage teacher-reported evaluation practices, most of which apply to post-conference practices linking evaluation to professional learning. The evidence refines the academic understanding of leadership for student learning and implies that leadership preparation and in-service programs might emphasize the six high-leverage evaluation practices to promote active use among practicing leaders. Policymakers might ensure that aspiring and in-service leaders can develop these practices and that there are strong links between teacher evaluation and professional learning systems for school leaders to use. [ABSTRACT FROM AUTHOR]

The role of principal supervisor has been shifting from a focus on management to one that emphasizes support for principals. External partners can sometimes help with redesigning the role and other aspects of district organization. However, most research focuses on large urban districts with role conceptions and organizational structures that are not easily applied to midsized districts. In this study, we leverage contingency theory as a way to consider how contextual difference might matter in the use of principal supervisors to support and develop principals of underperforming schools. We interviewed district superintendents, principal supervisors, and principals in five mid-sized districts partnered with USSP, an in-service educational systems leadership provider with research evidence of impact on student achievement outcomes. We found that mid-sized districts commonly prioritized characteristics and traits regularly associated with good principal supervisors, but they were limited by district size and context in how they could initiate change. Despite some differences in how districts established the principal supervisor role, participants across levels described how principal supervisors were supported and, in turn, supported principals in intensive ways. Study results suggest that reorienting the principal supervisor's role, even in mid-sized districts, can build leadership capacity of principals leading underperforming schools. [ABSTRACT FROM AUTHOR]

Email has become a prominent communication tool for principals. Although principals have reported benefits of communicating via email, they have also indicated that it has intensified their workload. Specifically, principals have indicated that they receive a large volume of email, which contributes to extending and fragmenting their workdays. From actual email records, this study examined how email contributed to principal time demands and time use. Results indicated that the sample of principals received a substantial amount of email, which occurred during an extensive portion of the day, and also intensified during instructional hours. The comparisons of the timing of email activity revealed that principals experienced similar time demands from email, but used their time differently to address the demands. In addition, the email activities of principals exhibited descriptive differences from school district leaders. The findings indicated the need for more studies of principals' email activities and the time demands of principals, as well as suggested the need for principal preparation programs to provide specific training related to email and other such information technology. [ABSTRACT FROM AUTHOR]

This article examines the constitutional right to compensation for the violation of fundamental rights in the Indian context. It begins by exploring the historical development of this right, tracing its origins to the drafting of the Indian Constitution in 1950. The article then goes on to analyse the current state of the law in India with respect to this right, examining recent judicial decisions and legislative developments in this area. One key finding is the significant expansion of the right to compensation for violations of fundamental rights in India over the past decade. This expansion has been driven in part by the evolution of constitutional jurisprudence on this issue, as well as by the increasing recognition of the importance of this right among legal scholars, policymakers, and civil society organisations. This research also identifies several challenges that continue to limit the full realisation of this right in practice, including limited access to justice, institutional capacity constraints, and inadequate legislative frameworks. Overall, this article provides a comprehensive and nuanced analysis of the constitutional right to compensation for violation of fundamental rights in India, contributing to the ongoing discourse in this area and providing valuable insights for legal scholars, policymakers, and other stakeholders interested in promoting human rights and the rule of law in India. [ABSTRACT FROM AUTHOR]

The subaltern studies, especially those developed by South Asian thinkers, allude to the consequences of imperialism on colonized peoples, proposing a rewriting of history. In this theoretical essay, adopting a post-colonial perspective, the specific objective is to understand whether there is, and how it is configured, epistemic violence in the relations between organizational researchers in Brazil and subaltern research subjects. The general aim is to propose epistemic pathways to mitigate possible epistemic violence experienced by these individuals in research conducted in the field. To achieve this, the thoughts of intellectuals associated with the post-colonial perspective are drawn upon, including Gayatri Chakravorty Spivak, Mary Louise Pratt, and Boaventura de Sousa Santos. It is pointed out that there is a structure that promotes the silencing of subaltern subjects in the field of Administration research, and thus, three pathways are proposed to mitigate this context. [ABSTRACT FROM AUTHOR]

