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Guidelines
Kinds of Guidelines Terms modified by Guidelines Selected AbstractsVISITATION AND CHILD SUPPORT GUIDELINESFAMILY COURT REVIEW, Issue 2 2004A Comment on Fabricius, Braver Fabricius and Braver argue that nonresident fathers incur appreciable visitation expenses and that their child support obligations should be reduced accordingly. To assess whether fathers incur "appreciable" expenses requires data from mothers and fathers on expenditures in dollar terms rather than data from college students on items kept in the nonresident father's house. The Fabricius and Braver data also overstate the degree to which all divorced fathers do anything for their children. Representative data indicate that father visitation declines substantially over time. Father's postdivorce, post,child support standard of living remains twice that of mothers and children. The cliff model,making adjustments for visitation only in the rare cases of very high shared physical custody,is sensible policy. [source] DEVELOPING CULTURALLY COMPETENT MARRIAGE AND FAMILY THERAPISTS: TREATMENT GUIDELINES FOR NON-AFRICAN-AMERICAN THERAPISTS WORKING WITH AFRICAN-AMERICAN FAMILIESJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2002Roy A. Bean To serve African-American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to examine the most common expert recommendations for family therapy with African Americans. Fifteen specific guidelines were generated, including orient the family to therapy, do not assume familiarity, address issue of racism, intervene multi-systemically, do home visits, use problem-solving focus, involve religious leader, incorporate the father, and acknowledge strengths. conceptual and empirical support for each guideline is discussed, and conclusions are made regarding culturally conpetent therapy with African-American families. [source] GUIDELINES FOR WEANING OF BRONCHODILATOR THERAPYJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2005LG Roddick No abstract is available for this article. [source] JOURNAL OF SOCIOLINGUISTICS SUBMISSION GUIDELINESJOURNAL OF SOCIOLINGUISTICS, Issue 1 2008Article first published online: 31 JAN 200 [source] A CONCEPTUAL UNDERSTANDING OF REQUIREMENTS FOR THEORY-BUILDING RESEARCH: GUIDELINES FOR SCIENTIFIC THEORY BUILDING,JOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 3 2008JOHN G. WACKER Business academics have focused their attention on empirical investigation of programs' effect on organizational competitive performance. These studies primarily emphasize theory building. With the many definitions of theory, academics are not certain whether their research papers meet the specific requirements for theory development required by the academic field of the philosophy of science. Certainly, supply chain academics generally believe that their academic articles fulfill the requirements of theory building. Although many of these articles do have elements of theory, more focus is needed on the specific requirements of theory to assure that academic research is "good" theory building. The primary purpose of this research paper is to logically develop a set of guidelines to assist empirical researchers to assure that their studies fulfill the requirements of good theory based upon traditional scientific theory building. By fulfilling the requirements of good theory, researchers will develop studies that will have a lasting impact on their academic field. To achieve a lasting impact on an academic field, it is necessary to follow a logical plan. This article provides a plan for logical guidelines for developing an understanding of how and why "good" theory building is achieved. This article logically develops a formal conceptual definition of theory along with its related properties to understand these guidelines. Next, it analyzes the requirements of theory, "good" theory, and their properties. These guidelines are included in the existing philosophy of science publications. However, this article consolidates these sources and logically explains why these guidelines are needed. In the conclusion, the guidelines are summarized to serve as a summary checklist for supply chain researchers to use for ensuring their articles will be recognized as a contribution to the academic field. So in that sense, this article does not develop a revolutionary new insight into theory-building empirical articles, but rather integrates diverse traditional philosophy of science requirements into a much simpler set of guidelines. Through logical development of these guidelines, researchers will understand the structure of theory and how to ensure their studies can be modified to have a lasting impact on the field of supply chain management. [source] JUVENILE DELINQUENCY GUIDELINES: Improving Court Practice in Juvenile Delinquency CasesJUVENILE AND FAMILY COURT JOURNAL, Issue 3 2005Mary V. Mentaberry No abstract is available for this article. [source] Juvenile Delinquency Guidelines: Improving Court Practice in Juvenile