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Journal of Evaluation in Clinical Practice

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https://www.readbyqxmd.com/read/28620976/oral-nutritional-supplement-use-in-relation-to-length-of-stay-in-heart-failure-patients-at-a-regional-medical-center
#1
Ellen B Babb, James Rohrer
RATIONALE, AIMS, AND OBJECTIVES: Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improve nutritional status. Little information is available on ONS use and LOS among heart failure patients. METHODS: This study used a retrospective design to examine whether routine ONS use was associated with hospital LOS among 570 heart failure inpatients (89 ONS = yes; 481 ONS = no) at a regional medical center, adjusting for significant personal, locational, and time variables using multiple logistic regression analysis...
June 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28608613/remote-control-improves-quality-of-life-in-elderly-pacemaker-patients-versus-standard-ambulatory-based-follow-up
#2
Rosanna Irene Comoretto, Domenico Facchin, Marco Ghidina, Alessandro Proclemer, Dario Gregori
BACKGROUND: Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation. No studies have investigated the HRQoL trend for elderly patients with a remote device monitoring follow-up system. METHODS: Using EuroQol-5D Questionnaire and the PM-specific Assessment of Quality of Life and Related Events Questionnaire, HRQoL was measured at baseline and then repeatedly during the 6 months following PM implantation in a cohort of 42 consecutive patients...
June 13, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28585354/-real-world-pediatric-endocrine-practice-how-much-is-it-influenced-by-physician-s-gender-and-region-of-practice-results-of-an-international-survey
#3
Keren Smuel, Yonatan Yeshayahu
OBJECTIVE: To determine whether hormonal treatments for frequent clinical cases (short stature, delayed and precocious puberty) are prescribed strictly according to clinical guidelines or based on personal tendencies, and whether the decisions correlate with physician's personal demographics (age, sex, and place of practice). METHODS: Cross-sectional survey, with made-up clinical cases, distributed to pediatric endocrinologists using 2 web-based professional forums, Israeli and an international...
June 6, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28585254/use-of-clinical-guidelines-in-cardiology-practice-in-sudan
#4
Hwaida Elsadig, Marjorie Weiss, Jenny Scott, Raisa Laaksonen
RATIONALE, AIMS, AND OBJECTIVE: The aim of this study was to explore the views of prescribers in cardiology in Sudan about the use of guidelines in clinical practice and the extent to which guidelines whether national or international can be adopted in clinical practice in Sudan. METHODS: Interviews were conducted with the consultants in 2 of the main cardiac hospitals in Sudan. This was followed by a survey amongst the doctors in the hospitals to examine the views of a larger population of prescribers about the matter investigated...
June 6, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28585242/addressing-unmet-needs-of-patients-with-chronic-diseases-impact-of-the-visit-website-during-consultations
#5
Yew Kong Lee, Chirk Jenn Ng, Wah Yun Low
RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations. METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT))...
June 6, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28568649/psychosis-and-identity-alteration-or-loss
#6
Tania Gergel, Eduardo Iacoponi
The onset of psychotic disorders often brings major changes to an individual, which, for some, are never fully reversed and remain a dominant force. Despite such changes, the individual still experiences themselves as a continuous person and must find some way to assimilate these shifts into their self-concept. From a philosophical perspective, the various models of continuing identity all depend upon some notion of fundamental stability, which seems a poor fit for the trajectory associated with psychotic disorders...
June 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28556526/examining-the-role-of-the-physician-as-a-source-of-variation-are-physician-related-variations-necessarily-unwarranted
#7
Mathew Mercuri, Amiram Gafni
RATIONALE, AIMS, AND OBJECTIVES: The physician is often implicated as an important cause of observed variations in health care service use. However, it is not clear if physician-related variation is problematic for patient care. This paper illustrates that observed physician-related variation is not necessarily unwarranted. METHODS: This is a narrative review. RESULTS: Many studies have attributed observed variations to the physician, but little attention is given towards discriminating between those variations that exist for good reasons and those that are unwarranted...
May 29, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28548368/developing-minimum-clinical-standards-for-physiotherapy-in-south-african-icus-a-qualitative-study
#8
Heleen van Aswegen, Shane Patman, Natascha Plani, Susan Hanekom
RATIONALE, AIMS, AND OBJECTIVES: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients...
May 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28548313/total-knee-replacement-are-there-any-baseline-factors-that-have-influence-in-patient-reported-outcomes
#9
A Escobar, L García Pérez, C Herrera-Espiñeira, F Aizpuru, C Sarasqueta, M Gonzalez Sáenz de Tejada, J M Quintana, A Bilbao
BACKGROUND: There is conflicting evidence about what factors influence outcomes after total knee replacement (TKR). The objective is to identify baseline factors that differentiate patients who achieve both, minimal clinically important difference (MCID) and a patient acceptable symptom state (PASS) in pain and function, measured by WOMAC, after TKR from those who do not attain scores above the cutoff in either of these dimensions. METHODS: One-year prospective multicentre study...
May 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28544273/use-of-clinical-guidelines-in-remote-australia-a-realist-evaluation
#10
Sandeep Reddy, Victoria Orpin, Sally Herring, Stephanie Mackie-Schneider, Janet Struber
AIM: The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. METHOD: To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory...
May 24, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28544126/self-and-identity-in-borderline-personality-disorder-agency-and-mental-time-travel
#11
Natalie Gold, Michalis Kyratsous
We consider how conceptions of the self and identity from the philosophical literature can help us to understand identity disturbance in borderline personality disorder (BPD). We present 3 philosophical approaches: connectedness, narrative, and agency. We show how these map on to 3 different ways in which the self can be temporally extended. The connectedness approach is dominant in philosophy, and the narrative approach has been used by psychiatry, but we argue that the lesser-known agency approach provides a promising way to theorize some aspects of identity disturbance in BPD...
