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Aim: To examine the level of adherence to best‐practice guidelines of interprofessional teams with acute care nurse practitioners (ACNPs) compared to interprofessional teams without ACNPs. Design: A retrospective observational study was conducted in 2023. Method: A retrospective cohort was created including 280 patients who underwent a coronary artery bypass graft and/or a valve repair and hospitalised in a cardiac surgery unit of a university affiliated hospital in Québec (Canada) between 1 January 2019 to 31 January 2020. The level of adherence to best‐practice guidelines was measured from a composite score in percentage. The composite score was created from a newly developed tool including 99 items across six categories (patient information, pharmacotherapy, laboratory tests, post‐operative assessment, patient and interprofessional teams' characteristics). Multivariate linear and logistic regression models were computed to examine the effect of interprofessional teams with ACNPs on the level of adherence to best‐practice guidelines. Results: Most of the patients of the cohort were male and underwent a coronary artery bypass graft procedure. Patients under the care of interprofessional teams with ACNP were 1.72 times more likely to reach a level of adherence higher than 80% compared to interprofessional teams without ACNPs and were 2.29 times more likely to be within the highest quartile of the scores for the level of adherence to best‐practice guidelines of the cohort. Impact: This study provides empirical data supporting the benefits of ACNP practice for patients, interprofessional teams and healthcare organisations. Relevance for Practice: Our findings identify the important contributions of interprofessional teams that include ACNPs using a validated instrument, as well as their contribution to the delivery of high quality patient care. Reporting Method: This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The Association for Continence Professionals first published their guidance for the provision of absorbent products for adult incontinence in 2017. This consensus document is targeted towards commissioning leads, NHS Trust Boards, Bladder and Bowel leads, among others, and has been updated over the years to ensure that all adults who suffer with continence issues undergo a comprehensive assessment and have access to an equitable service. This article provides an overview of the latest guidelines which were published in February 2023. [ABSTRACT FROM AUTHOR]

Background: To date, no tool is currently available to measure the adherence to best practice guidelines by interprofessional teams with acute care nurse practitioners (ACNPs) in the post-operative cardiac surgery setting. Method: An extraction tool was developed, validated, and pilottested (n = 30) to measure the level of adherence to best practice in cardiac surgery. A multi-step approach was utilized, including a systematic review, a content and criterion validation, and a pilot-test of all items of the instrument. Findings: The average content validity index of all items was 0.89. A Spearman correlation of 0.91 was identified between five items of the extraction tool and five gold standards of comparison. A Cohen Kappa of 0.72 was identified between the reviewers who participated in the pilot-test. Implications: This validated tool will help further the understanding of the contributions of ACNPs and their impact on the care of post-operative cardiac surgery patients. [ABSTRACT FROM AUTHOR]

Diabetes‐related foot disease is a serious and common complication for people with diabetes mellitus. The gold standard care for a person with diabetes‐related foot disease is the involvement of a multidisciplinary foot team engaged in evidence‐based care. To date, there are seven International Working Group on the Diabetic Foot (IWGDF) guidelines published to assist healthcare providers in managing diabetes‐related foot disease around the world. This review discusses the acute management of diabetes‐related foot infection with insights from experts of various specialities (internal medicine, infectious disease, vascular surgery, radiology) with a discussion on the implementation of IWGDF guidelines in real life practice and the challenges that healthcare providers may face. [ABSTRACT FROM AUTHOR]

Education is associated with improved health outcomes. However, fewer non-Hispanic Black Americans earn high school diplomas, baccalaureate, or advanced degrees than White Americans, placing them at higher risk for poor health outcomes. Racial disparities in education have been linked to social injustice and structural racism. Through the Framework for the 21st Century School Nursing PracticeTM, school nurses can impact academic success and college readiness for Black youth. An integrative review of the literature was conducted to describe programs to promote college readiness for Black high school students and evaluate school nurse involvement. Findings of the eighteen unique studies included in this review were: programs included mostly female participants, and most yielded improvements in students' non-cognitive skills (i.e. sense of belonging/confidence) and college knowledge. None of the programs included school nurse involvement. School nurses can advocate for anti-racist college readiness programs with intentional, asset-based approaches to position youth for success in college. [ABSTRACT FROM AUTHOR]

