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Adherence to guidelines

Raul Zamora-Ros, Valerie Cayssials, Ramón Cleries, María Luisa Redondo, Maria-Jose Sánchez, Miguel Rodríguez-Barranco, Jose-Juan Sánchez-Cruz, Olatz Mokoroa, Leire Gil, Pilar Amiano, Carmen Navarro, María Dolores Chirlaque, José María Huerta, Aurelio Barricarte, Eva Ardanaz, Conchi Moreno-Iribas, Antonio Agudo
PURPOSE: Dietary guidelines for egg consumption for general population differ among public health agencies. Our aim was to investigate the association between egg intake and both all-cause and specific-cause of mortality in a Mediterranean population. METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort included 40,621 men and women aged 29-69 years old in the nineties from 5 Spanish regions. After a mean of 18 years of follow-up, 3,561 deaths were recorded, of which 1,694 were from cancer, 761 from CVD, and 870 from other causes...
June 15, 2018: European Journal of Nutrition
Helen H Lee, Nicholas M Dalesio, Anthony T Lo Sasso, William C Van Cleve
BACKGROUND: Pediatric adenotonsillectomies are common and carry known risks of potentially severe complications. Complications that require a revisit, to either the emergency department or hospital readmission, increase costs and may be tied to lower reimbursements by federal programs. In 2011 and 2012, recommendations by pediatric and surgical organizations regarding selection of candidates for ambulatory procedures were issued. We hypothesized that guideline-associated changes in practice patterns would lower the odds of revisits...
June 12, 2018: Anesthesia and Analgesia
Ashish A Deshmukh, Shervin M Shirvani, Anna Likhacheva, Jagpreet Chhatwal, Elizabeth Y Chiao, Kalyani Sonawane
Given the recent emphasis on the totality of the diet by national guidelines, we examined the relationship between the quality of diet and overall and cancer-specific mortality among cancer survivors. From the Third National Health and Nutrition Examination Survey (NHANES III), 1191 participants diagnosed with cancer were identified. Healthy Eating Index (HEI) scores were utilized; higher HEI score indicated better adherence to dietary recommendations. During a median follow-up of 17.2 years, a total of 607 cancer-specific deaths occurred...
April 2018: JNCI cancer spectrum
Chloé Gervès-Pinquié, Anne Girault, Serena Phillips, Sarah Raskin, Mandi Pratt-Chapman
Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines. Articles indexed in Medline, Cochrane, CINAHL, and Web of Science between January 2000 and March 2017 were analyzed. We conducted a systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
June 14, 2018: Health Economics Review
Michael Laxy, Edward C F Wilson, Clare E Boothby, Simon J Griffin
OBJECTIVE: To assess the fidelity of general practitioners' (GPs) adherence to a long-term pragmatic trial protocol. DESIGN: Retrospective analyses of electronic primary care records of participants in the pragmatic cluster-randomised ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care)-Cambridge trial, comparing intensive multifactorial treatment (IT) versus routine care (RC). Data were collected from the date of diagnosis until December 2010...
June 14, 2018: BMJ Open
Nyawira Mwangi, Muchai Gachago, Michael Gichangi, Stephen Gichuhi, Kibata Githeko, Atieno Jalango, Jefitha Karimurio, Joseph Kibachio, Lawrence Muthami, Nancy Ngugi, Carmichael Nduri, Patrick Nyaga, Joseph Nyamori, Alain Nazaire Mbongo Zindamoyen, Covadonga Bascaran, Allen Foster
BACKGROUND: The use of clinical practice guidelines envisages augmenting quality and best practice in clinical outcomes. Generic guidelines that are not adapted for local use often fail to produce these outcomes. Adaptation is a systematic and rigorous process that should maintain the quality and validity of the guideline, while making it more usable by the targeted users. Diverse skills are required for the task of adaptation. Although adapting a guideline is not a guarantee that it will be implemented, adaptation may improve acceptance and adherence to its recommendations...
June 15, 2018: Implementation Science: IS
Erin L Symonds, Kalindra Simpson, Michelle Coats, Angela Chaplin, Karen Saxty, Jayne Sandford, Graeme P Young Am, Charles Cock, Robert Fraser, Peter A Bampton
OBJECTIVE: To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. DESIGN: Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals...
