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"Evidence Based Practice"

Stephanie E Reuter, Allan M Evans, Michael B Ward
Palivizumab for RSV immunoprophylaxis in premature infants poses a significant economic challenge. While standard dosing of palivizumab results in unnecessary drug accumulation without additional clinical benefit, some clinicians have moved outside of evidence-based practice by implementing untested dose modifications, potentially jeopardising efficacy. Using an industry-developed population pharmacokinetic model, this study evaluated the previously published alternate dosing regimens and developed a revised regimen that minimises palivizumab dose requirements whilst maintaining established therapeutic concentrations...
November 14, 2018: CPT: Pharmacometrics & Systems Pharmacology
Connie Kasari, Alexandra Sturm, Wendy Shih
Purpose: This review article introduces research methods for personalization of intervention. Our goals are to review evidence-based practices for improving social communication impairment in children with autism spectrum disorder generally and then how these practices can be systematized in ways that personalize intervention, especially for children who respond slowly to an initial evidence-based practice. Method: The narrative reflects on the current status of modular and targeted interventions on social communication outcomes in the field of autism research...
November 8, 2018: Journal of Speech, Language, and Hearing Research: JSLHR
Ruth Tulleners, David Brain, Xing Lee, Qinglu Cheng, Nicholas Graves, Rosana E Pacella
Wound management in Australia suffers from a lack of adequate coordination and communication between sectors that impacts patient outcomes and costs. Wound Innovations is a specialist service comprising of a transdisciplinary team that aims to streamline and improve patient care and outcomes. We compared patient experiences and outcomes prior to accessing this specialist service, and the 3 months following their enrolment at the clinic. Information on patient experiences, wound history, and outcomes was collected through interviews and a review of medical records for the 12 months prior to enrolment at the clinic...
November 11, 2018: International Wound Journal
Kurubaran Ganasegeran, Surajudeen Abiola Abdulrahman, Sami Abdo Radman Al-Dubai, Sin Wan Tham, Muralitharan Perumal
Evidence-based practices that rely upon pain relieving medications and interventional strategies for symptom alleviation in chronic pain survivors have shown modest benefits. The recent emphasis of spiritual care as a new dimension of treatment strategy incorporated within the biopsychosocial model has inspired new hopes to mediate mental and physical health for illness coping. This study aimed to explore the factors associated with spirituality needs among chronic pain patients in a general hospital in Malaysia...
November 8, 2018: Journal of Religion and Health
Douglas Wan, Jeff S Healey, Chris S Simpson
Atrial fibrillation has a high disease burden-both in prevalence and associated consequences. Despite anticoagulation being an effective treatment in atrial fibrillation, stroke prevention is slow to reflect evidence-based practice. Real-world data reveal a substantial portion of patients who would benefit from anticoagulation, yet do not receive it adequately or at all. A large part of this suboptimal treatment is due to the underutilization of direct oral anticoagulants (DOACs). In response to abundant evidence published over a short timeframe, international guidelines have adopted DOAC usage ahead of policy and fund holders...
November 2018: Canadian Journal of Cardiology
Sarah B Green, Adelais Markaki
OBJECTIVE: Clinician education and expertise in palliative care varies widely across pediatric oncology programs. The purpose of this evidence-based practice review was to identify interprofessional palliative care education models applicable to pediatric oncology settings as well as methods for evaluating their impact on clinical practice. RESULTS: Based on a literature search in PubMed, CINAHL and Embase, which identified 13 articles meeting inclusion/exclusion criteria, the following three themes emerged: (1) establishment of effective modalities and teaching strategies, (2) development of an interprofessional palliative care curriculum, and (3) program evaluation to assess impact on providers' self-perceived comfort in delivering palliative care and patient/family perceptions of care received...
November 7, 2018: BMC Research Notes
Ryan J Fink, Andrew Young, N David Yanez, Marissa Hom, Jennifer Mai, Matthias Merkel
PURPOSE: A new postcardiac surgery fluid resuscitation strategy was implemented in our Cardiovascular Intensive Care Unit (CVICU) to implement evidence-based practice. We transitioned from a primarily albumin fluid-based strategy to a lactated Ringer's fluid-based strategy. We sought to determine whether a new postoperative fluid resuscitation strategy significantly altered the fluid composition for postcardiac surgery patients and what effect that would have on fluid resuscitation costs...
