Recommendations For Best Practices Research Articles

Qualitative Interviews with Stakeholders in Herbal Pharmacovigilance and Recommendations for Best Practices to be Applied Worldwide.

The use of herbal products globally is substantial, but varying definitions and regulatory frameworks have led to differences in their status as medicinal products and in approaches to monitoring their safety. This article explores the current landscape of herbal pharmacovigilance, drawing insights from interviews with global experts in the field, and offers recommendations for best practices to enhance the safety and benefit-to-harm balance of herbal products. This study comprised semi-structured interviews with members of the International Society of Pharmacovigilance-Herbal and Traditional Medicines Special Interest Group and the Nutrivigilance Information Exchange Network, recruited using purposive sampling. Data were stored and coded using NVIVO® and analysed thematically using a qualitative inductive approach. Sixteen participants from 11 countries were interviewed, revealing diverse regulatory approaches and challenges in herbal pharmacovigilance. Key themes included legal status, awareness, identification and coding of herbal products, pre-/post-marketing product control, reporting of adverse drug reactions, causality assessment and signals of herbal products. This study yielded five general recommendations to further improve herbal pharmacovigilance worldwide. This study offers an overview of the global landscape of herbal pharmacovigilance, highlighting challenges in monitoring herbal products and presenting universal recommendations. These recommendations encompass increasing awareness, enhancing education and improving legislative frameworks. Given the growing use of herbal products, the implementation of strong pharmacovigilance practices is crucial to ensure consumer safety.

B - 74 The Effect of Perimenopause on Women’s Executive Functioning: a Systematic Review

Abstract Objective This systematic review aims to examine the existing literature on the impact of perimenopause/menopause on cognitive function, identify overlaps with adult ADHD symptoms, and provide evidence-based recommendations for distinguishing between the two conditions, guiding clinical practice and identifying considerations for selection of neuropsychological testing with this population. Data Selection A search of electronic databases, including PubMed, PsycINFO, and MEDLINE, will be conducted to identify relevant peer-reviewed studies published between 2000 and 2024. Studies examining cognitive changes during perimenopause/menopause, diagnostic challenges in distinguishing perimenopause/menopause-related cognitive decline from adult ADHD symptoms, and interventions for accurate assessment and management will be included. Data extraction and synthesis will be performed following PRISMA guidelines. Data Synthesis The analysis will review a range of literature on the cognitive changes associated with perimenopause/menopause, including deficits in attention, memory, and executive function, which may overlap with symptoms of adult ADHD. Attention will be paid to looking for distinct patterns of cognitive impairment and hormonal profiles between perimenopause/menopause-related cognitive decline and adult ADHD. Various screening tools and neuropsychological assessments will be examined for their utility in differentiating between the two conditions. Conclusions The current systematic review, with its focus on the impact of menopause and perimenopause on women’s cognitive functioning, particularly executive functioning, has the potential to significantly advance our understanding in this area. It will be able to provide clinical recommendations and considerations for individuals administering and interpreting neuropsychological testing with this population. Recommendations for best practices will be proposed, potentially revolutionizing the way we approach and manage these conditions.

Development of an interprofessional diagnostic toolkit to enhance outside walking gait-related participation of people after stroke in Germany: study protocol of an ongoing multi-methods study

IntroductionPersons after stroke experience limitations in activities of daily living even in the chronic phase. Many patients who had a stroke report mobility limitations with loss of social roles such...

Intrathecal drug delivery for the management of pain and spasticity in adults: British Pain Society’s recommendations for best clinical practice

The British Pain Society updated their recommendations on intrathecal drug delivery (ITDD) for the management of pain and spasticity in adults. The recommendations are primarily evidence based but where necessary comprise the consensus opinion of the working group. The recommendations are accompanied by information for patients and their carers, intended to inform and support patients in their decision making. The updated guidance includes recent evidence base of ITDD use in pain and spasticity, address the issues of drug pump compatibility following the latest manufacturer and Medicines and Healthcare products Regulatory Agency (MHRA) recommendations as well as provide an update on the indications and complication management particularly endocrine complications and intrathecal granuloma formation.

Patient and community centered approaches to sepsis among birthing people

Sepsis is the second leading cause of maternal death in the U.S. For racial and ethnic minoritized birthing people, especially those who are Black and living in underserved communities, labor and postpartum are particularly vulnerable risk periods. To reduce sepsis-related morbidity and mortality and promote maternal health equity, community co-led, and co-designed interventions are urgently needed. In this commentary, we introduce the design and goals of our EnCoRe MoMS study as an exemplar for employing community based participatory research principals iteratively throughout the research process and integrated across all study aims. We also highlight our early lessons learned and recommendations for best practices. Our novel model and ongoing work have implications for scaling academic-community research partnerships for other causes of severe maternal morbidity and maternal health equity nationally.

