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Evidence best practice

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https://www.readbyqxmd.com/read/29053215/the-identification-of-barriers-to-insulin-therapy-and-approaches-for-overcoming-them
#1
REVIEW
D Russell-Jones, F Pouwer, K Khunti
Poor glycaemic control in type 2 diabetes (T2D) is a global problem despite the availability of numerous glucose-lowering therapies and clear guidelines for T2D management. Tackling clinical or therapeutic inertia, where the person with diabetes and/or their healthcare providers do not intensify treatment regimens despite this being appropriate, is key to improving patients' long-term outcomes. This gap between best practice and current level of care is most pronounced when considering insulin regimens, with studies showing that insulin initiation/intensification is frequently and inappropriately delayed for several years...
October 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29052946/hierarchical-evaluation-of-electrical-stimulation-protocols-for-chronic-wound-healing-an-effect-size-meta-analysis
#2
Charles Khouri, Sylvain Kotzki, Matthieu Roustit, Sophie Blaise, Francois Gueyffier, Jena-Luc Cracowski
Electrical stimulation (ES) has been tested for decades to improve chronic wound healing. However, uncertainty remains on the magnitude of the efficacy and on the best applicable protocol. We conducted an effect size meta-analysis to assess the overall efficacy of ES on wound healing, to compare the efficacy of the different modalities of electrical stimulation, and to determine whether efficacy differs depending on the wound etiology, size and age of the chronic wound. Twenty-nine randomized clinical trials with 1510 patients and 1753 ulcers were selected...
October 20, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29052289/exploring-implementation-of-the-careful-nursing-philosophy-and-professional-practice-model-%C3%A2-in-hospital-based-practice
#3
Sinéad Murphy, Raphael Mc Mullin, Sinéad Brennan, Therese Connell Meehan
AIM: To explore the effectiveness and feasibility of implementing the two clinical dimensions of the Careful Nursing Philosophy and Professional Practice Model(©) (Careful Nursing) in an acute care hospital. BACKGROUND: Implementation of a professional practice model by nurses in hospitals supports nurses' control over their practice and enhances the quality of their contribution to patient care. Implementing such change is complex and initially best approached on a small scale...
October 19, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/29052162/international-regulations-and-recommendations-for-utility-data-for-health-technology-assessment
#4
REVIEW
Donna Rowen, Ismail Azzabi Zouraq, Helene Chevrou-Severac, Ben van Hout
Recommendations and guidelines for the collection, generation, source and usage of utility data for health technology assessment (HTA) vary across different countries, with no international consensus. Many international agencies generate their own guidelines providing details on their preferred methods for HTA submissions, and there is variability in both what they recommend and the clarity and amount of detail provided in their guidelines. This article provides an overview of international regulations and recommendations for utility data in HTA for a selection of key HTA countries: Australia, Canada, France, Germany, the Netherlands, Spain (Catalonia), Sweden and the UK (England/Wales and Scotland)...
October 19, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29052064/determinants-of-variability-in-management-of-acute-calculous-cholecystitis
#5
Philippe Paci, Nancy E Mayo, Pepa A Kaneva, Julio F Fiore, Gerald M Fried, Liane S Feldman
BACKGROUND: While evidence supports early compared to delayed cholecystectomy as optimal management of acute calculous cholecystitis (ACC), significant variability in practice remains. The purpose of this study was to identify variables associated with early cholecystectomy, to target opportunities to improve adherence to best practices. METHODS: Adult patients admitted to surgical units with ACC at two hospitals in a university hospital network between June 2010 and January 2015 were reviewed...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29051902/trends-in-surgical-practices-for-lateral-epicondylitis-among-newly-trained-orthopaedic-surgeons
#6
Dean Wang, Ryan M Degen, Christopher L Camp, Michael H McGraw, David W Altchek, Joshua S Dines
BACKGROUND: Much controversy exists regarding the optimal surgical intervention for lateral epicondylitis because of a multitude of options available and the lack of comparative studies. Knowledge of the current practice trends would help guide the design of comparative studies needed to determine which surgical technique results in the best outcome. PURPOSE: To review the latest practice trends for the surgical treatment of lateral epicondylitis among newly trained surgeons in the United States utilizing the American Board of Orthopaedic Surgery (ABOS) database...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29047384/enhancing-evidence-based-diabetes-and-chronic-disease-control-among-local-health-departments-a-multi-phase-dissemination-study-with-a-stepped-wedge-cluster-randomized-trial-component
#7
Renee G Parks, Rachel G Tabak, Peg Allen, Elizabeth A Baker, Katherine A Stamatakis, Allison R Poehler, Yan Yan, Marshall H Chin, Jenine K Harris, Maureen Dobbins, Ross C Brownson
BACKGROUND: The rates of diabetes and prediabetes in the USA are growing, significantly impacting the quality and length of life of those diagnosed and financially burdening society. Premature death and disability can be prevented through implementation of evidence-based programs and policies (EBPPs). Local health departments (LHDs) are uniquely positioned to implement diabetes control EBPPs because of their knowledge of, and focus on, community-level needs, contexts, and resources. There is a significant gap, however, between known diabetes control EBPPs and actual diabetes control activities conducted by LHDs...