November 7, 2018: Pharmacotherapy
Ahmad Mahdi Ahmad
Physiotherapy has recently become an essential part of enhanced recovery protocols after thoracic surgery. The evidence-based practice of physiotherapy is essential for the effective management of postoperative patients. Unfortunately, only a small body of literature has discussed the rationale of the physiotherapy interventions that are routinely implemented following thoracic surgery. Nonetheless, we can integrate the available knowledge into our practice until new evidence emerges. Therefore, in this review, the principles of physiotherapy after thoracic surgery are presented, along with a detailed description of physiotherapy interventions, with the goals of enhancing the knowledge and practical skills of physiotherapists in postoperative care units and helping them to re-evaluate and justify their traditional practices...
October 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Scott McLachlan, Henry W W Potts, Kudakwashe Dube, Derek Buchanan, Stephen Lean, Thomas Gallagher, Owen Johnson, Bridget Daley, William Marsh, Norman Fenton
BACKGROUND: Learning Health Systems (LHS) can focus population medicine and Evidence Based Practice; smart technology delivering the next generation of improved healthcare described as Precision Medicine, and yet researchers in the LHS domain presently lack the ability to recognise their relevant works as falling within this domain. OBJECTIVE: To review LHS literature and develop a framework describing the domain that can be used as a tool to analyse the literature and support researchers to identify health informatics investigations as falling with the domain of LHS...
June 15, 2018: Journal of Innovation in Health Informatics
Gianluca Merlo, Giuseppe Chiazzese, Manuela Sanches-Ferreira, Antonella Chifari, Luciano Seta, Colin McGee, Alberto Mirisola, Isabella Giammusso
BACKGROUND: The most recent computing technologies can promote the application of evidence-based practice (EBP) in the field of Applied Behavior Analysis (ABA). OBJECTIVE: The study describes how the use of technology can simplify the application of evidence-based practices in applied behaviour analysis. METHODS: The WHAAM application demonstrates this in the following two case studies. We are monitoring dysfunctional behaviours, collecting behavioural data, performing systematic direct observations, creating a visual baseline and intervention charts and evaluating the planned interventions using the TAU-U statistical index...
June 29, 2018: Journal of Innovation in Health Informatics
Larry Weems, Jodi Strong, Dianne Plummer, Jenny Martin, Thomas N Zweng, Jeff Lindsay, David Paculdo, Mary Tran, John Peabody
BACKGROUND: Heart failure and pneumonia are among the most measured and expensive conditions to treat in the United States across all payer types and are top of mind for value-driven hospital organizations and payers seeking to not only improve the quality of care for patients but also reduce unnecessary spending. Care standardization potentially leads to better patient outcomes and reduced excess costs but is a difficult objective to achieve. METHODS: A pre-post analysis of clinical practice, patient outcomes, and cost was designed to determine if serial measurement and feedback using simulated patients improves patient care quality and reduces costs for two common conditions cared for by hospitalists: pneumonia and heart failure...
October 31, 2018: Joint Commission Journal on Quality and Patient Safety
Anthony J Goff, William S Page, Nicholas C Clark
OBJECTIVE: Strength training acute programme variables (APVs) can impact tibiofemoral joint injury outcomes. Exercise descriptors (EDs; e.g. patient-position) specify configurations within which APVs are applied. Evidence-based practice depends on adequate reporting of APVs and EDs to replicate strength training interventions in clinical practice. This systematic review assessed APV and ED reporting for adults with tibiofemoral joint injury (anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL)/medial collateral ligament (MCL)/lateral collateral ligament (LCL)/meniscus/hyaline cartilage (HC))...
October 24, 2018: Physical Therapy in Sport
Leah Burt, Susan Corbridge
Problem/Background: The ability to accurately diagnose patients based on symptom profiles is a vital yet challenging skill that Nurse Practitioners (NPs) undertake frequently. PURPOSE: This integrative literature review highlights a variety of evidence based, practical educational strategies that foster the development of diagnostic reasoning. METHODS: An integrative literature review was conducted in order to identify original research focusing on diagnostic reasoning educational interventions...