The establishment of Saorstát Éireann (the Irish Free State) in 1922 did not herald a fundamental overhaul of the administrative machinery inherited from Whitehall and Dublin Castle. Path dependent continuities in legislation and executive orders underpinned the new dispensation. At the same time, a process of evolutionary change, which we call 'administrative greening', was underway. Drawing on data in the Irish State Administration Database (ISAD), and building on our analysis in Biggins, J., MacCarthaigh, M., & Scott, C. (2024). Priming the state: Continuity and junctures in the foundation of the Irish administration. Irish Political Studies, we explore these dynamics of both continuity and change in the formative years of the new state's public administration. In so doing, we attest to patterns of normative production and reproduction, illustrated with reference to a number of legislative and administrative examples. [ABSTRACT FROM AUTHOR]

The knowledge base in the field of vaccination research and development has greatly improved. In the present era, utilizing a novel vaccine design and optimization strategy improves the vaccination efficiency and activity. In this regard, a novel drug delivery system produces nanosized, vaccine-loaded carrier molecules, which is called Nanovaccine. The advancement in nanovaccine and improved technology comes under preclinical and clinical trials, whereas different routes of administration strategy are applied against infectious diseases. The nanovaccine has high efficiency and immunogenicity compared to the traditional vaccine. Its long-lasting effect reduces the booster dose as well. One of the factors like routes of administration affects the efficiency of nanovaccine. The parenteral and mucosal vaccination is a traditional administration approach. In order to increase the safety and effectiveness of vaccines, innovative administration methods such as needless injection and polymeric formulations are now being developed. The presented paper shows a mechanism involved in nanovaccine delivery, and a method of administration via a different route, to learn more about their possible effects on immunogenicity, effectiveness, safety, sustained release and dose frequency reduction. The various advanced vaccine delivery methods, with special emphasis on its industrial and regulatory requirements for the higher production of nanovaccine, are also discussed. Illustrations of nanovaccine delivery systems overcoming barriers such as mucus layer and enzymatic degradation. Diagrams demonstrating the potential benefits of nanovaccines in enhancing immune response and providing targeted protection against pathogens. [ABSTRACT FROM AUTHOR]

Background: Acutely highlighted during the COVID‐19 pandemic, the tenuousness of the blood supply continues to be a lynchpin of the most important medical procedures. Online advertisements have become a mainstay in donor recruitment. We set out to determine the effectiveness of online search ads and variations thereof on blood donations with an emphasis on first‐time donors. Study Design and Methods: From September 01, 2022 through March 31, 2023, we performed a campaign comparison experiment through a major search‐ads platform with two distinct messages: one altruistic ("Altruistic") and one with a prospect of rewards ("Promotion"). We developed a method to track donation outcomes and associated them with impressions, click‐throughs, and conversions. We compared the performance of the Altruistic and Promotion arms to a control group that was not associated with any search‐ads ("Baseline"). Results: Analyzing 34,157 donations during the study period, the Promotion group, and not Altruistic, had a significant difference of first‐time donors over Baseline (24% vs. 12%, p = 7e‐6). We analyzed 49,305 appointments and discovered that appointments made from the Altruistic arm resulted in a significantly higher percentage of donations when compared to Baseline (57% vs. 53%, p =.009); however, the Promotion group had a higher percentage of donations from first‐time donors when compared to Baseline (12% vs. 8%, p =.006). Conclusion: We developed a method for determining the effectiveness of online search ads on donation outcomes. Rewards/promotions messaging was most effective at recruiting first‐time donors. Our methodology is generalizable to different blood centers to explore messaging effectiveness among their unique communities. [ABSTRACT FROM AUTHOR]

