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Clinical practice policy

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https://www.readbyqxmd.com/read/28738475/-trend-of-caesarean-section-rate-and-puerpera-characteristics-based-on-robson-classification
#1
J X Wang, H Q Sun, K Huang, X F Zheng, F B Tao
Objective: To analyze the trend in caesarean section rate and puerpera characteristics in hospital, and provide valuable information for maternal and child health policy making and clinical practice. Methods: A total of 12 041 women who delivered in the affiliated Chaohu Hospital of Anhui Medical University from October 1, 2010 to September 30, 2016 were selected. Based on Robson classification system, changes in the rate of caesarean delivery as well as its relationship with two-child policy and infant sex ratio were analyzed...
July 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28738033/how-can-i-implement-accurate-delirium-screening-and-prevention-practices
#2
Kimberly Sanchez
As a clinical nurse specialist (CNS), I am tasked with improving patient outcomes through collaborative research, evidence-based practice, and process improvement efforts that affect the quality and safety of patient care. However, I have learned over time that it is not enough to simply incorporate the latest evidence into organizational policies and procedures; it has to be followed in practice. 
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August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28736389/hiv-testing-experiences-and-their-implications-for-patient-engagement-with-hiv-care-and-treatment-on-the-eve-of-test-and-treat-findings-from-a-multicountry-qualitative-study
#3
Alison Wringe, Mosa Moshabela, Constance Nyamukapa, Dominic Bukenya, Ken Ondenge, William Ddaaki, Joyce Wamoyi, Janet Seeley, Kathryn Church, Basia Zaba, Victoria Hosegood, Oliver Bonnington, Morten Skovdal, Jenny Renju
OBJECTIVE: In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. METHODS: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28733068/effects-of-eu-harmonization-policies-on-national-public-supervision-of-clinical-trials-a-dynamic-cycle-of-institutional-change-and-institutional-work
#4
Jacqueline C F van Oijen, Kor J Grit, Hester M van de Bovenkamp, Roland A Bal
BACKGROUND: The EU Clinical Trials Directive (EUCTD) and the EU Clinical Trials Regulation aim to harmonize good clinical practice (GCP) of clinical trials across Member States. Using the Netherlands as a case study, this paper analyzes how endeavours to implement the EUCTD set in motion a dynamic process of institutional change and institutional work. This process lead to substantial differences between policy and actual practice; therefore, it is important to learn more about the implementation of harmonization policies...
June 30, 2017: Health Policy
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#5
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28730278/mobilizing-community-health-workers-to-address-mental-health-disparities-for-underserved-populations-a-systematic-review
#6
Miya L Barnett, Araceli Gonzalez, Jeanne Miranda, Denise A Chavira, Anna S Lau
This systematic review evaluates efforts to date to involve community health workers (CHWs) in delivering evidence-based mental health interventions to underserved communities in the United States and in low- and middle-income countries. Forty-three articles (39 trials) were reviewed to characterize the background characteristics of CHW, their role in intervention delivery, the types of interventions they delivered, and the implementation supports they received. The majority of trials found that CHW-delivered interventions led to symptom reduction...
July 20, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28728574/creation-of-a-core-outcome-set-for-clinical-trials-of-people-with-shoulder-pain-a-study-protocol
#7
Joel J Gagnier, Matthew J Page, Hsiaomin Huang, Arianne P Verhagen, Rachelle Buchbinder
BACKGROUND: The selection of appropriate outcomes or domains is crucial when designing clinical trials, to appreciate the effects of different interventions, pool results, and make valid comparisons between trials. If the findings are to influence policy and practice, then the chosen outcomes need to be relevant and important to key stakeholders, including patients and the public, healthcare professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28727995/physician-perceptions-about-living-organ-donation-in-patients-with-amyotrophic-lateral-sclerosis
#8
S Ansari, M B Bromberg, S B Gibson
OBJECTIVES: Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. PATIENTS AND METHODS: An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure...
