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Expert practice

David Misdrahi, Arnaud Tessier, Joel Swendsen, Fabrice Berna, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Jean-Marie Danion, Marie De Pradier, Jean-Michel Dorey, Caroline Dubertret, Julien Dubreucq, Catherine Faget, Franck Gabayet, Romain Rey, Raphaelle Richieri, Christine Passerieux, Aurélie Schandrin, Franck Schurhoff, Anne Marie Tronche, Mathieu Urbach, Pierre Michel Llorca, Guillaume Fond
OBJECTIVE: Medication nonadherence is one of the most important, and potentially modifiable, prognostic factors in the outcome of patients with schizophrenia. The aim of this article is to propose a new classification of adherence profiles according to the Medication Adherence Rating Scale (MARS) in a large community-dwelling sample of French patients with schizophrenia to provide a new tool to help clinicians in daily practice. METHODS: 319 community-dwelling patients from a national network of 10 Schizophrenia Expert Centers were interviewed between January 2009 and January 2014...
September 2016: Journal of Clinical Psychiatry
Barbara Farquharson, Marie Johnston, Karen Smith, Brian Williams, Shaun Treweek, Stephan U Dombrowski, Nadine Dougall, Purva Abhyankar
AIMS: To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text+visual and text-only) with usual care. BACKGROUND: Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for Acute Coronary Syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions...
October 25, 2016: Journal of Advanced Nursing
Sebastian Schneeweiss, Wesley Eddings, Robert J Glynn, Elisabetta Patorno, Jeremy Rassen, Jessica M Franklin
BACKGROUND: Data-adaptive approaches to confounding adjustment may improve performance beyond expert knowledge when analyzing electronic healthcare databases and have additional practical advantages for analyzing multiple databases in rapid cycles. Improvements seemed possible if outcome predictors were reliably identified empirically and adjusted. METHODS: In five cohort studies from diverse healthcare databases, we implemented a base-case high-dimensional propensity score algorithm with propensity score decile-adjusted outcome models to estimate treatment effects among prescription drug initiators...
October 21, 2016: Epidemiology
Enrique Castro-Sánchez, Yiannis Kyratsis, Michiyo Iwami, Timothy M Rawson, Alison H Holmes
BACKGROUND: The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as 'serious games' have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a) to synthesise research evidence on the use of serious games in IPC to support healthcare workers' behaviour change and best practice learning; and b) to identify gaps across the formulation and evaluation of serious games in IPC...
2016: Antimicrobial Resistance and Infection Control
Amber R Atwater, Mariah Rudd, Audrey Brown, John S Wiener, Robert Benjamin, W Robert Lee, Jullia A Rosdahl
BACKGROUND : There is limited information on the impact of widespread adoption of the electronic health record (EHR) on graduate medical education (GME). OBJECTIVE : To identify areas of consensus by education experts, where the use of EHR impacts GME, with the goal of developing strategies and tools to enhance GME teaching and learning in the EHR environment. METHODS : Information was solicited from experienced US physician educators who use EPIC EHR following 3 steps: 2 rounds of online surveys using the Delphi technique, followed by telephone interviews...
October 2016: Journal of Graduate Medical Education
Marek L Kowalski, Ignacio Ansotegui, Werner Aberer, Mona Al-Ahmad, Mubeccel Akdis, Barbara K Ballmer-Weber, Kirsten Beyer, Miguel Blanca, Simon Brown, Chaweewan Bunnag, Arnaldo Capriles Hulett, Mariana Castells, Hiok Hee Chng, Frederic De Blay, Motohiro Ebisawa, Stanley Fineman, David B K Golden, Tari Haahtela, Michael Kaliner, Connie Katelaris, Bee Wah Lee, Joanna Makowska, Ulrich Muller, Joaquim Mullol, John Oppenheimer, Hae-Sim Park, James Parkerson, Giovanni Passalacqua, Ruby Pawankar, Harald Renz, Franziska Rueff, Mario Sanchez-Borges, Joaquin Sastre, Glenis Scadding, Scott Sicherer, Pongsakorn Tantilipikorn, James Tracy, Vera van Kempen, Barbara Bohle, G Walter Canonica, Luis Caraballo, Maximiliano Gomez, Komei Ito, Erika Jensen-Jarolim, Mark Larche, Giovanni Melioli, Lars K Poulsen, Rudolf Valenta, Torsten Zuberbier
One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing), deliberate induction in the office of allergic symptoms to offending compounds (provocation tests) or intentional application of potentially dangerous substances (allergy vaccine) to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided...