The authors aimed to examine adoption of behavioral health crisis care (BHCC) services included in the Substance Abuse and Mental Health Services Administration's (SAMHSA's) best practices guidelines. Secondary data from SAMHSA's Behavioral Health Treatment Services Locator in 2022 were used. BHCC best practices were measured on a summated scale capturing whether a mental health treatment facility (N=9,385) adopted BHCC best practices, including provision of these services to all age groups: emergency psychiatric walk-in services, crisis intervention teams, onsite stabilization, mobile or offsite crisis responses, suicide prevention, and peer support. Descriptive statistics were used to examine organizational characteristics (such as facility operation, type, geographic area, license, and payment methods) of mental health treatment facilities nationwide, and a map was created to show locations of best practices BHCC facilities. Logistic regressions were performed to identify facilities' organizational characteristics associated with adopting BHCC best practices. Only 6.0% (N=564) of mental health treatment facilities fully adopted BHCC best practices. Suicide prevention was the most common BHCC service, offered by 69.8% (N=6,554) of the facilities. A mobile or offsite crisis response service was the least common, adopted by 22.4% (N=2,101). Higher odds of adopting BHCC best practices were significantly associated with public ownership (adjusted OR [AOR]=1.95), accepting self-pay (AOR=3.18), accepting Medicare (AOR=2.68), and receiving any grant funding (AOR=2.45). Despite SAMHSA guidelines recommending comprehensive BHCC services, a fraction of facilities have fully adopted BHCC best practices. Efforts are needed to facilitate widespread uptake of BHCC best practices nationwide. [ABSTRACT FROM AUTHOR]

Stable isotope ratios of nitrogen and oxygen (15N/14N and 18O/16O) of nitrate (NO3–) are excellent tracers for developing systematic understanding of sources, conversions, and deposition of reactive atmospheric nitrogen (Nr) in the environment. Despite recent analytical advances, standardized sampling of NO3–) isotopes in precipitation is still lacking. To advance atmospheric studies on Nr species, we propose best-practice guidelines for accurate and precise sampling and analysis of NO3– isotopes in precipitation based on the experience obtained from an international research project coordinated by the International Atomic Energy Agency (IAEA). The precipitation sampling and preservation strategies yielded a good agreement between the NO3– concentrations measured at the laboratories of 16 countries and at the IAEA. Compared to conventional methods (e.g., bacterial denitrification), we confirmed the accurate performance of the lower cost Ti(III) reduction method for isotope analyses (15N and 18O) of NO3– in precipitation samples. These isotopic data depict different origins and oxidation pathways of inorganic nitrogen. This work emphasized the capability of NO3– isotopes to assess the origin and atmospheric oxidation of Nr and outlined a pathway to improve laboratory capability and expertise at a global scale. The incorporation of other isotopes like 17O in Nr is recommended in future studies. [ABSTRACT FROM AUTHOR]

Background: Children with osteogenesis imperfecta (OI) live in fear of fracturing their bones. As fractures are unpredictable, there is a need for tools and knowledge to immobilize a fracture during emergencies. Inspired by a patient with OI recognized for fracture management, the aim of this patient-initiated project was to establish best practices for the safe splinting of fractures during emergencies, including the creation of an evidence-informed OI Splint Kit. Methods: A clinical practice guideline study was conducted to create an evidence-informed splint kit for patients. A systematic review of the literature was conducted to identify kits and materials used to immobilize fractures with splints during emergencies. An expert Task Force was convened to review the results and a timeline was established to create a splint kit. The prototype underwent iterative cycles of modifications based on feedback from the Task Force. Results: Four electronic databases were searched (Medline, CINHAL, PsychInfo, and Scopus), revealing zero publications pertaining to fracture immobilization kits. The Task Force used their clinical expertise and experiences to develop the OI Splint Kit. The following itemswere included: splinting tools, bilingual educational material, instructional cards, video tutorials, and memory card game. Conclusion: A gap remains in terms of validated kits to assist in fracture immobilization during emergencies. A portable and practical OI Splint Kit was developed to assist in fracture immobilization emergencies, based on interprofessional clinical expertise and patient experiential knowledge. The kit is subject to ongoing testing quality evaluations to ensure its suitability for use in various contexts. [ABSTRACT FROM AUTHOR]