Delinquency Cases SIXTEEN KEY PRINCIPLESJUVENILE AND FAMILY COURT JOURNAL, Issue 3 2005Article first published online: 14 JUL 200 ABSTRACT This article is excerpted from the National Council of Juvenile and Family Court Judges' landmark JUVENILE DELINQUENCY GUIDELINES: Improving Court Practice in Juvenile Delinquency Cases, Chapter I, Foundations for Excellence, published in 2005. Beginning with a basic discussion of why separate courts for juveniles and adults continue to be necessary, the article describes the goals and key principles of a juvenile delinquency court of excellence. [source] MANUSCRIPT GUIDELINES & NOTESNAVAL ENGINEERS JOURNAL, Issue 4 2005Article first published online: 29 OCT 200 No abstract is available for this article. [source] MANUSCRIPT GUIDELINES & NOTESNAVAL ENGINEERS JOURNAL, Issue 6 2000Article first published online: 18 MAR 200 No abstract is available for this article. [source] MANUSCRIPT GUIDELINES & NOTESNAVAL ENGINEERS JOURNAL, Issue 5 2000Article first published online: 18 MAR 200 No abstract is available for this article. [source] GUIDELINES FOR IMPLEMENTING PREDICTIVE MAINTENANCE*PRODUCTION AND OPERATIONS MANAGEMENT, Issue 2 2002KATHLEEN E. MCKONE Recent advances in predictive maintenance technologies have led many manufacturers to abandon traditional periodic maintenance policies and replace them with predictive maintenance policies. The models in this paper explicitly evaluate the decision to utilize both predictive and periodic maintenance when the objective is to minimize expected maintenance costs per unit time. Renewal theory is used to obtain optimal policies as unique solutions of integral equations that depend on the failure distribution and prediction capabilities. Based on this research, we recommend that practitioners do not abandon the traditional maintenance methods but follow our guidelines for utilizing periodic maintenance in conjunction with the new technologies. [source] Global Guideline for Type 2 Diabetes: recommendations for standard, comprehensive, and minimal careDIABETIC MEDICINE, Issue 6 2006IDF Clinical Guidelines Task Force Abstract The Clinical Guidelines Task Force of the International Diabetes Federation has created an evidence-based Global Guideline for the care of people with Type 2 diabetes around the world. The recommendations developed for three levels of care (standard, comprehensive, and minimal), which can be applied in settings with different resources, are presented here. The source document is published elsewhere. [source] Difference in the sensitivity to chemical compounds between female and male neonates of Daphnia magnaENVIRONMENTAL TOXICOLOGY, Issue 5 2008Erika Ikuno Abstract Daphnia magna usually produce female offspring by parthenogenesis, and thus only female neonates are used to evaluate the environmental toxicity to chemicals. Additionally, it is known that male daphnids are induced by exposure to a juvenile hormone, methyl farnesoate, during late ovarian development. In this study, we investigated the concentration of methyl farnesoate in a 24-h exposure producing 100% males, and the difference in sensitivity to chemical compounds, potassium dichromate, pentachlorophenol, and paraquat, between females and males, referring to OECD Test Guideline 202. The results show that the minimum concentration for 100%-male induction of methyl farnesoate in adult females was 50 ,g/L. In addition, acute toxicity tests (immobility test) with the other chemicals showed that male neonates have higher tolerance to potassium dichromate and pentachlorophenol than females for at least 24 h after birth, while no sex difference was observed in the sensitivity to paraquat. The differences in the median effective concentrations in these compounds between female and male neonates suggest two different overall modes of action. Using female daphnids for environmentally toxicity testing seems reasonable, since the females are more sensitive to chemicals than males. Furthermore, the method of male induction established in this study could be used for screening of endocrine disruptors. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2008. [source] Chemical structure-based predictive model for methanogenic anaerobic biodegradation potentialENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 9 2007William Meylan Abstract Many screening-level models exist for predicting aerobic biodegradation potential from chemical structure, but anaerobic biodegradation generally has been ignored by modelers. We used a fragment contribution approach to develop a model for predicting biodegradation potential under methanogenic anaerobic conditions. The new model has 37 fragments (substructures) and classifies a substance as either fast or slow, relative to the potential to be biodegraded in the "serum bottle" anaerobic biodegradation screening test (Organization for Economic Cooperation and Development Guideline 311). The model correctly classified 90, 77, and 91% of the chemicals in the training set (n = 169) and two