Recommendations For Best Practices Research Articles

Adapting the in vitro micronucleus assay (OECD Test Guideline No. 487) for testing of manufactured nanomaterials: recommendations for best practices.

The current Organisation for Economic Co-Operation and Development test guideline number 487 (OECD TG No. 487) provides instruction on how to conduct the in vitro micronucleus assay. This assay is one of the gold standard approaches for measuring the mutagenicity of test items; however, it is directed at testing low molecular weight molecules and may not be appropriate for particulate materials (e.g. engineered nanoparticles [ENPs]). This study aimed to adapt the in vitro micronucleus assay for ENP testing and underpins the development of an OECD guidance document. A harmonized, nano-specific protocol was generated and evaluated by two independent laboratories. Cell lines utilized were human lymphoblastoid (TK6) cells, human liver hepatocytes (HepG2) cells, Chinese hamster lung fibroblast (V79) cells, whole blood, and buffy coat cells from healthy human volunteers. These cells were exposed to reference ENPs from the Joint Research Council (JRC): SiO2 (RLS-0102), Au5nm and Au30nm (RLS-03, RLS-010), CeO2 (NM212), and BaSO4 (NM220). Tungsten carbide-cobalt (WC/Co) was used as a trial particulate positive control. The chemical controls were positive in all cell cultures, but WC/Co was only positive in TK6 and buffy coat cells. In TK6 cells, mutagenicity was observed for SiO2- and both Au types. In HepG2 cells, Au5nm and SiO2 showed sub-two-fold increases in micronuclei. In V79 cells, whole blood, and buffy coat cells, no genotoxicity was detected with the test materials. The data confirmed that ENPs could be tested with the harmonized protocol, additionally, concordant data were observed across the two laboratories with V79 cells. WC/Co may be a suitable particulate positive control in the in vitro micronucleus assay when using TK6 and buffy coat cells. Detailed recommendations are therefore provided to adapt OECD TG No. 487 for testing ENP.

A qualitative exploration of the use of telehealth for opioid treatment: Implications for nurse-managed care.

To characterise experiences with telehealth for Medications for Opioid Use Disorder (MOUD) services among patients, prescribers, nurses and substance use counsellors to inform future best practices. We engaged a qualitative descriptive study design. Semi-structured interviews were conducted with prescribers (nurse practitioners and physicians, n = 20), nurses and substance use counsellors (n = 7), and patients (n = 20) between June and September 2021. Interviews were verbatim transcribed. Thematic analysis was conducted using a qualitative descriptive method. Among both providers and patients, four themes were identified: (1) Difficulties with telehealth connection (2) Flexibility in follow-up and retention, (3) Policy changes that enabled expanded care, (4) Path forward with telehealth. Two additional findings emerged from provider interviews: (1) Expansion of nurse-managed office-based opioid treatment, and (2) Novel methods to engage patients. Patients and providers continued to view telehealth as an acceptable means for delivery and management of MOUD, particularly when utilised in a hybrid manner between in-person visits. Nurse-managed care for this service was evident as nurses extended the breadth of services offered and utilised novel methods such as text messages and management of 'call-in' lines to engage patients. Use of telehealth for MOUD should be incorporated into practice settings to reach patients in a flexible manner. Nurses in particular can use this medium to extend office-based opioid treatment by conducting assessments and expanding capacity for other wrap-around services. We identify recommendations for best practices in the use of telehealth for opioid use disorder management and highlight the value of nurse-managed care. The consolidated criteria for reporting qualitative research. Patients with opioid use disorder and prescribers with experience using telehealth were interviewed for this study.

Finding Nori—Understanding Key Factors Driving US Consumers’ Commitment for Sea-Vegetable Products

The trend toward sustainable and healthy food consumption has stimulated widespread debate. US consumers demand healthy and sustainable food options and are increasingly interested in alternative proteins such as macro-algae, also known as sea-vegetables. The present study is built on the responses of an online survey aiming to explore US consumers’ commitment towards varying sea-vegetable-based products. Affordability, sustainability, taste, environmental friendliness, and health benefits, as well as product novelty and versatility, were the factors under investigation. All factors were found to be equally strong predictors for sea-vegetable product commitment. Best-practice recommendations for US food marketers and agricultural producers are also provided.

