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Background: Exercise interventions are often incompletely described in reports of clinical trials, hampering evaluation of results and replication and implementation into practice., Objective: The aim of this study was to develop a standardized method for reporting exercise programs in clinical trials: the Consensus on Exercise Reporting Template (CERT)., Design and Methods: Using the EQUATOR Network's methodological framework, 137 exercise experts were invited to participate in a Delphi consensus study. A list of 41 items was identified from a meta-epidemiologic study of 73 systematic reviews of exercise. For each item, participants indicated agreement on an 11-point rating scale. Consensus for item inclusion was defined a priori as greater than 70% agreement of respondents rating an item 7 or above. Three sequential rounds of anonymous online questionnaires and a Delphi workshop were used., Results: There were 57 (response rate=42%), 54 (response rate=95%), and 49 (response rate=91%) respondents to rounds 1 through 3, respectively, from 11 countries and a range of disciplines. In round 1, 2 items were excluded; 24 items reached consensus for inclusion (8 items accepted in original format), and 16 items were revised in response to participant suggestions. Of 14 items in round 2, 3 were excluded, 11 reached consensus for inclusion (4 items accepted in original format), and 7 were reworded. Sixteen items were included in round 3, and all items reached greater than 70% consensus for inclusion., Limitations: The views of included Delphi panelists may differ from those of experts who declined participation and may not fully represent the views of all exercise experts., Conclusions: The CERT, a 16-item checklist developed by an international panel of exercise experts, is designed to improve the reporting of exercise programs in all evaluative study designs and contains 7 categories: materials, provider, delivery, location, dosage, tailoring, and compliance. The CERT will encourage transparency, improve trial interpretation and replication, and facilitate implementation of effective exercise interventions into practice., (© 2016 American Physical Therapy Association.)

Purpose: To discover evidence for defining the registered nurse's (RN's) role in the management of epidural analgesia in the labor and delivery setting., Design: The Labor Epidural Nurse Safety (LENS) study consisted of two parts. The first part was a 10-year retrospective review of the outcomes of 2,568 laboring women for whom epidural catheters had been placed and verified by an anesthesiologist or certified registered nurse anesthetist, then continuous epidural infusion initiated, and basal rate or patient-controlled epidural analgesia (PCEA) dose increased, if needed, within specified parameters by specially trained labor and delivery RNs. The second part compared the outcomes of the neonates born to the 2,568 women in the first part of the study with neonates born to mothers who received PCEA with a continuous infusion initiated and managed exclusively by anesthesiologists and/or certified registered nurse anesthetists at two control sites., Methods: Maternal outcomes were quantified by incidences of clinically significant hypotension and sentinel events, such as respiratory distress, cardio/respiratory distress, loss of consciousness, and seizures. Evidence of neonatal outcomes was collected by comparing Apgar scores., Findings: No sentinel events occurred, and there was no increase in maternal hypotensive events in the RN-managed group. There were no statistically significant differences in Apgar scores between the experimental and control groups., Conclusion: Specially trained RNs can safely initiate continuous infusions and increase the basal rate of epidural analgesia infusions or PCEA doses administered to laboring women, after insertion and confirmation of correct catheter placement by a qualified anesthesia provider, without adversely affecting maternal and fetal/neonatal outcomes., (Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

The hand-arm-vibration syndrome (HAVS) is a complex entity composed of circulatory, sensory, and motor disturbances, as well as associated musculoskeletal components. This study was performed to find a diagnostic testing modality with sufficient sensitivity, specificity, and predictive value to be utilized as a screening test for this disorder in a working population. A full range of testing modalities was utilized in the shipyard medical department. In addition, a clinical diagnosis of vascular and sensorineural disease was established in the workers by a combination of plethysmography, vibrometry, two point discrimination, and monofilament testing in an independent occupational medicine clinic. No one test modality met the requirements for such a definitive diagnostic test. Rather, a range of modalities was required to reach any acceptable level of predictive value, with sufficient degrees of specificity and sensitivity.