2016: World Allergy Organization Journal
Benedicto Crespo-Facorro, Miguel Bernardo, Josep Maria Argimon, Manuel Arrojo, Maria Fe Bravo-Ortiz, Ana Cabrera-Cifuentes, Julián Carretero-Román, Manuel A Franco-Martín, Paz García-Portilla, Josep Maria Haro, José Manuel Olivares, Rafael Penadés, Javier Del Pino-Montes, Julio Sanjuán, Celso Arango
Schizophrenia is a clinically heterogeneous syndrome affecting multiple dimensions of the patient's life. Treatment requires a multidimensional approach in which we should take into account the effectiveness (the ability of an intervention to get the desired result under ideal conditions), effectiveness (the degree to which the intended effect is obtained under usual clinical practice conditions) and efficiency (the value of the intervention with respect to the cost to the individual or society). In a first phase, a group of 90 national experts from all s, from a multidimensional and multidisciplinary perspective of the disease, defined the concepts of efficiency, effectiveness and efficiency around 7 key dimensions: symptoms; comorbidities; relapse and adherence; insight and subjective experience; cognition; quality of life, autonomy and functional capacity; and inclusion...
October 22, 2016: Revista de Psiquiatrí́a y Salud Mental
A T Cruz, A L Hersh, J R Starke, S E Beekmann, P M Polgreen, R Banerjee
OBJECTIVE: To evaluate the extent to which advancements in the diagnosis and treatment of latent tuberculous infection (LTBI) have been integrated into practice by pediatric infectious disease (PID) specialists. DESIGN: We conducted an online survey of the Infectious Diseases Society of America's Emerging Infections Network (EIN) membership. RESULTS: Of the 323 members, 197 (61%) responded: 7% cared for ⩾5 children with TB disease and 34% for ⩾5 children with LTBI annually...
November 2016: International Journal of Tuberculosis and Lung Disease
John F Strang, Haley Meagher, Lauren Kenworthy, Annelou L C de Vries, Edgardo Menvielle, Scott Leibowitz, Aron Janssen, Peggy Cohen-Kettenis, Daniel E Shumer, Laura Edwards-Leeper, Richard R Pleak, Norman Spack, Dan H Karasic, Herbert Schreier, Anouk Balleur, Amy Tishelman, Diane Ehrensaft, Leslie Rodnan, Emily S Kuschner, Francie Mandel, Antonia Caretto, Hal C Lewis, Laura G Anthony
Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence. This study develops initial clinical consensus guidelines for the assessment and care of adolescents with co-occurring ASD and GD, from the best clinical practices of current experts in the field...
October 24, 2016: Journal of Clinical Child and Adolescent Psychology
Lisa G Pont, Tessa K Morgan, Margaret Williamson, Flora M Haaijer, Mieke L van Driel
OBJECTIVES: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. METHODS: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners scored the validity of each indicator for measuring quality in Australian general practice. Four quality domains were considered: monitoring antibiotic resistance, benefit to individual patients, value for money and value to policymakers...
October 24, 2016: International Journal of Pharmacy Practice
Melissa Cumming, Anthony Osinski, Lynne O'Hearn, Pamela Waksmonski, Michele Herman, Deborah Gordon, Elzbieta Griffiths, Kim Knox, Eileen McHale, Karen Quillen, Jorge Rios, Patricia Pisciotto, Lynne Uhl, Alfred DeMaria, Chester Andrzejewski
A collaboration that grew over time between local hemovigilance stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper-based method of reporting adverse reactions and monthly transfusion activity for regulatory compliance purposes to statewide adoption of electronic reporting via the National Healthcare Safety Network (NHSN). The NHSN is a web-based surveillance system that offers the capacity to capture transfusion-related adverse events, incidents, and monthly transfusion statistics from participating facilities...
October 23, 2016: Transfusion
Abdul H Sultan, Ash Monga, Joseph Lee, Anton Emmanuel, Christine Norton, Giulio Santoro, Tracy Hull, Bary Berghmans, Stuart Brody, Bernard T Haylen
INTRODUCTION AND HYPOTHESIS: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology...
