Objective
To describe innovative models of psychosocial care delivery that align with published Standards of Psychosocial Care of Children with Cancer and their Families, in efforts to bridge the ...divide between research and practice.
Methods
The Mattie Miracle Cancer Foundation, in partnership with the American Psychosocial Oncology Society reviewed 22 letters of intent and 13 full grants and awarded small grants to researchers with high quality projects that aimed to implement any of the published 15 Standards of Care. For three of the highest rated funded research projects, we describe the Standard implemented, the novel research design and implementation strategies, and how the research findings might inform the development, implementation, and dissemination of effective solutions for bridging Standard‐to‐practice gaps.
Results
The first study presented is an innovative eHealth intervention for parents of children with cancer designed to improve family functioning and decrease symptoms of acute distress, anxiety, and posttraumatic stress. The second study addresses the acceptability and feasibility of using daily text message assessments of oral chemotherapy adherence in adolescents and young adults with leukemia, and the third creates a blueprint for providing psychosocial services to siblings, including ways to overcome common implementation barriers.
Conclusions
Several themes emerged from the studies presented, including (1) attention to barriers to previous attempts at implementation; (2) technology's role in delivering care; (3) the need for stakeholder involvement; and (4) consideration for multi‐pronged solutions that address heterogeneity in care settings. Next steps for integrating the Standards of Psychosocial Care into clinical practice are discussed.
Abstract Background In recent years, the European Commission has supported an increased focus on rare cancers in order to improve quality of care, disseminate best practice and set up networks to ...improve access that is essential to continued progress. At European Union (EU) conference in 2009, an agreement was reached to create a ‘European Standard of Care for Children with Cancer’. In 2013, the European Paediatric Oncology Society launched a Europe-wide survey in order to assess the implementation of the Standards. Methods Representative experts from 36 countries, including 27 EU members, were invited to complete a questionnaire describing the quality of treatment and care received by young cancer patients in their country, together with the characteristics of the health care infrastructure and paediatric haematology–oncology (PHO) teams. Findings Thirty-five European countries provided comprehensive responses. Within the responding countries, 341 PHO centres were identified. Only 18 countries consider they have full diagnostic services, all necessary drugs and supportive care. The annual incidence rate is approximately 146.1 new cancer cases/million children and adolescents. In 24 countries, paediatric haematology and oncology is officially recognised as a specific qualification. A total of 1178 specialists certified in PHO are currently working in Europe. Finally, 31 (88.6%) countries provide a multidisciplinary palliative care for terminally ill children. Interpretation This survey provides quantitative data that demonstrate the current healthcare inequalities for children and adolescents with cancer in Europe. This variability in care provision and quality is likely to underlie the variation in childhood cancer survival rate in these countries.
Hydrogen can be produced from many different renewable and non-renewable feedstocks and technological pathways, with widely varying greenhouse gas emissions. For hydrogen to have a role in future ...low-carbon energy systems, it is necessary to demonstrate that it has sufficiently low carbon emissions. This paper explores how green hydrogen has been defined, reviews nascent green hydrogen characterisation initiatives, and highlights the main challenges that standards and guarantee of origin schemes must overcome to develop a market for green hydrogen.
Most existing green hydrogen initiatives are in Europe. In anticipation of a future market for green hydrogen, international standards are starting to be discussed by national and international standardisation organisations and policy makers. A range of approaches have been taken to defining green hydrogen and guarantees of origin. These vary on whether green hydrogen must be produced from renewable energy, on the boundaries of the carbon accounting system, the emission thresholds at which hydrogen is considered green, and on which feedstocks and production technologies are included in the scheme. Decisions on these factors are often influenced by other national and international standards, and the legal framework in which the green hydrogen supply chain operates.
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•There is not a universally accepted definition for green hydrogen.•Several green characterisation initiatives are under development.•Guarantees of origin demonstrate to consumers that they are using green hydrogen.•Harmonisation of guarantees of origin would facilitate international trade.•Policies must be aligned with those of other energy carriers to avoid discrimination.
Verbal communication during coronary artery bypass graft (CABG) procedures is essential for safe and efficient cardiac surgery, yet sensitive to failure due to a current lack of standardization. The ...goal of this study was to improve communication during CABG by identifying critical items in verbal interaction between surgeons, anesthetists, and perfusionists. Based on 6 video recordings, a list was assembled containing items of communication in CABG procedures. Personal interviews and a consecutive focus group meeting with surgeons, anesthetists, and perfusionists revealed which of these items were considered critical. Afterward, the recordings were systematically analyzed on the communication of these critical items. Practitioners considered 64 items to be critical to verbally communicate for safe CABG surgery. On average, these critical items were verbalized in 4.4 out of 6 recorded CABGs. Observations also show that the surgical subteam is the most verbally active subteam and the initiator of the majority of all exchanges. The exchange type involved was mainly “direction” and “status.” The majority of communication during critical events is between 2 subteams and occurs in the form of call-back loops. Over half of the call-backs are substantive and communication is rarely directed at a specific team member by name. In this study, a list was developed containing 64 items that practitioners unanimously considered critical to verbalize during a CABG procedure. It forms the foundation of a quality standard for verbal communication during cardiopulmonary bypass (CPB) and can increase safety and efficiency of cardiac surgery.
