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Family caregivers care for individuals in the home environment. Family caregivers of individuals with chronic obstructive pulmonary disease (COPD) observe breathlessness in the care recipient. Breathlessness is a main symptom of COPD, and watching breathlessness creates emotional distress and a toll on family caregivers. The purpose of this integrative review was to explore the literature on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of family caregiver experiences of breathlessness will allow for further development of evidence-based practice and research. An integrative review was performed using the five-step process of the Whittemore and Knafl Integrative Review Model. Literature search results were reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An overarching theme of constant care and burden resulted from the 18 studies on family caregivers and witnessed breathlessness in individuals with COPD. Three themes: psychosocial implications of caregivers, response ambiguity, and knowledge of interventions represented family caregivers and breathlessness in the care recipient among the studies. This integrative review provides insight on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of the family caregiver perception of breathlessness in the care recipient can help home healthcare professionals empathize with and offer support specific to the needs of family caregivers of individuals with breathlessness from COPD, heart failure, and other chronic diseases. [ABSTRACT FROM AUTHOR]

The Women's Health Initiative (WHI) has been a major contributor to diet and chronic disease research among postmenopausal US women over its 30+ year history (1993 to present). The WHI program included full-scale randomized trials of a low-fat dietary pattern high in fruits, vegetables, and grains, and of calcium and vitamin D supplementation, each with designated primary and secondary chronic disease outcomes. The history of these trials will be briefly reviewed here, along with principal findings that included evidence for breast cancer-related benefits for each of the 2 interventions. In recent years, WHI investigators have developed an active research program in nutritional biomarker development and in the application of these biomarkers in WHI cohorts, among various other nutritional epidemiology uses of WHI observational study resources. The intake biomarker work, which primarily relies on blood and urine metabolomics profiles, lends support to the low-fat dietary pattern trial results, and supports chronic disease benefits of higher carbohydrate diets more generally, especially through the fiber component of carbohydrate. [ABSTRACT FROM AUTHOR]

In evidence-based medicine, systematic review continues to carry the highest weight in terms of quality and reliability, synthesizing robust information from previously published cohort studies to provide a comprehensive overview of a topic. Meta-analysis provides further depth by allowing for comparative analysis between the studied intervention and the control group, providing the most up-to-date evidence on their characteristics and efficacy. We discuss the principles and methodology of meta-analysis, and its applicability to the field of surgical research. The clinical question is defined using PICO framework (Problem, Intervention, Comparison, Outcome). Then a systematic article search is performed across multiple medical databases using relevant search terms, which are then filtered out based on appropriate screening tools. Pertinent data from the selected articles are collected and undergo critical appraisal by at least two independent reviewers. Additional statistical tests may be performed to identify the presence of any significant bias. The data are then synthesized to perform comparative analysis between the intervention and comparison groups. In this article, we discuss specifically the usage of R software (R Foundation for Statistical Computing, Vienna, Austria) for data analysis and visualization. Meta-analysis results of the pooled data are presented using forest plots. Concerns for potential bias may be addressed through the creation of funnel plots. Meta-analysis is a powerful tool to provide highly reliable medical evidence. It may be readily performed by independent researchers with minimal need for funding or institutional approval. The ability to conduct such studies is an asset to budding medical scholars. [ABSTRACT FROM AUTHOR]

Anxiety is one of the most prevalent psychological conditions in the pediatric population, and its associated impairments often persist into adulthood. Pediatricians are in a unique position to screen, briefly intervene, and facilitate treatment to prevent long-term impacts. However, they often do not have adequate training to do so. The current study addressed this gap by providing a brief online educational workshop aimed to promote: (1) screening for anxiety and (2) follow-up with appropriate evidence-based interventions. Fifty-three providers participated, and 38 completed surveys pre- and post-training. Findings indicate acceptability of the training to providers, improved knowledge related to anxiety, and increased readiness to manage anxiety during a medical visit. This study supports the utility of a brief, online training on screening and provision of evidence-based treatment for anxiety in pediatric primary care. [ABSTRACT FROM AUTHOR]

Background: Delirium is a state of altered level of consciousness often leading to confusion, inattention, and changes to levels of cognition. Delirium increases average length of stay in the hospital and costs the US health care system approximately $148 billion each year in associated medical costs. Sleep hygiene is an important factor in delirium prevention for all hospitalized patients. Objectives: This quality improvement project was designed to increase implementation of an evidence-based sleep hygiene bundle in the neurocritical care population in order to decrease rates of hospital-acquired delirium. Methods: This project followed the Plan, Do, Study, Act (PDSA) framework to facilitate a continuous quality improvement intervention at amid-Atlantic academicmedical center in the neurocritical care population. The continuous quality improvement included the incorporation of "sleep" as a topic into the daily rounding checklist, thus optimizing the ability to improve adherence to a multicomponent sleep hygiene bundle. The intervention includes the preintervention-postintervention occurrences of delirium and use of the daily rounding checklist. Results: Nursing adherence to documentation of delirium assessments was high at approximately 99%. Following the intervention, there was a 41% decrease in the number of patients who screened positive for hospital-acquired delirium. Discussion: The improvement in cases of hospital-acquired delirium may be attributed to the project intervention. Recommendations for future interventions include analysis of training on sleep plans, focus on nursing education regarding delirium assessment tools, or a measure of staff and/or patient satisfaction related to the intervention. [ABSTRACT FROM AUTHOR]

Scholars and advocates are at odds about how to achieve higher levels of child safety and permanency. Calls for change include the recent upEND focus on eradication of child welfare services to a radical refocusing of the present system towards prevention/early intervention. To clarify the implications of reform over abolition, we seek to portray a future in which the abolition of child welfare has occurred, in juxtaposition to maintaining four core elements of established child maltreatment programmes around the world: (1) receiving and responding to community signals about the risk to children; (2) assessment of need coupled with a proportionate response; (3) rights protections to ensure fairness when placement outside the family is required; and (4) procedures for accountability and quality improvement. For each of these functions, we outline abolitionist advocates' positions and implications for children and parents. Across these elements, we delineate how assigning these responsibilities to communities, as suggested by upEND, would likely (1) exaggerate racial and economic inequities and (2) create structural barriers that would increase harm to children. We suggest several evidence‐informed enhancements to practice, research and policy that would mitigate these inequities while also increasing safety and permanency. [ABSTRACT FROM AUTHOR]

Purpose: Research-supported family programmes are proven to be effective in reducing dysfunctional behaviours in youth. A fundamental role is played by professionals with high competence levels and a positive attitude to evidence-based practice (EBP). The aim of the study was to assess the efficacy of prior training for the facilitators of the PCF-AFECT, in order to ascertain whether it led to improvements in their competence levels and whether favourable attitudes to evidence-based practice were associated with higher competence levels. Method: A quantitative method was used, with a sample of professionals from Spain (N = 150). Results: Results showed that the training was effective in the case of four categories of professional competencies. Favourable attitudes to EBP were associated with clusters of professionals with higher competencies. Discussion: Both findings contribute scientifically to the identification of the core components or gold standards of training that are needed for the facilitators of research-supported family programmes. [ABSTRACT FROM AUTHOR]

