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Best practices

Aaron B Parrish, Yas Sanaiha, Beverley A Petrie, Marcia M Russell, Formosa Chen
The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed...
October 2016: American Surgeon
Rebecca Ruch-Gallie, Heather Weir, Lori R Kogan
Cognitive functioning is often compromised with increasing levels of stress and fatigue, both of which are often experienced by veterinarians. Many high-stress fields have implemented checklists to reduce human error. The use of these checklists has been shown to improve the quality of medical care, including adherence to evidence-based best practices and improvement of patient safety. Although it has been recognized that veterinary medicine would likely demonstrate similar benefits, there have been no published studies to date evaluating the use of checklists for improving quality of care in veterinary medicine...
October 25, 2016: Journal of Veterinary Medical Education
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques, Leonardo Régis Leira Pereira
Several newer antiepileptic drugs (AEDs) have been introduced into clinical practice, offering choices for individualizing the treatment of epilepsy since AEDs have different efficacy and tolerability profiles. In particular, questions exist regarding which AEDs are the best options for the monotherapy of focal epilepsy. Is carbamazepine (CBZ), which is considered the standard treatment for focal epilepsy, still the best option for monotherapy of focal epilepsy, despite the emergence of new AEDs? In this systematic review, we compared the relative tolerability of all available AEDs for monotherapy of all types of epilepsy as well as their efficacy in the monotherapy of focal epilepsy...
October 25, 2016: Pharmacotherapy
Cheryl Fisher, Georgie Cusack, Kim Cox, Kathryn Feigenbaum, Gwenyth R Wallen
Organizations must ensure that nursing care delivery is based on best evidence. This article describes how a clinical research hospital used a competency-based approach to structure the development and execution of a strategic plan and integrated evidence-based practice concepts into the activities of nurses at all levels. The article will also describe the process for developing and implementing the competency across our department including outcomes achieved.
November 2016: Journal of Nursing Administration
P P T Jeurissen, B A Ravesteijn, R T J M Janssen, M A C Tanke
After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery.<br/> AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses.<br/> METHOD: Review of academic articles and policy studies.<br/> RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health...
2016: Tijdschrift Voor Psychiatrie
D Brynn Hibbert, Pall Thordarson
Data analysis is central to understanding phenomena in host-guest chemistry. We describe here recent developments in this field starting with the revelation that the popular Job plot method is inappropriate for most problems in host-guest chemistry and that the focus should instead be on systematically fitting data and testing all reasonable binding models. We then discuss approaches for estimating uncertainties in binding studies using case studies and simulations to highlight key issues. Related to this is the need for ready access to data and transparency in the methodology or software used, and we demonstrate an example a webportal () that aims to address this issue...
October 25, 2016: Chemical Communications: Chem Comm
Yule Xu, Ao Rong, Yanlong Bi, Wei Xu
Purpose. To evaluate the efficacy of intravitreal conbercept (IVC) plus modified grid laser photocoagulation (MGP) versus IVC alone for treatment of diffuse diabetic macular edema (DDME). Methods. In this retrospective study, 51 DDME patients were treated with either IVC alone (IVC group) or IVC plus MGP (combined group) with 12 months of follow-up. The clinical records of those patients were reviewed. Results. 26 patients (31 eyes) received IVC alone and 25 patients (30 eyes) received combined therapy. At month 12, the mean best-corrected visual acuity (BCVA) letter score improvement was 9...
2016: Journal of Ophthalmology
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
Susan M Perkins, Peter Bacchetti, Cynthia S Davey, Christopher J Lindsell, Madhu Mazumdar, Robert A Oster, Peter N Peduzzi, David M Rocke, Kyle D Rudser, Mimi Kim
Given the increasing level and scope of biostatistics expertise needed at academic health centers today, we developed best practices guidelines for biostatistics units to be more effective in providing biostatistical support to their institutions, and in fostering an environment in which unit members can thrive professionally. Our recommendations focus on the key areas of: 1) funding sources and mechanisms; 2) providing and prioritizing access to biostatistical resources; and 3) interacting with investigators...
2016: American Statistician
Steven Walker, Anna C Bibby, Nick A Maskell
Malignant pleural effusions (MPEs) are an important cause of cancer-related mortality and morbidity. It is a heterogeneous group of conditions, which leads to debilitating symptoms and confers a poor prognosis. Recent well-designed randomized trials have provided a broader evidence base for an expanding range of treatment options. Together, with new prognostic scoring systems and a greater understanding of how different patient phenotypes respond to treatment, this allows greater personalization of management...
