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Evidence based informed practice

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https://www.readbyqxmd.com/read/28535545/portuguese-recommendations-for-the-use-of-methotrexate-in-rheumatic-diseases-2016-update
#1
Ana Catarina Duarte, Daniela Santos-Faria, Maria João Gonçalves, Alexandre Sepriano, Ana Filipa Mourão, Cátia Duarte, Joana Sousa Neves, Ana Filipa Águeda, Pedro Ávila Ribeiro, Alexandra Daniel, Adriano Neto, Ana Cordeiro, Ana Rodrigues, Anabela Barcelos, Cândida Silva, Cristina Ponte, Elsa Vieira-Sousa, Filipa Teixeira, Filipa Oliveira-Ramos, Filipe Araújo, Filipe Barcelos, Helena Canhão, Helena Santos, João Ramos, Joaquim Pereira, José Costa, José António Melo Gomes, Luís Cunha-Miranda, Lúcia Costa, Marcos Cerqueira, Margarida Cruz, Maria José Santos, Miguel Bernardes, Paula Oliveira, Pedro Abreu, Ricardo Figueira, Rita Barros, Sandra Falcão, Patrícia Pinto, Sofia Pimenta, Susana Capela, Vitor Teixeira, João Eurico Fonseca
BACKGROUND: Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. OBJECTIVES: To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. METHODS: The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project...
May 9, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28534277/how-do-small-groups-make-decisions-a-theoretical-framework-to-inform-the-implementation-and-study-of-clinical-competency-committees
#2
Saad Chahine, Sayra Cristancho, Jessica Padgett, Lorelei Lingard
In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making...
May 22, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28532730/readiness-for-and-predictors-of-evidence-base-practice-in-greek-healthcare-settings
#3
Athina E Patelarou, Aggelos Laliotis, Hero Brokalaki, John Petrakis, Vassilis Dafermos, Evmorfia Koukia
BACKGROUND: Implementation of evidence-based practice (EBP) remains limited in healthcare settings and knowledge of predictors of healthcare professionals' EBP activities is lacking. AIM: Describe nurses' readiness for EBP and identify related predictors in Greek healthcare settings we conducted a survey. RESULTS: Nurses scored high in the EBP readiness scale reflecting significant positive readiness toward EBP and consistently reported favourable attitudes toward and beliefs about EBP...
June 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#4
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532612/why-evidence-based-medicine-failed-in-patient-care-and-medicine-based-evidence-will-succeed
#5
Ralph I Horwitz, Burton H Singer
Evidence-based medicine (EBM) has succeeded in strengthening the evidence base for population medicine. Where EBM has failed is in answering the practicing doctor's question of what a likely outcome would be when a given treatment is administered to a particular patient with her own distinctive biological and biographical (life experience) profile. We propose Medicine-based evidence (MBE), based on the profiles of individual patients, as the evidence base for individualized or personalized medicine. MBE will build an archive of patient profiles using data from all study types and data sources, and will include both clinical and socio-behavioral information...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532305/production-and-use-of-estimates-for-monitoring-progress-in-the-health-sector-the-case-of-bangladesh
#6
Karar Zunaid Ahsan, Tazeen Tahsina, Afrin Iqbal, Nazia Binte Ali, Suman Kanti Chowdhury, Tanvir M Huda, Shams El Arifeen
BACKGROUND:  In order to support the progress towards the post-2015 development agenda for the health sector, the importance of high-quality and timely estimates has become evident both globally and at the country level. OBJECTIVE AND METHODS: Based on desk review, key informant interviews and expert panel discussions, the paper critically reviews health estimates from both the local (i.e. nationally generated information by the government and other agencies) and the global sources (which are mostly modeled or interpolated estimates developed by international organizations based on different sources of information), and assesses the country capacity and monitoring strategies to meet the increasing data demand in the coming years...
January 2017: Global Health Action
https://www.readbyqxmd.com/read/28529087/a-critical-analysis-of-australian-policies-and-guidelines-for-water-immersion-during-labour-and-birth
#7
Megan Cooper, Helen McCutcheon, Jane Warland
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth...
May 18, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28528173/school-wellness-team-best-practices-to-promote-wellness-policy-implementation
#8
Erika Profili, Diana S Rubio, Hannah G Lane, Lea H Jaspers, Megan S Lopes, Maureen M Black, Erin R Hager
Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28526718/p16-hpv-and-cetuximab-what-is-the-evidence
#9
James A Bonner, Ricard Mesia, Jordi Giralt, Amanda Psyrri, Ulrich Keilholz, David I Rosenthal, Frank Beier, Jeltje Schulten, Jan B Vermorken
Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide. It has recently been appreciated that human papillomavirus (HPV) status (or p16 status, which is a frequently used surrogate for HPV status) is prognostic for oropharyngeal SCCHN. Here, we review and contextualize existing p16 and HPV data, focusing on the cetuximab registration trials in previously untreated, locoregionally advanced, nonmetastatic SCCHN (LA SCCHN) and in recurrent and/or metastatic SCCHN (R/M SCCHN): the IMCL-9815 and EXTREME clinical trials, respectively...