Systematic Review On The Effect Of Evaporation On The Evaluation Of Serum Electrolyte Levels

Evaporation is a critical factor that can influence the accuracy and reliability of serum electrolyte measurements. This systematic review aims to assess the impact of evaporation on serum electrolyte levels and its implications for clinical and laboratory practices. We analyzed studies that investigated the effects of evaporation on various electrolytes, including sodium, potassium, chloride, and bicarbonate. The review highlights the mechanisms by which evaporation affects electrolyte concentrations, evaluates different strategies to mitigate these effects, and provides recommendations for best practices in serum electrolyte analysis

Analyzing sex imbalance in EGA and dbGaP biological databases: Recommendations for better practices

Analyzing sex imbalance in EGA and dbGaP biological databases: Recommendations for better practices

European Society for Gynaecological Endoscopy (ESGE) Good Practice Recommendations on surgical techniques for removal of fibroids: part 1 abdominal (laparoscopic and open) myomectomy.

Uterine fibroids are the most common benign tumours of the female reproductive tract and can cause a range of symptoms including abnormal uterine bleeding, pain, pressure symptoms and subfertility. Surgery may be required for some symptomatic fibroids via abdominal or transvaginal routes. The European Society for Gynaecological Endoscopy Uterine Fibroids Working Group developed recommendations based on the best available evidence and expert opinion for the surgical treatment of uterine fibroids. In this first part of the recommendations, abdominal approaches to surgical treatment of fibroids including laparoscopic, robot- assisted and open myomectomy are described.

How We Would Treat Our Own Congenital Cardiac Catheterization Laboratory Patient

The field of congenital cardiac catheterization (CCC) has changed dramatically since it began eight decades ago. New techniques and devices have expanded the indications for interventional catheterization. Heart teams who care for patients in the pediatric and congenital cardiac catheterization laboratory are confronted with a growing number of patients presenting for a wide range of increasingly technically-challenging cases. Multiple societies have published expert guidelines for CCC management to provide recommendations for best practice. We reviewed risk stratification strategies for CCC and describe our institution's comprehensive, multidisciplinary approach to the periprocedural management of patients with congenital heart disease undergoing cardiac catheterization, using the index case of a 6-year-old patient with multiple heart defects. We concluded that risk stratification and a comprehensive, multidisciplinary team approach that begins when a procedure is booked is essential to inform management and optimize outcomes. Clinical decision-making should be informed by expert guidelines and evolving risk stratification research.

Facilitators and barriers to monitoring and evaluation at syringe service programs

BackgroundSyringe services programs (SSPs) provide harm reduction supplies and services to people who use drugs and are often required by funders or partners to collect data from program participants. SSPs can use these data during monitoring and evaluation (M&E) to inform programmatic decision making, however little is known about facilitators and barriers to collecting and using data at SSPs.MethodsUsing the Consolidated Framework for Implementation Research (CFIR), we conducted 12 key informant interviews with SSP staff to describe the overall landscape of data systems at SSPs, understand facilitators and barriers to data collection and use at SSPs, and generate recommendations for best practices for data collection at SSPs. We used 30 CFIR constructs to develop individual interview guides, guide data analysis, and interpret study findings.ResultsFour main themes emerged from our analysis: SSP M&E systems are primarily designed to be responsive to perceived SSP client needs and preferences; SSP staffing capacity influences the likelihood of modifying M&E systems; external funding frequently forces changes to M&E systems; and strong M&E systems are often a necessary precursor for accessing funding.ConclusionsOur findings highlight that SSPs are not resistant to data collection and M&E, but face substantial barriers to implementation, including lack of funding and disjointed data reporting requirements. There is a need to expand M&E-focused funding opportunities, harmonize quantitative indicators collected across funders, and minimize data collection to essential data points for SSPs.

Development and Integration of Models for Teaching Ram Breeding Soundness Examinations in Veterinary Education.