Aim: To summarize recommendations from available evidence‐based guidelines that enhance, address or guide antiretroviral therapy adherence among adult persons living with human immunodeficiency virus. Design: An integrative literature review approach. Data source: Guidelines were accessed through Google from the databases of the Canadian Medical Association InfoBase clinical practice database, National Guidelines Clearinghouse, Writer's Guidelines database, the National Institute for Health and Clinical Excellence, UNICEF and WHO. Databases such as PubMed, Google Scholar, EBSCOhost (CINAHL, ERIC, Academic search complete, E‐journals, Psych Info and MEDLINE), EMERALD INSIGHT, JSTOR, SCIENCE DIRECT and FINDPLUS were also searched, followed by a citation search. Data sources were searched between 1996 and January 2022. Review Methods: The five steps of the integrative literature review process, as described by Whittemore and Knafl, were used. These steps are as follows: step one; problem identification, step two; literature search, step three; data evaluation; step four: data analysis and the final step was data presentation. Results: Sixteen guidelines related to antiretroviral therapy adherence were included for data extraction and synthesis. The findings revealed two themes as follows: theme 1: monitoring antiretroviral therapy adherence and theme 2: interventions to promote antiretroviral therapy adherence related to education and counselling, adherence tools, health service delivery and antiretroviral strategies. Conclusion: Antiretroviral therapy adherence in adult persons requires both interventions as well as monitoring. The various contributing factors relating to antiretroviral therapy adherence should be further explored. Impact: Evidence from the included guidelines can assist nurses in promoting a person's adherence to antiretroviral treatment, which could improve their health and well‐being. [ABSTRACT FROM AUTHOR]

This paper focuses on teaching and learning approaches that assist novice and other educators in higher education. These principles are applied to a real-world example of an undergraduate teaching session inclusive of local and international nursing students. Educational theory pertaining to the session is briefly discussed, however, the focus is on the teaching and learning strategies applied. Specific attention is afforded to lesson planning, active learning, and the use of technology in large group teaching. The responsibility of the educator to promote teaching credibility, student engagement, and pre-lecture preparation is reviewed with reference to key literature, while strategies to achieve best practice are proposed. [ABSTRACT FROM AUTHOR]

Computational fluid dynamics (CFD), a powerful analysis tool in wind engineering, has been applied to a wide variety of problems over the past few decades. The application of CFD to environmental wind problems in the built environment is much more common than its application to structural wind problems, in both practice and research. This paper briefly reviews the history of urban wind problems and the development of wind engineering. Then, the progress in the applications of CFD to environmental problems is outlined, particularly in terms of the evolution of the studies presented over time at the International Conferences on Wind Engineering. The major achievements of CFD in environmental wind engineering in the last 30 years are discussed in terms of Large Eddy Simulation versus the Reynolds-averaged Navier-Stokes model, appropriate boundary conditions, verification and validation, and best practice guidelines. Furthermore, notable topics in recent applications of CFD to the built environment, including complicated particle (e.g., snow, rain, sand, sea salt) dispersion, are reviewed. Finally, the future direction of the applications of CFD to environmental problems as an advanced design and research tool is discussed. • CFD widley used in environmental wind engineering (buildings). • Focus on urban wind problems & historical development. • Progress in applying CFD to environmental problems reviewed. • Key achievements in CFD for wind: LES vs. RANS models, boundary conditions, validation methods. • Recent applications include complex particle dispersion (snow, rain, etc.) [ABSTRACT FROM AUTHOR]

This article describes the process and context of the development of the Best Practice Guidelines (BPG) for working with clients with diverse sex characteristics, sexualities, and genders in Aotearoa/New Zealand and a verbatim section from the BPG is included. Changes in theory, research and applied practice in the discipline of psychology are briefly outlined, along with an account of the process of development and publication of the BPG. The BPG provide guidance on basic awareness, knowledge and skills, and a competence framework for registered psychologists to work with clients with diverse sex characteristics, sexualities and genders. Guidelines published by the New Zealand Psychologists Board are underpinned by the Code of Ethics and aim to support the delivery of evidence based, competent and ethical psychological practice. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to develop an update of the evidence-based guidelines for the management of pain in older people. Design: Review of evidence since 2010 using a systematic and consensus approach is performed. Results: Recognition of the type of pain and routine assessment of pain should inform the use of specific environmental, behavioural and pharmacological interventions. Individualised care plans and analgesic protocols for specific clinical situations, patients and health care settings can be developed from these guidelines. Conclusion: Management of pain must be considered as an important component of the health care provided to all people, regardless of their chronological age or severity of illness. By clearly outlining areas where evidence is not available, these guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with adverse effects of treatment and the potential for drug interactions. [ABSTRACT FROM AUTHOR]

