Implementation Of Best Practices Research Articles

CLRM-03 INCIDENCE OF INTRACRANIAL HEMORRHAGE IN GLIOMA PATIENTS WITH VENOUS THROMBOEMBOLISM CONVERTED FROM LMWH TO APIXABAN

Venous Thromboembolism (VTE) occurs in approximately 15-30% of patients with glioma 1,2 who are treated with therapeutic anticoagulants. Anticoagulation treatment increases the incidence of intracranial hemorrhage (ICH) with variable incidence between studies 1.9% to 20s% 3-6. The “common practice” treatment for VTE in glioma patients includes subcutaneous administration of low molecular weight heparin (LMWH, enoxaparin) injection, which requires daily self-injection. Switching glioma patients with VTE from LMWH to oral anticoagulants would limit the difficulty and the inconvenience of daily self-injecting in primary brain tumor patients and decrease the room for error in administering the dose along and the risk for heparin induced thrombocytopenia7. The goal of this project is to evaluate the incidence of intracranial hemorrhage in glioma patients with VTE converted from LMWH to Apixaban. We hypothesize that patients with brain tumors and Venous Thromboembolism can be converted safely from LMWH to Apixaban. To examine this hypothesis, we will enroll adult patients with pathologically confirmed supra-tentorial glioma and VTE, patient must have been treated with LMWH for ≥ 5 days. We will exclude patients with bleeding diathesis, severe hypersensitivity to Apixaban or pregnant or unable to provide informed consent. To assess the validity of our hypothesis: Primary Objective: To estimate the incidence of ICH in glioma patients with history of VTE after the conversion from LMWH to oral Apixaban. Secondary Objective: To estimate the incidence of recurrent VTE in glioma patients with history of VTE after the conversion from LMWH to oral Apixaban. To our knowledge, this is the first of its kind study to estimate the risk of ICH in glioma patients with VTE treated with oral anti-coagulation. Successful completion of our trial will provide answers to an important clinical question that could allow our patients using more convenient yet effective treatment by establishing and implementation of best practices.

Five Guiding Principles to Make Jupyter Notebooks Fit for Earth Observation Data Education

There is a growing demand to train Earth Observation (EO) data users in how to access and use existing and upcoming data. A promising tool for data-related training is computational notebooks, which are interactive web applications that combine text, code and computational output. Here, we present the Learning Tool for Python (LTPy), which is a training course (based on Jupyter notebooks) on atmospheric composition data. LTPy consists of more than 70 notebooks and has taught over 1000 EO data users so far, whose feedback is overall positive. We adapted five guiding principles from different fields (mainly scientific computing and Jupyter notebook research) to make the Jupyter notebooks more educational and reusable. The Jupyter notebooks developed (i) follow the literate programming paradigm by a text/code ratio of 3, (ii) use instructional design elements to improve navigation and user experience, (iii) modularize functions to follow best practices for scientific computing, (iv) leverage the wider Jupyter ecosystem to make content accessible and (v) aim for being reproducible. We see two areas for future developments: first, to collect feedback and evaluate whether the instructional design elements proposed meet their objective; and second, to develop tools that automatize the implementation of best practices.

The lasting consequences of childhood sexual abuse on human capital and economic well-being.

Childhood sexual abuse is a prevalent problem, yet understanding of later‐in‐life outcomes is limited due to unobservable determinants. I examine impacts on human capital and economic well‐being by estimating likely ranges around causal effects, using a nationally representative U.S. sample. Findings suggest that childhood sexual abuse leads to lower educational attainment and worse labor market outcomes. Results are robust to partial identification methods applying varying assumptions about unobservable confounding, using information on confounding from observables including other types of child abuse. I show that associations between childhood sexual abuse and education outcomes and earnings are at least as large for males as for females. Childhood sexual abuse by someone other than a caregiver is as influential or more so than caregiver sexual abuse in predicting worse outcomes. Considering the societal burden of childhood sexual abuse, findings could inform policy and resource allocation decisions for development and implementation of best practices for prevention and support.

