Joint Position Statement on EMS Performance Measures Beyond Response Times

A joint position statement from the Canadian Association of Neonatal Nurses (CANN), the Canadian Association of Perinatal and Women's Health Nurses (CAPWHN), the Council of International Neonatal Nurses (COINN), and the National Association of Neonatal Nurses (NANN) was published in 2017 in the Canadian Journal of Nursing Research. This new position statement provides an evidence-based framework for the institutional implementation of developmentally supportive, neuroprotective care in the neonatal intensive care unit (NICU).1,2 BACKGROUND AND SIGNIFICANCE The use of age-appropriate care as an organized framework for care delivery in the NICU is founded on the work of Als3 and her synactive theory of development. This theoretical construct has been advanced by the work of Gibbins and colleagues4 with the “universe of developmental care” conceptual model and developmentally supportive care core measures.5 The core measures for developmentally supportive care were endorsed by NANN in 2011 as its clinical practice guidelines for Age-Appropriate Care of the Premature and Critically Ill Hospitalized Infant6 and have been recently revised and expanded to reflect the most current evidence-based best practices in developmentally supportive, neuroprotective care.7 The core measures for developmentally supportive care outline disease-independent core competencies for professionals serving premature and critically ill hospitalized infants. Supported by The Joint Commission and the Primer Standards of Accreditation and Health Canada, the institutional implementation of these core measures requires a strong framework for institutional operationalization. This framework is presented in the newly published guidelines for the institutional implementation of developmental neuroprotective care in the NICU and summarized at http://dx.doi.org/10.1177/0844562117706882 and http://dx.doi.org/10.1177/0844562117708126.1,2 HIGHLIGHTS These 2-part guidelines include the first international joint position statement between 4 sister nursing associations, as well as best practice recommendations to adopt and integrate developmental neuroprotective care at the institutional level. Part A of the guidelines presents the background and rationale for the development of institutional implementation guidelines. This includes a thorough literature review of the history, levels of evidence, and support for developmental care in the NICU, as well as implementation strategies extracted from the implementation science literature.8 Part B of the guidelines presents detailed recommendations for each implementation phase supported and justified by the current evidence.2 The guidelines are operationalized over 5 phases: Plan, Educate, Prioritize, Evaluate, and Ensure Sustainability. Each phase includes different steps over time to ensure their implementation. These phases and steps might sometimes occur in parallel, whereas others might be delayed, depending on the need and priorities of each unit. Likewise, they can work in circularity, where one change might influence another. However, the best chance for successful adoption and integration of a developmentally supportive, neuroprotective care philosophy and subsequent implementation within an organization are patience, endurance, and persistence.9 Clearly defined standards, accountability metrics, and strong leadership are needed to facilitate and sustain a cultural transformation. CONCLUSION As the professional voice of neonatal nurses around the world, NANN, CANN, CAPWHN, & COINN recommend the use of these guidelines to provide a framework for the standardization of the implementation of developmentally supportive, neuroprotective care. These guidelines provide flexibility to support the individual needs of each unit and organization by providing an evidence-based systematic approach to implementation in NICUs. The full joint position statement can be accessed at Milette et al Part A1 and Part B.2 The articles are open access and freely available to all. See the full articles for more guidance in this area.LEAD AUTHORS Isabelle Milette, MScN, NNP, developmental care specialist, Neonatal Intensive Care Unit, CHU Sainte-Justine; and Co-founder and President, Developmental Care Partnership. Marie-Josée Martel, PhD, Professor, Nursing Department, Université du Québec à Trois-Rivières; and Co-founder and Vice president, Developmental Care Partnership. Margarida Ribeiro da Silva, MScN, NNP, Neonatal Intensive Care Unit, Montreal Children's Hospital; and Collaborator in Developmental Care Partnership. Mary Coughlin, MS, BSN, RN, NNP, RNC-E, Founder and President, Caring Essentials Collaborative.

Lordy, Miss Scarlett!

