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1

An Evidence-Based Approach to the Diagnosis and Management of Acute Respiratory Infections  

Microsoft Academic Search

Acute respiratory infections (ARIs) are commonly experienced in primary care. Although most ARIs are viral in nature and resolve without treatment, nurse practitioners and other clinicians prescribe antibiotics for them 40% to 50% of the time. Thus, the purpose of this article is to review current evidence-based recommendations about the diagnosis and management of ARIs in adults.

Ann Marie Hart

2007-01-01

2

Network Influences on Dissemination of Evidence-Based Guidelines in State Tobacco Control Programs  

ERIC Educational Resources Information Center

Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's "Best Practices for Comprehensive Tobacco Control Programs," are…

Luke, Douglas A.; Wald, Lana M.; Carothers, Bobbi J.; Bach, Laura E.; Harris, Jenine K.

2013-01-01

3

Speeding the dissemination and implementation of evidence-based interventions for cancer control and prevention.  

PubMed

Despite the growing menu of evidence-based interventions to prevent and control cancer, such interventions continue to be underused in practice. This commentary describes interactive approaches to speeding the dissemination and implementation of evidence-based interventions and illustrates these approaches using examples from obesity prevention and tobacco control. PMID:25046091

Leeman, Jennifer; Jilcott-Pitts, Stephanie; Myers, Allison

2014-01-01

4

Evidence-based Screening for Low Bone Mineral Density in HIV-infected Men.  

PubMed

Low bone mineral density, which leads to osteoporosis and fracture risk, is an emerging clinical problem in HIV-infected patients. Our evidence-based practice project screened a convenience sample of 225 HIV-infected men for low bone mineral density using the Osteoporosis Self-Assessment Tool, and of those men, 173 were also screened by quantitative ultrasound of the calcaneus. One hundred twelve men had low bone mineral density by either or both screening methods. Seventy-one of these 112 men were tested by dual-energy x-ray absorptiometry and 73% had low bone mineral density. The positive protective value of the Osteoporosis Self-Assessment Tool was 73% and for quantitative ultrasound was 88%. These results suggest that routine low bone mineral density screening should be included as standard practice for all HIV-infected patients. PMID:24823286

Albright, Patsi; Du, Ping; Haas, Richard E; Pugh, Linda C

2014-01-01

5

When to start antiretroviral therapy: the need for an evidence base during early HIV infection  

PubMed Central

Background Strategies for use of antiretroviral therapy (ART) have traditionally focused on providing treatment to persons who stand to benefit immediately from initiating the therapy. There is global consensus that any HIV+ person with CD4 counts less than 350 cells/?l should initiate ART. However, it remains controversial whether ART is indicated in asymptomatic HIV-infected persons with CD4 counts above 350 cells/?l, or whether it is more advisable to defer initiation until the CD4 count has dropped to 350 cells/?l. The question of when the best time is to initiate ART during early HIV infection has always been vigorously debated. The lack of an evidence base from randomized trials, in conjunction with varying degrees of therapeutic aggressiveness and optimism tempered by the risks of drug resistance and side effects, has resulted in divided expert opinion and inconsistencies among treatment guidelines. Discussion On the basis of recent data showing that early ART initiation reduces heterosexual HIV transmission, some countries are considering adopting a strategy of universal treatment of all HIV+ persons irrespective of their CD4 count and whether ART is of benefit to the individual or not, in order to reduce onward HIV transmission. Since ART has been found to be associated with both short-term and long-term toxicity, defining the benefit:risk ratio is the critical missing link in the discussion on earlier use of ART. For early ART initiation to be justified, this ratio must favor benefit over risk. An unfavorable ratio would argue against using early ART. Summary There is currently no evidence from randomized controlled trials to suggest that a strategy of initiating ART when the CD4 count is above 350 cells/?l (versus deferring initiation to around 350 cells/?l) results in benefit to the HIV+ person and data from observational studies are inconsistent. Large, clinical endpoint-driven randomized studies to determine the individual health benefits versus risks of earlier ART initiation are sorely needed. The counter-argument to this debate topic can be freely accessed here: http://www.biomedcentral.com/1741-7015/11/147. PMID:23767777

2013-01-01

6

Evidence-Based Interventions for Pediatric Weight Control  

Microsoft Academic Search

Childhood obesity can lead to later life-threatening conditions that impact negatively on quality of life and morbidity and mortality outcomes. This article describes a method to evaluate individual interventions that have been found effective for long-term weight control in children and adolescents. The randomized controlled trials from a 2009 meta-analysis of interventions for treating obesity in children and adolescents were

Nuananong Seal; Marion Broome

2011-01-01

7

Applying mindful evidence-based practice at the bedside: using catheter-associated urinary tract infection as a model.  

PubMed

We introduce a mindful evidence-based practice model to operationalize mindfulness to improve bedside infection prevention practices. Using catheter-associated urinary tract infection prevention as an example, we illustrate how clinicians can be more mindful about appropriate catheter indications and timely catheter removal. PMID:24018928

Kiyoshi-Teo, Hiroko; Krein, Sarah L; Saint, Sanjay

2013-10-01

8

Are Bracken Control Methods Effective? An Evidence-Based Approach. Gavin. B. Stewart & Andrew. S. Pullin  

E-print Network

Are Bracken Control Methods Effective? An Evidence-Based Approach. Gavin. B. Stewart & Andrew. S to reduce the abundance of bracken, Pteridium aquilinum (L.) Kuhn. We report on our progress to date methods of synthesis. 2. Background Control of bracken is a widespread conservation problem on heathland

Miall, Chris

9

Evidence-based medicine training during residency: a randomized controlled trial of efficacy  

Microsoft Academic Search

BACKGROUND: Evidence-based medicine (EBM) has been widely integrated into residency curricula, although results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking. We sought to determine if an EBM workshop improved internal medicine residents' EBM knowledge and skills and use of secondary evidence resources. METHODS: This randomized controlled trial included 48 internal medicine residents at

David A Feldstein; Matthew J Maenner; Rachaya Srisurichan; Mary A Roach; Bennett S Vogelman

2010-01-01

10

Journal Club: a venue to advance evidence-based infection prevention practice.  

PubMed

Journal Clubs are a well-recognized strategy used by clinicians to critique and keep up to date with relevant literature. This article provides an example of an assessment of an article appearing in this issue of the American Journal of Infection Control titled, "US School/Academic Institution Disaster and Pandemic Preparedness and Seasonal Influenza Vaccination Among School Nurses." PMID:22938853

Manning, Mary Lou; Davis, James

2012-09-01

11

Teaching Emergency Medicine Residents Evidence-Based Critical Appraisal Skills: A Controlled Trial  

Microsoft Academic Search

Study Objectives: To compare the performance of an evidence-based medicine (EBM) approach and a traditional approach to teaching critical appraisal skills to emergency medicine residents. Methods: This was a prospective, case-controlled trial of 32 emergency medicine residents (16 control and 16 intervention). Intervention residents were exposed to a monthly, 1-hour journal club using an EBM approach to critical appraisal over

Jeffrey J Bazarian; Colleen O Davis; Linda L Spillane; Howard Blumstein; Sandra M Schneider

1999-01-01

12

Effect of evidence based risk information on “informed choice” in colorectal cancer screening: randomised controlled trial  

Microsoft Academic Search

Objective To compare the effect of evidence based information on risk with that of standard information on informed choice in screening for colorectal cancer.Design Randomised controlled trial with 6 months’ follow-up.Setting German statutory health insurance scheme.Participants 1577 insured people who were members of the target group for colorectal cancer screening (age 50-75, no history of colorectal cancer).Interventions Brochure with evidence

Anke Steckelberg; Christian Hülfenhaus; Burkhard Haastert; Ingrid Mühlhauser

2011-01-01

13

Using evidence-based guidelines to reduce catheter related urinary tract infections in England  

Microsoft Academic Search

Acquiring a healthcare associated infection (HCAI) in hospital remains a significant threat to patient safety, and catheter associated urinary tract infections (CAUTI) account for the majority of these infections. This review focuses on the complementary and continuing influence of central policy, evidence for practice, and educational support on strategies to reduce the incidence of CAUTI in the National Health Service

Carol Pellowe

2009-01-01

14

Evidence-Based Management of Urinary Tract Infections Across the Lifespan: Current Update  

Microsoft Academic Search

Urinary tract infections (UTIs) are common in a busy primary care setting, accounting for approximately 7 million office visits annually. These infections affect all ages and both sexes, with the highest prevalence in women. The key to management of the uncomplicated UTI depends on the correct diagnosis and pharmacologic agent. Other variables to consider when treating UTIs are uropathogen resistance

Kathryn A. Blair

2007-01-01

15

Optimizing Care for HIV-Infected People Who Use Drugs: Evidence-Based Approaches to Overcoming Healthcare Disparities  

PubMed Central

Substance use disorders (SUDs) and human immunodeficiency virus (HIV) are pervasive epidemics that synergize, resulting in negative outcomes for HIV-infected people who use drugs (PWUDs). The expanding epidemiology of substance use demands a parallel evolution of the HIV specialist—beyond HIV to diagnosis and management of comorbid SUDs. The purpose of this paper is to describe healthcare disparities for HIV-infected PWUDs along each point of a continuum of care, and to suggest evidence-based strategies for overcoming these healthcare disparities. Despite extensive dedicated resources and availability of antiretroviral therapy (ART) in the United States, PWUDs continue to experience delayed HIV diagnosis, reduced entry into and retention in HIV care, delayed initiation of ART, and inferior HIV treatment outcomes. Overcoming these healthcare disparities requires integrated packages of clinical, pharmacological, behavioral, and social services, delivered in ways that are cost-effective and convenient and include, at a minimum, screening for and treatment of underlying SUDs. PMID:23797288

Meyer, Jaimie P.; Althoff, Amy L.; Altice, Frederick L.

2013-01-01

16

Recent advances in internet-delivered, evidence-based weight control programs for adults.  

PubMed

With the explosion of Internet accessibility, online delivery offers potential for significantly greater reach of evidence-based obesity treatment programs for adults. Online behavioral weight control has been shown to produce significant weight loss, with more recent programs demonstrating larger losses and general consumer satisfaction. A growing literature indicates several program parameters that may offer greatest engagement in online obesity interventions and better weight loss outcomes, including interactive, dynamic Web site features and synchronous counselor contact, although this research is in the early stages, and a clear picture of the essential components for the most effective online obesity program remains to be determined. Further research is required to enhance weight loss outcomes, determine cost-effectiveness of Internet-delivered programs, and identify the individuals most likely to benefit from treatment in this format. PMID:20046664

Krukowski, Rebecca A; West, Delia Smith; Harvey-Berino, Jean

2009-01-01

17

Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia  

PubMed Central

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated. PMID:21860786

Copenhaver, Michael M.; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A.; Kamarulzaman, Adeeba; Altice, Frederick L.

2011-01-01

18

A framework for developing an evidence-based, comprehensive tobacco control program  

PubMed Central

Background Tobacco control is an area where the translation of evidence into policy would seem to be straightforward, given the wealth of epidemiological, behavioural and other types of research available. Yet, even here challenges exist. These include information overload, concealment of key (industry-funded) evidence, contextualization, assessment of population impact, and the changing nature of the threat. Methods In the context of Israel's health targeting initiative, Healthy Israel 2020, we describe the steps taken to develop a comprehensive tobacco control strategy. We elaborate on the following: a) scientific issues influencing the choice of tobacco control strategies; b) organization of existing evidence of effectiveness of interventions into a manageable form, and c) consideration of relevant philosophical and political issues. We propose a framework for developing a plan and illustrate this process with a case study in Israel. Results Broad consensus exists regarding the effectiveness of most interventions, but current recommendations differ in the emphasis they place on different strategies. Scientific challenges include integration of complex and sometimes conflicting information from authoritative sources, and lack of estimates of population impact of interventions. Philosophical and political challenges include the use of evidence-based versus innovative policymaking, the importance of individual versus governmental responsibility, and whether and how interventions should be prioritized. The proposed framework includes: 1) compilation of a list of potential interventions 2) modification of that list based on local needs and political constraints; 3) streamlining the list by categorizing interventions into broad groupings of related interventions; together these groupings form the basis of a comprehensive plan; and 4) refinement of the plan by comparing it to existing comprehensive plans. Conclusions Development of a comprehensive tobacco control plan is a complex endeavour, involving crucial decisions regarding intervention components. "Off the shelf" plans, which need to be adapted to local settings, are available from a variety of sources, and a multitude of individual recommendations are available. The proposed framework for adapting existing approaches to the local social and political climate may assist others planning for smoke-free societies. Additionally, this experience has implications for development of evidence-based health plans addressing other risk factors. PMID:20507612

2010-01-01

19

Pediatric herpes simplex virus infections: an evidence-based approach to treatment.  

PubMed

Herpes simplex virus is a common virus that causes a variety of clinical presentations ranging from mild to life-threatening. Orolabial and genital herpes are common disorders that can often be managed in an outpatient setting; however, some patients do present to the emergency department with those conditions, and emergency clinicians should be aware of possible complications in the pediatric population. Neonatal herpes is a rare disorder, but prompt recognition and initiation of antiviral therapy is imperative, as the morbidity and mortality of the disease is high. Herpes encephalitis is an emergency that also requires a high index of suspicion to diagnose. Herpes simplex virus is also responsible for a variety of other clinical presentations, including herpes gladiatorum, herpetic whitlow, eczema herpeticum, and ocular herpes. This issue reviews the common clinical presentations of the herpes simplex virus, the life-threatening infections that require expedient identification and management, and recommended treatment regimens. PMID:24649621

Sanders, Jennifer E; Garcia, Sylvia E

2014-01-01

20

Luliconazole for the treatment of fungal infections: an evidence-based review  

PubMed Central

Luliconazole is an imidazole antifungal agent with a unique structure, as the imidazole moiety is incorporated into the ketene dithioacetate structure. Luliconazole is the R-enantiomer, and has more potent antifungal activity than lanoconazole, which is a racemic mixture. In this review, we summarize the in vitro data, animal studies, and clinical trial data relating to the use of topical luliconazole. Preclinical studies have demonstrated excellent activity against dermatophytes. Further, in vitro/in vivo studies have also shown favorable activity against Candida albicans, Malassezia spp., and Aspergillus fumigatus. Luliconazole, although belonging to the azole group, has strong fungicidal activity against Trichophyton spp., similar to that of terbinafine. The strong clinical antifungal activity of luliconazole is possibly attributable to a combination of strong in vitro antifungal activity and favorable pharmacokinetic properties in the skin. Clinical trials have demonstrated its superiority over placebo in dermatophytosis, and its antifungal activity to be at par or even better than that of terbinafine. Application of luliconazole 1% cream once daily is effective even in short-term use (one week for tinea corporis/cruris and 2 weeks for tinea pedis). A Phase I/IIa study has shown excellent local tolerability and a lack of systemic side effects with use of topical luliconazole solution for onychomycosis. Further studies to evaluate its efficacy in onychomycosis are underway. Luliconazole 1% cream was approved in Japan in 2005 for the treatment of tinea infections. It has recently been approved by US Food and Drug Administration for the treatment of interdigital tinea pedis, tinea cruris, and tinea corporis. Topical luliconazole has a favorable safety profile, with only mild application site reactions reported occasionally.

Khanna, Deepshikha; Bharti, Subhash

2014-01-01

21

Expanding the Evidence Base: Comparing Randomized Controlled Trials and Observational Studies of Statins.  

PubMed

It is widely accepted that randomized controlled trials (RCTs) are the gold standard for demonstrating the efficacy of a given therapy (results under ideal conditions). Observational studies, on the other hand, can complement this by demonstrating effectiveness (results under real-world conditions). To examine the role that observational studies can play in complementing data from RCTs, we reviewed published studies for statins, a class of drugs that have been widely used to reduce the risk of cardiovascular (CV) events by lowering low-density lipoprotein cholesterol levels. RCTs have consistently demonstrated the benefits of statin treatment in terms of CV risk reduction and have demonstrated that more intensive statin therapy has incremental benefits over less intensive treatment. Observational studies of statin use in 'real-world' populations have served to augment the evidence base generated from statin RCTs in preselected populations of patients who are often at high CV risk and have led to similar safety and efficacy findings. They have also raised questions about factors affecting medication adherence, under-treatment, switching between statins, and failure to reach low-density lipoprotein cholesterol target levels, questions for which the answers could lead to improved patient care. PMID:22487773

Atar, Dan; Ong, Seleen; Lansberg, Peter J

2012-03-27

22

Tobacco Control: Using evidence-based research to prevent, treat, and control tobacco use.  

Cancer.gov

Increasing Smoking Cessation in Low Income Adult Populations Erik Augustson, PhD, MPH Tobacco Control Research Branch Behavioral Research Program Division of Cancer Control and Population Sciences RFA Purpose • To promote innovative research

23

Tobacco Control: Using evidence-based research to prevent, treat, and control tobacco use.  

Cancer.gov

Measures and Determinants of Smokeless Tobacco Use Prevention and Cessation Mark Parascandola, PhD, MPH Tobacco Control Research Branch Division of Cancer Control and Population Sciences National Cancer Institute Purpose of the RFA • Understand

24

Infection control risks.  

PubMed

Managing infection risks is a core activity for infection control professionals, yet there is a relative paucity of literature on infection control risk management. The purpose of this review is to draw attention to some areas that require further clarification and research. These include risk management objectives, clarity about which risks are taken account of, agreed terminology both for experts and non-experts, and research on the importance of risk compensation in hospital-acquired infection control. PMID:19062132

Millar, M

2009-02-01

25

Hospital infection control in hematopoietic stem cell transplant recipients.  

PubMed Central

Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients contains a section on hospital infection control including evidence-based recommendations regarding ventilation, construction, equipment, plants, play areas and toys, health-care workers, visitors, patient skin and oral care, catheter-related infections, drug-resistant organisms, and specific nosocomial infections. These guidelines are intended to reduce the number and severity of hospital infections in hematopoietic stem cell transplant recipients. PMID:11294720

Dykewicz, C. A.

2001-01-01

26

Building the palliative care evidence base: Lessons from a randomized controlled trial of oxygen vs room air for refractory dyspnea.  

PubMed

Palliative care is increasingly seen as a standard component of high-quality comprehensive cancer care. However, several challenges remain to its widespread integration into clinical oncology practice, including workforce problems, reimbursement concerns, and a fledgling evidence base. This article discusses issues surrounding evidence base development in palliative cancer care, using the example of a recently published randomized controlled trial of oxygen versus room air. The Oxygen Trial randomized patients with refractory dyspnea and adequate Pao2 to oxygen or room air, administered via nasal cannula. Both groups experienced improvements in self-rated dyspnea scores, but no statistical differences were seen between intervention arms. These results suggest that supplementary oxygen is often unnecessary in the palliative setting, and that room air is similarly efficacious. This example highlights the importance and need for ongoing development of the evidence base in palliative medicine. The Palliative Care Research Cooperative (PCRC) is a novel National Institute of Nursing Research-funded research infrastructure that seeks to expand the palliative care evidence base. Its first multisite trial was recently completed, assessing the pragmatic question of whether statin medications can be safely discontinued in end-of-life settings. The PCRC will be a vehicle through which a high-quality evidence base will continue to expand and develop. Such ongoing research efforts are needed to inform and improve palliative care practice. PMID:24994919

LeBlanc, Thomas W; Abernethy, Amy P

2014-07-01

27

An outreach intervention to implement evidence based practice in residential care: a randomized controlled trial [ISRCTN67855475  

Microsoft Academic Search

BACKGROUND: The aim of this project was to assess whether outreach visits would improve the implementation of evidence based clinical practice in the area of falls reduction and stroke prevention in a residential care setting. METHODS: Twenty facilities took part in a randomized controlled trial with a seven month follow-up period. Two outreach visits were delivered by a pharmacist. At

Maria Crotty; Craig Whitehead; Debra Rowett; Julie Halbert; David Weller; Paul Finucane; Adrian Esterman

2004-01-01

28

An ontology of randomized controlled trials for evidence-based practice: content specification and evaluation using the competency decomposition method  

Microsoft Academic Search

Abstract Randomized controlled trials (RCTs) are one of the least biased sources of clinical research evidence, and are therefore a critical resource for the practice of evidence-based medicine. With over 10,000 new RCTs indexed in Medline each year, knowledge systems are needed,to help clinicians translate evidence into practice. Common,ontologies for RCTs and other domains,would,facilitate the development of these knowledge systems.

Ida Sim; Ben Olasov; Simona Carini

2004-01-01

29

Infection control for norovirus.  

PubMed

Norovirus infections are notoriously difficult to prevent and control, owing to their low infectious dose, high shedding titre, and environmental stability. The virus can spread through multiple transmission routes, of which person-to-person and foodborne are the most important. Recent advances in molecular diagnostics have helped to establish norovirus as the most common cause of sporadic gastroenteritis and the most common cause of outbreaks of acute gastroenteritis across all ages. In this article, we review the epidemiology and virology of noroviruses, and prevention and control guidelines, with a focus on the principles of disinfection and decontamination. Outbreak management relies on sound infection control principles, including hand hygiene, limiting exposure to infectious individuals, and thorough environmental decontamination. Ideally, all infection control recommendations would rely on empirical evidence, but a number of challenges, including the inability to culture noroviruses in the laboratory and the challenges of outbreak management in complex environments, has made it difficult to garner clear evidence of efficacy in certain areas of infection control. New experimental data on cultivable surrogates for human norovirus and on environmental survivability and relative resistance to commonly used disinfectants are providing new insights for further refinining disinfection practices. Finally, clinical trials are underway to evaluate the efficacy of vaccines, which may shift the current infection control principles to more targeted interventions. PMID:24813073

Barclay, L; Park, G W; Vega, E; Hall, A; Parashar, U; Vinjé, J; Lopman, B

2014-08-01

30

Infection control in Africa. Nosocomial infection.  

PubMed

This article discusses infection prevention and control in Africa and describes an available manual for infection control. The effectiveness of prevention and control efforts is dependent on health care services and the prevalence of disease. Funding for health care, the perceived economic impact of infection control, and trained administrators determine the availability of health services and the spread of disease. The challenge is to provide cleanliness, aseptic techniques in patient care, and protection for the health worker. If the hospital infection rate is as high as 15% of admissions and each case requires an additional 7 days of hospitalization, the estimated costs nationally could exceed US $110 million. Africa has a massive infectious disease burden, in addition to HIV and tuberculosis. The spread of Ebola fever shows how out-of-control infections can become. Most African countries are unequipped with infrastructure to handle surveillance of the new resistant bacterial strains resulting from indiscriminate use of antibiotics. In Zimbabwe, infection and prevention control was proved possible and cost effective. Education was provided at the village level in basic hygiene, home nursing, construction of fly-proof pit toilets, and a safe water supply. Training of trainers expanded the process of education. The "Infection Control Manual" provides the manager with the principles and background knowledge for prevention and control of infections. The Infection Control Association of Southern Africa is a useful source of information, standards, and support base. PMID:12321236

Pearse, J

1997-09-01

31

Evidence-based control of canine rabies: a critical review of population density reduction  

PubMed Central

Control measures for canine rabies include vaccination and reducing population density through culling or sterilization. Despite the evidence that culling fails to control canine rabies, efforts to reduce canine population density continue in many parts of the world. The rationale for reducing population density is that rabies transmission is density-dependent, with disease incidence increasing directly with host density. This may be based, in part, on an incomplete interpretation of historical field data for wildlife, with important implications for disease control in dog populations. Here, we examine historical and more recent field data, in the context of host ecology and epidemic theory, to understand better the role of density in rabies transmission and the reasons why culling fails to control rabies. We conclude that the relationship between host density, disease incidence and other factors is complex and may differ between species. This highlights the difficulties of interpreting field data and the constraints of extrapolations between species, particularly in terms of control policies. We also propose that the complex interactions between dogs and people may render culling of free-roaming dogs ineffective irrespective of the relationship between host density and disease incidence. We conclude that vaccination is the most effective means to control rabies in all species. PMID:23004351

Morters, Michelle K; Restif, Olivier; Hampson, Katie; Cleaveland, Sarah; Wood, James L N; Conlan, Andrew J K

2013-01-01

32

A framework for developing an evidence-based, comprehensive tobacco control program  

Microsoft Academic Search

BACKGROUND: Tobacco control is an area where the translation of evidence into policy would seem to be straightforward, given the wealth of epidemiological, behavioural and other types of research available. Yet, even here challenges exist. These include information overload, concealment of key (industry-funded) evidence, contextualization, assessment of population impact, and the changing nature of the threat. METHODS: In the context

Laura Rosen; Elliot Rosenberg; Martin McKee; Shosh Gan-Noy; Diane Levin; Elana Mayshar; Galia Shacham; John Borowski; Gabi Bin Nun; Boaz Lev

2010-01-01

33

Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics  

PubMed Central

Background Psychological models can be used to understand and predict behaviour in a wide range of settings. However, they have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. The aim of this study was to explore the usefulness of a range of psychological theories to predict health professional behaviour relating to management of upper respiratory tract infections (URTIs) without antibiotics. Methods Psychological measures were collected by postal questionnaire survey from a random sample of general practitioners (GPs) in Scotland. The outcome measures were clinical behaviour (using antibiotic prescription rates as a proxy indicator), behavioural simulation (scenario-based decisions to managing URTI with or without antibiotics) and behavioural intention (general intention to managing URTI without antibiotics). Explanatory variables were the constructs within the following theories: Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model (SM), and knowledge (a non-theoretical construct). For each outcome measure, multiple regression analysis was used to examine the predictive value of each theoretical model individually. Following this 'theory level' analysis, a 'cross theory' analysis was conducted to investigate the combined predictive value of all significant individual constructs across theories. Results All theories were tested, but only significant results are presented. When predicting behaviour, at the theory level, OLT explained 6% of the variance and, in a cross theory analysis, OLT 'evidence of habitual behaviour' also explained 6%. When predicting behavioural simulation, at the theory level, the proportion of variance explained was: TPB, 31%; SCT, 26%; II, 6%; OLT, 24%. GPs who reported having already decided to change their management to try to avoid the use of antibiotics made significantly fewer scenario-based decisions to prescribe. In the cross theory analysis, perceived behavioural control (TPB), evidence of habitual behaviour (OLT), CS-SRM cause (chance/bad luck), and intention entered the equation, together explaining 36% of the variance. When predicting intention, at the theory level, the proportion of variance explained was: TPB, 30%; SCT, 29%; CS-SRM 27%; OLT, 43%. GPs who reported that they had already decided to change their management to try to avoid the use of antibiotics had a significantly higher intention to manage URTIs without prescribing antibiotics. In the cross theory analysis, OLT evidence of habitual behaviour, TPB attitudes, risk perception, CS-SRM control by doctor, TPB perceived behavioural control and CS-SRM control by treatment entered the equation, together explaining 49% of the variance in intention. Conclusion The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for identifying factors that predict clinical behaviour. However, a number of conceptual and methodological challenges remain. PMID:17683558