Identification of spayed and neutered cats and dogs: Veterinary training and compliance with practice guidelines

Spay/neuter identification tattoos and ear-tipping are simple and cost-effective methods to minimize the likelihood of unnecessary anesthesia and surgery in companion animals or the misidentification of sexually intact animals. This study assessed training of sterilization identifiers in US and Canadian veterinary schools and practitioner compliance with guidelines for identifiers via surveys conducted in 2019. Faculty in all 34 schools responded to the survey, reporting that curricula included sterilization identifiers in 31% of lecture-based training, 75% of spay/neuter laboratory-based training, and 38% of clinical practice-based training. A total of 425 facilities performing spay/neuter reported frequency and technical aspects of sterilization identifiers in client-owned and unowned (shelter, rescue, trap-neuter-return) animals. Facilities encountering large numbers of animals of unknown background, performing a high number of surgeries, or with specialized spay/neuter training were significantly more likely to use identifiers. Only 5% of private practices tattooed all owned animals, and 21% tattooed all unowned animals. In contrast, 80% of shelters and 72% of spay/neuter clinics tattooed all owned animals, and 84% of shelters and 70% of spay/neuter clinics tattooed all unowned animals. Green was the most common tattoo color (97%); the most common placement was near or in the incision for female cats (99%), female dogs (99%), and male dogs (92%), and ventral abdomen in male cats (55%). Enhanced training and implementation of best practices described in professional guidelines for sterilization identifiers are needed throughout the veterinary industry to protect animals from unnecessary procedures and to prevent unintended litters in animals misidentified as previously sterilized.

Distal Versus Conventional Radial Access for Coronary Angiography and Intervention: The DISCO RADIAL Trial.

Currently, transradial access (TRA) is the recommended access for coronary procedures because of increased safety, with radial artery occlusion (RAO) being its most frequent complication, which will increasingly affect patients undergoing multiple procedures during their lifetimes. Recently, distal radial access (DRA) has emerged as a promising alternative access to minimize RAO risk. A large-scale, international, randomized trial comparing RAO with TRA and DRA is lacking. The aim of this study was to assess the superiority of DRA compared with conventional TRA with respect to forearm RAO. DISCO RADIAL (Distal vs Conventional Radial Access) was an international, multicenter, randomized controlled trial in which patients with indications for percutaneous coronary procedure using a 6-F Slender sheath were randomized to DRA or TRA with systematic implementation of best practices to reduce RAO. The primary endpoint was the incidence of forearm RAO assessed by vascular ultrasound at discharge. Secondary endpoints include crossover, hemostasis time, and access site-related complications. Overall, 657 patients underwent TRA, and 650 patients underwent DRA. Forearm RAO did not differ between groups (0.91% vs 0.31%; P=0.29). Patent hemostasis was achieved in 94.4% of TRA patients. Crossover rates were higher with DRA (3.5% vs 7.4%; P=0.002), and median hemostasis time was shorter (180 vs 153minutes; P< 0.001). Radial artery spasm occurred more with DRA (2.7% vs 5.4%; P=0.015). Overall bleeding events and vascular complications did not differ between groups. With the implementation of a rigorous hemostasis protocol, DRA and TRA have equally low RAO rates. DRA is associated with a higher crossover rate but a shorter hemostasis time.