There is a lack of evidence-based guidelines for the administration methods of ceftriaxone in emergency departments (EDs), resulting in the reliance on individual institutional protocols for decision-making. This study was performed to compare the effects of administering ceftriaxone via intravenous push (IVP) and intravenous piggyback (IVPB) on 28-day mortality in patients with sepsis. This was a retrospective study of patients aged 18 years or older with sepsis or septic shock who visited an ED and were treated with ceftriaxone as an initial antibiotic between March 2010 and February 2019. Patients were divided into the IVP group and the IVPB group based on the administration method. The primary outcome was 28-day mortality, and multivariable Cox proportional hazards regression analysis was performed to evaluate the relationship between antibiotic administration methods and 28-day mortality. During the study period, a total of 939 patients were included in the final analysis, and the overall mortality rate was 12.2%. The antibiotic administration time was significantly lower in the IVP group than in the IVPB group, and the rates of antibiotic administration within 1 h and within 3 h were higher in the IVP group than in the IVPB group (p < 0.05). However, there was no significant difference in 28-day mortality between the two groups (hazard ratio 1.07, 95% confidence interval 0.69–1.65). IVP administration of ceftriaxone reduced the time of antibiotic administration compared with IVPB, but there was no difference in 28-day mortality. [ABSTRACT FROM AUTHOR]

Deploying systems-theoretical conceptuality, this paper improves understanding of the organisational consequences of the intensified societal engagement of a research university. Aligning its work with Luhmannian organisational analysis, it addresses the dynamic interplay between two modes of administrative decision-making communication, namely, the traditional professional administration and the New-Public-Management-oriented (NPM) managerial techniques. Our research observes how the politico-economic conditions of the society translate into the university's decisions concerning an initiative to engage in start-up entrepreneurship. The article contributes to higher education literature by showing that the university's professional administration is a discrete organisational function internally differentiated into specialised administrative branches, each of which operates according to a sense-making regime associated with its primary societal system reference, such as education, science and the economy. The article also demonstrates the structurally conditioned differences in branch-specific temporalisations of the entrepreneurial initiative during decision-making. Inspired by the Luhmannian view on temporality, we demonstrate how administrative decisions synchronise the varied structural time horizons within the university's professional administration. Focus on temporality in decision-making thus allows us to see how the NPM-inspired managerial techniques are operationalised in administrative communication at universities. Consequently, the paper argues that university administration is a complex dynamic entity, which varyingly aligns itself to national policy scripts, and only selectively enacts features of a global trend known as NPM. [ABSTRACT FROM AUTHOR]

Considering the enormous challenges cities face due to the climate crisis dramatically and urgently affecting Brazil, as seen recently in Rio Grande do Sul, in this editorial we discuss the administration's contributions in reflecting and acting on urban management and governance. RAC has pioneered addressing conceptual boundaries, interdisciplinary approaches, and the relationship between theory and practice, valuing knowledge production that can help confront contemporary challenges. In this context, discussing the role of administration and its contribution to urban management is essential to inspire professors, researchers, and professionals in our field to co-create more resilient, fair, and sustainable cities. [ABSTRACT FROM AUTHOR]

Considering the enormous challenges cities face due to the climate crisis dramatically and urgently affecting Brazil, as seen recently in Rio Grande do Sul, in this editorial we discuss the administration's contributions in reflecting and acting on urban management and governance. RAC has pioneered addressing conceptual boundaries, interdisciplinary approaches, and the relationship between theory and practice, valuing knowledge production that can help confront contemporary challenges. In this context, discussing the role of administration and its contribution to urban management is essential to inspire professors, researchers, and professionals in our field to co-create more resilient, fair, and sustainable cities. [ABSTRACT FROM AUTHOR]

The contribution of taxpayer-funded revenue means that the revenue component is essential and very important for the development of the unitary state of the Republic of Indonesia. Efforts to increase taxpayer compliance with tax payments need to be considered. This is the core or root of tax regulation and criminal law sanctions. Criminal offenses in the field of taxation are included in the field of administrative law (administrative criminal law or subsidiary offense), with ease and flexibility to be prosecuted as long as the legal objectives are achieved. Taxpayers are happy to pay in accordance with their tax obligations. Utilization of general and unique criminal regulatory standards for criminal demonstrations in the field of tax collection is inappropriate and may lead to legal problems in court. Thus, general offenses and exceptions relating to tax collection cannot be criminally prosecuted and all their consequences. Corruption can be applied to tax offenses in two ways. That is, according to article 43A(3), they are distinct from each other, or article 14 is incorporated into the tax law. Law No. 31 of 1999 was revised by PP No. 20 of 2001 which regulates the eradicating criminal of corruption. [ABSTRACT FROM AUTHOR]

