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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/29771251/-ebm-guidelines-protocols-knowledge-attitudes-and-utilization-in-the-era-of-law-on-professional-responsibility-and-safety-of-health-care
#1
Silvia Minozzi, Francesca Ruggiero, Matteo Capobussi, Marien González-Lorenzo, Micaela La Regina, Alessandro Squizzato, Lorenzo Moja, Francesco Orlandini
INTRODUCTION: <AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29760865/the-uphill-battle-of-performing-education-scholarship-barriers-educators-and-education-researchers-face
#2
Jaime Jordan, Wendy C Coates, Samuel Clarke, Daniel Runde, Emilie Fowlkes, Jaqueline Kurth, Lalena Yarris
Introduction: Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups' perceptions regarding barriers to scholarship and potential strategies for success. Methods: Core emergency medicine (EM) educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757315/a-multi-center-prospective-cohort-study-to-evaluate-the-effect-of-differential-pricing-and-health-systems-strengthening-on-access-to-medicines-and-management-of-hypertension-and-diabetes-in-ghana-a-study-protocol
#3
Linda Meta Mobula, Stephen Sarfo, Lynda Arthur, Gilbert Burnham, Jacob Plange-Rhule, Daniel Ansong, Edith Gavor, David Ofori-Adjei
Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs).  Access to treatment is likely a key barrier to the control and prevention of NCD outcomes.  Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability...
February 7, 2018: Gates open research
https://www.readbyqxmd.com/read/29744793/perceptions-opinions-and-knowledge-of-pharmacists-towards-the-use-of-complementary-medicines-by-people-living-with-cancer
#4
Joanna Harnett, Trong Quy Le, Lorraine Smith, Ines Krass
Background Biologically-based complementary medicine (BB-CM) use is prevalent amongst people living with cancer. Pharmacists play an important role in the provision of standard treatments for cancer. Less is known about pharmacist's provision of BB-CM information. Objective This study investigated the opinions, perceptions and knowledge of pharmacists regarding the use of BB-CMs by people living with cancer and the facilitators and barriers to providing information and advice. Setting Australia. Method A cross-sectional 53-item survey was developed and the survey link distributed in two professional associations newsletters...
May 9, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29735382/evidence-based-nonpharmacologic-strategies-for-comprehensive-pain-care-the-consortium-pain-task-force-white-paper
#5
Heather Tick, Arya Nielsen, Kenneth R Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L Lemmon, Peter Wayne, Veronica Zador
Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC...
March 1, 2018: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29735003/australian-pharmacists-knowledge-of-the-efficacy-and-safety-of-complementary-medicines
#6
Freya Waddington, Mark Naunton, Greg Kyle, Gabrielle O'Kane, Gabrielle Cooper, Jackson Thomas
Global usage and expenditure on complementary medicines is increasing. Over 50% of consumers purchase these products from pharmacies and expect pharmacists to provide them with appropriate information regarding efficacy and safety of these products. Internationally, pharmacists have identified their lack of detailed knowledge of the efficacy and safety of these products as a barrier to recommending these products. Currently, little is known about the actual knowledge Australian pharmacists have of these products...
May 8, 2018: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29732601/longitudinal-ultrasound-curriculum-incorporation-at-west-virginia-university-school-of-medicine-a-description-and-graduating-students-perceptions
#7
Joseph Minardi, Holly Ressetar, Theresa Foreman, Kristen Craig, Melinda Sharon, John Bassler, Stephen Davis, Anthony Machi, Scott Cottrell, Nicolas Denne, Norman Ferrari, Kenneth Landreth, Bruce Palmer, Gregory Schaefer, Robert Tallaksen, David Wilks, Dorian Williams
OBJECTIVES: Sonography is a clinical tool being incorporated in multiple medical specialties with evidence of improved patient care and cost. Some schools have begun implementing ultrasound curricula. We hope to build upon that foundation and provide another potential framework of incorporation. There are several barriers, including curricular space, equipment and physical space, adequate faculty, and performing assessment. METHODS: At West Virginia University, we began a longitudinal ultrasound curriculum in 2012 with incorporation of didactic and practical sessions into gross anatomy, our systems-based second-year curriculum, physical diagnosis course, and clinical rotations...