Background: Children with osteogenesis imperfecta (OI) live in fear of fracturing a bone. As fractures are unpredictable, there is a need for tools and knowledge to immobilize a fracture during emergencies. Inspired by a patient recognized in their local OI community for fracture management, the aim of this patient-initiated project was to establish best practices for the safe handling of fractures, including the creation of an evidence-informed OI Splint Kit. Methods: A systematic review of the literature was conducted to identify kits and tools used to immobilize fractures during emergencies. An expert Task Force consisting of patients, clinicians, and decision makers was conjured to review the synthesized results. Priorities were delineated and a timeline was established to create the OI Splint Kit. The prototype underwent iterative cycles of modifications based on feedback from the Task Force. Results: Four electronic data bases were searched (Medline, CINHAL, PsychInfo, and Scopus), revealing zero publications pertaining to kits for fracture immobilization. The Task Force used their clinical expertise and patient experiences to develop the OI Splint Kit. The following items were included: splinting tools, bilingual educational material, instructional cards, video tutorials, and a memory card game. Conclusion: A gap remains in validated kits to assist in fracture immobilization during emergencies. A tangible and practical OI Splint Kit was developed to fulfill this need, based on inter-professional clinical expertise and patient experiential knowledge. The kit is subject to rigorous testing and ongoing quality evaluations, ensuring it will be suitable for use in various contexts.

Background and objective: In Australia, little is known about delivery of care for people with idiopathic pulmonary fibrosis (IPF). This study examined the organization of IPF care across Australia, how it aligns with guidance for best practice, and identified barriers and facilitators to best care. Methods: Data on the organization of IPF care in Australia were collected from public hospitals using a study‐specific questionnaire between February and July 2020. Semi‐structured telephone interviews were conducted with respiratory physicians from around Australia between April and December 2020. Interviews were transcribed verbatim and thematic analysis was undertaken. Results: Almost all hospitals (n = 38, 97%) held multidisciplinary meetings (MDMs) for diagnosing IPF, with 90% of multidisciplinary teams including expert respiratory physicians and radiologists; however, rheumatologists, interstitial lung disease nurses and a histopathologist were often not available. More than 90% of institutions had access to oxygen therapy, pulmonary rehabilitation and advanced care planning, but access to psychological support and clinical trials was limited (53% and 58%, respectively). Fifteen respiratory physicians (27% regional) were interviewed. Approaches to diagnosis, treatment and access to referral services were generally consistent with best practice guidance; however, regional respondents reported barriers related to inadequate staffing, lack of a nurse coordinator, inadequate access to clinical trials and funding models. Telehealth technologies were perceived as facilitators to best care. Conclusion: Clinical management of IPF in Australia generally aligns with best practice guidance, but there may be some inequity of access to specialist services, particularly in regional areas, that should be addressed to ensure optimal care for all. Specialist services for the diagnosis and care of patients with idiopathic pulmonary fibrosis (IPF) are available across Australia and generally align with best practice guidance. Telehealth technologies were perceived as facilitators of best care, but inequities in access to services for patients with IPF in regional areas remained. [ABSTRACT FROM AUTHOR]

Neurodevelopmental supportive care provides preterm infants with evidence-based care to ensure the best possible neurological outcomes. The study aimed to determine the compliance of current nursing care practices with best practice guidelines by means of a situational analysis. The situational analysis was done in 2 cycles in the neonatal intensive care units (n = 25) of a private healthcare provider in South Africa. Structured observations were done in cycle 1 using the Implementation of Neurodevelopmental Supportive Care checklist. Cycle 2 comprised focus group discussions to verify findings from cycle 1. Seventeen conclusion statements were formulated, which were thematically combined to be presented as 9 categories: neonatal intensive care unit design, individualized care, family-centered care, infant positioning, handling techniques, environmental manipulation, pain management, knowledge of infant behavior, and feeding. The conclusion statements identified improvement opportunities in current practice and offer suggestions, which can be used to guide an implementation strategy for best practice guidelines of neurodevelopmental supportive care in the neonatal intensive care units of the private healthcare group in future. Addressing improvement opportunities in all the categories will ensure that all aspects of the guideline requirements are met, resulting in a comprehensive strategy improving practice and patient outcomes. [ABSTRACT FROM AUTHOR]

Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT.

