The experience of children and families with lymphoedema – a journey within a journey

This paper reports on a study in the UK that explored the experience of children suffering with Lymphoedema and that of their families. Qualitative data was collected from 20 children between the ages of 6 and 18 and their respective parents. Single, semi‐structured interviews were used in which children and their parents were asked to share how lymphoedema impacted on their family life. Children were asked about their school experience, their dreams and their aspirations. Three categories emerged. Firstly, the negotiation of the health care system. Themes included correct diagnosis, finding robust information and reaching a knowledgeable expert. The second category explored the complex role of the parents as advocates. Themes within this category included the dilemmas of parenting and the increasing challenges as children reached adolescence. The final category involved the impact on the family unit. The first theme concerned the integration of lymphoedema into daily activities and the intrusion on family time. The second explored the impact on siblings and the final theme the changing dilemmas as children moved through the stages of childhood and faced adulthood.     

Towards a Consensus View on Understanding Nanomaterials Hazards and Managing Exposure: Knowledge Gaps and Recommendations

The aim of this article is to present an overview of salient issues of exposure, characterisation and hazard assessment of nanomaterials as they emerged from the consensus-building of experts undertaken within the four year European Commission coordination project NanoImpactNet. The approach adopted is to consolidate and condense the findings and problem-identification in such a way as to identify knowledge-gaps and generate a set of interim recommendations of use to industry, regulators, research bodies and funders. The categories of recommendation arising from the consensual view address: significant gaps in vital factual knowledge of exposure, characterisation and hazards; the development, dissemination and standardisation of appropriate laboratory protocols; address a wide range of technical issues in establishing an adequate risk assessment platform; the more efficient and coordinated gathering of basic data; greater inter-organisational cooperation; regulatory harmonization; the wider use of the life-cycle approaches; and the wider involvement of all stakeholders in the discussion and solution-finding efforts for nanosafety.     

Delayed diagnosis of self-inflicted cuts – A case report

Assessment of individuals with injuries that may have been caused by intentional self-harm is part of routine work of forensic physicians.We present a case of deliberate self-harm of a 19 years old woman who claimed she had been cut by her partner during a quarrel while her partner claimed that she had injured herself. No forensic examination was performed. The case was first reviewed several months after the incident by experts giving consultations for the defense (the authors) by that time the only documentation of injury available were scant medical records and photos of very low quality.This case shows the importance of recognizing self-inflicted injuries even when only scant documentation is available, by comparing the injuries described to the different accounts of the incident as described by the complainant and defendant.Also the importance of availability of access of defense lawyers to forensic medical consultations is stressed.     

《美国提供急诊服务医院解毒剂存储专家建议》介绍

解毒剂是治疗和挽救中毒患者的关键措施，但包括美国和加拿大等诸多国家的报道一再证明临床普遍存在解毒剂存储品种及数量不足的情况。2009年美国发布了提供急诊服务的医院解毒剂存储专家建议。本文简介了用于指导医院合理存储解毒剂的美国专家建议和“解毒剂灾害脆弱性评估”概念，以期对中国解毒剂使用管理提供借鉴。     

The changing paradigm of an aesthetic practice during the COVID‐19 pandemic: An expert consensus

Until vaccination for the SARS‐CoV‐2 becomes a reality, it appears that the infection is here to stay. With many countries lifting lockdown restrictions, aesthetic clinics have started reopening with strict standard operating procedures in place. It is pertinent that the physician today understands the infection, disinfection measures, and personal protective equipment to reduce chances of viral transmission and provide safe clinical settings for oneself, the staff and the patients. An online meeting of eight experts in the field of aesthetic dermatology was convened, which particularly focussed on PPE in detail, risk categorization of aesthetic procedures, preprocedure recommendations, and generalized and specialized SOP's for aesthetic procedures. These recommendations were aimed to bridge the gap between published guidelines and clinical practice and are by no means fully conclusive, but signify learnings over the past few months in an active clinical aesthetic practice.     

Driving Experts Address Expanding Access Through Pathways to Older Driver Rehabilitation Services: Expert Meeting Results and Implications

As one of the first papers in this special issue, this paper describes the expert meeting that established the goals of the Gaps and Pathways Project. Through a unique Audience response system (ARS), this expert panel established over 60 consensus statements grounded in evidence of either research literature or expert clinical practice. The paper describes the process and identifies the outcomes of the panel including gaps of need for occupational therapy service and potential ideas for future research.     

《2019年APASL慢加急性肝衰竭共识建议（更新）》要点

本文对《2019年APASL慢加急性肝衰竭共识建议（更新）》中慢加急性肝衰竭的概念、定义、治疗、预后以及儿童慢加急性肝衰竭等方面推荐意见的更新要点进行归纳和分析，以期临床医生能更好地理解新版指南，指导慢加急性肝衰竭临床实践。