Eccles, Martin P; Grimshaw, Jeremy M; Johnston, Marie; Steen, Nick; Pitts, Nigel B; Thomas, Ruth; Glidewell, Elizabeth; Maclennan, Graeme; Bonetti, Debbie; Walker, Anne

2007-01-01

34

Barriers and Facilitators to Evidence-based Blood Pressure Control in Community Practice  

PubMed Central

Introduction The Electronic Communications and Home Blood Pressure Monitoring trial (e-BP) demonstrated that team care incorporating a pharmacist to manage hypertension using secure E-mail with patients resulted in almost twice the rate of blood pressure (BP) control compared with usual care. To translate e-BP into community practices, we sought to identify contextual barriers and facilitators to implementation. Methods Interviews were conducted with medical providers, staff, pharmacists, and patients associated with community-based primary care clinics whose physician leaders had expressed interest in implementing e-BP. Transcripts were analyzed using qualitative template analysis, incorporating codes derived from the Consolidated Framework for Implementation Research (CFIR). Results Barriers included incorporating an unfamiliar pharmacist into the health care team, lack of information technology resources, and provider resistance to using a single BP management protocol. Facilitators included the intervention’s perceived potential to improve quality of care, empower patients, and save staff time. Sustainability of the intervention emerged as an overarching theme. Conclusion A qualitative approach to planning for translation is recommended to gain an understanding of contexts and to collaborate to adapt interventions through iterative, bidirectional information gathering. Interviewees affirmed that web pharmacist care offers small primary care practices a means to expand their workforce and provide patient-centered care. Reproducing e-BP in these practices will be challenging, but our interviewees expressed eagerness to try and were optimistic that a tailored intervention could succeed. PMID:24004706

Robins, Lynne S.; Jackson, J. Elizabeth; Green, Beverly B.; Korngiebel, Diane; Force, Rex W.; Baldwin, Laura-Mae

2013-01-01

35

Evidence-Based Practice in the Use of Antibiotics for Respiratory Tract Infections in Primary Health Centers in Kuwait  

Microsoft Academic Search

Objectives: The objective of this study was to evaluate the use of antibiotics in treating upper respiratory tract infections (URTIs) in primary health centers in Kuwait and investigate the extent to which antibiotic use follows international guidelines. SubjectsandMethods: A nationwide cross-sectional study was conducted with a sample size of 615 patients selected by using a multi-stage cluster sampling method. Of

Salem Ayyad; Abdullah Al-Owaisheer; Faisal Al-Banwan; Abdullah Al-Mejalli; Mumtaz Shukkur; Lukman Thalib

2010-01-01

36

Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial  

Microsoft Academic Search

BACKGROUND: At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. METHODS: This was a randomised controlled trial involving six postgraduate education centres

James Davis; Evi Chryssafidou; Javier Zamora; David Davies; Khalid Khan; Arri Coomarasamy

2007-01-01

37

Randomised controlled trial of the effect of evidence based information on women's willingness to participate in cervical cancer screening  

PubMed Central

Study objectives: To assess whether providing women with additional information on the pros and cons of screening, compared with information currently offered by the NHS, affects their intention to attend for screening. Design: Randomised controlled trial. Participants were randomly assigned to receive either the control, (based on an NHS Cervical Screening Programme leaflet currently used), or the intervention leaflet (containing additional information on risks and uncertainties). Setting: Three general practices in Birmingham. Participants: 300 women aged 20 to 64 attending the practices during a one month period. Main outcome measures: Intention to attend for screening. Main results: 283 women (94.3%) completed the study. Fewer women in the intervention (79%) than the control group (88%) expressed intention to have screening after reading the information leaflet (difference between groups 9.2%, 95% confidence intervals (CI) 3.2% to 21.7%). The crude odds ratio (OR) and 95% CI was 0.50 (0.26 to 0.97). After adjusting for other factors, the trend persisted (OR 0.60, 95% CI 0.28 to 1.29). Having a previous Pap smear was the only significant predictor of intention to have screening (adjusted OR 2.54, 95% CI 1.03 to 6.21). Subgroup analysis showed no intervention effect in intended uptake between women at higher and lower risk of cervical cancer (p=0.59). Conclusions: Providing women with evidence based information on the risks, uncertainties, and the benefits of screening, is likely to deter some, but not differentially those at higher risk. PMID:12883063

Adab, P; Marshall, T; Rouse, A; Randhawa, B; Sangha, H; Bhangoo, N

2003-01-01

38

Medical Students' and Tutors' Experiences of Directed and Self-Directed Learning Programs in Evidence-Based Medicine: A Qualitative Evaluation Accompanying a Randomized Controlled Trial  

ERIC Educational Resources Information Center

This qualitative study aims to interpret the results of a randomized controlled trial comparing two educational programs (directed learning and self-directed learning) in evidence-based medicine (EBM) for medical students at the University of Oslo from 2002 to 2003. There is currently very little comparative educational research in this field. In…

Bradley, Peter; Oterholt, Christina; Nordheim, Lena; Bjorndal, Arild

2005-01-01

39

Evidence-based clinical practice in falls prevention: a randomised controlled trial of a falls prevention service  

Microsoft Academic Search

Aims: Evidence-based guidelines recommend a range of treatments for falls and injury prevention. We undertook a randomised trial of a falls prevention service to screen for falls risk factors and recommend to GPs an evidenced base prescription for falls prevention. Methods: All patients who presented with a fall to the Emergency Department at Flinders Medical Centre over a 22-week period

Craig Whitehead; Rachel Wundke; Maria Crotty; Paul Finucane

2003-01-01

40

Selecting a control in IVF and acupuncture RCTs: How sham controls may unnecessarily complicate the RCT evidence base  

PubMed Central

Background Acupuncture has typically been tested in trials that evaluate subjective, patient-reported outcomes such as pain. Ratings of pain and similar subjective states can be strongly influenced by respondents’ pre-judgments, preferences, and expectations about treatment benefits. Therefore, controlling for these expectations or “placebo effects” by using a sham acupuncture control group is critically important in trials of acupuncture for pain-related conditions. This need for sham acupuncture controls in trials of acupuncture for pain-related conditions may have led to the belief that sham acupuncture is always the most “rigorous” control, and that it should therefore be used for all acupuncture trials, including trials of adjuvant acupuncture for IVF. Objective To examine the theoretical and methodological rationales for the use of sham acupuncture controls in trials of adjuvant acupuncture for IVF, and to identify the drawbacks of using a sham acupuncture control that may have its own effects on the pregnancy outcome. Conclusions In trials of adjuvant acupuncture for IVF, the outcome is pregnancy, which is entirely objective and unlikely to be affected by a patient’s expectations of a benefit of acupuncture. Because it seems unlikely that an IVF patient’s knowledge of whether or not she was receiving adjuvant acupuncture would affect her ability to become pregnant from IVF, using sham acupuncture to control for expectation/placebo effects seems unnecessary in this context. Even if adjuvant acupuncture were to increase IVF success rates only through a psychosomatic effect mechanism, such as by reducing stress, this stress reduction effect would be integral to the working mechanism by which adjuvant acupuncture increases IVF pregnancy rates, and therefore, it seems inappropriate to control for and separate out any such stress-reduction effect by using a sham control. Because of the risk that the sham is not an inert placebo but rather an active treatment that may affect the pregnancy outcome, using sham acupuncture as the control may unnecessarily confuse rather than clarify the interpretation of the effects of IVF adjuvant acupuncture. Using both theoretical concerns and epidemiological evidence, researchers should carefully weigh the benefits and drawbacks of using sham acupuncture to blind patients in adjuvant acupuncture for IVF trials, and should question, rather than automatically accept, whether “placebo effects” are an important risk of bias in this context. PMID:21570069

Manheimer, Eric

2011-01-01

41

Environmental surface infection control, 2003.  

PubMed

Infection control guidelines address the routine use of disposable covers and cleaning and disinfecting treatment-area surfaces contaminated during patient care. While the rationale and approaches for accomplishing environmental surface disinfection have been considered in many previous infection control recommendations, exaggerated claims have led to some confusion regarding the wide variety of available surface covers and disinfectant products. The Centers for Disease Control and Prevention Guideline for Infection Control in Dental Health-Care Settings, 2003, considers the current state of scientific and clinical knowledge in environmental infection control, reinforce basic principles, and provide updated recommendations aimed at minimizing the potential for microbial cross-contamination and cross-infection from inanimate surfaces. PMID:15641332

Molinari, John A; Palenik, Charles John

2004-01-01

42

A Randomized Control Trial Examining the Effect of Acceptance and Commitment Training on Clinician Willingness to Use Evidence-Based Pharmacotherapy  

Microsoft Academic Search

This study evaluated the effectiveness of acceptance and commitment training (ACT) for increasing drug and alcohol counselors' willingness to use evidence-based agonist and antagonist pharmacotherapy. Fifty-nine drug and alcohol counselors were randomly assigned to either a 1-day ACT workshop or a 1-day educational control workshop. Both groups then attended a 2-day workshop on empirically supported treatments for substance abuse. Measures

Alethea A. Varra; Steven C. Hayes; Nancy Roget; Gary Fisher

2008-01-01

43

Infection Control in Dental Settings  

MedlinePLUS

... Guidelines Safety Infant Formula and Fluorosis Scientific Reviews Fluoride in Drinking Water Health Effects and Environmental Impact ... Statistics Reference Statistics Engineering & Operations Training Programs Other Fluoride Products Links to Other Organizations Infection Control in ...

44

Day Care Infection Control Protocol.  

ERIC Educational Resources Information Center

This day care infection control manual was assembled to provide technical guidance for the prevention and control of communicable diseases to child day care facilities in Seattle and King County, Washington. For each disease, the manual provides background information, public health control recommendations, and letters that can be used to…

Seattle-King County Dept. of Public Health, Seattle, WA.

45

Evidence-based practice  

Microsoft Academic Search

Evidence-based practice (EBP) has been received with enthusiasm and interest by many nurses. It has, however, raised skepticism and negative reactions from others. This article seeks to address the place of EBP in care of the elderly by outlining EBP and providing some pertinent examples of how it can be used in caring for older people. Finally, it promotes EBP

Rhonda Nay

2003-01-01

46

Evidence-based dentistry  

Microsoft Academic Search

We live in an age of information, innovation and change. Clinical decision making based on good quality evidence should lead to more effective and efficient treatments. Each practitioner has a role in assesing this information. This paper outlines this role, together with the advantages and problems of introducing an evidence-based approach to dentistry.

D Richards; A Lawrence

1998-01-01

47

Glutathione S-Transferase Polymorphism Interactions with Smoking Status and HPV Infection in Cervical Cancer Risk: An Evidence-Based Meta-Analysis  

PubMed Central

Background Human papillomavirus (HPV) infection is considered the major cause of cervical cancer (CC), but a number of infected women do not develop invasive lesions, suggesting the role of genetic susceptibility and environmental co-factors for cancer outbreak. Glutathione S- transferases (GSTs) are multifunctional enzymes that play a key role in the detoxification of varieties of both endogenous products of oxidative stress and exogenous carcinogens. Methods MEDLINE, EMBASE, and Cochrane databases were searched. All studies evaluating the association between GSTM1 polymorphisms and cervical cancer were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed-or random-effects model. Results A total of 23 case-control studies were included in the meta-analysis. The overall result showed that the association between GSTM1 null genotype and risk for cervical cancer was statistically significant (OR?=?1.56; 95%CI, 1.39–1.75). Subgroup analyses were performed based on ethnicity, smoking and HPV infection. Our results showed that smokers with null GSTM1 genotype had higher risk of cervical cancer (OR?=?2.27, 95%CI, 1.46–3.54). For the ethnicity stratification, significant increased risk of null GSTM1 genotype was found in Chinese and Indian population, but no increased risk in other population was found. Conclusions this meta-analysis provided strong evidence that the GSTM1 genotype is associated with CC development, especially in Chinese and Indian populations. Smoking and HPV infection modified the association between the null GSTM1 genotype and CC. PMID:24391774

Zhen, Shuai; Hu, Chen-Ming; Bian, Li-Hong

2013-01-01

48

Infection control in fixed prosthodontics.  

PubMed

The breadth and depth of our knowledge of infection control continues to increase in dramatic proportions. The literature is already massive and there is nothing to suggest an abatement of this situation. In truth, we can expect the very opposite; an escalation in attention at every level of concern, from the effectiveness of the chemical agents as actually used in the dental environment, to our methods of delivery, as well as the effects on the materials, equipment, and even the personnel in the dental setting. This trend undoubtedly will continue as our understanding of disease processes and the mechanisms of disease transmission increases. This will, in part, directly impact the scope and direction of future study of infection control practices in dentistry. PMID:1397436

Naylor, W P

1992-07-01

49

Randomized Controlled Trials in Evidence-Based Mental Health Care: Getting the Right Answer to the Right Question  

Microsoft Academic Search

The purpose of clinical research is to answer this ques- tion: Would a new treatment, when added to the exist- ing range of treatment options available in practice, help patients? Randomized controlled trials (RCTs)— in particular, double-blind RCTs—have important methodological advantages over observational studies for addressing this question. These advantages, how- ever, come at a price. RCTs compare treatments using

Susan M. Essock; Robert E. Drake; Richard G. Frank; Thomas G. McGuire

2003-01-01

50

Evidence-Based Medicine  

Microsoft Academic Search

Zum Thema  \\u000a Evidence-Based-Medicine (EMB), die auf klinischer Forschung gegründete wissenschaftliche Medizin, wird beschrieben als „gewissenhafter,\\u000a ausdrücklicher und vernüftiger Gebrauch der gegenwärtig besten externen, wissenschaftlichen Evidenz für Entscheidungen in\\u000a der medizinischen Versorgung individueller Patienten. Die Praxis der EBM bedeutet die Integration individueller klinischer\\u000a Expertise mit der externen Evidenz aus systematischer Forschung”.\\u000a \\u000a \\u000a \\u000a Auf den ärztlichen Entscheidungsprozeß sei also ausdrücklich hingewiesen, auch wenn

G. Antes

1998-01-01

51

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?  

PubMed Central

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a “life course approach.” Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses. PMID:22628907

Singh, Kavita; Reddy, K Srinath; Prabhakaran, Dorairaj

2011-01-01

52

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?  

PubMed

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a "life course approach." Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses. PMID:22628907

Singh, Kavita; Reddy, K Srinath; Prabhakaran, Dorairaj

2011-12-01

53

Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies.  

PubMed

There has been enormous debate regarding the possibility of a link between childhood vaccinations and the subsequent development of autism. This has in recent times become a major public health issue with vaccine preventable diseases increasing in the community due to the fear of a 'link' between vaccinations and autism. We performed a meta-analysis to summarise available evidence from case-control and cohort studies on this topic (MEDLINE, PubMed, EMBASE, Google Scholar up to April, 2014). Eligible studies assessed the relationship between vaccine administration and the subsequent development of autism or autism spectrum disorders (ASD). Two reviewers extracted data on study characteristics, methods, and outcomes. Disagreement was resolved by consensus with another author. Five cohort studies involving 1,256,407 children, and five case-control studies involving 9,920 children were included in this analysis. The cohort data revealed no relationship between vaccination and autism (OR: 0.99; 95% CI: 0.92 to 1.06) or ASD (OR: 0.91; 95% CI: 0.68 to 1.20), nor was there a relationship between autism and MMR (OR: 0.84; 95% CI: 0.70 to 1.01), or thimerosal (OR: 1.00; 95% CI: 0.77 to 1.31), or mercury (Hg) (OR: 1.00; 95% CI: 0.93 to 1.07). Similarly the case-control data found no evidence for increased risk of developing autism or ASD following MMR, Hg, or thimerosal exposure when grouped by condition (OR: 0.90, 95% CI: 0.83 to 0.98; p=0.02) or grouped by exposure type (OR: 0.85, 95% CI: 0.76 to 0.95; p=0.01). Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder. PMID:24814559

Taylor, Luke E; Swerdfeger, Amy L; Eslick, Guy D

2014-06-17

54

Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials.  

PubMed

The aim of this study was to determine appropriate endoscopic treatment of patients with bleeding ulcers by synthesizing results of randomized controlled trials. We performed dual independent bibliographic database searches to identify randomized trials of thermal therapy, injection therapy, or clips for bleeding ulcers with active bleeding, visible vessels, or clots, focusing on results from studies without second-look endoscopy and re-treatment. The primary end point was further (persistent plus recurrent) bleeding. Compared with epinephrine, further bleeding was reduced significantly by other monotherapies (relative risk [RR], 0.58 [95% CI, 0.36-0.93]; number-needed-to-treat [NNT], 9 [95% CI, 5-53]), and epinephrine followed by another modality (RR, 0.34 [95% CI, 0.23-0.50]; NNT, 5 [95% CI, 5-7]); epinephrine was not significantly less effective in studies with second-look and re-treatment. Compared with no endoscopic therapy, further bleeding was reduced by thermal contact (heater probe, bipolar electrocoagulation) (RR, 0.44 [95% CI, 0.36-0.54]; NNT, 4 [95% CI, 3-5]) and sclerosant therapy (RR, 0.56 [95% CI, 0.38-0.83]; NNT, 5 [95% CI, 4-13]). Clips were more effective than epinephrine (RR, 0.22 [95% CI, 0.09-0.55]; NNT, 5 [95% CI, 4-9]), but not different than other therapies, although the latter studies were heterogeneous, showing better and worse results for clips. Endoscopic therapy was effective for active bleeding (RR, 0.29 [95% CI, 0.20-0.43]; NNT, 2 [95% CI, 2-2]) and a nonbleeding visible vessel (RR, 0.49; [95% CI, 0.40-0.59]; NNT, 5 [95% CI, 4-6]), but not for a clot. Bolus followed by continuous-infusion proton pump inhibitor after endoscopic therapy significantly improved outcome compared with placebo/no therapy (RR, 0.40 [95% CI, 0.28-0.59]; NNT, 12 [95% CI, 10-18]), but not compared with histamine(2)-receptor antagonists. Thermal devices, sclerosants, clips, and thrombin/fibrin glue appear to be effective endoscopic hemostatic therapies. Epinephrine should not be used alone. Endoscopic therapy should be performed for ulcers with active bleeding and nonbleeding visible vessels, but efficacy is uncertain for clots. Bolus followed by continuous-infusion intravenous proton pump inhibitor should be used after endoscopic therapy. PMID:18986845

Laine, Loren; McQuaid, Kenneth R

2009-01-01

55

Adapting Evidence-based Programs  

Cancer.gov

Be familiar with fellow module participants. Understand what evidence-based means, what evidence-based programs are, and why they are important to use in health interventions. Be familiar with the structure of the tutorial.

56

Effectiveness of evidence-based medicine training for undergraduate students at a Chinese Military Medical University: a self-controlled trial  

PubMed Central

Background To evaluate the effect of the integration of evidence-based medicine (EBM) into medical curriculum by measuring undergraduate medical students’ EBM knowledge, attitudes, personal application, and anticipated future use. Methods A self-controlled trial was conducted with 251 undergraduate students at a Chinese Military Medical University, using a validated questionnaire regarding the students’ evidence-based practice (EBP) about knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and future anticipated use (EBP-F). The educational intervention was a 20-hour EBM course formally included in the university’s medical curriculum, combining lectures with small group discussion and student-teacher exchange sessions. Data were analyzed using paired t-tests to test the significance of the difference between a before and after comparison. Results The difference between the pre- and post-training scores were statistically significant for EBP-K, EBP-A, EBP-P, and EBP-F. The scores for EBP-P showed the most pronounced percentage change after EBM training (48.97?±?8.6%), followed by EBP-A (20.83?±?2.1%), EBP-K (19.21?±?3.2%), and EBP-F (17.82?±?5.7%). Stratified analyses by gender, and program subtypes did not result in any significant changes to the results. Conclusions The integration of EBM into the medical curriculum improved undergraduate medical students’ EBM knowledge, attitudes, personal application, and anticipated future use. A well-designed EBM training course and objective outcome measurements are necessary to ensure the optimum learning opportunity for students. PMID:24996537

2014-01-01

57

A KT intervention including the evidence alert system to improve clinician's evidence-based practice behavior--a cluster randomized controlled trial  

PubMed Central

Background It is difficult to foster research utilization among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions but little is known about; the impact and viability of multifaceted KT strategies using an online KT tool, their effectiveness with AHPs and their effect on evidence-based practice (EBP) decision-making behavior. The study aim was to measure the effectiveness of a multifaceted KT intervention including a customized KT tool, to change EBP behavior, knowledge, and attitudes of AHPs. Methods This is an evaluator-blinded, cluster randomized controlled trial conducted in an Australian community-based cerebral palsy service. 135 AHPs (physiotherapists, occupational therapists, speech pathologists, psychologists and social workers) from four regions were cluster randomized (n?=?4), to either the KT intervention group (n?=?73 AHPs) or the control group (n?=?62 AHPs), using computer-generated random numbers, concealed in opaque envelopes, by an independent officer. The KT intervention included three-day skills training workshop and multifaceted workplace supports to redress barriers (paid EBP time, mentoring, system changes and access to an online research synthesis tool). Primary outcome (self- and peer-rated EBP behavior) was measured using the Goal Attainment Scale (individual level). Secondary outcomes (knowledge and attitudes) were measured using exams and the Evidence Based Practice Attitude Scale. Results The intervention group’s primary outcome scores improved relative to the control group, however when clustering was taken into account, the findings were non-significant: self-rated EBP behavior [effect size 4.97 (95% CI -10.47, 20.41) (p?=?0.52)]; peer-rated EBP behavior [effect size 5.86 (95% CI -17.77, 29.50) (p?=?0.62)]. Statistically significant improvements in EBP knowledge were detected [effect size 2.97 (95% CI 1.97, 3.97 (p?

2013-01-01

58

Ceftazidime-avibactam: an evidence-based review of its pharmacology and potential use in the treatment of Gram-negative bacterial infections.  

PubMed

Avibactam (NXL104, AVE1330A) is a semi-synthetic, non-?-lactam, ?-lactamase inhibitor that is active against Ambler class A, class C, and some class D serine ?-lactamases. In this review, we summarize the in vitro data, pharmacology, mechanisms of action and resistance, and clinical trial data relating to the use of this agent combined with ceftazidime for the treatment of Gram-negative bacterial infections. The addition of avibactam to ceftazidime improves its in vitro activity against Enterobacteriaceae and Pseudomonas aeruginosa. Avibactam does not improve the activity of ceftazidime against Acinetobacter spp., Burkholderia spp., or most anaerobic Gram-negative rods. Pharmacodynamic data indicate that ceftazidime-avibactam is bactericidal at concentrations achievable in human serum. Animal studies demonstrate that ceftazidime-avibactam is effective in ceftazidime-resistant Gram-negative septicemia, meningitis, pyelonephritis, and pneumonia. Limited clinical trials published to date have reported that ceftazidime-avibactam is as effective as therapy with a carbapenem in complicated urinary tract infection and complicated intra-abdominal infection (combined with metronidazole) including infection caused by cephalosporin-resistant Gram-negative isolates. Safety and tolerability of ceftazidime-avibactam in clinical trials has been excellent, with few serious drug-related adverse events reported. Given the abundant clinical experience with ceftazidime and the significant improvement that avibactam provides in its activity against contemporary ?-lactamase-producing Gram-negative pathogens, it is likely this new combination agent will play a role in the empiric treatment of complicated urinary tract infections (monotherapy) and complicated intra-abdominal infections (in combination with metronidazole) caused or suspected to be caused by antimicrobial-resistant pathogens (eg, extended spectrum beta-lactamase-, AmpC-, or Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae and multidrug-resistant P. aeruginosa). Potential future uses also include hospital-acquired pneumonia (in combination with antistaphylococcal and antipneumococcal agents) or treatment of skin and soft tissue infections caused by antimicrobial-resistant Gram-negative pathogens (eg, diabetic foot infections), but further clinical trials are required. PMID:24493994

Lagacé-Wiens, Philippe; Walkty, Andrew; Karlowsky, James A

2014-01-01

59

Colistimethate sodium for the treatment of chronic pulmonary infection in cystic fibrosis: an evidence-based review of its place in therapy  

PubMed Central

Chronic bacterial respiratory-tract infections are a major driving force in the pathogenesis of cystic fibrosis (CF) lung disease and promote chronic lung-function decline, destruction, and progression to respiratory failure at a premature age. Gram-negative bacteria colonizing the airways in CF are a major problem in CF therapy due to their tendency to develop a high degree of resistance to antibiotic agents over time. Pseudomonas aeruginosa is the dominating bacterial strain infecting the CF lung from early childhood on, and multiresistant strains frequently develop after years of therapy. Colistin has been used for treating pulmonary bacterial infections in CF for decades due to its very good Gram-negative activity. However, drawbacks include concerns regarding toxicity when being applied systemically, and the lack of approval for application by inhalation in the USA for many years. Other antibiotic substances for systemic use are available with good to excellent Gram-negative and anti-Pseudomonas activity, while there are only three substances approved for inhalation use in the treatment of chronic pulmonary infection with proven benefit in CF. The emergence of multiresistant strains leaving nearly no antibiotic substance as a treatment option, the limited number of antibiotics with high activity against P. aeruginosa, the concerns about increasing the risk of antibiotic resistance by continuous antibiotic therapy, the development of new drug formulations and drug-delivery devices, and, finally, the differing treatment strategies used in CF centers call for defining the place of this “old” drug, colistimethate, in today’s CF therapy. This article reviews the available evidence to reflect on the place of colistimethate sodium in the therapy of chronic pulmonary infection in CF. PMID:25278817

Koerner-Rettberg, Cordula; Ballmann, Manfred

2014-01-01

60

Evidence-Based Practice  

PubMed Central

Objectives: The aim of this study was to describe nurses’ practices, attitudes, knowledge/skills and perceived barriers in relation to evidence-based practice (EBP) in Oman. Methods: This descriptive cross-sectional study was conducted between February and November 2012. A self-reported 24-item questionnaire was used to measure EBP practices, attitudes and knowledge/skills among a convenience sample of 600 nurses working in four governmental hospitals in Muscat, Oman. Responses were scored on a one to seven rating scale. Barriers to EBP were measured on a five-point Likert scale using two subscales. Descriptive statistics and general linear regression were used to analyse the data. Results: A total of 414 nurses were included in the study. The greatest barriers to developing EBP among nurses were insufficient time for research (3.51 ± 0.97) and insufficient resources to change practices (3.64 ± 0.99). Nurses with more years of experience reported increased use of EBP (P <0.01), more positive attitudes towards EBP (P <0.001) and fewer barriers to research (P <0.01). Significant positive correlations were found between years of experience and practice (r = 0.16) and attitudes (r = 0.20). Nurses with a baccalaureate degree reported fewer barriers to research than those qualified at a diploma level (P <0.001). Nurses who perceived more barriers to research reported less use of EBP (P <0.001), less positive attitudes towards EBP (P <0.001) and limited EBP knowledge/skills (P <0.001). Conclusion: These findings provide a basis for enhancing nursing practices, knowledge and skills. Continuing education for nurses and minimising barriers is crucial to increasing the use of EBP in Oman.

