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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/28067194/mapping-actions-to-improve-access-to-medicines-for-mental-disorders-in-low-and-middle-income-countries
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27926624/improving-the-use-of-evidence-based-practice-and-research-utilization-through-the-identification-of-barriers-to-implementation-in-a-critical-access-hospital
#7
Dawn Carol Stavor, Judith Zedreck-Gonzalez, Rosemary L Hoffmann
OBJECTIVE: This study explored the relationship between perceived barriers to research use and the implementation of evidence-based practice (EBP) among rural hospital nurses. BACKGROUND: The Institute of Medicine recommends that 90% of clinical decisions be evidence based by 2020. METHODS: This descriptive, quality improvement study used a convenience sampling of registered nurses (RNs). Participants completed multiple questionnaires. RESULTS: Overall the attitude toward EBP was positive...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#8
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27900739/-evidence-based-knowledge-translation-from-scientific-evidence-to-clinical-nursing-practice
#9
Kee-Hsin Chen, Ching-Chiu Kao, Chiehfeng Chen
In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27893918/breast-milk-collection-and-storage-in-the-neonatal-intensive-care-unit-nurses-knowledge-practice-and-perceived-barriers
#10
Huda Falah Gharaibeh, Nihaya Al-Sheyab, Shefa Yousef Malkawi
BACKGROUND: Temporary storage of human milk under appropriate conditions encourages prolonged breast-feeding. PURPOSE: This study aimed to assess neonatal nurses' knowledge and practice, as well as barriers, related to breast milk collection and storage and to investigate the association between nurses' knowledge and practice and other variables. METHOD: A cross-sectional design was used. Consecutive samplings of 75 nurses were recruited. The questions were based on a literature review of guidelines for collecting and storing breast milk from various sources, such as the Centers for Disease Control and Prevention and the Academy of Breastfeeding Medicine...
December 1, 2016: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/27875451/developing-a-framework-to-help-bedside-nurses-bring-about-change
#11
Jordan S Porter, Kelley A Strout
: Nurses across all care settings and experience levels are being called upon to lead. In a 2011 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine examined the ways nurses could more fully apply their knowledge of direct patient care to address the increasing demands placed on the health care system since the passage of the Affordable Care Act. The report asked: "What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?"Multiple variables influence a nurse's ability to assume a leadership role, and multiple barriers to these roles continue to exist...
December 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27869877/-computerized-decision-support-systems-ebm-at-the-bedside
#12
Matteo Capobussi, Rita Banzi, Lorenzo Moja, Stefanos Bonovas, Marien González-Lorenzo, Elisa Giulia Liberati, Hernan Polo Friz, Oriana Nanni, Massimo Mangia, Francesca Ruggiero
INTRODUCTION: One of the aims of Evidence-Based Medicine is to improve quality and appropriateness of care by the expedition of the knowledge transfer process. Computerized Decision Support Systems (CDSSs) are computer programs that provide alerts to the prescribing doctor directly at the moment of medical examination. In fact, alerts are integrated within the single patient electronic health record. CDSS based on the best available and updated evidence and guidelines may be an efficient tool to facilitate the transfer of the latest results from clinical research directly at the bedside, thus supporting decision-making...
November 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27857272/clinical-approach-for-patient-centered-physical-activity-assessment-and-interventions
#13
Allica Austin, Shamsha Damani, Therese Bevers
BACKGROUND: A physical activity algorithm for adults was created with the aim of reducing patients' barriers for physical activity by providing healthcare professionals with a standardized process to guide clinical discussions on physical activity to reduce the risk of chronic diseases, specifically cancer. OBJECTIVES: The physical activity algorithm was designed as an applicable process that could be adopted in many professional settings with the mission to provide relevant, safe, and appropriate physical activity interventions...
