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Evidence based practice

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https://www.readbyqxmd.com/read/28441679/the-drivers-of-discretionary-utilization-clinical-history-versus-physician-supply
#1
Gregory W Ruhnke, Willard G Manning, David T Rubin, David O Meltzer
PURPOSE: Because the effect of physician supply on utilization remains controversial, literature based on non-Medicare populations is sparse, and a physician supply expansion is under way, the potential for physician-induced demand across diverse populations is important to understand. A substantial proportion of gastrointestinal endoscopies may be inappropriate. The authors analyzed the impact of physician supply, practice patterns, and clinical history on esophagogastroduodenoscopy (EGD, defined as discretionary) among patients hospitalized with lower gastrointestinal bleeding (LGIB)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441335/systematic-review-of-cognitive-behavioural-therapy-for-social-anxiety-disorder-in-psychosis
#2
REVIEW
Maria Michail, Max Birchwood, Lynda Tait
BACKGROUND: Social anxiety is highly prevalent among people with psychosis and linked with significant social disability and poorer prognosis. Although cognitive-behavioural therapy (CBT) has shown to be effective for the treatment of social anxiety in non-psychotic populations, there is a lack of evidence on the clinical effectiveness of CBT for the treatment of social anxiety when this is co-morbid in psychosis. METHODS: A systematic review to summarise and critically appraise the literature on the effectiveness of CBT interventions for the treatment of social anxiety in psychosis...
April 25, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28441315/an-overview-of-chronic-spinal-pain-revisiting-diagnostic-categories-and-exploring-an-evolving-role-for-neurostimulation
#3
Ashwini Sharan, Jonathan Riley, Christian Hoelscher
STUDY DESIGN: Topic Overview OBJECTIVE.: To describe the varied etiologies resulting in chronic spinal pain and review the current available evidence for treatments. SUMMARY OF BACKGROUND DATA: Chronic pain conditions, especially those that affect the axial back and radiate to the extremities, affect a large population. This results in pronounced disability and a high socioeconomic burden. Our understanding of the underlying mechanisms for chronic pain is limited...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#4
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28441160/evidence-based-practice-and-u-s-healthcare-outcomes-findings-from-a-national-survey-with-nursing-professional-development-practitioners
#5
Mary G Harper, Lynn Gallagher-Ford, Joan I Warren, Michelle Troseth, Loraine T Sinnott, Bindu Koshy Thomas
Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners' EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities...
April 24, 2017: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#6
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28440126/transcranial-doppler-screening-for-stroke-risk-in-children-with-sickle-cell-disease-a-systematic-review
#7
Sara Mazzucco, Marina Diomedi, Amrana Qureshi, Laura Sainati, Soundrie T Padayachee
Background Sickle cell disease (SCD) is one of the most common causes of stroke in children worldwide. Based on the results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP), annual transcranial Doppler ultrasound (TCD) screening for affected children is standard practice. However, the need for TCD surveillance programs could override the accuracy of the screening, affecting the correct stratification of stroke risk and subsequent clinical management of the target population. Aims To shed light on this issue, a systematic review of the literature on TCD screening for children and adolescents with SCD was carried out (CRD42016050549), according to a list of clinically relevant questions, with a particular focus on screening practices in European countries...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28440052/doctoral-profile-of-the-medical-radiation-sciences-a-baseline-for-australia-and-new-zealand
#8
Ernest U Ekpo, Beverly Snaith, Martine A Harris, Mark F McEntee
INTRODUCTION: Research is critical to evidence-based practice, and the rapid developments in technology provide opportunities to innovate and improve practice. Little is known about the research profile of the medical radiation science (MRS) profession in Australia and New Zealand (NZ). This study provides a baseline of their doctoral activity. METHODS: A cross-sectional survey of MRS professionals in Australia and NZ holding a doctorate or undertaking doctoral studies, was performed using an online tool (Bristol Online Survey(®) , Bristol, UK)...