Ammouri, Ali A.; Raddaha, Ahmad A.; Dsouza, Preethy; Geethakrishnan, Renu; Noronha, Judith A.; Obeidat, Arwa A.; Shakman, Lina

2014-01-01

61

A Systematic Review of Evidence-Based Behavioral Interventions for African American Youth at Risk for HIV\\/STI Infection, 1988–2007  

Microsoft Academic Search

\\u000a In the United States, African American youth are disproportionally affected by human immunodeficiency virus (HIV) and sexually\\u000a transmitted infections (STIs). An estimated 1.2 million people are living with HIV\\/AIDS (Glynn & Rhodes, 2005). Data from\\u000a 33 states in the United States with confidential name-based reporting show that in 2006 African Americans of all ages represented\\u000a 49% of HIV\\/AIDS diagnosis, although

Khiya Marshall; Nicole Crepaz; Ann O’Leary

62

Evidence-based decision-making in infectious diseases epidemiology, prevention and control: matching research questions to study designs and quality appraisal tools  

PubMed Central

Background The Project on a Framework for Rating Evidence in Public Health (PRECEPT) was initiated and is being funded by the European Centre for Disease Prevention and Control (ECDC) to define a methodology for evaluating and grading evidence and strength of recommendations in the field of public health, with emphasis on infectious disease epidemiology, prevention and control. One of the first steps was to review existing quality appraisal tools (QATs) for individual research studies of various designs relevant to this area, using a question-based approach. Methods Through team discussions and expert consultations, we identified 20 relevant types of public health questions, which were grouped into six domains, i.e. characteristics of the pathogen, burden of disease, diagnosis, risk factors, intervention, and implementation of intervention. Previously published systematic reviews were used and supplemented by expert consultation to identify suitable QATs. Finally, a matrix was constructed for matching questions to study designs suitable to address them and respective QATs. Key features of each of the included QATs were then analyzed, in particular in respect to its intended use, types of questions and answers, presence/absence of a quality score, and if a validation was performed. Results In total we identified 21 QATs and 26 study designs, and matched them. Four QATs were suitable for experimental quantitative study designs, eleven for observational quantitative studies, two for qualitative studies, three for economic studies, one for diagnostic test accuracy studies, and one for animal studies. Included QATs consisted of six to 28 items. Six of the QATs had a summary quality score. Fourteen QATs had undergone at least one validation procedure. Conclusions The results of this methodological study can be used as an inventory of potentially relevant questions, appropriate study designs and QATs for researchers and authorities engaged with evidence-based decision-making in infectious disease epidemiology, prevention and control. PMID:24886571

2014-01-01

63

Effects of student participation in hand hygiene monitoring on knowledge and perception of infection control practices.  

PubMed

Studies report that students in health care professions do not retain knowledge of infection control and demonstrate poor hand hygiene compliance. This study describes the effect of a multifaceted approach (education, skills training, and monitoring) on nursing students' knowledge of infection control principles, opinions, hand hygiene practices, and value of nursing research in evidence-based practice. Students participated in hand hygiene monitoring of health care workers with 900 observations. Students demonstrated strong knowledge of hand hygiene principles: 63% reported that hand hygiene monitoring positively influenced their own compliance. Although posters have been identified as effective prompts, students did not perceive poster reminders as effective in prompting handwashing. Students reported that hand hygiene activities helped them value the role of the nurse in research and evidence-based practice. This study may help educators clarify misconceptions that result in student noncompliance in hand hygiene practices. PMID:21366164

Waltman, Patricia A; Schenk, Laura K; Martin, Tina M; Walker, Jean

2011-04-01

64

Evidence-based financial management.  

PubMed

Like the practice of evidence-based medicine, evidence-based financial management can be used by providers to improve results. The concept provides a framework that managers and researchers can use to help direct efforts in gathering and using evidence to support management decisions in health care. PMID:14560582

Finkler, Steven A; Henley, Richard J; Ward, David M

2003-10-01

65

Using Evidence-Based Information  

Microsoft Academic Search

The purpose of this article is to demystify the process and the common terminology used in the world of evidence-based health care and to point the reader to important resources necessary to answer a clinical question in an evidence-based fashion.

Laurie Scudder

2006-01-01

66

Evidence-Based Language Practice  

ERIC Educational Resources Information Center

The purpose of this paper was to examine evidence-based procedures in medicine and to demonstrate that the same protocols can be used in English language instruction. In the evidence-based methodology, studies are divided into those that address specific language problems. Integrated studies are presented as a systematic overview, meta-analysis,…

Pollock, Eric J.

2005-01-01

67

Enterobiasis (Pinworm Infection): Prevention and Control  

MedlinePLUS

... as Pinworm Infection) Parasites Home Share Compartir Prevention & Control Washing your hands with soap and warm water ... there. In institutions, day care centers, and schools, control of pinworm can be difficult, but mass drug ...

68

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial  

PubMed Central

Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s ?2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p?=?0.023), knowledge where to find (20.4%, p?=?0.007), access to (21.7%, p?control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p?=?0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p?=?0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected. PMID:24589291

2014-01-01

69

A Simple, Fast, Easy Method to Identify the Evidence Base in Pain-Relief Research: Validation of a Computer Search Strategy Used Alone to Identify Quality Randomized Controlled Trials  

Microsoft Academic Search

Clinicians need a simple, fast, reliable, and inexpensive way of identifying the evidence base relevant to their clin- ical practice. It is often believed that the only way to iden- tify all relevant evidence is to perform hand-searches of the literature to supplement computer searches; this is complex and labor intensive. However, most of quality randomized controlled trials cited in

Tony K. F. Chow; Colin S. Goodchild; John J. McNeil

2004-01-01

70

Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial  

PubMed Central

Background Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. Method/Design This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO?+?smokerlyzer to sustain motivation of smoker’s quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the health service packages. Intention-to-treat analysis will be followed. Factors influencing smoking cessation will be analyzed by the structure equation model. Discussion This multicomponent intervention, accessible at primary healthcare clinics, and focusing on the individual as well as the family and social environment, is unique and expected to work effectively. Trial registration Current Controlled Trials ISRCTN89315117 PMID:24308874

2013-01-01

71

Infection control in severely burned patients  

PubMed Central

In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag (Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help the control of infection in these immunocomprimised patients. Strict infection control practices (physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms. PMID:24701406

Coban, Yusuf Kenan

2012-01-01

72

Infection control, ethics and accountability  

Microsoft Academic Search

Health care-associated infections (HAIs) are a major clinical and economic problem in Australian hospitals, and a significant proportion are preventable. • HAIs are the result of complex environmental, microbiological, pathological, behavioural and organisational factors, and prevention requires a multifaceted (\\

Gwendolyn L Gilbert; Paul Y Cheung; Ian B Kerridge

2009-01-01

73

Evidence-Based Practice and Chiropractic Care  

PubMed Central

Evidence-based practice has had a growing impact on chiropractic education and the delivery of chiropractic care. For evidence-based practice to penetrate and transform a profession, the penetration must occur at 2 levels. One level is the degree to which individual practitioners possess the willingness and basic skills to search and assess the literature. Chiropractic education received a significant boost in this realm in 2005 when the National Center for Complementary and Alternative Medicine awarded 4 chiropractic institutions R25 education grants to strengthen their research/evidence-based practice curricula. The second level relates to whether the therapeutic interventions commonly employed by a particular health care discipline are supported by clinical research. A growing body of randomized controlled trials provides evidence of the effectiveness and safety of manual therapies. PMID:23875117

LeFebvre, Ron; Peterson, David; Haas, Mitchell

2013-01-01

74

Psychiatric Mental Health Evidence-Based Practice  

Microsoft Academic Search

This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element

Michael J. Rice

2008-01-01

75

Compliance with infection prevention and control in oral health-care facilities: a global perspective.  

PubMed

Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control. PMID:25244364

Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

2014-12-01

76

Infection control during filoviral hemorrhagic Fever outbreaks.  

PubMed

Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg) hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website. PMID:22529631

Raabea, Vanessa N; Borcherta, Matthias

2012-01-01

77

Scissors: are they an infection control risk?  

PubMed

Increasing bacterial resistance means that nurses must re-examine infection control procedures. Bacteria were cultured from 59% of scissors swabbed. Some were still contaminated after cleaning. Some nurses do not appear to recognise the risk of infection from using their scissors for a variety of purposes. PMID:12029719

Kelly, J; Trundle, C

2000-10-01

78

Infection Control: Old Problems and New Challenges  

Microsoft Academic Search

Infection control faces radical changes at the beginning of the third millennium. The first part of this review focuses on problems not yet solved, such as 1) surveillance systems, which should be active and extremely flexible; 2) infection outbreaks in hospitals and strategies to avoid them; 3) hand washing and alternatives such as rapid hand antisepsis; 4) water and food

Alejandro E. Macias; Samuel Ponce-de-Leon

79

Improving evidence-based primary care for chronic kidney disease: study protocol for a cluster randomized control trial for translating evidence into practice (TRANSLATE CKD)  

PubMed Central

Background Chronic kidney disease (CKD) and end stage renal disease (ESRD) are steadily increasing in prevalence in the United States. While there is reasonable evidence that specific activities can be implemented by primary care physicians (PCPs) to delay CKD progression and reduce mortality, CKD is under-recognized and undertreated in primary care offices, and PCPs are generally not familiar with treatment guidelines. The current study addresses the question of whether the facilitated TRANSLATE model compared to computer decision support (CDS) alone will lead to improved evidence-based care for CKD in primary care offices. Methods/Design This protocol consists of a cluster randomized controlled trial (CRCT) followed by a process and cost analysis. Only practices providing ambulatory primary care as their principal function, located in non-hospital settings, employing at least one primary care physician, with a minimum of 2,000 patients seen in the prior year, are eligible. The intervention will occur at the cluster level and consists of providing CKD-specific CDS versus CKD-specific CDS plus practice facilitation for all elements of the TRANSLATE model. Patient-level data will be collected from each participating practice to examine adherence to guideline-concordant care, progression of CKD and all-cause mortality. Patients are considered to meet stage three CKD criteria if at least two consecutive estimated glomerular filtration rate (eGFR) measurements at least three months apart fall below 60 ml/min. The process evaluation (cluster level) will determine through qualitative methods the fidelity of the facilitated TRANSLATE program and find the challenges and enablers of the implementation process. The cost-effectiveness analysis will compare the benefit of the intervention of CDS alone against the intervention of CDS plus TRANSLATE (practice facilitation) in relationship to overall cost per quality adjusted years of life. Discussion This study has three major innovations. First, this study adapts the TRANSLATE method, proven effective in diabetes care, to CKD. Second, we are creating a generalizable CDS specific to the Kidney Disease Outcome Quality Initiative (KDOQI) guidelines for CKD. Additionally, this study will evaluate the effects of CDS versus CDS with facilitation and answer key questions regarding the cost-effectiveness of a facilitated model for improving CKD outcomes. The study is testing virtual facilitation and Academic detailing making the findings generalizable to any area of the country. Trial registration Registered as NCT01767883 on clinicaltrials.gov NCT01767883 PMID:23927603

2013-01-01

80

TLRs control hematopoiesis during infection  

PubMed Central

Summary Recent research has shown: i) that Toll-like receptor (TLR) agonists drive hematopoietic stem and progenitor cells (HSPCs) to proliferate and differentiate along the myeloid lineage in vitro, and ii) that direct TLR-mediated stimulation of HSPCs also promotes macrophage differentiation in vivo following infection. These new insights demonstrate that TLR signaling in HSPCs, in addition to other TLR-dependent mechanisms, can contribute to HSPC expansion and myeloid differentiation after infection. Evidence is therefore mounting that direct TLR-induced programming of hematopoiesis plays a key role in host defense by rapidly replenishing the innate immune system with the cells needed to deal with pathogens. PMID:24122753

Yanez, Alberto; Goodridge, Helen S.; Gozalbo, Daniel; Gil, M. Luisa

2014-01-01

81

38 CFR 51.190 - Infection control.  

...190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must...

2014-07-01

82

INFECTION CONTROL IN ALTERNATIVE HEALTHCARE SETTINGS  

PubMed Central

SYNOPSIS With the changing healthcare delivery, patients receive care at various settings including acute care hospitals, skilled nursing facilities, outpatient primary care and specialty clinics, as well as at home, exposing them to pathogens in various settings. Various healthcare settings face unique challenges requiring individualized infection control programs. Infection control programs in skilled nursing facilities should address: surveillance for infections and antimicrobial resistance, outbreak investigation and control plan for epidemics, isolation precautions, hand hygiene, staff education, and employee and resident health programs. Infection control programs in ambulatory clinics should address: Triage and standard – transmission based precautions, cleaning, disinfection and sterilization principles, surveillance in surgical clinics, safe injection practices, and bioterrorism and disaster planning for ambulatory clinics. PMID:21316005

Flanagan, Elaine; Chopra, Teena; Mody, Lona

2011-01-01

83

38 CFR 51.190 - Infection control.  

Code of Federal Regulations, 2011 CFR

...Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and...

2011-07-01

84

38 CFR 51.190 - Infection control.  

Code of Federal Regulations, 2013 CFR

...Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and...

2013-07-01

85

38 CFR 51.190 - Infection control.  

Code of Federal Regulations, 2010 CFR

...Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and...

2010-07-01

86

38 CFR 51.190 - Infection control.  

Code of Federal Regulations, 2012 CFR

...Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.190 Infection control. The facility management must establish and...

2012-07-01

87

38 CFR 52.190 - Infection control.  

...control. 52.190 Section 52.190 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.190 Infection...

2014-07-01

88

Practical risk-adjusted quality control charts for infection control  

Microsoft Academic Search

Background:Control chart methodology has been widely touted for monitoring and improving quality in the health care setting. P charts and U charts are frequently recommended for rate and ratio statistics, but their practical value in infection control may be limited because they (1) are not risk-adjusted, and (2) perform poorly with small denominators. The Standardized Infection Ratio is a statistic

Tracy L. Gustafson

2000-01-01

89

Evidence-Based mini-manual  

E-print Network

1 Evidence-Based Medicine: mini-manual Based in part on the Evidence-Based Medicine Toolkit, http-making. The appraisal tools are adapted from the Users' Guides series prepared by the Evidence Based Medicine Working School of Public Health Sciences July, 2009 #12;2 #12;3 What is Evidence-Based Medicine? Evidence-based

MacMillan, Andrew

90

Broadening the Evidence Base for Evidence-Based Guidelines  

Microsoft Academic Search

Evidence-based evaluations of clinical preventive services help define priorities for research in prevention as part of primary health care. In this article, we draw on our experiences with the U.S. Preventive Services Task Force (USPSTF) to outline some major areas where research is needed to define the appropriate use of specific screening tests, counseling interventions, immunizations, and chemoprophylaxis. Areas of

David Atkins; Carolyn G. DiGuiseppi

1998-01-01

91

Updating the evidence base on the operational costs of supplementary immunization activities for current and future accelerated disease control, elimination and eradication efforts  

PubMed Central

Background To achieve globally or regionally defined accelerated disease control, elimination and eradication (ADC/E/E) goals against vaccine-preventable diseases requires complementing national routine immunization programs with intensive, time-limited, and targeted Supplementary Immunization Activities (SIAs). Many global and country-level SIA costing efforts have historically relied on what are now outdated benchmark figures. Mobilizing adequate resources for successful implementation of SIAs requires updated estimates of non-vaccine costs per target population. Methods This assessment updates the evidence base on the SIA operational costs through a review of literature between 1992 and 2012, and an analysis of actual expenditures from 142 SIAs conducted between 2004 and 2011 and documented in country immunization plans. These are complemented with an analysis of budgets from 31 SIAs conducted between 2006 and 2011 in order to assess the proportion of total SIA costs per person associated with various cost components. All results are presented in 2010 US dollars. Results Existing evidence indicate that average SIA operational costs were usually less than US$0.50 per person in 2010 dollars. However, the evidence is sparse, non-standardized, and largely out of date. Average operational costs per person generated from our analysis of country immunization plans are consistently higher than published estimates, approaching US$1.00 for injectable vaccines. The results illustrate that the benchmarks often used to project needs underestimate the true costs of SIAs and the analysis suggests that SIA operational costs have been increasing over time in real terms. Our assessment also illustrates that operational costs vary across several dimensions. Variations in the actual costs of SIAs likely to reflect the extents to which economies of scale associated with campaign-based delivery can be attained, the underlying strength of the immunization program, sensitivities to the relative ease of vaccine administration (i.e. orally, or by injection), and differences in disease-specific programmatic approaches. The assessment of SIA budgets by cost component illustrates that four cost drivers make up the largest proportion of costs across all vaccines: human resources, program management, social mobilization, and vehicles and transportation. These findings suggest that SIAs leverage existing health system infrastructure, reinforcing the fact that strong routine immunization programs are an important pre-requisite for achieving ADC/E/E goals. Conclusions The results presented here will be useful for national and global-level actors involved in planning, budgeting, resource mobilization, and financing of SIAs in order to create more realistic assessments of resource requirements for both existing ADC/E/E efforts as well as for new vaccines that may deploy a catch-up campaign-based delivery component. However, limitations of our analysis suggest a need to conduct further research into operational costs of SIAs. Understanding the changing face of delivery costs and cost structures for SIAs will continue to be critical to avoid funding gaps and in order to improve vaccination coverage, reduce health inequities, and achieve the ADC/E/E goals many of which have been endorsed by the World Health Assembly and are included in the Decade of Vaccines Global Vaccine Action Plan. PMID:24450832

2014-01-01

92

Can psychological models bridge the gap between clinical guidelines and clinicians' behaviour? A randomised controlled trial of an intervention to influence dentists' intention to implement evidence-based practice  

Microsoft Academic Search

Objective The lag between publication of evidence for clinical practice and implementation by clinicians may be decades. Research using psychological models demonstrates that changing intention is very important in changing behaviour. This study examined an intervention (rehearsing alternative actions) to change dentists' intention to implement evidence-based practice (EBP) for third molar (TM) management.Design Randomised controlled trial \\/ postal.Setting Primary care.Subjects

M Johnston; N B Pitts; C Deery; I Ricketts; M Bahrami; C Ramsay; J Johnston; D Bonetti

2003-01-01

93

Infection control in equine critical care settings.  

PubMed

There is a recognizable standard of practice for infection control in veterinary medicine. Effort must be given to control and prevention of infectious disease transmission within a facility and among animal populations. In the critical care setting, patients typically have a high degree of systemic illness and immune compromise, are commonly subjected to invasive procedures and placement of indwelling devices, and frequently receive antimicrobials and gastric protectants. Every equine critical care unit is distinctive in its physical and operational features and the types of patients that are managed. Infection control programs must therefore be tailored to each facility's needs. PMID:25016503

Burgess, Brandy A; Morley, Paul S

2014-08-01

94

Towards Evidence-Based Sustainable  

E-print Network

Towards Evidence- Based Sustainable Communities Report on Survey of Urban Sustainability Centers. Hilda Blanco and Genevieve Giuliano at the Center for Sustainable Communities, the School of Policy Poticha, Director of the Office for Sustainable Housing and Communities, and Ben Winter and Joshua Geyer

Wang, Hai

95

Principles of evidence based medicine  

Microsoft Academic Search

Health care professionals are increasingly required to base clinical decisions on the best available evidence. Evidence based medicine (EBM) is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values. This paper explains the concept of EBM and introduces the five step EBM model: formulation of answerable

A K Akobeng

2005-01-01

96

Evidence Based Navigation in Swarms  

Microsoft Academic Search

A low-complexity, evidence based navigation algorithm for swarms of mobile sensors is presented. It can be effectively used in scenarios where a particular event signature is characterized by a mix of weak signal modalities with certain degrees of intensity, distributed in a local region. The method is based on Dempster-Shafer (DS) evidence theory and enables the mobile nodes to process

Duminda A. Dewasurendra; Peter H. Bauer; Matthias Scheutz; Kamal Premaratne

2006-01-01

97

Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections.  

PubMed Central

OBJECTIVE: To draw up evidence-based guidelines to make injections safer. METHODS: A development group summarized evidence-based best practices for preventing injection-associated infections in resource-limited settings. The development process included a breakdown of the WHO reference definition of a safe injection into a list of potentially critical steps, a review of the literature for each of these steps, the formulation of best practices, and the submission of the draft document to peer review. FINDINGS: Eliminating unnecessary injections is the highest priority in preventing injection-associated infections. However, when intradermal, subcutaneous, or intramuscular injections are medically indicated, best infection control practices include the use of sterile injection equipment, the prevention of contamination of injection equipment and medication, the prevention of needle-stick injuries to the provider, and the prevention of access to used needles. CONCLUSION: The availability of best infection control practices for intradermal, subcutaneous, and intramuscular injections will provide a reference for global efforts to achieve the goal of safe and appropriate use of injections. WHO will revise the best practices five years after initial development, i.e. in 2005. PMID:12973641

Hutin, Yvan; Hauri, Anja; Chiarello, Linda; Catlin, Mary; Stilwell, Barbara; Ghebrehiwet, Tesfamicael; Garner, Julia

2003-01-01

98

Evidence-Based Treatment of Acute Pancreatitis  

PubMed Central

Background: The management of acute pancreatitis (AP) is still based on speculative and unproven paradigms in many centers. Therefore, we performed an evidence-based analysis to assess the best available treatment. Methods: A comprehensive Medline and Cochrane Library search was performed evaluating the indication and timing of interventional and surgical approaches, and the value of aprotinin, lexipafant, gabexate mesylate, and octreotide treatment. Each study was ranked according to the evidence-based methodology of Sackett; whenever feasible, we performed new meta-analyses using the random-effects model. Recommendations were based on the available level of evidence (A = large randomized; B = small randomized; C = prospective trial). Results: None of the evaluated medical treatments is recommended (level A). Patients with AP should receive early enteral nutrition (level B). While mild biliary AP is best treated by primary cholecystectomy (level B), patients with severe biliary AP require emergency endoscopic papillotomy followed by interval cholecystectomy (level A). Patients with necrotizing AP should receive imipenem or meropenem prophylaxis to decrease the risk of infected necrosis and mortality (level A). Sterile necrosis per se is not an indication for surgery (level C), and not all patients with infected necrosis require immediate surgery (level B). In general, early necrosectomy should be avoided (level B), and single necrosectomy with postoperative lavage should be preferred over “open-packing” because of fewer complications with comparable mortality rates (level C). Conclusions: While providing new insights into key aspects of AP management, this evidence-based analysis highlights the need for further clinical trials, particularly regarding the indications for antibiotic prophylaxis and surgery. PMID:16432347

Heinrich, Stefan; Schafer, Markus; Rousson, Valentin; Clavien, Pierre-Alain

2006-01-01

99

RCN introduce new guidelines in infection control.  

PubMed

The RCN Safety Representatives Conference Co-ordinating Committee urge all nurses, not only to be vaccinated against hepatitis B, but also to ensure that they understand, and appreciate, infection control guidelines, and to ensure that, in their local working environment, they are followed closely. This statement is contained in the preface of the Royal College of Nursing's Introduction to Hepatitis B and Nursing Guidelines for Infection Control, launched in London on 30th June 1987, as part of the RCN's active campaign on hepatitis B. It is anticipated that these guidelines will have an enormous impact on the NHS. PMID:10284270

Sims-Williams, F

1987-08-01

100

How Evidence-Based Are the Recommendations in Evidence-Based Guidelines?  

Microsoft Academic Search

BackgroundTreatment recommendations for the same condition from different guideline bodies often disagree, even when the same randomized controlled trial (RCT) evidence is cited. Guideline appraisal tools focus on methodology and quality of reporting, but not on the nature of the supporting evidence. This study was done to evaluate the quality of the evidence (based on consideration of its internal validity,

Finlay A. McAlister; Sean van Diepen; Rajdeep S. Padwal; Jeffrey A. Johnson; Sumit R. Majumdar

2007-01-01

101

Overview of Evidence-based Medicine: Challenges for Evidence-based Laboratory Medicine  

Microsoft Academic Search

Evidence-based medicine (EBM) has been driven by the need to cope with information overload, by cost-control, and by a public impatient for the best in diagnostics and treatment. Clinical guidelines, care maps, and outcome measures are quality improvement tools for the appro- priateness, efficiency, and effectiveness of health ser- vices. Although they are imperfect, their value increases with the quality

Matthew J. McQueen

2001-01-01

102

Infections Control in North American Dental Schools.  

ERIC Educational Resources Information Center

Results from 1982 and 1987 surveys of dental schools concerning infection control issues found greater recent emphasis on instrument sterilization and barrier use, but some inconsistency and confusion concerning hepatitis B and HIV virus carrier patients and personnel. The information was used to develop guidelines for school policy formation.…

Sampson, Elise; Dhuru, Virendra B.

1989-01-01

103

Infection control practices for dental radiography.  

PubMed

Infection control for dental radiography employs the same materials, processes, and techniques used in the operatory, yet unless proper procedures are established and followed, there is a definite potential for cross-contamination to clinical area surfaces and DHCP. In general, the aseptic practices used are relatively simple and inexpensive, yet they require complete application in every situation. PMID:15218669

Palenik, Charles John

2004-06-01

104

Correlates of infection control practices in dentistry  

Microsoft Academic Search

Background: Studies conducted in the first decade of the AIDS epidemic indicated that, in general, dentists had suboptimal levels of compliance with standard infection control practices, including work practices designed to reduce exposure to bloodborne pathogens. This study was designed to assess current rates of compliance with these practices in a population of Maryland dentists and to identify correlates of

Robyn R. M. Gershon; Christine Karkashian; David Vlahov; Martha Grimes; Elizabeth Spannhake

1998-01-01

105

Controlling droplet-transmitted respiratory infections  

PubMed Central

OBJECTIVE To promote incorporation of new guidelines on control of respiratory infections into family physicians’ practices. SOURCES OF INFORMATION The World Health Organization website on pandemic influenza, the Canadian Pandemic Influenza Plan, the Ontario guidelines on respiratory infection control, and research on implementing guidelines into family practice were reviewed. We also researched and calculated what the costs of implementing the guidelines would be. MAIN MESSAGE Effective control of respiratory infections in physicians’ offices can be achieved by displaying signs in the waiting room, having reception staff give masks to patients with cough and fever, instructing these patients to clean their hands with alcohol gel and to sit at least 1 m from others, inquiring about patients’ or their close contacts’ recent travel, using disinfectant wipes to clean possibly contaminated surfaces in waiting rooms and examining areas, and having staff and care providers wear masks and wash hands or use alcohol gel. The approximate annual cost of incorporating the guidelines is about $800 per physician. CONCLUSION Because the outbreak of an influenza pandemic is likely imminent, implementing standard guidelines for control of respiratory infections in primary care offices seems wise. Following these guidelines would help prevent patients and staff from contracting serious respiratory illnesses. PMID:17279182

Hogg, William; Huston, Patricia

2006-01-01

106

Sicily statement on evidence-based practice  

Microsoft Academic Search

BACKGROUND: A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and

Martin Dawes; William Summerskill; Paul Glasziou; Antonino Cartabellotta; Janet Martin; Kevork Hopayian; Franz Porzsolt; Amanda Burls; James Osborne

2005-01-01

107

Infection control and biosecurity in equine disease control.  