In higher education, the discursive establishment of ‘faculty’ vs. ‘administrator’ creates a dualistic, hierarchical structure, informing relationalities between/within ourselves and faculty. As administrators, we found/find ourselves in relational encounters, entanglements of material-discursive bodies, that we were/are a part of producing. In these relational encounters, we experience ethics, care, and response-ability within immanent decision-making processes that bear the imprint of tradition and hierarchy. We think-write-live with our academic roles, gendered-racial-cultural-ethic identities, and experiences as administrators in higher education to consider how various philosophical concepts inform how we do admining. We ask, how do post-philosophical perspectives come into being with/in/through administration(ing), especially in the current political, higher education context? We think with relational encounters and post-philosophical concepts to illuminate that contemporary, care-full contestations of admining can create new educational imaginaries in hope-full renewals. [ABSTRACT FROM AUTHOR]

This is a qualitative, descriptive study that investigated how teaching in administration produces subjectivities through an ergological look. Semistructured interviews were carried out with the purpose of reaching the reality and the way of doing and thinking about the teachers' work. Resulting in the categorized: Researcher-professor or Professor-researcher; Teaching; Teaching Subjectivity and Relationship with the University. It was found that in the daily teaching work there are renormalizations and production of subjectivities, due to the fact that the teaching work is involved in dilemmas and negotiations, being an activity full of unpredictability, diversity of people and expectations, realities and opinions, in addition to having a need constant innovation. For this reason, the teaching work uses the subjectivity of the individual, who through his experiences and values readapts the lesson planning, creates new mechanisms to cover not only current issues, but also to denote a new mentality. [ABSTRACT FROM AUTHOR]

Considering the conception of teaching and learning in Administration as an empirical object, the objective of this study is to investigate the possible parallels between the Teaching Case and the literature of active methodologies, in order to show how this methodology was perceived by students. Therefore, this article adopted a qualitative research approach, with theoretical reflections on active methodologies, and was based on the Case Study method to carry out investigations with students through questionnaires on the Survey Monkey platform. As main results, it was found that the Teaching Case is an adequate strategy for remote teaching - ascending format after the advent of COVID-19 -, contributing to effective and meaningful learning and thus being recognized by students, who highlighted its ability to contribution on four central aspects: practical learning; dynamism of classes; challenge quality; and engagement. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Postinffammatory hyperpigmentation (PIH) is a common sequela of acne vulgaris. Topical treatment with hydroquinone is the standard treatment, but may be associated with complications. Cysteamine is a relatively safe depigmenting agent with an observed depigmenting effect. We designed this study to assess the efficacy of a cysteamine 5% cream in treating acne-induced PIH. METHODS: Twenty-eight out of 32 participants finalized this investigator-blind, randomized, and controlled trial (registered in Iranian Registry of Clinical Trials [IRCTID: IRCT20140212016557N5]). We randomized the patients to apply either cysteamine 5% or hydroquinone 4%/ascorbic acid 3% (HC) cream. Postacne hyperpigmentation index (PAHPI) and melanin index were the assessment measures after four months of treatment. We evaluated the quality of life by the Dermatology Life Quality Index (DLQI) questionnaire. RESULTS: Both cysteamine and HC cream significantly decreased the PAHPI score and melanin index of acne-induced PIH patients (p<0.05). The decrease in PAHPI score and melanin index were not significantly different in treatment groups after four months (p>0.05). Quality of life ameliorated significantly only with cysteamine treatment. However, no significant change in quality of life was observed between groups. LIMITATIONS: Limitations of our study include the relatively small sample size and absence of follow-up. CONCLUSION: Cysteamine cream is an effective treatment of post-acne PIH, with similar efficacy to the accepted treatment of PIH, i.e., hydroquinone cream. [ABSTRACT FROM AUTHOR]

