Development Of Guidelines Research Articles

Effects of a Revision to the Standard Admission Order Set on Laxative Prescribing for Opioid-Induced Constipation

Purpose: Opioid-induced constipation (OIC) is highly prevalent in patients with cancer-related pain on opioid analgesics and has negative consequences on physical and psychological well-being and quality of life. Oncology clinical practice guidelines recommend the use of osmotic and stimulant laxatives for the prevention and management of opioid-induced constipation, not stool softeners such as docusate sodium. Prescribing practices continue to fall behind these recommendations. Methods: This quality improvement project revised the laxative options available in the standard admission order set in the electronic medical record. Specifically, docusate sodium was removed and replaced with senna and polyethylene glycol 3350. Results: A total of 2,742 patient admissions preintervention were compared to 2,752 admissions postintervention. The number of orders for docusate (p < .001) and docusate-senna (p = .002) orders decreased significantly after the intervention, in addition to the number of OIC diagnoses (p < .001). However, the number of orders for polyethylene glycol (p = .559), senna (p = .582), other laxatives (p = .245), or functional bowel disorder medications (p = .533) did not change significantly. No significant differences were observed in the frequency of laxative orders placed within 24 hours of an opioid order, number of laxatives prescribed at discharge, admissions related to bowel-related complications, or length of stay. Conclusions: Interventions utilizing the electronic medical record can facilitate evidence-based management of OIC. Development of clinical practice guidelines and tailoring these interventions further is needed to adapt this approach at other institutions and sustain practice change.

Developing a core outcome set for Netherton syndrome: An international multi-stakeholder e-Delphi consensus study.

Netherton syndrome (NS; OMIM#256500) is a rare and severe disorder of epidermal maturation and keratinization caused by pathogenic variants in the serine protease inhibitor Kazal type 5 (SPINK5), leading to severe skin barrier impairment. Although effective treatment is crucial for NS patients, there is a lack of knowledge on what the best treatment options are for these patients. Large heterogeneity in reported outcomes and measurement instruments hinders accurate comparison of treatment results across studies and the development of a treatment guideline. Therefore, we aimed to develop a core outcome set (COS) for NS that can be used in clinical care and research. This study was performed in accordance with the recommendations of the Core Outcome Measures in Effectiveness Trials (COMET) initiative. After identification of outcomes through a literature search and classification based on the International Classification of Functioning and taxonomies published by the COMET initiative, discussion groups were organized at the 2nd International Netherton Congress 2022 to finalize the provisional outcome list. Through a 2-round e-Delphi, 41 stakeholders (patients and family members, professionals, and representatives of industry) from 14 countries rated the importance of the outcomes using a 9-point Likert scale. An online consensus meeting attended by 14 stakeholders finalized the COS. The core outcome set for NS comprised 21 outcomes in 10 domains. These included four 'skin' outcomes, two 'sensation' outcomes, two 'side-effects of treatment' outcomes, one 'vitality' outcome, one 'emotional functioning' outcome, two 'physical development' outcomes, two 'nutrition' outcomes, two 'infections' outcomes, two 'allergies' outcomes, and three 'assessment results' outcomes. In this study, consensus was reached on 21 outcomes to be included in the COS for NS. The selection of outcomes in the COS underlines that NS not only affects the skin, but is a disease requiring a broad multidisciplinary approach in clinical care and research. International implementation of this COS will lead to more uniform reporting, thereby enabling comparison of study results, which may facilitate future treatment guideline development. The next step is to further conceptually define the outcomes and reach consensus on how the measure these.

Effectiveness of pharmacological procedural sedation in children with autism spectrum disorder: A systematic review and meta-analysis.

Management of primary healthcare and routine minor procedures for children with autism spectrum disorder (ASD) can be challenging; therefore, when behavioural strategies fail, sedative medications are often employed. We evaluated the effectiveness of the current pharmacological strategies for managing children with ASD. We performed a systematic review and meta-analysis of the current approaches for procedural sedation in children with ASD. Twenty studies met inclusion criteria. Dexmedetomidine, midazolam, propofol and chloral hydrate were the most efficient agents for successful procedures, while propofol had the highest number of adverse events. The most frequently used agents were dexmedetomidine and midazolam or a combination of the two, and the effectiveness of dexmedetomidine plus midazolam was superior to dexmedetomidine alone. Multiple effective drug regimens exist for procedural sedation in children with ASD. These results could support the development of specific guidelines for procedural sedation in children with ASD.