independent validation sets (n = 35 and 23), respectively. Accuracy of predictions of fast and slow degradation was equal for training-set chemicals, but fast-degradation predictions were less accurate than slow-degradation predictions for the validation sets. Analysis of the signs of the fragment coefficients for this and the other (aerobic) Biowin© models suggests that in the context of simple group contribution models, the majority of positive and negative structural influences on ultimate degradation are the same for aerobic and methanogenic anaerobic biodegradation. [source] Estrogenic endpoints in fish early life-stage tests: Luciferase and vitellogenin induction in estrogen-responsive transgenic zebrafishENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 1 2006Rinus Bogers Abstract This study incorporated specific endpoints for estrogenic activity in the early life-stage (ELS) test, as described in Guideline 210 of the Organization for Economic Cooperation and Development and traditionally used for toxicity screening of chemicals. A transgenic zebrafish model expressing an estrogen receptor,mediated luciferase reporter gene was exposed to ethi-nylestradiol (EE2), and luciferase activity as well as vitellogenin (VTG) was measured. Concentrations of EE2 were tested at 1, 3, or 10 ng/L for 30 d from fertilization or during only the last 4 d with dimethylsulfoxide (DMSO) as presolvent (0.01%). Exposure to EE2 induced no toxic effects. Mean body weights were significantly higher in groups exposed for 30 d in the presence of DMSO, but condition factors were not affected. Significant luciferase and VTG induction occurred following 30-d exposure (3 and 10 ng EE2/L), while only VTG levels were affected in the 4-d exposure (10 ng EE2/L). This study demonstrated the usefulness of incorporating estrogenic endpoints in the OECD ELS test, fitting the requirements for screening estrogenic activity of chemicals. Quantitative measurement of both VTG and luciferase activity proved to be rapid and sensitive. Additional value of using transgenic zebrafish lies in combining VTG measurement with the more mechanistic approach of luciferase induction in one experiment. [source] We Live in the Age of the Clinical GuidelineEPILEPSIA, Issue 11 2006Article first published online: 16 NOV 200 No abstract is available for this article. [source] We Live in the Age of the Clinical GuidelineEPILEPSIA, Issue 7 2006Simon Shorvon No abstract is available for this article. [source] Guideline on the selection and use of therapeutic products to treat haemophilia and other hereditary bleeding disordersHAEMOPHILIA, Issue 4 2008A UNITED KINGDOM HAEMOPHILIA CENTER DOCTORS' ORGANISATION (UKHCDO) GUIDELINE APPROVED BY THE BRITISH COMMITTEE FOR STANDARDS IN HAEMATOLOGY Summary., Evidence-based guidelines are presented on the selection and use of therapeutic products to treat haemophilia and other hereditary bleeding disorders. They include details of therapeutic products available in the UK and they update and replace previous United Kingdom Haemophilia Centre Doctors' Organisation guidelines. [source] Animal use replacement, reduction, and refinement: Development of an integrated testing strategy for bioconcentration of chemicals in fish,INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2007Watze de Wolf Abstract When addressing the use of fish for the environmental safety of chemicals and effluents, there are many opportunities for applying the principles of the 3Rs: Reduce, Refine, and Replace. The current environmental regulatory testing strategy for bioconcentration and secondary poisoning has been reviewed, and alternative approaches that provide useful information are described. Several approaches can be used to reduce the number of fish used in the Organization for Economic Cooperation and Development (OECD) Test Guideline 305, including alternative in vivo test methods such as the dietary accumulation test and the static exposure approach. The best replacement approach would seem to use read-across, chemical grouping, and quantitative structure-activity relationships with an assessment of the key processes in bioconcentration: Adsorption, distribution, metabolism, and excretion. Biomimetic extraction has particular usefulness in addressing bioavailable chemicals and is in some circumstances capable of predicting uptake. Use of alternative organisms such as invertebrates should also be considered. A single cut-off value for molecular weight and size beyond which no absorption will take place cannot be identified. Recommendations for their use in bioaccumulative (B) categorization schemes are provided. Assessment of biotransformation with in vitro assays and in silico approaches holds significant promise. Further research is needed to identify their variability and confidence limits and the ways to use this as a basis to estimate bioconcentration factors. A tiered bioconcentration testing strategy has been developed taking account of the alternatives discussed. [source] Are guidelines on use of