July 5, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28724431/biological-embedding-of-childhood-adversity-from-physiological-mechanisms-to-clinical-implications
#9
REVIEW
Anne E Berens, Sarah K G Jensen, Charles A Nelson
BACKGROUND: Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses. Additional work has shed light on the potential molecular mechanisms by which early adversity becomes "biologically embedded" in altered physiology across body systems...
July 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28723832/patient-perceived-facilitators-of-and-barriers-to-electronic-portal-use-a-systematic-review
#10
Kimberly R Powell
This systematic review describes characteristics of portal users and their perceptions of this emerging technology. Recent empirical evidence (2010-2016) was reviewed to answer three questions: (1) What are the characteristics of electronic patient portal users? (2) What are patient-perceived facilitators of electronic patient portal use? (3) What are patient-perceived barriers to electronic patient portal use? Characteristics of portal users are described according to three broad categories: demographic characteristics, patterns of use, and complexity and duration of disease...
July 18, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28721183/infertility-in-the-global-south-raising-awareness-and-generating-insights-for-policy-and-practice
#11
T Gerrits, F Van Rooij, T Esho, W Ndegwa, J Goossens, A Bilajbegovic, A Jansen, B Kioko, L Koppen, S Kemunto Migiro, S Mwenda, H Bos
Infertility is a highly prevalent reproductive health condition in the global South, which often has a devastating impact on the people concerned. Yet, thus far it hardly received any attention from policy makers, Non-Governmental Organizations (NGOs) or donors working in the field of Sexual and Reproductive Health and Rights (SRHR). For this reason we have set up a project to increase knowledge and awareness about infertility and childlessness among those stakeholders and organizations and to generate insight into (possible) interventions in this field...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28720515/ahrq-series-on-complex-intervention-systematic-reviews-paper-4-selecting-analytic-approaches
#12
Meera Viswanathan, Melissa L McPheeters, M Hassan Murad, Mary E Butler, Emily E Beth Devine, Michele P Dyson, Jeanne-Marie Guise, Leila C Kahwati, Jeremy N V Miles, Sally C Morton
BACKGROUND: Systematic reviews of complex interventions can vary widely in purpose, data availability and heterogeneity, and stakeholder expectations. RATIONALE: This article addresses the uncertainty that systematic reviewers face in selecting methods for reviews of complex interventions. Specifically, it lays out parameters for systematic reviewers to consider when selecting analytic approaches that best answer the questions at hand, and suggests analytic techniques that may be appropriate in different circumstances...
June 29, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28720109/cancer-related-fatigue-implementing-guidelines-for-optimal-management
#13
Elizabeth J M Pearson, Meg E Morris, Carol E McKinstry
BACKGROUND: Cancer-related fatigue (CRF) is a key concern for people living with cancer and can impair physical functioning and activities of daily living. Evidence-based guidelines for CRF are available, yet inconsistently implemented globally. This study aimed to identify barriers and enablers to applying a cancer fatigue guideline and to derive implementation strategies. METHODS: A mixed-method study explored the feasibility of implementing the CRF guideline developed by the Canadian Association for Psychosocial Oncology (CAPO)...
July 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28720092/a-qualitative-study-of-clinic-and-community-member-perspectives-on-intervention-toolkits-unless-the-toolkit-is-used-it-won-t-help-solve-the-problem
#14
Melinda M Davis, Sonya Howk, Margaret Spurlock, Paul B McGinnis, Deborah J Cohen, Lyle J Fagnan
BACKGROUND: Intervention toolkits are common products of grant-funded research in public health and primary care settings. Toolkits are designed to address the knowledge translation gap by speeding implementation and dissemination of research into practice. However, few studies describe characteristics of effective intervention toolkits and their implementation. Therefore, we conducted this study to explore what clinic and community-based users want in intervention toolkits and to identify the factors that support application in practice...