The Italian guideline on diagnosis and treatment of dementia and mild cognitive impairment.

Approximately 2 million people in Italy are currently living with dementia or mild cognitive impairment (MCI), and 4 million are involved as family members or caregivers. Considering the significant impact of dementia, the Italian Ministry of Health entrusted the Italian National Institute of Health (Istituto Superiore di Sanità) with the development of a guideline within the Italian National Guideline System (Sistema Nazionale Linee Guida, SNLG) on the diagnosis and treatment of dementia and MCI. The main objective was to provide evidence-based recommendations aimed at reducing the variability and ensuring the appropriateness of clinical practices throughout the whole care process from identification and diagnosis to the end of life for people with dementia (PwD) or MCI and their families/caregivers. The GRADE-ADOLOPMENT approach was used to adopt, adapt and update the guideline developed by the National Institute for Health and Care Excellence in 2018 (NG97). The methodology was based on the Methodological Handbook produced by the SNLG. A multidisciplinary panel of 29 experts and four representatives of family members/caregivers discussed and approved 47 review questions. Of these, 34 questions were adopted from the NG97, and 13 were new questions, including 10 questions referring to MCI. Systematic literature reviews were performed for each question, and a team of methodological and clinical experts qualitatively assessed and summarised results from included studies based on the GRADE approach. To facilitate the implementation and dissemination of the contents of this guideline, a care pathway and a leaflet dedicated to PwD or MCI and their families/caregivers were also developed. The literature review for this guideline included studies published up to November 2023. More than 1000 peer-reviewed publications were included, covering the following areas: (i) identification, diagnosis and post-diagnostic support; (ii) care models and care coordination; (iii) pharmacological interventions for cognitive symptoms; (iv) non-pharmacological interventions for cognitive symptoms; (v) non-cognitive symptoms, intercurrent illnesses and palliative care. The multidisciplinary panel discussed and approved 167 clinical practice recommendations and 39 research recommendations. Italy's first National Guideline on dementia and MCI addresses diagnosis, treatment and care within the National Healthcare System. It includes recommendations on pharmacological and non-pharmacological approaches, and emphasises tailored interventions, comprehensive cognitive assessment, staff training and palliative care. The guideline also underlines the need to involve PwD in decision-making and supporting caregivers throughout the entire course of the disease. Structured strategies for the dissemination and implementation of the guideline will be defined within the Italian Fund for Alzheimer and other Dementias 2024-2026. An interactive care pathway and a leaflet dedicated to PwD and their carers are already available. The guideline will be updated starting January 2027, but early updates may be planned in case of breakthrough advancements.

"Another tool for the sexual health toolkit": U.S. health care provider knowledge and attitudes about doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections among men who have sex with men.

Doxycycline post-exposure prophylaxis (doxy-PEP) reduces chlamydia, gonorrhea, and syphilis infections among men who have sex with men (MSM) and transwomen (TW). Perspectives of health care providers (HCPs) regarding doxy-PEP can inform implementation efforts. From August 2022 to January 2023, HCPs were recruited from 13 cities with high sexually transmitted infection (STI) rates for semi-structured, in-depth interviews about their awareness of and attitudes towards doxy-PEP for STI prevention. HCPs were purposively sampled to include people with experience prescribing PrEP and provision of care to MSM. Interviews were conducted virtually via Zoom. Transcripts and debrief reports were analyzed using a directed content analysis approach to explore knowledge, attitudes, and beliefs about doxy-PEP. Among 30 HCPs, almost half (47%) were between 31-40 years of age, 53% identified as male, and 47% reported their sexual orientation as gay or queer. Half (53%) of participants practiced in the South, 43% had >100 MSM in their clinic panel, and 17% had previously prescribed doxy-PEP. We identified four overarching themes: 1) HCPs expressed positive attitudes towards doxy-PEP; 2) antimicrobial resistance concerns limit enthusiasm for some HCPs; 3) additional data about the long-term safety of doxy-PEP would improve their confidence; and 4) development of guidelines would facilitate the prescription of doxy-PEP, including eligibility, dosing instructions, and treatment management. HCPs were motivated to prescribe doxy-PEP with almost 20% already having prescribed it. Guidelines and data about long-term safety, especially antimicrobial resistance, would facilitate introduction of doxy-PEP into clinical practice.