May 24, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28544476/usefulness-of-a-decision-tree-model-for-the-analysis-of-adverse-drug-reactions-evaluation-of-a-risk-prediction-model-of-vancomycin-associated-nephrotoxicity-constructed-using-a-data-mining-procedure
#12
Shungo Imai, Takehiro Yamada, Kumiko Kasashi, Masaki Kobayashi, Ken Iseki
OBJECTIVES: Several publications concerning decision tree (DT) analysis in medical fields have recently demonstrated its usefulness for defining prognostic factors in various diseases. However, there are minimal reports on the predictors of adverse drug reactions. We attempted to use DT analysis to discover combinations of multiple risk factors that would increase the risk of nephrotoxicity associated with vancomycin (VCM). To demonstrate the usefulness of DT analysis, we compared its predictive performance with that of multiple logistic regression analysis...
May 23, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28512920/an-audit-of-adherence-to-heart-failure-guidelines-in-an-australian-hospital-a-pharmacist-perspective
#13
Viviane Khalil, Melanie Danninger, Wei Wang, Hanan Khalil
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28512760/different-perspectives-of-validity-in-psychiatry
#14
Diogo Telles Correia
It is important to improve our understanding about what might be the specific characteristics of mental disorders to strengthen the scientific credibility of psychiatry and to clarify its position among other medical and nonmedical sciences. On the other hand, this issue has diagnostic, research, therapeutic, legal, financial, and moral implications. Some authors defend a realistic and absolutist attitude towards validity and others an instrumental and relativistic stance. Regarding the organization of concepts, dimensional or categorical approaches have both advantages and disadvantages...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28508556/impact-of-co-morbidities-on-resource-use-and-adherence-to-guidelines-among-commercially-insured-adults-with-new-visits-for-back-pain
#15
Sean D Rundell, Laura S Gold, Ryan N Hansen, Brian W Bresnahan
RATIONALE, AIMS AND OBJECTIVES: To assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. METHODS: We conducted a retrospective cohort study using administrative claims data from 2007-2011. We included individuals ≥18 years with an index visit for back pain. Co-morbidities were measured 12 months prior to index. Co-morbidity burden was measured using Quan's Co-morbidity Index. Co-morbidities categories were measured using chronic condition indicators from the Agency for Healthcare Research and Quality...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28508440/has-evidence-based-medicine-ever-been-modern-a-latour-inspired-understanding-of-a-changing-ebm
#16
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trish Greenhalgh
Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals of a changing EBHC. In this paper, we present French philosopher Bruno Latour's vision on modernity as a framework to discuss current changes in the discourse on EBHC/EBM. Drawing on Latour's work, we argue that the early EBM movement had a strong modernist agenda with an aim to "purify" clinical reality into a dichotomy of objective "evidence" from nature and subjective "preferences" from human society and culture...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28508408/variations-in-status-of-preparation-of-personal-protective-equipment-for-preventing-norovirus-gastroenteritis-in-long-term-care-facilities-for-the-elderly
#17
Saori Fujiki, Tatsuro Ishizaki, Takeo Nakayama
RATIONALE, AIM, AND OBJECTIVES: Residents of long-term care facilities are highly susceptible to norovirus gastroenteritis, and each facility is concerned about the need to implement norovirus infection control. Among control measures, personal protective equipment (PPE), such as disposable gloves and masks, plays a major role in reducing infectious spread. However, the preparation status of PPE in facilities before infection outbreaks has not been reported. The aim was to clarify the implementation status of preventive measures for norovirus gastroenteritis and the cost of preparing the necessary PPE in long-term care facilities...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28503788/indicators-of-inappropriate-tumour-marker-use-through-the-mining-of-electronic-health-records
#18
Massimo Gion, Giulia Cardinali, Chiara Trevisiol, Marco Zappa, Giulia Rainato, Aline S C Fabricio
RATIONALE, AIMS, AND OBJECTIVES: Although the issue of monitoring appropriateness of tumour markers (TMs) request in outpatients remains crucial, proper indicators are still demanding. The present study developed and explored indicators of inappropriate TM ordering in outpatients through the data mining of electronic health records (EHRs). METHODS: Carcinoembryonic antigen (CEA), alfa-fetoprotein (AFP), carbohydrate antigen (CA)125, CA15.3, CA19.9, and prostate-specific antigen (PSA) ordered in outpatients during a year were examined by mining EHRs of a Local Health Authority in Italy...
May 15, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28497485/creating-chronicity
#19
Anna Luise Kirkengen
An authentic sickness history is the vantage point for juxtaposing a biomedical and a biographical-phenomenological reading. What, in a biomedical framework, appears to be a longstanding state of comorbidity of different and unrelated types of diseases is rendered transparent in a biographical reading. This particular reading, evidencing the shortcomings of a biomedical framework regarding identifying the social sources of an increasingly complex burden of disease, is reflected upon in light of recent research in the neurosciences...
May 12, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28474487/medication-safety-and-the-usability-of-electronic-prescribing-as-perceived-by-physicians-a-semistructured-interview-among-primary-health-care-physicians-in-finland
#20
Hanna Kauppinen, Riitta Ahonen, Pekka Mäntyselkä, Johanna Timonen
RATIONALE, AIMS AND OBJECTIVES: In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland. METHOD: Data were collected by conducting 42 interviews among primary health care physicians in spring 2015...
May 4, 2017: Journal of Evaluation in Clinical Practice
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