Proficiency with ram breeding soundness examinations requires competency with palpation, a skill that can be difficult to teach and assess. There are limited small ruminant clinical skills models available, despite the advantages they offer in veterinary education. We developed reusable models for teaching ram breeding soundness examinations, focusing on scrotal assessment and palpation. Then we integrated these models into a practical session where multiple clinical aspects were included. We created anatomically normal ("sound") testes using 3D modeling software before editing these to display common abnormalities ("unsound" testes). Then, we 3D printed two-part molds and cast the silicone testes. Testes were inserted into siliconized, lubricated stockings facilitating free movement during palpation. Scrotal sacs were sewn from polar fleece and suspended to mimic natural orientation in a live, standing ram. As well as for scheduled classes, we used the models as a station in our course's Objective Structured Clinical Examination (OSCE) assessment. Our models offer advantages in the veterinary education context. Their relatively low cost and durability facilitates their classification as "open access" within our skills lab for student deliberate practice outside scheduled classes. They provide a uniform student learning experience that does not rely on live animals or clinical case load and aligns with best-practice recommendations from accrediting bodies. Student engagement and OSCE outcomes were good, but going forward it would be ideal to collaborate with a program that uses live rams for teaching and assessing this skill to directly examine the impact of our models on confidence and competence.

Impact of Literature in English Language Teaching - Challenges and Opportunities: A Literature Review

The integration of literature into English language teaching (ELT) is increasingly recognized for its ability to enhance linguistic skills and cultural awareness. This literature review aims to provide valuable insights and recommendations for best practices in applying literature within ELT across various educational contexts. Employing a literature review methodology, the study examines both primary and secondary sources, including recent articles, conference papers, and other relevant documents obtained from academic databases and online search engines such as Google Scholar and ERIC. The review process involves selecting pertinent publications, collecting and analyzing data, discussing related topics, integrating supporting information, and drawing conclusions. The findings reveal that while integrating literature into ELT presents certain challenges, such as selecting appropriate texts and addressing varied student proficiency levels, it also offers significant opportunities for enriching language instruction. Additionally, various effective strategies for integrating literature into ELT across different countries are identified. The study highlights the potential of literature to improve English language teaching and provides recommendations for leveraging literary resources to maximize educational benefits.

Addressing Missing Data Due to COVID-19: Two Early Childhood Case Studies

One part of COVID-19’s staggering impact on education has been to suspend or fundamentally alter ongoing education research projects. This article addresses how to analyze the simple but fundamental example of a multi-cohort study in which student assessment data for the final cohort are missing because schools were closed, learning was virtual, and/or assessments were canceled or inconsistently ­collected due to COVID-19. We argue that current best-practice recommendations for addressing missing data may fall short in such studies because the assumptions that underpin these recommendations are violated. We then provide a new, simple decision-making framework for empirical researchers facing this situation and provide two empirical examples of how to apply this framework drawn from early childhood studies, one a cluster randomized trial and the other a descriptive longitudinal study. Based on this framework and the assumptions required to address missing data, we advise against the standard recommendation of adjusting for missing outcomes (e.g., via imputation or weighting). Instead, we generally recommend changing the target quantity by restricting to fully observed cohorts or by pivoting to focusing on an alternative outcome.

Guidance of development, validation, and evaluation of algorithms for populating health status in observational studies of routinely collected data (DEVELOP-RCD)

BackgroundIn recent years, there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data (RCD). These studies rely on algorithms to identify specific health conditions (e.g. diabetes or sepsis) for statistical analyses. However, there has been substantial variation in the algorithm development and validation, leading to frequently suboptimal performance and posing a significant threat to the validity of study findings. Unfortunately, these issues are often overlooked.MethodsWe systematically developed guidance for the development, validation, and evaluation of algorithms designed to identify health status (DEVELOP-RCD). Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development, validation, and evaluation. Subsequently, we conducted an empirical study on an algorithm for identifying sepsis. Based on these findings, we formulated specific workflow and recommendations for algorithm development, validation, and evaluation within the guidance. Finally, the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it.ResultsA standardized workflow for algorithm development, validation, and evaluation was established. Guided by specific health status considerations, the workflow comprises four integrated steps: assessing an existing algorithm’s suitability for the target health status; developing a new algorithm using recommended methods; validating the algorithm using prescribed performance measures; and evaluating the impact of the algorithm on study results. Additionally, 13 good practice recommendations were formulated with detailed explanations. Furthermore, a practical study on sepsis identification was included to demonstrate the application of this guidance.ConclusionsThe establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD. This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.

Assessing dimensions of thought disorder with large language models: The tradeoff of accuracy and consistency

Natural Language Processing (NLP) methods have shown promise for the assessment of formal thought disorder, a hallmark feature of schizophrenia in which disturbances to the structure, organization, or coherence of thought can manifest as disordered or incoherent speech. We investigated the suitability of modern Large Language Models (LLMs - e.g., GPT-3.5, GPT-4, and Llama 3) to predict expert-generated ratings for three dimensions of thought disorder (coherence, content, and tangentiality) assigned to speech samples collected from both patients with a diagnosis of schizophrenia (n = 26) and healthy control participants (n = 25). In addition to (1) evaluating the accuracy of LLM-generated ratings relative to human experts, we also (2) investigated the degree to which the LLMs produced consistent ratings across multiple trials, and we (3) sought to understand the factors that impacted the consistency of LLM-generated output. We found that machine-generated ratings of the level of thought disorder in speech matched favorably those of expert humans, and we identified a tradeoff between accuracy and consistency in LLM ratings. Unlike traditional NLP methods, LLMs were not always consistent in their predictions, but these inconsistencies could be mitigated with careful parameter selection and ensemble methods. We discuss implications for NLP-based assessment of thought disorder and provide recommendations of best practices for integrating these methods in the field of psychiatry.