This paper introduces newly published guidelines on geoheritage conservation in protected and conserved areas within the “IUCN WCPA Best Practice Guidelines” series. It explains the need for the guidelines and outlines the ethical basis of geoheritage values and geoconservation principles as the fundamental framework within which to advance geoheritage conservation. Best practice in establishing and managing protected and conserved areas for geoconservation is described with examples from around the world. Particular emphasis is given to the methodology and practice for dealing with the many threats to geoheritage, highlighting in particular how to improve practice for areas with caves and karst, glacial and periglacial, and volcanic features and processes, and for palaeontology and mineral sites. Guidance to improve education and communication to the public through modern and conventional means is also highlighted as a key stage in delivering effective geoconservation. A request is made to geoconservation experts to continue to share best practice examples of developing methodologies and best practice in management to guide non-experts in their work. Finally, a number of suggestions are made on how geoconservation can be further promoted. [ABSTRACT FROM AUTHOR]

Placenta accreta spectrum is a term used to describe abnormal adherence and abnormal invasion of the placenta into the uterine wall during pregnancy. The incidence of placenta accreta spectrum has steadily increased over the last 40 years and is most notably linked to rising cesarean birth rates. This condition is associated with increased maternal morbidity and mortality because of the high risk of severe hemorrhage and likely need for hysterectomy at the time of birth. Early diagnosis of abnormal placentation is preferable in order to coordinate birth planning with a interprofessional collaborative team within a high‐level perinatal care center. This article describes the case of a woman diagnosed with placenta accreta spectrum and the clinical course of her pregnancy and birth. [ABSTRACT FROM AUTHOR]

Gold standard colonoscopy in the UK demands a 90% cecal intubation (CI) rate. Endoscopists must provide photographic evidence of CI, which can include images of the terminal ileum, appendix orifice, anastomosis or ileocecal valve. Whilst photographic proof of intubation should be obtained for all complete colonoscopies, this is not routinely audited. Three hundred and ninety-six complete colonoscopies were analyzed, 200 in an initial audit, and 196 in a second audit. Photos taken during colonoscopy were reviewed for evidence of successful CI, as well as whether these photographs had been marked as "proof of intubation" (POI). Results were shared at departmental governance meetings in order to assess any improvement in practice. Initial audit revealed 70% of colonoscopies had provided sufficient proof of CI but only 50% provided photographs that were described as such. Twenty percent of colonoscopies provided sufficient images, but these were not identified as POI. Thirty percent of all colonoscopies provided insufficient proof of CI. Upon repeat audit, 71% of colonoscopies met best practice standards, with the remaining 29% showing insufficient evidence of CI. In the modern era of digital technology, lack of photographic evidence should be seen as unacceptable and may raise important clinical and medicolegal concerns. We recommend that audits such as this become standard practice to ensure best practice. [ABSTRACT FROM AUTHOR]

Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT. [ABSTRACT FROM AUTHOR]

Proximal spinal muscular atrophy (SMA) is an autosomal-recessive inherited neuromuscular disorder caused by the degeneration of alpha motor neurons in the anterior horn of the spinal cord. Patients show hypotonia, muscular atrophy and weakness of voluntary proximal muscles. SMA is one of the most common genetic diseases, with a frequency of about 1 in 7,000 newborns in Germany. The vast majority of patients carry a homozygous deletion of exons 7 and 8 of the survival motor neuron (SMN) 1 gene on chromosome 5q13.2; only about 3–4 % of patients are compound heterozygous for this common mutation and an additional subtle mutation in SMN1. The severity of the disease is mainly influenced by the copy number of the highly homologous SMN2. Since the discovery of the underlying genetic defect 25 years ago, both the diagnostics of SMA and its treatment have undergone constant and in recent times rapid improvements. SMA has become one of the first neuromuscular disorders with effective therapies based on gene targeted strategies such as splice correction of SMN2 via antisense oligonucleotides or small molecules or gene replacement therapy with a self-complementary adeno-associated virus 9 expressing the SMN1-cDNA. With the availability of treatment options, which are most effective when therapy starts at a pre-symptomatic stage, a newborn screening is indispensable and about to be introduced in Germany. New challenges for diagnostic labs as well as for genetic counsellors are inevitable. This article aims at summarising the current state of SMA diagnostics, treatment and perspectives for this disorder and offering best practice testing guidelines to diagnostic labs. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity is increasing in Thailand. The Thai Society for Metabolic and Bariatric Surgery just developed the first Thailand guideline for Bariatric surgery as a gold standard treatment of morbid obesity. Objective: To enhance the quality of care in obesity treatment through metabolic and bariatric surgery Methods: The present study would provide suggestions for management that were derived from available knowledge, peerreviewed of scientific literature, and expert opinion. The guideline was developed by performing a review of currently available literatures regarding obesity, obesity treatments, and metabolic surgery from all references published worldwide. Results: The intent of issuing such a guideline is to provide definite criteria for surgery, pre-operative care, and post-operative care, including practical points in each step. Conclusion: This is the first practice guideline on bariatric surgery for the treatment of obese patient in Thailand. The guideline would be revised in the future should additional evidence become available and future research is needed to gather more evidence and study clinical outcomes for the development of future practice guidelines. [ABSTRACT FROM AUTHOR]