Problems and prospects of the development of Ukraine’s ICT market in the conditions of war

Methods. The scientific results presented in this article were obtained through the use of such research methods as the method of analysis when identifying factors restraining the development of the Ukrainian market of information and communication technologies, the method of comparisons – when clarifying the differences in the influence of the IT sector on the pre-war the economy of Ukraine and its functioning in a state of war; general and specific – when establishing the specifics of the development of the market of information and communication technologies in wartime conditions. Results. The state of the market of information and communication technologies during the war period was studied within the framework of macroeconomic indicators from the point of view of meaningful content and market interaction. The dynamics of the domestic market of information technologies before the war were analyzed and the impact of the IT sector on the economy of Ukraine during the war was considered. It was found that the level of technological development determines not only the economic potential of the country, but also the role and place of this country in the global society, the scope and prospects of its economic and political integration with the whole world. Based on the results of the study, the internal obstacles faced by the Ukrainian information technology sector during the war period were assessed. The implementation of best practices, in particular in the areas of development, implementation and use of information technologies, products and services, is proposed, subject to proper scientific, technical and legal support for the reform of the information technology sector. It was established that the Ukrainian market of information and communication technologies is in a phase of slow development in the conditions of war. The problems of today, which restrain the development of the market of information and communication technologies, are given. Recommendations are provided for further activation of the market of information and communication technologies, taking into account the fact that the activity is conducted in conditions of war. Novelty. The article identifies the specifics of the impact of the information and communication technology sector on the national economy in the pre-war period and during the war. The main trends in the development of information and communication technologies in Ukraine and investment opportunities in this sector are analyzed. The importance of the sector of information and communication technologies for achieving progressive changes in the national economy in the post-war period is determined. Practical value. The practical role of information and communication technologies as a factor in GDP growth is substantiated. The dynamics of the development of the ICT market of Ukraine were analyzed, there was made a comparison of the development in the pre-war period and during the war. The main trends in the development of the country's IT sphere during the war period have been identified. Prospective directions for further implementation at the national level in the post-war period are presented.

Fostering operational management “Best Practices” in subsidiary plants in the Western Balkans: The role of MNC home-country environment and resource allocation

We investigate the adoption of operational management “best practices” in multinational corporation (MNC) subsidiary plants in the Western Balkans. Building on the Practice-Based View (PBV), we suggest that subsidiary plants are more likely to operate according to widely recognized best practices, if these practices are already common in the MNC home country. We also examine the degree to which the MNC can facilitate best practices in their plants by allocating organizational and human resources. We test our hypotheses using survey data from subsidiary managers and secondary company data ( n = 129), supplemented with manager interviews ( n = 14), collected from European, U.S., and Asian MNCs with subsidiary plants in Bosnia and Herzegovina, Croatia, Serbia, and North Macedonia. Results indicate that the subsidiary plants adopt practices that are common in the MNC home country. They do so to a greater extent when the MNC commits organizational resources to the plants, such as codified written procedures and trainings. Contrary to our expectations, there is no benefit to allocating human resources, such as expatriates and business travelers. We provide insights into the transfer and implementation of best practices in the Western Balkan context, enhance our understanding of the PBV by presenting a specific application of this theoretical perspective, and provide practically relevant results for managers and policymakers.

Remedial safety in in‐situ chemical oxidation, crucial to success

AbstractIn‐situ chemical oxidation (ISCO) has been developed as a remedial technique for several decades, implemented under a variety of Health, Safety &amp; Environmental practices. A positive safety culture and implementation of best practices are important for the protection of all workers, as well as the general environment and the public, and for compliance with regulatory requirements and professional workplace expectations and ethical obligations. ISCO is arguably one of the highest‐risk approaches for in situ remediation, and the consequence of poor safety practices, lack of training, and a failure to sharing previous knowledge can be substantial. Since 2000, the remediation industry has experienced step changes in the evolution of safety practices, shifting focus from a centralized autocratic planning process, toward a behavior‐based safety‐first individual empowerment, resulting in—“I am responsible for the safety of myself and the team.” Supporting this step‐change, this paper explains the need for safety‐first work practices, provides examples of common inadequate or incomplete practices, discusses the top four adverse incidents in ISCO projects (impacts to storm sewers; impacts to other utilities; errors and omissions; and inadequate contingency planning), and provides a description of the top three skills to mitigate risks (planning, executing, and correcting).