An overview of the calibration process for a digital hydrophone

Digital hydrophones are instruments for measuring underwater sound that incorporate the entire data chain into a single unit. Calibration of analog and digital hydrophones is largely similar but differs in measurement signal type. Digital hydrophone calibration is not currently captured in the standards outlining hydrophone calibration (such as IEC 60565), so they currently cannot be calibrated to a recognized standard. The testing setup and calibration methods are the same as for an analog hydrophone but without needing external digitization or analog signal conditioning. Potential issues regarding digital hydrophone calibration: careful calculation of signal amplitudes is required at upper frequency band; the lack of analog output requires different units of measure or information on counts/volt conversion. The first point here is also a current issue for analog hydrophones where the digitization and the processing of data during the calibration are not prescribed. Ideally, both of these issues would be addressed in future standards updates, which would improve the operation of both analog and digital hydrophones. This paper will expand on the issues highlighted here involving digital hydrophone calibration and offer recommendations for best practice. It will also provide an outline of the current calibration procedure as used at Ocean Sonics.

Auditing the Representation of Females Versus Males in Heat Adaptation Research.

The aim of this audit was to quantify female representation in research on heat adaptation. Using a standardized audit tool, the PubMed database was searched for heat adaptation literature from inception to February 2023. Studies were included if they investigated heat adaptation among female and male adults (≥18-50years) who were free from noncommunicable diseases, with heat adaptation the primary or secondary outcome of interest. The number and sex of participants, athletic caliber, menstrual status, research theme, journal impact factor, Altmetric score, Field-Weighted Citation Impact, and type of heat exposure were extracted. A total of 477 studies were identified in this audit, including 7,707 participants with ∼13% of these being female. Most studies investigated male-only cohorts (∼74%, n = 5,672 males), with ∼5% (n = 360 females) including female-only cohorts. Of the 126 studies that included females, only 10% provided some evidence of appropriate methodological control to account for ovarian hormone status, with no study meeting best-practice recommendations. Of the included female participants, 40% were able to be classified to an athletic caliber, with 67% of these being allocated to Tier 2 (i.e.,trained/developmental) or below. Exercise heat acclimation was the dominant method of heat exposure (437 interventions), with 21 studies investigating sex differences in exercise heat acclimation interventions. We recommend that future research on heat adaptation in female participants use methodological approaches that consider the potential impact of sexual dimorphism on study outcomes to provide evidence-based guidelines for female athletes preparing for exercise or competition in hot conditions.

Is the Comparator in Your Diagnostic Cost-Effectiveness Model “Standard of Care”? Recommendations from Literature Reviews and Expert Interviews on How to Identify and Operationalize It

ObjectivesThis research aimed to develop best-practice recommendations for identifying the “standard of care” (SoC) and integrate it when it is the comparator in diagnostic economic models (SoC comparator). MethodsA multi-methods approach comprising 2 pragmatic literature reviews and 9 expert interviews was used. Experts rated their agreement with draft recommendations based on the authors’ analysis of the reviews. These were refined iteratively to produce final recommendations. ResultsFourteen best-practice recommendations are provided. Care pathway mapping (using quantitative, qualitative, or mixed-methods approaches) should be used for identifying the SoC comparator. Guidelines analysis can be integrated with expert opinion to identify pathway variability and discrepancies from clinical practice. For integrating the SoC comparator into the model, recommendations around structure, input sourcing, data aggregation and reporting, input uncertainty, and model variability are presented. For example, modelers should consider that the reference standard is not synonymous with the SoC, and the SoC may not be the only comparator. The comparator limitations should be discussed with clinical experts, but elicitation of its diagnostic accuracy is not recommended. Probabilistic sensitivity analysis is recommended when evaluating the overall input uncertainty, and deterministic sensitivity analysis is useful when there is high model uncertainty or SoC variability. Consensus could not be reached for some topics (eg, the role of real-world data, model averaging, and alternative model structures), but the reported discussions provide points for consideration. ConclusionsTo our knowledge, this is the first guidance to support modelers when identifying and operationalizing the SoC comparator in diagnostic cost-effectiveness models.

Health professionals' education related to people with intellectual and developmental disabilities: A scoping review.

People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.

Consensus Guidelines: Best Practices for the Prevention, Detection and Management of Hepatitis B Virus Reactivation in Clinical Trials with Immunosuppressive/Immunomodulatory Therapy.