To describe current practice in the management of rectal cancer, to identify uncertainties that usually arise in the multidisciplinary team (MDT)'s discussions ('grey zones') and propose next generation studies which may provide answers to them. A questionnaire on the areas of controversy in managing T2, T3 and T4 rectal cancer was drawn up and distributed to the Rectal-Assisi Think Tank Meeting (ATTM) Expert European Board. Less than 70% agreement on a treatment option was indicated as uncertainty and selected as a 'grey zone'. Topics with large disagreement were selected by the task force group for discussion at the Rectal-ATTM. The controversial clinical issues that had been identified within cT2–cT3–cT4 needed further investigation. The discussions focused on the role of (1) neoadjuvant therapy and organ preservation on cT2-3a low-middle rectal cancer; (2) neoadjuvant therapy in cT3 low rectal cancer without high risk features; (3) total neoadjuvant therapy, radiotherapy boost and the best chemo-radiotherapy schedule in T4 tumors. A description of each area of investigation and trial proposals are reported. The meeting successfully identified 'grey zones' and, in the light of new evidence, proposed clinical trials for treatment of early, intermediate and advanced stage rectal cancer. [ABSTRACT FROM AUTHOR]

The article focuses on Clinical practice guidelines for Cochlear Implant treatment. Topics include its use in importance for accession of auditory information for persons with hearing loss, approval by the Food and Drug Administration (FDA) for adults with bilateral profound sensorineural hearing loss, and the requirement of appropriate evidence-based care from audiologists and cochlear implant teams.

Objectives: Our aim was to explore the application of systematic criteria proposed by Bentall, Corcoran, Howard, Black and Kinderman (2001) to determine whether they are helpful in determining the quality of psychological models, which are used to develop and guide treatment. Method: We chose to conduct a systematic review of models of hallucinations. PsycINFO, MEDLINE and PubMED were used to identify relevant articles. Each model was classified as a high, medium or low level of fit with the criteria. Results: Nineteen models met the inclusion criteria. Two models were a high level of fit, twelve a medium level of fit while the rest were a low level of fit. Some difficulties were encountered applying the criteria and are discussed. Conclusions: Bentall et al.'s (2001) criteria proved useful. Frith's (2015) and Hoffman's (1986) models were deemed the best level of fit. The role of self-monitoring and language-production processes in hallucination formation may merit further investigation. There is an outstanding need for international standardized guidelines to advance the quality of psychological models to assist the design and delivery of more effective interventions. [ABSTRACT FROM AUTHOR]

Many mental health practitioners have had or will have the opportunity to work with clients who engage in sex work (CSW). Sex work stigma is pervasive in the general population, and among mental health professionals, including sex and relationship therapists. Such stigma may lead to differential, unfair, and even unethical treatment of CSW. Although there is a clear need for best practice guidelines for mental health practice with CSW, no guidelines have been developed thus far. Therefore, drawing on feminist, multicultural, and sex-positive philosophies, this paper presents ten guidelines that are designed to: (1) address and increase mental health professionals' self-awareness of their own bias about sex work; (2) provide useful information about the multifaceted lived experience of CSW; and (3) offer culturally-appropriate counseling skills and intervention strategies in working with CSW. Acknowledging that multicultural competence is a professional process, rather than an outcome or an end, the guidelines included in this paper are developed with the underlying assumption that all mental health professionals are committed to be sex work-affirming and competent in working with CSW, regardless of therapeutic orientation. The guidelines discussed in this paper are informed by current literature about sex work and people who engage in it. [ABSTRACT FROM AUTHOR]

