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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/29162047/treatment-recommendations-within-the-leeway-of-clinical-guidelines-a-qualitative-interview-study-on-oncologists-clinical-deliberation
#1
I Otte, S Salloch, A Reinacher-Schick, J Vollmann
BACKGROUND: Recommending the optimal treatment for an individual patient requires a well-balanced consideration of various medical, social and ethical factors. The interplay of these factors, interpretation of the patient's situation and understanding of the existing clinical guidelines can lead to divergent therapy recommendations, depending on the attending physician. Gaining a better understanding of the individual process of medical decision-making and the differences occurring will support the delivery of optimal individualized care within the clinical setting...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29136247/behavioral-mental-health-an-emerging-field-of-service-or-an-oxymoron
#2
Christopher G Hudson
Proliferation in the use of the terminology around behavioral mental health suggests, on one hand, an emerging field of service that integrates psychiatric, substance abuse, and related services. On the other hand, this development also raises questions about the coherence of this approach. This review explores the history, definitional issues, current trends, and available data on the impact of this field. It considers a variety of critiques of behavioral mental health, such as possibility that the field attempts to integrate fundamentally incompatible domains, that the term "behavioral mental health" is thus an oxymoron, and that it represents a co-optation by the insurance industry of traditional ideals of mental health and of behavioral medicine or as code for the implementation of a medical model that emphasizes short-term, behavioral, and psychopharmacological treatments at the expense of a truly biopsychosocial orientation...
November 9, 2017: Social Work
https://www.readbyqxmd.com/read/29126361/a-survey-of-the-current-practice-of-intramuscular-botulinum-toxin-injections-for-hemiplegic-shoulder-pain-in-the-uk
#3
Richard J Holmes, Louise A Connell
PURPOSE: To describe the current UK practice for the use of intramuscular Botulinum Toxin type A injections to treat hemiplegic shoulder pain. METHOD: A UK-based cross-sectional study using an online survey. Participants (n = 68) were medical and non-medical practitioners recruited via the membership of the British Society for Rehabilitation Medicine and the British Neurotoxin Network. Data was analysed using descriptive statistics and content analysis. RESULTS: The majority of respondents would consider Botulinum Toxin type A for hemiplegic shoulder pain (86...
November 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29110668/measuring-the-bias-against-low-income-country-research-an-implicit-association-test
#4
Matthew Harris, James Macinko, Geronimo Jimenez, Pricila Mullachery
BACKGROUND: With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries...
November 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29094773/availability-of-prostate-cancer-exercise-rehabilitation-resources-and-practice-patterns-in-belgium-results-of-a-cross-sectional-study
#5
R Bultijnck, B Van Ruymbeke, S Everaert, H Bagué, E Rammant, S Rimbaut, V Fonteyne, N Lumen, K Decaestecker, P Ost
Exercise is recommended for prostate cancer (PCa) patients treated with androgen deprivation therapy. The goal of the study was to assess the availability of hospital-based rehabilitation resources and national practice patterns for PCa in Belgium. A questionnaire was conducted with rehabilitation physical therapists in all Belgian hospital with urology and rehabilitation departments. Practice patterns were compared with the American College of Sports Medicine guidelines. PCa prevalence data were obtained from the Belgian Cancer Registry and attitude of physicians towards physical activity was documented...
November 2, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29081997/implementation-of-effective-practices-in-health-facilities-a-systematic-review-of-cluster-randomised-trials
#6
Emma R Allanson, Özge Tunçalp, Joshua P Vogel, Dina N Khan, Olufemi T Oladapo, Qian Long, Ahmet Metin Gülmezoglu
BACKGROUND: The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. METHODS: All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29073653/the-state-of-quality-improvement-and-patient-safety-teaching-in-health-professional-education-in-new-zealand
#7
Gillian Robb, Iwona Stolarek, Susan Wells, Gillian Bohm
AIM: To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. METHODS: All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT)...