Korean nurses' knowledge, opinions and current practice of trauma-informed pediatric nursing care in South Korea: a descriptive study.

This study aimed to investigate the knowledge, opinions, competence, and barriers of nurses providing trauma-informed care (TIC) to children in hospitals. Data were collected from 198 nurses nationwide using the TIC Provider Survey developed by the Center for Pediatric Traumatic Stress in July, 2024. Descriptive statistics, t tests, and one-way ANOVA were conducted using the IBM SPSS Statistics software (ver. 23.0, IBM Corp.). Of the 13 items assessing knowledge of TIC, seven had a correct response rate of over 90%. However, the correct response rate for these three items were less than 30%. Regarding opinions on the TIC, more than 90% of participants agreed with five of the seven items. In self-rated competence in providing TIC, they were not competent in responding to a child's (or parent's) questions about whether the child is going to die or understanding how traumatic stress may present differently according to developmental stages. The major barriers to providing TIC were time constraints, lack of training, and organizational support. Items with relatively low performance rates were 'teach parents what to say to their child after a difficult/sick/scary experience, and teach child or parents the specific ways to cope with unpleasant experiences'. This study suggests that it can contribute to the development of specific guidelines for nurses to effectively apply TIC in pediatric and family nursing practice, emphasizing the need for educational programs to support this implementation.

Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions

Integrative Medicine (IM), which includes therapies such as acupuncture, herbal medicine, yoga, and meditation, is gaining attention for managing chronic pain conditions. However, concerns about the quality of evidence supporting the use of these interventions persist. The 5th Annual Jaseng Academic conference 2024, in Seoul, South Korea, themed "Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions," addressed these concerns by focusing on advancements in study design, evidence synthesis, and open science practices. This conference proceeding summarizes key insights from the conference, emphasizing the role of pragmatic randomized controlled trials (pRCTs) in evaluating real-world effectiveness, and addressing the complexities involved in IM research such as sham controls. The integration of IM therapies into comprehensive pain management strategies (particularly in Korea), supported by government-backed research and policy initiatives was also discussed. Advancements in methodologies were addressed, such as bibliometric analysis, evidence mapping, and the development of clinical practice guidelines (CPGs) for integrative therapies. These methodologies offer valuable insights but face challenges due to the heterogeneity of IM interventions, and potential synergistic or antagonistic effects when combined with conventional medicine. Finally, the potential of open science to enhance transparency, reporting, and reproducibility in IM was explored, emphasizing the increased role of adherence to reporting guidelines (CONSORT and PRISMA). The future of IM research is built upon the continued efforts of refined study designs, rigorous evidence synthesis, and the integration of open science principles, for a robust and more credible evidence base.

Jewelry of Eastern Lanna Identity: Strategies and Approaches for Contemporary Jewelry Design from Cultural Identity

Today’s jewelry designs look more contemporary, emphasizing self-expression by reflecting the perspectives and ideas of designers and artists in the context of society, culture, ethnicity, aesthetics, technology and ways of life through designs that are unique and in line with today’s lifestyles to create new artistic approaches. This research presents strategies and guidelines for designing contemporary jewelry from cultural capital by using the eastern Lanna area as a case study. The researchers conducted a unique analysis by studying the image and identity of the provinces in the eastern Lanna region, which led to the development of strategies and guidelines for jewelry design that reflect the eastern Lanna identity, as well as assessment of the perceptions of and satisfaction with jewelry prototypes designed by these strategies and such guidelines. The results showed that, in this research, the BLEND strategy was used in contemporary jewelry design, which was developed from the interpretation of the identity, image and characteristics of the provinces in the eastern Lanna group, into a design development in the form of a mixed design, or hybridization. These guidelines for creative design have generated design terms and conditions to present the value of work that expresses identity through four elements, namely 1) color, 2) materials, 3) patterns/shapes, and 4) story contents, which are synthesized through the perception of representative images to design and produce jewelry prototypes. The results of the evaluation of the jewelry prototypes as a whole revealed that the jewelry can express the eastern Lanna identity in an effective way, resulting in the creation of new knowledge in design, which is the development of concepts and processes to interpret new meanings in design in order to create value and worth as part of the utilization of cultural capital in the development of the country.