PubMed

Infectious diseases are an important cause of morbidity and mortality in horses, along with economic costs and broader impacts associated with the loss of members of a species that generates income, acts as a working animal and is a companion. Endemic diseases continue to challenge, emerging diseases are an ever-present threat and outbreaks can be both destructive and disruptive. While infectious diseases can never be completely prevented, measures can be introduced to restrict the entry of pathogens into a population or limit the implications of the presence of a pathogen. Objective research regarding infection control and biosecurity in horses is limited, yet a variety of practical infection prevention and control measures can be used. Unfortunately, infection control can be challenging, because of the nature of the equine industry (e.g. frequent horse movement) and endemic pathogens, but also because of lack of understanding or motivation to try to improve practices. Recognition of the basic concepts of infection control and biosecurity, and indeed the need for measures to control infectious diseases, is the foundation for successful infection prevention and control. PMID:24802183

Weese, J S

2014-11-01

108

75 FR 63844 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...regarding the practice of healthcare infection control and strategies for surveillance,...

2010-10-18

109

Clostridium difficileClostridium difficile An infection Control NursesAn infection Control Nurses  

E-print Network

Audits EducationEducation #12;MonitoringMonitoring Hospital Acquired C diff 2004 - 2005, XXX 0 5 10 15 20 25 30 35/ReportingMonitoring/Reporting Hospital Acquired C. diff, Ward XXX, 2004- 2006 0 1 2 3 4 5 6 J2004 F M A M J J A S O N DJan-05 F M A M J JClostridium difficileClostridium difficile An infection Control NursesAn infection Control Nurses

Glasgow, University of

110

Treatment of cutaneous warts: an evidence-based review.  

PubMed

Cutaneous warts are common skin lesions caused by human papillomavirus infection. Treatment is aimed at relieving the patient's physical and psychological discomfort and at preventing the spread of infection by autoinoculation. Among the available medical and destructive therapeutic options for cutaneous warts, none is uniformly effective or virucidal. Moreover, in most cases their safety and efficacy has not been assessed in double-blind, controlled clinical trials, so that the reproducibility of many of the listed treatments is difficult to evaluate and a possible placebo effect cannot be ruled out. The aim of this article is to describe the outcome of current therapies for each clinical wart type according to evidence-based medicine studies published in the literature. For each clinical form, the existing treatments are classified as first-, second-, and third-line therapy. First-line therapy includes medical treatments (salicylic acid, silver nitrate, glutaraldehyde) that are useful to treat a single wart or a few and/or small common warts of short duration (less than 1 year). If these treatments have failed or are contraindicated, cryotherapy may be considered as second-line therapy. For recurrent or difficult-to-treat lesions, third-line therapy includes a variety of alternative therapeutic options (topical, intralesional, systemic, and physical destruction) that are generally off-label (not US FDA approved), and whose use is limited by drawbacks or adverse effects. From pooled evidence-based medicine data, it is possible to conclude that significantly higher remission rates may be expected only with cryotherapy and salicylic acid used in combination. PMID:22292461

Dall'oglio, Federica; D'Amico, Valentina; Nasca, Maria R; Micali, Giuseppe

2012-04-01

111

Global control of hepatitis B virus infection.  

PubMed

Worldwide about 350 million people are chronic carriers of the hepatitis B virus (HBV). The infection can cause acute and chronic liver disease including cirrhosis and hepatocellular carcinoma (HCC). Hepatocellular injuries of HBV infection are predominantly immune-mediated, and the natural history of chronic infection can be divided into three phases based on virus-host interactions-namely, immune tolerance, immune clearance, and viral integration phases. Four serotypes (adw, ayw, adr, and ayr) and seven genotypes (A to G) of HBV have been identified, and they show some distinct geographic distributions. The HBV genotypes may have clinical relevance and are currently under investigation. On the basis of disease burden and the availability of safe and effective vaccines, the WHO recommended that by the end of the 20th century hepatitis B vaccine be incorporated into routine infant and childhood immunisation programmes for all countries. The efficacy of universal immunisation has been shown in different countries, with striking reductions of the prevalence of HBV carriage in children. Most important, hepatitis B vaccination can protect children against HCC and fulminant hepatitis, as has been shown in Taiwan. Nevertheless, the implementation of worldwide vaccination against HBV requires greater effort to overcome the social and economic hurdles. Safe and effective antiviral treatments are available but are still far from ideal, a situation that, hopefully, will be improved soon. With hepatitis B immunisation, the global control of HBV infection is possible by the end of the first half of 21st century. PMID:12127351

Kao, Jia-Horng; Chen, Ding-Shinn

2002-07-01

112

Evidence-based Science Communication  

NASA Astrophysics Data System (ADS)

This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

Kahan, D.

2012-12-01

113

Methods for developing evidence-based recommendations by the Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC)  

Microsoft Academic Search

The Advisory Committee on Immunization Practices (ACIP) provides expert external advice and guidance to the Director of the Centers for Disease Control and Prevention and the Secretary of the U.S. Department of Health and Human Services on use of vaccines and related agents for control of vaccine-preventable disease in the United States. During the October 2010 ACIP meeting, the ACIP

Faruque Ahmed; Jonathan L. Temte; Doug Campos-Outcalt; Holger J. Schünemann

2011-01-01

114

Evidence-Based Practice in Psychology  

ERIC Educational Resources Information Center

The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…

American Psychologist, 2006

2006-01-01

115

An Evidence-Based Systematic Review of  

E-print Network

and the highest quality of care. Methods Utilizing the Johns Hopkins Nursing Evidence-Based Practice (EBP) modelAn Evidence-Based Systematic Review of Efficacious Interventions for the Management of Delirium (Kang et al., 2012). The main objective of this Evidence-Based Practice (EBP) project was to compare

Connor, Ed

116

Evidence-Based Practices for Designing Public  

E-print Network

Evidence-Based Practices for Designing Public Engagement in Transportation Kathryn Quick Assistant Questions for Evidence-Based Design 1. What are the purposes of this public engagement effort? 2. Can we for Evidence-Based Design 1. What are the purposes of this public engagement effort? 2. Can we move beyond

Minnesota, University of

117

Development of a deployment infection control course.  

PubMed

Since the beginning of military operations in Iraq and Afghanistan, multidrug-resistant bacteria have been noted to be infecting and colonizing combat casualties. Studies suggest the primary source of these bacteria is nosocomial transmission. A focus area for improvement has been to enhance infection control (IC) at hospitals in the combat theater. A 5-day IC course was developed and implemented to provide just-in-time training to those personnel who have been identified to lead IC efforts while deployed. Twenty-nine students have attended the first 6 offerings of this course. A pre- and post-course test showed an average 21% improvement in knowledge. A follow-up questionnaire provided to those students who deployed found the course had enhanced performance of their IC duties. We describe the deployment-unique training developed to provide basic IC, emphasizing the unique challenges found in the combat setting. PMID:21265306

Crouch, Helen K; Murray, Clinton K; Hospenthal, Duane R

2010-12-01

118

Photodynamic Antimicrobial Polymers for Infection Control  

PubMed Central

Hospital-acquired infections pose both a major risk to patient wellbeing and an economic burden on global healthcare systems, with the problem compounded by the emergence of multidrug resistant and biocide tolerant bacterial pathogens. Many inanimate surfaces can act as a reservoir for infection, and adequate disinfection is difficult to achieve and requires direct intervention. In this study we demonstrate the preparation and performance of materials with inherent photodynamic, surface-active, persistent antimicrobial properties through the incorporation of photosensitizers into high density poly(ethylene) (HDPE) using hot-melt extrusion, which require no external intervention except a source of visible light. Our aim is to prevent bacterial adherence to these surfaces and eliminate them as reservoirs of nosocomial pathogens, thus presenting a valuable advance in infection control. A two-layer system with one layer comprising photosensitizer-incorporated HDPE, and one layer comprising HDPE alone is also described to demonstrate the versatility of our approach. The photosensitizer-incorporated materials are capable of reducing the adherence of viable bacteria by up to 3.62 Log colony forming units (CFU) per square centimeter of material surface for methicillin resistant Staphylococcus aureus (MRSA), and by up to 1.51 Log CFU/cm2 for Escherichia coli. Potential applications for the technology are in antimicrobial coatings for, or materials comprising objects, such as tubing, collection bags, handrails, finger-plates on hospital doors, or medical equipment found in the healthcare setting. PMID:25250740

McCoy, Colin P.; O'Neil, Edward J.; Cowley, John F.; Carson, Louise; De Baroid, Aine T.; Gdowski, Greg T.; Gorman, Sean P.; Jones, David S.

2014-01-01

119

Photodynamic antimicrobial polymers for infection control.  

PubMed

Hospital-acquired infections pose both a major risk to patient wellbeing and an economic burden on global healthcare systems, with the problem compounded by the emergence of multidrug resistant and biocide tolerant bacterial pathogens. Many inanimate surfaces can act as a reservoir for infection, and adequate disinfection is difficult to achieve and requires direct intervention. In this study we demonstrate the preparation and performance of materials with inherent photodynamic, surface-active, persistent antimicrobial properties through the incorporation of photosensitizers into high density poly(ethylene) (HDPE) using hot-melt extrusion, which require no external intervention except a source of visible light. Our aim is to prevent bacterial adherence to these surfaces and eliminate them as reservoirs of nosocomial pathogens, thus presenting a valuable advance in infection control. A two-layer system with one layer comprising photosensitizer-incorporated HDPE, and one layer comprising HDPE alone is also described to demonstrate the versatility of our approach. The photosensitizer-incorporated materials are capable of reducing the adherence of viable bacteria by up to 3.62 Log colony forming units (CFU) per square centimeter of material surface for methicillin resistant Staphylococcus aureus (MRSA), and by up to 1.51 Log CFU/cm2 for Escherichia coli. Potential applications for the technology are in antimicrobial coatings for, or materials comprising objects, such as tubing, collection bags, handrails, finger-plates on hospital doors, or medical equipment found in the healthcare setting. PMID:25250740

McCoy, Colin P; O'Neil, Edward J; Cowley, John F; Carson, Louise; De Baróid, Aine T; Gdowski, Greg T; Gorman, Sean P; Jones, David S

2014-01-01

120

Why isn't more injury prevention evidence-based?  

PubMed

The focus on evidence-based practice is critical to addressing the issue of injuries, yet advances in the science of injury prevention have not always led to advances in practice. Effective approaches are not always adopted, or when adopted and transferred from one setting to another, they do not always achieve expected results. These challenges were the basis of two breakout sessions at the second European Injury Control and Safety Promotion Conference in Paris, France (October 2008). In summarising the key issues raised during those sessions, this article describes what is meant by evidence-based practice, discusses why evidence-based practice tends not to occur and considers approaches that may facilitate the adoption and implementation of evidence-based strategies. To address the challenge, specific action is required, both on the part of the research community and those responsible for developing and implementing injury prevention policies and programmes. PMID:19941204

MacKay, J Morag; Vincenten, Joanne

2009-06-01

121

Infection control in the patient with AIDS.  

PubMed

In this discussion of infection control in patients with acquired immune deficiency syndrome (AIDS), attention is directed to nursing. Due to the fact that the majority of individuals who suffer with AIDS will be homosexual, intravenous drug users, or both, it is essential that the nurse historian be aware of his/her own feelings about the lifestyles of these patients. History-taking should be done in a nonjudgmental manner. A major pitfall to be avoided when taking a history is making assumptions about an individual's sexual preferences or activities based on the response to a simple question about marital status. It is important to note whether or not the person has a monogamous relationship or leads a polyandrous lifestyle. Another area that should be tactfully but explicitly explored when interviewing an individual who is homosexual or bisexual is the number of different sexual partners that he/she has been involved with on a weekly or monthly basis. Whether the patient has a history of sexually transmitted diseases should be determined. The use of recreational drugs should be explored. When taking the history of a client who uses intravenous drugs, it is important for the nurse to record the agents and sites of injection as well as to note whether the individual uses his/her own equipment. When reviewing the major body systems and the presence or absence of related symptoms, the nurse should note whether the client has experienced skin rashes/lesions, swollen lymph nodes, fever, extreme fatigue, weight loss, shortness of breath, changes in bowel habits, cuts or bruises that do not heal, and headaches, dizziness, blurred vision, or stiff neck. The physical examination of the individual with AIDS and an opportunistic infection usually will reveal positive findings in the central nervous system, respiratory system, gastrointestinal system, and/or the integumentary system, as well as the lymphatic system. As the leading cause of morbidity in the compromised host is infection, infection prevention should be regarded as a pragmatic necessity. 2 major things that nurses can do in the acute care setting to control infection are to limit the frequency of invasive or traumatic procedures and to reduce the acquisition of new potential pathogens. PMID:6084677

Ungvarski, P J

1984-12-01

122

Teaching residents evidence-based medicine skills  

Microsoft Academic Search

OBJECTIVES: To measure the effectiveness of an educational intervention designed to teach residents four essential evidence-based medicine\\u000a (EBM) skills: question formulation, literature searching, understanding quantitative outcomes, and critical appraisal.\\u000a \\u000a \\u000a DESIGN: Firm-based, controlled trial.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Urban public hospital.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: Fifty-five first-year internal medicine residents: 18 in the experimental group and 37 in the control group.\\u000a \\u000a \\u000a \\u000a \\u000a INTERVENTION: An EBM course, taught 2

Christopher A. Smith; Pamela S. Ganschow; Brendan M. Reilly; Arthur T. Evans; Robert A. McNutt; Albert Osei; Muhammad Saquib; Satish Surabhi; Sunil Yadav

2000-01-01

123

Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre.  

PubMed

We evaluated the effect of an intervention on call centre nurses' knowledge of decision support and skills in coaching callers facing value-sensitive health decisions. Forty-one registered nurses at a health call centre were randomly assigned to an intervention or control group. The intervention was a coaching protocol, online tutorial, skills building workshop and performance feedback. The main outcome measures were: knowledge test; blinded quality assessment of coaching skills during simulated calls and call duration. Compared with controls, nurses in the intervention group had better knowledge (74 versus 60%, P = 0.007) and decision coaching skills (81 versus 44%, P < 0.001), particularly in assessing decisional needs (information, values clarity, support, stage and timing of decision) and addressing support issues. Call duration did not differ (18.5 versus 16.7 min, P = 0.73). The coaching protocol was rated as compatible with nurses' views on decision-making and more advantageous compared with their usual practices. The intervention improved the quality of nurses' decision coaching without affecting call duration. PMID:17227607

Stacey, Dawn; O'Connor, Annette M; Graham, Ian D; Pomey, Marie-Pascale

2006-01-01

124

Infection Control Procedures in Commercial Dental Laboratories in Jordan  

Microsoft Academic Search

The risk of cross-infection in dental clinics and laboratories has attracted the attention of practitioners for the past few years, yet several medical centers have discarded compliance with infection control guidelines, resulting in a non-safe environ- ment for research and medical care. In Jordan, there is lack of known standard infection control programs that are conducted by the Jordanian Dental

Ziad Nawaf Al-Dwairi

125

Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols.  

PubMed

The present study uses a within-group controlled design to examine the efficacy and safety of two psychological approaches to posttraumatic stress disorder (PTSD) in 10 patients with a concurrent psychotic disorder. Patients were randomly assigned either to prolonged exposure (PE; N=5) or eye movement desensitization and reprocessing (EMDR; N=5). Before, during, and after treatment, a total of 20 weekly assessments of PTSD symptoms, hallucinations, and delusions were carried out. Twelve weekly assessments of adverse events took place during the treatment phase. PTSD diagnosis, level of social functioning, psychosis-prone thinking, and general psychopathology were assessed pretreatment, posttreatment, and at three-month follow-up. Throughout the treatment, adverse events were monitored at each session. An intention-to-treat analysis of the 10 patients starting treatment showed that the PTSD treatment protocols of PE and EMDR significantly reduced PTSD symptom severity; PE and EMDR were equally effective and safe. Eight of the 10 patients completed the full intervention period. Seven of the 10 patients (70%) no longer met the diagnostic criteria for PTSD at follow-up. No serious adverse events occurred, nor did patients show any worsening of hallucinations, delusions, psychosis proneness, general psychopathology, or social functioning. The results of this feasibility trial suggest that PTSD patients with comorbid psychotic disorders benefit from trauma-focused treatment approaches such as PE and EMDR. PMID:24094795

de Bont, Paul A J M; van Minnen, Agnes; de Jongh, Ad

2013-12-01

126

Evidence-based guidelines for managing mucositis  

Microsoft Academic Search

OBJECTIVES: To discuss implementation of evidence-based clinical practice guidelines for mucositis.DATA SOURCE: Published articles, book chapters, web sources, clinical experience, unpublished manuscripts.CONCLUSION: Nurses can implement evidence-based guidelines but must include an evaluation component to determine effect on clinical outcomes.IMPLICATIONS FOR NURSING PRACTICE: Nurses have an integral role implementing and evaluating evidence-based practice guidelines for managing mucositis. When evidence is lacking

Deborah B. McGuire; Edward B. Rubenstein; Douglas E. Peterson

2004-01-01

127

Inleiding in evidence-based medicine  

Microsoft Academic Search

Samenvatting  In Capita selecta worden evidence based handelen en de theorievorming daarover verder uitgediept. Belangwekkende publicaties,\\u000a methoden, technieken, definities en discussies zullen in deze rubriek regelmatig aan de orde komen. Evidence based handelen\\u000a wordt op deze wijze voor de paramedici in een breder perspectief geplaatst. In deze tweede aflevering van Capita selecta een\\u000a gedeelte uit `Inleiding in evidence-based medicine’ (Offringa e.a.,

M. Offringa; W. J. J. Assendelft; R. J. P. M. Scholten

2003-01-01

128

Severity of infection following the introduction of new infection control measures for medical abortion  

PubMed Central

Background In response to concerns about serious infections following medical abortion, in early 2006 Planned Parenthood changed the route of misoprostol administration from vaginal to buccal and required either routine antibiotic coverage or universal screening and treatment for chlamydia; in July 2007, Planned Parenthood began requiring routine antibiotic coverage for all medical abortions. We previously reported a pronounced drop in the rate of serious infection following the adoption of these new infection control measures. Our objective here is to assess whether the degree of severity of the serious infections differed in the three infection-control groups (vaginal misoprostol and no antibiotics, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics) or, equivalently, to assess whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories. Of particular importance is whether the new infection control measures selectively reduced the least severe serious infections but did not diminish the rate of the most severe infections. Methods We performed a retrospective analysis assessing the degree of severity of infections before infection controls were implemented and after each of the two new measures was adopted: buccal administration of antibiotics with either screen-and-treat or routine antibiotic coverage. We ranked the severity of infection from 1 (when treatment occurred in an emergency department) to 4 (when death occurred). We compared the distribution of the severity of serious infections in the three infection control groups (none, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics), or, equivalently, assessed whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories using the Jonckheere-Terpstra test for a doubly ordered 4×3 table. Results The distribution of infection by severity was the same for all three infection control groups. Likewise, when the two new infection control groups—buccal misoprostol plus either screen-and-treat or routine antibiotics—were combined, the distribution of infection by severity was the same before and after the new measures were implemented. Conclusion The pronounced decline in the rate of serious infections occurred in each category of severity. PMID:21397090

Fjerstad, Mary; Trussell, James; Lichtenberg, E Steve; Sivin, Irving; Cullins, Vanessa

2013-01-01

129

77 FR 28392 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the...

2012-05-14

130

75 FR 22816 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the...

2010-04-30

131

78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announce the...

2013-05-14

132

78 FR 62636 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announce the...

2013-10-22

133

76 FR 63622 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee, (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the...

2011-10-13

134

75 FR 50770 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the...

2010-08-17

135

75 FR 3912 - Healthcare Infection Control Practices Advisory Committee (HICPAC)  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC) In...L. 92-463), the Centers for Disease Control and Prevention (CDC) announces the...

2010-01-25

136

Evidence-Based Practices in Secondary Transition  

ERIC Educational Resources Information Center

A literature review was conducted to identify evidence-based practices in secondary transition using quality indicator checklists for experimental research. Practices were categorized by the Taxonomy for Transition Programming. Overall, 32 secondary transition evidence-based practices were identified. Two practices had a strong level of evidence,…

Test, David W.; Fowler, Catherine H.; Richter, Sharon M.; White, James; Mazzotti, Valerie; Walker, Allison R.; Kohler, Paula; Kortering, Larry

2009-01-01

137

Evidence-Based Practice and School Nursing  

ERIC Educational Resources Information Center

School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…

Adams, Susan; McCarthy, Ann Marie

2005-01-01

138

Implementing Evidence-Based Social Work Practice  

ERIC Educational Resources Information Center

Recently, social work has been influenced by new forms of practice that hold promise for bringing practice and research together to strengthen the scientific knowledge base supporting social work intervention. The most recent new practice framework is evidence-based practice. However, although evidence-based practice has many qualities that might…

Mullen, Edward J.; Bledsoe, Sarah E.; Bellamy, Jennifer L.

2008-01-01

139

Evidence-based practice and orthopaedic nursing  

Microsoft Academic Search

Evidence-based practice has become part of the language of health care. This article illustrates the professional implications for orthopaedic nurses and the challenges it raises for current and future practice development. The article suggests steps for developing an evidence-based approach to orthopaedic practice, the necessary skills nurses need to develop, and the benefits of a multidisciplinary view in developing practice.

Julia Kneale

2000-01-01

140

The Politics of Evidence-Based Medicine  

Microsoft Academic Search

The impetus for these essays on evidence in medicine and law is commonly called evidence-based medicine: the movement to evaluate the safety, effectiveness, and cost of medical practices using tools from science and social science and to base clinical practice on such knowledge. Evidence-based medicine is portrayed as an alternative to medicine based on authority, tradition, and the physician's personal

Marc A. Rodwin

2001-01-01

141

Evidence-Based Research in Education.  

ERIC Educational Resources Information Center

This educational newsletter highlights a lead article, "Evidence-Based Research in Education." The article explains that evidence-based research emerged in the field of medicine over 50 years ago, resulting in major advances in the treatment and prevention of disease. It adds that clinical guidelines and protocols are based on the results of…

Research Exchange, 2003

2003-01-01

142

Evidence-Based Clearinghouses in Social Work  

ERIC Educational Resources Information Center

Objectives: The purpose of this article is to describe several evidence-based clearinghouses focused on social work and related intervention outcomes, placing them in the context of how such clearinghouses can contribute to research dissemination to foster effective, evidence-based practice. Method: The study employed an analysis of data provided…

Soydan, Haluk; Mullen, Edward J.; Alexandra, Laine; Rehnman, Jenny; Li, You-Ping

2010-01-01

143

Practicing Evidence-Based Practices  

Microsoft Academic Search

\\u000a Public education in the United States has a history of local control in the development of curriculum and instruction. Although\\u000a notable court decisions have led to more universal applications of educational policy and practices (Brown v. Board of Education\\u000a 1954, Oberti v. Clementon 1993), it has been federal law that has resulted in significant changes in instruction. The Individuals\\u000a with

Ruth Blennerhassett Eren; Pamela Owen Brucker

144

Strategies for searching and managing evidence-based practice resources.  

PubMed

Evidence-based nursing practice requires the use of effective search strategies to locate relevant resources to guide practice change. Continuing education and staff development professionals can assist nurses to conduct effective literature searches. This article provides suggestions for strategies to aid in identifying search terms. Strategies also are recommended for refining searches by using controlled vocabulary, truncation, Boolean operators, PICOT (Population/Patient Problem, Intervention, Comparison, Outcome, Time) searching, and search limits. Suggestions for methods of managing resources also are identified. Using these approaches will assist in more effective literature searches and may help evidence-based practice decisions. J Contin Educ Nurs. 2014;45(10):461-466. PMID:25221988

Robb, Meigan; Shellenbarger, Teresa

2014-10-01

145

Sicily statement on evidence-based practice  

PubMed Central

Background A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC"). Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'. PMID:15634359

Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

2005-01-01

146

An evidence-based approach to spine surgery.  

PubMed

Health care reform will emphasize evidence-based medicine to provide the highest quality care. Recent literature has emerged in spinal surgery that has profoundly increased the evidence base for several spinal procedures. There is now good evidence from randomized controlled trials that surgical treatment of symptomatic lumbar disc herniation, decompression for spinal stenosis, and decompression and fusion for degenerative spondylolisthesis all offer significant clinical benefit in the face of serious back and radicular pain when compared with nonsurgical care. Studies of nonsurgical and surgical treatments for chronic low back pain are inconclusive, limited by study design/methodology. Continuing to increase study quality in the field of spine surgery is more important now than ever before. Optimizing diagnostic specificity, surgical indications, and measuring outcomes with validated instruments should help the spine care community acquire essential data to provide the highest quality evidence-based care, while simultaneously eliminating procedures that lack evidence of efficacy or value. PMID:19890181

Allen, R Todd; Rihn, Jeffrey A; Glassman, Steven D; Currier, Bradford; Albert, Todd J; Phillips, Frank M

2009-01-01

147

Systematic review of adherence to infection control guidelines in dentistry  

Microsoft Academic Search

Objectives: The purpose of this study was to determine the knowledge and attitudes of dental health care workers (DHCWs) towards infection control procedures, to examine DHCWs’ practising behaviour in respect of infection control, and to determine whether a relationship exists between knowledge, attitudes and behaviour.Methods:Within this systematic review, study quality was assessed in line with selection criteria relating to study

B. L Gordon; F. J. T Burke; J Bagg; H. S Marlborough; E. S McHugh

2001-01-01

148

Guidelines for the Prevention and Control of Nosocomial Infections.  

National Technical Information Service (NTIS)

This manual is intended for use by hospital personnel who are responsible for infection surveillance and control. The guidelines have been derived from a variety of sources, including studies conducted by the Centers for Disease Control and by others and ...

1982-01-01

149

Modern trends in infection control practices in intensive care units.  

PubMed

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection. PMID:23753240

Gandra, Sumanth; Ellison, Richard T

2014-11-01

150

Translating Research and Building the Evidence Base  

E-print Network

Translating Research and Building the Evidence Base John Eckenrode Professor of Human Development Director, Bronfenbrenner Center For Translational Research CCE Stakeholder Consortium March 22, 2013 #12;Mission of the Bronfenbrenner Center for Translational Research (BCTR) To strengthen and speed

Keinan, Alon

151

Evidence-Based Medicine and Medical Authority  

Microsoft Academic Search

Over the last five years evidence-based medicine (EBM) has been promoted in mainstream medical literature in Canada, the United States, and the United Kingdom as a new paradigm in medical education and practice. \\

Keith Denny

1999-01-01

152

Infantile spasms--evidence based medical management.  