"ADHD — A joint position statement." Australian and New Zealand Journal of Psychiatry, 34(sup1), p. A64

Surgical Journal Editors' Joint Position Statement: Scientific Data from Clinical Trials: Investigators' Responsibilities and Rights: Letters to the Editor

This joint position statement (JPS) on immersion pulmonary oedema (IPO) and diving is the product of a workshop held at the 52nd Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) from 12-17 May 2024, and consultation with the United Kingdom Diving Medical Committee (UKDMC), three members of which attended the meeting. The JPS is a consensus of experts with relevant evidence cited where available. The statement reviews the nomenclature, pathophysiology, risk factors, clinical features, prehospital treatment, investigation of and the fitness for future compressed gas diving following an episode of IPO. Immersion pulmonary oedema is a life-threatening illness that requires emergency management as described in this statement. A diver with previous suspected or confirmed IPO should consult a medical practitioner experienced in diving medicine. The SPUMS and the UKDMC strongly advise against further compressed gas diving if an individual has experienced an episode of IPO.

To compare conventional radiographic and cone beam computed tomography (CBCT) findings with reference to the American Association of Endodontics and American Academy of Oral and Maxillofacial Radiology (AAE/AAOMR) joint position statement and to determine the effect of the CBCT on the initial diagnoses and treatment plans in a single-centre Postgraduate Endodontic Programme. The clinical CBCT scans of patients, treated at the Endodontic Department of the University of British Columbia, were reviewed for CBCT referrals by comparing them with corresponding radiographs. The features considered were periapical lesions, missed/extra canals, root fractures, complex anatomy, calcified canals and root resorption of tooth/teeth in question. Reasons for the CBCT prescriptions were assigned to 3 groups: to formulate the primary diagnosis, to confirm the diagnosis achieved by clinical examination and conventional radiographs, and to assist in treatment planning. Variables were compared statistically using chi-square and McNemar tests. A total of 128 CBCT examinations were performed on 110 patients. No CBCT examination was performed more than once on the same tooth. Overall, 76% of CBCT examinations were performed on previously root filled teeth. CBCT images revealed a significantly higher incidence of periapical lesions (P=0.002), missed canals (P<0.001), vertical root fractures (P=0.004) and complex anatomy (P=0.008) than periapical radiographs. CBCT was prescribed most frequently to assist surgical treatment planning (62%) rather than for generating a diagnosis (9%) or confirming diagnoses (29%). Both the diagnosis (P=0.001) and the treatment plan (P=0.005) initially made by examining periapical radiographs were altered significantly by the subsequent CBCT examination by revealing information such as new periapical lesions, missed canals or involvement of buccal or lingual cortical bone. CBCT examinations were prescribed mainly to assist treatment planning rather than for diagnosis. The majority of CBCT examinations were performed on previously root filled teeth. The additional information obtained from CBCT scans resulted in the alteration of the initial diagnoses as well as subsequent treatment plans in 59 out of 128 cases.

Functional Mitral Regurgitation in Heart Failure: Analysis of the ESC Multidisciplinary Heart-Team Position Statement and Review of Current Guidelines

American Society for Pain Management Nursing and Hospice and Palliative Nurses Association Position Statement: Pain Management at the End of Life

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as Nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in individuals with overweight or obesity. In this context, a panel of experts from three medical societies was organized to develop an evidence-based guideline on the screening, diagnosis, treatment, and follow-up of MASLD. A MEDLINE search was performed to identify randomized clinical trials, meta-analyses, cohort studies, observational studies, and other relevant studies on NAFLD. In the absence of studies on a certain topic or when the quality of the study was not adequate, the opinion of experts was adopted. Classes of Recommendation and Levels of Evidence were determined using prespecified criteria. Based on the literature review, 48 specific recommendations were elaborated, including 11 on screening and diagnosis, 9 on follow-up,14 on nonpharmacologic treatment, and 14 on pharmacologic and surgical treatment. A literature search allowed the development of evidence-based guidelines on the screening, diagnosis, treatment, and follow-up of MASLD in individuals with overweight or obesity.

