guidance

指导
  • 文章类型: Journal Article
    我们饶有兴趣地阅读了Lo等人最近的论文。,他们认为,迫切需要确保用于支持国际和国家指南制定的建模证据的质量。在这里,我们概述了结核病建模和分析联盟的努力,与世界卫生组织全球结核病影响测量工作组一起,编写材料,以提高国家一级结核病建模的质量和透明度,为决策提供信息。
    We read with great interest the recent paper by Lo et al., who argue that there is an urgent need to ensure the quality of modelling evidence used to support international and national guideline development. Here we outline efforts by the Tuberculosis Modelling and Analysis Consortium, together with the World Health Organization Global Task Force on Tuberculosis Impact Measurement, to develop material to improve the quality and transparency of country-level tuberculosis modelling to inform decision-making.
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  • 文章类型: Journal Article
    运动障碍是具有可治疗和不可治疗原因的慢性神经综合征。运动障碍的主要原因是帕金森病和相关疾病。单光子发射计算机断层扫描(SPECT)和正电子发射断层扫描(PET)图像的功能成像研究在诊断和鉴别诊断中起着至关重要的作用,以指导疾病管理。自从有了新的先进成像技术和放射性药物发展以来,有必要制定最新的共识准则。因此,泰国核医学学会,泰国神经学会,和泰国医学物理学家协会合作制定了运动障碍核医学研究指南,用于患者护理。我们已经广泛审查了其他相关协会的现行实践指南和高质量的论文,以及我们自己在运动障碍核医学实践中的经验。我们还调整了最适合在泰国和其他发展中国家的应用。
    Movement disorders are chronic neurological syndromes with both treatable and non-treatable causes. The top causes of movement disorders are Parkinson\'s disease and related disorders. Functional imaging investigations with Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) images play vital roles in diagnosis and differential diagnosis to guide disease management. Since there have been new advanced imaging technologies and radiopharmaceuticals development, there is a need for up-to-date consensus guidelines. Thus, the Nuclear Medicine Society of Thailand, the Neurological Society of Thailand, and the Thai Medical Physicist Society collaborated to establish the guideline for Nuclear Medicine investigations in movement disorder for practical use in patient care. We have extensively reviewed the current practice guidelines from other related societies and good quality papers as well as our own experience in Nuclear Medicine practice in movement disorders. We also adjust for the most suitability for application in Thailand and other developing countries.
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  • 文章类型: Journal Article
    背景:口腔疾病是全球主要的公共卫生问题,影响受影响者的生活质量。虽然对高质量的重要性存在共识,循证指南,为医学实践和公共卫生决策提供信息,口腔健康指南的生产者通常不遵守适当的方法和标准。本研究旨在系统地确定在全球范围内制定口腔健康循证指南的组织,并调查制定建议所遵循的方法学过程。
    方法:我们搜索了许多电子数据库,指南库,和指南开发者的网站,科学社会,和国际组织(2012年1月至2023年10月),以确定制定针对任何口腔健康主题的指南并明确宣布在其制定中纳入研究证据的组织。成对的评审员根据预定义的选择标准和提取的有关组织特征的数据,独立评估潜在合格的组织,他们指南的关键特征,以及在制定正式建议时遵循的过程。描述性统计用于分析和总结数据。
    结果:我们纳入了46个制定口腔健康循证指南的组织。这些组织主要是专业协会和科学学会(67%),其次是政府组织(28%)。总的来说,组织制作了55种不同的指导方针文件类型,其中大多数包含临床实践建议(77%)。小组主要由医疗保健专业人员(87%)组成,其次是研究方法学家(40%),决策者(24%),和患者伴侣(18%)。大多数(60%)的指南报告了他们的资金来源,但只有三分之一(33%)包括利益冲突(COI)政策管理。55种准则文件中使用的方法因组织而异,但只有19个(35%)包含正式建议。一半(51%)的准则文件提到了方法论手册,46%的人建议采用结构化的方法或系统来评估证据的确定性和建议的强度,37%的人提到使用框架从证据转向决策,GRADE-EtD是使用最广泛的(27%)。
    结论:我们的发现强调了口腔健康指南中使用的术语和方法与当前国际标准的一致性和标准化的必要性,以制定值得信赖的建议。
    BACKGROUND: Oral diseases are a major global public health problem, impacting the quality of life of those affected. While consensus exists on the importance of high-quality, evidence-informed guidelines to inform practice and public health decisions in medicine, appropriate methodologies and standards are not commonly adhered to among producers of oral health guidelines. This study aimed to systematically identify organizations that develop evidence-informed guidelines in oral health globally and survey the methodological process followed to formulate recommendations.