PubMed

Infantile spasms constitute significant burden of refractory epilepsy in children. The first line treatment choice varies at different centres. The author presents concise evidence based update on medical management of infantile spasms. PMID:24986193

Sahu, Jitendra Kumar

2014-10-01

153

The Art of Evidence-Based Practice  

Microsoft Academic Search

The purpose of this article is to discuss evidence-based practice (EBP) from the perspective of a self-identified evidence-based practitioner. Discussion of EBP includes choosing an initial intervention and evaluation procedures, the iterative process of rechoosing and refining an intervention over the treatment life span, and the importance of evi- dence within the specific clinical situation. Two illustrative case studies are

David E. Pollio

2006-01-01

154

Evidence-based practice in acute ophthalmology  

Microsoft Academic Search

AimTo study the overall level of evidence-based practice in an accident and emergency eye unit in the UK and evaluate the extent of evidence-based practice by ophthalmologists and nurse practitioners (NPs).MethodsThe case notes of all new patients attending our accident and emergency department for a period of 1 week were reviewed prospectively. For each case, the diagnosis at presentation and

R Bhatt; S Sandramouli

2007-01-01

155

Evidence-Based Practice: Management of Vertigo  

PubMed Central

Synopsis The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented. PMID:22980676

Nguyen-Huynh, Anh T.

2012-01-01

156

Infection control and prevention: a review of hospital-acquired infections and the economic implications.  

PubMed

The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program has proposed changes to the Hospital Inpatient Prospective Payment System and Fiscal Year Rates: Proposed Rule CMS 1488-P-Healthcare-associated infection. Payment will be linked to performance. Under the new rule, payment will be withheld from hospitals for care associated with treating certain catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery. Infection-prevention strategies are essential. In the healthcare setting, the infection control department is categorized as non-revenue-producing. Funds dedicated to resources such as staff, educational programs, and prevention measures are vastly limited. Hospital leaders will need to balance the upfront cost needed to prevent hospital-related infections with the non-reimbursed expense accrued secondary to potentially preventable infections. The purpose of this paper is to present case studies and cost analysis of hospital-acquired infections and present strategies that reduce infections and cost. PMID:21603406

Reed, Deoine; Kemmerly, Sandra A

2009-01-01

157

Asymptomatic Leishmania infection: a new challenge for Leishmania control.  

PubMed

Visceral leishmaniasis (VL) is a serious parasitic disease, causing high morbidity and mortality in the developing world. The pathogenesis of VL is complex, and the clinical presentation ranges from asymptomatic infection to severe and fatal disease. Despite a wealth of research on the full-blown "clinical VL" syndrome, asymptomatic leishmania infections remain poorly understood. Asymptomatic infection could present a major challenge for control programs if its infectiousness is confirmed. In this viewpoint, we highlight the crucial knowledge gaps as well as the obstacles in research on asymptomatic leishmanial infection. Research in this area is essential for the development of more-effective VL control strategies. PMID:24585564

Singh, Om Prakash; Hasker, Epco; Sacks, David; Boelaert, Marleen; Sundar, Shyam

2014-05-01

158

Framework for controlling infection through isolation precautions in Japan.  

PubMed

In Japan, nurses certified in infection control face organizational and structural challenges to the implementation of the recommended isolation precautions. In this study, we developed a conceptual framework for the problem-solving process of certified nurses in infection control when implementing appropriate isolation-precaution measures. We conducted a qualitative, descriptive study using directed content analysis. Semistructured interviews were conducted with 40 nurses who had over five?years' experience in infection control. Factors assessing the risk of infection in patients were identified, including microorganism characteristics, patient characteristics, and risk of infection to the entire unit. The nurses also assessed the risk of infection in institutions from the following perspectives: organizational culture, infection control system, human resources, environment surrounding the facility, ethical issues, and external factors. Individual characteristics, such as attributes, knowledge, expertise, and job function, were identified as major influencing factors in the problem-solving process. These findings could be useful for newly-certified nurses in infection control and provide recommendations on implementing isolation-precaution measures. PMID:24635895

Kawakami, Kazumi; Misao, Hanako

2014-03-01

159

A Third-Generation Evidence Base for Human Spaceflight Risks  

NASA Technical Reports Server (NTRS)

NASA's Human Research Program seeks to understand and mitigate risks to crew health and performance in exploration missions center dot HRP's evidence base consists of an Evidence Report for each HRP risk center dot Three generations of Evidence Reports 1) Review articles + Good content - Limited authorship, infrequent updates 2) Wikipedia articles + Viewed often, very open to contributions - Summary of reviews, very few contributions 3) HRP-controlled wiki articles + Incremental additions to review articles with editorial control

Kundrot, Craig E.; Lumpkins, Sarah; Steil, Jennifer; Pellis, Neal; Charles, John

2014-01-01

160

Infection control for SARS in a tertiary neonatal centre.  

PubMed

The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs. PMID:12937045

Ng, P C; So, K W; Leung, T F; Cheng, F W T; Lyon, D J; Wong, W; Cheung, K L; Fung, K S C; Lee, C H; Li, A M; Hon, K L E; Li, C K; Fok, T F

2003-09-01

161

Effectiveness of environmental decontamination as an infection control measure.  

PubMed

The effectiveness of environmental decontamination (ED) as a measure in the control of infectious diseases is controversial. This work quantifies the effectiveness of ED by analysing the transmission of pathogens from the environment to susceptible hosts in a Susceptible-Infected-Susceptible model. Analysis of the model shows that ED can render a population disease-free only when the duration of infection (D) is within a certain range. As host-to-host transmission rate is increased, D falls outside this range and the higher levels of ED have a diminishing return in reducing the number of infected hosts at endemic equilibrium. To avoid this, ED can be combined with other control measures, such as treating infected individuals to push the duration of infection into the specified range. We propose decision criteria and minimum ED efforts required for control policies to be effective. PMID:21676360

Bani-Yaghoub, M; Gautam, R; Döpfer, D; Kaspar, C W; Ivanek, R

2012-03-01

162

Measures to control and prevent Clostridium difficile infection.  

PubMed

Control of Clostridium difficile infection (CDI) outbreaks in health care facilities presents significant challenges to infection control specialists and other health care workers. C. difficile spores survive routine environmental cleaning with detergents and hand hygiene with alcohol-based gels. Enhanced cleaning of all potentially contaminated surfaces with 10% sodium hypochlorite reduces the environmental burden of C. difficile, and use of barrier precautions reduces C. difficile transmission. Thorough handwashing with chlorhexidine or with soap and water has been shown to be effective in removing C. difficile spores from hands. Achieving high-level compliance with these measures is a major challenge for infection control programs. Good antimicrobial stewardship complements infection control efforts and environmental interventions to provide a comprehensive strategy to prevent and control outbreaks of CDI. The efficacy of metronidazole or vancomycin prophylaxis to prevent CDI in patients who are receiving other antimicrobials is unproven, and treatment with these agents is ineffective against C. difficile in asymptomatic carriers. PMID:18177221

Gerding, Dale N; Muto, Carlene A; Owens, Robert C

2008-01-15

163

Building new hospitals: a UK infection control perspective.  

PubMed

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection. PMID:16337712

Stockley, J M; Constantine, C E; Orr, K E

2006-03-01

164

Human natural killer cells control Plasmodium falciparum infection by eliminating infected  

E-print Network

Human natural killer cells control Plasmodium falciparum infection by eliminating infected red, Singapore 138602; b Humanized Mouse Unit, Institute of Molecular and Cell Biology, Agency for Science for review October 25, 2013) Immunodeficient mouse­human chimeras provide a powerful approach to study host

Dao, Ming

165

ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC)  

PubMed Central

Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance. PMID:24718396

Chandy, Sujith J.; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O.C.; Bachhav, Sagar S.; Kshirsagar, Nilima A.

2014-01-01

166

Infections and cancer: debate about using vaccines as a cancer control tool  

PubMed Central

In 2012, Infectious Agents and Cancer commissioned a thematic series collection of articles on Prevention of HPV related cancer. The articles have attracted wide interest and stimulated debate, including about the utility of vaccines in cancer control. The application of vaccines to cancer control fulfills a promise envisioned at the turn of the 20th century when remarkable experiments showed that some cancers were caused by infections. This suggested the possibility of applying infection-control strategies to cancer control. Vaccines represent the most practical cost-effective technology to prevent wide human suffering and death from many acute infectious diseases, such as small pox or polio. Hitherto applied to control of acute fatal infections, vaccines, if developed, might provide a potent way to control cancer. The articles in the HPV thematic series show success in developing and applying a vaccine against human papilloma virus (HPV). A vaccine is also available against hepatitis B virus (HBV), which causes liver cancer. These vaccines augment the tools available to control the associated cancers. Scientific endeavor continues for six other cancer-associated infections, mostly viruses. Not surprisingly, debate about the safety of vaccines targeting cancer has been triggered in the scientific community. Questions about safety have been raised for those populations where other means to control these cancers may be available. Although it is difficult to quantify risk from vaccines in individuals where other cancer control services exist, it is likely to be low. Vaccines are much safer today than before. Technological advancement in vaccine development and manufacture and improved regulatory review and efficient distribution have minimized substantially the risk for harm from vaccines. Formal and informal debate about the pros and cons of applying vaccines as a cancer control tools is ongoing in scientific journals and on the web. Infectious Agents and Cancer encourages evidence-based discussion to clarify understanding of the role of vaccines in cancer control. In a similar vein, the journal will not consider anecdotal reports and rhetorical arguments because they are unlikely to inform policy, regulation, or the public. PMID:23642130

2013-01-01

167

Infections and cancer: debate about using vaccines as a cancer control tool.  

PubMed

In 2012, Infectious Agents and Cancer commissioned a thematic series collection of articles on Prevention of HPV related cancer. The articles have attracted wide interest and stimulated debate, including about the utility of vaccines in cancer control. The application of vaccines to cancer control fulfills a promise envisioned at the turn of the 20th century when remarkable experiments showed that some cancers were caused by infections. This suggested the possibility of applying infection-control strategies to cancer control. Vaccines represent the most practical cost-effective technology to prevent wide human suffering and death from many acute infectious diseases, such as small pox or polio. Hitherto applied to control of acute fatal infections, vaccines, if developed, might provide a potent way to control cancer. The articles in the HPV thematic series show success in developing and applying a vaccine against human papilloma virus (HPV). A vaccine is also available against hepatitis B virus (HBV), which causes liver cancer. These vaccines augment the tools available to control the associated cancers. Scientific endeavor continues for six other cancer-associated infections, mostly viruses. Not surprisingly, debate about the safety of vaccines targeting cancer has been triggered in the scientific community. Questions about safety have been raised for those populations where other means to control these cancers may be available. Although it is difficult to quantify risk from vaccines in individuals where other cancer control services exist, it is likely to be low. Vaccines are much safer today than before. Technological advancement in vaccine development and manufacture and improved regulatory review and efficient distribution have minimized substantially the risk for harm from vaccines. Formal and informal debate about the pros and cons of applying vaccines as a cancer control tools is ongoing in scientific journals and on the web. Infectious Agents and Cancer encourages evidence-based discussion to clarify understanding of the role of vaccines in cancer control. In a similar vein, the journal will not consider anecdotal reports and rhetorical arguments because they are unlikely to inform policy, regulation, or the public. PMID:23642130

Mbulaiteye, Sam M; Buonaguro, Franco M

2013-01-01

168

Lessons to be Learned from Evidence-based Medicine: Practice and Promise of Evidence-based Medicine and Evidence-based Education.  

ERIC Educational Resources Information Center

Presents statistics of deaths caused by medical errors and argues the effects of misconceptions in diagnosis and treatment. Suggests evidence-based medicine to enhance the quality of practice and minimize error rates. Presents 10 evidence-based lessons and discusses the possible benefits of evidence-based medicine to evidence-based education and…

Wolf, Fredric M.

2000-01-01

169

42 CFR 418.60 - Condition of participation: Infection control.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of Participation: Patient...participation: Infection control. The hospice must maintain and document an effective...protects patients, families, visitors, and hospice personnel by preventing and...

2013-10-01

170

42 CFR 418.60 - Condition of participation: Infection control.  

Code of Federal Regulations, 2010 CFR

...SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of Participation: Patient...participation: Infection control. The hospice must maintain and document an effective...protects patients, families, visitors, and hospice personnel by preventing and...

2010-10-01

171

42 CFR 418.60 - Condition of participation: Infection control.  

Code of Federal Regulations, 2011 CFR

...SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of Participation: Patient...participation: Infection control. The hospice must maintain and document an effective...protects patients, families, visitors, and hospice personnel by preventing and...

2011-10-01

172

42 CFR 418.60 - Condition of participation: Infection control.  

Code of Federal Regulations, 2012 CFR

...CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of Participation: Patient...participation: Infection control. The hospice must maintain and document an effective...protects patients, families, visitors, and hospice personnel by preventing and...

2012-10-01

173

Infection Control: The Use and Handling of Toothbrushes  

MedlinePLUS

... Guidelines Safety Infant Formula and Fluorosis Scientific Reviews Fluoride in Drinking Water Health Effects and Environmental Impact ... Statistics Reference Statistics Engineering & Operations Training Programs Other Fluoride Products Links to Other Organizations Infection Control in ...

174

42 CFR 485.725 - Condition of participation: Infection control.  

Code of Federal Regulations, 2011 CFR

...Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.725 Condition of participation: Infection control. The organization that provides...

2011-10-01

175

42 CFR 485.725 - Condition of participation: Infection control.  

Code of Federal Regulations, 2010 CFR

...Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.725 Condition of participation: Infection control. The organization that provides...

2010-10-01

176

Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial  

PubMed Central

Background Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed. Methods/design The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following intervention delivery (patient level outcomes). In consenting hospitals, eligible patients will be recruited for a follow-up telephone interview conducted by trained researchers. A cost-effectiveness analysis and process evaluation using mixed-methods will be conducted. Sample size calculations are based on including 30 patients on average per department. Outcome assessors will be blinded to group allocation. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612001286831 (date registered 12 December 2012). PMID:25012235

2014-01-01

177

Innate immune control and regulation of influenza virus infections  

PubMed Central

Adaptive immune responses are critical for the control and clearance of influenza A virus (IAV) infection. However, in recent years, it has become increasingly apparent that innate immune cells, including natural killer cells, alveolar macrophages (aM?), and dendritic cells (DC) are essential following IAV infection in the direct control of viral replication or in the induction and regulation of virus-specific adaptive immune responses. This review will discuss the role of these innate immune cells following IAV infection, with a particular focus on DC and their ability to induce and regulate the adaptive IAV-specific immune response. PMID:19643736

McGill, Jodi; Heusel, Jonathan W.; Legge, Kevin L.

2009-01-01

178

Control of Theileria sergenti infection by vaccination  

Microsoft Academic Search

Bovine piroplasmosis caused byTheileria sergenti is a major cause of economic loss in grazing cattle in Japan. Infected calves show chronic anaemia with intraerythrocytic\\u000a piroplasms and occasionally die in severe cases. We found that parasite stocks and isolates consist of genetically and antigenically\\u000a mixed populations. To differentiate parasite populations bearing 3 allelic forms of p32\\/34, an immunodominant piroplasm surface\\u000a protein,

M. Onuma; S. Kubota; T. Kakuda; Y. Sako; M. Asada; H. Kabeya; C. Sugimoto

1997-01-01

179

Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology  

Microsoft Academic Search

We present an overview of issues related to evidence-based practice and the role that the school psychology profession can play in developing and disseminating evidence-based interventions (EBIs). Historical problems relating to and the recurring debate about the integration of research into practice are presented as a context for the current challenges faced by those engaged in the EBI movement in

Thomas R. Kratochwill; Elisa Steele Shernoff

2003-01-01

180

Evidence Based Research: Implications for Counselor Educators.  

ERIC Educational Resources Information Center

For the past decade, the practice of evidence based research (EBR) in treatment decisions has been a standard in the medical field, and is quickly becoming a standard of practice in other human service fields. Counselor educators are faced with the necessity to begin to implement EBR into their teaching and scholarship, but have limited knowledge…

Bartley, Amy E.; Biles, Kathy E.; Low, Lori L.; Nakazawa-Hewitt, M.; Windish, Bonnie L.

181

Evidence Based Education Request Desk. EBE #359  

ERIC Educational Resources Information Center

This Evidence Based Education (EBE) response describes characteristics of graduation coach initiatives in three states (Georgia, Alabama, and California). Regional Educational Laboratory (REL) Southeast has received over 19 requests for information on various initiatives, programs or research related to improving graduation rates. For example, the…

Regional Educational Laboratory Southeast, 2008

2008-01-01

182

Evidence Based Education Request Desk. EBE #510  

ERIC Educational Resources Information Center

This Evidence Based Education (EBE) request focused on research-supported vocabulary interventions for middle elementary students. Limited vocabulary is an important factor in underachievement of children in disadvantaged homes. Children with larger vocabularies find reading easier, read more widely, and do better in school (Lubliner & Smetana,…

Regional Educational Laboratory Southeast, 2009

2009-01-01

183

Statewide Implementation of Evidence-Based Programs  

ERIC Educational Resources Information Center

Evidence-based programs will be useful to the extent they produce benefits to individuals on a socially significant scale. It appears the combination of effective programs and effective implementation methods is required to assure consistent uses of programs and reliable benefits to children and families. To date, focus has been placed primarily…

Fixsen, Dean; Blase, Karen; Metz, Allison; van Dyke, Melissa

2013-01-01

184

Evidence-Based Practice Goes beyond Google  

ERIC Educational Resources Information Center

Evidence-based practice (EBP) is applying research to assist in the selection of interventions that result in increased client quality care. Recently the Commission on Accreditation of Allied Health Education Programs (2010), a new accreditation body for recreational therapy education, included standards that state students should obtain knowledge…

Klitzing, Sandra

2012-01-01

185

Finding Evidence-Based Practice Information  

ERIC Educational Resources Information Center

Locating sources that are rich in evidence-based practice information can be more difficult for physical as well as occupational therapists in practice settings in which there is not direct access to a health sciences library. In addition, once information has been found, there may not be an easy way to access the data. This commentary will…

Childs, Gary M.

2009-01-01

186

The Evidence Base for Positive Peer Culture  

ERIC Educational Resources Information Center

This article explores the evidence base for Positive Peer Culture (PPC) which is a total system for developing positive youth cultures in youth serving organizations. It challenges a popular belief among some researchers that group programs which bring together troubled youth are inherently negative.

Laursen, Erik K.

2010-01-01

187

The ABCs of evidence-based practice  

Microsoft Academic Search

Evidence-based practice is an expectation of all health care practitioners. Associate degree nurses are no exception. Associate degree nursing students currently have little to no exposure as to how to integrate research into their practice. This article describes a course created and implemented to bring this knowledge to associate degree nursing students at their specified level of mandated competency.

Karen S. Lotz

2010-01-01

188

Evidence-based medicine for occupational health  

Microsoft Academic Search

inusing medical subject headings, and unreliable search strategies. With the use of the abstracts only, most clinical questions could be answered satisfactorily, but concrete risk estimates were often lacking. The lack of availability of full text journals decreased the reliability of the critical appraisal and risk estimation. Conclusions Evidence-based medicine is a feasible and useful method for occupational medicine. Instruction

J. H. A. M. Verbeek; Dijk van F. J. H; A. Malmivaara; C. T. J. Hulshof; K. Rasanen; E. Kankaanpaa; K. Mukala

2002-01-01

189

The Principles of Evidence-Based Medicine  

Microsoft Academic Search

Evidence-based medicine (EBM) integrates individual clinical expertise with the best available external evidence in the care of individual patients. By enabling clinicians to directly appraise and apply current clinical research, EBM deals with the problems of deterioration in clinical performance, information overload, and lag in application of research findings to clinical practice. Thus, EBM is a useful tool to address

S Wiebe

2000-01-01

190

Updated Diagnoses and Evidence-based Treatments  

E-print Network

Updated Diagnoses and Evidence-based Treatments for Addiction Carlton Erickson, Ph for diagnosis by computer (e.g., SCID) · oen used by untrained personnel Recommended: · trained assessment counselor/technician · not given by computer w/o other criteria

Hofmann, Hans A.

191

Evidence-Based Assessment of Personality Disorders  

ERIC Educational Resources Information Center

The purpose of this article is to provide a foundation for the development of evidence-based guidelines for the assessment of personality disorders, focusing in particular on integrated assessment strategies. The general strategy recommended herein is to first administer a self-report inventory to alert oneself to the potential presence of…

Widiger, Thomas A.; Samuel, Douglas B.

2005-01-01

192

Evidence-Based Practices and Autism  

Microsoft Academic Search

Interventions for autism are increasing being held to standards such as ‘evidence-based practice’ in psychology and ‘scientifically-based research’ in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special education has raised additional concerns. An analysis of the benefits and limitations of current

Gary B. Mesibov; Victoria Shea

2011-01-01

193

Evidence-Based Practice and Social Work  

Microsoft Academic Search

The essential features of contemporary evidence-based practice (EBP) are outlined, with specific reference to the applications of this model to various areas of social work, micro through macro. EBP is seen as a welcome addition to our field, representing a fuller and more comprehensive development of earlier and related positions such as empirical clinical practice within social work, and the

C. Aaron McNeece; Bruce A. Thyer

2004-01-01

194

Metadata for Evidence Based Medicine resources  

Microsoft Academic Search

A new metadata element set based on Dublin Core Metadata Element Set (DC) and Admin- Core: Administrative Container C ore (A-Core) was proposed for Evidence Based Medicine (EBM) sources after reviewing metadata elements and contents of current EBM sources and medical metadata for Internet resources. The metadata schema was designed to provide a common format for existing primary and secondary

Yukiko Sakai

2001-01-01

195

Finding an Evidence-Based Program  

Cancer.gov

Know how to use your needs assessment and program goals and objectives to help you select your program. Be able to find evidence-based program resources. Know how to use search options to narrow your program choices and find out what programs will and will not work with your community.

196

Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up  

ERIC Educational Resources Information Center

The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented…

Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

2005-01-01

197

Evidence-based HIV prevention in community settings: provider perspectives on evidence and effectiveness  

Microsoft Academic Search

As part of the efforts to expand evidence-based practice (EBP) in HIV prevention at the community level, the Centers for Disease Control and Prevention (CDC) created the Diffusion of Effective Behavioral Interventions (DEBI) program. Frontline service providers, who are charged with adopting and implementing these interventions, however, have resisted and criticized the dissemination of evidence-based HIV prevention interventions. Their failure

Jill Owczarzak

2012-01-01

198

Evidence-based HIV prevention in community settings: provider perspectives on evidence and effectiveness  

Microsoft Academic Search

As part of the efforts to expand evidence-based practice (EBP) in HIV prevention at the community level, the Centers for Disease Control and Prevention (CDC) created the Diffusion of Effective Behavioral Interventions (DEBI) program. Frontline service providers, who are charged with adopting and implementing these interventions, however, have resisted and criticized the dissemination of evidence-based HIV prevention interventions. Their failure

Jill Owczarzak

2011-01-01

199

Promoting Evidence-Based Practice in Child Protection  

Microsoft Academic Search

This article argues for the adoption of an evidence-based approach to decision-making in child protection. Such a change hinges upon the availability of good quality, up-to-date evidence that is readily accessible to practitioners and policy-makers. Following a resume' of the arguments for recognizing controlled trials as methodologically superior to other forms of methodology in evaluating professional interventions, the article presents

Geraldine Macdonald

1998-01-01

200

The Infection Control Management of MRSA in Acute Care  

Microsoft Academic Search

Background: Many acute care facilities report endemic methicillin-resistant Staphylococcus aureus (MRSA), while others describe the occurrence of sporadic disease outbreaks. The timely implementation of effective infection control measures is essential to minimise the incidence of MRSA cases and the magnitude of disease outbreaks. Management strategies for the containment and control of MRSA currently vary between facilities and demonstrate varying levels

Elizabeth J Halcomb; Ritin Fernandez; Rhonda Griffiths; PJ Newton; Louise D Hickman

2008-01-01

201

IL-10 Signaling Blockade Controls Murine West Nile Virus Infection  

PubMed Central

West Nile virus (WNV), a mosquito-borne single-stranded RNA flavivirus, can cause significant human morbidity and mortality. Our data show that interleukin-10 (IL-10) is dramatically elevated both in vitro and in vivo following WNV infection. Consistent with an etiologic role of IL-10 in WNV pathogenesis, we find that WNV infection is markedly diminished in IL-10 deficient (IL-10?/?) mice, and pharmacologic blockade of IL-10 signaling by IL-10 neutralizing antibody increases survival of WNV-infected mice. Increased production of antiviral cytokines in IL-10?/? mice is associated with more efficient control of WNV infection. Moreover, CD4+ T cells produce copious amounts of IL-10, and may be an important cellular source of IL-10 during WNV infection in vivo. In conclusion, IL-10 signaling plays a negative role in immunity against WNV infection, and blockade of IL-10 signaling by genetic or pharmacologic means helps to control viral infection, suggesting a novel anti-WNV therapeutic strategy. PMID:19816558

Bai, Fengwei; Wang, Penghua; Kamanaka, Masahito; Connolly, Tarah M.; Gate, David; Montgomery, Ruth R.; Flavell, Richard A.; Fikrig, Erol

2009-01-01

202

Antibiotic policies to control hospital-acquired infection  

Microsoft Academic Search

Despite record resources being directed to infection control (IC), hospital-acquired infection (HAI) seems to be an ever increasing problem. Most of the high profile organisms are multidrug- resistant (MDR) either with acquired, e.g. methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum b-lactamase (ESBL) producers, or natural resistance (Clostridium difficile), and some such as MRSA are not merely replacing methicillin-susceptible S. aureus (MSSA)

I. M. Gould

2008-01-01

203

Creating evidence-based research in adapted physical activity.  

PubMed

Professional practice guided by the best research evidence is a usually referred to as evidence-based practice. The aim of the present paper is to describe five fundamental beliefs of adapted physical activity practices that should be considered in an 8-step research model to create evidence-based research in adapted physical activity. The five beliefs are individualization, critical thinking, self-determination, program effectiveness, and multifactor complexity. The research model includes conceptualize the problem, conduct research on the process of the problem, conceptualize and specify the intervention, evaluate intervention outcomes, evaluate intervention processes, determine person-by-treatment interactions, determine context-dependent limitations, and investigate factors related to intervention adoption maintenance. The eight steps are explained with reference to two research programs that used a randomized control group design. PMID:22467832

Reid, Greg; Bouffard, Marcel; MacDonald, Catherine

2012-04-01

204

Evidence-based dentistry as it relates to dental materials.  

