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Evidence based health care

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https://www.readbyqxmd.com/read/28647722/developing-implementation-strategies-for-firearm-safety-promotion-in-paediatric-primary-care-for-suicide-prevention-in-two-large-us-health-systems-a-study-protocol-for-a-mixed-methods-implementation-study
#1
Courtney Benjamin Wolk, Shari Jager-Hyman, Steven C Marcus, Brian K Ahmedani, John E Zeber, Joel A Fein, Gregory K Brown, Adina Lieberman, Rinad S Beidas
INTRODUCTION: The promotion of safe firearm practices, or firearms means restriction, is a promising but infrequently used suicide prevention strategy in the USA. Safety Check is an evidence-based practice for improving parental firearm safety behaviour in paediatric primary care. However, providers rarely discuss firearm safety during visits, suggesting the need to better understand barriers and facilitators to promoting this approach. This study, Adolescent Suicide Prevention In Routine clinical Encounters, aims to engender a better understanding of how to implement the three firearm components of Safety Check as a suicide prevention strategy in paediatric primary care...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647664/patient-perceived-responsiveness-of-primary-care-systems-across-europe-and-the-relationship-with-the-health-expenditure-and-remuneration-systems-of-primary-care-doctors
#2
Anna Maria Murante, Chiara Seghieri, Milena Vainieri, Willemijn L A Schäfer
BACKGROUND: Health systems are expected to be responsive, that is to provide services that are user-oriented and respectful of people. Several surveys have tried to measure all or some of the dimensions of the responsiveness (e.g. autonomy, choice, clarity of communication, confidentiality, dignity, prompt attention, quality of basic amenities, and access to family and community support), however there is little evidence regarding the level of responsiveness of primary care (PC) systems...
June 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28646897/an-exploration-of-facilitators-and-challenges-in-the-scale-up-of-a-national-public-sector-community-health-worker-cadre-in-zambia-a-qualitative-study
#3
Sydney Chauwa Phiri, Margaret Lippitt Prust, Caroline Phiri Chibawe, Ronald Misapa, Jan Willem van den Broek, Nikhil Wilmink
BACKGROUND: In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system...
June 24, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28646886/implementation-science-for-ambulatory-care-safety-a-novel-method-to-develop-context-sensitive-interventions-to-reduce-quality-gaps-in-monitoring-high-risk-patients
#4
Kathryn M McDonald, George Su, Sarah Lisker, Emily S Patterson, Urmimala Sarkar
BACKGROUND: Missed evidence-based monitoring in high-risk conditions (e.g., cancer) leads to delayed diagnosis. Current technological solutions fail to close this safety gap. In response, we aim to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. METHODS: Based on interviews with staff in otolaryngology, pulmonary, urology, breast, and gastroenterology clinics at a large urban publicly funded health system, we applied journey mapping to co-develop a visual representation of how patients are monitored for high-risk conditions...
June 24, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28646707/use-of-research-in-undergraduate-nursing-students-theses-a-mixed-methods-study
#5
Anita Nordsteien, May-Elin T Horntvedt, Jonn Syse
BACKGROUND: Health care personnel are expected to be familiar with evidence-based practice (EBP). Asking clinical questions, conducting systematic literature searches and conducting critical appraisal of research findings have been some of the barriers to EBP. To improve undergraduate nurses' research skills, a collaborative library-faculty teaching intervention was established in 2012. OBJECTIVES: The aim of this study was to evaluate how the collaborative library-faculty teaching intervention affected the nursing students' research skills when writing their final theses...
June 10, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#6
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645890/tailored-communication-within-mobile-apps-for-diabetes-self-management-a-systematic-review
#7
Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu
BACKGROUND: The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects...
June 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28645619/supporting-and-caring-for-transgender-and-gender-nonconforming-youth-in-the-urology-practice
#8
REVIEW
L E Conard
INTRODUCTION: Gender identity is a person's internal sense of gender, which may be different than the sex they were assigned at birth. Pediatric urologists are starting to see more transgender and gender non-conforming (TGN) youth and need to be able to provide culturally competent and appropriate care for these patients and their caregivers. This review will discuss common transgender terminology, specific health concerns and treatment options. METHODS AND MATERIALS: A systematic literature review was performed on Medline(®), PubMed(®), and Google Scholar™ for key words transgender, gender dysphoria and gender identity disorder...
June 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#9
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
https://www.readbyqxmd.com/read/28644591/a-heart-for-travel-travel-health-considerations-for-patients-with-heart-disease-and-cardiac-devices
#10
G Flaherty, S De Freitas
Cardiovascular disease is the leading cause of death in adult international travellers. Patients living with heart disease should receive specific, individualised pre-travel health advice. The purpose of this article is to provide evidence-based advice to physicians who are consulted by travellers with cardiovascular disease. Fitness-to-travel evaluation will often be conducted by the general practitioner but other medical specialists may also be consulted for advice. Patients with chronic medical conditions should purchase travel health insurance...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28643560/design-quality-in-the-context-of-healthcare-environments-a-scoping-review
#11
Anna Anåker, Ann Heylighen, Susanna Nordin, Marie Elf
OBJECTIVE: We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. BACKGROUND: High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security...
