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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/28735562/diagnostic-and-therapeutic-knowledge-and-practices-in-the-management-of-congenital-syphilis-by-pediatricians-in-public-maternity-hospitals-in-brazil
#1
Raquel Rodrigues Dos Santos, Roberta Pereira Niquini, Francisco Inácio Bastos, Rosa Maria Soares Madeira Domingues
The study aimed to assess conformity with Brazil's standard protocol for diagnostic and therapeutic practices in the management of congenital syphilis by pediatricians in public maternity hospitals. A cross-sectional study was conducted in 2015 with 41 pediatricians working in all the public maternity hospitals in Teresina, the capital of Piauí State, Northeast Brazil, through self-completed questionnaires. The study assessed the conformity of knowledge and practices according to the Brazilian Ministry of Health protocols...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28724394/development-of-newborn-screening-connect-nbs-connect-a-self-reported-patient-registry-and-its-role-in-improvement-of-care-for-patients-with-inherited-metabolic-disorders
#2
Yetsa Osara, Kathryn Coakley, Aishwarya Devarajan, Rani H Singh
BACKGROUND: Newborn Screening Connect (NBS Connect) is a web-based self-reported patient registry and resource for individuals and families affected by disorders included in the newborn screening panel. NBS Connect was launched in 2012 by Emory University after years of planning and grassroots work by professionals, consumers, and industry. Individuals with phenylketonuria (PKU), maple syrup urine disease (MSUD) or tyrosinemia (TYR) have been recruited through distribution of outreach materials, presentations at parent organization meetings and direct recruitment at clinic appointments...
July 19, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28717430/knowledge-attitude-and-practices-among-iranian-neurologists-toward-evidence-based-medicine
#3
Kaveh Shafiei, Fatemeh Sedaghati
Background: Evidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology. Methods: A self-administered anonymous questionnaire was distributed and filled by neurologists. Results: A total of 200 neurologists were randomly sampled and with response rate of 56%. 33.9% of responder had previously participated in EBM courses...
January 5, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28657796/a-systematic-review-of-the-literature-addressing-veterinary-care-for-underserved-communities
#4
Elizabeth LaVallee, Megan Kiely Mueller, Emily McCobb
Currently, there is a care gap in veterinary medicine affecting low-income and underserved communities, resulting in decreased nonhuman-animal health and welfare. The use of low-price and community veterinary clinics in underserved populations is a strategy to improve companion-animal health through preventative care, spay/neuter, and other low-price care programs and services. Little research has documented the structure and effectiveness of such initiatives. This systematic review aimed to assess current published research pertaining to accessible health care, community-based veterinary medicine, and the use of community medicine in teaching programs...
June 28, 2017: Journal of Applied Animal Welfare Science: JAAWS
https://www.readbyqxmd.com/read/28624292/the-use-of-non-prescription-medicines-during-lactation-a-qualitative-study-of-community-pharmacists-attitudes-and-perspectives
#5
Tin Fei Sim, H Laetitia Hattingh, Jillian Sherriff, Lisa B G Tee
BACKGROUND: Community pharmacists play a significant role in the provision of non-prescription medicines. There is evidence that women self-medicate and use non-prescription medicines whilst breastfeeding. Studies have demonstrated that breastfeeding women are likely to seek advice from pharmacists, presenting a unique opportunity for pharmacists to provide on-going support of these women especially in relation to the appropriate use of non-prescription medicines. OBJECTIVES: This study aimed to explore community pharmacists' attitudes and perspectives towards the use of non-prescription medicines during breastfeeding...
June 10, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28619604/clinical-implementation-of-pharmacogenomics-for-personalized-precision-medicine-barriers-and-solutions
#6
REVIEW
Michelle Elizabeth Klein, Md Masud Parvez, Jae-Gook Shin
Clinical implementation of pharmacogenomics (PGx) leads to personalized medicine, which improves the efficacy, safety, and cost-effectiveness of treatments. Although PGx-based research has been conducted for more than a decade, several barriers have slowed down its widespread implementation in clinical practice. Globally, there is an imbalance in programs and solutions required to empower the clinical implementation of PGx between countries. Therefore, we aimed to review these issues comprehensively, determine the major barriers, and find the best solutions...