November 2, 2018: International Journal of Nursing Education Scholarship
Jenna M Godfrey, Kevin J Little, Roger Cornwall, Thomas J Sitzman
BACKGROUND: Distal radius fractures are the most common fracture of childhood, occurring in ∼1 per 100 children annually. Given the high incidence of these fractures, we explored feasibility of a bundled payment model. We determined the total treatment costs for each child and identified components of fracture management that contributed to variations in cost. METHODS: We retrospectively reviewed all hospital and physician costs related to the treatment of closed distal radius fractures at a large academic children's hospital...
October 29, 2018: Journal of Pediatric Orthopedics
Rachel McDowell, Alice McKendry, Gabrielle Smyth, Pauline Cardwell
Osteogenesis imperfecta (OI) is a rare genetic condition that causes bones to become brittle and fracture. This article draws on the reflective experiences of two second-year children's nursing students on placement. It includes a case study that explores the assessment and care of a child with OI. Due to the lack of available evidence and understanding of nursing care for children with OI, the article also includes a personal reflection on clinical practice. There has been extensive development in evidence-based practice in nursing, which includes reflective practice...
October 30, 2018: Nursing Children and Young People
Lauren L Bennett, Amy N Cohen, Alexander S Young
Evidence-based practices effectively reduce weight in people with serious mental illness (SMI), yet participation is limited. Positive relationships between self-efficacy (SE), readiness to change (RtC), and subsequent participation in weight loss interventions have been demonstrated in the general population. The role of SE and RtC in predicting participation in individuals with SMI is explored. A total of 82 participants recruited from a county mental health clinic and a Veterans Affairs mental health clinic were randomly assigned to a weight management intervention or usual care...
November 2018: Journal of Nervous and Mental Disease
Kirsten Ribu
The numbers of college and university students with autism spectrum disorders (ASD) are steadily rising, but research on their academic performance reports mixed results. The diversity of the population makes it necessary to target each student individually. This paper describes an ongoing study and experience with pedagogical intervention for ten undergraduate IT students at Oslo Metropolitan University (OsloMet) over several years. The intervention design is based on knowledge of research in the field and evidence-based practices, as well as professional skills...
2018: Studies in Health Technology and Informatics
Jenna Rogers, Christine A Sorkness, Kimberly Spencer, Christine Pfund
As part of their mission, Clinical and Translational Science Award (CTSA) hubs are charged with developing, testing, and disseminating evidence-based practices to other CTSA hubs. Over the past 7 years, the University of Wisconsin-Madison has answered this charge by implementing the facilitator training (FT) initiative for research mentors. Three elements to advance training across the CTSA hubs have been critical: (1) using an FT model to empower others to build research mentor training at their local institutions; (2) tracking implementation of training events across the CTSA hubs over time; and (3) partnering with implementation sites to build local capacity and evaluate the effectiveness and quality of training...
June 2018: Journal of Clinical and Translational Science
Ruby White Starr
This article highlights the ways in which power is conceptualized, activated, and institutionalized in American culture. Drawing from research and the author's experience within mainstream and culturally-specific organizations in the violence against women field, this article exposes the subtle, yet pervasive mechanisms that lead to the marginalization of culturally specific communities and smaller, typically culturally specific, community-based organizations. By design and unconsciously, researchers, mainstream organization, and leaders often perpetuate a system designed to localize research, evaluation, services and resources for white people, organizations and institutions...
2018: Journal of Family Violence
Margaret W Dyson, Colby Chlebowski, Lauren Brookman-Frazee
Publicly funded mental health services play an important role in serving children with autism spectrum disorder (ASD). Previous research indicates a high likelihood of adaptations when therapists deliver evidence based practices to non-ASD populations, though less is known about therapists' use of adaptations for children with ASD receiving mental health services. The current study uses a mixed quantitative and qualitative approach to characterize the types and reasons therapists adapted a clinical intervention [An Individualized Mental Health Intervention for Children with ASD (AIM HI)] for delivery with clinically complex children with ASD served in publicly funded mental health settings and identify therapist characteristics that predict use of adaptations...
October 27, 2018: Journal of Autism and Developmental Disorders
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