April 25, 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28439797/desmoid-type-fibromatosis-who-when-and-how-to-treat
#9
REVIEW
Javier Martínez Trufero, Isabel Pajares Bernad, Irene Torres Ramón, Jorge Hernando Cubero, Roberto Pazo Cid
Desmoid-type fibromatosis is a sarcoma subtype that gathers some singular characteristics, making it a difficult challenge to face in clinical practice. Despite its excellent survival prognosis, these tumors may be unpredictable, ranging from an asymptomatic indolent course to persistent, local, and extended recurrences that significantly impair quality of life. Although surgery was initially considered the first elective treatment, collected published data during the past few years are now pointing to the "wait and see" approach as a reasonable initial strategy because many patients can live a long life with the disease without having symptoms...
May 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28439788/therapist-and-organizational-factors-associated-with-participation-in-evidence-based-practice-initiatives-in-a-large-urban-publicly-funded-mental-health-system
#10
Laura C Skriner, Courtney Benjamin Wolk, Rebecca E Stewart, Danielle R Adams, Ronnie M Rubin, Arthur C Evans, Rinad S Beidas
No abstract text is available yet for this article.
April 24, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28439594/the-effect-of-chronotherapy-on-depressive-symptoms-evidence-based-practice
#11
Anas H Khalifeh
The global prevalence of depression is increasing, along with rates of depression-associated disability and mortality, rendering depressive disorders a major public health issue. Chronotherapy involves a variety of strategies that control exposure to environmental stimuli that influence the biological clock, such as sleep deprivation (SD) or wake therapy (WT), sleep phase advance (SPA), and light and dark therapy (LT, DT). The purpose of this Evidence-Based Practice (EBP) paper is to answer PICOT questions by a review the effectiveness of chronotherapeutics interventions on depressive symptoms with depression and the depressive episode in the course of bipolar disorder...
May 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28439447/the-development-of-a-veterans-health-administration-emergency-management-research-agenda
#12
Aram Dobalian, Maria Claver, Deborah Riopelle, Tamar Wyte-Lake, Ismelda Canelo
INTRODUCTION: The Veterans Health Administration (VHA), the largest integrated healthcare delivery system in the United States, is charged with ensuring timely access to high-quality care for veterans during disasters, and supporting national, state, local, and tribal emergency management and homeland security efforts. In 2008, the VHA Office of Public Health (OPH) sponsored the first VHA Emergency Management Research Agenda-setting conference to develop research priorities that address the needs of veterans and to position VHA as a national leader in emergency management by having VHA serve as a "laboratory" for the development of evidence-based emergency management practices...
March 23, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28439378/oman-vision-2050-for-health-research-a-strategic-plan-for-the-future-based-on-the-past-and-present-experience
#13
REVIEW
Adhra Hilal Nasser Al Mawali, Ahmed Mohamed Al Qasmi, Sultana Mohamed Saif Al Sabahi, John Idikula, Mahmoud Attia Abd Elaty, Magdi Morsi, Ali Talib Al Hinai
Health care delivery in Oman has attained great heights since the modern renaissance in 1970. Although the health service had the main impetus all these years, the importance of health research began to take place by mid 1990's and is now gaining momentum as an important responsibility and activity of the Ministry of Health (MoH). Although there has been progressively increasing investment and commitment to research activities in the recent Five Year Plan for Health Development, it still lags behind in the quality and quantity of research output...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28439347/r2c2-in-action-testing-an-evidence-based-model-to-facilitate-feedback-and-coaching-in-residency
#14
Joan Sargeant, Karen Mann, Sarah Manos, Ian Epstein, Andrew Warren, Cindy Shearer, Michelle Boudreau
BACKGROUND: Feedback is increasingly seen as a collaborative conversation between supervisors and learners, where learners are actively and reflectively engaged with feedback and use it to improve. Based on this, and through earlier research, we developed an evidence- and theory-informed, 4-phase model for facilitating feedback and practice improvement-the R2C2 model (relationship, reaction, content, coaching). OBJECTIVE: Our goal was to explore the utility and acceptability of the R2C2 model in residency education, specifically for engaging residents in their feedback and in using it to improve, as well as the factors influencing its use...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439180/enhancing-diversity-in-biomedical-data-science