    METHODS: We searched numerous electronic databases, guideline repositories, and websites of guideline developers, scientific societies, and international organizations (January 2012-October 2023) to identify organizations that develop guidelines addressing any oral health topic and that explicitly declare the inclusion of research evidence in their development. Pairs of reviewers independently evaluated potentially eligible organizations according to predefined selection criteria and extracted data about the organization\'s characteristics, key features of their guidelines, and the process followed when formulating formal recommendations. Descriptive statistics were used to analyze and summarize data.
    RESULTS: We included 46 organizations that developed evidence-informed guidelines in oral health. The organizations were mainly professional associations and scientific societies (67%), followed by governmental organizations (28%). In total, organizations produced 55 different guideline document types, most of them containing recommendations for clinical practice (77%). Panels were primarily composed of healthcare professionals (87%), followed by research methodologists (40%), policymakers (24%), and patient partners (18%). Most (60%) of the guidelines reported their funding source, but only one out of three (33%) included a conflict of interest (COI) policy management. The methodology used in the 55 guideline document types varied across the organizations, but only 19 (35%) contained formal recommendations. Half (51%) of the guideline documents referred to a methodology handbook, 46% suggested a structured approach or system for rating the certainty of the evidence and the strength of recommendations, and 37% mentioned using a framework to move from evidence to decisions, with the GRADE-EtD being the most widely used (27%).
    CONCLUSIONS: Our findings underscore the need for alignment and standardization of both terminology and methodologies used in oral health guidelines with current international standards to formulate trustworthy recommendations.
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  • 文章类型: Journal Article
    背景:患者参与研究的一个组成部分,也被称为耐心和公众参与,通过补偿适当地承认患者伴侣的贡献(例如,共同作者,酬金)。尽管已知补偿患者伴侣的好处,我们之前的工作表明,补偿很少报道,研究人员认为在这个问题上缺乏指导。为了解决这个差距,我们确定并总结了患者合作伙伴补偿的可用指南和政策文件.
    方法:我们按照JBI建议的方法进行了范围审查。我们搜索了灰色文献(谷歌,GoogleScholar)于2022年3月,Overton(国际政策文件数据库)于2022年4月。我们包括文章,关于患者合作伙伴对其研究贡献的补偿的指导或政策文件。两名审阅者独立提取和综合了文档特征和建议。
    结果:我们确定了65个指南或政策文件。大多数文件在加拿大出版(57%,n=37)或英国(26%,n=17)。最常见的推荐非经济补偿方法是为患者伴侣提供培训机会(40%,n=26),并促进患者伴侣出席会议(38%,n=25)。大多数指导文件(95%)建议进行财务补偿(即为他们的研究贡献提供具有货币价值的东西)患者合作伙伴。跨指导文件,经济补偿的建议货币价值相对一致,并且与患者伴侣所扮演的角色和/或具体参与活动相关.例如,获得患者伴侣反馈的中值货币价值(即,咨询)为19美元/小时(美元)(范围为12美元-50美元/小时)。我们确定了一些指导特定人群补偿的文件,包括青年和土著人民。
    结论:存在多种公开可用的资源来指导研究人员,患者合作伙伴和机构制定量身定制的患者合作伙伴补偿策略。我们的发现挑战了缺乏指导会阻碍患者伴侣经济补偿的看法。未来的努力应优先考虑这些补偿策略的有效实施,以确保患者合作伙伴得到适当的认可。
    患者伴侣共同作者告知了方案制定,标识的数据项,和解释的发现。
    BACKGROUND: An integral aspect of patient engagement in research, also known as patient and public involvement, is appropriately recognising patient partners for their contributions through compensation (e.g., coauthorship, honoraria). Despite known benefits to compensating patient partners, our previous work suggested compensation is rarely reported and researchers perceive a lack of guidance on this issue. To address this gap, we identified and summarised available guidance and policy documents for patient partner compensation.