October 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29046084/penetrating-neck-injuries-a-guide-to-evaluation-and-management
#8
J L Nowicki, B Stew, E Ooi
Introduction Penetrating neck injury is a relatively uncommon trauma presentation with the potential for significant morbidity and possible mortality. There are no international consensus guidelines on penetrating neck injury management and published reviews tend to focus on traditional zonal approaches. Recent improvements in imaging modalities have altered the way in which penetrating neck injuries are now best approached with a more conservative stance. A literature review was completed to provide clinicians with a current practice guideline for evaluation and management of penetrating neck injuries...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29045653/a-quality-improvement-project-to-reduce-hypothermia-in-preterm-infants-on-admission-to-the-neonatal-intensive-care-unit
#9
Wai Yan Yip, Bin Huey Quek, Mary Choi Wan Fong, Thilagamangai, Sally Siew Gim Ong, Bee Leong Lim, Bo Chu Lo, Pratibha Agarwal
Objective: To study effectiveness of quality improvement interventions in reducing hypothermia in preterm infants on admission to neonatal intensive care unit. Design: Quality improvement methodologies including multidisciplinary planning and implementation of evidence-based interventions. Data during and post-implementation were collected. Setting and participants: In total, 84 preterm infants with birth weights ≤ 1500 g delivered during implementation period (October 2008-April 2009) were compared with 168 historical controls and 947 infants in the subsequent 4 years...
October 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29045273/oneflorida-clinical-research-consortium-linking-a-clinical-and-translational-science-institute-with-a-community-based-distributive-medical-education-model
#10
Elizabeth Shenkman, Myra Hurt, William Hogan, Olveen Carrasquillo, Steven Smith, Andrew Brickman, David Nelson
PROBLEM: Developing a national pragmatic clinical trial infrastructure is central to understanding the effectiveness of interventions applied under usual conditions and where people receive health care. To address this challenge, three Florida universities- the University of Florida Clinical and Translational Science Institute, Florida State University (with its community-based distributive medical education model), and the University of Miami-created (2010-2013) a statewide consortium, the OneFlorida Clinical Research Consortium, to support the conduct of pragmatic clinical trials and provide mentored research experiences for medical and graduate students in real-world practice settings...
October 17, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29044561/aquatic-treadmill-water-level-influence-on-pelvic-limb-kinematics-in-cranial-cruciate-ligament-deficient-dogs-with-surgically-stabilised-stifles
#11
G Bertocci, C Smalley, N Brown, K Bialczak, D Carroll
OBJECTIVE: To compare pelvic limb joint kinematics and temporal gait characteristics during land-based and aquatic-based treadmill walking in dogs that have undergone surgical stabilisation for cranial cruciate ligament deficiency. MATERIALS AND METHODS: Client-owned dogs with surgically stabilised stifles following cranial cruciate ligament deficiency performed three walking trials consisting of three consecutive gait cycles on an aquatic treadmill under four water levels...
October 17, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29043925/filipino-therapists-experiences-and-attitudes-of-interprofessional-education-and-collaboration-a-cross-sectional-survey
#12
Michael Palapal Sy
For the past more than 50 years, the World Health Organisation has acknowledged through empirical findings that health workers that learn together work together effectively to provide the best care for their patients. This study aimed to: (1) describe the perceived extent of interprofessional education (IPE) experience among Filipino occupational therapists (OTs), physical therapists (PTs), and speech-language-pathologists (SLPs); (2) identify their attitudes towards interprofessional collaboration (IPC); and (3) compare their attitudes towards IPC according to: prior IPE experience, classification of IPE experience, profession, years of practice, and practice setting...
