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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/28208807/telehealth-increasing-access-to-high-quality-care-by-expanding-the-role-of-technology-in-correctional-medicine
#1
REVIEW
Jeremy D Young, Melissa E Badowski
The United States (US) has a large correctional population. However, many incarcerated persons lack access to evidence-based, up-to-date medical care, particularly by subspecialty providers, due to limitations of geography, travel, cost and other resources. The use of telehealth technologies can remove these barriers, increasing access to high quality, multidisciplinary care. Studies have shown that, with telemedicine, timely triage and medical management can be provided across many disciplines, which may lead to improved clinical outcomes and significant cost savings...
February 13, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28207415/attitudes-skill-and-use-of-evidence-based-practice-among-us-western-herbal-medicine-providers-a-national-survey
#2
James E Snow, Matthew J Leach, Bevin A Clare
Background Evidence-based practice (EBP) has been the focus of increasing attention in the teaching and delivery of both complementary and conventional healthcare. Western herbal medicine (WHM) is a system of complementary healthcare rooted in tradition. How WHM practitioners perceive, are prepared for, and use EBP, has to date been largely ignored. We therefore examined the use, opinion, skills, and training in EBP, and barriers and facilitators of EBP uptake, among herbal practitioners in the United States (US)...
February 16, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#3
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28188191/payer-coverage-for-hereditary-cancer-panels-barriers-opportunities-and-implications-for-the-precision-medicine-initiative
#4
Julia R Trosman, Christine B Weldon, Michael P Douglas, Allison W Kurian, R Kate Kelley, Patricia A Deverka, Kathryn A Phillips
Background: Hereditary cancer panels (HCPs), testing for multiple genes and syndromes, are rapidly transforming cancer risk assessment but are controversial and lack formal insurance coverage. We aimed to identify payers' perspectives on barriers to HCP coverage and opportunities to address them. Comprehensive cancer risk assessment is highly relevant to the Precision Medicine Initiative (PMI), and payers' considerations could inform PMI's efforts. We describe our findings and discuss them in the context of PMI priorities...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28187718/an-education-programme-influencing-health-professionals-to-recommend-exercise-to-their-type-2-diabetes-patients-understanding-the-processes-a-case-study-from-oxfordshire-uk
#5
Anne Matthews, Natasha Jones, Alastair Thomas, Perdy van den Berg, Charlie Foster
BACKGROUND: Increasing levels of physical activity decreases the risk of premature mortality associated with chronic diseases e.g., coronary heart disease, type 2 diabetes, stroke. Despite this, most adults in England do not meet physical activity guidelines. Physical activity advice and signposting offered to at-risk patients by primary care providers is recommended. However, exercise medicine education is sparse, leading to poor practitioner knowledge of the risk reduction evidence and strategies to implement effective patient behaviour change...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28186480/evidence-based-practice-of-nurses-working-in-university-hospitals-in-the-french-speaking-part-of-switzerland-a-descriptive-and-correlational-study
#6
Jenny Gentizon, Patricia Borrero, Sonja Vincent-Suter, Pierluigi Ballabeni, Diane Morin, Manuela Eicher
Introduction : evidence-based practice (EBP) is too scarcely applied in nursing and is a key contemporary challenge for the discipline. Method and objective : This descriptive and correlational study invited 221 nurses working in three different clinical settings of university hospitals in Switzerland. The objective of this study was to describe their level of knowledge, beliefs and implementation of EBP. Results : of the 221 nurses in this study, only 67 were familiar EBP (30%). These demonstrate favorable beliefs and attitudes towards EBP, but indicate a lack of skills and knowledge to implement it...
1, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28178913/training-us-health-care-professionals-on-human-trafficking-where-do-we-go-from-here
#7
Clydette Powell, Kirsten Dickins, Hanni Stoklosa
: Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28144123/state-of-simulation-in-healthcare-education-an-initial-survey-in-beijing
#8
Zichen Zhao, Pengfei Niu, Xiang Ji, Robert M Sweet
BACKGROUND AND OBJECTIVES: In 2013, medical error was the third leading cause of death in the United States.(1) In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. METHODS: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28143942/bridging-the-education-action-gap-a-near-peer-case-based-undergraduate-ethics-teaching-programme
#9
Wing May Kong, Selena Knight
Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies...