The pandemic underscored the significance of a digital health system. Healthcare sector has become one of the most important infrastructures since then. Undoubtedly, the digital health is the ultimate way to ensure accessibility, inclusiveness and delivery of healthcare services in an affordable and efficient manner. However, rising cyber-threat is one of the biggest concerns for healthcare organizations. The data breach incidents on Indian Council of Medical Research and on Covid-19 vaccine database in 2023 highlight the utter need to address the issue. To mitigate such incidents, India has established Computer Emergency and Response Team (CERT-In) which has been endowed with primary responsibility to prevent, treat, respond and report such threats. Although, CERT-In is responsible to report any cyber-incident but there is no information concerning the affected organizations and on frequency and severity of such cyber-incidents. It is doubtful as to how any authority is supposed to respond in lack of data or policy makers formulate a comprehensive framework to deal with the issue. CERT-In faces challenges in accurately reporting cyber incidents and contain discrepancies compared to other organizations' data and lacking detailed incident information. This research aims to analyze government records and secondary sources to understand the cyber-threat landscape, particularly in the healthcare industry. Using normative and comparative methods, it suggests measures which can be adopted by CERT-In based on assessments of U.S. and E.U. reporting practices. Findings stress the need for improved reporting practices and transparency in cybersecurity assessments to enhance data accuracy and completeness, urging policymakers and stakeholders to take action against cyber threats. [ABSTRACT FROM AUTHOR]

Swedish universities and colleges have received a substantial funding increase since the turn of the millennium, as part of continued policies of expanding the admission of students to higher education to broader layers of the population and strengthen Swedish public research and development to increase the competitiveness of the Swedish knowledge-based economy. In this article, publicly available statistics are used to trace how this increase in funding has been used by the sector. Comparing figures on income (base grant for research, third-party funding and base grant for education) with statistics on personnel and student enrolment as well as data on actual expenditure, the article draws some conclusions that are used to discuss some common misunderstandings and erroneous beliefs, including claims of a 'depletion' of the base grant for research and an uninhibited growth of the number of administrative staff, which are common themes in the Swedish and international debate over higher education. [ABSTRACT FROM AUTHOR]

This scoping review analyzed the literature on decision making by academic library administrators. The authors reviewed 756 records retrieved from three databases and 627 additional records from citing and cited references; 33 articles met the inclusion criteria. Library administrators make widespread use of internal and external inputs in decision making. Six categories of inputs were identified, along with seven groups of influencing factors. This research contributes to the profession by identifying types of information that reduce uncertainties related to operational decision making and planning. Further research is needed on the relationship between inputs and complexity and levels of decision making. [ABSTRACT FROM AUTHOR]

Workload in the emergency department (ED) fluctuates and there is no established model for measurement of clinician-level ED workload. The aim of this study was to measure perceived ED workload and assess the relationship between perceived workload and objective measures of workload from the electronic medical record (EMR). This study was conducted at a tertiary care, academic ED from July 1, 2020 through April 13, 2021. Attending workload perceptions were collected using a 5-point scale in three care areas with variable acuity. We collected eight EMR measures thought to correlate with perceived workload. EMR values were compared across areas of the department using ANOVA and correlated with attending workload ratings using linear regression. We collected 315 unique workload ratings, which were normally distributed. For the entire department, there was a weak positive correlation between reported workload perception and mean percentage of inpatient admissions (r = 0.23; p < 0.001), intensive care unit admissions (r = 0.2; p < 0.001), patient arrivals per shift (r = 0.14; p = 0.017), critical care billed visits (r = 0.22; p < 0.001), cardiopulmonary resuscitation code activations (r = 0.2; p < 0.001), and level 5 visits (r = 0.13; p = 0.02). There was weak negative correlation for ED discharges (r = –0.23; p < 0.001). Several correlations were stronger in individual care areas, including percent admissions in the lowest-acuity area (r = 0.43; p = 0.033) and patient arrivals in the highest-acuity area (r = 0.44; p <.01). No significant correlation was found in any area for observation admissions or trauma activations. In this study, EMR measures of workload were not closely correlated with ED attending physician workload perception. Future study should examine additional factors contributing to physician workload outside of the EMR. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate if peripheral administration of 3% hypertonic saline (HTS) provides timely treatment with a rate of infusion-related adverse events at or below what is reported in the literature. Methods: This was a single-center, retrospective study conducted in a large academic medical center in New York City. Eligible patients were inpatients receiving either 2% or 3% HTS for severe hyponatremia, elevated intracranial pressure, or cerebral edema. The primary outcome was incidence of infusion-related adverse events. Secondary endpoints included achievement of appropriate sodium correction, incidence of over-correction, length of time from ordering to medication administration, and incidence of osmotic demyelination syndrome (ODS). Main Results: A total of 199 patients were included in analysis (85 in the 3% HTS group and 114 in the 2% HTS group). No difference was found between groups for rate of infusion related adverse events or incidence of sodium overcorrection groups (0 vs 1 [0.9%]; p = 0.39). Significantly more patients in the 3% HTS group received intermittent administration (p < 0.001), whereas more patients in the 2% HTS group received a continuous infusion (p < 0.001). There were no reports of ODS in either group. No difference in length of time to administration was found between groups. Conclusion: Our study, one of the largest to evaluate peripheral administration of 3% HTS, found that it is not associated with an increase in infusion related adverse events or sodium overcorrection versus 2% HTS. Peripheral administration should be recommended to provide timely treatment for patients requiring HTS. [ABSTRACT FROM AUTHOR]