June 12, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#7
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28599742/assessing-marijuana-use-during-pregnancy
#8
Allyssa L Harris, Chiamaka S Okorie
Recreational and medicinal marijuana uses have become more prevalent in recent years. Women's health nurses are increasingly likely to encounter pregnant women who use or have used marijuana. Research has found that inadequate screening for substance use, inadequate knowledge about the effects of marijuana use, and punitive counseling are barriers to women's understanding of the importance of seeking treatment for substance use. Provision of evidence-based counseling, education, and resources support women and strengthen the patient-provider relationship...
June 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/28592474/implementing-intensive-care-unit-family-centered-care-resources-to-identify-and-address-gaps
#9
David Y Hwang, Robert El-Kareh, Judy E Davidson
During creation of the 2017 Society of Critical Care Medicine Guidelines for Family-Centered Care in the Intensive Care Unit, 2 implementation tools were developed to assist intensive care unit clinicians in incorporating the new recommendations into local practice: a gap analysis tool and a work tools document. The gap analysis tool helps intensive care unit teams rapidly develop unit- or organization-specific recommendations to enhance family-centered care and assess local barriers to implementation. The work tools document identifies readily available and tested resources that may further assist with action planning for change...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28588206/in-situ-freeze-drying-forming-amorphous-solids-directly-within-capsules-an-investigation-of-dissolution-enhancement-for-a-poorly-soluble-drug
#10
Abdulmalik Alqurshi, K L Andrew Chan, Paul G Royall
Conversion into the amorphous form enhances the dissolution of poorly soluble drugs, however the barrier to market for medicines containing an amorphous drug is poor stability. The aim was to produce the amorphous form of a drug within a capsule, without thermal or mechanical stress during manufacture. To facilitate this aim, the mechanism for drug-polymer interaction was explored. Nifedipine and polyvinylpyrrolidone were dissolved in tert-butanol at different drug/polymer ratios. These solutions were dispensed into gelatin capsules and freeze-dried...
June 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28583164/health-professionals-views-on-the-barriers-and-enablers-to-evidence-based-practice-for-acute-stroke-care-a-systematic-review
#11
REVIEW
Leonard Baatiema, Michael E Otim, George Mnatzaganian, Ama de-Graft Aikins, Judith Coombes, Shawn Somerset
BACKGROUND: Adoption of contemporary evidence-based guidelines for acute stroke management is often delayed due to a range of key enablers and barriers. Recent reviews on such barriers focus mainly on specific acute stroke therapies or generalised stroke care guidelines. This review examined the overall barriers and enablers, as perceived by health professionals which affect how evidence-based practice guidelines (stroke unit care, thrombolysis administration, aspirin usage and decompressive surgery) for acute stroke care are adopted in hospital settings...
June 5, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28562301/pain-assessment-and-treatment-in-children-with-significant-impairment-of-the-central-nervous-system
#12
Julie Hauer, Amy J Houtrow
Pain is a frequent and significant problem for children with impairment of the central nervous system, with the highest frequency and severity occurring in children with the greatest impairment. Despite the significance of the problem, this population remains vulnerable to underrecognition and undertreatment of pain. Barriers to treatment may include uncertainty in identifying pain along with limited experience and fear with the use of medications for pain treatment. Behavioral pain-assessment tools are reviewed in this clinical report, along with other strategies for monitoring pain after an intervention...
May 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28527495/consumer-mobile-health-apps-current-state-barriers-and-future-directions
#13
REVIEW
Cheng-Kai Kao, David M Liebovitz
This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28526075/testing-times-trends-in-availability-price-and-market-share-of-malaria-diagnostics-in-the-public-and-private-healthcare-sector-across-eight-sub-saharan-african-countries-from-2009-to-2015
#14
Kara Hanson, Catherine Goodman
BACKGROUND: The World Health Organization guidelines have recommended that all cases of suspected malaria should receive a confirmatory test with microscopy or a malaria rapid diagnostic test (RDT), however evidence from sub-Saharan Africa (SSA) illustrates that only one-third of children under five with a recent fever received a test. The aim of this study was to evaluate availability, price and market share of microscopy and RDT from 2009/11 to 2014/15 in 8 SSA countries, to better understand barriers to improving access to malaria confirmatory testing in the public and private health sectors...