Many educational programs aimed at addressing child maltreatment focus on teaching people how to recognize only one type of child maltreatment, most commonly child sexual abuse, rather than all types of abuse and neglect children might experience. Limited empirical evidence exists on the effectiveness of educational programs that teach adults how to identify all types of child maltreatment, as well as what reporting responsibilities are and how to properly make a report of maltreatment once it is suspected. The goal of the present study was to fill that gap by examining whether an educational program called KNOW and TELL® increased participants' knowledge on how to identify various types of child maltreatment, what the state's mandated reporting laws are, and how to make a report in the event maltreatment is suspected. A comparison of pre-training and post-training assessment results suggests that participants demonstrated improved knowledge on the signs of child maltreatment, reporting responsibilities, and intervention procedures after completing the training. The findings of this research support the development and implementation of state-specific educational programs that raise awareness on child maltreatment and teach adults what their statutorily mandated responsibilities are and how to report child maltreatment when it is suspected. [ABSTRACT FROM AUTHOR]

The underlying tenet of evidence-based decision-making in health services is assessing all the relevant evidence. Using the traditional qualitative and quantitative approaches to identifying evidence may not capture the full spectrum of factors that need to be addressed. A selective mixed-method approach may provide a comprehensive assessment of the relevant knowledge. This paper adds to the methodological literature by outlining a novel sequential, mixed-method, exploratory process for identifying evidence-based data standards that may be used for health service decision-making. The three-phase process, entitled Delphi Plus, engages peer-nominated topic-specific experts to assess all publicly available and practice-based items and, through a series of reviews, reach an evidence-based consensus on standards for decision-making. Each process phase is outlined in-depth and supplemented by practical learnings gained through its implementation. The Delphi Plus methodology provides the first comprehensive process for combining the published and practised data to develop evidence-based data standards. The routine use of Delphi Plus would provide a framework for benchmarking in health services, enabling greater monitoring and evaluation of client outcomes and improving quality care. This manuscript describes the process of implementing Delphi Plus and provides an example of data standards generated from its use, which directly inform the Australian Government's Primary Health Care 10 Year Plan. [ABSTRACT FROM AUTHOR]

Purpose: A routine preoperative assessment is considered both ineffective and inefficient. Despite the widespread application of lean thinking in healthcare, there is little evidence of successful experiences in preoperative admissions in order to reduce "No value added" activities. A conceptual framework reporting the drivers (clinic, tools, innovation, organization, and governance) and impacts (patient, efficiency, sustainability, time, learning and growth) was developed. Methodology: Drawing on the experience of an Italian high complexity hospital, this paper analyzes the case study by reporting evidence on how to implement lean in preoperative assessment and how to evaluate the positive results obtained. Results: Applying lean principles, the identification of value improved the appropriateness of care by creating 40 personalized pathways; the value stream resulted in a reduction of "No Value Added Time" from 37% to 28%, chest X-rays from 41% to 14% and cardiac visits from 49% to 37%; the pursuit of continuous flow through innovation contributed to increase the use of digitalization; the new pull organization helped to reduce the average time spent per year by 1.5 h; the continuous improvement was ensured through the governance of results. Conclusion: The proposed framework should be used to improve the quality of care in preoperative admissions by adopting the lean drivers for successful implementation and reporting the impacts. [ABSTRACT FROM AUTHOR]

In evidence-based medicine frameworks, the highest level of evidence is derived from quantitative synthesis of double-masked, high-quality, randomly assigned controlled trials. Meta-analyses of randomly assigned controlled trials have demonstrated that screening mammography reduces breast cancer deaths. In the United States, every major guideline-producing organization has recommended screening mammography in average-risk women; however, there are controversies about age and frequency. Carefully controlled observational research studies and statistical modeling studies can address evidence gaps and inform evidence-based, contemporary screening practices. As breast imaging radiologists develop and evaluate existing and new screening tests and technologies, they will need to understand the key methodological considerations and scientific criteria used by policy makers and health service researchers to support dissemination and implementation of evidence-based screening tests. The Wilson and Jungner principles and the U.S. Preventive Services Task Force general analytic framework provide structured evaluations of the effectiveness of screening tests. Key considerations in both frameworks include public health significance, natural history of disease, cost-effectiveness, and characteristics of screening tests and treatments. Rigorous evaluation of screening tests using analytic frameworks can maximize the benefits of screening tests while reducing potential harms. The purpose of this article is to review key methodological considerations and analytic frameworks used to evaluate screening studies and develop evidence-based recommendations. [ABSTRACT FROM AUTHOR]

Purpose: This evidence-based initiative assessed the effect of adding a mobility champion to an existing progressive mobility protocol on functional decline in hospitalized older adults as evidenced by recommended discharge to home versus an inpatient rehabilitation facility. Method: Older adults admitted from home to a 47-bed medical-surgical telemetry unit who were assessed as ambulatory, either independently or with assistance (Level 5), and with a progressive mobility order in the electronic health record were included in the initiative. Patient care associates who volunteered to be mobility champions were trained how to safely ambulate patients. Results: Patients who worked with a mobility champion were less likely to be referred to inpatient rehabilitation post discharge for further care due to functional decline. Conclusion: Mobility has a critical role in the maintenance of hospitalized older adults' functional abilities and is a determinate of their post discharge disposition. [Journal of Gerontological Nursing, 50(11), 37–43.] [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age, and presents a significant challenge to the global population. This review provides comprehensive evidence of interventions, including food and dietary supplements, aimed at reversing PCOS and improving fertility outcomes. Various dietary supplements are known to cause metabolic changes and hormonal regulation and have a potential impact on increasing pregnancy rates. Although some biochemical alterations have been observed, these metabolic changes do not directly reverse the disorder. Moreover, the lack of sufficient evidence does not convince clinicians to standardize dietary supplements as alternatives to medical or pharmacological interventions. This calls for a study of women with PCOS taking dietary supplements. In addition, unbiased studies of combinations of treatment options for supplements, including large cohort clinical trials, will lead to evidence-based medicine. [ABSTRACT FROM AUTHOR]

Businesses, government agencies, human services organizations, and academic institutions address diversity, equity, and inclusion (DEI) in a variety of ways, including training. Yet, little scholarly attention has been paid to the empirical outcomes from DEI training. The purpose of study is to evaluate the effectiveness of a racial equity workshop implemented over five years with community stakeholders and the unique inclusion of a caucus modality that supplements the workshop by learning and practicing racial equity skills. Mixed method results suggest that workshop participants increased their knowledge of race and racism, systemic disparities, and biases. Caucus participants reflected on their values and beliefs and actively applied anti-racism and racial equity skills. Both groups indicated intent to change their behavior and caucus attendees explained how they had already begun behavior changes. With the extant literature, these research findings can assist stakeholders to implement DEI training and foster more equitable decisions and organizations. [ABSTRACT FROM AUTHOR]

Cannabis, often criticized, has active compounds that indicate multiple medical benefits. However, before the potential decriminalization and legalization of medical cannabis, pharmacists play a crucial role in the decision-making for personalized therapy and evidence-based medicine. This study investigates pharmacists’ perspectives on medical cannabis, covering medical use, societal impact, research, legality, and regulation. This study was conducted through semi-structured interviews with pharmacists from different sectors. Interviews were conducted with 16 pharmacists, with 4 from each sector: industry, academia, community, and hospital. There was a consensus on the need for streamlined research before potential decriminalization and legalization of cannabis, highlighting concerns about abuse and misuse despite its benefits. With that in mind, all participants agree that there is a need to update the current legislation and regulations to better control the use and distribution of medical cannabis. Several participants also called to attention that education plays an important role in the potential decriminalization of medical cannabis, with cannabis-related stigma being a potential deterrent for not only the public but also healthcare professionals. As medical cannabis is a new subject in Malaysia, this study could ignite further multidisciplinary human-related research with strict regulations which will ultimately result in evidence-based medicine. [ABSTRACT FROM AUTHOR]