June 18, 2018: Medical Journal of Australia
Jane Francis, Sharon Unger, Nicole Bando, Ashleigh Vance, Sharyn Gibbins, Alex Kiss, Paige Church, Daniel Sellen, Deborah L O'Connor
OBJECTIVES: Infant feeding guidelines are important public health strategies to promote optimal growth, development and chronic disease prevention, but their effectiveness is contingent upon families' ability to adhere to them. Little is known of adherence to guidelines among nutritionally vulnerable infants, specifically those born very-low-birth-weight (<1500 grams). This study investigated whether post-discharge feeding practices for very-low-birth-weight infants align with current recommendations and explored parental and infant baseline socio-demographics related to these practices...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
Christopher C Xiao, Mitchell Anderson, Lucas D Harless, Jonathan Liang
BACKGROUND: Chronic rhinosinusitis (CRS) is a prevalent illness in the United States that accounts for 18-22 million physician visits annually. The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) has defined diagnostic criteria, but a recent study demonstrated that nearly all patients diagnosed by nonspecialists did not meet these criteria. In this study we aimed to evaluate the diagnostic rate of CRS by primary care physicians and otolaryngologists. METHODS: We retrospectively reviewed a random sample of adult patients diagnosed with CRS in 2016, based on ICD-10 codes from primary care and otolaryngology departments...
June 14, 2018: International Forum of Allergy & Rhinology
An-Wen Chan, Kinwah Fung, Peter C Austin, S Joseph Kim, Lianne G Singer, Nancy N Baxter, Raed Alhusayen, Paula A Rochon
Solid organ transplant recipients have a high risk of keratinocyte carcinoma (non-melanoma skin cancer). Consensus-based transplant guidelines recommend annual dermatological examination but the impact on skin cancer-related outcomes is unclear. We conducted a population-based, retrospective, inception cohort study using administrative health databases in Ontario, Canada to evaluate the association between adherence to annual dermatology assessments (time-varying exposure) and keratinocyte carcinoma-related morbidity and mortality after transplantation...
June 13, 2018: American Journal of Transplantation
Angela Lowenstern, Shuang Li, Ann Marie Navar, Salim Virani, L Veronica Lee, Michael J Louie, Eric D Peterson, Tracy Y Wang
BACKGROUND: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline recommends statin treatment based on patients' predicted atherosclerotic cardiovascular disease (ASCVD) risk. Whether clinician-reported guideline adoption translates to implementation into practice is unknown. OBJECTIVES: We aimed to compare clinician lipid management in hypothetical scenarios versus observed practice. METHODS: The PALM Registry asked 774 clinicians how they would treat 4 hypothetical scenarios of primary prevention patients with: (1) diabetes; (2) high 10-year ASCVD risk (≥7...
June 2018: American Heart Journal
Ian Hennessee, Timothée Guilavogui, Alioune Camara, Eric S Halsey, Barbara Marston, Deborah McFarland, Matthew Freeman, Mateusz M Plucinski
BACKGROUND: Malaria case management in the context of the 2014-2016 West African Ebola virus disease (EVD) epidemic was complicated by a similar initial clinical presentation of the two diseases. In September 2014, the World Health Organization (WHO) released recommendations titled, "Guidance on temporary malaria control measures in Ebola-affected countries", which aimed at reducing the risk of EVD transmission and improving malaria outcomes. This guidance recommended malaria diagnostic testing of fever cases only if adequate personal protective equipment (PPE) was available, defined as examination gloves, face shield, disposable gown, boots, and head cover; otherwise presumptive anti-malarial treatment was recommended...
June 14, 2018: Malaria Journal
Sanne J E Bruijniks, Gerdien Franx, Marcus J H Huibers
BACKGROUND: Although psychotherapy is an effective treatment for depression, a large number of patients still do not receive care according to the protocols that are used in clinical trials. Instead, patients often receive a modified version of the original intervention. It is not clear how and when treatment protocols are used or modified in the Dutch specialized mental health care and whether these changes lead to suboptimal adherence to treatment protocols. METHODS: In the context of an ongoing multicenter trial that investigates whether twice-weekly sessions of protocolized interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) for depression lead to better treatment outcomes compared to once-weekly sessions, two focus groups using semi-structured interviews were organized...
June 14, 2018: BMC Psychiatry
Jasper M M Vanhoof, Bert Vandenberghe, David Geerts, Pieter Philippaerts, Patrick De Mazière, Annette DeVito Dabbs, Sabina De Geest, Fabienne Dobbels
Traditional quantitative and qualitative research methods inadequately capture the complexity of patients' daily self-management. Contextual inquiry methodology, using home visits, allows a more in-depth understanding of how patients integrate immunosuppressive medication intake, physical activity and healthy eating in their daily lives, and which difficulties they experience when doing so. This mixed-method study comprised two home visits in 19 purposively selected adult heart, lung, liver and kidney transplant patients, asking them to demonstrate how they implement the aforementioned health behaviours...