May 6, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29705517/crossing-the-roof-of-the-world-trade-in-medicinal-plants-from-nepal-to-china
#8
Jun He, Bin Yang, Min Dong, Yunshang Wang
ETHNOPHARMACOLOGICAL RELEVANCE: Trade in medicinal and aromatic plants (MAPs) between Nepal and China has taken place for centuries along the Tibetan border. While there is anecdotal evidence that economic development in China over the past decades, coupled with regional infrastructure development and increasing market integration, has substantially changed this trade, there are no current published studies investigating this, e.g. in terms of species and market structure. This knowledge gap impedes the development of public interventions, e...
April 26, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29683053/multidisciplinary-prerounding-meeting-as-a-continuous-quality-improvement-tool-leveraging-to-reduce-continuous-benzodiazepine-use-at-an-academic-medical-center
#9
Alexander H Flannery, Melissa L Thompson Bastin, Ashley Montgomery-Yates, Corrine Hook, Evan Cassity, Phillip M Eaton, Peter E Morris
BACKGROUND: Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. METHODS: This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29681620/recontacting-or-not-recontacting-a-survey-of-current-practices-in-clinical-genetics-centres-in-europe
#10
Fabio Sirchia, Daniele Carrieri, Sandi Dheensa, Caroline Benjamin, Hülya Kayserili, Christophe Cordier, Carla G van El, Peter D Turnpenny, Bela Melegh, Álvaro Mendes, Tanya F Halbersma-Konings, Irene M van Langen, Anneke M Lucassen, Angus J Clarke, Francesca Forzano, Susan E Kelly
Advances in genomic medicine are improving diagnosis and treatment of some health conditions, and the question of whether former patients should be recontacted is therefore timely. The issue of recontacting is becoming more important with increased integration of genomics in 'mainstream' medicine. Empirical evidence is needed to advance the discussion over whether and how recontacting should be implemented. We administered a web-based survey to genetic services in European countries to collect information about existing infrastructures and practices relevant to recontacting patients...
April 23, 2018: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29676534/consensus-based-european-guidelines-for-treatment-of-atopic-eczema-atopic-dermatitis-in-adults-and-children-part-i
#11
A Wollenberg, S Barbarot, T Bieber, S Christen-Zaech, M Deleuran, A Fink-Wagner, U Gieler, G Girolomoni, S Lau, A Muraro, M Czarnecka-Operacz, T Schäfer, P Schmid-Grendelmeier, D Simon, Z Szalai, J C Szepietowski, A Taïeb, A Torrelo, T Werfel, J Ring
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions...
May 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29675459/bioengineered-systems-and-designer-matrices-that-recapitulate-the-intestinal-stem-cell-niche
#12
REVIEW
Yuli Wang, Raehyun Kim, Samuel S Hinman, Bailey Zwarycz, Scott T Magness, Nancy L Allbritton
The relationship between intestinal stem cells (ISCs) and the surrounding niche environment is complex and dynamic. Key factors localized at the base of the crypt are necessary to promote ISC self-renewal and proliferation, to ultimately provide a constant stream of differentiated cells to maintain the epithelial barrier. These factors diminish as epithelial cells divide, migrate away from the crypt base, differentiate into the postmitotic lineages, and end their life span in approximately 7 days when they are sloughed into the intestinal lumen...
March 2018: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29674514/pharmacokinetic-studies-in-children-recommendations-for-practice-and-research
#13
REVIEW
Charlotte I S Barker, Joseph F Standing, Lauren E Kelly, Lauren Hanly Faught, Allison C Needham, Michael J Rieder, Saskia N de Wildt, Martin Offringa
Optimising the dosing of medicines for neonates and children remains a challenge. The importance of pharmacokinetic (PK) and pharmacodynamic (PD) research is recognised both in medicines regulation and paediatric clinical pharmacology, yet there remain barriers to undertaking high-quality PK and PD studies. While these studies are essential in understanding the dose-concentration-effect relationship and should underpin dosing recommendations, this review examines how challenges affecting the design and conduct of paediatric pharmacological studies can be overcome using targeted pharmacometric strategies...