October 24, 2016: Therapeutic Advances in Respiratory Disease
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible. AIM: To identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND SETTING: Cross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
William A Cantara, Erik D Olson, Karin Musier-Forsyth
In addition to their role in correctly attaching specific amino acids to cognate tRNAs, aminoacyl-tRNA synthetases (aaRS) have been found to possess many alternative functions and often bind to and act on other nucleic acids. In contrast to the well-defined 3D structure of tRNA, the structures of many of the other RNAs recognized by aaRSs have not been solved. Despite advances in the use of X-ray crystallography (XRC), nuclear magnetic resonance (NMR) spectroscopy and cryo-electron microscopy (cryo-EM) for structural characterization of biomolecules, significant challenges to solving RNA structures still exist...
October 21, 2016: Methods: a Companion to Methods in Enzymology
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
Slavica Stankic, Sneha Suman, Francia Haque, Jasmina Vidic
Th antibacterial activity of metal oxide nanoparticles has received marked global attention as they can be specifically synthesized to exhibit significant toxicity to bacteria. The importance of their application as antibacterial agents is evident keeping in mind the limited range and effectiveness of antibiotics, on one hand, and the plethora of metal oxides, on the other, along with the propensity of nanoparticles to induce resistance being much lower than that of antibiotics. Effective inhibition against a wide range of bacteria is well known for several nano oxides consisting of one metal (Fe3O4, TiO2, CuO, ZnO), whereas, research in the field of multi-metal oxides still demands extensive exploration...
October 24, 2016: Journal of Nanobiotechnology
Erin Grgurich, Cynthia Arnemann, Kim Amon, Rose Horton, Jestin N Carlson
As neonatal endotracheal intubation (ETI) is a low-frequency, high-consequence event, it is essential that providers have access to resources to aid in ETI. We sought to determine the impact of video laryngoscopy (VL) with just-in-time training on intubation outcomes over direct laryngoscopy (DL) when performed by neonatal nurses. We conducted a prospective, randomized, crossover study with neonatal nurses employed at a level 2 neonatal intensive care unit (NICU). Nurses performed both DL and VL on a neonatal mannequin using a CMAC (Karl Storz Corp, Tuttlingen, Germany) either with the assistance of the screen (VL) or without (DL)...
October 2016: Journal of Perinatal & Neonatal Nursing
Paul S Sheeran, Naomi Matsuura, Mark A Borden, Ross Williams, Terry O Matsunaga, Peter N Burns, Paul A Dayton
Continued advances in the field of ultrasound and ultrasound contrast agents have created new approaches to imaging and medical intervention. Phase-shift perfluorocarbon droplets, which can be vaporized by ultrasound energy to transition from the liquid to the vapor state, are one of the most highly researched alternatives to clinical ultrasound contrast agents (i.e. microbubbles). In this review, part of a special issue on methods in biomedical ultrasonics, we survey current techniques to prepare ultrasound-activated nanoscale phase-shift perfluorocarbon droplets, including sonication, extrusion, homogenization, microfluidics, and microbubble condensation...
October 20, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
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
Daniel R Clayburgh, Daniel Brickman
No abstract text is available yet for this article.
October 24, 2016: Laryngoscope
Nicholas Brandmeir, Elena Nehrbass, James McInerney
INTRODUCTION:  Deep brain stimulator (DBS) infections are a persistent problem for patients undergoing this procedure. They may require further surgery, treatment with antibiotics, or even removal of the device. To date, no consensus exists on the best practices to avoid DBS infections or what factors predispose patients to an eventual infection. The goal of this study was to examine several patient factors for association with DBS infection. METHODS:  A single-center, single-surgeon quality improvement database was queried...
September 20, 2016: Curēus
Andrew M Jones, James Lomas, Peter T Moore, Nigel Rice
We conduct a quasi-Monte-Carlo comparison of the recent developments in parametric and semiparametric regression methods for healthcare costs, both against each other and against standard practice. The population of English National Health Service hospital in-patient episodes for the financial year 2007-2008 (summed for each patient) is randomly divided into two equally sized subpopulations to form an estimation set and a validation set. Evaluating out-of-sample using the validation set, a conditional density approximation estimator shows considerable promise in forecasting conditional means, performing best for accuracy of forecasting and among the best four for bias and goodness of fit...
October 2016: Journal of the Royal Statistical Society. Series A, (Statistics in Society)
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