October 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28990797/competing-agendas-and-other-tensions-in-developing-patient-centred-communication-in-audiology-education-a-qualitative-study-of-educator-perspectives
#8
Samantha Tai, Caitlin Barr, Robyn Woodward-Kron
OBJECTIVE: Patient-centred communication (PCC) is an essential skill for effective healthcare provision and is accepted as a core competency in medicine and allied health. In audiology, recent studies have shown that audiologists rarely display PCC in adult hearing interactions. This highlights a need to investigate how PCC is taught and learnt in audiology. There is a paucity of studies on PCC in audiology education. The aim of this study is to examine educator perceptions of teaching PCC, including barriers and facilitators, in Australian graduate audiology programmes...
October 9, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28987076/potential-facilitators-and-barriers-to-awareness-of-n-of-1-trials-for-physicians-in-traditional-chinese-medicine
#9
Jiang Li, Dang Wei, Junqiang Niu, Min Yang, Long Ge, Xiaoqin Wang, Wenzhen Yuan, Jinhui Tian, Hongcai Shang, Jingbo Zhai, Kehu Yang, Min Dai
Context • N-of-1 trials are multiple crossover trials with randomized and blinded methods, conducted with a single participant to evaluate the effectiveness and safety of a therapy. They can be a helpful tool for enriching clinical research for traditional Chinese medicine (TCM), but the approach has gained little traction in TCM. Information is needed before supporters of the trials can pursue a change to that status. Objective • The study intended to obtain data needed to support TCM clinicians' adoption of N-of-1 trials...
October 2, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28972977/managerial-attitudes-and-perceived-barriers-regarding-evidence-based-practice-an-international-survey
#10
Eric Barends, Josh Villanueva, Denise M Rousseau, Rob B Briner, Denise M Jepsen, Edward Houghton, Steven Ten Have
Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived barriers related to EBP. In medicine and nursing, an abundance of research exists on this subject, although such studies are rare in management. To address this gap, we surveyed 2,789 management practitioners in Belgium, the Netherlands, the United States, the United Kingdom and Australia...
2017: PloS One
https://www.readbyqxmd.com/read/28953291/family-physicians-and-provision-of-immediate-postpartum-contraception-a-cera-study
#11
Michelle H Moniz, Anna K McEvoy, Michelle Hofmeister, Missy Plegue, Tammy Chang
BACKGROUND AND OBJECTIVES: The Centers for Disease Control and Prevention (CDC) support the provision of intrauterine devices (IUDs) and the contraceptive implant to women immediately after childbirth. We aimed to assess perceived training needs and barriers to immediate postpartum contraceptive service delivery among US family physicians. METHODS: We contributed items regarding postpartum contraception to the 2015 Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey of a national cohort of family medicine educators...
September 2017: Family Medicine
https://www.readbyqxmd.com/read/28949100/cancer-multidisciplinary-team-meetings-in-practice-results-from-a-multi-institutional-quantitative-survey-and-implications-for-policy-change
#12
Nicole M Rankin, Michelle Lai, Danielle Miller, Philip Beale, Allan Spigelman, Gabrielle Prest, Kim Turley, John Simes
AIM: Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. METHODS: We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses...
September 26, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28930219/qigong-in-cancer-care-theory-evidence-base-and-practice
#13
Penelope Klein
Background: The purpose of this discussion is to explore the theory, evidence base, and practice of Qigong for individuals with cancer. Questions addressed are: What is qigong? How does it work? What evidence exists supporting its practice in integrative oncology? What barriers to wide-spread programming access exist? Methods: Sources for this discussion include a review of scholarly texts, the Internet, PubMed, field observations, and expert opinion. Results: Qigong is a gentle, mind/body exercise integral within Chinese medicine...