    METHODS: We conducted this scoping review in accordance with methods suggested by the JBI. We searched the grey literature (Google, Google Scholar) in March 2022 and Overton (an international database of policy documents) in April 2022. We included articles, guidance or policy documents regarding the compensation of patient partners for their research contributions. Two reviewers independently extracted and synthesised document characteristics and recommendations.
    RESULTS: We identified 65 guidance or policy documents. Most documents were published in Canada (57%, n = 37) or the United Kingdom (26%, n = 17). The most common recommended methods of nonfinancial compensation were offering training opportunities to patient partners (40%, n = 26) and facilitating patient partner attendance at conferences (38%, n = 25). The majority of guidance documents (95%) suggested financially compensating (i.e., offering something of monetary value) patient partners for their research contributions. Across guidance documents, the recommended monetary value of financial compensation was relatively consistent and associated with the role played by patient partners and/or specific engagement activities. For instance, the median monetary value for obtaining patient partner feedback (i.e., consultation) was $19/h (USD) (range of $12-$50/h). We identified several documents that guide the compensation of specific populations, including youth and Indigenous peoples.
    CONCLUSIONS: Multiple publicly available resources exist to guide researchers, patient partners and institutions in developing tailored patient partner compensation strategies. Our findings challenge the perception that a lack of guidance hinders patient partner financial compensation. Future efforts should prioritise the effective implementation of these compensation strategies to ensure that patient partners are appropriately recognised.
    UNASSIGNED: The patient partner coauthor informed protocol development, identified data items, and interpreted findings.
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  • 文章类型: Journal Article
    背景:对于新合格的专业护士来说,过渡到专业角色是很困难的。鉴于这些护士在向实践过渡期间所经历的挑战,支持对他们变得高效至关重要,安全,自信,胜任他们的职业角色。
    目的:本研究的目的是探索新合格的专业护士的过渡经验,以建立接诊模式。
    方法:本研究采用定性方法有目的地收集数据。采用Walker和Avant建议的步骤进行了概念分析,并利用Dickoff的调查清单对相关概念进行了分类,詹姆斯和维登巴赫的实践理论。
    结果:开发了一种在临床领域为新合格的专业护士提供指导和支持的指导模式。该模型由六个组件组成,即,临床环境,运营经理和导师,新合格的专业护士,导师,对学习的评估,和结果。
    结论:研究表明,新合格的专业护士在进入临床实践时面临许多过渡挑战。他们被扔得很远,体验现实冲击,还没有准备好开始扮演他们的职业角色。与会者一致认为,他们的独立实践角色需要指导和支持。贡献:在医院的过渡期内,新合格的专业护士的导师模式是必要的。护理教育机构可以将此preceptorship模型作为其课程的一部分来实施,以使资格预审的学生为职业角色做好准备。
    BACKGROUND:  Transitioning to a professional role is difficult for newly qualified professional nurses. Given the challenges that these nurses experience during the transition to practice, support is essential for them to become efficient, safe, confident, and competent in their professional roles.
    OBJECTIVE:  The purpose of this study was to explore the transition experiences of newly qualified professional nurses to develop a preceptorship model.
    METHODS:  This study employed a qualitative approach to purposively collect data. Concept analyses were conducted applying the steps suggested by Walker and Avant, and the related concepts were classified utilising the survey list of Dickoff, James and Wiedenbach\'s practice theory.
    RESULTS:  A preceptorship model for the facilitation of guidance and support in the clinical area for newly qualified professional nurses was developed. The model consists of six components, namely, the clinical environment, the operational manager and preceptor, the newly qualified professional nurse, the preceptorship, the assessment of learning, and the outcome.
    CONCLUSIONS:  The study revealed that newly qualified professional nurses face many transition challenges when entering clinical practice. They are thrown far in, experience a reality shock, and are not ready to start performing their professional role. The participants agreed that guidance and support are needed for their independent practice role.Contribution: The preceptorship model for newly qualified professional nurses would be necessary for the transition period within hospitals. This preceptorship model may be implemented by nursing education institutions as part of their curriculum to prepare pre-qualifying students for the professional role.