On the criminal law measures of regulation of surrogacy in foreign countries

The relevance of the article is termined by the fact that the surrogacy industry is currently rapidly developing. This is not only an effective way to help couples who do not have the opportunity to conceive children on their own, but also a big business. The cost of commercial surrogacy is quite high. This correct and useful deed quickly turned into a high-budget illegal event. It involves transnational criminal organizations. In this connection, the attitude towards surrogacy around the world is diverse and ambiguous. There are countries where this act is prohibited under threat of punishment. The aim of the study is to comprehensively study the legal problems of regulating relations associated with surrogacy. The research methodology is based on the analysis of the criminal law regulation of similar relations in foreign countries, implementation of best practices in the legislation of the Russian Federation as well as improvement of regulatory legal acts in matters of assisted reproduction and protection of individuals from illegal exploitation. The author came to the conclusion that it is necessary to adopt uniform standards for all countries that regulate surrogacy, which would take into account the interests of all the parties involved and create a mechanism for crim-inal law counteraction to shadow surrogacy.

Establishing a Community of Practice among Leaders Providing Technical Assistance: Lessons Learned before and during the COVID-19 Pandemic

The prevalence of youth behavioral health problems before and during the COVID-19 pandemic justifies continued investment in comprehensive school behavioral health systems that link education and behavioral health partners. Technical assistance (TA) providers typically build capacity among school-community partners to advance implementation of best practices in school behavioral health. The pandemic created major disruptions in the delivery of interventions and caused TA providers to adjust the what, where, when, why, and how they provided consultation and support to partners. The TA Community of Practice (TACoP) brought together seasoned TA providers to share knowledge and resources and engage in problem-solving as they struggled in their unique roles as change agents. This article describes the value of the TACoP in responding to immediate and novel challenges, such as collaboration, community-building, and practice-based issues, within

Nurses' roles in changing practice through implementing best practices: A systematic review.

Nurses play an important role in the implementation of best practices. However, the role of nurses in changing practice by implementing best practices requires further exploration. No systematic review was found that summarised the best available evidence on the roles of nurses in changing practice through the implementation of best practices. This study summarised the best available evidence on the roles of nurses in changing practice through the implementation of best practices. A systematic review was used to search for studies in the English language, where a best practice was implemented in a clinical context and which included findings regarding the roles of nurses when implementing best practices. Scopus, EBSCOhost (Academic Search Ultimate, APA PsycInfo, CINAHL with Full Text, ERIC, Health Source: Nursing/Academic Edition, MasterFILE Premier, MEDLINE Complete), PUBMED, and ScienceDirect databases were searched from January 2013 to June 2021. The search generated 1343 citations. After removing duplicates and applying eligibility criteria, 27 studies were included. Five definite roles were identified as follows: leadership, education and training, collaboration, communication and feedback and development and tailoring of the best practice. These roles are interrelated, but equally crucial in order to implement best practices. This study found five interrelated but equally crucial nurse roles in changing practice through the implementation of best practices.ContributionThe study’s findings and gaps identified can be used for further nursing research, improving practice change and health outcomes through the implementation of best practices and the role nurses can play in this process.