• A baseline closure concept is presented for simulation of bubbly flow with phase change. • A new correlation for computation of inter-phase heat transfer coefficient is presented. • The new correlation is tested for evaporating and condensing bubbly flows. • The simulations are carried out by applying the best practice guidelines for CFD. • A general improvement is evidenced in comparison to the Ranz-Marshall correlation. In line with the best practice guidelines for computational fluid dynamics in nuclear reactor safety, Helmholtz-Zentrum Dresden – Rossendorf proposed an Euler-Euler baseline closure concept some years ago. The consideration is that simulations with a fixed set of closures instead of case by case tuning may help to identify model inadequacy and facilitate further improvement. Currently, the baseline model concerns interphase momentum and turbulence exchange as well as bubble coalescence and breakup. It has been tested for a wide range of isothermal applications with different geometrical configurations and material systems. In the present work, the baseline model is extended to non-isothermal flows by including a mechanistic model for the computation of overall interphase heat transfer coefficient. The extended baseline model is validated for both bubble-growing in superheated liquid and -condensing in sub-cooled liquid. The baseline model proposal is independent on the use of a certain CFD code. The presented simulation is carried out with the commercial software ANSYS CFX by employing the best practice guidelines. The simulated liquid temperature, gas volume fraction, vapor bubble size and velocity are compared with the measured ones. The effectivity of the model is demonstrated by a general good agreement. [ABSTRACT FROM AUTHOR]

Abstract Correct use of Computational Fluid Dynamics (CFD) tools is essential in order to have confidence in the results. A comprehensive set of Best Practice Guidelines (BPG) in numerical simulations for Fuel Cells and Hydrogen applications has been one of the main outputs of the SUSANA project. These BPG focus on the practical needs of engineers in consultancies and industry undertaking CFD simulations or evaluating CFD simulation results in support of hazard/risk assessments of hydrogen facilities, as well as on the needs of regulatory authorities. This contribution presents a summary of the BPG document. All crucial aspects of numerical simulations are addressed, such as selection of the physical models, domain design, meshing, boundary conditions and selection of numerical parameters. BPG cover all hydrogen safety relative phenomena, i.e. release and dispersion, ignition, jet fire, deflagration and detonation. A series of CFD benchmarking exercises are also presented serving as examples of appropriate modelling strategies. Highlights • Best Practice Guidelines for H 2 safety simulations were developed for the first time. • BPG cover the whole range of phenomena such as dispersion, ignition and explosion. • All crucial aspects of numerical simulations are addressed. • CFD benchmarking exercises demonstrating proper modelling strategies are presented. [ABSTRACT FROM AUTHOR]

Objectives: Professional athletes undergo annual pre-season laboratory screening, although clinical evidence supporting the practice is limited and no uniform set of guidelines on pre-season laboratory screening exists. The aim of this study was to assess the clinical value of annual pre-season laboratory screening tests for a major professional sports team over multiple years.Design: Retrospective chart review.Methods: A retrospective analysis was performed of all laboratory results as well as screening ECGs for a single major professional sports team over a 9-year timeframe (2009-2017).Results: The data show that 10.01% of initial screening test results were abnormal and 40.32% of abnormal tests resulted in additional testing. Overall, only 0.35% of initial tests resulted in a clinically significant outcome. Non-US born players showed a significantly higher average rate of abnormal tests/year compared to US-born players (p-value 0.006), but there was no difference in clinically significant outcomes. There was no relationship between athlete age and laboratory screening outcomes.Conclusions: In our study population, yearly pre-season laboratory screening of professional athletes did not yield substantial clinically significant outcomes and would not be warranted under normal clinical standards. Future best practice guidelines should combine research concerning effects of family medical history, race, gender, country of origin, and type of sport on athlete health when creating recommendations for which pre-season laboratory screenings may be pertinent even with evidence of little utility. [ABSTRACT FROM AUTHOR]

