Objectives: Clinical guidelines or guidance is an important tool for preventing and treating antimicrobial-resistant (AMR) infections. We sought to understand and support the effective use of guidelines and guidance for AMR infections.
Methods: Key informant interviews and a stakeholder meeting on the development and use of guidelines and guidance for management of AMR infections; the interview findings and meeting discussion informed a conceptual framework for AMR infection clinical guidelines.
Participants: Interview participants included experts with experience in guidelines development and physician and pharmacist hospital leaders and antibiotic stewardship program leaders. Stakeholder meeting participants included federal and nonfederal participants involved in research, policy, and practice related to prevention and management of AMR infections.
Results: Participants described challenges related to timeliness of guidelines, methodologic limitations of the development process, and issues with usability across a range of clinical settings. These findings, and participants' suggestions for mitigating the challenges identified, informed a conceptual framework for AMR infection clinical guidelines. The framework components include (1) science and evidence, (2) guideline and guidance development and dissemination, and (3) implementation and real-world practice. These components are supported by engaged stakeholders whose leadership and resources help to improve patient and population AMR infection prevention and management.
Conclusions: Use of guidelines and guidance documents for management of AMR infections can be supported through (1) a robust body of scientific evidence to inform guidelines and guidance; (2) approaches and tools to support timely, transparent guidelines that are relevant and actionable for all clinical audiences; and (3) tools to implement guidelines and guidance effectively.
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http://dx.doi.org/10.1017/ash.2022.319 | DOI Listing |
J Endocr Soc
January 2025
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Division of Endocrinology, Diabetes and Metabolism, Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY 11040, USA.
Sodium-glucose cotransporter 2 inhibitors (SGLT2is), originally approved by the US Food and Drug Administration for glycemic control in type 2 diabetes mellitus (DM2), have shown substantial cardiovascular and renal benefits, leading to their expanded use in managing heart failure (HF) and chronic kidney disease in the outpatient setting. Despite these benefits, their use for inpatient hyperglycemia management is not universally endorsed due to safety concerns and inadequate data. However, emerging evidence suggests potential advantages of initiating SGLT2i treatment for patients during hospitalization in the setting of HF.
View Article and Find Full Text PDFJ Intellect Dev Disabil
December 2024
Culture, Diversity and Development Research Group - CUDIDE, Deparment of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain.
Background: People with intellectual disabilities may find difficulties in their school-to-work transition. The current study aimed to determine which factors have been investigated and which are relevant to this transition process.
Method: A systematic review was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included studies published between 2011 and 2023 on initiatives that facilitate the school-to-work transition.
Sci Rep
January 2025
Department of Rehabilitation Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
Accurately extracting organs from medical images provides radiologist with more comprehensive evidences to clinical diagnose, which offers up a higher accuracy and efficiency. However, the key to achieving accurate segmentation lies in abundant clues for contour distinction, which has a high demand for the network architecture design and its practical training status. To this end, we design auxiliary and refined constraints to optimize the energy function by supplying additional guidance in training procedure, thus promoting model's ability to capture information.
View Article and Find Full Text PDFJ Clin Rheumatol
January 2025
From the Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA.
Introduction: Large language models (LLMs) such as ChatGPT can potentially transform the delivery of health information. This study aims to evaluate the accuracy and completeness of ChatGPT in responding to questions on recombinant zoster vaccination (RZV) in patients with rheumatic and musculoskeletal diseases.
Methods: A cross-sectional study was conducted using 20 prompts based on information from the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the American College of Rheumatology (ACR).
JMIR Res Protoc
January 2025
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Background: Although existing disease preparedness and response frameworks provide guidance about strengthening emergency response capacity, little attention is paid to health service continuity during emergency responses. During the 2014 Ebola outbreak, there were 11,325 reported deaths due to the Ebola virus and yet disruption in access to care caused more than 10,000 additional deaths due to measles, HIV/AIDS, tuberculosis, and malaria. Low- and middle-income countries account for the largest disease burden due to HIV, tuberculosis, and malaria and yet previous responses to health emergencies showed that HIV, tuberculosis, and malaria service delivery can be significantly disrupted.
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