North American Guidelines for Children’s Agricultural Tasks: five-year assessment and priorities for the future.

Am J Ind Med. 2006 Nov;49(11):911-9

Authors: Doty B, Marlenga B

BACKGROUND: The North American Guidelines for Children’s Agricultural Tasks (NAGCAT) are a safety resource created to assist parents in selecting safe work for their children 7-16 years of age. Since their release in 1999, a growing body of scientific evidence has accumulated regarding NAGCAT. The purpose of this project was to assess the current scientific and programmatic evidence regarding the efficacy and utilization of the NAGCAT resource in order to determine the priorities for the next 5 years. METHODS: A systematic, evidenced-based method was employed to accomplish the project objectives. Our data sources included results from a survey of agricultural safety practitioners and researchers, a comprehensive synthesis of the peer-reviewed literature, and recommendations from a priority-setting meeting. RESULTS: Five main priorities were identified: to address the perceptions and barriers associated with the use and non-use of the NAGCAT resource; to revise and re-format a core set of the guidelines; to develop a NAGCAT resource dissemination/marketing plan; to provide training and support for agricultural safety professionals and parents using NAGCAT; and to conduct further research to facilitate accomplishing these priorities. CONCLUSIONS: This assessment and priority identification process was successful in outlining the next steps for the NAGCAT resource. As we move toward 2010, those involved in pediatric agricultural injury prevention will have a blueprint to ensure that NAGCAT are an effective and widely used resource for preventing work-related injuries.

PMID: 17036349 [PubMed - in process]

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Handling of peripheral intravenous cannulae: effects of evidence-based clinical guidelines.

J Clin Nurs. 2006 Nov;15(11):1354-61

Authors: Ahlqvist M, Bogren A, Hagman S, Nazar I, Nilsson K, Nordin K, Valfridsson BS, Söderlund M, Nordström G

AIM: This study aimed at evaluating the outcome of implemented evidence-based clinical guidelines by means of surveying the frequency of thrombophlebitis, nurses’ care, handling and documentation of peripheral intravenous cannulae. BACKGROUND: Peripheral intravenous cannulae are frequently used for vascular access and, thereby, the patients will be exposed to local and systemic infectious complications. Evidence-based knowledge of how to prevent these complications and how to care for patients with peripheral intravenous cannula is therefore of great importance. Deficient care, handling and documentation of peripheral intravenous cannulae have previously been reported. DESIGN: A cross-sectional survey was conducted by a group of nurses at three wards at a university hospital before and after the implementation of the evidence-based guidelines. METHOD: A structured observation protocol was used to review the frequency of thrombophlebitis, the nurses’ care, handling and the documentation of peripheral intravenous cannulae in the patient’s record. RESULTS: A total of 107 and 99 cannulae respectively were observed before and after the implementation of the guidelines. The frequency of peripheral intravenous cannulae without signs of thrombophlebitis increased by 21% (P

PMID: 17038095 [PubMed - in process]

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GENERAL GUIDELINES FOR THE ASSESSMENT OF INTERNAL DOSE FROM MONITORING DATA: PROGRESS OF THE IDEAS PROJECT.

Radiat Prot Dosimetry. 2006 Oct 13;

Authors: Doerfel H, Andrasi A, Bailey M, Blanchardon E, Cruz-Suarez R, Berkovski V, Castellani CM, Hurtgen C, Leguen B, Malatova I, Marsh J, Stather J, Zeger J

In recent major international intercomparison exercises on intake and internal dose assessments from monitoring data, the results calculated by different participants varied significantly. Based on this experience the need for harmonisation of the procedures has been formulated within an EU 5th Framework Programme research project. The aim of the project, IDEAS, is to develop general guidelines for standardising assessments of intakes and internal doses. The IDEAS project started in October 2001 and ended in June 2005. The project is closely related to some goals of the work of Committee 2 of the ICRP and since 2003 there has been close cooperation between the two groups. To ensure that the guidelines are applicable to a wide range of practical situations, the first step was to compile a database of well-documented cases of internal contamination. In parallel, an improved version of an existing software package was developed and distributed to the partners for further use. A large number of cases from the database was evaluated independently by the partners and the results reviewed. Based on these evaluations, guidelines were drafted and discussed with dosimetry professionals from around the world by means of a virtual workshop on the Internet early in 2004. The guidelines have been revised and refined on the basis of the experiences and discussions in this virtual workshop. The general philosophy of the Guidelines is presented here, focusing on the principles of harmonisation, optimisation and proportionality. Finally, the proposed Levels of Task to structure the approach of internal dose evaluation are reported.

PMID: 17041240 [PubMed - as supplied by publisher]

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Adherence of academic geriatric practitioners to osteoporosis screening guidelines.

Osteoporos Int. 2006 Oct 17;

Authors: McNally DN, Kenny AM, Smith JA

OBJECTIVES: To examine the bone mineral density (BMD) testing habits of geriatricians and geriatric fellows at the University of Connecticut fellowship training program to evaluate their adherence screening guidelines. DESIGN: Retrospective chart review. SETTING: University based academic geriatric practice in Farmington, CT. PARTICIPANTS: Chart review of two hundred female patients over age 65 under care of seven faculty geriatricians and eight geriatric fellows in training. MEASUREMENTS: Data collected included BMD testing status, patient’s osteoporosis risk factors and functional status. RESULTS: Physicians ordered BMD tests in 151 (76%) patients; 128 (64%) had a bone mineral density test within three years. A personal history of fracture was the only osteoporosis risk factor that correlated to higher rates of osteoporosis testing. Physicians were more likely to order BMD screening in younger patients (92% in 65-74 vs. 74% in ages 85+, P=.031), patients independent in activities of daily living (72% vs. 32, P=.002), and patients without dementia (70% vs.37%, p=.007). BMD testing results found 82% with osteopenia or osteoporosis. CONCLUSIONS: A geriatric group that is highly attuned to bone health demonstrated more optimal adherence to OP testing guidelines for all “at-risk” older women and better than reported previously. Functional status more strongly predicted BMD testing than osteoporosis risk factors. This study suggests that with improved physician education and familiarity with the disease, high rates of BMD testing for earlier identification of geriatric patients at risk for osteoporosis are achievable.