AbstractBackground: To investigate evidence-based medicine (EBM) use by physicians and pharmacists in the United Arab Emirates (UAE). Method: A cross-sectional study using a validated questionnaire. Results: Overall, 70.7% of physicians and 35.3% of pharmacists had positive attitude toward EBM. Physicians with 10–15 years of professional experience scored highest on EBM implementation; no statistical association was found (p = 0.099). Younger pharmacists aged 25–35 years were more interested in implementing EBM compared to older pharmacists (p = 0.011). Physicians in Al Ain performed better than those in other cities (p < 0.0001), and pharmacists in Abu Dhabi implemented EBM better than others (p = 0.014). Conclusion: Age and years of experience could influence implementing EBM. [ABSTRACT FROM AUTHOR]

Background: Practice facilitation (PF) is an evidence-based multicomponent in-person implementation strategy. COVID-19-related lockdowns caused many implementation initiatives to rapidly shift to virtual settings, but there is limited evidence on PF deployed exclusively using virtual meeting platforms. Our objective was to assess the feasibility and acceptability of virtual PF used in a primary care setting to implement interdisciplinary opioid safety committees (OSCs) to improve care for patients using opioid medicines for persistent pain and reduce high-dose opioid prescribing. We also describe alignment of virtual PF with the core functions of PF and fidelity of participating clinics to the OSC intervention. Methods: We applied qualitative and quantitative methods to evaluate virtual PF used to implement a quality improvement project at Kaiser Permanente Washington, an integrated health system in Washington State. We established interdisciplinary OSCs in primary care clinics using virtual PF. OSCs were tasked with promoting opioid safety and high-quality pain care through population management and chart reviews. We used administrative data to calculate feasibility measures including attendance and retention. Acceptability data came from interviews with OSC members conducted by evaluators. Measures of fidelity to the OSC intervention were abstracted from meeting notes and administrative data. We used qualitative methods to assess the adherence of virtual PF to the core functions of PF. Results: Facilitators carried out a comprehensive PF approach virtually and demonstrated adherence to the core functions of PF. We established OSCs in eight clinics and conducted an average of 17.5 virtual PF meetings over eight months of PF for each clinic. Average attendance was 75% and we had 84% retention. OSC members were highly satisfied with virtual PF. Facilitators effectively supported teams through implementation and technical challenges and OSC members gained skills through virtual PF. We implemented OSCs with high fidelity, suggesting virtual PF is an effective implementation strategy. Conclusions: We found virtual PF is a feasible and acceptable implementation strategy for this intervention and identified strategies to support care teams through challenges. Our findings can help inform future implementation efforts, especially those hoping to engage geographically dispersed clinics or remote clinical staff. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Financial relationships between clinical guideline authors and pharmaceutical companies introduce conflicts of interest (COI), potentially biasing guideline recommendations. Thus, proper management of COI is paramount for clinical guideline authors. Nevertheless, little is known about COI among neurology clinical guideline authors. This study aimed to evaluate the financial relationships between pharmaceutical companies and authors of Clinical Practice Guideline for Headache Disorders (CPGHD) in Japan. Methods: This is a retrospective analysis of 2016–2020 personal payments data disclosed by all pharmaceutical companies affiliated with the Japan Pharmaceutical Manufacturers Association. We examined amounts and fraction of personal payments to all 57 CPGHD authors and all neurologists board-certified by the Japanese Society of Neurology. Payment data was descriptively analyzed at individual author level. Results: Among 57 CPGHD authors, 56 (98.3%) received personal payments totaling $2.7 million from pharmaceutical companies between 2016 and 2020. Median five-year payments were $89,955 for CPGHD authors, while $521 for board-certified neurologists. The CPGHD chairperson and vice chairperson received substantial payments during the guideline development period. Nevertheless, because of less rigorous and transparent COI policy compared to international standard policies, only 10 authors disclosed their financial relationships with the pharmaceutical companies in the guideline. Conclusions: More than 98% of CPGHD authors received much higher personal payments from pharmaceutical companies than those to board-certified neurologists during the guideline development period in Japan. [ABSTRACT FROM AUTHOR]

Psychedelics, including ketamine, 3,4-Methyl enedioxy methamphetamine (MDMA), and psilocybin, have gained attention for their potential therapeutic role in mental health treatment. While recreational use is prohibited in Canada, medicinal exemptions can be granted. There are several psychedelic clinics in Ontario, Canada, promoting the use of psychedelics for a variety of medical indications. Our objective was to identify the indications for which psychedelics are being prescribed in Ontario clinics and assess the quality of evidence used to support these claims. Internet searches were conducted using Google and Bing to identify psychedelic clinics in Ontario. Inclusion criteria was as follow: clinics were physically located in Ontario, had a functioning website link, and demonstrated involvement of a licensed physician or nurse practitioner. Identified clinics were evaluated for their claims of effectiveness, the quality of evidence used to support these claims, and statements on psychedelic-related harms. The cited studies were appraised for quality using Oxford Centre for Evidence-Based Medicine Levels of Evidence, "level 5" being the lowest quality and "level 1" being the highest quality. Out of 200 search results, 10 psychedelic clinic websites met our inclusion criteria. These clinics advertised psychedelics for 47 medical conditions, most commonly for depression. Only 2 out of 10 clinics described potential risks associated with psychedelic use. There were 29 studies cited by these websites, majority coming from "level 4" evidence consisting of case-series and case-control studies. Overall, the cited evidence quality was low to moderate. Psychedelic clinics in Ontario promote a wide range of medical indications for psychedelics using primarily low to moderate "level 4" evidence. There is limited information shared on the potential adverse effects of psychedelics. Our study emphasizes the importance of using transparent and high-quality evidence by clinics and clinicians to ensure safe and effective use of psychedelics in mental health treatments. [ABSTRACT FROM AUTHOR]

Enteral tube feeding is commonly used for children and young people with complex health and care needs. Blended diets are becoming more widely used and there is increasing evidence to show the benefits of a blended diet for children, young people and their families. This article aims to collate recent evidence on blended diets and describe the implications for nursing practice. Studies exploring blended diets have identified benefits such as improved gastrointestinal symptoms, positive engagement with families around food and mealtimes and the normalisation of enteral tube feeding. Research has also explored the nutritional and microbial content of food blends as well as the viscosity and risk of tube blockage. These are key considerations when supporting families to make informed decisions and use blended diets safely. Nurses play an important role in supporting the safe and effective use of blended diets as part of a wider multidisciplinary team. It is necessary that they have an understanding of the evidence underpinning nursing practice in this area. [ABSTRACT FROM AUTHOR]

