The prescribing of prisms in clinical practice

The use of prisms in cases of decompensated heterophoria is an established treatment modality. The clinical literature lacks consensus upon the appropriate use of prisms, and fails to provide the necessary evidence base. While the experimental literature can guide the practitioner, the lack of double-blind, placebo-controlled clinical studies needs to be addressed

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Administrative applications

Nurse managers play a critical role in ensuring an appropriate number and mix of staff are available to ensure safe patient care is provided. When leadership decisions are effective, we see improved patient care outcomes, better staff performance, increased job satisfaction and staff retention. However, when decision making is less effective both patients and staff can be negatively impacted. The impact is particularly noticeable for patients who may experience increased adverse events, including greater risk of dying. Making evidence-based staffing decisions can be challenging for nurse managers given the complexity of today’s workplace and importantly, a lack of access to real-time data. Many factors impact on their decisions including nursing shortages; challenges to skills mix (human capital such as experience and qualifications); staff stress, burnout and fatigue; changes to the complexity of patient care needs; an aging workforce and communication inefficiencies. There are many workload measurement tools used internationally, but most are not based on real-time data showing patient acuity, bed occupancy rates and the quality and availability of staffing resources, all factors which are necessary to make cost-effective staffing decisions. Instead, nurse managers are left with many static and disparate reporting systems that do not meet managerial requirements for decision-making. This can result in increased workloads and stress for nurse managers, which also ultimately impact clinical staff. Hospitals need to develop and use software systems which will harness existing data, allowing nurse managers to extract, analyze and interpret data in a timely manner to support appropriate and safe nurse staffing decisions

Genomics and the origin of species

Speciation is a fundamental evolutionary process, the knowledge of which is crucial for understanding the origins of biodiversity. Genomic approaches are an increasingly important aspect of this research field. We review current understanding of genome-wide effects of accumulating reproductive isolation and of genomic properties that influence the process of speciation. Building on this work, we identify emergent trends and gaps in our understanding, propose new approaches to more fully integrate genomics into speciation research, translate speciation theory into hypotheses that are testable using genomic tools and provide an integrative definition of the field of speciation genomics