Influence of Classroom-Level Factors on Implementation Fidelity During Scale-up of Evidence-Based Interventions

Prevention Science - As evidence-based interventions (EBIs) become more widely disseminated, fidelity of implementation (FOI) often wanes. This study explores the association between FOI and...     

Evaluating the impact of a targeted brief HIV intervention on multiple inter-related HIV risk factors of knowledge and attitudes among incarcerated drug users

Increases in HIV prevalence indicate ongoing need for HIV interventions. A brief manualized intervention called the Texas Christian University (TCU) WaySafe, which addresses multiple HIV risks, was further evaluated to determine how it addressed individual’s knowledge deficiencies in the assessed risks. The sample of 1,256 offenders in eight correctional substance abuse treatment programs participated either in treatment as usual (TAU) or TCU WaySafe. From multivariate multilevel analysis, WaySafe was more effective in improving the greatest need area, whether knowledge, motivation, or confidence regarding HIV risky behaviors. Findings underscored the importance of addressing HIV risk areas with the greatest need for change and strengthens previous findings of the intervention’s potential for individuals with varying HIV risks.     

Management of acute food protein-induced enterocolitis syndrome emergencies at home and in a medical facility

ObjectiveAcute food protein-induced enterocolitis syndrome (FPIES) is characterized by delayed repetitive vomiting after ingestion of a trigger food, and severe reactions may lead to dehydration, hypotension, and shock. We provide recommendations on management of FPIES emergencies in a medical facility and at home.Data SourcesThis review summarizes the literature on clinical context, pathophysiology, presentation, and treatment of FPIES emergencies.Study SelectionsWe referred to the 2017 International Consensus Guidelines for the Diagnosis and Management of FPIES and performed a literature search identifying relevant recent primary articles and review articles on clinical management.ResultsManagement of FPIES emergencies in a medical facility is based on severity of symptoms and involves rehydration, ondansetron, and corticosteroids. A proactive approach for reactions occurring at home involves prescribing oral ondansetron and providing an individualized treatment plan based on the evolution of symptoms and severity of past reactions. A better understanding of the pathophysiology of FPIES and randomized trials on ondansedron and cocorticosteroid use could lead to more targeted treatments.ConclusionChildren with FPIES are at risk for severe symptoms constituting a medical emergency. Management of FPIES emergencies is largely supportive, with treatment tailored to the symptoms, severity of the patient’s condition, location of reaction, and reaction history.