ALGORITHM FOR ORGANIZING AND CONDUCTING A SUCCESSFUL INTEREST REPRESENTATION ADVOCACY CAMPAIGN

Today, social advocacy is an effective tool for social change that influences attitudes, relations in the society, strengthens civil society, and contributes to the opening of democratic spaces for the implementation of best practices in social work and social equality. Social workers are aiming at helping people who are suffering from unemployment, violations of rights, difficult life circumstances, discrimination, etc. Thus social workers are in the constant process of individual work with vulnerable groups and often use interest representation as an intervention (protection of rights, representation of interests of individuals/groups of people to gain access to services, etc).&#x0D; &#x0D; The article analyzes several legal provisions that regulate advocacy, in particular, determining the basic rights of citizens and their associations. An algorithm for a successful advocacy campaign to represent the interests of vulnerable groups is proposed, which consists of eight stages (identification of social problems and goal setting, problem analysis, and goal setting, targeting, finding and identifying allies, identifying resources, creating a work plan, implementing a plan, monitoring and evaluation).&#x0D; &#x0D; The peculiarities and difficulties that may arise during the planning and implementation of the advocacy campaign are identified (weakness of the initiative group working on advocacy campaign planning; refusals and inaction of a certain "target" (representative of the authority)) advocacy team); too long campaign and, as a result, exhaustion of the initiative group; difficult confrontations of stakeholders who resist and have strong ties to the government; the unfavorable political situation for the social problem that needs to be solved; corruption schemes). Therefore, it is critical to focus on the systematic information component of the campaign (through constant communication with stakeholders), the availability of information to be conveyed to the target audience, be an attentive and timely response to arguments, and evidence of vulnerable groups affected by advocacy. It is emphasized that an important aspect of planning and implementing an advocacy campaign is to form a coalition and expand partnerships with other organizations that work in the context of a particular social problem or want to expand their activities.

Assessing the Underlying Drivers of Change over Two Decades of Land Use and Land Cover Dynamics along the Standard Gauge Railway Corridor, Kenya

Land cover has been modified by anthropogenic activities for thousands of years, although the speed of change has increased in recent decades, particularly driven by socio-economic development. The development of transport infrastructure can accelerate land use land cover change, resulting in impacts on natural resources such as water, biodiversity, and food production. To understand the interaction between land cover and social–ecological drivers, changing land cover patterns and drivers of change must be identified and quantified. This study documents land cover dynamics along the Standard Gauge Railway (SGR) corridor in Kenya and evaluates the underlying drivers of this change from 2000 to 2019. The study utilised GIS and remote sensing techniques to assess the land use and land cover changes along the SGR corridor, while correlational and regression analyses were used to evaluate various drivers of the changes. Results showed that built-up areas, bare lands, water bodies, croplands and forests increased by 144.39%, 74.73%, 74.42%, 9.32% and 4.85%, respectively, while wetlands, grasslands and shrub lands reduced by 98.54%, 67.00% and 33.86%, respectively. The underlying drivers responsible for these land use and land cover dynamics are population growth, urbanisation, economic growth and agro-ecological factors. Such land cover changes affect environmental sustainability, and we stress the need to adequately identify and address the cumulative social and environmental impacts of mega-infrastructure projects and their interacting investments. The findings of this study provide an evidence base for the evaluation of the social–ecological impacts of the SGR and the implementation of best practices that will lead to enhanced sustainability in the development corridors in Kenya and beyond.

"Trends in corporate governance practices at the level of companies listed on the Bucharest stock exchange "

"The purpose of this paper is to study the interest given to governance practices in Romania, but also the motivational and non-motivational factors existing in this regard. The research is conducted on a sample of 160 companies listed on the Bucharest Stock Exchange, for the years 2015-2019 (pre-pandemic period) and 2020. Information on the degree of implementation of good practices was obtained by using the Declaration “Apply or Explain”. For a better comparability, the extracted data were divided into 4 categories, namely: the provisions of the Governance Code were observed; they were not respected; they have been partially complied with; section missing. For each data found, one point was awarded to the corresponding section and zero points to the other sections, then a summary of the total scores obtained for each category was made. The results of the study indicate that, in general, companies do not give due importance to the recommendations of the Romanian Governance Code, having a rather reserved character due to the costs involved in fulfilling them."

Implementation of peer support in mental health services: A systematic review of the literature.