Spanish-Language Measures of Intimate Partner Violence: A Systematic Review of Psychometric Evidence and Translation Methodology.

Intimate partner violence (IPV) is prevalent worldwide, including in Latinx populations. Reported rates of IPV in Latinx populations vary widely, indicating that measurement errors may be impeding researchers' and clinicians' understanding of IPV in these populations. We conducted a systematic review across a range of social science databases to evaluate psychometric properties and translation methodologies of Spanish-language IPV measures. Records were included if they included Spanish measures assessing IPV victimization. We identified 91 records with a total of 70 measures and evaluated the measures' extant psychometric evidence using the COnsensus-based Standards for the selection of health Measurement Instruments. For the measures translated from English to Spanish, we evaluated the translation methodology based on best-practice recommendations for achieving translations that are psychometrically equivalent to their original versions. We found that validation information about measures was sparse and that few translations adhered to best-practice recommendations. Based on our a priori criteria we recommend the Plazaola-Castaño translation of the Index of Spouse Abuse. In closing, we discuss the validity evidence of translated measures independent of the original language version and best-practice recommendations in translating psychological measures.

Long-term intravenous devices: a narrative review of their placement.

This review summarizes the latest findings and recommendations about the characteristics, indications and use of peripheral and central long-term venous access devices.The various complications inherent in these devices are becoming better known, and their contributing factors determined, which could make it possible to reduce their incidence. Some measures are integrated into recommendations for good practice, such as appropriate selection of devices, the preferential use of the thinnest catheters, and cyanoacrylate glue and dressings impregnated with chlorhexidine. Improving understanding of the phenomena leading to infectious and thrombotic complications, as well as better knowing the differences between intravenous devices and their respective indications, should lead to improvement of in-hospital and out-of-hospital care.

Building capacity for local public health: lessons from a mixed-methods evaluation of an academic-public health partnership used in response to COVID-19.

The Massachusetts Academic Health Department Consortium (AHD) established the Academic Public Health Volunteer Corps (APHVC) to support Local Health Departments (LHDs, n = 351) to meet rapidly emerging needs during the COVID-19 pandemic through engaging student volunteers. A program evaluation captured lessons learned and informed recommendations for sustainability and future replication. The mixed-methods evaluation leveraged the Consolidated Framework for Implementation Research (CFIR). Data were stratified by LHD engagement with APHVC. Quantitative surveys informed probes for qualitative focus groups and interviews; findings were categorized into CFIR constructs using a deductive approach. One-fifth of LHDs (n = 76, 27 used APHVC services, 45 did not) completed the survey. Eleven employees participated in follow-up focus groups or interviews. APHVC filled resource gaps, built capacity, and provided high-quality deliverables. LHDs experienced issues with reliability and communication of volunteers and lacked time to train volunteers. CFIR aided in evaluating APHVC in real time, producing actionable recommendations for best practices, dissemination, and future iterations of the program. Results are being used to enhance program effectiveness and sustainability, community health, and health equity across Massachusetts, and may help inform academic practice-based programs across the United States.

Reflections on working as and supervising trial therapists on trials of psychosocial interventions.

This editorial provides an overview of the challenges and benefits of working as and supervising trial therapists from the perspective of investigators and trial therapists. Key differences between trial therapy and standard care are considered, with recommendations for best practice.

FIGO good practice recommendations on optimizing models of care for the prevention and mitigation of preterm birth.

The global challenge of preterm birth persists with little or no progress being made to reduce its prevalence or mitigate its consequences, especially in low-resource settings where health systems are less well developed. Improved delivery of respectful person-centered care employing effective care models delivered by skilled healthcare professionals is essential for addressing these needs. These FIGO good practice recommendations provide an overview of the evidence regarding the effectiveness of the various care models for preventing and managing preterm birth across global contexts. We also highlight that continuity of care within existing, context-appropriate care models (such as midwifery-led care and group care), in primary as well as secondary care, is pivotal to delivering high quality care across the pregnancy continuum-prior to conception, through pregnancy and birth, and preparation for a subsequent pregnancy-to improve care to prevent and manage preterm birth.