PubMed

Evidence-based dentistry (EBD) is reviewed in depth to underscore the limitations for evidence-based dental materials information that exist at this time. Anecdotal estimates of evidence for dental practice are in the range of 8 percent to 10 percent. While the process of evaluating the literature base for dental evidence began 20 years ago, it was not practical to implement it until high-speed wireless connections, open access to journals, and omnipresent connections via smart phones became a reality. EBD includes five stages of information collection and analysis, starting with a careful definition of a clinical question using the PICO(T) approach. Clinical evidence in randomized control trials is considered the best. Clinical trial perspectives (prospective, cross-sectional, retrospective) and outcome designs (RCTs, SCTs, CCTs, cohort studies, case-control studies) are quite varied. Aggregation techniques (including meta-analyses) allow meaningful combinations of clinical data from trials with similar designs but with fewer rigors. Appraisals attempt to assess the entire evidence base without bias and answer clinical questions. Varying intensities to these approaches, Cochrane Collaboration, ADA-EBD Library, UTHSCSA CATs Library, are used to answer questions. Dental materials evidence from clinical trials is infrequent, short-term, and often not compliant with current guidelines (registration, CONSORT, PRISMA). Reports in current evidence libraries indicate less than 5 percent of evidence is related to restorative dental materials. PMID:24571523

Bayne, Stephen C; Fitzgerald, Mark

2014-01-01

205

Evidence-based practice in action  

Microsoft Academic Search

As Associate Editor for Journal of Pediatric Nursing (JPN), I will be assisting with evidence-based practice (EBP) submissions or other clinically based articles. I welcome questions, works-in-progress for constructive criticism, and finished submissions for review. This article comprises an overview of the EBP process, an EBP submission format for JPN, and 4 examples of EBP in a variety of pediatric

Maura MacPhee

2002-01-01

206

Evidence-based practice in action.  

PubMed

As Associate Editor for Journal of Pediatric Nursing (JPN), I will be assisting with evidence-based practice (EBP) submissions or other clinically based articles. I welcome questions, works-in-progress for constructive criticism, and finished submissions for review. This article comprises an overview of the EBP process, an EBP submission format for JPN, and 4 examples of EBP in a variety of pediatric clinical settings. PMID:12219333

MacPhee, Maura

2002-08-01

207

Evidence-based medicine in de praktijk  

Microsoft Academic Search

Samenvatting  Evidence-based medicine (EBM) heeft de laatste jaren een grote vlucht genomen in veel gebieden van de geneeskunde, maar over\\u000a de toepasbaarheid van deze methode in de bedrijfsgeneeskunde is relatief weinig bekend. Aan de hand van vier verschillende\\u000a vraagstukken uit de dagelijkse praktijk zijn met behulp van de EBM-methode, zoekvragen opgesteld die met de publiek toegankelijke\\u000a database van medische literatuur Medline,

J. H. A. M. Verbeek; Frank van Dijk; Antti Malmivaara; Carel Hulshof; Kimmo Räsänen; Eilo Kankaanpää; Kristiina Mukala

2004-01-01

208

Evidence-Based Approach to Oncology  

Microsoft Academic Search

In the early years of the 21st century, clinicians and medical researchers often use the term evidence-based medicine. Cancer\\u000a prevention, screening, diagnosis, and therapy, we hear, must be based on the best evidence to provide the best care. But is\\u000a this approach new? And if it is, what have we been doing until now? In this chapter, we hope to

Emily DeVoto; Barnett S. Kramer

209

Modernism, Postmodernism and (Evidence-Based) Practice  

Microsoft Academic Search

One dominant discourse in the mental health arena revolves around evidence-based practice (EBP). Although there is ongoing\\u000a debate about the implementation of EBP in the mental health field, most of these discussions have been limited to modernist\\u000a ideas. While discussions about EBP have occurred from alternate perspectives, particularly postmodernism, a lack of open dialogue\\u000a has resulted in these two groups

Heather L. Ramey; Sarah Grubb

2009-01-01

210

Clustering of Medical Publications for Evidence Based Medicine Summarisation  

E-print Network

Clustering of Medical Publications for Evidence Based Medicine Summarisation Sara Faisal Shash properties of medi- cal publications for the aim of Evidence Based Medicine summarisa- tion. Given a dataset of such clustering for natural language processing tasks in Evidence Based Medicine. 1 Introduction Evidence Based

Aliod, Diego Mollá

211

Evidence-Based Practice for Outpatient Clinical Teams  

ERIC Educational Resources Information Center

This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

Hamilton, John D.

2006-01-01

212

Bioengineered probiotics, a strategic approach to control enteric infections  

PubMed Central

Enteric infections account for high morbidity and mortality and are considered to be the fifth leading cause of death at all ages worldwide. Seventy percent of all enteric infections are foodborne. Thus significant efforts have been directed toward the detection, control and prevention of foodborne diseases. Many antimicrobials including antibiotics have been used for their control and prevention. However, probiotics offer a potential alternative intervention strategy owing to their general health beneficial properties and inhibitory effects against foodborne pathogens. Often, antimicrobial probiotic action is non-specific and non-discriminatory or may be ineffective. In such cases, bioengineered probiotics expressing foreign gene products to achieve specific function is highly desirable. In this review we summarize the strategic development of recombinant bioengineered probiotics to control enteric infections, and to examine how scientific advancements in the human microbiome and their immunomodulatory effects help develop such novel and safe bioengineered probiotics. PMID:23327986

Amalaradjou, Mary Anne Roshni; Bhunia, Arun K

2013-01-01

213

Operating room management: operative suite considerations, infection control.  

PubMed

An operating room's condition is rarely directly implicated in dis-ease transmission. Even so, to prevent such rare transmissions,hospitals must be thoughtful in designing operating rooms as important adjuncts to infection control. Proper ventilation in and near the operating room is the single most important component in establishing an environment that stops the spread of infection. Other considerations include attention to traffic control, equipment maintenance and storage, and construction materials that enhance the ability to maintain clean rooms. Hospitals can avert potential infectious problems through preventive maintenance and the use of infection control risk assessments (ICRAs) for preemptive consideration of infectious risks before renovations, repairs and new construction. Guidelines should be consulted and incorporated into each operating room's policies and procedures. PMID:16326209

Allo, Maria D; Tedesco, Maureen

2005-12-01

214

Teaching Evidence-Based Practice to Administrative Groups: The Professional Academy of Evidence-Based Practice  

Microsoft Academic Search

As the field of social work moves toward the implementation of evidence-based practice, agencies require training, mentoring, and peer networking to ensure successful adoption. This article defines successful adoption as knowledge and competence in the process of evidence-based practice. Successful adoption is best accomplished through the education and training of organization teams comprising key leaders—executive staff and board members. The

Stephanie Krauss; Barbara Levin

2010-01-01

215

Posttranscriptional control of DHFR gene expression during adenovirus 2 infection.  

PubMed Central

The effects of productive adenovirus infection on host gene expression were studied by using a line of methotrexate-resistant HeLa cells with amplified dihydrofolate reductase (DHFR) genes. We have previously reported that synthesis of DHFR is induced threefold early in infection and is shut off late in infection (Yoder et al., Mol. Cell. Biol. 3:819-828, 1983). These changes in DHFR protein synthesis are accompanied by changes in both the steady-state cytoplasmic levels of DHFR mRNA and in the rate of appearance of DHFR mRNA in the cytoplasm. In this report, we examined the mechanism of nuclear control of DHFR mRNA levels. Transcription of DHFR-specific sequences continued at a constant rate throughout infection, representing 0.015% of the total transcriptional activity. In contrast, nuclear steady-state levels of DHFR sequences changed in correspondence to the changing rate of appearance of DHFR mRNA in the cytoplasm. That is, nuclear levels of DHFR-specific sequences rose 2.5-fold early in infection and declined to a level below that found in uninfected cells late in infection. Thus, the relative nuclear stability of DHFR sequences changed throughout the course of infection such that during the time of induction, DHFR sequences were preferentially stabilized. This stabilization was transient, however, and was no longer observed by the time of shutoff. These data indicate that posttranscriptional nuclear events are important in the regulation of DHFR gene expression by adenovirus. PMID:2983122

Yoder, S S; Berget, S M

1985-01-01

216

Evidence that hepatitis C virus genome partly controls infection outcome  

PubMed Central

Infection by hepatitis C virus (HCV) leads to one of two outcomes; either the infection resolves within approximately 6 months or the virus can persist indefinitely. Host genetics are known to affect the likelihood of clearance or persistence. By contrast, the importance of the virus genotype in determining infection outcome is unknown, as quantifying this effect traditionally requires well-characterized transmission networks, which are rare. Extending phylogenetic approaches previously developed to estimate the virus control over set-point viral load in HIV-1 infections, we simulate inheritance of a binary trait along a phylogenetic tree, use this data to quantify how infection outcomes cluster and ascertain the effect of virus genotype on these. We apply our method to the Hepatitis C Incidence and Transmission Study in prisons (HITS-p) data set from Australia, as this cohort prospectively identified incident cases including viraemic subjects who ultimately clear the virus, thus providing us with a unique collection of sequences from clearing infections. We detect significant correlations between infection outcome and virus distance in the phylogeny for viruses of Genotype 1, with estimates lying at around 67%. No statistically significant estimates were obtained for viruses of Genotype 3a. PMID:24944567

Hartfield, Matthew; Bull, Rowena; White, Peter A; Lloyd, Andrew; Luciani, Fabio; Alizon, Samuel

2014-01-01

217

Carboxymethylcellulose film for bacterial wound infection control and healing.  

PubMed

Infection control and wound healing profiles of sodium carboxymethylcellulose (SCMC) films were investigated as a function of their anti-bacterial action, physical structures, polymer molecular weights and carboxymethyl substitution degrees. The films were prepared with in vitro polymer/film and in vivo microbe-colonized wound healing/systemic infection profiles examined. Adhesive high carboxymethyl substituted SCMC films aided healing via attaching to microbes and removing them from wound. Pseudomonas aeruginosa was removed via encapsulating in gelling low molecular weight SCMC film, whereas Staphylococcus aureus was trapped in tight folds of high molecular weight SCMC film. Incomplete microbe removal from wound did not necessary translate to inability to heal as microbe remnant at wound induced fibroblast migration and aided tissue reconstruction. Using no film nonetheless will cause systemic blood infection. SCMC films negate infection and promote wound healing via specific polymer-microbe adhesion, and removal of S. aureus and P. aeruginosa requires films of different polymer characteristics. PMID:25129756

Wong, Tin Wui; Ramli, Nor Amlizan

2014-11-01

218

Poverty and infection in the developing world: healthcare-related infections and infection control in the tropics.  

PubMed

In many hospitals serving the poorest communities of Africa and other parts of the developing world, infection control activities are limited by poor infrastructure, overcrowding, inadequate hygiene and water supply, poorly functioning laboratory services and a shortage of trained staff. Hospital transmission of communicable diseases, a high prevalence of human immunodeficiency virus and multidrug-resistant tuberculosis, lack of resources for isolation and disinfection, and widespread antimicrobial resistance create major risks for healthcare-related infections. Few data exist on the prevalence or impact of these infections in such environments. There is a need for interventions to reduce the burden of healthcare-related infections in the tropics and to set up effective surveillance programmes to determine their impact. Both the Global (G8) International Development Summit of 2005 and the United Nations Millennium Development Goals (MDGs) have committed major resources to alleviating poverty and poor health in the developing world over the next decade. Targeting resources specifically to infection control in low-resource settings must be a part of this effort, if the wider aims of the MDGs to improve healthcare are to be achieved. PMID:17945396

Shears, P

2007-11-01

219

Ataxia Telangiectasia Mutated Kinase Controls Chronic Gammaherpesvirus Infection  

PubMed Central

Gammaherpesviruses, such as Epstein-Barr virus (EBV), are ubiquitous cancer-associated pathogens that interact with DNA damage response, a tumor suppressor network. Chronic gammaherpesvirus infection and pathogenesis in a DNA damage response-insufficient host are poorly understood. Ataxia-telangiectasia (A-T) is associated with insufficiency of ataxia-telangiectasia mutated (ATM), a critical DNA damage response kinase. A-T patients display a pattern of anti-EBV antibodies suggestive of poorly controlled EBV replication; however, parameters of chronic EBV infection and pathogenesis in the A-T population remain unclear. Here we demonstrate that chronic gammaherpesvirus infection is poorly controlled in an animal model of A-T. Intriguingly, in spite of a global increase in T cell activation and numbers in wild-type (wt) and ATM-deficient mice in response to mouse gammaherpesvirus 68 (MHV68) infection, the generation of an MHV68-specific immune response was altered in the absence of ATM. Our finding that ATM expression is necessary for an optimal adaptive immune response against gammaherpesvirus unveils an important connection between DNA damage response and immune control of chronic gammaherpesvirus infection, a connection that is likely to impact viral pathogenesis in an ATM-insufficient host. PMID:22993144

Kulinski, Joseph M.; Leonardo, Steven M.; Mounce, Bryan C.; Malherbe, Laurent; Gauld, Stephen B.

2012-01-01

220

Queer challenges to evidence-based practice.  

PubMed

This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. PMID:23738815

Zeeman, Laetitia; Aranda, Kay; Grant, Alec

2014-06-01

221

Evidence-based estimation of insulin resistance.  

PubMed

Insulin resistance is a complex phenotype. Surrogate markers based on peripheral glucose and insulin (and in some cases NEFA) concentrations can provide, at best, moderate approximations to direct physiological measurements (Pearson r values 0.6-0.7). Where the focus is solely on insulin resistance, the evidence reviewed in the paper by Otten et al in this issue (DOI: 10.1007/s00125-014-3285-x ) suggests that surrogate markers based on fasting samples alone are as valid as those that require multiple samples and an oral glucose load. This provides an evidence base for simplifying the design of some clinical studies. PMID:25031068

Petrie, John R

2014-09-01

222

Hawaii's statewide evidence-based practice program.  

PubMed

Hawaii's innovative statewide evidence-based practice program facilitates practice change across multiple health care systems. The innovation eliminated duplicative efforts and provided resources, was compatible with the values of health care organizations, and had experience with a pilot program. Interpersonal and mass media communication promoted and embedded the practice change. Users included nurse champions with multidisciplinary team members. The rate of adoption varied across projects and, although resources seemed to be a major determinant of successful institutionalization, there does not seem to be a predictable pattern of successful project implementation. PMID:25155528

Mark, Debra D; Latimer, Rene'e W; White, Joan P; Bransford, Deborah; Johnson, Katherine G; Song, Valerie L

2014-09-01

223

Cost Evaluation of Evidence-Based Treatments  

PubMed Central

Many treatment programs have adopted or are considering adopting evidence-based treatments (EBTs). When a program evaluates whether to adopt a new intervention, it must consider program objectives, operational goals, and costs. This article examines cost concepts, cost estimation, and use of cost information to make the final decision on whether to adopt an EBT. Cost categories, including variable and fixed, accounting and opportunity, and costs borne by patients and others, are defined and illustrated using the example of expenditures for contingency management. Ultimately, cost is one consideration in the overall determination of whether implementing an EBT is the best use of a program’s resources. PMID:22002453

Sindelar, Jody L.; Ball, Samuel A.

2010-01-01

224

Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial  

PubMed Central

Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections <28 days of duration. Patients with no informed consent, not fluent in German, a previous hospital stay within 14 days, severe immunosuppression or chronic infection, intravenous drug use or a terminal condition are excluded. Randomization to either guidelines-enforced management or procalcitonin-guided antibiotic therapy is stratified by centre and type of lower respiratory tract infections. During hospitalization, all patients are reassessed at days 3, 5, 7 and at the day of discharge. After 30 and 180 days, structured phone interviews by blinded medical students are conducted. Depending on the randomization allocation, initiation and discontinuation of antibiotics is encouraged or discouraged based on evidence-based guidelines or procalcitonin cut off ranges, respectively. The primary endpoint is the risk of combined disease-specific failure after 30 days. Secondary outcomes are antibiotic exposure, side effects from antibiotics, rate and duration of hospitalization, time to clinical stability, disease activity scores and cost effectiveness. The study hypothesis is that procalcitonin-guidance is non-inferior (i.e., at worst a 7.5% higher combined failure rate) to the management with enforced guidelines, but is associated with a reduced total antibiotic use and length of hospital stay. Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877 PMID:17615073

Schuetz, Philipp; Christ-Crain, Mirjam; Wolbers, Marcel; Schild, Ursula; Thomann, Robert; Falconnier, Claudine; Widmer, Isabelle; Neidert, Stefanie; Blum, Claudine A; Schönenberger, Ronald; Henzen, Christoph; Bregenzer, Thomas; Hoess, Claus; Krause, Martin; Bucher, Heiner C; Zimmerli, Werner; Müller, Beat

2007-01-01

225

Compliance of Saudi dental students with infection control guidelines.  

PubMed

The aim of this study was to investigate compliance of dental students in a Saudi dental school with recommended infection control protocols. A pilot-tested questionnaire concerning various aspects of infection control practices was distributed to 330 dental students. The response rate was 93.9% (n = 311). About 99% of students recorded the medical history of their patients and 80% were vaccinated against hepatitis B. The highest compliance (100%) with recommended guidelines was reported for wearing gloves and use of a new saliva ejector for each patient. Over 90% of the respondents changed gloves between patients, wore face masks, changed hand instruments, burs and handpieces between patients, used a rubber dam in restorative procedures and discarded sharp objects in special containers. A lower usage rate was reported for changing face masks between patients (81%), disinfecting impression materials (87%) and dental prosthesis (74%) and wearing gowns (57%). Eye glasses and face shield were used by less than one-third of the sample. The majority of students were found to be in compliance with most of the investigated infection control measures. Nevertheless, further education is needed to improve some infection control measures including vaccination for Hepatitis B virus (HBV), wearing eye glasses, gowns and face shields and disinfecting impression materials and dental prostheses. PMID:23879255

Ahmad, Ibrahim Ali; Rehan, Elaf Ali; Pani, Sharat Chandra

2013-08-01

226

Tuberculosis Infection-Control Practices in United States Emergency Departments  

Microsoft Academic Search

Study objective: To determine the frequency with which patients with suspected tuberculosis (TB) or TB risk factors present to US emergency departments and to describe current ED TB infection-control facilities and practices. Design: Mailed survey of a sample of EDs in US acute care facilities. Participants: A random sample (n=446) of subjects who responded to a 1992 survey of all

Gregory J Moran; Mary Anne Fuchs; William R Jarvis; David A Talan

1995-01-01

227

Control of Acute Dengue Virus Infection by Natural Killer Cells  

PubMed Central

Dengue fever is the most important arthropod-borne viral disease worldwide, affecting 50–100 million individuals annually. The clinical picture associated with acute dengue virus (DENV) infections ranges from classical febrile illness to life-threatening disease. The innate immunity is the first line of defense in the control of viral replication. This review will examine the particular role of natural killer (NK) cells in DENV infection. Over recent years, our understanding of the interplay between NK cells and viral pathogenesis has improved significantly. NK cells express an array of inhibitory and activating receptors that enable them to detect infected targets while sparing normal cells, and to recruit adaptive immune cells. To date, the exact mechanism by which NK cells may contribute to the control of DENV infection remains elusive. Importantly, DENV has acquired mechanisms to evade NK cell responses, further underlining the relevance of these cells in pathophysiology. Hence, understanding how NK cells affect the outcome of DENV infection could benefit the management of this acute disease. PMID:24860571

Petitdemange, Caroline; Wauquier, Nadia; Rey, Juliana; Hervier, Baptiste; Leroy, Eric; Vieillard, Vincent

2014-01-01

228

Control of acute dengue virus infection by natural killer cells.  

PubMed

Dengue fever is the most important arthropod-borne viral disease worldwide, affecting 50-100 million individuals annually. The clinical picture associated with acute dengue virus (DENV) infections ranges from classical febrile illness to life-threatening disease. The innate immunity is the first line of defense in the control of viral replication. This review will examine the particular role of natural killer (NK) cells in DENV infection. Over recent years, our understanding of the interplay between NK cells and viral pathogenesis has improved significantly. NK cells express an array of inhibitory and activating receptors that enable them to detect infected targets while sparing normal cells, and to recruit adaptive immune cells. To date, the exact mechanism by which NK cells may contribute to the control of DENV infection remains elusive. Importantly, DENV has acquired mechanisms to evade NK cell responses, further underlining the relevance of these cells in pathophysiology. Hence, understanding how NK cells affect the outcome of DENV infection could benefit the management of this acute disease. PMID:24860571

Petitdemange, Caroline; Wauquier, Nadia; Rey, Juliana; Hervier, Baptiste; Leroy, Eric; Vieillard, Vincent

2014-01-01

229

78 FR 6328 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal  

Federal Register 2010, 2011, 2012, 2013

...HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee: Notice of Charter...October 6, 1972, that the Healthcare Infection Control Practices Advisory Committee, Department...

2013-01-30

230

The Coalition for Evidence-Based Policy  

NSDL National Science Digital Library

The Coalition for Evidence-Based Policy's aim is to increase government effectiveness by using evidence of what works based on rigorous policy analysis. On the "Mission & Activities" tab near the top of any page, visitors can read of the ineffective policies the Coalition targets. For example, the site details government-funded social programs that have failed to make progress in the areas they are supposed to help, such as "poverty reduction", "K-12 education", and "economic mobility." Further down the page is a list of programs that have been deemed effective by the Coalition - "Nurse-Family Partnership," "Career Academies," and "Success for All in Grades K-2." The "Publications" tab lists the five types of publications of the Coalition, including "Rigorous Evidence," their monthly e-newsletter that can be subscribed to for free for anyone interested in evidence-based policy. Some of the other publications include "Published Op-Eds/Letters to the Editor" and "Coalition Policy Proposals," which have covered, among other things, "Technology Development," "Crime/Substance Abuse," and "Health Care."

231

Evidence-based chinese medicine for hypertension.  

PubMed

Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go. PMID:23861720

Wang, Jie; Xiong, Xingjiang

2013-01-01

232

Evidence-Based Chinese Medicine for Hypertension  

PubMed Central

Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go. PMID:23861720

Wang, Jie; Xiong, Xingjiang

2013-01-01

233

Managing infection control, hazards communication, and infectious waste disposal.  

PubMed

Dentistry entered a new era in the 1980s when the development of the AIDS crisis targeted dental facilities as one source of potential cross-infection with pathogenic microorganisms. As governmental agencies "discovered" dentistry, regulations forced practitioners to assume duties not previously required. Also, substantial costs of compliance became a significant consideration to employers. Managing the compliance and cost considerations of governmental regulation requires dedicating personnel, preferably one person, to the management of infection control, hazards communication, and infectious waste disposal tasks. predictably, this person--the safety supervisor--will develop into the new auxiliary specialist of the 1990s. PMID:2032576

Runnells, R R; Powell, G L

1991-04-01

234

Silver sulfadiazine for control of burn wound infections.  

PubMed

Silver sulfadiazine (Silvadene, U.S.; Flamazine, U.K.; Flammazine, N.; Sulplata, S.A.) is the newest topical antimicrobial agent available following worldwide clinical trials. Good control of infection is achieved without pain or other demonstrable side effects, using either dressings or the exposure technic. Many burned areas kept free of infection heal without grafting. Where necessary, early preparation for and good take of grafts has been attained by utilizing this new therapeutic agent. Markedly reduced mortality from burn wound sepsis has generally been observed. PMID:1092631

Fox, C L

1975-05-01

235

Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics  

PubMed Central

Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for reconsideration of the methods used for moral evaluation and resolution, however the options should not include obscuring normative content by seemingly neutral technical measure. PMID:16277663

Goldenberg, Maya J

2005-01-01

236

Slaving and release in co-infection control  

PubMed Central

Background Animal and human infection with multiple parasite species is the norm rather than the exception, and empirical studies and animal models have provided evidence for a diverse range of interactions among parasites. We demonstrate how an optimal control strategy should be tailored to the pathogen community and tempered by species-level knowledge of drug sensitivity with use of a simple epidemiological model of gastro-intestinal nematodes. Methods We construct a fully mechanistic model of macroparasite co-infection and use it to explore a range of control scenarios involving chemotherapy as well as improvements to sanitation. Results Scenarios are presented whereby control not only releases a more resistant parasite from antagonistic interactions, but risks increasing co-infection rates, exacerbating the burden of disease. In contrast, synergisms between species result in their becoming epidemiologically slaved within hosts, presenting a novel opportunity for controlling drug resistant parasites by targeting co-circulating species. Conclusions Understanding the effects on control of multi-parasite species interactions, and vice versa, is of increasing urgency in the advent of integrated mass intervention programmes. PMID:23721567

2013-01-01

237

Gut motor function: immunological control in enteric infection and inflammation.  

PubMed

Alteration in gastrointestinal (GI) motility occurs in a variety of clinical settings which include acute enteritis, inflammatory bowel disease, intestinal pseudo-obstruction and irritable bowel syndrome (IBS). Most disorders affecting the GI tract arise as a result of noxious stimulation from the lumen via either microbes or chemicals. However, it is not clear how injurious processes initiated in the mucosa alter function in the deeper motor apparatus of the gut wall. Activation of immune cells may lead to changes in motor-sensory function in the gut resulting in the development of an efficient defence force which assists in the eviction of the noxious agent from the intestinal lumen. This review addresses the interface between immune and motor system in the context of host resistance based on the studies in murine model of enteric nematode parasite infection. These studies clearly demonstrate that the infection-induced T helper 2 type immune response is critical in producing the alterations of infection-induced intestinal muscle function in this infection and that this immune-mediated alteration in muscle function is associated with host defence mechanisms. In addition, by manipulating the host immune response, it is possible to modulate the accompanying muscle function, and this may have clinical relevance. These observations not only provide valuable information on the immunological control of gut motor function and its role in host defence in enteric infection, but also provide a basis for understanding pathophysiology of gastrointestinal motility disorders such as in IBS. PMID:16487236

Khan, W I; Collins, S M

2006-03-01

238

Evidence-based management of recurrent miscarriages  

PubMed Central

Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

Jeve, Yadava B.; Davies, William

2014-01-01

239

Training the Evidence-Based Practitioner  

PubMed Central

An important goal of chiropractic clinical education should be to teach specific evidence-based practice (EBP) skills to chiropractic students, interns, and doctors. Using a nominal group process, the authors produced a document similar to the Council of Chiropractic Education standards for clinical competencies that can be used to drive an EBP curriculum. Standard texts and journal articles were consulted to create the standards for this program and each standard and corresponding learning objective was discussed in detail and was then graded by the committee in terms of importance and the level of competency that should be attained. Six standards and 31 learning objectives were generated with the learning objectives being further divided into lists of specific competencies. It is the hope of these authors that by sharing this document it can serve as a comprehensive and detailed seed document for other institutions. PMID:21677870

LeFebvre, Ronald P.; Peterson, David H.; Haas, Mitchell; Gillette, Richard G.; Novak, Charles W.; Tapper, Janet; Muench, John P.