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  • 文章类型: Journal Article
    2024年1月18日,美国(US)疾病控制和预防中心(CDC)发布了最新的COVID-19非处方药指南。疾病预防控制中心表示,“大多数COVID-19患者患有轻度疾病,可以在家康复。你可以用非处方药治疗症状,例如对乙酰氨基酚(泰诺)或布洛芬(Motrin,Advil),帮助你感觉更好。“在这篇评论中,我们考虑了不同类型证据的贡献,并得出结论,医疗保健提供者在选择治疗COVID-19症状的非处方药时,应该为他或她的每个患者做出单独的临床判断。此判断应基于患者的整体获益与风险特征。我们相信,个人医疗保健提供者比任何人都更了解他或她的每个患者,包括指导委员会的专家成员。基于所有这些考虑,他们为每位患者做出的精明而明智的个人临床决策可能会带来远胜于伤害的好处。
    On January 18, 2024, the US Centers for Disease Control and Prevention issued their most recent guidelines for over-the-counter drugs for coronavirus disease 2019 (COVID-19). Specifically, the organization stated that \"Most people with COVID-19 have mild illness and can recover at home. You can treat symptoms with over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), to help you feel better.\" In this review we consider the contributions of different types of evidence and conclude that healthcare providers should make individual clinical judgments for each of their patients in the selection of over-the-counter drugs to treat symptoms of COVID-19. This judgment should be based on the entire benefit to risk profile of the patient. It is our belief that the individual healthcare provider knows far more about each of his or her patients than anyone, including expert members of guideline committees. Their astute and judicious individual clinical decision-making for each individual patient based on all these considerations has the potential to do far more good than harm.
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  • 文章类型: Journal Article
    本文已迁移。这篇文章被标记为推荐。医学院有责任培训明天的医生,在危机中面临着迅速安全地将学生送入劳动力队伍的挑战。全球,医学院面临着前所未有的病毒爆发和包括SARS在内的流行病的破坏,埃博拉病毒,H1N1和COVID-19带来了独特的挑战。目前,由于COVID-19,全球范围内的医学院和医学教育都受到了干扰。尽管与临床医学和已知的大流行风险有着密切的联系,许多医学院在没有制定大流行计划的情况下措手不及,为了应对感染和死亡的指数上升,不堪重负的卫生服务和广泛的社区传播风险。在教学中评估COVID-19的传播风险,临床和社区依恋以及继续医学教育至关重要,因为医学院系面临随后的大流行浪潮。基于亚洲医学系的现有最佳证据和国际专业知识的共识声明,澳大利亚和欧洲的发展是为了帮助指导对教职员工和学生的保护,优先考虑教学活动和进一步的教育发展。预防感染,感染控制,详细介绍了接触者追踪和医疗监测,以尽量减少传播和提高安全性。关于教学活动计划的建议可以提高医学院系应对随后的COVID-19感染波的反应能力。鼓励采取全球办法和对话。
    This article was migrated. The article was marked as recommended. Medical faculties have the responsibility to train tomorrow\'s doctors and in a crisis face the challenge of delivering students into the workforce promptly and safely. Worldwide, medical faculties have faced unprecedented disruptions from viral outbreaks and pandemics including SARS, Ebola, H1N1 and COVID-19 which bring unique challenges. Currently there is worldwide disruption to medical faculties and medical education due to COVID-19. Despite close links with clinical medicine and the known risks of pandemics, many medical faculties have been caught off guard without pandemic planning in place, to deal with an exponential rise in infections and deaths, overwhelmed health services and widespread community risk of transmission. Assessing transmission risk of COVID-19 in teaching, clinical and community attachments and continuing medical education is paramount as medical faculties face subsequent pandemics waves. Consensus statements based on best available evidence and international expertise from medical faculties in Asia, Australia and Europe were developed to help guide the protection of staff and students, priorities on teaching activities and further educational development. Infection prevention, infection control, contact tracing and medical surveillance are detailed to minimise transmission and to enhance safety. Recommendations on teaching activities planning can enhance responsiveness of medical faculties to tackle subsequent waves of COVID-19 infection. A global approach and dialogue are encouraged.