December 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27785350/training-emergency-physicians-in-sex-and-gender-based-medicine-assessing-attitudes-of-program-directors-and-residency-graduates
#14
Tracy E Madsen, Alyson J McGregor
BACKGROUND: Sex and gender influence disease presentation, treatment, healthcare access, and long-term outcomes. It is uncertain to what extent sex- and gender-based medicine (SGBM) content has been integrated into emergency medicine (EM) residency curricula. We aimed to determine if SGBM is being taught in EM residency training, if EM residency program directors (PDs) declare SGBM a curriculum priority, and if recent graduates (RGs) of EM residency programs declare SGBM as relevant to their practice...
2016: Biology of Sex Differences
https://www.readbyqxmd.com/read/27754281/hw-04-1-usefulness-of-big-data-in-clinical-research
#15
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27748248/implementation-of-sleep-and-circadian-science-recommendations-from-the-sleep-research-society-and-national-institutes-of-health-workshop
#16
Sairam Parthasarathy, Mary A Carskadon, Girardin Jean-Louis, Judith Owens, Adam Bramoweth, Daniel Combs, Lauren Hale, Elizabeth Harrison, Chantelle N Hart, Brant P Hasler, Sarah M Honaker, Elisabeth Hertenstein, Samuel Kuna, Clete Kushida, Jessica C Levenson, Caitlin Murray, Allan I Pack, Vivek Pillai, Kristi Pruiksma, Azizi Seixas, Patrick Strollo, Saurabh S Thosar, Natasha Williams, Daniel Buysse
No abstract text is available yet for this article.
December 1, 2016: Sleep
https://www.readbyqxmd.com/read/27735926/experiences-from-a-pilot-program-bringing-brca1-2-genetic-screening-to-theus-ashkenazi-jewish-population
#17
Chana Wiesman, Esther Rose, Allison Grant, Adam Zimilover, Susan Klugman, Nicole Schreiber-Agus
PURPOSE: The notion of offering population-based screening to the Ashkenazi Jewish (AJ) population for the BRCA1/2 founder mutations continues to gain support. A program called the BRCAcommunity initiative was designed to identify the benefits and barriers associated with implementing this screening in a clinical setting. METHODS: Interested AJ individuals were stratified into high-risk (HR) and low-risk (LR) groups based on self-reported cancer histories. Those at HR were offered traditional genetic counseling/testing; those at LR were offered group genetic counseling and subsidized AJ BRCA founder mutation testing...
October 13, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27733918/novel-models-to-improve-access-to-medicines-for-chronic-diseases-in-south-africa-an-analysis-of-stakeholder-perspectives-on-community-based-distribution-models
#18
Bvudzai Priscilla Magadzire, Bruno Marchal, Kim Ward
BACKGROUND: The rising demand for chronic disease treatment and the barriers to accessing these medicines have led to the development of novel models for distributing medicines in South Africa's public sector, including distribution away from health centres, known as community-based distribution (CBD). In this article, we provide a typology of CBD models and outline perceived facilitators and barriers to their implementation using an adapted health systems framework with a view to analysing how future policy decisions on CBD could impact existing models and the health system as a whole...
2016: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/27720694/the-power-of-capturing-and-using-information-at-the-point-of-care
#19
William H Gruber, Adam C Powell, John B Torous
Historically, the process of scientific discovery and the process of clinical delivery have been poorly integrated. As a result of the Decade of Health Information Technology (2004-2014), many of the former barriers to capturing, processing, and retrieving medical information at the point of care have been surmounted. This change has the potential to both transform how new medical discoveries are made and how evidence-based medicine is put into practice. To illustrate the impact of this ongoing change, several examples are provided of institutions which have innovatively used information at the point of care...
October 6, 2016: Healthcare
https://www.readbyqxmd.com/read/27694289/preparing-dental-students-and-residents-to-overcome-internal-and-external-barriers-to-evidence-based-practice
#20
Brandon G Coleman, Thomas M Johnson, Kenneth J Erley, Richard Topolski, Michael Rethman, Douglas D Lancaster
In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice...
October 2016: Journal of Dental Education
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