2011-01-01

240

Evidence-based management of recurrent miscarriages.  

PubMed

Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

Jeve, Yadava B; Davies, William

2014-07-01

241

Evidence-based practice: A challenge for European developmental psychology  

Microsoft Academic Search

In recent years the evidence-based practice movement has been seeing great gains in impact. Standards for research leading to evidence-based practice have been defined. So far, however, in the area of education standards of evidence are not extensively implemented and in most federal European policies an evidence-based reform has not been attained. The present paper advocates investing effort in evidence-based

Christiane Spiel

2009-01-01

242

Evidence-Based Practice and Organizational Development in Libraries  

E-print Network

, on the basis of evidence, to improve the programs and services offered to customers. When evidence-based practice (EBP) in libraries emerged, Lancaster’s students already knew what that was all about. As librarians they would be able to create healthy... of the rather recent movement to emphasize “evidence-based librarianship,” “evidence- based medicine,” and “evidence-based management.” In my idealism, I had always assumed that everyone shared my enthusiasm for published information, would always want...

Russell, Keith

2008-01-01

243

Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example  

ERIC Educational Resources Information Center

This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

Schoenwald, Sonja K.

2008-01-01

244

The ABCs of Evidence-Based Practice for Teachers  

ERIC Educational Resources Information Center

It is critical teachers adhere to federal policies regarding evidence-based practices. Quickly identifying and effectively using evidence-based programs and practices is particularly important for special educators, because students in special education often already have academic or behavioral deficits. Using evidence-based practices with…

Kretlow, Allison G.; Blatz, Sharon L.

2011-01-01

245

Information Retrieval for Evidence-Based Decision Making.  

ERIC Educational Resources Information Center

Discusses evidence-based decision making; describes techniques to support evidence-based retrieval in the field of medicine which emphasize the retrieval and application of high quality knowledge to solve real-world problems; and considers the transferability of evidence-based information seeking to other fields. (Contains 69 references.) (LRW)

Ford, Nigel; Miller, Dave; Booth, Andrew; O'Rourke, Alan; Ralph, Jane; Turnock, Edward

1999-01-01

246

The Evidence Missing from Evidence-Based Practice  

ERIC Educational Resources Information Center

Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. Regrettably, the task force report was largely silent on three critical issues. As a consequence, it omitted much of the evidence necessary for a complete picture of evidence-based

Stuart, Richard B.; Lilienfeld, Scott O.

2007-01-01

247

Evaluation of Evidence-Based Practices in Online Learning  

E-print Network

Evaluation of Evidence-Based Practices in Online Learning A Meta-Analysis and Review of Online Learning Studies #12;#12;Evaluation of Evidence-Based Practices in Online Learning: A Meta.S. Department of Education, Office of Planning, Evaluation, and Policy Development, Evaluation of Evidence-Based

Alpay, S. Pamir

248

Cultural adaptations of evidence-based family interventions to strengthen families and improve children's developmental outcomes  

Microsoft Academic Search

Evidence-based parenting and family interventions are effective in improving parenting skills, positive parent–child relations and children's developmental outcomes. Programmes based on “principles of effective prevention” do not prove that a programme works. Evidence-based programmes (EBPs) are programmes tested in multiple randomized control trials by different researchers and producing large effect sizes. Hence, selecting a family EBP that best matches the

Karol L. Kumpfer; Cátia Magalhães; Jing Xie

2012-01-01

249

Clinical governance and infection control in the United Kingdom.  

PubMed

The recent organizational changes in the NHS have at their core the concept of clinical governance. Although initially poorly defined and understood this term has now taken on a clear identity, placing quality alongside fiscal probity and corporate governance at the top of NHS priorities. Integral to clinical governance are the basic elements of clear national standards for services and treatments that are to be locally delivered through assured, monitored, high quality healthcare. It is within this framework that workers in infection control must develop their own methods of applying clinical governance. This review explores the implications that the strategy of clinical governance holds for the speciality of infection control, emphasizing the benefits its active adoption can bring and highlighting the key relevance of clinical risk management in this setting. It illustrates clinical governance as a tool to engage colleagues on a multi-disciplinary front, most particularly the crucial link to senior Trust management. PMID:11281117

Masterson, R G; Teare, E L

2001-01-01

250

Vaccine to Control the Viral Infection of Fish.  

DOEpatents

Subunit vaccines and their use for immunizing fish against infection by viruses are disclosed. In particular, plasmid pG8 is constructed by joining, with the plasmid pUC8, DNA which encodes the glycoprotein of infectious hematopoietic necrosis virus (IHNV). E. coli cells are transformed by pG8, whereby pure viral antigen is produced to provide a vaccine for the control of IHNV in fish. 10 figs.

Leong, JoAnn Ching

1994-10-11

251

Vaccine to control the viral infection of fish  

DOEpatents

Subunit vaccines and their use for immunizing fish against infection by viruses are disclosed. In particular, plasmid pG8 is constructed by joining, with the plasmid pUC8, DNA which encodes the glycoprotein of infectious hematopoietic necrosis virus (IHNV). E. coli cells are transformed by pG8, whereby pure viral antigen is produced to provide a vaccine for the control of IHNV in fish.

Leong, Jo-Ann C. (Albany, OR)

1994-10-11

252

Cutaneous fungal infection following renal transplantation: a case control study.  

PubMed

The prevalence of cutaneous fungal infection was studied in 72 patients who had undergone renal transplantation and compared with a group of age and sex matched controls. Samples were obtained from toe nails, toe webs, and the upper back; clinically suspicious lesions from other areas were also examined. A total of 576 sites were sampled (288 in each group). Pathogenic fungi were identified from 44 sites (15%) in the renal transplant (RT) group compared with 26 sites (9%) in the control group, (P less than 0.05). However, site-specific differences were less marked; no difference was found between the RT group and controls when the results from the toe nails and toe webs were analysed separately. Trichophyton mentagrophytes was the most common species isolated from both groups. Colonization of the back with Pityrosporum yeasts was significantly more common in the RT group, but few patients in either group had tinea versicolor. 'Mixed infections', with more than one species of fungus isolated in an individual, were only found in the RT group. We also examined the relationship between the presence of fungal infection and the presence or absence of cutaneous malignancy in the renal transplant group. No increase in the prevalence of fungal colonization was found in those patients who had developed cutaneous malignancy compared with those who had not. PMID:3318908

Shuttleworth, D; Philpot, C M; Salaman, J R

1987-11-01

253

Evidence-Based Management of Anticoagulant Therapy  

PubMed Central

Background: High-quality anticoagulation management is required to keep these narrow therapeutic index medications as effective and safe as possible. This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: Most practical clinical questions regarding the management of anticoagulation, both oral and parenteral, have not been adequately addressed by randomized trials. We found sufficient evidence for summaries of recommendations for 23 questions, of which only two are strong rather than weak recommendations. Strong recommendations include targeting an international normalized ratio of 2.0 to 3.0 for patients on vitamin K antagonist therapy (Grade 1B) and not routinely using pharmacogenetic testing for guiding doses of vitamin K antagonist (Grade 1B). Weak recommendations deal with such issues as loading doses, initiation overlap, monitoring frequency, vitamin K supplementation, patient self-management, weight and renal function adjustment of doses, dosing decision support, drug interactions to avoid, and prevention and management of bleeding complications. We also address anticoagulation management services and intensive patient education. Conclusions: We offer guidance for many common anticoagulation-related management problems. Most anticoagulation management questions have not been adequately studied. PMID:22315259

Schulman, Sam; Witt, Daniel M.; Vandvik, Per Olav; Fish, Jason; Kovacs, Michael J.; Svensson, Peter J.; Veenstra, David L.; Crowther, Mark; Guyatt, Gordon H.

2012-01-01

254

Increasing capacity for evidence-based practice through the evidence-based practice academy.  

PubMed

Although mentoring is an important aspect of implementing evidence-based practice (EBP), few models exist for EBP education. The EBP Academy is an innovative, 6-month educational program designed to develop clinical staff as EBP nurse mentors. Sessions provide protected time for participants to work on their EBP projects with assigned mentors who have EBP expertise and similar clinical or research interests. Participants develop EBP projects focused on improving care in their clinical areas. Evaluation of the EBP Academy is based on a four-level model, including participant feedback about the program, perception of meeting program objectives, ability to apply knowledge to practice through EBP projects, and outcome data measured as a result of implementing the EBP changes. By developing EBP mentors, capacity to move nursing practice to a stronger evidence-based foundation can be enhanced. Positive, professional nursing and patient outcomes have been demonstrated when structured EBP education is provided. PMID:24494661

Green, Angela; Jeffs, Debra; Huett, Amy; Jones, Luann R; Schmid, Barbara; Scott, Angela R; Walker, Liz

2014-02-01

255

Current issues in infection control practices in dental hygiene - Part II  

Microsoft Academic Search

16 has competencies on this topic. Although these documents were not reviewed in detail for the degree of inclusion of infection control issues, their inclusion suggests that dental hygienists are educated to some degree in infection control issues. Although this provides some reassurance that an entry level dental hygienist has some knowledge about infection control, several surveys of oral health

Judy Lux

256

The potential for a controlled human infection platform in Singapore.  

PubMed

For over 100 years, controlled human infection (CHI) studies have been performed to advance the understanding of the pathogenesis, treatment and prevention of infectious diseases. This methodology has seen a resurgence, as it offers an efficient model for selecting the most promising agents for further development from available candidates. CHI studies are utilised to bridge safety and immunogenicity testing and phase II/III efficacy studies. However, as this platform is not currently utilised in Asia, opportunities to study therapeutics and vaccines for infections that are important in Asia are missed. This review examines the regulatory differences for CHI studies between countries and summarises other regulatory differences in clinical trials as a whole. We found that the regulations that would apply to CHI studies in Singapore closely mirror those in the United Kingdom, and conclude that the regulatory and ethical guidelines in Singapore are compatible with the conduct of CHI studies. PMID:25273928

Balasingam, S; Horby, P; Wilder-Smith, A

2014-09-01

257

Comprehensive control of human papillomavirus infections and related diseases.  

PubMed

Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of existing screening programs using HPV-based technology, 3) extension of adapted screening programs to developing populations, and 4) consideration of the broader spectrum of cancers and other diseases preventable by HPV vaccination in women, as well as in men. Despite the huge advances already achieved, there must be ongoing efforts including international advocacy to achieve widespread-optimally universal-implementation of HPV prevention strategies in both developed and developing countries. This article summarizes information from the chapters presented in a special ICO Monograph 'Comprehensive Control of HPV Infections and Related Diseases' Vaccine Volume 30, Supplement 5, 2012. Additional details on each subtopic and full information regarding the supporting literature references may be found in the original chapters. PMID:24332295

Bosch, F Xavier; Broker, Thomas R; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L; Doorbar, John; Stern, Peter L; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E; Schiller, John T; Markowitz, Lauri E; Fisher, William A; Canfell, Karen; Denny, Lynette A; Franco, Eduardo L; Steben, Marc; Kane, Mark A; Schiffman, Mark; Meijer, Chris J L M; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

2013-12-31

258

Comprehensive control of human papillomavirus infections and related diseases.  

PubMed

Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of existing screening programs using HPV-based technology, 3) extension of adapted screening programs to developing populations, and 4) consideration of the broader spectrum of cancers and other diseases preventable by HPV vaccination in women, as well as in men. Despite the huge advances already achieved, there must be ongoing efforts including international advocacy to achieve widespread-optimally universal-implementation of HPV prevention strategies in both developed and developing countries. This article summarizes information from the chapters presented in a special ICO Monograph 'Comprehensive Control of HPV Infections and Related Diseases' Vaccine Volume 30, Supplement 5, 2012. Additional details on each subtopic and full information regarding the supporting literature references may be found in the original chapters. PMID:24331817

Bosch, F Xavier; Broker, Thomas R; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L; Doorbar, John; Stern, Peter L; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E; Schiller, John T; Markowitz, Lauri E; Fisher, William A; Canfell, Karen; Denny, Lynette A; Franco, Eduardo L; Steben, Marc; Kane, Mark A; Schiffman, Mark; Meijer, Chris J L M; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

2013-12-30

259

Comprehensive Control of Human Papillomavirus Infections and Related Diseases  

PubMed Central

Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of existing screening programs using HPV-based technology, 3) extension of adapted screening programs to developing populations, and 4) consideration of the broader spectrum of cancers and other diseases preventable by HPV vaccination in women, as well as in men. Despite the huge advances already achieved, there must be ongoing efforts including international advocacy to achieve widespread—optimally universal—implementation of HPV prevention strategies in both developed and developing countries. This article summarizes information from the chapters presented in a special ICO Monograph ‘Comprehensive Control of HPV Infections and Related Diseases’ Vaccine Volume 30, Supplement 5, 2012. Additional details on each subtopic and full information regarding the supporting literature references may be found in the original chapters. PMID:24229716

Bosch, F. Xavier; Broker, Thomas R.; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L.; Doorbar, John; Stern, Peter L.; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E.; Schiller, John T.; Markowitz, Lauri E.; Fisher, William A.; Canfell, Karen; Denny, Lynette A.; Franco, Eduardo L.; Steben, Marc; Kane, Mark A.; Schiffman, Mark; Meijer, Chris J.L.M.; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J.; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

2014-01-01

260

Comprehensive control of human papillomavirus infections and related diseases.  

PubMed

Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of existing screening programs using HPV-based technology, 3) extension of adapted screening programs to developing populations, and 4) consideration of the broader spectrum of cancers and other diseases preventable by HPV vaccination in women, as well as in men. Despite the huge advances already achieved, there must be ongoing efforts including international advocacy to achieve widespread-optimally universal-implementation of HPV prevention strategies in both developed and developing countries. This article summarizes information from the chapters presented in a special ICO Monograph 'Comprehensive Control of HPV Infections and Related Diseases' Vaccine Volume 30, Supplement 5, 2012. Additional details on each subtopic and full information regarding the supporting literature references may be found in the original chapters. PMID:24331745

Bosch, F Xavier; Broker, Thomas R; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L; Doorbar, John; Stern, Peter L; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E; Schiller, John T; Markowitz, Lauri E; Fisher, William A; Canfell, Karen; Denny, Lynette A; Franco, Eduardo L; Steben, Marc; Kane, Mark A; Schiffman, Mark; Meijer, Chris J L M; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

2013-12-29

261

Comprehensive control of human papillomavirus infections and related diseases.  

PubMed

Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of existing screening programs using HPV-based technology, 3) extension of adapted screening programs to developing populations, and 4) consideration of the broader spectrum of cancers and other diseases preventable by HPV vaccination in women, as well as in men. Despite the huge advances already achieved, there must be ongoing efforts including international advocacy to achieve widespread-optimally universal-implementation of HPV prevention strategies in both developed and developing countries. This article summarizes information from the chapters presented in a special ICO Monograph 'Comprehensive Control of HPV Infections and Related Diseases' Vaccine Volume 30, Supplement 5, 2012. Additional details on each subtopic and full information regarding the supporting literature references may be found in the original chapters. PMID:24229716

Bosch, F Xavier; Broker, Thomas R; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L; Doorbar, John; Stern, Peter L; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E; Schiller, John T; Markowitz, Lauri E; Fisher, William A; Canfell, Karen; Denny, Lynette A; Franco, Eduardo L; Steben, Marc; Kane, Mark A; Schiffman, Mark; Meijer, Chris J L M; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

2013-11-22

262

Why "What Works" Won't Work: Evidence-Based Practice and the Democratic Deficit in Educational Research  

ERIC Educational Resources Information Center

In this essay, Gert Biesta provides a critical analysis of the idea of evidence-based practice and the ways in which it has been promoted and implemented in the field of education, focusing on the tension between scientific and democratic control over educational practice and research. Biesta examines three key assumptions of evidence-based

Biesta, Gert

2007-01-01

263

Infections  

MedlinePLUS

... Externa) Eye Infections Pinkeye (Conjunctivitis) Styes Fungal Infections (Ringworm, Yeast, etc.) Diaper Rash Infections That Pets Carry Pneumocystis Pneumonia Tinea (Ringworm, Jock Itch, Athlete's Foot) Immunizations Flu Center ...

264

Updating the evidence base for suctioning adult patients: A systematic review  

PubMed Central

OBJECTIVES: To update a previous clinical practice guideline on suctioning in adult patients, published in the Canadian Respiratory Journal in 2001. METHODS: A primary search of the MEDLINE (from 1998), CINAHL, EMBASE and The Cochrane Library (all from 1996) databases up to November 2007, was conducted. These dates reflect the search limits reached in the previous clinical practice guideline. A secondary search of the reference lists of retrieved articles was also performed. Two reviewers independently appraised each study before meeting to reach consensus. Study quality was evaluated using the Jadad and PEDro scales. When sufficient data were available, a meta-analysis was conducted using a random effects model. Data are reported as ORs, weighted mean differences and 95% CIs. When no comparisons were possible, qualitative analyses of the data were completed. RESULTS: Eighty-one studies were critically appraised from a pool of 123. A total of 28 randomized controlled trials or randomized crossover studies were accepted for inclusion. Meta-analysis was possible for open versus closed suctioning only. Recommendations from 2001 with respect to hyperoxygenation, hyperinflation, use of a ventilator circuit adaptor and subglottic suctioning were confirmed. New evidence was identified with respect to indications for suctioning, open suction versus closed suction systems, use of medications and infection control. CONCLUSIONS: While new evidence continues to be varied in strength, and is still lacking in some areas of suctioning practice, the evidence base has improved since 2001. Members of the health care team should incorporate this evidence into their practice. PMID:19557211

Overend, Tom J; Anderson, Cathy M; Brooks, Dina; Cicutto, Lisa; Keim, Michael; McAuslan, Debra; Nonoyama, Mika

2009-01-01

265

Infection control and its application to the administration of intravenous medications during gastrointestinal endoscopy  

Microsoft Academic Search

Several infection control practices and procedures crucial to the prevention of disease transmission in the health care setting are reviewed and discussed. Emphasis is placed on the importance of infection control to gastrointestinal endoscopy. Recommendations that minimize the risk of nosocomial infection during the preparation, handling, and administration of intravenous medications, particularly propofol, are provided. These recommendations include the labeling

Lawrence F Muscarella

2004-01-01

266

Implementation of infection control best practice in intensive care units throughout Europe: a mixed-method evaluation study  

PubMed Central

Background The implementation of evidence-based infection control practices is essential, yet challenging for healthcare institutions worldwide. Although acknowledged that implementation success varies with contextual factors, little is known regarding the most critical specific conditions within the complex cultural milieu of varying economic, political, and healthcare systems. Given the increasing reliance on unified global schemes to improve patient safety and healthcare effectiveness, research on this topic is needed and timely. The ‘InDepth’ work package of the European FP7 Prevention of Hospital Infections by Intervention and Training (PROHIBIT) consortium aims to assess barriers and facilitators to the successful implementation of catheter-related bloodstream infection (CRBSI) prevention in intensive care units (ICU) across several European countries. Methods We use a qualitative case study approach in the ICUs of six purposefully selected acute care hospitals among the 15 participants in the PROHIBIT CRBSI intervention study. For sensitizing schemes we apply the theory of diffusion of innovation, published implementation frameworks, sensemaking, and new institutionalism. We conduct interviews with hospital health providers/agents at different organizational levels and ethnographic observations, and conduct rich artifact collection, and photography during two rounds of on-site visits, once before and once one year into the intervention. Data analysis is based on grounded theory. Given the challenge of different languages and cultures, we enlist the help of local interpreters, allot two days for site visits, and perform triangulation across multiple data sources. Qualitative measures of implementation success will consider the longitudinal interaction between the initiative and the institutional context. Quantitative outcomes on catheter-related bloodstream infections and performance indicators from another work package of the consortium will produce a final mixed-methods report. Conclusion A mixed-methods study of this scale with longitudinal follow-up is unique in the field of infection control. It highlights the ‘Why’ and ‘How’ of best practice implementation, revealing key factors that determine success of a uniform intervention in the context of several varying cultural, economic, political, and medical systems across Europe. These new insights will guide future implementation of more tailored and hence more successful infection control programs. Trial registration Trial number: PROHIBIT-241928 (FP7 reference number) PMID:23421909

2013-01-01

267

Management of fibromyalgia syndrome - an interdisciplinary evidence-based guideline  

PubMed Central

The prevalence of fibromyalgia syndrome (FMS) of 1–2% in the general population associated with high disease-related costs and the conflicting data on treatment effectiveness had led to the development of evidence-based guidelines designed to provide patients and physicians guidance in selecting among the alternatives. Until now no evidence-based interdisciplinary (including patients) guideline for the management of FMS was available in Europe. Therefore a guideline for the management of fibromyalgia syndrome (FMS) was developed by 13 German medical and psychological associations and two patient self-help organisations. The task was coordinated by two German scientific umbrella organisations, the Association of the Scientific Medical Societies in Germany AWMF and the German Interdisciplinary Association of Pain Therapy DIVS. A systematic search of the literature including all controlled studies, systematic reviews and meta-analyses of pharmacological and non-pharmacological treatments of FMS was performed in the Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/ 2006). Levels of evidence were assigned according to the classification system of the Oxford-Centre for Evidence Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures were used to reach a consensus on recommendations. The guideline was reviewed and finally approved by the boards of the societies involved and published online by the AWMF on april 25, 2008: http://www.uni-duesseldorf.de/AWMF/ll/041-004.htm. A short version of the guideline for patients is available as well: http://www.uni-duesseldorf.de/AWMF/ll/041-004p.htm. The following procedures in the management of FMS were strongly recommended: information on diagnosis and therapeutic options and patient-centered communication, aerobic exercise, cognitive and operant behavioural therapy, multicomponent treatment and amitriptyline. Based on expert opinion, a stepwise FMS-management was proposed. Step 1 comprises confirming the diagnosis and patient education and treatment of physical or mental comorbidities or aerobic exercise or cognitive behavioural therapy or amitriptyline. Step 2 includes multicomponent treatment. Step 3 comprises no further treatment or self-management (aerobic exercise, stress management) and/or booster multicomponent therapy and/or pharmacological therapy (duloxetine or fluoxetine or paroxetine or pregabalin or tramadol/aminoacetophen) and/or psychotherapy (hypnotherapy or written emotional disclosure) and/or physical therapy (balneotherapy or whole body heat therapy) and/or complementary therapies (homoeopathy or vegetarian diet). The choice of treatment options should be based on informed decision-making and respect of the patients’ preferences. PMID:19675740

Hauser, Winfried; Arnold, Bernhard; Eich, Wolfgang; Felde, Eva; Flugge, Christl; Henningsen, Peter; Herrmann, Markus; Kollner, Volker; Kuhn, Edeltraud; Nutzinger, Detlev; Offenbacher, Martin; Schiltenwolf, Marcus; Sommer, Claudia; Thieme, Kati; Kopp, Ina

2008-01-01

268

Cultures of control: A historical analysis of the development of infection control nursing in Ireland.  

PubMed

Responses to the rise of antimicrobial resistance in Europe and North America included establishment of special hospital infection control teams of a microbiologist and a nurse. Based on the testimonies of seven infection control nurses in Irish hospitals appointed during 1979-1990, this article examines the early development and expressions of their disciplinary practice. Fairman's model of collaborative practice was used to examine the context in which the role emerged, the places practice was negotiated and mutually constructed, and exemplars of collaborative practice. Aspects of the relationship between theory and method in Wengraf's biographical narrative interpretive method (BNIM) used to generate the nurses' accounts of their early experiences in the role are highlighted. Practice was contingent on effective negotiation of places of practice, and disciplinary practice bore hallmarks of collaborative practice. The infection control nurse transitioned from conspicuous outsider and object of suspicion to valued resource for patients and staff. Infection control nursing came to be a prototype for new specialist nursing roles in hospitals. PMID:23901627

McNamra, Martin S; Fealy, Gerard M; Geraghty, Ruth

2013-01-01

269

The Evidence-Based Manifesto for School Librarians  

ERIC Educational Resources Information Center

School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

Todd, Ross

2008-01-01

270

Evidence-Based Practice in Rehabilitation Counseling: Perceptions and Practices  

ERIC Educational Resources Information Center

This study describes certified rehabilitation counselors' attitudes (n=163) about evidence based practice, knowledge and skills related to obtaining and evaluating evidence, use of literature in practice, availability of information, and perceived barriers to evidence-based practice. Responses related to knowledge and skills were mixed with strong…

Bezyak, Jill L.; Kubota, Coleen; Rosenthal, David

2010-01-01

271

Opening Pandora's Box: Evidence-based practice for educational psychologists  

Microsoft Academic Search

Over the past few years evidence-based practice has become of central concern to health and social services in this country. The fundamental tenant is that there must be a clear link between professional practice and its research base. This paper outlines the concept of evidence-based practice and how it rests on the concept of good quality research -- defined as

Mark Fox

2003-01-01

272

Counting what counts: performance measurement and evidence-based practice  

Microsoft Academic Search

Purpose – The purpose of this paper is to explore conceptual and practical links between performance measurement and evidence-based library and information practice (EBLIP) and to identify lessons to be learned from evidence-based healthcare. Design\\/methodology\\/approach – The paper presents a selective review of key writings in EBLIP for reference to performance measurement. Findings – The paper finds that performance measurement

Andrew Booth

2006-01-01

273

Evidence-Based Practice: Integrating Classroom Curriculum and Field Education  

ERIC Educational Resources Information Center

This article describes the use of problem-based learning to teach the scope and consequences of evidence-based practices in mental health through an innovative assignment that integrates classroom and field learning. The authors illustrate the planning and implementation of the Evidence-Based Practice: Integrating Classroom Curriculum and Field…

Tuchman, Ellen; Lalane, Monique

2011-01-01

274

Towards an Understanding of Evidence-Based Practice  

ERIC Educational Resources Information Center

The past two decades have seen a rise in the use of the term "evidence-based practice" and a simultaneous increase in the variations in its definition and evaluation. Subsequently, this rise in interest for evidence-based practices has become a double-edged sword for practitioners--that is, while there are a number of interpretations on the…

Digennaro Reed, Florence D.; Reed, Derek D.