July 2017: HERD
https://www.readbyqxmd.com/read/28642833/creating-a-biomarker-panel-for-early-detection-of-chemotherapy-related-cardiac-dysfunction-in-breast-cancer-patients
#12
Krithika Srikanthan, Rebecca Klug, Maria Tirona, Ellen Thompson, Haresh Visweshwar, Nitin Puri, Joseph Shapiro, Komal Sodhi
Cardiotoxicity is an important issue for breast cancer patients receiving anthracycline-trastuzumab therapy in the adjuvant setting. Studies show that 3-36% of patients receiving anthracyclines and/or trastuzumab experience chemotherapy related cardiac dysfunction (CRCD) and approximately 17% of patients must stop chemotherapy due to the consequences of CRCD. There is currently no standardized, clinically verified way to detect CRCD early, but common practices include serial echocardiography and troponin measurements, which can be timely, costly, and not always available in areas where health care resources are scarce...
March 2017: Journal of Clinical & Experimental Cardiology
https://www.readbyqxmd.com/read/28642218/the-effectiveness-of-information-technology-supported-shared-care-for-patients-with-chronic-disease-a-systematic-review
#13
Laura Kooij, Wim G Groen, Wim H van Harten
BACKGROUND: In patients with chronic disease, many health care professionals are involved during treatment and follow-up. This leads to fragmentation that in turn may lead to suboptimal care. Shared care is a means to improve the integration of care delivered by various providers, specifically primary care physicians (PCPs) and specialty care professionals, for patients with chronic disease. The use of information technology (IT) in this field seems promising. OBJECTIVE: Our aim was to systematically review the literature regarding the effectiveness of IT-supported shared care interventions in chronic disease in terms of provider or professional, process, health or clinical and financial outcomes...
June 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#14
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#15
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28641582/a-multicentre-randomised-controlled-trial-of-levetiracetam-versus-phenytoin-for-convulsive-status-epilepticus-in-children-protocol-convulsive-status-epilepticus-paediatric-trial-consept-a-predict-study
#16
Stuart R Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland, Jocelyn Neutze, Susan Donath, Cynthia Sharpe, Simon Harvey, Andrew Davidson, Simon Craig, Natalie Phillips, Shane George, Arjun Rao, Nicholas Cheng, Michael Zhang, Kam Sinn, Amit Kochar, Christine Brabyn, Franz E Babl
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28640082/the-reliability-and-validity-of-a-new-professionalism-assessment-scale-for-young-health-care-workers
#17
Jianjun Wang, Bosheng He, Xudong Miao, Xiaoqin Huang, Yihua Lu, Jianrong Chen
With the development of medical technique, many medical challenges have been solved. This cross-sectional study was aimed to assess the reliability and validity of a new developed scale for assessing the professionalism of young health care workers.This cross-sectional population-based study was conducted based on cluster sampling method in 2015. The participants were from 2 medical centers of Nantong city of Jiangsu province in China. The internal consistency reliability was assessed using Cronbach's alpha and split-half reliability coefficients...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639971/effective-approaches-to-address-the-global-cardiovascular-disease-burden
#18
Pablo M Lamelas, Salim Yusuf, J D Schwalm
PURPOSE OF REVIEW: Describe the global burden of cardiovascular disease (CVD), highlight barriers to evidence-based care and propose effective interventions based on identified barriers. RECENT FINDINGS: The global burden of CVD is increasing worldwide. This trend is steeper in lower income countries, where CVD incidence and fatality remains high. Risk factor control, around the world, remains poor, especially in lower and middle-income countries. Barriers at the patient, healthcare provider and health system have been identified...
July 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28639707/dressings-and-topical-agents-for-treating-pressure-ulcers
#19
REVIEW
Maggie J Westby, Jo C Dumville, Marta O Soares, Nikki Stubbs, Gill Norman
BACKGROUND: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and promote healing, and there are many options to choose from including alginate, hydrocolloid and protease-modulating dressings. Topical agents have also been used as alternatives to dressings in order to promote healing.A clear and current overview of all the evidence is required to facilitate decision-making regarding the use of dressings or topical agents for the treatment of pressure ulcers...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639384/nurses-attitudes-towards-older-people-care-an-integrative-review
#20
REVIEW
Kathy L Rush, Stormee Hickey, Sheila Epp, Robert Janke
AIMS/OBJECTIVES: To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. BACKGROUND: Population aging is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues...
June 21, 2017: Journal of Clinical Nursing
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