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, ...remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). In the United States, the rate of postpartum hemorrhage increased 26% between 1994 and 2006 primarily because of increased rates of atony (3). In contrast, maternal mortality from postpartum obstetric hemorrhage has decreased since the late 1980s and accounted for slightly more than 10% of maternal mortalities (approximately 1.7 deaths per 100,000 live births) in 2009 (2, 4). This observed decrease in mortality is associated with increasing rates of transfusion and peripartum hysterectomy (2-4).The purpose of this Practice Bulletin is to discuss the risk factors for postpartum hemorrhage as well as its evaluation, prevention, and management. In addition, this document will encourage obstetrician-gynecologists and other obstetric care providers to play key roles in implementing standardized bundles of care (eg, policies, guidelines, and algorithms) for the management of postpartum hemorrhage.
The Green Building concept is very popular worldwide. The adverse impact of construction on the environment significantly promotes the development of the green building concept worldwide. Green ...buildings are generally termed as environmentally friendly buildings. Therefore, over the past several decades, there have been many green building rating tools developed by institutions to evaluate these buildings. However, a majority of the green buildings certified with these rating tools are assessed primarily on their design and construction. The life-cycle of a green building extends beyond these initial phases, with its full benefits becoming more apparent during the operational stages of the building. However, there is a clear lack of green building projects obtaining green certificates that evaluate the operational stages of the building. Therefore, this research aims to identify the barriers preventing the certification of green buildings in their operational stages. Initially, commonly used international green building rating tools were identified and analysed on the evaluation criteria. Following this analysis, Chinese standards on green building evaluation were also discussed in detail. Furthermore, a case study building with three-star certification for the operational stage was incorporated into the analysis. This case study building was analysed with the Chinese standards, namely Chinese evaluation standard green building (ESGB) 2014, along with other international standards such as the Leadership in Environmental and Energy Design Leadership (LEED), the Building Research Establishment's Environmental Assessment Method (BREEAM), and Green Star. Structured interviews were also carried out to identify the barriers, while measures to overcome these barriers were also discussed. The inconsistency of government regulations, the inability of the market to protect developers' interests, and the inability to meet technical requirements were identified as the three main barriers.
•Majority of green buildings are certified during the design stage.•Green building certification within the operational stage is to a significant minimum.•Identifying barriers to certify green buildings in operational stage is essential.•Inability of the market to protect developers' interests is one of the main barriers.
The EU has established a new architecture of international labour standards governance within the Trade and Sustainable Development (TSD) chapters of its Free Trade Agreements (FTAs). To examine the ...operationalization of this framework, we draw upon 121 interviews undertaken with key informants in three FTAs signed with the Caribbean, South Korea and Moldova. We engage with wider debates over external governance and the projection of EU power by showing how operational failings, including a lack of legal and political prioritization of TSD chapters and shortcomings in the implementation of key provisions, have hindered the impact of the FTAs upon labour standards. We also identify significant limitations to the EU's ‘common formulation’ approach when applied to different trading partner contexts, alongside ambiguities about the underlying purpose of the trade–labour linkage. Reflection about the function and purpose of labour standards provisions in EU trade policy is therefore required.
•An effective and economic approach to quantify endogenous metabolites.•PCI-IS method combined with MNFs was used to quantify endogenous metabolites.•We used this method to quantify androstenedione ...and testosterone in human plasma.
Quantification of endogenous metabolites has enabled the discovery of biomarkers for diagnosis and provided for an understanding of disease etiology. The standard addition and stable isotope labeled-internal standard (SIL-IS) methods are currently the most widely used approaches to quantifying endogenous metabolites, but both have some limitations for clinical measurement. In this study, we developed a new approach for endogenous metabolite quantification by the postcolumn infused-internal standard (PCI-IS) method combined with the matrix normalization factor (MNF) method. MNF was used to correct the difference in MEs between standard solution and biofluids, and PCI-IS additionally tailored the correction of the MEs for individual samples. Androstenedione and testosterone were selected as test articles to verify this new approach to quantifying metabolites in plasma. The repeatability (n=4 runs) and intermediate precision (n=3 days) in terms of the peak area of androstenedione and testosterone at all tested concentrations were all less than 11% relative standard deviation (RSD). The accuracy test revealed that the recoveries were between 95.72% and 113.46%. The concentrations of androstenedione and testosterone in fifty plasma samples obtained from healthy volunteers were quantified by the PCI-IS combined with the MNF method, and the quantification results were compared with the results of the SIL-IS method. The Pearson correlation test showed that the correlation coefficient was 0.98 for both androstenedione and testosterone. We demonstrated that the PCI-IS combined with the MNF method is an effective and accurate method for quantifying endogenous metabolites.
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