May 18, 2017: Oncologist
https://www.readbyqxmd.com/read/28526669/development-of-an-evidence-informed-blog-to-promote-healthy-eating-among-mothers-use-of-the-intervention-mapping-protocol
#10
Audrée-Anne Dumas, Simone Lemieux, Annie Lapointe, Véronique Provencher, Julie Robitaille, Sophie Desroches
BACKGROUND: Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#11
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#12
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28526015/construction-and-implications-of-structural-equation-modeling-network-for-pediatric-cataract-a-data-mining-research-of-rare-diseases
#13
Erping Long, Shuangjuan Xu, Zhenzhen Liu, Xiaohang Wu, Xiayin Zhang, Jinghui Wang, Wangting Li, Runzhong Liu, Zicong Chen, Kexin Chen, Tongyong Yu, Dongxuan Wu, Xutu Zhao, Jingjing Chen, Zhuoling Lin, Qianzhong Cao, Duoru Lin, Xiaoyan Li, Jingheng Cai, Haotian Lin
BACKGROUND: The majority of rare diseases are complex diseases caused by a combination of multiple morbigenous factors. However, uncovering the complex etiology and pathogenesis of rare diseases is difficult due to limited clinical resources and conventional statistical methods. This study aims to investigate the interrelationship and the effectiveness of potential factors of pediatric cataract, for the exploration of data mining strategy in the scenarios of rare diseases. METHODS: We established a pilot rare disease specialized care center to systematically record all information and the entire treatment process of pediatric cataract patients...
May 19, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28525577/moving-triadic-gaze-intervention-into-practice-measuring-clinician-attitude-and-implementation-fidelity
#14
Julie Feuerstein, Lesley B Olswang, Kathryn Greenslade, Gay Lloyd Pinder, Patricia Dowden, Jodi Madden
Purpose: This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training. Method: Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play...
May 19, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28524930/nutrition-support-in-hospitalised-adults-at-nutritional-risk
#15
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Steven Kwasi Korang, Kirstine Halberg Engell, Marie Skøtt Nielsen, Kang Zhang, Maria Didriksen, Lisbeth Lund, Niklas Lindahl, Sara Hallum, Ning Liang, Wenjing Xiong, Xuemei Yang, Pernille Brunsgaard, Alexandre Garioud, Sanam Safi, Jane Lindschou, Jens Kondrup, Christian Gluud, Janus C Jakobsen
BACKGROUND: The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of essential nutrients and improve clinical outcome. Previous reviews have shown conflicting results with regard to the effects of nutrition support. OBJECTIVES: To assess the benefits and harms of nutrition support versus no intervention, treatment as usual, or placebo in hospitalised adults at nutritional risk...
May 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28523542/eating-disorders-and-epigenetics
#16
Lea Thaler, Howard Steiger
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28523378/examining-practitioner-competencies-organizational-support-and-barriers-to-engaging-fathers-in-parenting-interventions
#17
L A Tully, D A J Collins, P J Piotrowska, K S Mairet, D J Hawes, C Moul, R K Lenroot, P J Frick, V A Anderson, E R Kimonis, M R Dadds
Evidence-based parenting interventions have been developed and evaluated largely with mothers. This study examined practitioner reports of rates of father attendance, barriers to engagement, organizational support for father-inclusive practice, participation in training in father engagement, and competencies in working with fathers. It also explored predictors of practitioner competence and rates of father attendance. Practitioners (N = 210) who delivered parenting interventions completed an online survey...
May 18, 2017: Child Psychiatry and Human Development
https://www.readbyqxmd.com/read/28522604/hospital-level-variation-in-practice-patterns-and-patient-outcomes-for-pediatric-patients-hospitalized-with-functional-constipation
#18
Jamie Librizzi, Samuel Flores, Keith Morse, Kelly Kelleher, Jodi Carter, Ryan Bode
BACKGROUND AND OBJECTIVE: Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. METHODS: We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System...
May 18, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28522221/comparative-efficacy-and-safety-of-different-circumcisions-for-patients-with-redundant-prepuce-or-phimosis-a-network-meta-analysis
#19
REVIEW
Chuiguo Huang, Pan Song, Changbao Xu, Ruofan Wang, Lei Wei, Xinghua Zhao
BACKGROUND: Phimosis and redundant prepuce are defined as the inability of the foreskin to be retracted behind the glans penis in uncircumcised males. To synthesize the evidence and provide the hierarchies of different circumcisions for phimosis and redundant prepuce, we performed an overall network meta-analysis (NMA) based on their comparative efficacy and safety. MATERIAL AND METHODS: Electronic databases including PubMed, Embase, Wan Fang, VIP, CNKI and CBM database were researched from randomized controlled trials (RCTs) for redundant prepuce or phimosis...
May 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28521194/preconception-care-for-women-with-type-2-diabetes-mellitus-a-mixed-methods-study-of-provider-knowledge-and-practice
#20
J Klein, J A Boyle, R Kirkham, C Connors, C Whitbread, J Oats, F Barzi, D McIntyre, I Lee, M Luey, J Shaw, A D H Brown, L J Maple-Brown
AIMS: Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. METHODS: Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews...
May 5, 2017: Diabetes Research and Clinical Practice
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