colony-stimulating factors in solid cancers flawed?INTERNAL MEDICINE JOURNAL, Issue 4 2009I. E. Haines Abstract In cancer care in Australia, we are very reliant on an array of expensive pharmaceuticals. Our use of these treatments is often based on multinational or foreign clinical studies. Oncologists are, to varying degrees, reliant on how the studies are interpreted by the writers of journal editorials, clinical guidelines and opinion pieces. Therefore it is important that these guidelines are balanced and evidence based. We have examined in detail one of the most influential and wide ranging clinical guidelines used in oncology, The American Society of Clinical Oncology (ASCO) 2006 Update of Recommendations for the use of White Blood Cell Factors: An Evidence-Based Clinical Practice Guideline. We have discussed in detail some of the controversial recommendations in this guideline and have exposed what we believe are some flaws in these recommendations. We would urge that we continue to be rigorous in our oversight of international research agendas and international clinical guidelines in the future. [source] Quality Audit in Financial Investment ServicesINTERNATIONAL JOURNAL OF AUDITING, Issue 2 2000Stanislav Karapetrovic This paper discusses the following two questions: What is a ,Quality Audit'? Why and how does it apply to financial investment services? ,Quality' in this important field of service is understood as the perception of the investor about achieving satisfactory returns, under generally accepted risks, within a planned time. The service provider normally assures this quality with due care mostly in information gathering, communication and investment decision-making. Once this quality assurance is adequately formalized and documented, a ,quality audit' can be performed. The ISO 9000 international standards and guidelines describe a quality system that can be applied to provide meaningful quality assurance in investment services. Respective quality audits are described in the ISO 10011 Quality Audit Guideline. The development of quality assurance systems and quality audits for compliance and improved performance presents benefits to both the client and the investment service provider. [source] Guideline on the Management of Hand Eczema ICD-10 Code: L20.JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 2009First page of article [source] Development of a Clinical Practice Guideline for Testing Nasogastric Tube PlacementJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2009Sue Peter PURPOSE.,A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing. DESIGN AND METHODS.,,Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals. RESULTS.,,Aspirate was obtained for 97% of all tests and pH was , 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid-inhibiting medications had multiple pH testing fails. PRACTICE IMPLICATIONS.,Nasogastric tube placement continues to present a challenge for those high-risk patients on continuous feeds and/or receiving acid-inhibiting medications. [source] Altering Investment Decisions to Manage Financial Reporting Outcomes: Asset-Backed Commercial Paper Conduits and FIN 46JOURNAL OF ACCOUNTING RESEARCH, Issue 5 2008DANIEL A. BENS ABSTRACT We evaluate the manner in which sponsors of highly leveraged asset-backed commercial paper (ABCP) conduits responded to Financial Accounting Standards Board Interpretation No. 46 (FIN 46), Consolidation of Variable Interest Entities an Interpretation of ARB No. 51, and its Canadian counterpart Accounting Standards Board of Accounting Guideline 15 (AcG-15), Consolidation of Variable Interest Entities. By matching commercial paper investors with corporations seeking liquidity, ABCP sponsors facilitate a significant amount of short-term, securitized financing in the United States. FIN 46 and AcG-15 require sponsors to consolidate their ABCP conduits with their financial statements. We demonstrate that the volume of ABCP began to decline when FIN 46 was first proposed, and that this decline is primarily attributable to a reduction in North American banks' sponsorship of ABCP. We also demonstrate that North American banks entered into costly restructuring arrangements to avoid having to consolidate their conduits per the new accounting standards. Our results suggest that, in certain settings, accounting standards appear to have real effects on investment activity and product-market competition. [source] Clinical Practice Guideline for the Evaluation of Fever and Infection in Older Adult Residents of Long-Term Care Facilities: 2008 Update by the Infectious Diseases Society of AmericaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2009Kevin P. High MD Residents of long-term care facilities (LTCFs) are at great risk for infection. Most residents are older and have multiple comorbidities that complicate recognition of infection; for example, typically defined fever is absent in more than one-half of LTCF residents with serious infection. Furthermore, LTCFs often do not have the on-site equipment