Background Invasive fungal disease (IFD) in the early post-allogeneic HSCT (alloHCT) period is associated with increased likelihood of catastrophic outcomes. The utility of oral modified release (MR) posaconazole tablets is limited by reduced drug absorption from gastrointestinal toxicity induced by cytotoxic chemotherapy, necessitating a switch to the IV posaconazole formulation. Objectives To describe the population pharmacokinetics of posaconazole for oral MR and IV formulations in alloHCT patients and determine dosing regimens likely to achieve therapeutic exposures. Methods We performed a prospective observational pharmacokinetic study in adult patients in the early post-alloHCT period requiring a change in posaconazole formulation (oral to IV). Samples were analysed using a validated LC-MS/MS method. Population pharmacokinetic analysis and Monte Carlo simulations (n  = 1000) were performed using Pmetrics for R. Results Twenty patients aged between 21 and 70 years were included in the study. A two-compartment model, incorporating mucositis/diarrhoea to modify the bioavailability for oral administration best described the data. To achieve ≥90% PTA, simulations showed that higher than currently recommended doses of oral MR posaconazole were required for prophylaxis C min targets (≥0.5 and ≥0.7 mg/L), while increased doses of both formulations were required for IFD treatment PK/PD targets, with patients experiencing oral mucositis/diarrhoea unlikely to achieve these. Conclusions Increased doses of posaconazole should be considered for both prophylaxis and treatment of IFD to increase the proportion of alloHCT patients achieving therapeutic exposures, particularly the oral formulation in patients with mucositis and/or diarrhoea. Posaconazole therapeutic drug monitoring should be considered for all formulations in this setting. [ABSTRACT FROM AUTHOR]

Purpose This article summarizes emerging nontraditional therapies administered via the nebulization route for use in the emergency department (ED). Summary Although traditional routes of medication administration (eg, intravenous) have been the mainstay of administration modalities for decades, these routes may not be appropriate for all patients. Nowhere is this more readily apparent than in the ED setting, where patients with a variety of presentations receive care. One unique route for medication administration that has increasingly gained popularity in the ED is that of aerosolized drug delivery. This route holds promise as direct delivery of medications to the site of action could yield a more rapid and effective therapeutic response while also minimizing systemic adverse effects by utilizing a fraction of the systemic dose. Medication administration via nebulization also provides an alternative that is conducive to rapid, less invasive access, which is advantageous in the emergent setting of the ED. This review is intended to analyze the existing literature regarding this route of administration, including the nuances that can impact drug efficacy, as well as the available literature regarding novel, noncommercial nebulized medication therapy given in the ED. Conclusion Multiple medications have been investigated for administration via this route, and when implementing any of these therapies several practical considerations must be taken into account, from medication preparation to administration, to ensure optimal efficacy while minimizing adverse effects. The pharmacist is an essential bedside team member in these scenarios to assist with navigating unique and complex nuances of this therapy as they develop. [ABSTRACT FROM AUTHOR]