Available Guidelines (available + guideline)

Distribution by Scientific Domains

Selected Abstracts

Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting

U Blume-Peytavi
Abstract Background, Development of the skin barrier continues up to 12 months after birth; therefore, care must be taken when cleansing and bathing infants' skin. Available guidelines for skin care in newborns are, however, limited. In 2007, the 1st European Round Table meeting on ,Best Practice for Infant Cleansing' was held, at which a panel of expert dermatologists and paediatricians from across Europe aimed to provide a consensus on infant bathing and cleansing. Outcomes, Based on discussions at the meeting and a comprehensive literature review, the panel developed a series of recommendations relating to several aspects of infant skin care, including initial and routine bathing, safety while bathing, and post-bathing procedures. The panel also focused on the use of liquid cleansers in bathing, particularly relating to the benefits of liquid cleansers over water alone, and the criteria that should be used when choosing an appropriate liquid cleanser for infants. Alkaline soaps have numerous disadvantages compared with liquid cleansers, with effects on skin pH and lipid content, as well as causing skin drying and irritation. Liquid cleansers used in newborns should have documented evidence of their mildness on skin and eyes, and those containing an emollient may have further benefits. Finally, the panel discussed seasonal differences in skin care, and issues relating to infants at high risk of atopic dermatitis. The panel further discussed the need of clinical studies to investigate the impact of liquid cleansers on skin physiology parameters on newborns' and infants' skin. Conclusions, Bathing is generally superior to washing, provided basic safety procedures are followed, and has psychological benefits for the infant and parents. When bathing infants with a liquid cleanser, a mild one not altering the normal pH of the skin surface or causing irritation to skin or eyes should be chosen. Conflicts of interest M.J. Cork and F. Vanaclocha are advisors to Johnson and Johnson. U. Blume-Peytavi is a member of the advisory board of the ,Penaten Beirat', Johnson & Johnson, Germany. J. Faergemann, C. Gelmetti, J. Szczapa declared to have no conflict of interest. [source]

National guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus,what do they tell us?

H. HumphreysArticle first published online: 30 JUN 200
Abstract Guidelines to control and prevent methicillin-resistant Staphylococcus aureus (MRSA) infection are available in many countries. Infection control and prevention teams determine local strategies using such national guidelines, but not all guidelines involve a rigorous assessment of the literature to determine the strength of the recommendations. Available guidelines drafted by national agencies or prominent professional organisations in Germany, New Zealand, North America, The Netherlands, Ireland and the UK were reviewed. Significant literature reviews were a component of guidelines from the UK and North America. Recommendations were not graded on the strength of the evidence in guidelines from New Zealand and The Netherlands. The Netherlands, a country with a very low prevalence of MRSA, had the simplest set of guidelines. Few of the recommendations in any of the guidelines achieved the highest grading, i.e., based on well-designed, experimental, clinical or epidemiological studies, even though the logic of the proposed measures is clear. The onset of community-acquired MRSA is reflected in the recent publication of guidelines from North America. New developments, such as rapid testing and mathematical modelling, are of importance in helping to control MRSA in settings of both low and high endemicity. National guidelines are increasingly evidence-based, although good scientific studies concerning some aspects of MRSA control are lacking. However, general principles, e.g., early detection and isolation, are recommended by all guidelines. There is still a role for consensus and the opinion of experts in devising national guidelines. [source]

Managing stakeholders or the environment?

The challenge of relating indicators in practice
Abstract Many organizations present their environmental work in the form of annual reports and use the indicators in them for follow-up. However, internal communication and management is needed for environmental improvements. The indicators found in reports may be suitable for external communication, but are they also suitable internally and operationally? This article reviews the existing literature on environmental indicators. With the help of an operational approach, from organisation theory, and a life-cycle approach, indicators are analysed. The analysis shows that formulating indicators for internal management is not an easy task; available guidelines are of little help. It is concluded that the environment can be managed internally by relating indicators. Therefore, an additional set of indicators for internal management and a wider responsibility for the life cycle are recommended. The analysis and recommendations are illustrated with examples drawn from the field of property management. Copyright 2008 John Wiley & Sons, Ltd and ERP Environment. [source]

Determinants of Early Medical Management of Nausea and Vomiting of Pregnancy

BIRTH, Issue 1 2009
Anas Lacasse BSc
ABSTRACT: Background: Early medical management of nausea and vomiting during pregnancy is desirable but less than optimal. The aims of this study were to describe the management of nausea and vomiting during the first prenatal visit and to identify the determinants of 1) addressing the subject of nausea and vomiting during pregnancy with the health practitioner and 2) receiving an antiemetic prescription.Methods: A prospective study was conducted of 283 women who reported nausea and vomiting during the first trimester of pregnancy. Women were eligible if they were at least 18 years of age and , 16 weeks' gestation at the time of their first prenatal visit. Participants completed a questionnaire to determine their maternal characteristics, the presence of nausea and vomiting during pregnancy, and its management.Results: Of the 283 study participants, 79 percent reported that the condition was addressed during their first prenatal visit, 52 percent reported being asked about the intensity and severity of their symptoms, and 22 percent reported being questioned about the extent to which it disrupted their daily tasks. Health practitioners prescribed an antiemetic for 27 percent of women and recommended a nonpharmacological method for 14 percent. Multivariate models showed that the severity of the nausea and vomiting, previous use of an antiemetic, and smoking before pregnancy were significantly associated with an increased likelihood of addressing the subject of nausea and vomiting during pregnancy. Variables associated with an increased likelihood of women receiving an antiemetic prescription included nausea and vomiting severity, excessive salivation, previous antiemetic use, and work status.Conclusions: Health practitioners can improve their management of nausea and vomiting during pregnancy based on the available guidelines for treatment and they should address important factors such as symptom severity and work status at the first prenatal visit to assess women's need for antiemetic treatment. (BIRTH 36:1 March 2009) [source]

Treatment of mechanical valve thrombosis during pregnancy

Calvin Choi M.D.
Abstract Pregnant patients with mechanical valves require anticoagulation. The risk of bleeding and embryopathy associated with oral anticoagulation must be weighed against the risk of valve thrombosis. In the presence of a mechanical valve thrombosis, an appropriate treatment modality must be selected, as it is critical for the health of mother and fetus. In this review, we present a pregnant patient with mechanical valve thrombosis (MVT) who underwent thrombolytic therapy, subsequent anticoagulation according to available guidelines, and delivered a healthy baby at full term. Copyright 2007 Wiley Periodicals, Inc. [source]