or personnel to evaluate suspected infection in the fashion typically performed in acute care hospitals. In recognition of the differences between LTCFs and hospitals with regard to hosts and resources present, the Infectious Diseases Society of America first provided guidelines for evaluation of fever and infection in LTCF residents in 2000. The guideline presented here represents the second edition, updated by data generated over the intervening 8 years. It focuses on the typical elderly person institutionalized with multiple chronic comorbidities and functional disabilities (e.g., a nursing home resident). Specific topic reviews and recommendations are provided with regard to what resources are typically available to evaluate suspected infection, what symptoms and signs suggest infection in a resident of an LTCF, who should initially evaluate the resident with suspected infection, what clinical evaluation should be performed, how LTCF staff can effectively communicate about possible infection with clinicians, and what laboratory tests should be ordered. Finally, a general outline of how a suspected outbreak of a specific infectious disease should be investigated in an LTCF is provided. [source] Guidelines Abstracted from the Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Stroke RehabilitationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2006Miriam Rodin MD OBJECTIVES: To assist facilities in identifying those evidence-based processes of poststroke care that enhance measurable patient outcomes. The guideline(s) should be used by facilities (hospitals, subacute-care units and providers of long-term care) to implement a structured approach to improve rehabilitative practices and by clinicians to determine best interventions to achieve improved patient outcomes. OPTIONS: The guideline considers five elements of poststroke rehabilitation care: interdisciplinary teams; use of standardized assessments; intensity, timing, and duration of therapy; involvement of patients' families and caregivers in decision-making; and educational interventions for patients, families, and caregivers. Evidence, benefits, harms, and recommendations for each of the five designated elements and specific annotated recommendations for poststroke managements are presented separately. OUTCOMES: The overall guideline considers improvement in functional status measures as the primary outcome. Achieving community-dwelling status and preventing complications, death, and rehospitalization are also important outcomes. Costs are not specifically addressed. PARTICIPANTS: The Department of Veterans Affairs/Department of Defense (VA/DoD) Stroke Rehabilitation Working Group consisted of 28, largely VA and military hospital, representatives of medical and allied professions concerned with stroke diagnosis, management, and rehabilitation. Nine additional members with similar credentials served as the editorial committee. Technical consultation was contracted from ACS Federal Health Care, Inc., and the Center for Evidence-Based Practice, State University of New York,Upstate Medical University, Department of Family Medicine conducted evidence appraisal. Consensus was achieved over several years of facilitated group discussion and iterative evaluation of draft documents and supporting evidence. SPONSOR: The guideline was prepared under the auspices of the VA/DoD. No other source of support was identified in the document, or supporting documents. [source] Hypertension guideline implementation: experiences of Finnish primary care nursesJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008Seija Alanen MNSc Abstract Rationale, aims and objectives, Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. Method, We assessed the style of implementation and adoption of the national Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as ,disseminators' (n = 13) or ,implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. Results, Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion that the HT Guideline has been adopted into clinical practice. The recommendations in the HT Guideline were adopted in clinical practice with varying success, and slightly more often in implementer health centres than in disseminator health centres. Nurses in implementer health centres more often agreed that multiple channels had been used in the implementation (P < 0.001). According to senior nursing officers the implementation of the HT Guideline had led to a new division of labour between nurses and doctors in about a half of the health centres, clearly more often in implementer health centres (P < 0.001). Conclusions, The HT Guideline was well adopted into clinical practice in Finland. The implementation of the HT Guideline had an impact on clinical practices, and on creating a new division of labour between nurses and doctors. [source] Strategy for Implementation of IFAC International Education Guideline No. 9: "Prequalification Education, Tests of Professional Competence and Practical Experience of Professional Accountants": A