Peer support within mental health services has a growing evidence base and aligns with current policies of recovery-oriented care. Despite these advantages, widespread implementation of peer support remains limited, likely due to various methodological and implementation issues. Researchers have noted the importance of utilizing an implementation framework to understand best practices for implementation. Therefore, the purpose of the current study was to synthesize the existing literature on the implementation of peer support interventions and identify barriers and facilitators using an implementation framework. The Consolidated Framework for Implementation Research (CFIR) was used to organize the literature obtained in the systematic search and synthesize best practices for implementation. The systematic search identified 19 published articles that were coded for relevant information including implementation barriers and facilitators. The review highlighted a number of important elements for implementation within the CFIR domains, including clear role definition, a flexible organizational culture, and education for peer and nonpeer staff. Implementation barriers included an organizational culture without a recovery focus, allied practitioners' beliefs about peer support, and an unclear peer role. The results of this review provide a summary of best practices for the implementation of peer support in mental health services that can be used by researchers and service providers in future implementation. These practices should continue to be tested and reworked as the climate of recovery-oriented services within mental health organizations evolves. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Genomic and Bioinformatic Resources for Perennial Fruit Species.

In the post-genomic era, data management and development of bioinformatic tools are critical for the adequate exploitation of genomics data. In this review, we address the actual situation for the subset of crops represented by the perennial fruit species. The agronomical singularity of these species compared to plant and crop model species provides significant challenges on the implementation of good practices generally not addressed in other species. Studies are usually performed over several years in non-controlled environments, usage of rootstock is common, and breeders heavily rely on vegetative propagation. A reference genome is now available for all the major species as well as many members of the economically important genera for breeding purposes. Development of pangenome for these species is beginning to gain momentum which will require a substantial effort in term of bioinformatic tool development. The available tools for genome annotation and functional analysis will also be presented.

Digital photography in the evaluation and management of female patients with congenital adrenal hyperplasia: A standardized protocol for quality improvement

Digital photography can be securely stored in the medical record and enhance documentation of physical exam findings and monitor wound healing. A standardized protocol that respects the dignity of the patient and maintains the fidelity of objective documentation is needed for patients with differences in sexual development (DSD) and congenital adrenal hyperplasia (CAH). The purpose of this study was to evaluate the feasibility, acceptability, and applications of a HIPAA-compliant digital photography protocol in the care of female patients with CAH. A protocol for standardized digital imaging including consent, permission, data capture, and storage in the electronic medical record (EMR) was implemented. Patients undergoing physical examination during multidisciplinary CAH clinic visits, preoperative evaluation, and postoperative follow-up from October 2020 through May 2021 were included. Male patients with CAH, patients with clitoromegaly or urogenital sinus not from CAH, and patients seen through telehealth were excluded. Consent was obtained from caregivers and permission from patients. Images of the exam were taken during clinic visits or at the time of surgery with no identifying features included. Images were directly uploaded into the patient's chart in the HIPAA-protected EMR separate from other clinical documentation and not stored on personal devices. There were 17 patients with CAH seen with median age 6 years (range 2 weeks-18 years). There was a median of 3 photos per patient during the study period with cooperation from both the patient and their caregiver. Amongst the patients seen, 6 patients underwent reconstruction with a median of 10 photos per patient. Images were available and used for preoperative planning and counseling. Patients with previous images did not require repeat examinations and were subjected to fewer genital examinations. Fewer providers were present during exams. Images taken by providers and caregivers during the postoperative period were used to monitor wound healing and surgical outcomes. Protocol implementation improved patient care by reducing the number of exams and number of providers present, enhancing clinical documentation, and providing a means of tracking the physical exam over time. This was in concordance with guidelines for limiting exams for patients with DSD and CAH. Implementation of best practices for medical photography was important in respecting patient dignity and confidentiality. Implementation of standardized digital photography was feasible and acceptable to patients and caregivers. Digital images reduced the need for repeat physical examination and provided a visual means of enhancing clinical documentation.

Impact of a pediatric oncology nutrition program: Lessons learnt over a decade.