Hepatitis B virus reactivation (HBVr) during and after immunosuppressive/immunomodulatory (IS/IM) therapy is associated with significant morbidity and mortality, including hepatic decompensation and acute liver failure. The risk of HBVr with IS/IM has been heterogeneous and often unpredictable. As a result, patients with active or previous HBV infection are often excluded from clinical drug trials of such agents. Thorough screening for HBV infection, antiviral prophylaxis, and careful monitoring for HBVr have proven to be effective in reducing the rate of HBVr and improving its outcome in the context of IS/IM. Therefore, safe enrollment and management of certain HBV-marker-positive patients in clinical trials is possible. There is a great, unmet need for consistent, evidence-based recommendations for best practices pertaining to enrollment, monitoring, and management of HBVr in clinical trial participants receiving IS/IM. The aim of these consensus guidelines is to provide a step-by-step blueprint to safely enroll, monitor and manage the patient with inactive chronic or resolved HBV in IS/IM clinical trials from the time of screening through to the end of post-treatment follow up.

GERD after Bariatric Surgery: A Review of the Underlying Causes and Recommendations for Management.

GERD after bariatric surgery is an ongoing concern for bariatric surgeons and their patients. This paper reviews the association of persistent or de novo GERD after multiple types of bariatric surgery, and focuses on the work up and management of GERD after SG. Two recent large, multicenter randomized clinical trials have shown stronger associations between SG and GERD compared to RYGB. A large group of internationally recognized bariatric surgeons collaborated on 72 consensus statements to help guide the bariatric community on the subject of redo surgeries after SG, including as it pertains to GERD. We present an algorithm that consolidates the best-practices recommendations of the work-up and management of GERD after sleeve gastrectomy, and mention areas of persistent controversy where future research is warranted.

Evidence Synthesis and Linkage for Modelling the Cost-Effectiveness of Diagnostic Tests: Preliminary Good Practice Recommendations.

To develop preliminary good practice recommendations for synthesising and linking evidence of treatment effectiveness when modelling the cost-effectiveness of diagnostic tests. We conducted a targeted review of guidance from key Health Technology Assessment (HTA) bodies to summarise current recommendations on synthesis and linkage of treatment effectiveness evidence within economic evaluations of diagnostic tests. We then focused on a specific case study, the cost-effectiveness of troponin for the diagnosis of myocardial infarction, and reviewed the approach taken to synthesise and link treatment effectiveness evidence in different modelling studies. The Australian and UK HTA bodies provided advice for synthesising and linking treatment effectiveness in diagnostic models, acknowledging that linking test results to treatment options and their outcomes is common. Across all reviewed models for the case study, uniform test-directed treatment decision making was assumed, i.e., all those who tested positive were treated. Treatment outcome data from a variety of sources, including expert opinion, were utilised for linked clinical outcomes. Preliminary good practice recommendations for data identification, integration and description are proposed. Modelling the cost-effectiveness of diagnostic tests poses unique challenges in linking evidence on test accuracy to treatment effectiveness data to understand how a test impacts patient outcomes and costs. Upfront consideration of how a test and its results will likely be incorporated into patient diagnostic pathways is key to exploring the optimal design of such models. We propose some preliminary good practice recommendations to improve the quality of cost-effectiveness evaluations of diagnostics tests going forward.

High‐resolution strain mapping in a thermionic LaB6 scanning electron microscope

AbstractThe high source stability and brightness of field emission gun equipped scanning electron microscopes (SEM) makes them ideal for high‐resolution digital image correlation (HRDIC). However, their high initial capital cost can be prohibitive for research organisations and groups. Conventional thermionic SEMs using either a tungsten hairpin or LaB6 filament are far more widespread due to their lower cost. Whilst it is understood that overall performance and ultimate resolution are lower than field emission SEMs, we propose that there is no fundamental reason why these instruments are unsuitable for HRDIC. We investigate the use of a LaB6 SEM as a viable tool for HRDIC. We detail the subtleties of performing HRDIC using a LaB6 thermionic source SEM, providing technical recommendations for best practices in using these instruments for strain mapping. The effects of instrument parameters on strain measurement noise are examined, with a focus on parameters of key relevance to in situ and ex situ mechanical testing. Errors in focus and image pixel size are found to be the primary contributors to the strain noise floor values, with stage accuracy being of secondary importance. We present a case study in oxygen‐free high‐conductivity copper, OFHC‐Cu, which is used in the designs of nuclear fusion components as a heat sink interlayer. Heterogeneous strain patterns are observed in this material, with high levels of strain localisation at grain boundaries. Active slip systems are identified using the relative displacement ratio method, demonstrating the quality of these data and the suitability of LaB6 instruments for HRDIC strain mapping, achieving performance approaching that expected of a field emission SEM.

Promoting surgical smoke management in a pediatric operating room: a best practice implementation project.