January 12, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28927507/providing-physical-care-to-persons-with-serious-mental-illness-attitudes-confidence-barriers-and-psychological-empowerment
#14
Margaret Knight, Paula Bolton, Lynne Kopeski
The prevalence of metabolic syndrome (MetS) in people with serious mental illness (SMI) has been well documented in the mental health literature. Despite the adoption of various guidelines for monitoring risk factors for diabetes and cardiovascular risk in this population, limited translation has occurred in actual practice (Hermes, Sernyak, & Rosenheck, 2013). The Institute of Medicine (IoM) (2009) has noted a lag time in the application of knowledge within clinical settings. Evidence-based practice was deemed as a means of improving healthcare outcomes through the use of science supported standards of care...
October 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28927448/barriers-and-facilitators-to-implementing-addiction-medicine-fellowships-a-qualitative-study-with-fellows-medical-students-residents-and-preceptors
#15
J Klimas, W Small, K Ahamad, W Cullen, A Mead, L Rieb, E Wood, R McNeil
BACKGROUND: Although progress in science has driven advances in addiction medicine, this subject has not been adequately taught to medical trainees and physicians. As a result, there has been poor integration of evidence-based practices in addiction medicine into physician training which has impeded addiction treatment and care. Recently, a number of training initiatives have emerged internationally, including the addiction medicine fellowships in Vancouver, Canada. This study was undertaken to examine barriers and facilitators of implementing addiction medicine fellowships...
September 20, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28915280/communication-concepts-for-prevention-and-early-intervention-in-aesthetic-medicine-consensus-and-literature-review
#16
Uliana Gout, Chytra V Anand, Andre Braz, Yates Yen Yu Chao, Sabrina Guillen Fabi, Martina Kerscher, Marina Landau, Tatjana Pavicic, Peter Hsien Li Peng, Berthold Rzany, Gerhard Sattler, Tunk Tiryaki, Heidi A Waldorf, Thierry Besins
BACKGROUND: Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. OBJECTIVES: To introduce the framework for P&E communication strategies within a younger population and explore the barriers that may be encountered. METHODS: A literature review on P&E communication strategies in aesthetic medicine and related topics of interest was conducted and used to construct a working framework that may be applied in clinical practice...
September 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28892437/public-health-system-research-in-public-health-emergency-preparedness-in-the-united-states-2009-2015-actionable-knowledge-base
#17
REVIEW
Elena Savoia, Leesa Lin, Dottie Bernard, Noah Klein, Lyndon P James, Stefano Guicciardi
BACKGROUND: In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. OBJECTIVES: To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research...
September 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28858917/why-do-we-fail-to-deliver-evidence-based-practice-in-critical-care-medicine
#18
Curtis H Weiss
PURPOSE OF REVIEW: The use of evidence-based practices in clinical practice is frequently inadequate. Recent research has uncovered many barriers to the implementation of evidence-based practices in critical care medicine. Using a comprehensive conceptual framework, this review identifies and classifies the barriers to implementation of several major critical care evidence-based practices. RECENT FINDINGS: The many barriers that have been recently identified can be classified into domains of the consolidated framework for implementation research (CFIR)...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28854877/demand-side-financing-for-maternal-and-newborn-health-what-do-we-know-about-factors-that-affect-implementation-of-cash-transfers-and-voucher-programmes
#19
Benjamin M Hunter, Susan F Murray
BACKGROUND: Demand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health...
August 31, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28835778/effectiveness-of-intra-articular-therapies-in-osteoarthritis-a-literature-review
#20
REVIEW
Peter Wehling, Christopher Evans, Jana Wehling, William Maixner
Osteoarthritis is a painful, chronic disease with widespread burden on patients, communities, health and social care systems. Conservative therapies, such as nonpharmacological interventions, systemic drug treatment and intra-articular therapies are used before resorting to surgery; nonetheless, disease control often remains inadequate. Recent advances in osteoarthritis management have aimed to provide greater variety of treatment options. Here, we summarize a targeted literature review evaluating efficacy and safety of intra-articular therapies for osteoarthritis...
August 2017: Therapeutic Advances in Musculoskeletal Disease
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