The management of malnutrition in children with cancer remains a challenge in low-middle-income countries (LMICs). We describe our pediatric oncology nutrition program and its impact over the past decade. We evaluated the impact of our nutrition program in accordance with the International Society of Paediatric Oncology-Paediatric Oncology in Developing Countries (SIOP PODC) Nutritional Program Evaluation in the areas of service delivery (number served, increments in delivery, number of trained care providers), patients at-risk (proportion identified with malnutrition at diagnosis/follow-up), and efficiency of nutritional interventions (proportion assessed, proportion achieved healthy weight, clinicians trained). We analyzed available data for trends between 2009 and 2020, and comparisons were made using the Fisher t test. This study was approved by our institutional ethics committee. From 2010 to 2020, 17749 children treated at our center were beneficiaries of the nutritional program, including assessment and intervention. During this period, trained pediatric nutritionists increased from 2 to 8; SIOP PODC level from 2 to 3-4, and nutrition budget increased 15-fold. At diagnosis (n=5618) and six-month follow-up (n=2674), 59.6% and 51.2% children were undernourished, 34.8% and 43% well nourished, and 4.7% and 5.7% overnourished. From 2016 onward, fewer children were undernourished at follow-up-69.5% (2016), 60% (2018), 54% (2019), and 55% (2020, P<0.001). The program helped train over 500 clinicians in nutrition. Improved financial support and capacity building have helped build and sustain an effective nutrition program. Priority areas include implementation of best practices, early nutritional intervention, continued education, and locally relevant research.

Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013–2021

BackgroundA considerable gap in knowledge exists around mental health trends in diverse racial and ethnic adolescent and young adult populations. The purpose of this study is to examine annual trends for mental health and help-seeking by race/ethnicity in a national sample of college students. MethodsSurvey data come from >350,000 students at 373 campuses that participated in the Healthy Minds Study between 2013 and 2021. Analyses are descriptive in nature focusing on year-by-year prevalence and help-seeking rates for each racial/ethnic group. ResultsIn 2020–2021, >60% of students met criteria for one or more mental health problems, a nearly 50% increase from 2013. Mental health worsened among all groups over the study period. American Indian/Alaskan Native students experienced the largest increases in depression, anxiety, suicidal ideation, and meeting criteria for one or more mental health problem. Students of color had the lowest rates of mental health service utilization. The highest annual rate of past-year treatment for Asian, Black, and Latinx students was at or below the lowest rate for White students. Although Arab American students experienced a 22% increase in prevalence, there was an 18% decrease in treatment. LimitationsResponse rates raise the potential of nonresponse bias. Sample weights adjust along known characteristics, but there may be differences on unobserved characteristics. ConclusionsFindings have important implications for campus mental health programming and underscore the urgency of reducing mental health inequalities in college student populations through the identification and implementation of best practices both in clinical settings and through system-level change.

Independence of clinical events committees: A consensus statement from clinical research organizations

BackgroundRandomized clinical trials are the gold standard to assess the causal relationship between an intervention and subsequent outcomes, also known as clinical endpoints. In order to limit bias, central clinical events committees (CEC) are established to ensure consistent event reporting across participating centers, as well as complete and accurate ascertainment of endpoints. However, defining independence is challenging. MethodsThis consensus statement was generated by teleconferences and electronic communications among clinical research organizations from the United States, Europe and Australia. This document does not constitute regulatory guidance. ResultsAn independent CEC is defined when the adjudicators are not primarily involved in designing, funding, sponsoring, organizing, conducting, analyzing or regulating the clinical trial for which they serve as an adjudicator, beyond their role as CEC member. Moreover, independence requires absence of conflicts of interest with the steering committee, sponsor, grant giver, manufacturer, coordinating center, other independent committees, core laboratories, medical monitor, safety physician, participating clinical sites, statistician or data manager, regulatory agencies or authorities, which could influence (or be perceived to influence) a member's objectivity in evaluating trial data. Such conflicts of interest include financial benefits, directing or advisory role (paid or unpaid), decision-making position, as well as being a direct relative. An independent adjudicator has no other role within a clinical trial. ConclusionsThis consensus statement presents a standardized definition of an independent CEC to be considered by clinical research organizations, manufacturers, and investigators. In addition, it provides recommendations on best practices for implementation of an independent CEC.