July 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28718188/weaning-premature-infants-from-nasal-continuous-positive-airway-pressure-current-practice-and-scientific-evidence
#15
André Kidszun, Christine Arnold, Julia Winter, Catharina Whybra-Trümpler, Eva Mildenberger
Objective In the past decade, a number of trials have been conducted to determine the optimal strategy of weaning premature infants from nasal continuous airway pressure (nCPAP). However, a paucity of information exists on how weaning is actually performed in clinical routine. Aim of this study was to investigate the current practice of weaning premature infants from nCPAP in Germany. Methods An online survey was performed in German tertiary care neonatal units. Results All 160 German tertiary care units were contacted...
July 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28717814/malnutrition-in-hospitalised-older-adults-a-multicentre-observational-study-of-prevalence-associations-and-outcomes
#16
E O'Shea, S Trawley, E Manning, A Barrett, V Browne, S Timmons
BACKGROUND: Malnutrition is common in older adults and is associated with high costs and adverse outcomes. The prevalence, predictors and outcomes of malnutrition on admission to hospital are not clear for this population. DESIGN: Prospective Cohort Study. SETTING: Six hospital sites (five public, one private). PARTICIPANTS: In total, 606 older adults aged 70+ were included. All elective and acute admissions to any speciality were eligible...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28715062/gestational-weight-gain-historical-evolution-of-a-contested-health-outcome
#17
Edmond D Shenassa, Celena Kinsey, Marian Moser Jones, Jenifer Fahey
The history of research on gestational weight gain (GWG) in the United States and United Kingdom provides a context for current clinical practice. We trace the evolution of research on GWG in scientific literature from the 19th century to the present and examine its implications for contemporary clinical and public health practice. Obstetricians, beginning in the late 1800s, recommended dieting during pregnancy in order to limit GWG to 20 lb or less, driven by a belief that excessive weight gain was a cause of toxemia...
July 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28714810/advances-in-cardiovascular-health-in-women-over-the-past-decade-guideline-recommendations-for-practice
#18
Pejman Raeisi-Giglou, Annabelle Santos Volgman, Hena Patel, Susan Campbell, Amparo Villablanca, Eileen Hsich
Cardiovascular disease (CVD) remains the number one cause of death in women. It is estimated that 44 million women in the United States are either living with or at risk for heart disease. This article highlights the recent significant progress made in improving care, clinical decision-making, and policy implications for women with CVD. We provide our perspective supported by evidence-based advances in cardiovascular research and clinical care guidelines in seven areas: (1) primary CVD prevention and community heart care, (2) secondary prevention of CVD, (3) stroke, (4) heart failure and cardiomyopathies, (5) ischemia with nonobstructive coronary artery disease, (6) spontaneous coronary artery dissection, and (7) arrhythmias and device therapies...
July 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28714111/room-for-improvement-in-breast-milk-feeding-after-very-preterm-birth-in-europe-results-from-the-epice-cohort
#19
Emilija Wilson, Anna-Karin Edstedt Bonamy, Mercedes Bonet, Liis Toome, Carina Rodrigues, Elizabeth A Howell, Marina Cuttini, Jennifer Zeitlin
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined the association between maternal, obstetric, and infant clinical factors; neonatal and maternal care unit policies; and BMF at discharge from the NICU...
July 17, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28712629/the-prime-diabetes-model-novel-methods-for-estimating-long-term-clinical-and-cost-outcomes-in-type-1-diabetes-mellitus
#20
William J Valentine, Richard F Pollock, Rhodri Saunders, Jay Bae, Kirsi Norrbacka, Kristina Boye
BACKGROUND: Recent publications describing long-term follow-up from landmark trials and diabetes registries represent an opportunity to revisit modeling options in type 1 diabetes mellitus (T1DM). OBJECTIVES: To develop a new product-independent model capable of predicting long-term clinical and cost outcomes. METHODS: After a systematic literature review to identify clinical trial and registry data, a model was developed (the PRIME Diabetes Model) to simulate T1DM progression and complication onset...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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