November 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#13
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29039710/one-year-mixed-methods-case-study-of-a-community-academic-advisory-board-addressing-childhood-obesity
#14
Jamie Zoellner, Jennie L Hill, Donna Brock, Morgan L Barlow, Ramine Alexander, Fabiana Brito, Bryan Price, Corliss L Jones, Ruby Marshall, Paul A Estabrooks
OBJECTIVE: Using a community-based participatory research and systems-based approach, the purpose of this community case study is to describe the planning process and first-year experiences of community-academic advisory board (CAB) partners involved with the development of an evidence-based childhood obesity treatment program in a medically underserved region. METHOD: Regional community partners ( n = 9; Pittsylvania/Danville Health District, Children's Healthcare Center, Danville Parks & Recreation, and Danville Boys & Girls Club) and academic partners ( n = 9) met monthly to select and adapt an evidence-based childhood obesity program, develop evaluation and recruitment protocols, and plan for program implementation...
November 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#15
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29037899/the-management-of-first-line-biologic-therapy-failures-in-rheumatoid-arthritis-current-practice-and-future-perspectives
#16
REVIEW
Ennio Giulio Favalli, Maria Gabriella Raimondo, Andrea Becciolini, Chiara Crotti, Martina Biggioggero, Roberto Caporali
The introduction of biologic disease-modifying anti-rheumatic drugs (bDMARDs) has dramatically changed the management of rheumatoid arthritis (RA). However, in a real-life setting about 30-40%. of bDMARD treated patients experience drug discontinuation because of either inefficacy or adverse events. According to international recommendations, to date the best strategy for managing first-line bDMARD failures has not been defined yet and available data (especially on TNF inhibitors [TNFis]) seem to drive toward a personalized approach for the individual patient...
October 13, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29036771/oral-hormonal-contraception-in-special-circumstances
#17
Patricia Moore, Catherine Streeton
BACKGROUND: Despite the general consensus that long-acting reversible contraceptives (LARCs) are the most appropriate choice of contraception for most women, there are special circumstances when the contraceptive and non-contraceptive needs of the patient are met by oral methods. OBJECTIVE: By using case histories, we seek to demonstrate the medical and practical complexities in managing contraceptive needs that may result in oral contraception being the most appropriate choice...
October 2017: Australian Family Physician
https://www.readbyqxmd.com/read/29036756/acupuncture-or-acupressure-for-induction-of-labour
#18
REVIEW
Caroline A Smith, Mike Armour, Hannah G Dahlen
BACKGROUND: This is one of a series of reviews of methods of cervical ripening and labour induction. The use of complementary therapies is increasing. Women may look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. Acupressure is using the thumbs or fingers to apply pressure to specific points. The limited observational studies to date suggest acupuncture for induction of labour has no known adverse effects to the fetus, and may be effective...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29036569/opportunities-for-epidemiologists-in-implementation-science-a-primer
#19
Gila Neta, Ross C Brownson, David A Chambers
The field of epidemiology has been defined as the study of the spread and control of disease. However, epidemiology frequently focuses on studies of etiology and distribution of disease at the cost of understanding the best ways to control disease. Moreover, only a small fraction of scientific discoveries is translated into public health practice, and the process from discovery to translation is exceedingly slow. Given the importance of translational science, the future of epidemiologic training should include competency in implementation science, whose goal is to rapidly move evidence into practice...
September 27, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29035967/pediatric-clinical-handover-a-best-practice-implementation-project
#20
Zhuowen Yu, Yuxia Zhang, Ying Gu, Xiaofeng Xu, Alexa McArthur
BACKGROUND: Communication of information between and among healthcare providers is an essential element of patient care. Poor clinical handover has been associated with inaccurate clinical assessment and diagnosis, delays in diagnosis, medication errors and decreased patient satisfaction. Effective and efficient transition of patient care information requires an evidence-based handover approach. OBJECTIVES: The aim of this evidence implementation project was to make a contribution to promote evidence-based practice in clinical handover in a pediatric setting and thereby enhance patient safety and service delivery...
October 2017: JBI Database of Systematic Reviews and Implementation Reports
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