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A Arias, O A Peters, I L Broyles
AIM: To develop, implement and evaluate an innovative curriculum in biostatistics in response to the needs of fostering critical thinking in graduate health care education for evidence-based practice and life-long learning education. METHODOLOGY: The curriculum was designed for first-year residents in a postgraduate endodontic program using a six-step approach to curriculum development to provide sufficient understanding to critically evaluate biomedical publications, to design the best research strategy to address a specific problem and to analyse data by appropriate statistical test selection...
October 26, 2016: International Endodontic Journal
Salem A Beshyah, Ibrahim H Sherif, Farida Chentli, Amir Hamrahian, Aly B Khalil, Hussein Raef, Mohamed El-Fikki, Selim Jambart
BACKGROUND: Prolactinomas are the commonest functional tumors of the pituitary gland. There are still controversies regarding medical therapy in specific clinical situations. Patients may be managed by different specialists in the Middle East and North Africa (MENA) region and no data exist on patterns of clinical management. OBJECTIVES: To ascertain the diagnostic and therapeutic approaches to prolactinomas among relevant professionals from the MENA region. METHODS: An online survey of a large sample of physicians was conducted...
October 25, 2016: Pituitary
Joseph A Ricci, Kayva Crawford, Olivia A Ho, Bernard T Lee, Ketan M Patel, Matthew L Iorio
BACKGROUND: Venous thromboembolism encompasses a spectrum of disease, ranging from asymptomatic deep vein thrombosis to fatal pulmonary embolism. As microsurgical techniques increase in complexity, the overriding benefit from a microsurgical versus a venous thromboembolism prophylactic regimen remains unclear. This study evaluated the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on the utility of prophylaxis in microsurgical procedures...
November 2016: Plastic and Reconstructive Surgery
Chuan Zhou, Heang-Ping Chan, Lubomir M Hadjiiski, Aamer Chughtai, Jun Wei, Ella A Kazerooni
PURPOSE: The authors are developing an automated method to identify the best-quality coronary arterial segment from multiple-phase coronary CT angiography (cCTA) acquisitions, which may be used by either interpreting physicians or computer-aided detection systems to optimally and efficiently utilize the diagnostic information available in multiple-phase cCTA for the detection of coronary artery disease. METHODS: After initialization with a manually identified seed point, each coronary artery tree is automatically extracted from multiple cCTA phases using our multiscale coronary artery response enhancement and 3D rolling balloon region growing vessel segmentation and tracking method...
October 2016: Medical Physics
Lin Wang, Guanrong Chen
A hybrid multi-agent systems model integrating the advantages of both metric interaction and topological interaction rules, called the metric-topological model, is developed. This model describes planar motions of mobile agents, where each agent can interact with all the agents within a circle of a constant radius, and can furthermore interact with some distant agents to reach a pre-assigned number of neighbors, if needed. Some sufficient conditions imposed only on system parameters and agent initial states are presented, which ensure achieving synchronization of the whole group of agents...
September 2016: Chaos
Karen Wells, Marie McCaig
BACKGROUND: This paper uses a case study to describe the implementation of the Magic Wand Question (MWQ), also known as the miracle question, in a child and adolescent mental health service (CAMHS) in Scotland. The MWQ, a common intervention, is based on a Solution-Focused Brief Therapy (SFBT) approach. This intervention was undertaken by a third year student nurse with the intention of demonstrating how practice can be more closely aligned to a recovery-focused, strengths-based approach, which is in line with national policy...
October 26, 2016: Journal of Child and Adolescent Psychiatric Nursing
John Deke
BACKGROUND: Cluster randomized controlled trials (CRCTs) often require a large number of clusters in order to detect small effects with high probability. However, there are contexts where it may be possible to design a CRCT with a much smaller number of clusters (10 or fewer) and still detect meaningful effects. OBJECTIVES: The objective is to offer recommendations for best practices in design and analysis for small CRCTs. RESEARCH DESIGN: I use simulations to examine alternative design and analysis approaches...
October 25, 2016: Evaluation Review
Suhny Abbara, Philipp Blanke, Christopher D Maroules, Michael Cheezum, Andrew D Choi, B Kelly Han, Mohamed Marwan, Chris Naoum, Bjarne L Norgaard, Ronen Rubinshtein, Paul Schoenhagen, Todd Villines, Jonathon Leipsic
In response to recent technological advancements in acquisition techniques as well as a growing body of evidence regarding the optimal performance of coronary computed tomography angiography (coronary CTA), the Society of Cardiovascular Computed Tomography Guidelines Committee has produced this update to its previously established 2009 "Guidelines for the Performance of Coronary CTA" (1). The purpose of this document is to provide standards meant to ensure reliable practice methods and quality outcomes based on the best available data in order to improve the diagnostic care of patients...
October 12, 2016: Journal of Cardiovascular Computed Tomography
Yuna Rapoport, Peter Veldman
INTRODUCTION: As Descemet's Membrane Endothelial Keratoplasty (DMEK) continues to gain in popularity, the postoperative management of DMEK surgery is becoming increasingly important, as these management strategies may affect postoperative success rates. MATERIALS AND METHODS: This article reviews the current evidence for postoperative management in DMEK. RESULTS: There are variable strategies in the postoperative management of DMEK as it relates to postoperative positioning, need for and timing of rebubble, tamponade agent utilized (both primarily and at rebubble), steroid agent and tapering schedule, timing of secondary regraft when required, and postoperative monitoring...