Background: Australia's clinical trials sector is highly productive with continued sector investment needed to enhance research impact. Generating economic evidence alongside trials has the potential to facilitate the implementation of trial results into practice. Ascertaining the use of health economic evaluations alongside clinical trials can assist in determining whether clinical trials fully realize and operationalize their potential to change policy and practice. The aims of this study were to ascertain the uptake of health economic evaluations alongside Australian-led clinical trials and explore associations between uptake and trial characteristics. Methods: This observational study comprised a descriptive analysis of clinical trials registries, a cross-sectional survey of Australian Clinical Trials Alliance (ACTA) networks, and a subgroup analysis of completed acute care trials. Descriptive analyses of trial registrations were conducted, with logistic regressions used to identify predictors of proposing and subsequently publishing a health economic evaluation alongside acute care trials. Results: Few randomized Australian-led clinical trials (11% of 9251) and ACTA network trials (43% of 227) proposed a health economic evaluation. In the subgroup analysis, 22% of the 324 acute care trials and 53% of the 38 ACTA network acute care trials proposed a health economic evaluation. Acute care trials funded by government bodies were significantly more likely to propose and publish a health economic evaluation than those funded by hospitals, universities, and other funders, after adjusting for phase, registration year, primary sponsor type, and comparator. Conclusions: Current uptake of health economic evaluations alongside Australian-led clinical trials is low, with uptake higher among the subset of ACTA network trials. This is despite economic evidence playing an increasingly prominent role in health system management, as well as rising health expenditure, limited budgets, and competing demands. There is significant opportunity to embed health economic evaluations alongside clinical trials, particularly phase 3 trials, to increase research outputs and optimize research translation. Investing in clinical trial networks that support funding for a health economist or a health economic evaluation may be an effective strategy to increase the uptake of health economic evaluations alongside trials. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma acquired outside the hospital or other healthcare settings, typically affecting previously healthy individuals. This intersociety consensus aims to provide evidence-based recommendations for the antibiotic treatment of mild to moderate CAP in previously healthy children in Italy. A systematic review was conducted to identify the most recent and relevant evidence. Embase, Scopus, PubMed, and Cochrane databases were systematically screened, with a date restriction from 2012 to April 2024, but without language limitations. The review included studies conducted in high-income countries on antibiotic therapy in children over 3 months of age diagnosed with mild-moderate CAP. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. The final recommendations were obtained through a Delphi consensus of an expert panel. Amoxicillin is the first-line treatment if the child is at least immunized against Haemophilus influenzae type b (low/very low quality of evidence, strong recommendations), while amoxicillin-clavulanate or second- or third-generation cephalosporins should be prescribed for those unimmunized or with incomplete immunization coverage for both H. influenzae type b and Streptococcus pneumoniae (low/very low quality of evidence, strong recommendations). Macrolides should be considered in addition to amoxicillin in children over 5 years old, if symptoms persist and the clinical condition remains good after 48 h of therapy (low/very low quality of evidence, strong recommendations). The dosage of amoxicillin is 90 mg/kg/day divided in three doses, although two doses could be considered to improve compliance (moderate quality of evidence, weak recommendations). A five-day duration of therapy is recommended, with clinical monitoring and re-assessment approximately 72 h after the start of antibiotic treatment to evaluate symptom resolution (moderate quality of evidence, strong recommendations). To improve the management of CAP in pediatric patients, we have developed this consensus based on a thorough review of the best available evidence and extensive discussions with an expert panel. However, further efforts are needed. Future research should focus on enhancing diagnostic accuracy, optimizing antibiotic utilization, comparing the efficacy of different antibiotic regimens, and determining the optimal dosage and duration of treatment in different setting. [ABSTRACT FROM AUTHOR]

Background: Systematic review with meta-analysis integrates findings from multiple studies, offering robust conclusions on treatment effects and guiding evidence-based medicine. However, the process is often hampered by challenges such as inconsistent data reporting, complex calculations, and time constraints. Researchers must convert various statistical measures into a common format, which can be error-prone and labor-intensive without the right tools. Implementation: Meta-Analysis Accelerator was developed to address these challenges. The tool offers 21 different statistical conversions, including median & interquartile range (IQR) to mean & standard deviation (SD), standard error of the mean (SEM) to SD, and confidence interval (CI) to SD for one and two groups, among others. It is designed with an intuitive interface, ensuring that users can navigate the tool easily and perform conversions accurately and efficiently. The website structure includes a home page, conversion page, request a conversion feature, about page, articles page, and privacy policy page. This comprehensive design supports the tool's primary goal of simplifying the meta-analysis process. Results: Since its initial release in October 2023 as Meta Converter and subsequent renaming to Meta-Analysis Accelerator, the tool has gained widespread use globally. From March 2024 to May 2024, it received 12,236 visits from countries such as Egypt, France, Indonesia, and the USA, indicating its international appeal and utility. Approximately 46% of the visits were direct, reflecting its popularity and trust among users. Conclusions: Meta-Analysis Accelerator significantly enhances the efficiency and accuracy of meta-analysis of systematic reviews by providing a reliable platform for statistical data conversion. Its comprehensive variety of conversions, user-friendly interface, and continuous improvements make it an indispensable resource for researchers. The tool's ability to streamline data transformation ensures that researchers can focus more on data interpretation and less on manual calculations, thus advancing the quality and ease of conducting systematic reviews and meta-analyses. [ABSTRACT FROM AUTHOR]

Background: Obesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs. Methods: Women with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48). Results: There were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight. Conclusion: By incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced. [ABSTRACT FROM AUTHOR]

Simple Summary: Peripheral T-cell lymphoma (PTCL) is a collection of aggressive malignancies with poor long-term survival and limited effective treatment options. Despite unique challenges associated with identifying and targeting malignant T-cell antigens, the use of antibody-based therapies holds great potential. Here, we review the current and future roles of antibody-based therapies for PTCL. While antibody-based immunotherapeutic strategies have revolutionized the treatment of B-cell lymphomas, progress in T-cell lymphomas has suffered from suboptimal targets, disease heterogeneity, and limited effective treatment options. Nonetheless, recent advances in our understanding of T-cell biology, the identification of novel targets, and the emergence of new therapies provide hope for the future. In this review, we explore four areas of current and evolving antibody-based strategies for the treatment of peripheral T-cell lymphoma (PTCL): monoclonal antibodies (mAbs), bispecific antibodies (BsAs), chimeric antigen receptor T-cell therapy (CAR-T), and antibody–drug conjugates (ADCs). As part of this discussion, we will also include limitations, lessons learned, and potential future directions. [ABSTRACT FROM AUTHOR]

Purpose: Constraint-induced movement therapy (CIMT) is a recommended intervention for arm recovery after acquired brain injury but is underutilised in practice. The purpose of this study is to describe the development of a behaviour change intervention targeted at therapists, to increase delivery of CIMT. Methods: A theoretically-informed approach for designing behaviour change interventions was used including identification of which behaviours needed to change (Step 1), barriers and enablers that needed to be addressed (Step 2), and intervention components to target those barriers and enablers (Step 3). Data collection methods included file audits and therapist interviews. Quantitative data (file audits) were analysed using descriptive statistics. Qualitative data analysis (interviews) was informed by the Theoretical Domains Framework (TDF) and Behaviour Change Wheel. Results: Fifty two occupational therapists, physiotherapists and allied health assistants participated in focus groups (n = 7) or individual interviews (n = 6). Key barriers (n = 20) and enablers (n = 10) were identified across 11 domains of the TDF and perceived to influence CIMT implementation. The subsequent behaviour change intervention included training workshops, nominated team champions, community of practice meetings, three-monthly file audit feedback cycles, poster reminders and drop-in support during CIMT. Conclusion: This study describes the development of a behaviour change intervention to increase CIMT delivery by clinicians. Trial registration: Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12617001147370. IMPLICATIONS FOR REHABILITATION: Constraint induced movement therapy (CIMT) is a highly effective intervention for arm recovery after acquired brain injury, recommended in multiple clinical practice guidelines, yet delivery of CIMT is often not part of routine practice. The Behaviour Change Wheel, COM-B (capability, opportunity, motivation- behaviour) system and Theoretical Domains Framework (TDF) helped identify barriers and enablers to CIMT delivery by therapists, and design a theoretically-informed behaviour change intervention. The effect of the behaviour change intervention on therapists practice can now be evaluated to determine if it increases the delivery of CIMT more routinely in practice. [ABSTRACT FROM AUTHOR]