Circulatory characteristics of early mobilization after surgery for bilateral pheochromocytoma: a case report

BackgroundSurgical treatment of pheochromocytomas is associated with circulatory dynamics instability, necessitating systemic management of the patient in the intensive care unit after surgery. Early mobilization after pheochromocytoma surgery is not described in the guidelines, and to our knowledge, no reports have specifically focused on circulatory dynamics during early mobilization after surgery.Case presentationA 31-year-old Japanese woman was diagnosed with bilateral pheochromocytoma and underwent a second-stage adrenalectomy for bilateral pheochromocytoma at our hospital. We evaluated circulatory dynamics during a passive upright posture on postoperative days 1 and 4. She was placed on a tilt bed in the supine position (0° head) for 15 min, passive upright posture (60°) for 15 min, and supine position again for 10 min. In the passive upright posture, both systolic and diastolic blood pressure decreased, and the heart rate increased by 10 bpm over approximately 10 minutes. After the postural change from the passive upright posture to the supine position, the heart rate decreased to a level lower than in the supine prior to the passive upright posture. The same measurements were taken on postoperative day 4. Systolic blood pressure decreased in the passive upright posture, but diastolic blood pressure remained unchanged. The heart rate also increased earlier after passive upright posture compared with that on the day after surgery. When the patient returned to the supine position from the passive upright posture, the heart rate decreased even further compared with its level prior to the passive upright posture, as observed on the day after surgery.ConclusionCirculatory dynamics may fluctuate after surgery for pheochromocytoma due to a relative decrease in epinephrine and norepinephrine secretion. In this case, the patient’s response may be close to normal by the fourth postoperative day, but circulatory dynamics fluctuations were noted on both the first and fourth postoperative days when the patient was supine after passive upright posture. Although the substantial variability of perioperative circulatory dynamics in patients with pheochromocytoma has improved considerably with the development of perioperative management guidelines, circulatory dynamics should be carefully monitored during early mobilization and after its completion.

Call the experts: identifying stakeholders in the long-term care of youth with hypospadias.

Long-term follow-up for individuals with hypospadias remains a critical area of need, yet evidence-based guidelines for such follow-up are lacking, and the role of involvement of relevant experts is not yet established. Using our hypospadias-specific health-related quality of life conceptual framework and a subsequent qualitative study of prepubertal males and parents of males with hypospadias, we identified potential priorities for long-term follow-up of youth with hypospadias. Using thematic codes from our patient and parent interviews, we searched PubMed for relevant articles and identified the specialties represented by all the authors of these articles. Our search strategy revealed consistent expertise across HRQOL themes and subthemes, including pediatric and adult urology, health psychology, psychiatry, endocrinology, genetics, and social work. Communication experts, as well as patients and families, were also represented in our literature search. Using these findings, we compiled a comprehensive list of potential stakeholders to inform the development of holistic care guidelines for individuals with hypospadias. By engaging these stakeholders, we aim to develop consensus-based, long-term follow-up guidelines and tools to address the evolving physical and psychosocial needs of people with hypospadias over a lifetime. The use of qualitatively derived thematic codes to search for relevant literature is an accessible approach to identifying relevant stakeholders. These findings underscore the importance of involving diverse, multidisciplinary expertise to ensure comprehensive, patient-centered care in complex genitourinary conditions.

Post stroke sexual dysfunction - a current review.