October 24, 2016: International Urogynecology Journal
Yana Puckett, Benedicto C Baronia
With the recent advances in eye tracking technology, it is now possible to track surgeons' eye movements while engaged in a surgical task or when surgical residents practice their surgical skills. Several studies have compared eye movements of surgical experts and novices and developed techniques to assess surgical skill on the basis of eye movement utilizing simulators and live surgery. None have evaluated simultaneous visual tracking between an expert and a novice during live surgery. Here, we describe a successful simultaneous deployment of visual tracking of an expert and a novice during live laparoscopic cholecystectomy...
September 20, 2016: Curēus
Yohei Sotomi, Pannipa Suwannasom, Patrick W Serruys, Yoshinobu Onuma
The advent of intracoronary stents greatly increased the safety and applicability of percutaneous coronary interventions. One of the drawbacks of drug eluting stents (DES) is the increased risk of late and very late stent thrombosis (ST). The risk of ST after the DES implantation were anticipated to be solved with the advent of fully biodegradable scaffolds which offers the possibility of transient scaffolding of the vessel to prevent acute vessel closure and recoil while also transiently eluting an antiproliferative drug to counteract the constrictive remodeling and excessive neointimal hyperplasia...
October 25, 2016: EuroIntervention
Massimiliano Berretta, Raffaele Di Francia, Brigida Stanzione, Gaetano Facchini, Arben LLeshi, Paolo De Paoli, Michele Spina, Umberto Tirelli
The introduction of Highly Active Antiretroviral Therapy (HAART) into clinical practice has dramatically changed the outcome of HIV-infected patients by prolonging their survival. The increase in life expectancy has led to an increased risk of non-AIDS-related mortality and morbidity, including cardiovascular diseases, neurocognitive diseases, neuroendocrine dysfunctions and cancer. Areas Covered: The GICAT (Italian Cooperation Group on AIDS and Tumors) has demonstrated that patients who receive a multidisciplinary approach with the combination of anticancer agents (AC) and HAART can achieve better responses and survival rates than patients who receive AC alone...
October 22, 2016: Expert Opinion on Pharmacotherapy
O T A Lyons, M Baguneid, T D Barwick, R E Bell, N Foster, S Homer-Vanniasinkam, S Hopkins, A Hussain, K Katsanos, B Modarai, J A T Sandoe, S Thomas, N M Price
OBJECTIVE/BACKGROUND: The management of aortic graft infection (AGI) is highly complex and in the absence of a universally accepted case definition and evidence-based guidelines, clinical approaches and outcomes vary widely. The objective was to define precise criteria for diagnosing AGI. METHODS: A process of expert review and consensus, involving formal collaboration between vascular surgeons, infection specialists, and radiologists from several English National Health Service hospital Trusts with large vascular services (Management of Aortic Graft Infection Collaboration [MAGIC]), produced the definition...
October 19, 2016: European Journal of Vascular and Endovascular Surgery
Pedro H T Q de Almeida, Joy C MacDermid, Tatiana Barcelos Pontes, Clarissa Cardoso Dos Santos-Couto-Paz, Licia Maria H da Mota, João Paulo C Matheus
STUDY DESIGN: Cross-sectional descriptive study. INTRODUCTION: Osteoarthritis (OA) is the most prevalent musculoskeletal disease in the adult and older adult populations. The use of orthoses to stabilize the thumb's articular complex is one of the most common conservative management strategies. Despite substantial research about this topic, there is insufficient evidence about the optimal use of orthoses to inform clinical practice, contributing to practice variations within and across health professionals...
October 19, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
D Guenat, D Riethmuller, R Ramanah, A Morel, F Aubin, C Mougin, J-L Prétet
Prescription of an HPV test in practice will enable the clinician to optimize the monitoring and the management of patients, especially in the context of cervical cancer screening. Numerous HPV tests are available that present different analytical and clinical sensitivity and specificity. International recommendations on clinical performance of HPV tests used for cervical cancer screening have been published by a group of experts, and tests that meet these performance criteria should be used. Apart from the HPV detection kit, the whole circuit from sampling to report of the results must be considered...
October 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Landon W Trost, Ricardo Munarriz, Run Wang, Allen Morey, Laurence Levine
INTRODUCTION: The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. AIM: To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. METHODS: A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM)...
November 2016: Journal of Sexual Medicine
Abdul H Sultan, Ash Monga, Joseph Lee, Anton Emmanuel, Christine Norton, Giulio Santoro, Tracy Hull, Bary Berghmans, Stuart Brody, Bernard T Haylen
INTRODUCTION: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology...
October 22, 2016: Neurourology and Urodynamics
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