The geriatric (≥65 years of age) population is one of the fastest growing age groups in the United States. As this number increases, so does the number of geriatric trauma patients. Because this group has higher mortality rates and requires more resources, a Geriatric Trauma Palliative Care Program was created at a Level 1 Trauma Center in Dallas, TX, to provide concurrent lifesaving therapies and primary palliative care to older adults. The trauma program implemented the American College of Surgeons (ACS) Trauma Quality Improvement Program Palliative Care Best Practices Guidelines (ACS, 2017) to better care for acute traumatic injuries as well as the specific spiritual, emotional, and psychiatric needs of the geriatric trauma palliative care patient and family. Using the guidelines, the team performed a gap analysis, carried out program development, created a palliative care pathway to guide our evidence-based practice implementation, and performed retrospective chart reviews for 3-month pre- and postimplementation analysis. Using Person's χ2 test and Fisher's exact test, our initial evaluation of the program showed statistically significant (p <.001) improvements in the measures related to the implementation of primary palliative care, pain and symptom management, and end-of-life care. The guidelines gave the team a consistent framework for implementing the basic competencies required to deliver primary palliative care, pain and symptom management, and end-of-life care to trauma patients. [ABSTRACT FROM AUTHOR]

Growth in online higher education offerings has been significant in recent years, with many Australian Universities launching programs to extend into new markets and meet the student demand for greater flexibility in delivery modes. Further, it is well understood that good support is an essential component to student success, satisfaction and retention. Despite this, orientation, including non-academic support, is often overlooked in online education systems. Therefore, the current study aimed to develop an orientation program to increase student preparedness and facilitate ongoing support, in addition to developing evidencebased best-practice strategies to support academic's when developing new online courses. [ABSTRACT FROM AUTHOR]

Predicting the propulsive power of ships with high accuracy still remains a challenge. Well established practices in the 1978 ITTC Power Prediction method have been questioned such as the form factor approach and its determination method. This paper investigates the possibility to improve the power predictions by the introduction of a combined CFD/EFD Method where the experimental determination of form factor is replaced by double body RANS computations. Following the Quality Assurance Procedure proposed by ITTC, a best practice guideline has been derived for the CFD based form factor determination method by applying systematic variations to the CFD set-ups. Following the verification and validation of the CFD based form factor method in model scale, the full scale speed-power-rpm relations between large number of speed trials and full scale predictions using the CFD based form factors in combination with ITTC-57 line and numerical friction lines are investigated. It is observed that the usage of CFD based form factors improves the predictions in general and no deterioration is noted within the limits of this study. Therefore, the combination of EFD and CFD is expected to provide immediate improvements to the 1978 ITTC Performance Prediction Method.

This article describes how one Ontario Public Health Unit implemented a best practice guideline throughout the organization and across disciplines to achieve best practice outcomes in the delivery of client-centered care. Integration of evidence-informed practice presents challenges for both implementation and sustainability. Applying a best practice guideline in the public health setting can add to the challenge. To address this, a variety of interventions were applied: building an interdisciplinary team, adapting a Registered Nurses’ Association of Ontario Best Practice Guideline to reflect public health practice for nursing and other disciplines, developing a working definition of “client,” engaging staff in knowledge translation, developing policy to support practice change, and incorporating client-centered care principles into daily practice. Outcomes indicate that nursing best practice guidelines, specific to client-centered care, can be successfully adapted and applied in public health practice. Considerations include the varied definitions of a “client,” the various roles of public health professionals, and engagement of both internal and external clients. Moreover, interdisciplinary staff can apply the principles of client-centered care when working with clients and when engaging in education-, practice-, and policy-level initiatives to support evidence-informed practice. [ABSTRACT FROM AUTHOR]

Background Our hospital identified delirium care as a quality improvement target. Baseline characterization of our delirium care and deficits was needed to guide improvement efforts. Methods Two inpatient units were selected: 1) A general internal medicine unit with a focus on geriatrics, and 2) a surgical unit. Retrospective chart audits were conducted for all patients over age 50 admitted during a one-month period to compare delirium care with best practice guideline (BPG) recommendations, and to determine the incidence of missed cases of delirium and negative outcomes in patients with delirium. The aim was to gather local data to prioritize improvement efforts and mobilize stakeholders. Results 186 charts were reviewed: 17 patients had physician-diagnosed delirium, 21 patients had missed delirium, and 148 patients had no delirium. Compliance with delirium BPGs was variable, but generally poor. There was a trend towards missed delirium and physician-diagnosed delirium being associated with greater odds of having above-median length of stay and lower odds of discharge home compared to no delirium diagnosis. Conclusion Overall, the chart audits confirmed delirium underrecognition and poor adherence to best practices in delirium management. Granular analysis of this data was used to mobilize stakeholders and prioritize improvement plans. [ABSTRACT FROM AUTHOR]