Sexual dysfunction manifests as various challenges during sexual activity and is a prevalent condition that significantly impacts quality of life. Post stroke sexual dysfunction (PSSD) is particularly concerning, yet it is often overlooked by both healthcare providers and patients. We conducted a comprehensive literature review, examining research and reports related to sexual dysfunction following stroke. Our aim is to synthetize an extensive, detailed and up-to-date overview of its prevalence, underlying mechanisms, and interventions. PSSD, often underestimated among stroke survivors, has a high incidence but remains poorly understood in terms of its neurobiological mechanisms. Swift and accurate diagnosis, coupled with timely rehabilitative intervention, is crucial. However, the development of comprehensive guidelines is impeded by a lack of high-quality literature. This review seeks to present recent advances in understanding PSSD, and to advocate for a structured strategy in terms of the long-term rehabilitation of stroke survivors.

The Paradox of Physical Activity and Coronary Artery Calcification: Implications for Cardiovascular Risk.

The introduction of CT scans and the subsequent Agatston score in the 1990s drastically improved our ability to detect coronary artery calcification (CAC). This led to its incorporation into cardiovascular risk assessment guidelines set forth by organizations such as the American Heart Association (AHA) and the American College of Cardiology (ACC). Over time, these guidelines have evolved significantly, reflecting an increasing understanding of CAC. Physical activity has become a key factor in the management of cardiovascular disease. However, the relationship between physical activity and CAC remains complex. Although physical activity is generally beneficial for cardiovascular health, paradoxically, high levels of physical activity have been associated with elevated CAC scores. However, these higher CAC levels may indicate the presence of more stable, calcified plaques that provide protection against plaque rupture. These contradictory findings call for balanced interpretations that acknowledge the cardiovascular benefits of physical activity. This review examines the historical development of clinical guidelines for CAC, the paradoxical relationship between physical activity and CAC, and potential underlying mechanisms. It emphasizes the need for future research to utilize objective measures and consistent methodologies to better understand the relationship between physical activity and CAC.

Virulence and resistance genes in <i>Campylobacter spp</i> isolated from asymptomatic children at Kibera slum in Nairobi, Kenya

BACKGROUND Campylobacter spp. are among the global causes of food poisoning and harbour virulence and resistance genes which play a role in invasion and antibiotic resistance. This study aimed to detect selected resistance and virulence genes in archived Campylobacter spp. isolated from children in Kibera, Nairobi, Kenya. MATERIALS AND METHODS This was a retrospective laboratory-based cross-sectional study on archived samples of Campylobacter spp. at the Department of Public Health, Pharmacology and Toxicology, University of Nairobi. Campylobacter isolates were cultured on modified charcoal cefoperazone deoxycholate agar (mCCDA) media. The presence of selected virulence genes and resistance genes was detected by multiplex polymerase chain reaction (mPCR). STATA13 was used in data analysis. Binary logistic regression was used to ascertain the association between the genes and the Campylobacter spp. RESULTS The Campylobacter spp. under this study were Campylobacter jejuni (C. jejuni) (50%), Campylobacter coli (C. coli) (38%) and Campylobacter lari (C. lari) (12%). The virulence genes detected were cgtB 37 (25%), pldA (20%), cdtA (17%), cdtB (16%), cdtC (6%), wlaN (5%), iam (4%), ciaB (4%) and VirB11 (3%). The virulence gene waaC was not detected in any of the isolates. The resistance genes detected were TetA (42%), Tet B (26%), GyrB (18%) and GyrA (14%). CONCLUSION The study revealed the presence of various virulence and resistance genes in Campylobacter spp. isolated from children. This information could help guide the development and enhancement of guidelines for the management of Campylobacter infections.

Perceptions of Multicancer Detection Tests Among Primary Care Physicians and Laypersons: A Qualitative Study.

Multicancer detection tests (MCDs) are blood-based tests designed to detect multiple cancer types. It is currently unclear whether these cancer screening tests improve mortality. To understand awareness of MCDs among providers and patients, as well as explore how they perceive the benefits, harms, and acceptability of MCDs, we have undertaken a focus group study in primary care physicians (PCPs) and laypersons to explore knowledge, attitudes, and expectations of cancer screening using MCDs. We conducted six focus groups with 45 PCP participants and 12 focus groups with 80 layperson participants. Participants were identified via a consumer research firm and found eligible following the completion of a screener survey. Moderators used a semi-structured guide containing open-ended questions and prompts to facilitate the discussion. Recordings were transcribed and coded line by line using a codebook developed based on questions and emerging discussion concepts, and emergent themes were identified. Both PCP and layperson participants felt the that benefits of MCDs included ease of use and potential ability to detect cancers early. However, they felt that additional data is needed to overcome some of the concerns related to MCDs. PCP participants expressed concerns related to lack of practice guidelines, cost of diagnostic follow-ups, privacy and insurance issues, fear/anxiety related to confirmation of MCD results, and malpractice liability related to perceived false negative test results. Layperson participants expressed concerns related to costs, insurance coverage, and privacy, as well as anxiety over the confirmation of a positive test result. There is a major need for more rigorous data regarding MCDs to inform the development of guidelines for use as cancer screening tools.

