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Introduction Providing comprehensive, evidence-based care to perinatal people with substance use disorders (SUD) requires multi-stakeholder collaboration and alignment. The National Maternal and Child Health Workforce Development Center facilitated a system-strengthening process with the Midwest substance use in pregnancy (SUPper) club, a regional collaborative of health care providers, state public health agencies, and community-rooted organizations. Methods Facilitators led a 2 day group model building (GMB) workshop with 20 participants and two semi-structured interviews. Workshop participants were invited to complete an evaluation. Results Two primary trends were identified as priorities for change: (1) Birthing people's perception/experience of stigma and (2) The Midwest SUPper Club's reach and influence. Three causal loop diagrams (CLDs) were created to capture the interconnected dynamics of the Midwest perinatal SUD system: (1) the influence of stigma on maternal and infant health outcomes, (2) the role of clinic, organizational, and state policies, and (3) the impact of workforce education and evidence-based practices on care. From the CLDs, four priorities for action emerged: (1) align and promote shared mental models across stakeholders, (2) expand education and training opportunities for the perinatal SUD workforce, (3) strengthen systems infrastructure to support care navigation for patients and providers, and (4) collaboratively identify evidence-based practices that meet regional needs. All evaluation respondents reported that the workshop supported the development of a shared mental model. Discussion The GMB process strengthened collaboration and advanced strategic planning for the SUPper Club. GMB can be further utilized among diverse stakeholders across MCH systems to create shared mental models and accelerate collaborative planning efforts., Author(s): Jessica Simon [sup.1] [sup.2] , Isabella Guynn [sup.2] [sup.3] , Meagan Thompson [sup.4] , Sarah Hambright [sup.5] , Cresta Jones [sup.6] , Kristen Hassmiller Lich [sup.2] [sup.3] Author Affiliations: [...]

INTRODUCTION Adolescence is defined by significant socio‐emotional changes and vulnerability. Adolescents and youth living with HIV (AYLHIV) experience worse clinical HIV outcomes—adherence, retention and viral load suppression—compared to adults [1]. [...]

PURPOSE The US Preventive Services Task Force (USPSTF) is an independent body that makes evidence-based recommendations regarding preventive services to improve health for people nationwide. Here, we summarize current USPSTF methods, describe how methods are evolving to address preventive health equity, and define evidence gaps for future research. METHODS We summarize current USPSTF methods as well as ongoing methods development. RESULTS The USPSTF prioritizes topics on the basis of disease burden, extent of new evidence, and whether the service can be provided in primary care and going forward will increasingly consider health equity. Analytic frameworks specify the key questions and linkages connecting the preventive service to health outcomes. Contextual questions provide information on natural history, current practice, health outcomes in high-risk groups, and health equity. The USPSTF assigns a level of certainty to the estimate of net benefit of a preventive service (high, moderate, or low). The magnitude of net benefit is also judged (substantial, moderate, small, or zero/negative). The USPSTF uses these assessments to assign a letter grade from A (recommend) to D (recommend against). I statements are issued when evidence is insufficient. CONCLUSIONS The USPSTF will continue to evolve its methods for simulation modeling and to use evidence to address conditions for which there are limited data for population groups who bear a disproportionate burden of disease. Additional pilot work is underway to better understand the relations of the social constructs of race, ethnicity, and gender with health outcomes to inform the development of a USPSTF health equity framework. Key words: preventive medicine; clinical practice guidelines; methodology; health equity https://doi.org/10.1370/afm.2946, INTRODUCTION The US Preventive Services Task Force (USPSTF) is an independent body formed in 1984 to make evidence-based recommendations regarding preventive services including screening, behavioral counseling, and preventive drugs. The [...]

Many teachers struggle to implement behavioral interventions in the classroom with sufficient treatment integrity. One way to support teachers' intervention implementation is through bug-in-the-ear (BITE) training, a training format in which a school-based consultant provides teachers real-time prompts and immediate performance feedback as teachers interact with students. In the current study, a multiple baseline design across three teachers was used to test the independent effects of BITE training on teachers' initial and maintained use of effective instruction delivery (EID), an intervention for increasing student compliance with teacher instructions. Student compliance in response to EID was also measured. Results indicated immediate and large increases in EID and student compliance, with both outcomes maintained at high levels post-BITE training. Teachers also rated BITE training positively on a social validity measure. Limitations, directions for future research, and implications for applied practice are discussed., Author(s): Roderick D. O'Handley [sup.1], Brad A. Dufrene [sup.2], Joy Wimberly [sup.2] Author Affiliations: (1) grid.253565.2, 0000 0001 2169 7773, Department of Special Education, Rehabilitation, and Counseling, California State University, [...]

Purpose To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults. Methods A taskforce involving 15 international experts and 2 methodologists used the GRADE approach to guideline development. The taskforce addressed three main topics: transfusion support in massively and non-massively bleeding critically ill patients (transfusion ratios, blood products, and point of care testing) and the use of tranexamic acid. The panel developed and answered structured guideline questions using population, intervention, comparison, and outcomes (PICO) format. Results The taskforce generated 26 clinical practice recommendations (2 strong recommendations, 13 conditional recommendations, 11 no recommendation), and identified 10 PICOs with insufficient evidence to make a recommendation. Conclusions This clinical practice guideline provides evidence-based recommendations for the management of massively and non-massively bleeding critically ill adult patients and identifies areas where further research is needed., Author(s): Alexander P. J. Vlaar [sup.1], Joanna C. Dionne [sup.2] [sup.3] [sup.4] [sup.21], Sanne de Bruin [sup.1], Marije Wijnberge [sup.1] [sup.5], S. Jorinde Raasveld [sup.1], Frank E. H. P. van [...]

