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Barriers Evidence Based Medicine

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https://www.readbyqxmd.com/read/29344455/qualitative-assessment-of-learning-strategies-among-medical-students-using-focus-group-discussions-and-in-depth-interviews
#1
Anuradha Sujai Joshi, Jaishree Deepak Ganjiwale, Jagdish Varma, Praveen Singh, Jyoti Nath Modi, Tejinder Singh
Background: Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. Aims and Objectives: The objective is to identify effective learning strategies used by medical students...
December 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#2
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#3
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29305720/barriers-for-the-implementation-of-guidelines-in-palliative-care-results-from-a-national-survey-of-professionals
#4
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: In 2015, an evidence- and consensus-based palliative care guideline in adults with incurable cancer was published by the German Guideline Program. Barriers and enablers for the guideline implementation of members of the German Association for Palliative Medicine (DGP) were unknown. Therefore, the aims of this study were (1) to evaluate professionals' knowledge, motivation, and outcome expectancy towards already existing recommendations for palliative care and (2) to evaluate the self-experienced competence in five medical key topics presented in the new guideline...
January 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29284761/refugees-in-conflict-creating-a-bridge-between-traditional-and-conventional-health-belief-models
#5
Eran Ben-Arye, Massimo Bonucci, Michel Daher, Rejin Kebudi, Bashar Saad, Thomas Breitkreuz, Maryam Rassouli, Elio Rossi, Nahla Gafer, Omar Nimri, Mohamed Hablas, Gunver Sophia Kienle, Noah Samuels, Michael Silbermann
The recent wave of migration from Middle Eastern countries to Europe presents significant challenges to the European health profession. These include the inevitable communication gap created by differences in health care beliefs between European oncologists, health care practitioners, and refugee patients. This article presents the conclusions of a workshop attended by a group of clinicians and researchers affiliated with the Middle East Cancer Consortium, as well as four European-based health-related organizations...
December 28, 2017: Oncologist
https://www.readbyqxmd.com/read/29278996/a-systematic-review-of-prehospital-telehealth-utilization
#6
Andrew S Winburn, Juliana J Brixey, James Langabeer, Tiffany Champagne-Langabeer
Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29248074/assessing-the-evidence-based-medicine-educational-needs-of-community-pharmacy-preceptors-within-an-experiential-program-in-qatar
#7
Bridget Paravattil, Noha El Sakrmy, Shahd Shaar
INTRODUCTION: Observations have shown a lack of evidence-based medicine (EBM) knowledge and skills among community pharmacy preceptors in Qatar. These skills are important when delivering evidence-based recommendations to healthcare providers and patients. The aim of this study was to explore the community pharmacy preceptors' knowledge and understanding of EBM and to identify challenges in applying this approach to community practice. METHODS: A survey instrument was developed to assess the knowledge of community pharmacy preceptors related to EBM...
January 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29243536/variation-in-pediatric-organ-donor-management-practices-among-us-organ-procurement-organizations
#8
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29235051/development-of-the-cns-tap-tool-for-the-selection-of-precision-medicine-therapies-in-neuro-oncology
#9
Joseph R Linzey, Bernard L Marini, Amy Pasternak, Cory Smith, Zac Miklja, Lili Zhao, Chandan Kumar-Sinha, Alyssa Paul, Nicholas Harris, Patricia L Robertson, Lindsey M Hoffman, Arul Chinnaiyan, Rajen Mody, Carl Koschmann
The number of targeted therapies utilized in precision medicine are rapidly increasing. Neuro-oncology offers a unique challenge due to the varying blood brain barrier (BBB) penetration of each agent. Neuro-oncologists face a difficult task weighing the growing number of potential targeted therapies and their likelihood of BBB penetration. We developed the CNS TAP Working Group and performed an extensive literature review for the evidence-based creation of the CNS TAP tool, which was retrospectively validated by analyzing brain tumor patients who underwent therapy targeted based on genomic results from an academic sequencing study (MiOncoseq, n = 17) or private molecular profiling (Foundation One, n = 7)...
December 12, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29229630/the-role-of-moisturizers-in-addressing-various-kinds-of-dermatitis-a-review
#10
REVIEW
Schandra Purnamawati, Budi Satria, Niken Indrastuti, Retno Danarti, Tatan Saefudin
Moisturizer is a major component of basic daily skin care, particularly in presence of epidermal barrier alteration and reduced epidermal water content. It is an important part of a dermatologist's strategy to maintain skin health as well as treating various dermatoses which co-exist with skin dryness, linked to impaired skin barrier function such as in atopic disorder as well as other types of dermatitis. Mastering the knowledge regarding action mechanism, application, dosage, adverse effects as well as specific clinical usage of moisturizers is must for a dermatologist, in order to support the capability to recommend their use, particularly for therapeutic purposes, in accordance with evidence-based medicine...