Survival and Toxicity Outcomes with Radiotherapy Technique and Timing in the Management of Wilms Tumor: a Systematic Review to Inform a National Clinical Practice Guideline Development

Purpose: Wilms tumor (WT) management has evolved into a multimodality paradigm that includes radiotherapy (RT), usually as an adjuvant or consolidative modality. Protocols are refined to maximize cure and compliance while minimizing acute toxicity and long-term effects. RT technique and timing are two factors that could improve these outcomes. We reviewed the evidence on survival and toxicity outcomes among WT patients with conventional versus advanced RT techniques and early versus delayed RT to inform a Department of Health (DOH) commissioned guideline. Materials and Methods: We systematically searched PubMed, EuropePMC, EBSCOHost, HERDIN, systematic review and clinical trial registries and official websites of scientific societies for relevant publications and grey literature. Eligibility screening, risk-of-bias assessment and data extraction were performed using a single-reviewer approach. Given the study and data heterogeneity, only a qualitative synthesis was performed. Certainty of evidence assessment was done using the GRADE approach. Results: We screened 314 studies and included seven in the review, including a phase 1/2 trial and six retrospective studies, all from first-world countries (US, France, Netherlands), except one from a newly industrialized country (Brazil). The certainty of evidence on the survival and toxicity outcomes with advanced RT techniques was very low. Moderate-certainty evidence supports that giving RT >14 days after surgery leads to increased mortality. Conclusion: Current evidence does not support the routine use of advanced RT techniques; proper contextualization is necessary. Tertiary centers managing WT should strive to administer RT within 14 days after surgery whenever possible. Keywords: Wilms tumor, nephroblastoma, radiotherapy, intensity-modulated radiotherapy, survival, toxicity

Mitigating not-invented-here syndrome in consultant knowledge transfer by developing appropriate implementation guidelines

Purpose This study aims to propose a framework for the development of implementation guidelines (IGs) that can help consultants mitigate not-invented-here (NIH) syndrome during a consultant intervention as a specific type of knowledge transfer. Design/methodology/approach The authors adopted a design science research approach for proposing an NIH-mitigating IG development framework. Inspired by findings and rich primary data from two consultant interventions, the authors, through theory building, ground five core principles in the general theory of NIH attitude functions. Finally, the authors revisit two consultant interventions to identify and describe mechanisms that led to the enactment of the principles. Findings The proposed framework provides five principles for developing NIH-mitigating IGs. The present research proposes that successful knowledge transfer and the mitigation of NIH syndrome as a prerequisite for this success are conditioned by adequately developed IGs. Originality/value The originality and value of the present research lie in the proposed NIH-mitigating IG development framework containing a set of principles for IG development as a proactive rather than reactive approach to NIH mitigation. To the best of the authors’ knowledge, this is the first research to address the problematics of mitigating NIH syndrome in consultant knowledge transfer by focusing on developing appropriate IGs. By developing and implementing IGs based on the proposed framework, a more successful transfer of knowledge from consultants to clients should take place, thus, increasing the value that clients receive from consultancy.

Enhancing nurse faculty resilience through self-leadership: guidelines for resource mobilization in dynamic academic environments.