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  • 文章类型: Journal Article
    背景:自2019年11月以来,SARS-CoV-2大流行给儿童和青少年预防和管理COVID-19带来了挑战。大多数开发新的治疗干预措施或重新调整现有干预措施的研究都是在成年人身上进行的,尽管大多数儿科感染病例都是轻度的,有许多严重和致命的感染病例。了解严重疾病的危险因素和安全证据,功效,儿童COVID-19治疗的有效性对于优化治疗是必要的。
    方法:儿科传染病专家小组,儿科传染病药理学,来自21个地理上不同的北美机构的儿科重症监护医学重新召集。通过一系列电话会议和基于网络的调查以及对风险因素数据进行荟萃分析的系统评价,包含一系列风险分层建议的指导声明,治疗,COVID-19的预防是根据专家共识制定和完善的。
    结果:有可识别的临床特征可以对有严重COVID-19风险的患者进行风险分层。这些风险因素可用于指导COVID-19住院和非住院儿童和青少年的治疗,并在仍有选择的情况下指导预防性治疗。
    BACKGROUND: Since November 2019, the SARS-CoV-2 pandemic has created challenges for preventing and managing COVID-19 in children and adolescents. Most research to develop new therapeutic interventions or to repurpose existing ones has been undertaken in adults, and although most cases of infection in pediatric populations are mild, there have been many cases of critical and fatal infection. Understanding the risk factors for severe illness and the evidence for safety, efficacy, and effectiveness of therapies for COVID-19 in children is necessary to optimize therapy.
    METHODS: A panel of experts in pediatric infectious diseases, pediatric infectious diseases pharmacology, and pediatric intensive care medicine from 21 geographically diverse North American institutions was re-convened. Through a series of teleconferences and web-based surveys and a systematic review with meta-analysis of data for risk factors, a guidance statement comprising a series of recommendations for risk stratification, treatment, and prevention of COVID-19 was developed and refined based on expert consensus.
    RESULTS: There are identifiable clinical characteristics that enable risk stratification for patients at risk for severe COVID-19. These risk factors can be used to guide the treatment of hospitalized and non-hospitalized children and adolescents with COVID-19 and to guide preventative therapy where options remain available.
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  • 文章类型: Journal Article
    斑马鱼模型中的运动反射(OKR)测定是研究各种眼科和神经系统疾病的有价值的工具。尽管近年来越来越受欢迎,该试验没有明确的报告指南.遵循研究中的报告指南,提高了可重复性,减少偏见,并减轻已发表作品中的漏报和不良方法。为了更好地了解斑马鱼OKR测定的最佳报告标准,我们进行了系统的文献综述,探索动物,环境,以及应该考虑的技术因素。使用来自三个在线数据库的搜索条件,共选择109篇研究论文进行审查。确定了多个关键因素,包括幼虫特征,样本量,固定方法,OKR设置,刺激的距离,详细的刺激参数,眼睛记录,和眼动分析。文献分析的结果强调了过去的研究论文中提供的信息不足,并且缺乏系统的方法来呈现与每个实验因素相关的参数。为了规避任何未来的错误并支持强有力的透明研究,我们创建了斑马鱼视动(ZOK)反射最小报告指南。
    Optokinetic reflex (OKR) assays in zebrafish models are a valuable tool for studying a diverse range of ophthalmological and neurological conditions. Despite its increasing popularity in recent years, there are no clear reporting guidelines for the assay. Following reporting guidelines in research enhances reproducibility, reduces bias, and mitigates underreporting and poor methodologies in published works. To better understand optimal reporting standards for an OKR assay in zebrafish, we performed a systematic literature review exploring the animal, environmental, and technical factors that should be considered. Using search criteria from three online databases, a total of 109 research papers were selected for review. Multiple crucial factors were identified, including larval characteristics, sample size, fixing method, OKR set-up, distance of stimulus, detailed stimulus parameters, eye recording, and eye movement analysis. The outcome of the literature analysis highlighted the insufficient information provided in past research papers and the lack of a systematic way to present the parameters related to each of the experimental factors. To circumvent any future errors and champion robust transparent research, we have created the zebrafish optokinetic (ZOK) reflex minimal reporting guideline.