The objective of this review was to evaluate the efficacy and safety of propofol in the treatment of critically ill patients diagnosed with alcohol withdrawal syndrome (AWS). A review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) criteria, and Embase, MEDLINE (PubMed), Cochrane CENTRAL, and Web of Science were queried for results through June 2024. Studies providing efficacy or safety data associated with propofol with a reported diagnosis of AWS in critically ill patients were included. Studies evaluating pediatric patients, those without quantitative and qualitative outcome data, and those not readily translatable to English were excluded. Five retrospective cohort analyses of 218 patients were included in this systematic review. Patients were found to have both significant and non‐significant increases in time to resolution of AWS symptoms when treated with propofol versus the AWS standard of care. Adjunct treatment with propofol was generally associated with reductions in total benzodiazepine use and increases in both ICU length of stay and duration of mechanical ventilation. The results of this systematic review provide the evidence necessary to support the use of propofol as an efficacious and safe medication in the management of severe and refractory AWS. Further investigation is required to determine optimal dosing strategies and durations of therapy. The results of this systematic review demonstrate the clinical utility of propofol as part of the management strategy for severe and refractory AWS. [ABSTRACT FROM AUTHOR]

There is an abundance of outcomes research for clinical hypnosis showing promising results. Nonetheless, hypnosis is still underutilized in clinical care. For a behavioral intervention to enter mainstream clinical care, efficacy needs to be demonstrated with exceptionally high quality of evidence, and its reporting needs to be complete and sufficiently clear to enable replication and clinical use. The present article provides best practice guidelines formulated by the Task Force for Establishing Efficacy Standards for Clinical Hypnosis for conducting and reporting clinical hypnosis research.The recommendations are presented in two tiers. Tier I recommendations include essential best practices, such as a call for the use of detailed research and intervention manuals, plans for and reporting of participant-education about hypnosis, the use of hypnotizability scales with good psychometric properties, and clear reporting of the hypnotizability measurement. Tier I also includes the sharing of intervention manuals, the reporting of the induction procedure, the labeling of the intervention for participants, and the definition of hypnosis used. Tier II includes preferred recommendations, calling for measurement of adherence to home practice, measurement of hypnotizability using scales with both subjective and behavioral measures of responsiveness, and the involvement of participants from the full hypnotizability spectrum. Tier II also includes the assessment of variables related to proposed mechanisms of action, the reporting of participants prior hypnosis experiences, and the relationship of expectancies and treatment outcomes.This list of recommendations will be useful for researchers, reviewers, and journal editors alike when conducting, reporting, or evaluating studies involving clinical hypnosis. [ABSTRACT FROM AUTHOR]

Background/Objectives: Caregivers of patients with heart disease may often feel physically, emotionally, and psychologically overwhelmed by their role. The analysis of cardiac rehabilitation (CR) components and caregivers' needs suggests that some interventions may benefit them. Therefore, this study aimed to identify a consensus on the CR components targeting caregivers of patients with heart disease. Methods: A three-round international e-Delphi study with experts on CR was conducted. In round 1, experts provided an electronic level of agreement on a set of initial recommendations originating from a previous scoping review. In round 2, experts were asked to re-rate the same items after feedback and summary data were provided from round 1. In round 3, the same experts were asked to re-rate items that did not reach a consensus from round 2. Results: A total of 57 experts were contacted via e-mail to participate in the Delphi panel, and 43 participated. The final version presents seven recommendations for caregivers of patients with heart disease in CR programs. Conclusions: These recommendations are an overview of the evidence and represent a tool for professionals to adapt to their context in the different stages of CR, integrating the caregiver as a care focus and as support for their sick family members. By identifying the components/interventions, there is potential to benchmark the development of a cardiac rehabilitation strategy to be used and tested by the healthcare team for optimizing the health and role of these caregivers. [ABSTRACT FROM AUTHOR]

Background/aims: The measurement of implementation outcomes can establish the success of implementing evidence into practice. However, implementation outcomes are seldom measured in acute healthcare settings, such as Paediatric Intensive Care Units (PICU), and if they are used, are likely to be non-validated, site or intervention-specific measures. To address this literature gap, this systematic review of systematic reviews aims to identify validated instruments to measure implementation outcomes of new EBP interventions in a PICU setting. Methods: A systematic review of systematic reviews was conducted in two phases. Phase One: Five electronic databases were searched between 06/10/22 and 14/10/22. Systematic reviews were selected using pre-determined eligibility criteria. Methodological quality was assessed using the Critical Appraisal Skills Programme tool and a data extraction table was used to allow further synthesis. Phase Two: Secondary eligibility criteria were used to extract and review instruments from the systematic reviews selected in Phase One. Instruments were analysed and mapped to the Consolidated Framework of Implementation Research (CFIR). Results: Phase One: Searches resulted in 3195 unique papers. Five systematic reviews were eligible for inclusion. All examined the psychometric properties of each instrument, utilising different methods to do so; three considered their pragmatic or usability properties; and one identified instruments that were transferrable to different settings. Each systematic review identified that most included instruments had limited evidence of their validity or reliability and had poor psychometric properties. Phase two: 93 instruments were screened, and nine were eligible for analysis. After analysis and CFIR mapping, two instruments were identified as potentially adaptable to the PICU setting. Conclusions: The methodological quality of implementation outcome measurement instruments is inadequate, warranting further validation research. Two instruments were identified that cover multiple CFIR domains and have scope to be adapted for use when implementing evidence-based practice into the PICU. Further work is needed to adapt and further validate an instrument for use in practice. Trial registration: For transparency of procedures and methods, the protocol for this systematic review was registered with PROSPERO (registration number CRD42022361638L). [ABSTRACT FROM AUTHOR]

Background: People with attention-deficit hyperactivity disorder (ADHD) are at risk of negative health outcomes, with risks reduced through evidence-based treatments. Therefore, ensuring continued access to treatment for young people with ADHD, especially as they transition from child to adult services, is a priority. Currently many young people with ADHD are unable to access adequate care, with negative consequences for patients and their communities. Preliminary evidence suggests digital health interventions (DHIs) may act as an effective adjunct to usual care, helping overcome barriers to access, and improving outcomes by increasing understanding of ADHD as a long-term condition. The aim of this mixed methods study is to explore the healthcare information preferences of people with lived experience of ADHD in the primary care context and considers these in the light of the emerging body of literature on DHIs for ADHD. To explore this, a descriptive summary of cross-sectional survey responses was compared and discussed in the context of DHIs identified in a scoping review. Results: Digital apps, followed by support groups, were deemed the most useful information resource types by survey respondents, but were the least currently used/provided. Over 40% participants indicated a preference for signposting to all resource types by their general practitioner (GP), suggesting that GPs are credible sources for ADHD healthcare information. The scoping review identified nine studies of DHI for ADHD, consisting of games, symptom monitoring, psychoeducation, and medication reminders, with limited evidence of effectiveness/implementation. Conclusions: People with ADHD state a preference for digital apps as an adjunct to usual care. However, these are currently the least provided information resource in primary care, indicating a key area for future development. The limited evidence base on DHIs for ADHD suggests combining digital apps and support networks, and utilising multimodal delivery methods may also enhance the delivery of healthcare information. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Patients suffering from postherpetic neuralgia (PHN) report unilateral chronic pain in one or more dermatomes after an acute herpes zoster (HZ) infection. The incidence of acute HZ ranges between three and five patients per 1000 person‐years. In one out of four patients, acute HZ‐related pain will transition into PHN. PHN can be very disabling for patients and reduce quality of life. Additionally, the treatment of PHN is characterized by high failure rates. The aim of this review is to give an update on the previous practical guideline published in 2011 and revised in 2015 (published in 2019) and to provide an overview of current interventional treatment options for HZ infection and PHN.The literature on the diagnosis and treatment of HZ and PHN was systematically reviewed and summarized.The most important treatment for acute HZ‐related pain is antiviral therapy within 72 h of symptom onset. Additional symptomatic treatment options are analgesic drugs according to the WHO pain ladder, tricyclic antidepressants (eg, nortriptyline), and antiepileptic drugs (eg, gabapentin). If pain is not sufficiently reduced, interventional treatment such as an epidural injection with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion (DRG) are options. Treatment for PHN is preferably transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics.Treatment of acute HZ‐related pain especially PHN is challenging. Besides the conventional treatment for PHN, interventional management is considered a new treatment option. PRF of DRG seems to be the most promising interventional management. [ABSTRACT FROM AUTHOR]