PMID: 17043904 [PubMed - as supplied by publisher]

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www.fevertravel.ch: An online study prototype to evaluate the safety and feasibility of computerized guidelines for fever in returning travellers and migrants.

Comput Methods Programs Biomed. 2006 Oct 10;

Authors: Ambresin AE, D’Acremont V, Mueller Y, Martin O, Burnand B, Genton B

Following the paper publication of practice guidelines for the management of febrile patients returning from the tropics, we constructed a consultation website that comprises a decision chart and specific diagnostic features providing medical diagnostic assistance to primary care physicians. We then integrated a research component to evaluate the implementation of these computerized guidelines. This study website has the same interface as the consultation website. In addition, one is able to record: (i) the pathway followed by the physician through the decision chart, (ii) the diagnostic tests performed, (iii) the initial and final diagnoses as well as outcome and (iv) reasons for non-adherence when the physician diverges from the proposed attitude. We believe that Internet technology is a powerful medium to reach physicians of different horizons in their own environment, and could prove to be an effective research tool to disseminate practice guidelines and evaluate their appropriateness. Here we describe the design, content, architecture and system implementation of this interactive study prototype aimed at integrating operational research in primary care practice.

PMID: 17045360 [PubMed - as supplied by publisher]

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Related ArticlesIs there evidence for recommending needleless closed catheter access systems in guidelines?

J Hosp Infect. 2006 Oct 12;

Authors: Casey AL, Lambert PA, Elliott TS

PMID: 17046108 [PubMed - as supplied by publisher]

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Care of Girls and Women with Turner Syndrome: A Guideline of the Turner Syndrome Study Group.

J Clin Endocrinol Metab. 2006 Oct 25;

Authors: Bondy CA

Objectives: To provide updated guidelines for the evaluation and treatment of girls and women with Turner syndrome (TS) Participants: The Turner Syndrome Consensus Study Group is a multi-disciplinary panel of experts with relevant clinical and research experience with TS that met in Bethesda, April, 2006. The meeting was supported by the National Institute of Child Health and unrestricted educational grants from pharmaceutical companies. Evidence The Study Group used peer-reviewed published information to form its principle recommendations. Expert opinion was used where good evidence was lacking. Consensus The study group met for three days to discuss key issues. Breakout groups focused on genetic, cardiological, auxological, psychological, gynecological and general medical concerns and drafted recommendations for presentation to the whole group. Draft reports were available for further comment on the meeting website. Synthesis of the section reports and final revisions were reviewed by E-mail: and approved by whole group consensus. Conclusions We suggest that parents receiving a prenatal diagnosis of TS be advised of the broad phenotypic spectrum and the good quality of life observed in TS in recent years. We recommend that magnetic resonance angiography be used in addition to echocardiography to evaluate the cardiovascular system and suggest that patients with defined cardiovascular defects be cautioned in regards to pregnancy and certain types of exercise. We recommend that puberty should not be delayed to promote statural growth. We suggest a comprehensive educational evaluation in early childhood to identify potential attention-deficit or non-verbal learning disorders. We suggest that caregivers address the prospect of premature ovarian failure in an open and sensitive manner and emphasize the critical importance of estrogen treatment for feminization and for bone health during the adult years. All individuals with TS require continued monitoring of hearing and thyroid function throughout the lifespan. We suggest that adults with TS be monitored for aortic enlargement, hypertension, diabetes and dyslipidemia.

PMID: 17047017 [PubMed - as supplied by publisher]

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Implementing feeding guidelines for NICU patients

JPEN J Parenter Enteral Nutr. 2006 Nov-Dec;30(6):515-8

Authors: Street JL, Montgomery D, Alder SC, Lambert DK, Gerstmann DR, Christensen RD

BACKGROUND: We devised a consistent approach to instituting and advancing enteral nutrition among neonatal intensive care unit (NICU) patients

PMID: 17047177 [PubMed - in process]

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The efficacy of 2002 CDC guidelines in preventing perinatal group B Streptococcal vertical transmission: a prospective study.

Arch Gynecol Obstet. 2006 Oct 18;

Authors: Lijoi D, Capua ED, Ferrero S, Mistrangelo E, Giannattasio A, Morano S, Ragni N

OBJECTIVES: The aim of the current study is to evaluate the differences in the rate of perinatal group B streptococcal vertical transmission between women who correctly underwent the CDC 2002 guidelines and women who did not. METHODS: Two study groups: women who correctly underwent the CDC 2002 guidelines (study group 1) and women who did not (study group 2). Intrapartum chemoprophylaxis (IC) was administered to all pregnant women identified as GBS carrier. All newborns received, in the first hour of life, a culture based screening for GBS colonization. RESULTS: One thousand six hundred and sixty nine women were enrolled in the study. The 2002 CDC guidelines were correctly applied in 1273 (76.3%) subjects. There was no early-onset GBS disease. No statistically significant difference in the total number of colonized newborns between study group 1 (4.1%) and study group 2 (3.3%) was found. When the analysis was limited to women with positive GBS screening, a significant difference (P

PMID: 17047973 [PubMed - as supplied by publisher]

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Letter: Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage.

Hum Reprod. 2006 Oct 18;

Authors: Bohlmann MK, Luedders DW, von Wolff M

PMID: 17050547 [PubMed - as supplied by publisher]

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