June 13, 2018: Clinical Transplantation
Adrien Hertault, Robert Rhee, George A Antoniou, Donald Adam, Hisashi Tonda, Hervé Rousseau, Aurélia Bianchini, Stéphan Haulon
OBJECTIVE: To evaluate radiation exposure in standard endovascular aneurysm repair (EVAR) using intra-operative guidance with pre-operative computed tomographic angiography (CTA) fusion and strict ALARA guidelines in a modern hybrid room. MATERIAL AND METHODS: Between February and November 2016, consecutive patients with AAA undergoing EVAR with a bifurcated device in a hybrid room under fusion imaging guidance were prospectively enrolled in six aortic centres from the United States (n = 1), Europe (n = 4), and Japan (n = 1)...
June 9, 2018: European Journal of Vascular and Endovascular Surgery
Dunstan R Bishanga, John Charles, Gaudiosa Tibaijuka, Rita Mutayoba, Mary Drake, Young-Mi Kim, Marya Plotkin, Neema Rusibamayila, Barbara Rawlins
BACKGROUND: Tanzania has a maternal mortality ratio of 556 per 100,000 live births, representing 21% of all deaths of women of reproductive age. Hemorrhage, mostly postpartum hemorrhage (PPH), is estimated to cause at least 25% of maternal deaths in Tanzania. In 2008, the Ministry of Health, Community Development, Gender, Elderly and Children launched interventions to improve efforts to prevent PPH. Competency-based training for skilled birth attendants and ongoing quality improvement prioritized the practice of active management of the third stage of labor (AMTSL)...
June 13, 2018: BMC Pregnancy and Childbirth
Rafael Blesa, Kazuhiro Toriyama, Kengo Ueda, Sean Knox, George Grossberg
INTRODUCTION: Alzheimer's disease (AD) is the most common cause of dementia, characterized by a progressive decline in cognition and function. Current treatment options for AD include the cholinesterase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine, as well as the N-methyl-D-aspartate receptor antagonist memantine. Treatment guidelines recommend the use of ChEIs as standard of care first-line therapy. Several randomized clinical studies have demonstrated the benefits of ChEIs on cognition, global function, behavior and activities of daily living...
June 12, 2018: Current Alzheimer Research
Ashleigh R Tuite, Minttu M Rönn, Emory E Wolf, Thomas L Gift, Harrell W Chesson, Andres Berruti, Kara Galer, Nicolas A Menzies, Katherine Hsu, Joshua A Salomon
BACKGROUND: The burden of gonorrhea infections in the United States is high. There are marked disparities by race/ethnicity and sexual orientation. We quantified the impact of screening and treatment on gonorrhea rates in the US population aged 15-39 years for the time period 2000 to 2015 and estimated the impact that alternative screening strategies might have had over the same time period. METHODS: We developed a national-level transmission model that divides the population by race/ethnicity, preferred sex of sex partners, age, sex, and sexual activity level...
June 11, 2018: Sexually Transmitted Diseases
Gheorghe-Andrei Dan, Konstantinos Iliodromitis, Daniel Scherr, Francisco Marín, Radoslaw Lenarczyk, Heidi L Estner, Marcin Kostkiewicz, Nikolaos Dagres, Gregory Y H Lip
Despite the huge progress made in the both understanding the mechanisms and the management of atrial fibrillation (AF) this arrhythmia still represents an important health and social burden. Atrial fibrillation is increasing in frequency and is a major cause of death, stroke, heart failure, cognitive decline, and hospitalizations. New data have emerged emphasizing the multidisciplinary approach to better management of this common arrhythmia. Despite the availability of AF management guidelines, practice among European centres may differ from the current guideline recommendations...
June 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Shirley Musich, Shaohung S Wang, Kay Schwebke, Luke Slindee, Evonne Waters, Charlotte S Yeh
Secondary cardiovascular disease (CVD) clinical trials have demonstrated that higher intensity levels of statin therapy are more effective than lower levels in reducing mortality rates. Despite updated treatment guidelines, statin therapy may be underutilized, with evidence that females are treated less aggressively than males. The primary objective of this study was to determine the prevalence of statin utilization by varying therapy intensity by sex. The secondary objective was to document the benefits of statin therapy intensity levels on all-cause mortality for males and females...
June 12, 2018: Population Health Management
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