Management of diabetes from preconception to the postnatal period: summary of NICE guidance

Diabetes in pregnancy is associated with risks to the woman (for example, higher rates of miscarriage, preeclampsia, and preterm labour) and to the developing fetus and baby (for example, higher rates of congenital malformations, macrosomia, birth injury, and perinatal mortality). This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) on how to manage diabetes and its complications from preconception to the postnatal period

Diagnosis, evaluation, and management of acute kidney injury : a KDIGO summary (part 1)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided

Protocol for development of the guideline for reporting evidence based practice educational interventions and teaching (GREET) statement

BACKGROUND: There are an increasing number of studies reporting the efficacy of educational strategies to facilitate the development of knowledge and skills underpinning evidence based practice (EBP). To date there is no standardised guideline for describing the teaching, evaluation, context or content of EBP educational strategies. The heterogeneity in the reporting of EBP educational interventions makes comparisons between studies difficult. The aim of this program of research is to develop the Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and an accompanying explanation and elaboration (E&E) paper. METHODS/DESIGN: Three stages are planned for the development process. Stage one will comprise a systematic review to identify features commonly reported in descriptions of EBP educational interventions. In stage two, corresponding authors of articles included in the systematic review and the editors of the journals in which these studies were published will be invited to participate in a Delphi process to reach consensus on items to be considered when reporting EBP educational interventions. The final stage of the project will include the development and pilot testing of the GREET statement and E&E paper. OUTCOME: The final outcome will be the creation of a Guideline for Reporting EBP Educational interventions and Teaching (GREET) statement and E&E paper. DISCUSSION: The reporting of health research including EBP educational research interventions, have been criticised for a lack of transparency and completeness. The development of the GREET statement will enable the standardised reporting of EBP educational research. This will provide a guide for researchers, reviewers and publishers for reporting EBP educational interventions

Contrast-induced acute kidney injury and renal support for acute kidney injury : a KDIGO summary (part 2)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever international multidisciplinary clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. Two topics, contrast-induced AKI and management of renal replacement therapy, deserve special attention because of the frequency in which they are encountered and the availability of evidence. Recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided. This review is an abridged version of the guideline and provides additional rationale and commentary for those recommendation statements that most directly impact the practice of critical care

Design issues for concrete reinforced with steel fibers, including fibers recovered from used tires

The writers are investigating the use of steel fibers, recovered from used tires (RSF), as concrete reinforcement, aiming at the development of design recommendations. This paper presents part of this research and examines initially an existing design guideline, developed by RILEM for steel fiber-reinforced concrete (SFRC), in order to assess the suitability of the guideline for the flexural design of concrete reinforced with RSF (RSFRC). This examination indicates that, although the RILEM guideline is in general suitable for the flexural design of RSFRC, there are some fundamental issues related to the evaluation of the tensile stress-strain behavior of SFRC that affect the accuracy of the guideline. Thus, based on this conclusion, a new approach is outlined for the evaluation of the tensile stress - strain behavior of SFRC and models are derived for different types of RSF and industrially produced fibers. These models are applied to the flexural design of concrete reinforced with RSF (RSFRC) and results are compared with those obtained by using the RILEM tensile stress-strain models. It is concluded that the model proposed in this study is more conservative and accurate than the RILEM models. Recommendations are also made on values of tensile strain to be used as the ultimate limit state, when predicting the resistance capacity of SFRC and RSFRC. © 2006 ASCE