The purpose of the study was to develop guidelines for the facilitation of self-leadership in nurse faculty. Of the 12 guidelines developed, this paper discusses the two related to resilience through self-leadership practices, namely: encouraging reliance on internal sources for self-preservation; and strengthening the positive self-image of nurse faculty through management and peer support. An exploratory, sequential mixed-methods design was used to guide the development of guidelines. Enhancing nurse faculty resilience can be achieved by promoting engagement in self-leadership activities. These activities contribute to faculty members' profound satisfaction, confidence in their knowledge, and overall competence. Resilience is enriched through practicing self-leadership in a supportive work environment and plays a crucial role in adapting to significant changes in the work environment. It has been identified as a key factor that facilitates the ability to persist against struggles and challenges in the workplace. The implementation of higher education reforms in South Africa has brought about increased workload, stress, and uncertainties to an already overwhelmed nurse faculty workforce, consisting of mainly female faculty. It is prudent that a supportive environment that empowers nurse faculty well-being and resilience be facilitated to ensure adaptation to a dynamic and competitive nursing education environment.

Management Gaps in the Implementation of Legislation Regulating Derelict and Ownerless Mines in South Africa

Little attention has been paid to the rehabilitation of derelict and ownerless mines in South Africa after their lifespan. This paper aims to explore management gaps in legislation that have resulted in the non-rehabilitation of derelict and ownerless mines in South Africa. There is growing evidence that supports the distressing effects of mining on people living around these mines in the North West Province. This paper was motivated by the current socio-economic status quo of old mining towns, the influx of illegal miners (Zama Zamas), severe environmental damages, and the violence associated with derelict mines. Underpinning this research was an ecosystem approach and integrated resources management principles, which formed the foundation for the decision-making process.The researcher used a mixed-method approach and employed convergent techniques. A semi-structured instrument was used to collect data from 200 respondents. The results indicated that there is a dire need for community-based consultative processes, and an absence of clear guidelines for derelict and ownerless mines to pressure mine management to adhere to rehabilitation standards. Moreover, the mining charter is ambiguous regarding policy implementation, budgetary allocation, and duration of the rehabilitation of these mines. The paper concluded that management challenges associated with derelict mines can be reduced if all stakeholders follow the guidelines as outlined in the environmental legislative framework (NEMA) of South Africa while being open to innovations in line with international best practices. It also contributes towards the development of guidelines for the management and implementation of legislation related to derelict and ownerless mines in South Africa from a philosophical, theoretical, and policy perspective.

Practice guideline of influenza vaccination and antiviral drugs use in children(2024 editon)

Influenza is the most common acute respiratory infectious diseases among children in China. The annual seasonal influenza outbreak has a significant impact on children's health, poses a significant disease and socioeconomic burden, and arouses a wide public concern. In recent years, a number of new influenza vaccines and influenza antivirals have been approved for use in children, expanding the choices for prevention and treatment of influenza. Pediatric Infection Group, Chinese Society of Infectious Diseases of Chinese Medical Association and Infection Group, Pediatric Expert Committee of National Health Commission Capacity Building and Continuing Education, and China Clinical Practice Guidelines Alliance Methodology Committee organized a multidisciplinary guideline development group (GDG) consisting of experts in pediatrics, infectious diseases,epidemiologists,health policy,and guideline methodology proposed eight key issues concerning influenza vaccination and antiviral use from a practice perspective. Through research question construction, evidence retrieval and synthesis, evidence appraisal and evidence-to-decision discussion, recommendations and implementation suggestions were formulated. This guideline is intended to provide guidance for pediatricians at different facility levels and healthcare providers engaged in vaccination services,and institutional professionals dealing with prevention and control of infectious diseases.

The guideline for the treatment and prevention of lower respiratory tract infections caused by human respiratory syncytial virus (2024 edition)

Human respiratory syncytial virus (RSV) is a major pathogen causing lower respiratory tract infections in humans. It is particularly a common cause of hospitalization among high-risk groups such as infants, tots, and the old people, imposing a heavy burden on families and society. The standardized treatment and prevention of this disease are increasingly emphasized by healthcare professionals. However, there are currently no standardized guidelines in China for lower respiratory tract infections caused by RSV. Therefore, our group for this guideline has developed the "Guidelines for the treatment and prevention of lower respiratory tract infections caused by human respiratory syncytial virus (2024 edition)" based on the latest evidence-based medical evidence and guideline development methods. The aim is to provide guidance to relevant healthcare professionals and improve prevention and treatment levels.