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  • 文章类型: Systematic Review
    背景:在围产期使用或正在接受药物治疗的妇女通常有复杂的需求并出现合并症。怀孕期间使用阿片类药物的女性,和他们的婴儿,经历糟糕的结果。妇女在怀孕期间使用药物是公共卫生的优先事项。这项范围审查旨在(1)绘制临床指南,英国各地针对围产期使用或正在接受药物治疗的女性的治疗方案和良好实践指导,(2)确定建议的卫生和社会护理最佳做法,以优化结果并减少这些妇女的不平等;(3)确定指导中的潜在差距。
    方法:我们遵循了JoannaBriggsInternational(JBI)关于范围审查和PRISMAScr扩展的指导。注册的协议,包含明确的搜索策略,inclusion,并遵守排除标准.审稿人双重筛选了25%,讨论分歧。使用预定义的模板提取数据,并在表中绘制。围绕商定的类别组织了最佳实践建议。
    结果:在筛选的968个文档中,111符合纳入标准。这些文件包括整个英国,国家,区域,和组织政策文件。它们与围产期使用药物或正在接受药物治疗的妇女相关的程度各不相同,他们应用的设置,和他们的目标用户。大多数是在没有患者或公众参与的情况下创建的,并且缺乏任何明确的证据基础。总的来说,文件推荐了与主要专业人员的综合护理模式,明确转诊途径和机构之间的信息共享。指导建议应将转介给专业助产士,药物,和社会关怀服务。全面评估,建议包括父亲/伴侣。最近的文件提倡采用创伤护理方法。在需要的情况下,建议在整个怀孕期间使用阿片类药物替代疗法(OST)。在产后为妇女提供支持方面发现了潜在的差距,尤其是当他们的孩子从他们的照顾。
    结论:此推荐实践综合为从业人员提供了关键信息,服务提供商和政策制定者。它还强调了指南必须以证据为基础,根据围产期使用药物或正在接受药物治疗的妇女的经验,并解决将婴儿从护理中移出的产后妇女的支持需求。
    BACKGROUND: Women who use or are in treatment for drug use during the perinatal period often have complex needs and presenting comorbidity. Women who use opioids during pregnancy, and their infants, experience poor outcomes. Drug use by women during pregnancy is a public health priority. This scoping review aimed to (1) map clinical guidelines, treatment protocols and good practice guidance across the UK for women who use or are in treatment for drug use during the perinatal period, (2) identify recommended best practice across health and social care for optimising outcomes and reducing inequalities for these women and (3) identify potential gaps within guidance.
    METHODS: We followed the Joanna Briggs International (JBI) guidance on scoping reviews and PRISMA Scr extension. A registered protocol, containing a clear search strategy, inclusion, and exclusion criteria was adhered to. Reviewers double screened 25%, discussing disagreements. Data were extracted using a predefined template and charted in tables. Recommendations for best practice were organised around agreed categories.
    RESULTS: Of 968 documents screened, 111 met the inclusion criteria. The documents included UK-wide, national, regional, and organisational policy documents. They varied in the degree they were relevant to women who use or are in treatment for drug use during the perinatal period, the settings to which they applied, and their intended users. Most were created without patient or public involvement and lacked any clear evidence base. Overall, documents recommended an integrated model of care with a lead professional, clear referral pathways and information sharing between agencies. Guidance suggested referrals should be made to specialist midwives, drug, and social care services. A holistic assessment, inclusive of fathers / partners was suggested. Recent documents advocated a trauma-informed care approach. Opioid substitution therapy (OST) was recommended throughout pregnancy where required. Potential gaps were identified around provision of support for women postnatally, especially when their baby is removed from their care.
    CONCLUSIONS: This synthesis of recommended practice provides key information for practitioners, service providers and policy makers. It also highlights the need for guidelines to be evidence-based, informed by the experiences of women who use or are in treatment for drug use during the perinatal period, and to address the support needs of postnatal women who have their babies removed from their care.
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