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Evidence based health care

Danielle Bloch, Nicole M Roth, Elba V Caraballo, Jorge Muñoz-Jordan, Elizabeth Hunsperger, Aidsa Rivera, Janice Pérez-Padilla, Brenda Rivera Garcia, Tyler M Sharp
BACKGROUND: Chikungunya virus (CHIKV) is transmitted by Aedes species mosquitoes and is the cause of an acute febrile illness characterized by potentially debilitating arthralgia. After emerging in the Caribbean in late 2013, the first locally-acquired case reported to public health authorities in Puerto Rico occurred in May 2014. During June-August 2014, household-based cluster investigations were conducted to identify factors associated with infection, development of disease, and case reporting...
October 2016: PLoS Neglected Tropical Diseases
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
Simon Sawyer, Jan Coles, Angela Williams, Brett Williams
CONTEXT: Intimate partner violence (IPV) is a significant cause of morbidity and mortality in women worldwide. Numerous health organisations have called for increased education for health care practitioners who encounter IPV patients and the first clinical guidelines for health services responding to IPV were recently published. This renewed focus has created a need to examine the current evidence for IPV education so that it may inform the next generation of educational interventions...
November 2016: Medical Education
Kaarina Korhonen, Hanna Remes, Pekka Martikainen
PURPOSE: There is inconsistent evidence for social differentials in the risk of depression in youth, and little is known about how education at this age influences the risk. We assess how parental socioeconomic position (SEP) and education predict depression from late adolescence to early adulthood, a time of major educational transitions. METHODS: We followed a nationally representative 20 % sample of Finnish adolescents born in 1986-1990 (n = 60,829) over two educational transitory stages at the age of 17-19 and 20-23 covering the years 2003-2011...
October 19, 2016: Social Psychiatry and Psychiatric Epidemiology
Jae M Sevelius, Madeline B Deutsch, Robert Grant
INTRODUCTION: Globally, transgender ("trans") women are one of the key populations most disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is the newest and most promising biomedical HIV prevention intervention to date. This paper reviews relevant literature to describe the current state of the science and describes the potential role of PrEP among trans women, including a discussion of unique considerations for maximizing the impact of PrEP for this vulnerable population...
2016: Journal of the International AIDS Society
Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Background and purpose - In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods - 5,068 HRAs performed during the period 2001-2013 in Finland were included...
October 19, 2016: Acta Orthopaedica
L Paglia
Despite the general advances in dental care, dental caries is still a global health problem affecting many children. Occlusal surfaces of first permanent molars are the most susceptible sites in the developing permanent dentition. Dentists should use sealants or fluoride varnish - as well as other means - to limit the onset of tooth decay. Application of sealants is a recommended procedure to prevent or control caries. Sealing occlusal surfaces of newly erupted permanent molars in children and teenagers delays caries onset up to 48 months compared with unsealed teeth...
September 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
Cristina R Lammers, Polly A Hulme, Howard Wey, Jennifer Kerkvliet, Shivaram P Arunachalam
Despite evidence of the benefits of preconception health care (PCHC), little is known about awareness and access to PCHC for rural, reproductive-aged women. This study aimed to assess the prevalence of PCHC conversations between rural reproductive-age women and health care providers, PCHC interventions received in the past year, and ascertain predictors of PCHC conversations and interventions. Women (n = 868; 18-45 years) completed a questionnaire including reproductive history, health care services utilization, and interest in PCHC...
October 18, 2016: Journal of Community Health
Michael S Crowell, Erik A Dedekam, Michael R Johnson, Scott C Dembowski, Richard B Westrick, Donald L Goss
BACKGROUND: While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic...
October 2016: International Journal of Sports Physical Therapy
Sandy Middleton, Chris Levi, Simeon Dale, N Wah Cheung, Elizabeth McInnes, Julie Considine, Catherine D'Este, Dominique A Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise Craig, Verena Schadewaldt, Patrick McElduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward
BACKGROUND: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T(3)) of patients with acute stroke to improve 90-day death and dependency...