The routine use of heat-producing tools in the perioperative setting generates surgical smoke. Surgical smoke poses a known health hazard for perioperative staff working in the operating room. The objective of this best practice project was to promote evidence-based practices regarding surgical plume management in a pediatric operating room. This project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System and the Getting Research into Practice audit and feedback strategy to promote evidence-based practices regarding surgical smoke management in a pediatric operating room. Seven audit criteria representing best-practice recommendations were used. A baseline audit was conducted, followed by the implementation of multiple strategies developed by the key stakeholders. The project was finalized with a follow-up audit to determine any changes in compliance with best-practice recommendations. Baseline audit data indicated an average of 41% compliance with best practices across all audit criteria, revealing the need for significant improvement in five of the seven criteria. Three barriers were identified and strategies were implemented, including the development and implementation of an educational module and a surgical smoke exposure risk assessment tool. Follow-up audits showed an overall improvement of 30% among five of the seven audit criteria. This project yielded improvements with best practices for surgical smoke management in the perioperative setting. However, additional work is required to ensure the sustainability of best practices in this setting.

Effectiveness of an adaptive, multifaceted intervention to enhance care for patients with complex multimorbidity in general practice: protocol for a pragmatic cluster randomised controlled trial (the MM600 trial)

IntroductionPatients with complex multimorbidity face a high treatment burden and frequently have low quality of life. General practice is the key organisational setting in terms of offering people with complex...

Audio-based AI classifiers show no evidence of improved COVID-19 screening over simple symptoms checkers

Recent work has reported that respiratory audio-trained AI classifiers can accurately predict SARS-CoV-2 infection status. However, it has not yet been determined whether such model performance is driven by latent audio biomarkers with true causal links to SARS-CoV-2 infection or by confounding effects, such as recruitment bias, present in observational studies. Here we undertake a large-scale study of audio-based AI classifiers as part of the UK government’s pandemic response. We collect a dataset of audio recordings from 67,842 individuals, with linked metadata, of whom 23,514 had positive polymerase chain reaction tests for SARS-CoV-2. In an unadjusted analysis, similar to that in previous works, AI classifiers predict SARS-CoV-2 infection status with high accuracy (ROC–AUC = 0.846 [0.838–0.854]). However, after matching on measured confounders, such as self-reported symptoms, performance is much weaker (ROC–AUC = 0.619 [0.594–0.644]). Upon quantifying the utility of audio-based classifiers in practical settings, we find them to be outperformed by predictions on the basis of user-reported symptoms. We make best-practice recommendations for handling recruitment bias, and for assessing audio-based classifiers by their utility in relevant practical settings. Our work provides insights into the value of AI audio analysis and the importance of study design and treatment of confounders in AI-enabled diagnostics.

Four best-practice recommendations for improving the conceptualization and operationalization of motivational intensity: Reply to Kaczmarek and Harmon-Jones.

Replies to the comments made by Kaczmarek and Harmon-Jones (see record 2024-44184-002) on the current authors original article (see record 2021-21096-001). Kaczmarek and Harmon-Jones (2023) provide a commentary on our original empirical piece, does motivational intensity exist distinct from valence and arousal? (Campbell et al., 2021). In this response, we articulate the motivation behind our work, including the major issues with the conceptualization and operationalization of motivational intensity in prior literature. For example, while motivational intensity was proposed to replace valence as the determinant of cognitive scope more than a decade and a half ago, in both this original work and ongoing work since then, motivational intensity has been operationalized in a variety of questionable ways, including via participants' ratings of valence, rather than motivational intensity. That is, in multiple studies, differences in cognitive processes measured in two conditions have been attributed to motivational intensity which was not explicitly measured, while the conditions do demonstrably differ in the valence participants experienced. We explain exactly what we found in Campbell et al. (2021) and our subsequent follow-up work (Campbell et al., 2023), and what aspects of our interpretation converge versus diverge with the views offered in Kaczmarek and Harmon-Jones' commentary. We also identify four important recommendations for best-practice research going forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Advancing Teachers' Professional Development: Exploring Models and Impact Assessment on Ict Integration in Colleges of Education

The integration of Information and Communication Technology (ICT) into education has revolutionized teaching and learning practices, necessitating proficient teacher utilization of ICT tools. This paper explores diverse models of advancing teachers' professional development in ICT integration, assessing their impact on pedagogical practices and educational outcomes. The study employs a mixed-methods approach, highlighting effective strategies and gaps in existing research. Models like collaborative communities of practice, job-embedded learning, and blended learning are examined for their alignment with modern educational goals. Teacher perceptions and attitudes are explored, emphasizing the influence of institutional support and collaborative learning environments. Pedagogical strategies for effective ICT integration, supported by technological resources, administrative backing, and policy frameworks, are discussed. The study's impact assessment reveals improvements in teachers' ICT skills and subsequent positive effects on student learning outcomes. Recommendations for best practices, such as customization, blended formats, and administrative support, are derived from the findings. Overall, the research underscores the multifaceted approach necessary for successful teacher professional development in the context of ICT integration, enhancing the quality of education

Enhancing Diagnostic Follow-up and Care Coordination for Children with Autism in a Busy Resident Continuity Clinic: Leveraging the Electronic Health Record.