Task Force Report of the International Association for Accounting Education and Research (IAAER)JOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 3 2001Belverd E. Needles This paper provides strategies for implementing the recommendations of the International Education Guideline No. 9 (hereafter referred to as Guideline), issued by the International Federation of Accountants. The three principal implementation issues addressed in this paper are as follows. (1) How to instill the characteristics of lifelong learning in future professional accountants through accounting education. (2) How to design and implement a program of accounting education that achieves the objectives of the Guideline. (3) How to develop awareness and encourage adoption of the recommendations of the Guideline by communicating and disseminating information through a series of projects within IFAC's constraints and policies. [source] Clinical Practice Guideline: Screening and Diagnosing AutismJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2001APRN-C, Mary Jo Goolsby EdD The clinical practice guideline (CPG) reviewed in this month's column concerns the screening and diagnosis of autism. Autism is the third most common developmental disability and affects more than 1 in 500 children, or nearly 400,000 people in the United States, in some form. Primary care providers of children, including pediatric nurse practitioners (PNPs) and family nurse practitioners (FNPs), should reasonably expect to care for at least one child with autism (CWA). The American Academy of Neurology (AAN) has therefore developed guidelines to help healthcare providers facilitate the early identification of children with autism. [source] European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy.JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2010Report of a joint task force of the European Federation of Neurological Societies, the Peripheral Nerve Society Revision of the guidelines on the use of skin biopsy in the diagnosis of peripheral neuropathy, published in 2005, has become appropriate due to publication of more relevant papers. Most of the new studies focused on small fiber neuropathy (SFN), a subtype of neuropathy for which the diagnosis was first developed through skin biopsy examination. This revision focuses on the use of this technique to diagnose SFN. Task force members searched the Medline database from 2005, the year of the publication of the first EFNS guideline, to June 30th, 2009. All pertinent papers were rated according to the EFNS and PNS guidance. After a consensus meeting, the task force members created a manuscript that was subsequently revised by two experts (JML and JVS) in the field of peripheral neuropathy and clinical neurophysiology, who were not previously involved in the use of skin biopsy. Distal leg skin biopsy with quantification of the linear density of intraepidermal nerve fibers (IENF), using generally agreed upon counting rules, is a reliable and efficient technique to assess the diagnosis of SFN (level A recommendation). Normative reference values are available for bright-field immunohistochemistry (level A recommendation) but not yet for confocal immunofluorescence or the blister technique. The morphometric analysis of IENF density, either performed with bright-field or immunofluorescence microscopy, should always refer to normative values matched for age (level A recommendation). Newly established laboratories should undergo adequate training in a well established skin biopsy laboratory and provide their own stratified age and gender-matched normative values, intra- and interobserver reliability, and interlaboratory agreement. Quality control of the procedure at all levels is mandatory (Good Practice Point). Procedures to quantify subepidermal nerve fibers and autonomic innervated structures, including erector pili muscles, and skin vessels are under development but need to be confirmed by further studies. Sweat gland innervation can be examined using an unbiased stereologic technique recently proposed (level B recommendation). A reduced IENF density is associated with the risk of developing neuropathic pain (level B recommendation), but it does not correlate with its intensity. Serial skin biopsies might be useful for detecting early changes of IENF density, which predict the progression of neuropathy, and to assess degeneration and regeneration of IENF (level C recommendation). However, further studies are warranted to confirm the potential usefulness of skin biopsy with measurement of IENF density as an outcome measure in clinical practice and research. Skin biopsy has not so far been useful for identifying the etiology of SFN. Finally, we emphasize that 3-mm skin biopsy at the ankle is a safe procedure based on the experience of 10 laboratories reporting absence of serious side effects in approximately 35,000 biopsies and a mere 0.19% incidence of non-serious side effects in about 15 years of practice (Good Practice Point). [source] | |||||||||||||||||||||||||||||||