Calculation of cerebral perfusion pressure in the management of traumatic brain injury: joint position statement by the councils of the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland (NACCS) and the Society of British Neurological Surgeons (SBNS)

This article is temporarily under embargo.

Smoking and diabetes interplay: A comprehensive review and joint statement

Pepperdine Libraries complete three-year NEH grant2020 ACRL Scholarly Communication RoadShow Hosts announcedUW-Eau Claire McIntyre Library named FDLP Library of the YearAMWA-EMWA-ISMPP Joint Position Statement on Predatory PublishingConsumer Reports archives come to DukeEBSCO releases PsychTHERAPY video database

Background: In late 2025, the United States Centers for Disease Control and Prevention shifted from a universal hepatitis B birth dose recommendation to a risk-based framework. This statement reaffirms the critical importance of maintaining Malaysia’s universal 24-hour birth dose policy within its National Immunisation Programme. Main Text: Malaysia’s universal birth dose, introduced in 1989, has been a monumental public health success, reducing childhood HBV surface antigen prevalence to ~0.3%. Abandoning this policy would jeopardise decades of progress. The universal approach acts as an essential “vaccine safety net”, protecting against systemic failures in antenatal screening, documentation, and care coordination that a risk-based strategy cannot overcome. Immunologically, the birth dose is crucial due to the neonatal vulnerability to chronic infection. The policy is also highly cost-effective and grounded in principles of equity and justice, ensuring protection for all newborns regardless of socioeconomic or geographic factors. Strengthening complementary measures, such as universal antenatal screening and digital health records, is encouraged. Conclusions: The Malaysian Paediatric Association, the Academy of Medicine of Malaysia College of Paediatrics, and the Malaysian Society of Paediatric Gastroenterology, Hepatology and Nutrition unanimously urge Malaysia to maintain its universal HBV birth dose. This policy remains a fundamental, non-negotiable pillar of child health and hepatitis B elimination efforts in the national context.

Prehospital use of tranexamic acid (TXA) has grown substantially over the past decade despite contradictory evidence supporting its widespread use. Since the previous guidance document on the prehospital use of TXA for injured patients was published by the National Association of EMS Physicians, the American College of Surgeons Committee on Trauma, and the American College of Emergency Physicians in 2016, new research has investigated outcomes of patients who receive TXA in the prehospital setting. To provide updated evidence-based guidance on the use of intravenous TXA for injured patients in the emergency medical services (EMS) setting, we performed a structured literature review and developed the following recommendations supported by the evidence summarized in the accompanying resource document.The National Association of EMS Physicians, the American College of Surgeons Committee on Trauma, and the American College of Emergency Physicians recommends:• Prehospital TXA administration may reduce mortality in adult trauma patients with hemorrhagic shock when administered after lifesaving interventions.• Prehospital TXA administration appears safe, with low risk of thromboembolic events or seizure.• The ideal dose, rate, and route of prehospital administration of TXA for adult trauma patients with hemorrhagic shock has not been determined. Current evidence suggests EMS agencies may administer either a 1-g intravenous/intraosseous dose (followed by a hospital-based 1-g infusion over 8 hours) or a 2-g intravenous/intraosseous dose as an infusion or slow push.• Prehospital TXA administration, if used for adult trauma patients, should be given to those with clinical signs of hemorrhagic shock and no later than 3 hours post-injury. There is no evidence to date to suggest improved clinical outcomes from TXA initiation beyond this time or in those without clinically significant bleeding.• The role of prehospital TXA in pediatric trauma patients with clinical signs of hemorrhagic shock has not been studied, and standardized dosing has not been established. If used, it should be given within 3 hours of injury.• Prehospital TXA administration, if used, should be clearly communicated to receiving health care professionals to promote appropriate monitoring and to avoid duplicate administration(s).• A multidisciplinary team, led by EMS physicians, that includes EMS clinicians, emergency physicians, and trauma surgeons should be responsible for developing a quality improvement program to assess prehospital TXA administration for protocol compliance and identification of clinical complications.