A high-quality primary care clinic should provide clear action points and important care coordination for a child receiving a new diagnosis of autism spectrum disorder (ASD). Unfortunately, a substantial proportion of caregivers report little-to-no post-diagnosis support from their home clinics and primary care providers often report lack of training and resources in providing these supports. We implemented an intervention package to investigate the impact on the frequency and quality of follow-up care for children with ASD in a busy, high-volume resident continuity clinic. The package consisted of a care coordination scheduling pathway and a standardized clinical template-embedded in the electronic health record (EHR)-that guided providers through best-practice recommendations and patient resources. As a result of these interventions, 74% of patients had ASD-specific follow-up, a more than threefold increase from baseline with a majority of providers using the EHR-embedded template to guide their visit. Providers also indicated a high degree of usability for the system and that it aided them in following best-practice guidelines for ASD care. Through explicit scheduling pathways and a novel EHR template, we saw a significant increase in ASD-specific follow-up visits and implementation of best practices for ASD care, demonstrating a new process for training and engaging primary care providers in clear action steps for post-diagnostic care without having to rely on tertiary referrals.

Recommendations for good clinical practice for DPD bone scintigraphy for cardiac amyloidosis.

Recommendations for good clinical practice for DPD bone scintigraphy for cardiac amyloidosis.

Scoping review: mapping clinical guidelines and policy documents that address the needs of women who are dependent on drugs during the perinatal period

BackgroundWomen who use or are in treatment for drug use during the perinatal period often have complex needs and presenting comorbidity. Women who use opioids during pregnancy, and their infants, experience poor outcomes. Drug use by women during pregnancy is a public health priority.This scoping review aimed to (1) map clinical guidelines, treatment protocols and good practice guidance across the UK for women who use or are in treatment for drug use during the perinatal period, (2) identify recommended best practice across health and social care for optimising outcomes and reducing inequalities for these women and (3) identify potential gaps within guidance.MethodsWe followed the Joanna Briggs International (JBI) guidance on scoping reviews and PRISMA Scr extension. A registered protocol, containing a clear search strategy, inclusion, and exclusion criteria was adhered to. Reviewers double screened 25%, discussing disagreements. Data were extracted using a predefined template and charted in tables. Recommendations for best practice were organised around agreed categories.ResultsOf 968 documents screened, 111 met the inclusion criteria. The documents included UK-wide, national, regional, and organisational policy documents. They varied in the degree they were relevant to women who use or are in treatment for drug use during the perinatal period, the settings to which they applied, and their intended users. Most were created without patient or public involvement and lacked any clear evidence base.Overall, documents recommended an integrated model of care with a lead professional, clear referral pathways and information sharing between agencies. Guidance suggested referrals should be made to specialist midwives, drug, and social care services. A holistic assessment, inclusive of fathers / partners was suggested. Recent documents advocated a trauma-informed care approach. Opioid substitution therapy (OST) was recommended throughout pregnancy where required. Potential gaps were identified around provision of support for women postnatally, especially when their baby is removed from their care.ConclusionsThis synthesis of recommended practice provides key information for practitioners, service providers and policy makers. It also highlights the need for guidelines to be evidence-based, informed by the experiences of women who use or are in treatment for drug use during the perinatal period, and to address the support needs of postnatal women who have their babies removed from their care.

Navigating Care Boundaries: Exploring the Limits between Compassionate Care and Neglect1

For over two decades in France, the concept of "bientraitance" has echoed within the walls of nursing homes. While recommendations for good professional practices stand as a beacon for the care of the elderly, aiming to prevent the indignity of mistreatment, they may not consistently guide daily care giving practices in these establishments. This study does not delve into the reasons for this discrepancy. Instead, it presents three situations extracted from the field, exploring the concepts of "bientraitance" and its antithesis. Employing a qualitative and reflective approach, the research seeks to examine the nuanced boundary between these two antagonistic modes of care. The caregiver's individual response becomes pivotal, signifying their positioning—whether to remain or contemplate a shift—while respecting the construction of their professional identity and the dignity of the vulnerable individual.