April 19, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29665383/impact-of-aging-alzheimer-s-disease-and-parkinson-s-disease-on-the-blood-brain-barrier-transport-of-therapeutics
#14
Yijun Pan, Joseph A Nicolazzo
Older people are at greater risk of medicine-induced toxicities resulting from either increased drug sensitivity or age-related pharmacokinetic changes. The scenario is further complicated with the two most prevalent age-related neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD). With aging, AD and PD, there is growing evidence of altered structure and function of the blood-brain barrier (BBB), including modifications to tight junctions and efflux transporters, such as P-glycoprotein...
April 14, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29661245/socioeconomic-health-inequality-in-malaria-indicators-in-rural-western-kenya-evidence-from-a-household-malaria-survey-on-burden-and-care-seeking-behaviour
#15
Vincent Were, Ann M Buff, Meghna Desai, Simon Kariuki, Aaron Samuels, Feiko O Ter Kuile, Penelope A Phillips-Howard, S Patrick Kachur, Louis Niessen
BACKGROUND: Health inequality is a recognized barrier to achieving health-related development goals. Health-equality data are essential for evidence-based planning and assessing the effectiveness of initiatives to promote equity. Such data have been captured but have not always been analysed or used to manage programming. Health data were examined for microeconomic differences in malaria indices and associated malaria control initiatives in western Kenya. METHODS: Data was analysed from a malaria cross-sectional survey conducted in July 2012 among 2719 people in 1063 households in Siaya County, Kenya...
April 16, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29650740/managing-complexity-in-care-of-patients-with-intellectual-and-developmental-disabilities-natural-fit-for-the-family-physician-as-an-expert-generalist
#16
REVIEW
Elizabeth Grier, Dara Abells, Ian Casson, Meg Gemmill, Jessica Ladouceur, Amanda Lepp, Ullanda Niel, Samantha Sacks, Kyle Sue
OBJECTIVE: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter. SOURCES OF INFORMATION: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29643049/evaluation-of-technology-enhanced-learning-programs-for-health-care-professionals-systematic-review
#17
REVIEW
Pam Nicoll, Sandra MacRury, Hugo C van Woerden, Keith Smyth
BACKGROUND: Technology-enhanced learning (TEL) programs are increasingly seen as the way in which education for health care professionals can be transformed, giving access to effective ongoing learning and training even where time or geographical barriers exist. Given the increasing emphasis on this mode of educational support for health care practitioners, it is vital that we can effectively evaluate and measure impact to ensure that TEL programs are effective and fit for purpose. This paper examines the current evidence base for the first time, in relation to the evaluation of TEL programs for health care professionals...
April 11, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29619651/increasing-access-to-and-utilization-of-cognitive-behavioral-therapy-for-insomnia-cbt-i-a-narrative-review
#18
Erin Koffel, Adam D Bramoweth, Christi S Ulmer
The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review...
April 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29608738/improving-access-and-provision-of-pre-travel-healthcare-for-travellers-visiting-friends-and-relatives-a-review-of-the-evidence
#19
Anita E Heywood, Nicholas Zwar
Background: Travellers visiting friends and relatives (VFR travellers) in their country of origin are at increased risk of a range of preventable infections. Risks are broadly related to circumstances of travel, risk misconceptions and access to health services. Despite nearly two decades of literature highlighting these increased risks little impact has been made on their risk disparity. Methods: This review draws on evidence from travel medicine literature, supplemented by evidence from the broader field of immigrant health, and is structured to include strategies that aim to reduce barriers at the patient, provider and health system level...
January 1, 2018: Journal of Travel Medicine
https://www.readbyqxmd.com/read/29605272/title-impact-of-ambiguous-and-restrictive-regulations-on-opioid-prescribing-practice-in-georgia
#20
Pati Dzotsenidze, Tamar Lekashvili, Nino Chikhladze, Maka Jorbenadze, Ioseb Abesadze, Dimitri Kordzaia
CONTEXT: Chronic pain management with opioids in incurable patients remains a challenge of modern medicine regardless of the evidence-based effectiveness of opioids and recommendations of authorities such as the World Health Organization (WHO) and International Narcotics Control Board (INCB). Many countries, including Georgia, maintain overly restrictive regulations that contribute to inadequate pain management. OBJECTIVE: To identify barriers to pain management in Georgia caused by legislation, administrative issues and physicians' lack of knowledge and understanding of legislative aspects governing opioid use, and their impact on opioid-prescribing practice...
March 29, 2018: Journal of Pain and Symptom Management
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