The aim of this Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) is to formulate an evidence-based guidance for the use of neuromuscular blocking agents (NMBA) in adults with acute respiratory distress syndrome (ARDS). The panel comprised 20 international clinical experts from 12 countries, and 2 patient representatives. We adhered to the methodology for trustworthy clinical practice guidelines and followed a strict conflict of interest policy. We convened panelists through teleconferences and web-based discussions. Guideline experts from the guidelines in intensive care, development, and evaluation Group provided methodological support. Two content experts provided input and shared their expertise with the panel but did not participate in drafting the final recommendations. We followed the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of evidence and grade recommendations and suggestions. We used the evidence to decision framework to generate recommendations. The panel provided input on guideline implementation and monitoring, and suggested future research priorities. The overall certainty in the evidence was low. The ICM-RPG panel issued one recommendation and two suggestions regarding the use of NMBAs in adults with ARDS. Current evidence does not support the early routine use of an NMBA infusion in adults with ARDS of any severity. It favours avoiding a continuous infusion of NMBA for patients who are ventilated using a lighter sedation strategy. However, for patients who require deep sedation to facilitate lung protective ventilation or prone positioning, and require neuromuscular blockade, an infusion of an NMBA for 48 h is a reasonable option., Author(s): Waleed Alhazzani [sup.1] [sup.2], E. Belley-Cote [sup.2], M. H. Møller [sup.3], D. C. Angus [sup.4], L. Papazian [sup.5] [sup.6], Y. M. Arabi [sup.7], G. Citerio [sup.8] [sup.9], B. Connolly [...]

Veterans with traumatic brain injury (TBI) may experience long-term challenges that compromise community reintegration (CR) outcomes. Resource facilitation (RF) is an evidence-based model of service delivery that bridges community support services following acute care or rehabilitation. Coalition building is an implementation strategy used to cultivate relationships to promote access and referral to CR services. This one-year, mixed-method community-based pilot study included a Veteran leadership planning team and thirteen coalition members. Wilder Collaboration Factors Inventory (WCFI) results show a decrease in overall coalition function concerns and an increase in coalition function strengths. Themes emerged in the areas of facilitators of coalition functioning, and barriers to coalition functioning. Coalition building can be used to cultivate relationships and build partnerships to promote Veteran access and referral to CR services. Keywords: brain injuries, community integration, veterans, rehabilitation counseling, Approximately 347,962 Veterans have been diagnosed with traumatic brain injury (TBI) since 2000 (Defense & Veterans Brain Injury, 2017). These individuals often face dynamic, ongoing, long-term challenges that compromise outcomes [...]

Objective To develop evidence-based clinical practice recommendations regarding transfusion practices in non-bleeding, critically ill adults. Design A task force involving 13 international experts and three methodologists used the GRADE approach for guideline development. Methods The task force identified four main topics: red blood cell transfusion thresholds, red blood cell transfusion avoidance strategies, platelet transfusion, and plasma transfusion. The panel developed structured guideline questions using population, intervention, comparison, and outcomes (PICO) format. Results The task force generated 16 clinical practice recommendations (3 strong recommendations, 13 conditional recommendations), and identified five PICOs with insufficient evidence to make any recommendation. Conclusions This clinical practice guideline provides evidence-based recommendations and identifies areas where further research is needed regarding transfusion practices and transfusion avoidance in non-bleeding, critically ill adults., Author(s): Alexander P. Vlaar [sup.1] [sup.18], Simon Oczkowski [sup.2] [sup.3] [sup.4], Sanne de Bruin [sup.1], Marije Wijnberge [sup.1] [sup.5], Massimo Antonelli [sup.6] [sup.7], Cecile Aubron [sup.8], Philippe Aries [sup.8], Jacques [...]

Primary care physicians, working in an environment where patients need to be evaluated, monitored, and motivated in short office visits, sometimes struggle to effectively treat patients with diabetes. Almost half [...]

As a result of increasing emphasis placed on high quality education for all students through such legislative mandates as the Every Student Succeeds Act (ESSA) and the Individuals with Disabilities Education Act (IDEA), teachers cannot afford to waste valuable instruction time. Evidence-based practices are required to assist all students as they work toward meeting federal and state content requirements. Cue-Do-Review, a teaching sequence that can be used in any lesson, regardless of content level, age of the students, or ability level, is one way to help ensure classroom instruction time is used effectively, as well as efficiently. By purposefully targeting specific teacher behaviors at the beginning, middle, and end of a lesson, students are more likely to connect with, and remember content. In the current study, graduate school teaching assistants were asked to participate in a short one-hour professional development session, during which they learned specific behaviors to include in their lessons at the beginning, middle, and end. Undergraduate candidates were given a survey both prior to the professional development (before midterm), and at the conclusion of the course near the end of the semester. The teaching assistants were also surveyed before and after the professional development activity. An analysis of results indicated that undergraduate candidates whose teaching assistants used the Cue-Do-Review sequence, responded more positively to the learning experience, sharing that the sequence had a positive effect on their perceptions of learning. The researchers suggest possible interpretations for the results as well as areas for future study. Keywords: lesson planning, lesson sequence, Cue-Do-Review, professional development, student perceptions of learning, teaching sequences, Introduction In an increasingly diverse classroom, it is no surprise that the process of learning varies greatly from student to student, and what works best for the individual student depends [...]

The Case for Creating, Following, and Passing Down Good Recipes Everyone has one aunt or grandmother who, when pressed for her prize-winning recipe, instructs to use a pinch of cinnamon [...]