May 19, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28471166/crocus-sativus-extract-tightens-the-blood-brain-barrier-reduces-amyloid-%C3%AE-load-and-related-toxicity-in-5xfad-mice
#15
Yazan S Batarseh, Sonali S Bharate, Vikas Kumar, Ajay Kumar, Ram A Vishwakarma, Sandip B Bharate, Amal Kaddoumi
Crocus sativus, commonly known as saffron or Kesar, is used in Ayurveda and other folk medicines for various purposes as an aphrodisiac, antispasmodic, and expectorant. Previous evidence suggested that Crocus sativus is linked to improving cognitive function in Alzheimer's disease (AD) patients. The aim of this study was to in vitro and in vivo investigate the mechanism(s) by which Crocus sativus exerts its positive effect against AD. The effect of Crocus sativus extract on Aβ load and related toxicity was evaluated...
May 15, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28470133/exploring-the-advantages-of-using-social-network-sites-snss-in-dental-medicine-organisations
#16
Mário Franco, Leonor Pais
Purpose The purpose of this paper is to deepen and contribute to knowledge of the use of social network sites (SNSs) in organisations, and more precisely, identify the advantages. Design/methodology/approach To reach this objective, a cross-section study was adopted based on application of a questionnaire, the final sample consisting of 78 dental medicine organisations in Portugal. Findings The results obtained lead to the conclusion that a great number of the organisations studied are connected to SNSs, particularly Facebook...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28468646/a-real-world-approach-to-evidence-based-medicine-in-general-practice-a-competency-framework-derived-from-a-systematic-review-and-delphi-process
#17
Kevin Galbraith, Alison Ward, Carl Heneghan
BACKGROUND: Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care...
May 3, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28465672/reasons-why-nurses-decline-influenza-vaccination-a-qualitative-study
#18
Anina Pless, Stuart R McLennan, Dunja Nicca, David M Shaw, Bernice S Elger
BACKGROUND: To explore reasons of non-vaccinated nursing staff for declining seasonal influenza vaccination. The annual influenza vaccination of healthcare workers reduces morbidity and mortality among vulnerable patients. Still, vaccination rates remain very low, particularly in nursing staff. While several studies have explored barriers for healthcare workers to get vaccinated, most have used a quantitative approach. METHODS: Data were collected by in-depth individual semi-structured interviews with 18 nurses from a range of fields, positions in organizational hierarchy, work experience and hospitals in two German-speaking cantons in Switzerland...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28447582/training-the-next-generation-of-canadian-clinician-scientists-charting-a-path-to-success
#19
Charles Yin, Patrick E Steadman, Tavis Apramian, Tianwei E Zhou, Abdullah Ishaque, Xin Wang, Alexandra Kuzyk, Nebras Warsi
Clinician-scientists are physicians with training in both clinical medicine and research that enables them to occupy a unique niche as specialists in basic and translational biomedical research. While there is widespread acknowledgement of the importance of clinician-scientists in today's landscape of evidence-based medical practice, training of clinician-scientists in Canada has been on the decline, with fewer opportunities to obtain funding. With the increasing length of training and lower financial compensation, fewer medical graduates are choosing to pursue such a career...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#20
Lauren E Zinns, Paul C Mullan, Karen J OʼConnell, Leticia M Ryan, Angela T Wratney
BACKGROUND: Postresuscitation debriefing (PRD) is recommended by the American Heart Association guidelines but is infrequently performed. Prior studies have identified barriers for pediatric emergency medicine (PEM) fellows including lack of a standardized curriculum. OBJECTIVE: Our objective was to create and assess the feasibility of a time-limited, structured PRD framework entitled REFLECT: Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasize key points, Communicate clearly, and Transform the future...
April 18, 2017: Pediatric Emergency Care
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