January 31, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28125828/characteristics-and-outcomes-of-fasting-orders-among-medical-inpatients
#10
Atsushi Sorita, Charat Thongprayoon, John T Ratelle, Ruth E Bates, Katie M Rieck, Aditya P Devalapalli, Adil Ahmed, Deanne T Kashiwagi
While many hospitalized patients have orders to fast in preparation for interventions, the extent to which these orders are necessary or adhere to evidence-based durations is unknown. In this study, we analyzed the length, indication, and associated outcomes of nil per os (NPO) orders for general medicine patients at an academic institution in the United States, and compared them to the best available evidence for recommended length of NPO. Of 924 NPO orders assessed, the indicated intervention was not performed for 183 (19...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28116028/characteristics-of-real-time-non-critical-incident-debriefing-practices-in-the-emergency-department
#11
Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert
INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114925/two-birds-with-one-stone-experiences-of-combining-clinical-and-research-training-in-addiction-medicine
#12
J Klimas, R McNeil, K Ahamad, A Mead, L Rieb, W Cullen, E Wood, W Small
BACKGROUND: Despite a large evidence-base upon which to base clinical practice, most health systems have not combined the training of healthcare providers in addiction medicine and research. As such, addiction care is often lacking, or not based on evidence or best practices. We undertook a qualitative study to assess the experiences of physicians who completed a clinician-scientist training programme in addiction medicine within a hospital setting. METHODS: We interviewed physicians from the St...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#13
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28097829/barriers-to-conducting-research-a-survey-of-trainees-in-emergency-medicine
#14
Alexander Olaussen, Paul A Jennings, Gerard O'Reilly, Biswadev Mitra, Peter A Cameron
OBJECTIVE: Research underpins evidence-based practice, but there are significant barriers to conducting research relevant to each clinical discipline. Understanding these barriers could allow strategies to reduce their impact. The present study was undertaken to understand specific barriers to research for emergency medicine (EM) trainees. METHODS: EM trainees attending research short courses were surveyed. Free-text responses were classified into themes and a list of pre-specified potential barriers was used for ranking purposes...
January 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28067194/mapping-actions-to-improve-access-to-medicines-for-mental-disorders-in-low-and-middle-income-countries
#15
C Barbui, T Dua, K Kolappa, B Saraceno, S Saxena
AIMS: In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013-2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines...
January 9, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28031008/action-and-function-of-vitamin-d-in-digestive-tract-physiology-and-pathology
#16
Maikel P Peppelenbosch, Gwenny M Fuhler, Auke Pieter Verhaar, Luc J W Van Der Laan
BACKGROUND: The body of biomedical literature on Vitamin D effector mechanisms in gastrointestinal biology and pathophysiology is rapidly expanding. Accordingly, new possibilities of vitamin D biology-based therapeutical intervention in gastroenterological disease are being identified. However, the literature lacks a concise review on these developments, hampering comprehension of the possibilities involved for many in the community. RESULTS: Genetic vitamin D receptor (VDR) polymorphisms and other VDR biology regulation are involved in predisposition to gastrointestinal cancers and might allow tailored strategies for managing those individuals especially at risk, e...
December 28, 2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27987564/how-contextual-issues-can-distort-shared-decision-making
#17
Gerald Gartlehner, Nina Matyas
Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. In practice, it might fall short of what it promises and might even be misused to whitewash monetary motives. In this article, which summarizes a presentation given at the 17(th) Annual Conference of the German Network Evidence-based Medicine on March 4(th), 2016 in Cologne, Germany, we discuss three contextual factors that in our opinion can have a tremendous impact on any informed decision making: 1) opinions and convictions of physicians or other clinicians; 2) uncertainty of the evidence regarding benefits and harms; 3) uncertainty of patients about their own values and preferences...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27971985/attitudes-adherence-and-barriers-among-puplicly-employed-gps-towards-evidence-based-medicine-and-clinical-practice-guidelines-in-cyprus
#18
N Panayides, P Petrou, B Zinieri, A Giannakou, G Ahniotou
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27938647/assessing-evidence-of-inequalities-in-access-to-medication-for-diabetic-populations-in-low-and-middle-income-countries-a-systematic-review
#19
REVIEW
Yodi Christiani, Teerapon Dhippayom, Nathorn Chaiyakunapruk
BACKGROUND: Inequalities in access to medications among people diagnosed with diabetes inlow- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death. OBJECTIVE: To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs. DESIGN: We conducted a systematic review of the literature using the PRISMA-Equity guidelines...
2016: Global Health Action
https://www.readbyqxmd.com/read/27935741/barriers-to-evidence-based-physician-decision-making-at-the-point-of-care-a-narrative-literature-review
#20
Kara Contreary, Anna Collins, Eugene C Rich
We conduct a narrative literature review using four real-world cases of clinical decisions to show how barriers to the use of evidence-based medicine affect physician decision-making at the point of care, and where adjustments could be made in the healthcare system to address these barriers. Our four cases constitute decisions typical of the types physicians make on a regular basis: diagnostic testing, initial treatment and treatment monitoring. To shed light on opportunities to improve patient care while reducing costs, we focus on barriers that could be addressed through changes to policy and/or practice at a particular level of the healthcare system...
January 2017: Journal of Comparative Effectiveness Research
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