October 26, 2016: Seminars in Ophthalmology
Aaron B Parrish, Yas Sanaiha, Beverley A Petrie, Marcia M Russell, Formosa Chen
The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed...
October 2016: American Surgeon
Rebecca Ruch-Gallie, Heather Weir, Lori R Kogan
Cognitive functioning is often compromised with increasing levels of stress and fatigue, both of which are often experienced by veterinarians. Many high-stress fields have implemented checklists to reduce human error. The use of these checklists has been shown to improve the quality of medical care, including adherence to evidence-based best practices and improvement of patient safety. Although it has been recognized that veterinary medicine would likely demonstrate similar benefits, there have been no published studies to date evaluating the use of checklists for improving quality of care in veterinary medicine...
October 25, 2016: Journal of Veterinary Medical Education
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques, Leonardo Régis Leira Pereira
Several newer antiepileptic drugs (AEDs) have been introduced into clinical practice, offering choices for individualizing the treatment of epilepsy since AEDs have different efficacy and tolerability profiles. In particular, questions exist regarding which AEDs are the best options for the monotherapy of focal epilepsy. Is carbamazepine (CBZ), which is considered the standard treatment for focal epilepsy, still the best option for monotherapy of focal epilepsy, despite the emergence of new AEDs? In this systematic review, we compared the relative tolerability of all available AEDs for monotherapy of all types of epilepsy as well as their efficacy in the monotherapy of focal epilepsy...
October 25, 2016: Pharmacotherapy
Cheryl Fisher, Georgie Cusack, Kim Cox, Kathryn Feigenbaum, Gwenyth R Wallen
Organizations must ensure that nursing care delivery is based on best evidence. This article describes how a clinical research hospital used a competency-based approach to structure the development and execution of a strategic plan and integrated evidence-based practice concepts into the activities of nurses at all levels. The article will also describe the process for developing and implementing the competency across our department including outcomes achieved.
November 2016: Journal of Nursing Administration
P P T Jeurissen, B A Ravesteijn, R T J M Janssen, M A C Tanke
After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery.<br/> AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses.<br/> METHOD: Review of academic articles and policy studies.<br/> RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health...
2016: Tijdschrift Voor Psychiatrie
D Brynn Hibbert, Pall Thordarson
Data analysis is central to understanding phenomena in host-guest chemistry. We describe here recent developments in this field starting with the revelation that the popular Job plot method is inappropriate for most problems in host-guest chemistry and that the focus should instead be on systematically fitting data and testing all reasonable binding models. We then discuss approaches for estimating uncertainties in binding studies using case studies and simulations to highlight key issues. Related to this is the need for ready access to data and transparency in the methodology or software used, and we demonstrate an example a webportal () that aims to address this issue...
October 25, 2016: Chemical Communications: Chem Comm
Yule Xu, Ao Rong, Yanlong Bi, Wei Xu
Purpose. To evaluate the efficacy of intravitreal conbercept (IVC) plus modified grid laser photocoagulation (MGP) versus IVC alone for treatment of diffuse diabetic macular edema (DDME). Methods. In this retrospective study, 51 DDME patients were treated with either IVC alone (IVC group) or IVC plus MGP (combined group) with 12 months of follow-up. The clinical records of those patients were reviewed. Results. 26 patients (31 eyes) received IVC alone and 25 patients (30 eyes) received combined therapy. At month 12, the mean best-corrected visual acuity (BCVA) letter score improvement was 9...
2016: Journal of Ophthalmology
Enrique Castro-Sánchez, Yiannis Kyratsis, Michiyo Iwami, Timothy M Rawson, Alison H Holmes
BACKGROUND: The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as 'serious games' have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a) to synthesise research evidence on the use of serious games in IPC to support healthcare workers' behaviour change and best practice learning; and b) to identify gaps across the formulation and evaluation of serious games in IPC...
2016: Antimicrobial Resistance and Infection Control
Susan M Perkins, Peter Bacchetti, Cynthia S Davey, Christopher J Lindsell, Madhu Mazumdar, Robert A Oster, Peter N Peduzzi, David M Rocke, Kyle D Rudser, Mimi Kim
Given the increasing level and scope of biostatistics expertise needed at academic health centers today, we developed best practices guidelines for biostatistics units to be more effective in providing biostatistical support to their institutions, and in fostering an environment in which unit members can thrive professionally. Our recommendations focus on the key areas of: 1) funding sources and mechanisms; 2) providing and prioritizing access to biostatistical resources; and 3) interacting with investigators...
2016: American Statistician
Steven Walker, Anna C Bibby, Nick A Maskell
Malignant pleural effusions (MPEs) are an important cause of cancer-related mortality and morbidity. It is a heterogeneous group of conditions, which leads to debilitating symptoms and confers a poor prognosis. Recent well-designed randomized trials have provided a broader evidence base for an expanding range of treatment options. Together, with new prognostic scoring systems and a greater understanding of how different patient phenotypes respond to treatment, this allows greater personalization of management...
October 24, 2016: Therapeutic Advances in Respiratory Disease
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible. AIM: To identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND SETTING: Cross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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