This editorial updates the scope and submission expectations of Implementation Science and Implementation Science Communications. We refine our protocol publishing policies and set out new expectations for reporting studies describing determinants and their relationship with implementation outcomes. Our central focus remains on the implementation of evidence-based interventions into healthcare practice and policy. We are most interested in rigorous empirical studies of the implementation of evidence-based healthcare interventions, practices, and policies, and the de-implementation of those that are demonstrated to be of low-value or no benefit. Alongside this, we remain interested in the systematic study of implementation mechanisms and processes and on the influences of patient, professional, and organizational behaviours. Novel theoretical and methodological developments are considered. For all submissions, we expect authors to demonstrate how their work is integrated with existing knowledge in the field and to clearly state the added value of the work to the field broadly. [ABSTRACT FROM AUTHOR]

We explore an unsolved challenge in the era of evidence-based medicine (EBM): the recognition of the patient as an epistemic agent or ‘knower’. While patients are increasingly acknowledged as carriers of values and preferences, it seems more challenging to acknowledge them as carriers of important causal information. In contrast, the science of pharmacovigilance depends on patient testimonies as valuable sources of causal evidence. This incompatibility can give rise to cases of what has been called participatory epistemic injustice. We analyse the testimony of a chronic pain patient and co-author of this article, Christine. Christine gives an auto-ethnographic account of her interactions with healthcare professionals trying to find the right pharmacological treatment for her condition. Through the analysis of her own story, she identifies some relevant themes for the epistemic interaction between healthcare professionals and chronic pain patients. We argue that such epistemic interactions are increasingly shaped by EBM and its conception of causality, which devalues patient subjective testimonies and emphasises statistical evidence. We conclude that outlier patients face an inherent risk of being left vulnerable to participatory epistemic injustice, particularly regarding the discovery of novel, rare adverse effects of medicines. [ABSTRACT FROM AUTHOR]

Background: Generating and analyzing process maps can help identify and prioritize barriers to the implementation of evidence-based practices in healthcare settings. Guidance on how to systematically apply and report these methods in implementation research is scant. We describe a method combining a qualitative approach to developing process maps with a quantitative evaluation of maps drawn from the quality improvement literature called failure mode and effects analysis (FMEA). Methods: We provide an outline and guidance for how investigators can use process mapping with FMEA to identify and prioritize barriers when implementing evidence-based clinical interventions. Suggestions for methods and reporting were generated based on established procedures for process mapping with FMEA and through review of original research papers which apply both methods in healthcare settings. We provide case examples to illustrate how this approach can be operationalized in implementation research. Results: The methodology of process mapping with FMEA can be divided into four broad phases: 1) formulating a plan, 2) generating process maps to identify and organize barriers over time, 3) prioritizing barriers through FMEA, and 4) devising an implementation strategy to address priority barriers. We identified 14 steps across the four phases. Two illustrative examples are provided. Case 1 describes the implementation of referrals to chiropractic care for adults with low back pain in primary care clinics. Case 2 describes the implementation of a family navigation intervention for children with autism spectrum disorder seeking care in pediatric clinics. For provisional guidance for reporting, we propose the REporting Process mapping and Analysis for Implementation Research (REPAIR) checklist. Conclusions: Process mapping with FMEA can elucidate barriers and facilitators to successful implementation of evidence-based clinical interventions. This paper provides initial guidance for more systematic applications of this methodology in implementation research. Future research should use a consensus-building approach, such as a multidisciplinary Delphi panel, to further delineate the reporting standards for studies that use process mapping with FMEA. [ABSTRACT FROM AUTHOR]

Health Technology Assessment (HTA) is essential for evidence-based healthcare decision-making, yet its integration into Iran's healthcare system faces political and logistical challenges. Despite HTA's potential to improve resource allocation, limited awareness, data gaps, and competing priorities hinder its implementation. This commentary emphasizes the need for political support, advocating capacity-building, collaboration, and alignment with long-term health policies. Leveraging international partnerships and monitoring outcomes can enhance HTA's role in improving healthcare in Iran and contributing to global health advancements. [ABSTRACT FROM AUTHOR]

Objectives: To compare the efficacy of the various wavelengths of low-level light therapy (LLLT) in alleviating knee pain, dysfunction, and stiffness in patients with knee osteoarthritis (KOA), and to compare the effectiveness of LLLT versus sham treatment in reducing knee pain, dysfunction, and stiffness. Methods: PubMed, Web of Science, EMBASE, and Cochrane Library were searched from inception to 12 December 2023. Randomized controlled trials that assessed the effects of different wavelengths of LLLT on alleviating pain of patients with KOA were included. A conventional meta-analysis and network meta-analysis were preformed, and standardized mean differences (SMD) with 95% confidence interval (CI) were calculated. Results: Thirteen studies involving 673 participants with KOA met inclusion criteria. Overall, LLLT was superior to sham LLLT for relieving pain (SMD = 0.96, 95% CI 0.31–1.61) but not for improving function (SMD = 0.21, 95% CI − 0.11 to 0.53) or stiffness (SMD = 0.07, 95% CI − 0.25 to 0.39). Surface under the cumulative ranking curve (SUCRA) value ranking showed the most effective wavelength of LLLT in reducing KOA pain was 904–905 nm (SUCRA, 86.90%), followed by multi-wavelengths (MWL) (SUCRA, 56.43%) and 785–850 nm (SUCRA, 54.97%). Compared to sham LLLT, L2 (SMD = 1.42, 95% CI = 0.31–2.53) and L1 (SMD = 0.82; 95% CI = 0.11–1.50) showed a significant reduction in KOA pain. However, MWL (SMD = 0.83; 95% CI = − 0.06 to 1.72) showed similar KOA pain reduction compared to sham LLLT. The certainty of evidence showed that the quality of evidence regarding the effectiveness of overall LLLT versus sham, and 904–905 nm versus sham were low, while the quality of evidence for MWL versus sham, and 785–850 nm versus sham was very low. Conclusion: While the 904–905 nm wavelength showed potential benefits in reducing KOA pain, the overall quality of the evidence was low. LLLT with 904–905 nm or 785–850 nm wavelengths yielded significantly better reduction in KOA pain compared to sham LLLT, but further high-quality research is warranted to validate these findings. [ABSTRACT FROM AUTHOR]