December 11, 2017: Clinical Medicine & Research
https://www.readbyqxmd.com/read/29224988/linking-hiv-negative-youth-to-prevention-services-in-12-u-s-cities-barriers-and-facilitators-to-implementing-the-hiv-prevention-continuum
#11
Mimi Doll, J Dennis Fortenberry, Denise Roseland, Kathleen McAuliff, Craig M Wilson, Cherrie B Boyer
PURPOSE: Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth...
December 7, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29224571/-worried-to-death-the-assessment-and-management-of-anxiety-in-patients-with-advanced-life-limiting-disease-a-national-survey-of-palliative-medicine-physicians
#12
N Atkin, V Vickerstaff, B Candy
BACKGROUND: Anxiety adversely affects quality of life and is common in adults with advanced life-limiting disease. There are no UK-wide guidelines on the assessment and management of anxiety in this specific population and there is little evidence regarding drug treatments. This study aimed to explore how palliative care physicians assess and manage anxiety in their patients, and to identify barriers encountered. METHODS: A cross-sectional survey was undertaken of all physicians working in specialist palliative care in the UK who were members of the Association for Palliative Medicine...
December 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29210557/improving-patient-safety-improving-communication
#13
Heather Bittner-Fagan, Joshua Davis, Margot Savoy
Communication among physicians, staff, and patients is a critical element in patient safety. Effective communication skills can be taught and improved through training and awareness. The practice of family medicine allows for long-term relationships with patients, which affords opportunities for ongoing, high-quality communication. There are many barriers to effective communication, including patient factors, clinician factors, and system factors, but tools and strategies exist to address these barriers, improve communication, and engage patients in their care...
December 2017: FP Essentials
https://www.readbyqxmd.com/read/29201367/services-aimed-at-achieving-desirable-clinical-outcomes-in-patients-with-chronic-kidney-disease-and-diabetes-mellitus-a-narrative-review
#14
REVIEW
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
There is a large number of patients with chronic kidney disease (CKD), diabetes mellitus (DM), and hypertension (HT) but whether the targets on blood pressure (BP) control in patients with DM and/or CKD are met is not clear. This narrative review therefore investigated evidence on services aimed at achieving desirable clinical results in patients with CKD and DM, and HT in Australia. Literature pertaining to pathology diagnosis and management of these patients as well as the complexities in management were considered...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29178120/awareness-attitudes-and-knowledge-about-evidencebased-medicine-among-doctors-in-gaza-a-crosssectional-survey
#15
Loai Albarqouni, Khamis Elessi
Evidence-based medicine (EBM) has emerged as a strategy to integrate research evidence within clinical decision-making. We have explored awareness, knowledge and attitudes about EBM among doctors in the Gaza Strip. In 2014, we conducted a cross-sectional survey among doctors working in health centres in Gaza, using a 20 item, web-based self-administered questionnaire. Approximately two thirds of the respondents welcomed EBM in principle, and believed that it could improve patient care. However, they had a relatively low level of knowledge about EBM...
November 19, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/29177130/sleep-disordered-breathing-and-spinal-cord-injury-challenges-and-opportunities
#16
Abdulghani Sankari, Jennifer L Martin, M Safwan Badr
Purpose of review: This paper focuses on the sleep disorders in patients with spinal cord injury (SCI/D), particularly mechanism of sleep disordered breathing (SDB) and challenges in diagnosis and management. Based on a review of recent literatures and studies the paper summarizes some main challenges with respect to management of SDB in patients with SCI; and what are the responsible mechanisms of disease? What are the barriers in diagnosing and treating SDB using standard treatment such as positive airway pressure (CPAP)?...
December 2017: Current Sleep Medicine Reports
https://www.readbyqxmd.com/read/29169287/point-of-care-testing-poct-and-evidence-based-laboratory-medicine-eblm-does-it-leverage-any-advantage-in-clinical-decision-making
#17
Christopher Florkowski, Andrew Don-Wauchope, Nuria Gimenez, Karina Rodriguez-Capote, Julien Wils, Annalise Zemlin
Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870...
November 23, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29162047/treatment-recommendations-within-the-leeway-of-clinical-guidelines-a-qualitative-interview-study-on-oncologists-clinical-deliberation
#18
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
#19
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
#20
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
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