#15
Judith E Canner, Archana J McEligot, María-Eglée Pérez, Lei Qian, Xinzhi Zhang
The gap in educational attainment separating underrepresented minorities from Whites and Asians remains wide. Such a gap has significant impact on workforce diversity and inclusion among cross-cutting Biomedical Data Science (BDS) research, which presents great opportunities as well as major challenges for addressing health disparities. This article provides a brief description of the newly established National Institutes of Health Big Data to Knowledge (BD2K) diversity initiatives at four universities: California State University, Monterey Bay; Fisk University; University of Puerto Rico, Río Piedras Campus; and California State University, Fullerton...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28439135/assessment-of-direct-oral-anticoagulant-prescribing-and-monitoring-pre-and-post-implementation-of-a-pharmacy-protocol-at-a-community-teaching-hospital
#16
Christina Miele, Mary Taylor, Aditi Shah
Background: Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective: The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28438887/a-systematic-review-of-strategies-to-prevent-cisplatin-induced-nephrotoxicity
#17
Daniel J Crona, Aimee Faso, Tomohiro F Nishijima, Kathleen A McGraw, Matthew D Galsky, Matthew I Milowsky
INTRODUCTION: Cisplatin, a platinum-based antineoplastic agent, is the cornerstone for the treatment of many malignancies. Nephrotoxicity is the primary dose-limiting toxicity, and various hydration regimens and supplementation strategies are used to prevent cisplatin-induced kidney injury. However, evidence-based recommendations on specific hydration regimens are limited. A systematic review was performed to evaluate clinical studies that have examined hydration and supplementation strategies to prevent cisplatin-induced nephrotoxicity...
April 24, 2017: Oncologist
https://www.readbyqxmd.com/read/28438841/practice-guideline-summary-sudden-unexpected-death-in-epilepsy-incidence-rates-and-risk-factors-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american-epilepsy-society
#18
Cynthia Harden, Torbjörn Tomson, David Gloss, Jeffrey Buchhalter, J Helen Cross, Elizabeth Donner, Jacqueline A French, Anthony Gil-Nagel, Dale C Hesdorffer, W Henry Smithson, Mark C Spitz, Thaddeus S Walczak, Josemir W Sander, Philippe Ryvlin
OBJECTIVE: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. METHODS: Systematic review of evidence; modified Grading Recommendations Assessment, Development, and Evaluation process for developing conclusions; recommendations developed by consensus. RESULTS: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0-17 years) is 0...
April 25, 2017: Neurology
https://www.readbyqxmd.com/read/28438819/essentials-of-essential-oils
#19
Chelsea R Manion, Rebecca M Widder
PURPOSE: Information to guide clinicians in educating and advising patients using or intending to use essential oils for self-administered aromatherapy or other medicinal purposes is presented. SUMMARY: The term essential oils refers to highly concentrated, aromatic oils extracted from plants by steam distillation, hydrodiffusion, or pressure. Market reports indicate strong growth in the use of essential oils in the United States in recent decades. Therapeutic claims made in the marketing of essential oils have led the Food and Drug Administration to caution a number of suppliers...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28438679/a-proposal-for-early-and-personalized-treatment-of-diabetic-retinopathy-based-on-clinical-pathophysiology-and-molecular-phenotyping
#20
Thomas W Gardner, Jeffrey M Sundstrom
This paper presents a new approach to the prevention and treatment of early stage diabetic retinopathy before vision is severely impaired. This approach includes two major steps. The first step is to understand the mechanisms of vision impairment and classify diabetic retinopathy on the basis of pathophysiologic adaptations, rather than on the presence of advanced pathologic lesions, as defined by current clinical practice conventions. The second step is to develop patient-specific molecular diagnoses of diabetic retinopathy so that patients can be treated based on their individual characteristics, a process analogous to the individualized diagnosis and treatment of cancer patients...
April 21, 2017: Vision Research
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