Integrating evidence from animal experiments is a critical component of biomedical research, providing essential prior information for in-depth investigations of disease mechanisms and new drug development. Animal models have played an irreplaceable role in simulating human diseases. However, the integration of evidence from animal experiments has faced numerous challenges, including insufficient emphasis, significant heterogeneity in study designs, high publication bias, and discrepancies with clinical research practices. This paper first identifies existing issues in the original research evidence from animal experiments, such as the selection and applicability of animal models, considerations in the design of experimental studies, and factors influencing the translation of animal experimental evidence. It then discusses various methods for integrating this evidence, including systematic review and meta-analysis, overview of systematic review/umbrella review, scoping review, and evidence mapping, while highlighting recent advancements in their application. Finally, the paper addresses the main challenges currently encountered in the integration of evidence from animal experiments and proposes targeted improvement strategies aimed at enhancing the efficiency of translating research outcomes into clinical practice and promoting the advancement of evidence-based medicine. By continuously optimizing original experimental research protocols and evidence integration practices, this work aims to establish a more efficient and scientific environment for the synthesis of evidence from animal experiments, ultimately contributing to clinical trials and human health. [ABSTRACT FROM AUTHOR]

Common bile duct (CBD) stones carry a risk of complications including biliary obstruction, acute cholangitis and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is regarded as the standard of treatment for CBD stones nowadays. However, ERCP can cause severe adverse events such as bleeding, post-ERCP pancreatitis and perforation. Therefore, it is important to provide practical guideline to manage CBD stones for clinicians. The Korean Pancreatobiliary Association (KPBA) established the first Korean guidelines for the management of CBD stones in 2013. Taking together the recently developed techniques for CBD stones and evidence newly obtained, the committee of the KPBA decided to perform an extensive revision of the guidelines. These revised guidelines were developed based on consensusbased guideline using Delphi methods. The main topics of these guidelines fall under the following topics: 1) diagnosis, 2) endoscopic management, 3) endoscopic management for difficult CBD stones. The specific recommendations are presented with the quality of evidence and classification of recommendations. [ABSTRACT FROM AUTHOR]

Background: The healthcare landscape is experiencing a profound period of change with accelerating developments in medical research, new treatments, care delivery and the use of innovative technology to meet the challenges of delivering care. These changes offer opportunities but as with all innovation, require careful management to reduce the likelihood of harm and error. Objective: The National Institute for Health and Care Excellence (NICE) has set out to introduce an adaptable, sustainable and systematic patient safety oversight group to ensure that patient safety is embedded at an organisation level supporting the healthcare system to overcome challenges and deliver high quality care, safely implementing the latest innovations in a timely manner. Method: The patient safety oversight group was established through a scoping exercise, led by the senior responsible officer and a small project team. The article sets out the methods used, including extensive internal engagement through structured interviews with senior leadership teams, purposive sampling, data synthesis and reporting. An overview of the group is given and considerations for promoting patient safety information flows and optimising the use of safety signal intelligence are made. Conclusion: Through reflection on changing needs within and surrounding the organisation, along with patient safety and complexity literature, NICE has developed an adaptable, systematic and sustainable model for managing patient safety. In addition to generating learning within NICE, the process highlights opportunities for improvement within the patient safety system. Result: NICE has developed an adaptable, systematic and sustainable model for managing patient safety. [ABSTRACT FROM AUTHOR]

The article discusses the collaborative effort of the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS) to establish a comprehensive methodology manual for developing clinical practice guidelines (CPGs). The document emphasizes the importance of evidence-based recommendations, rigorous validation, and continuous updates to ensure relevance and trustworthiness. It outlines the process of creating CPGs, including selecting writing committee members, conducting systematic literature reviews, formulating recommendations, achieving consensus through voting, and undergoing external validation before publication. The article also highlights the dissemination and implementation of CPGs, addressing gaps in knowledge, future perspectives, and the need for continuous learning and flexibility in guideline development. [Extracted from the article]

Alcohol consumption and harmful and hazardous drinking are significant contributors to the global burden of disease, accounting for about 3 million deaths each year globally. Owing to their stressful work environment, healthcare professionals are at a high risk of experiencing physical and mental health problems, particularly alcohol use disorders. Alcohol use disorder among healthcare professionals is of concern as it is associated with decreased work productivity and performance and associated ill health and cognitive impairment. This review, therefore, aimed to gather evidence on the prevalence and associated factors for alcohol use disorders among healthcare professionals. The findings revealed a high prevalence of alcohol use disorders among healthcare professionals, which were worsened during the COVID-19 pandemic. Additionally, there was a glaring dearth of studies conducted in low- and middle-income countries. Urgent interventions and support systems are therefore needed to address these issues. A comprehensive approach, considering individual and organizational factors, alongside evidence-based interventions, training and support programs, can promote workforce well-being and improve the quality of patient care. It is imperative to integrate alcohol use screening, preventive and treatment interventions with primary healthcare and psychiatry services. This will help ensure early diagnosis and timely initiation of preventive and therapeutic measures, reducing the risk of missed opportunities. Furthermore, offering effective human resource management support services to healthcare professionals would significantly enhance their well-being and help prevent alcohol use disorders. [ABSTRACT FROM AUTHOR]

Health libraries play a critical role in supporting medical training in Australia. Accreditation is an important means of ensuring a program of study and the education provider suitably equips trainees with the knowledge, skills and professional attributes necessary to practice in the profession. This study identifies a lack of consistency and specificity in Australian medical colleges accreditation requirements as they pertain to health libraries. The recommended accreditation standard developed in this study provides a benchmark for training providers that will ensure consistency of access to high-quality library collections, services and spaces for all medical trainees. Accreditation standards from 52 medical colleges and associations supporting Australian medical training programs were reviewed. Information extracted from accreditation documents was entered into a working text spreadsheet. Data was organized under three key categories: Collections, Services and Space. Additional categories were added to record the use of the noun Library and expectations for journal access. A data extraction tool was created in Microsoft Excel to note the requirements of each provider for libraries and collections, services and spaces. The results of the content analysis highlight a lack of consistency in accreditation providers' expectations for library collections, services and spaces. Most providers (87% n = 45) required host organizations to provide access to collections. Requirements for library space were mandated by 54% of providers (n = 28). Less than 50% of providers (n = 22) specified library services as requirements. This content analysis highlights the role of health libraries in supporting medical education, research and evidence-based practice. It also reinforces the need for improved specificity, consistency and clarity in accreditation requirements for health libraries in post-graduate medical training. The recommended benchmark accreditation standard developed in this study is a step toward addressing these issues and ensuring equity of access to library services and facilities for all medical trainees in Australia. [ABSTRACT FROM AUTHOR]

This report describes the incorporation of plain language and scientific communication best practices to supplement and simplify complex terminology and processes described on a highly utilized Systematic Review LibGuide. Guide content was evaluated pre- and post-revision using established metrics for readability, understandability, and actionability. The quality improvement process described in this report is accessible and feasible for other librarians to complete. Regardless of topic, if LibGuides are publicly available, it is important to ensure content is understandable by users, no matter their background or expertise, to ensure equitable access of information. [ABSTRACT FROM AUTHOR]