October 18, 2016: Implementation Science: IS
Maria Regina Torloni, Ana Pilar Betrán, José M Belizán
The Birth in Brazil study is the largest national hospital-based survey in Brazil regarding birth practices. Conducted in 2011-2012, it collected information from 266 public and private healthcare facilities and interviewed nearly 24,000 postpartum women. It is also the latest effort to map out how labor and delivery are managed in this county in the 21st century. The journal Reproductive Health has published a supplement including 10 articles presenting the results of a series of analyses using this valuable resource...
October 17, 2016: Reproductive Health
Tonje Holte Stea, Tommy Haugen, Sveinung Berntsen, Vigdis Guttormsen, Nina Cecilie Øverby, Kristin Haraldstad, Eivind Meland, Eirik Abildsnes
BACKGROUND: In light of the high prevalence of childhood overweight and obesity, there is a need of developing effective prevention programs to address the rising prevalence and the concomitant health consequences. The main aim of the present study is to systematically develop and implement a tailored family-based intervention for improving lifestyle habits among overweight and obese children, aged 6-10 years old, enhancing parental self-efficacy, family engagement and parent-child interaction...
October 18, 2016: BMC Public Health
Chengxiang Tang, Judy Xu, Meng Zhang
BACKGROUND: Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. METHODS: Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care...
October 18, 2016: BMC Health Services Research
Rebecca M Stanley, Rachel A Jones, Dylan P Cliff, Stewart G Trost, Donna Berthelsen, Jo Salmon, Marijka Batterham, Simon Eckermann, John J Reilly, Ngiare Brown, Karen J Mickle, Steven J Howard, Trina Hinkley, Xanne Janssen, Paul Chandler, Penny Cross, Fay Gowers, Anthony D Okely
BACKGROUND: Participation in regular physical activity (PA) during the early years helps children achieve healthy body weight and can substantially improve motor development, bone health, psychosocial health and cognitive development. Despite common assumptions that young children are naturally active, evidence shows that they are insufficiently active for health and developmental benefits. Exploring strategies to increase physical activity in young children is a public health and research priority...
October 19, 2016: BMC Public Health
Alessandro Cassini, Diamantis Plachouras, Tim Eckmanns, Muna Abu Sin, Hans-Peter Blank, Tanja Ducomble, Sebastian Haller, Thomas Harder, Anja Klingeberg, Madlen Sixtensson, Edward Velasco, Bettina Weiß, Piotr Kramarz, Dominique L Monnet, Mirjam E Kretzschmar, Carl Suetens
BACKGROUND: Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE) project and 2011-2012 data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs...
October 2016: PLoS Medicine
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
Angela M Rose, Ian R Hambleton, Selvi M Jeyaseelan, Christina Howitt, Rhea Harewood, Jacqueline Campbell, Tanya N Martelly, Tracey Blackman, Kenneth S George, Trevor A Hassell, David O Corbin, Rudolph Delice, Patsy Prussia, Branka Legetic, Anselm J Hennis
Objective To describe the surveillance model used to develop the first national, population-based, multiple noncommunicable disease (NCD) registry in the Caribbean (one of the first of its kind worldwide); registry implementation; lessons learned; and incidence and mortality rates from the first years of operation. Methods Driven by limited national resources, this initiative of the Barbados Ministry of Health (MoH), in collaboration with The University of the West Indies, was designed to collect prospective data on incident stroke and acute myocardial infarction (MI) (heart attack) cases from all health care facilities in this small island developing state (SIDS) in the Eastern Caribbean...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Daniel Ngui, Michael J H Qiu, Michael Mann
OBJECTIVE: In order to address the systematic and practice management issues associated with managing hypertension, we undertook a quality improvement project at a multi-physician clinic in Vancouver, British Columbia, Canada. We piloted an evidence-based electronic medical record (EMR) hypertension management dashboard based on the 2014 Canadian Hypertension Education Program (CHEP) guideline recommendations. Since June 1, 2015, our chronic disease coordinator utilized our EMR HTN Dashboard to generate patient recalls, create physician reminders and to enhance internal clinic referrals to provide 1:1 patient hypertension self-management education by physicians and our clinical pharmacist team...
September 2016: Journal of Hypertension
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