Children with developmental delays are more likely to experience difficulties in social-emotional skills and challenging behavior, which can lead to poor long-term outcomes if left untreated. The purpose of this literature review was to synthesize the literature related to home-based interventions to address social–emotional skills and challenging behavior. A systematic review of the literature resulted in the identification of 26 single-case design studies and 31 group design studies that evaluated a home-based intervention to improve social–emotional skills or challenging behavior for young children with a disability or delay. The most common interventions implemented were differential reinforcement, functional communication training, and antecedent-based interventions. Data based on the quality of experiment, characteristics of participants, and characteristics of interventions were analyzed. Fewer than half of the studies (41%) met design standards with or without reservations. However, the majority of studies that met design standards demonstrated strong or moderate evidence for the efficacy of the intervention (67%). Overall, the literature indicates caregivers can accurately implement established evidence-based practices with their young children to improve social–emotional skills and challenging behavior. Implications for practice and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Several studies have indicated that dietary interventions may offer protection against the development of cardiac damage in the case of anthracycline-induced cardiomyopathy (AIC). The goal of this study was to assess whether an evidence-based cardioprotective diet can be effective in preventing AIC in patients with breast cancer. Design: Randomized, open-label, controlled trial. The study period was set for 18 weeks, and the data were analyzed by generalized estimating equation modeling and one-way repeated measures analysis of variance. Setting/Location: Shahid Rajaie Hospital affiliated (Tehran, Iran). Subjects: Fifty anthracycline-treated patients with breast cancer. Interventions: Patients were randomized to receive either a 2-hour training in evidence-based cardio-protective diet or Carvedilol 6.25 mg bid. Outcome Measures: The primary outcome was the number of patients with abnormal left ventricular ejection fraction (LVEF) after 18 weeks. Results: At week 18, 12 (48%) out of 25 participants in the cardioprotective diet group had abnormal LVEF in comparison with 21 (84%) out of 25 in the carvedilol group (p = 0.007). Also, 2 (8%) out of 25 in the cardioprotective diet group compared with 7 (28%) out of 25 participants in the carvedilol group had abnormal global longitudinal strain (p = 0.066). The diet group showed significant improvements in the quality-of-life dimensions named "health change" and "general health" compared with the carvedilol group using the Short Form-36 Health Survey questionnaire. Conclusions: This study suggests that an evidence-based cardioprotective diet can contribute to the prevention of AIC. Although current treatments for AIC can be effective, further research is mandatory for more options. [ABSTRACT FROM AUTHOR]

Objectives: Thyroid eye disease (TED) treatment has been recently revolutionized with the approval of teprotumumab, a targeted insulin growth factor 1 receptor (IGF1R) inhibitor. To date, teprotumumab is the only FDA-approved drug for treating TED. In this article, we would like to temper the current enthusiasm around IGF1R inhibitors. Methods: critical review of the literature by independent academic practitioners. Results: several questions should be raised. First, "how an orphan drug has become a blockbuster with annual sales exceeding $1 billion?" Teprotumumab infusions are expensive, costing about USD 45,000 for one infusion and USD 360,000 for eight infusions in a 75 kg patient. Teprotumumab approval was based on two randomized clinical trials investigating active (clinical activity score ≥ 4) TED patients. Despite this, teprotumumab was approved by the FDA for "the treatment of TED" without distinguishing between active and inactive forms. The second question is as follows: "how can a new drug, compared only to a placebo, become the new standard without being compared to historically established gold standard medical or surgical treatments?" Teprotumumab has never been compared to other medical treatments in active TED nor to surgery in chronic TED. Up to 75% of patients may experience proptosis regression after treatment discontinuation. Finally, ototoxicity has emerged as a potentially devastating side effect requiring frequent monitoring. Investigation into the long-term side effects, especially in women of childbearing age, is also warranted. Conclusions: Teprotumumab is undoubtedly a major treatment option in TED. However, before prescribing a drug, practitioners should assess its benefit/risk ratio based on the following: (i) evidence-based medicine; (ii) their empirical experience; (iii) the cost/benefit analysis; (iv) the long-term outcomes and safety profile. [ABSTRACT FROM AUTHOR]

Introduction: Health services rely upon carers to provide care for loved ones with cancer, yet many carers often feel ill‐prepared for this role. Despite a multitude of programmes to support carer mental health, programmes that help carers feel better equipped to support a person with cancer are lacking. This study aimed to address this need by adapting an evidence‐based intervention to be suitable for carers of people with cancer. Methods: This study used an exploratory, qualitative design consisting of experienced‐based co‐design and an in‐depth stakeholder engagement strategy. An existing evidence‐based programme to promote resilience in the context of providing care was adapted for relevance to carers for people with cancer via two co‐design workshops with carers and healthcare professionals (n = 8). The resulting prototype programme was refined based on stakeholder consultations with staff and consumer members of cancer and carer support organisations across Australia (n = 16). Transcripts of the workshops, meetings and written feedback from carers were thematically analysed. Results: Major programme developments were guided by three themes that emerged from the co‐design workshops: 'creating value for carers', 'multiple contributors to carer distress' and 'the need for flexible implementation'. Analysis of the stakeholder consultation data showed that the themes of 'diversity in carer journeys' and 'creating impact for carers' were key to further tailoring the programme for applicability to practice. An adapted programme called 'iCanSupport' resulted from the process, with key adaptations being more relevant case study scenarios for carers and greater flexibility in accessing and engaging with the intervention to accommodate a range of carer circumstances. Conclusion: Programmes to build skills for becoming a carer for someone with cancer are absent, yet they are desired by carers. Using co‐design provided a user‐centric approach to adapt an existing evidence‐based programme. Programme evaluation is required to determine the effectiveness of the co‐designed approach in improving carer preparedness among a range of cohorts. Patient or Public Contribution: Carers and consumers with lived experience and others involved in supporting consumers made valuable contributions to co‐designing and refining the programme in addition to providing ongoing guidance in the unfolding analysis and reporting of this research. [ABSTRACT FROM AUTHOR]

Background: Currently, there are no agreed quality standards for post‐stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationalise and (3) prioritise best practice recommendations for post‐stroke aphasia care. Methods: Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation through a two‐round e‐Delphi exercise. Recommendations were then ranked for importance and feasibility and analysed using a graph theory–based voting system. In Phase 2, shortlisted recommendations from Phase 1 were converted into quality indicators for appraisal and voting in consensus meetings. In Phase 3, priorities for implementation were established by people with lived experience and health professionals following discussion and anonymous voting. Findings: In Phase 1, 23 best practice recommendations were identified and rated by people with lived experience (n = 26) and health professionals (n = 81). Ten recommendations were shortlisted. In Phase 2, people with lived experience (n = 4) and health professionals (n = 17) reached a consensus on 11 quality indicators, relating to assessment (n = 2), information provision (n = 3), communication partner training (n = 3), goal setting (n = 1), person and family‐centred care (n = 1) and provision of treatment (n = 1). In Phase 3, people with lived experience (n = 5) and health professionals (n = 7) identified three implementation priorities: assessment of aphasia, provision of aphasia‐friendly information and provision of therapy. Interpretation: Our 11 quality indicators and 3 implementation priorities are the first step to enabling systematic, efficient and person‐centred measurement and quality improvement in post‐stroke aphasia services. Quality indicators will be embedded in routine data collection systems, and strategies will be developed to address implementation priorities. Patient and Public Contribution: Protocol development was informed by our previous research, which explored the perspectives of 23 people living with aphasia about best practice aphasia services. Individuals with lived experience of aphasia participated as expert panel members in our three consensus meetings. We received support from consumer advisory networks associated with the Centre for Research Excellence in Aphasia Rehabilitation and Recovery and the Queensland Aphasia Research Centre. [ABSTRACT FROM AUTHOR]