2008-01-01

275

Evidence-Based Practice and the Culture of Adolescence  

Microsoft Academic Search

Evidence-based practice requires attention to the client context, including client culture. We propose that the developmental period of adolescence is characterized by a unique culture that has important implications for evidence-based practice. Specifically, this paper explores three features of adolescent culture (importance of technology, centrality of peers, and the ongoing challenge of identity formation and individuation) that may be especially

Timothy D. Nelson; Jennifer Mize Nelson

2010-01-01

276

Evidence-Based Practice Guidelines and School Nursing  

ERIC Educational Resources Information Center

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

Adams, Susan; McCarthy, Ann Marie

2007-01-01

277

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine  

E-print Network

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2011 measures, will strengthen the evidence base for such complex interventions as acupuncture. 1. Introduction is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage

Napadow, Vitaly

278

Evidence-Based Practice in Education. Conducting Educational Research  

ERIC Educational Resources Information Center

The book begins with an explication of evidence-based practice. Some of the ideas of its proponents are discussed, including the Campbell Collaboration, and the application to education of Cochrane-style reviews and meta-analyses. The thinking behind evidence-based practice has been the subject of much criticism, particularly in education, and…

Pring, Richard; Thomas, Gary

2004-01-01

279

Evidence-based Clinical Guidelines in , Zhisheng Huang1  

E-print Network

and have not yet supported for the se- mantic inter-operability. The semantic enriched guidelinesEvidence-based Clinical Guidelines in SemanticCT Qing Hu1,2 , Zhisheng Huang1 , Frank van Harmelen1. In this pa- per, we present a semantic approach of evidence-based clinical guidelines. That lightweight

van Harmelen, Frank

280

Evidence-based Assessment of Cognitive Functioning in Pediatric Psychology  

Microsoft Academic Search

Objective To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology. Methods From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g.,

Jonathan M. Campbell; Ronald T. Brown; Sarah E. Cavanagh; Sarah F. Vess; Mathew J. Segall

2008-01-01

281

Evidence-Based Guidelines in Laboratory Medicine: Principles and Methods  

Microsoft Academic Search

Background: Guidelines are commonly used tools for supporting medical decisions. Formulating evidence- based recommendations has become a leading principle in guideline development. Aim: This narrative review integrates the most recent methods of evidence-based guideline development and adapts those to the field of laboratory medicine. Summary: We present a 10-step process and a list of criteria for the development of laboratory

Wytze P. Oosterhuis; David E. Bruns; Joseph Watine; Sverre Sandberg; Andrea R. Horvath

2004-01-01

282

Opening Pandora's Box: Evidence-Based Practice for Educational Psychologists  

ERIC Educational Resources Information Center

Over the past few years evidence-based practice has become of central concern to health and social services in this country. The fundamental tenant is that there must be a clear link between professional practice and its research base. This paper outlines the concept of evidence-based practice and how it rests on the concept of good quality…

Fox, Mark

2003-01-01

283

Evidence based onderwijs: De leraar en de school aan zet  

E-print Network

Evidence based onderwijs: De leraar en de school aan zet Martin Valcke Martin.Valcke@UGent.be 8 februari 2012 Mentorendag UGent #12;Structuur · Controverse: Kwaliteitsvol onderwijs... wat werkt ... tips and tricks ...evidence based onderwijs ... · Meningen over kwaliteit: even "testen" · Effecten? Wat

Gent, Universiteit

284

[Forensic evidence-based medicine in computer communication networks].  

PubMed

As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks. PMID:24665620

Qiu, Yun-Liang; Peng, Ming-Qi

2013-12-01

285

Gut microbiota promote hematopoiesis to control bacterial infection.  

PubMed

The commensal microbiota impacts specific immune cell populations and their functions at peripheral sites, such as gut mucosal tissues. However, it remains unknown whether gut microbiota control immunity through regulation of hematopoiesis at primary immune sites. We reveal that germ-free mice display reduced proportions and differentiation potential of specific myeloid cell progenitors of both yolk sac and bone marrow origin. Homeostatic innate immune defects may lead to impaired early responses to pathogens. Indeed, following systemic infection with Listeria monocytogenes, germ-free and oral-antibiotic-treated mice display increased pathogen burden and acute death. Recolonization of germ-free mice with a complex microbiota restores defects in myelopoiesis and resistance to Listeria. These findings reveal that gut bacteria direct innate immune cell development via promoting hematopoiesis, contributing to our appreciation of the deep evolutionary connection between mammals and their microbiota. PMID:24629343

Khosravi, Arya; Yáñez, Alberto; Price, Jeremy G; Chow, Andrew; Merad, Miriam; Goodridge, Helen S; Mazmanian, Sarkis K

2014-03-12

286

Source control review in clinical trials of anti-infective agents in complicated intra-abdominal infections.  

PubMed

In clinical trials of complicated intra-abdominal infections, assessment of adequacy of the initial surgical approach to the management of the infection is of considerable importance in determining outcome. Antibiotic therapy would not be expected to adequately treat the infection if the surgical procedure was inadequate with respect to source control. Inclusion of such cases in an efficacy analysis of a particular therapeutic antibiotic may confound the results. We analyzed the source control review process used in double-blind clinical trials of antibiotics in complicated intra-abdominal infections identified through systematic review. We searched MEDLINE (PubMed) and ClinicalTrials.gov databases to identify relevant articles reporting results from double-blind clinical trials that used a source control review process. Eight prospective, randomized, double-blind, multicenter, clinical trials of 5 anti-infective agents in complicated intra-abdominal infections used a source control review process. We provide recommendations for an independent, adjudicated source control review process applicable to future clinical trials. PMID:23463643

Solomkin, Joseph S; Ristagno, Ross L; Das, Anita F; Cone, John B; Wilson, Samuel E; Rotstein, Ori D; Murphy, Brian S; Severin, Kimberley S; Bruss, Jon B

2013-06-01

287

Safety profile of Coartem®: the evidence base  

PubMed Central

This article reviews the comprehensive data on the safety and tolerability from over 6,300 patients who have taken artemether/lumefantrine (Coartem®) as part of Novartis-sponsored or independently-sponsored clinical trials. The majority of the reported adverse events seen in these studies are mild or moderate in severity and tend to affect the gastrointestinal or nervous systems. These adverse events, which are common in both adults and children, are also typical of symptoms of malaria or concomitant infections present in these patients. The wealth of safety data on artemether/lumefantrine has not identified any neurological, cardiac or haematological safety concerns. In addition, repeated administration is not associated with an increased risk of adverse drug reactions including neurological adverse events. This finding is especially relevant for children from regions with high malaria transmission rates who often receive many courses of anti-malarial medications during their lifetime. Data are also available to show that there were no clinically relevant differences in pregnancy outcomes in women exposed to artemether/lumefantrine compared with sulphadoxine-pyrimethamine during pregnancy. The six-dose regimen of artemether/lumefantrine is therefore well tolerated in a wide range of patient populations. In addition, post-marketing experience, based on the delivery of 250 million treatments as of July 2009, has not identified any new safety concerns for artemether/lumefantrine apart from hypersensitivity and allergies, known class effects of artemisinin derivatives. PMID:19818173

Falade, Catherine; Manyando, Christine

2009-01-01

288

Approaches to Evidence-based Teaching.  

ERIC Educational Resources Information Center

Presents a plenary presentation from the Association for Medical Education in Europe (AMEE) which calls for properly designed, controlled trials and systematic reviews of the effects of teaching and learning methods in order to make informed decisions about teaching practices. (Author/CCM)

Davies, Philip

2000-01-01

289

Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)  

PubMed Central

Background We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in a multicentre surveillance executed June and July 2012. Methods The IRIS includes two patient outcome-variables, i.e. the prevalence of healthcare associated infections (HAI) and rectal carriage of Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-E); two patient-related risk factors, i.e. use of medical devices, and antimicrobial therapy; and three ward-related risk factors, i.e. environmental contamination, availability of local guidelines, and shortcomings in infection prevention preconditions. Results were categorised as low-, intermediate- and high risk, presented in an easy-to-read graphic risk spider-plot. This plot was given as feedback to management and healthcare workers of the NH. Results Large differences were found among most the variables in the different NH. Common shortcomings were the availability of infection control guidelines and the level of environmental cleaning. Most striking differences were observed in the prevalence of ESBL carriage, ranged from zero to 20.6% (p?infection control situation of the participating NH. The results can be used to improve the quality of infection control based on the specific needs of a NH but needs further validation in future studies. Repeated measurement can determine the effectiveness of the interventions. This makes the IRIS a useful tool for quality systems. PMID:25243067

2014-01-01

290

Modeling of host genetics and resistance to infectious diseases: understanding and controlling nematode infections  

Microsoft Academic Search

This paper considers approaches to modeling the dynamics of infectious disease and the application of such models to nematode parasite infections in ruminants. Particularly, these models are developed to account for host genetics and may be used to assess the effects of using genetics to control nematode infections. Three main issues are critically examined: the infection transmission cycle from pasture

S. C Bishop; M. J Stear

2003-01-01

291

Case-control study of disease determinants for non-typhoidal Salmonella infections among Michigan children  

Microsoft Academic Search

BACKGROUND: Infections with Salmonella serotypes continue to be a significant global public health problem. In addition to contaminated foods, several other sources contribute to infections with Salmonella serotypes. We have assessed the role of socioeconomic factors, exposure to food, and environmental sources in the etiology of non-typhoidal Salmonella infections in Michigan children. FINDINGS: A case-control study among Michigan children aged

Muhammad Younus; Melinda J Wilkins; Herbert D Davies; Mohammad H Rahbar; Julie Funk; Chau Nguyen; Azfar-E A Siddiqi; Seongbeom Cho; Mahdi Saeed

2010-01-01

292

Controlled release of gentamicin from polyelectrolyte multilayers to treat implant-related infection  

E-print Network

Polyelectrolyte multilayered (PEM) coatings were fabricated to incorporate and release the small, hydrophilic antibiotic gentamicin from implant surfaces for infection control. The use of a cationic hydrolytically cleavable ...

Moskowitz, Joshua Seth

2012-01-01

293

Evidence-based assessment in case management to improve abnormal cancer screen follow-up.  

PubMed

The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented and illustrated in the Screening Adherence Follow-up (SAFe) protocol: (1) evidence for known risks and barriers for the target population; (2) standardized assessment elements; (3) evidence for the accuracy, efficiency, and validity of the protocol in use. Testing of the assessment tool in a pilot study of more than 600 women demonstrated practical utility in matching assessed needs with service intensity and confirmed that differential amounts of service and different provider effort achieved equally satisfactory adherence results. The evidence-based components described and the types and nature of evidence on which they draw can be generalized to new settings and client concerns. PMID:15974370

Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

2005-05-01

294

Management of membranoproliferative glomerulonephritis: evidence-based recommendations.  

PubMed

Idiopathic membranoproliferative glomerulonephritis (MPGN) is one of the least common types of GN. This article critically evaluates the literature and generates evidence-based recommendations for the management of idiopathic MPGN. For all age groups, for idiopathic MPGN with normal renal function and asymptomatic nonnephrotic range proteinuria, no specific therapy is necessary (grades B and C). Close follow-up every three to four months, with specific attention to renal function, proteinuria, and blood pressure control, is recommended. In children with MPGN and nephrotic syndrome and/or impaired renal function, a trial of steroids is warranted (grade A). The best data suggest high-dose, alternate-day steroids for a period of 6 to 12 months (40 mg/m2 on alternate days). If no benefit is seen, discontinuation with close follow-up and attention to conservative treatment (that is, blood pressure control, use of agents to reduce proteinuria, and correction of metabolic abnormalities) is recommended. In adults with MPGN, impaired renal function, and/or nephrotic-range proteinuria, a trial of aspirin (325 mg daily), dipyridamole (75 to 100 mg tid), or a combination of the two for 12 months is reasonable (grade B). Again, if no benefits are seen, the treatment should be stopped. Attention to factors known to delay the progression of renal decline and close follow-up should be part of the treatment plan (grades B and C). PMID:10369194

Levin, A

1999-06-01

295

Implementing Evidence-Based Practices for People With Schizophrenia  

PubMed Central

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

2009-01-01

296

Providers' Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions  

ERIC Educational Resources Information Center

Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV…

Owczarzak, Jill; Dickson-Gomez, Julia

2011-01-01

297

Developing Evidence-Based Practice: The Role of Case-Based Research  

Microsoft Academic Search

How can practitioners engage in evidence-based practice when the evidence for effectiveness of psychological treatments comes from randomized controlled trials using patient populations different from those encountered in everyday settings and treatment manuals that seem oversimplified and inflexible? The authors argue that important evidence about best practice comes from case-based research, which builds knowledge in a clinically useful manner and

David J. A. Edwards; Frank M. Dattilio; Dennis B. Bromley

2004-01-01

298

Treatment of urinary incontinence in men with electrical stimulation: Is practice evidence-based?  

Microsoft Academic Search

Electrical stimulation is frequently recommended for the treatment of urinary incontinence in men. However, few randomized, controlled trials allow practitioners to evaluate the evidence base for this practice. The purpose of this article is to determine, based on a review of the literature, whether adequate evidence exists to support the use of electrical stimulation as a treatment of male urinary

Katherine N. Moore

2000-01-01

299

From Muddling Through to Muddling Up - Evidence Based Policy Making and the Modernisation of British Government  

Microsoft Academic Search

This article considers the approach to evidence based policy making (EBPM) advanced in the Labour government's modernisation agenda. The article contends that EBPM must be understood as a project focused on enhancing the techniques of managing and controlling the policy making process as opposed to either improving the capacities of the social sciences to influence the 'practices of democracy' as

Wayne Parsons

2002-01-01

300

IRB decision-making with imperfect knowledge: a framework for evidence-based research ethics review.  

PubMed

Here we describe the five steps of evidence-based practice as applied to research ethics review and apply these steps to three exemplar dilemmas: incentive payments in substance abuse research; informed consent for biobanking; and placebo-controlled trials involving pregnant women in order to demonstrate the potential of empirical data to inform and improve IRB decision-making. PMID:23289698

Anderson, Emily E; DuBois, James M

2012-01-01

301

Outbreak of hepatitis C virus infections at an outpatient hemodialysis facility: the importance of infection control competencies.  

PubMed

In the United States, the prevalence of hepatitis C virus infection among patients treated in hemodialysis facilities is five times higher than among the general population. This study investigated eight new hepatitis C virus infections among patients treated at an outpatient hemodialysis facility. Epidemiologic investigation and viral sequencing demonstrated that transmission likely occurred between patients typically treated during the same or consecutive shifts at the same or a nearby station. Several infection control breaches were observed including lapses involving the preparation, handling, and administration of parenteral medications. Improved infection control education and training for all hemodialysis facility staff is an important component of assuring adherence to appropriate procedures and preventing future outbreaks. PMID:23785746

Rao, Agam K; Luckman, Emily; Wise, Matthew E; MacCannell, Taranisia; Blythe, David; Lin, Yulin; Xia, Guoliang; Drobeniuc, Jan; Noble-Wang, Judith; Arduino, Matthew J; Thompson, Nicola D; Patel, Priti R; Wilson, Lucy E

2013-01-01

302

In vitro biological control of infective larvae of Ancylostoma ceylanicum.  

PubMed

The aim of this study was to evaluate the predatory activity of the fungus Duddingtonia flagrans (AC001) on infective larvae of Ancylostoma ceylanicum after gastrointestinal transit in hamsters. Twenty animals were used in the experiment, divided into two groups: a treated group (10 animals) and a control group (10 animals). In the group treated with D. flagrans, each animal received mycelium from the AC001 isolate, at an oral dose of 5 mg/25 g of live weight. To evaluate the predatory activity of the fungus, fecal samples were collected from the animals in both groups, at the times of 6, 8, 12, 24 and 36 hours after the treatment. Then, subsamples of 2 g of feces were placed in Petri dishes containing 2% water-agar (2% WA) culture medium and 1000 L3 of A. ceylanicum. Over the study period, the following percentage reductions were observed: 43.2% (6 hours), 30.8% (8 hours), 25.8% (12 hours), 30% (24 hours) and 11% (36 hours). The fungus D. flagrans presented predatory activity on the L3 of A. ceylanicum, after passing through the hamsters' gastrointestinal tract. It was therefore concluded that the fungus D. flagrans may be an alternative for biological control of the L3 of A. ceylanicum. PMID:23070440

Fernandes, Fernanda Mara; Araújo, Jackson Victor; Braga, Fabio Ribeiro; Gazzinelli-Guimarães, Pedro Henrique; Araujo, Juliana Milani; Ferreira, Sebastião Rodrigo; Carvalho, Rogério Oliva; de Mello, Ingrid Ney Kramer; Fujiwara, Ricardo Toshio

2012-01-01

303

Relationship of Antimicrobial Control Policies and Hospital and Infection Control Characteristics to Antimicrobial Resistance Rates  

PubMed Central

Background Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. Objectives To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices, and systems-level indicators of implementation of the hand hygiene guideline of the Centers for Disease Control and Prevention. Methods An on-site survey of intensive care unit staff and infection control directors of 33 hospitals in the United States was conducted. The following data were collected: antimicrobial control policies; rates during the previous 12 months of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and ceftazidime-resistant Klebsiella pneumoniae; an implementation score of systems-level efforts to implement the guideline; staff attitudes toward practice guidelines; and observations of staff hand hygiene. Variables associated with resistance rates were examined for independent effects by using logistic regression. Results Resistance rates for S aureus, enterococci, and K pneumoniae were 52.5%, 18.2%, and 16.0%, respectively. Ten (30.3%) hospitals had an antibiotic control policy. No statistically significant correlation was observed between staff attitudes toward practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046). Conclusions Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance. PMID:17322010

Larson, Elaine L.; Quiros, Dave; Giblin, Tara; Lin, Susan

2007-01-01

304

Recommended infection-control practices for dentistry, 1993. Centers for Disease Control and Prevention.  

PubMed

This document updates previously published CDC recommendations for infection-control practices in dentistry to reflect new data, materials, technology, and equipment. When implemented, these recommendations should reduce the risk of disease transmission in the dental environment, from patient to dental health-care worker (DHCW), from DHCW to patient, and from patient to patient. Based on principles of infection control, the document delineates specific recommendations related to vaccination of DHCWs; protective attire and barrier techniques; handwashing and care of hands; the use and care of sharp instruments and needles; sterilization or disinfection of instruments; cleaning and disinfection of the dental unit and environmental surfaces; disinfection and the dental laboratory; use and care of handpieces, antiretraction valves, and other intraoral dental devices attached to air and water lines of dental units; single-use disposable instruments; the handling of biopsy specimens; use of extracted teeth in dental educational settings; disposal of waste materials; and implementation of recommendations. PMID:8502212

1993-05-28

305

Evidence Searching for Evidence-based Psychology Practice  

PubMed Central

There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down questions into searchable statements, and adapting statements to suit both the question being asked and the resource being searched. A number of free, evidence-based resources are listed. Knowing how and where to access this information will enable practitioners to more easily use an evidence-based approach to their practice. PMID:21503266

Falzon, Louise; Davidson, Karina W.; Bruns, Daniel

2010-01-01

306

Insufficient Evidence: The Problems of Evidence-Based Nursing.  

ERIC Educational Resources Information Center

Challenges the wisdom of basing nursing practice on the findings of statistical research and offers objections to the philosophy of evidence-based nursing. Proposes rethinking what counts as evidence, suggesting a model based on reflection after the event. (SK)

Rolfe, Gary

1999-01-01

307

Ms Siti ZUBAIDAH, Assistant Director of Nursing (Evidence Based-  

E-print Network

National University, Singapore 3 Alice Lee Centre for Nursing Studies, Singapore National University, Alice Lee Centre for Nursing Studies, University of Singapore #12;Ms Siti ZUBAIDAH, Assistant Director of Nursing (Evidence Based- Nursing Unit) Dr Emily Ang Deputy

Kan, Min-Yen

308

Using Evidence-Based Principles in Clinical Practice  

E-print Network

To help students better understand how to use evidence-based principles in clinical practice, Prof. Storkel is revising her SPLH 880 course so that students can access evidence from clinical research and apply it to specific ...

Storkel, Holly Lynn

2004-01-01

309

Towards Evidence-Based Practice in Science Education.  

ERIC Educational Resources Information Center

Suggests that teaching should be informed by research and reports interim findings from three of the four projects from the Evidence-based Practice in Science Education (EPSE) Research Network. (Author/DDR)

Millar, Robin; Leach, John; Osborne, Jonathan; Ratcliffe, Mary; Hames, Vicky; Hind, Andy; Bartholomew, Hannah; Collins, Sue; Lewis, Jenny; Scott, Phil; Duschl, Rick

2002-01-01

310

Evidence based practice: a survey of physiotherapists' current practice  

Microsoft Academic Search

Backgound and Purpose. Evidence-based practice is the explicit use of current best evidence in making decisions about the care of individual patients and is a concept of growing importance for physiotherapy. The aim of the present study was to investigate Australian physiotherapists' self-reported practice, skills and knowledge of evidence-based practice and to examine differences between recent and experienced grad- uates,

Ross Iles; Megan Davidson

2006-01-01

311

Evidence-Based Practice: Integrating Classroom Curriculum and Field Education  

Microsoft Academic Search

This article describes the use of problem-based learning to teach the scope and consequences of evidence-based practices in mental health through an innovative assignment that integrates classroom and field learning. The authors illustrate the planning and implementation of the Evidence-Based Practice: Integrating Classroom Curriculum and Field Education Assignment designed to promote a deeper, more comprehensive and critical understanding of the

Ellen Tuchman; Monique Lalane

2011-01-01

312

Preparing Future Generations of Evidence-Based Endocrinologists  

Microsoft Academic Search

There is much to recommend an increased emphasis on evidence-based medicine (EBM) training in medical education. Evidence-based\\u000a practice has emerged as a national priority in efforts to improve health care quality (1). Physicians are encouraged to identify, appraise, and apply the best evidence in their decision making for individual patients.\\u000a However, this ideal remains far from realization. Physicians leave the

Michael L. Green

313

History and Development of Evidence-based Medicine  

Microsoft Academic Search

This article illustrates the timeline of the development of evidence-based medicine (EBM). The term “evidence-based medicine” is relatively new. In fact, as far as we can tell, investigators from McMaster’s University began using the term during the 1990s. EBM was defined as “a systemic approach to analyze published research as the basis of clinical decision making.” Then in 1996, the

Jeffrey A. Claridge; Timothy C. Fabian

2005-01-01

314

The art of inconsistency: evidence-based practice my way.  

PubMed

Inconsistency of care in the Neonatal Intensive Care Unit is a common complaint amongst caregivers. This paper discusses evidence-based medicine and standards of care in relation to personal preference where care-giving choices are concerned. It is suggested that moral distress may be diminished by consistently applying evidence-based practice, adhering to standards of care and optimizing the team dynamic by engaging in consensus-based collaboration. PMID:19710655

Golec, L

2009-09-01

315

From evidence-based medicine to genomic medicine  

Microsoft Academic Search

The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding\\u000a and in delivering the health care. Clinicians, public health practitioners, health commissioners\\/purchasers, health planners,\\u000a politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based\\u000a medicine’ aims at the conscientious, explicit and judicious use of the

Dhavendra Kumar

2007-01-01

316

Evidence-Based Public Health: Origins, Assumptions, and Cautions  

Microsoft Academic Search

\\u000a This chapter presents the origins and assumptions of evidence-based medicine as rooted in the philosophy of science called\\u000a positivism. The basic principles of the positivist approach to science, empiricism, exclusivity, universality, and autonomy\\u000a are explained and identified in reproductive and perinatal health outcomes related studies from the systematic reviews of\\u000a the Cochrane Library, the premier database on evidence-based medicine. A

Luis A. Avilés; Dani Filc

317

Overcoming Challenges to Using Evidence-Based Interventions in Schools  

Microsoft Academic Search

The Center for School Mental Health Assistance at the University of Maryland recently completed a review of evidence-based prevention and treatment programs that can be used by school mental health clinicians. Based on the review, a school-based program operating in 22 Baltimore City schools has purchased and trained clinicians in a number of protocols for evidence-based interventions. We present findings

Cindy M. Schaeffer; Eric Bruns; Mark Weist; Sharon Hoover Stephan; Julie Goldstein; Yolanda Simpson

2005-01-01

318

Evidence Based Medicine in Pediatric Practice: Brief Review  

PubMed Central

Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715

Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin

2010-01-01

319

Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial  

Microsoft Academic Search

BACKGROUND:: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based

Philipp Schuetz; Mirjam Christ-Crain; Marcel Wolbers; Ursula Schild; Robert Thomann; Claudine Falconnier; Isabelle Widmer; Stefanie Neidert; Claudine A Blum; Ronald Schönenberger; Christoph Henzen; Thomas Bregenzer; Claus Hoess; Martin Krause; Heiner C Bucher; Werner Zimmerli; Beat Müller

2007-01-01

320

Surveillance, prevention and control of hospital-acquired infections  

Microsoft Academic Search

Summary One thousand post-mortem reports were analysed retrospectively to see whether the patient had had a nosocomial or community-acquired infection and whether this led directly to or contributed to the patient's death. In 7.4% of all autopsies nosocomial infection was the direct cause of death. In 6.3% of the patients, nosocomial infection was a contributory factor leading to death. The

F. Daschner; H. Nadjem; H. Langmaack; W. Sandritter

1978-01-01

321

Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice  

ERIC Educational Resources Information Center

Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

2014-01-01

322

Evidence Based Dental Care: Integrating Clinical Expertise with Systematic Research  

PubMed Central

Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the “gold standard” in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21st century, more and more practitioners are joining the train, more education on the subject is being provided to elucidate the knotty areas and there is increasing advocacy for the emergence of the field into a specialty discipline. Evidence-Based Dentistry (EBD), if endorsed by the dental profession, including the research community, may well- influence the extent to which society values dental research. Hence, dental researchers should understand the precepts of EBD, and should also recognize the challenges it presents to the research community to strengthen the available evidence and improve the processes of summarizing the evidence and translating it into practice This paper examines the concept of evidence-based dentistry (EBD), including some of the barriers and will discuss about clinical practice guidelines. PMID:24701551

Kishore, Mallika; Panat, Sunil R.; Aggarwal, Ashish; Agarwal, Nupur; Upadhyay, Nitin; Alok, Abhijeet

2014-01-01

323

Specialized Community-Based Care: An Evidence-Based Analysis  

PubMed Central

Background Specialized community-based care (SCBC) refers to services that manage chronic illness through formalized links between primary and specialized care. Objectives The objectives of this evidence-based analysis (EBA) were as follows: to summarize the literature on SCBC, also known as intermediate care to synthesize the evidence from previous Medical Advisory Secretariat (now Health Quality Ontario) EBAs on SCBC for heart failure, diabetes, chronic obstructive pulmonary disease (COPD), and chronic wounds to examine the role of SCBC in family practice Results Part 1: Systematic Review of Intermediate Care Seven systematic reviews on intermediate care since 2008 were identified. The literature base is complex and difficult to define. There is evidence to suggest that intermediate care is effective in improving outcomes; however, the effective interventions are still uncertain. Part 2: Synthesis of Evidence in Intermediate Care Mortality • Heart failure Significant reduction in patients receiving SCBC • COPD Nonsignificant reduction in patients receiving SCBC Hospitalization • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Emergency Department Visits • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Disease-Specific Patient Outcomes • COPD Nonsignificant improvement in lung function in patients receiving SCBC • Diabetes Significant reduction in hemoglobin A1c (HbA1c) and systolic blood pressure in patients receiving SCBC • Chronic wounds Significant increase in the proportion of healed wounds in patients receiving SCBC Quality of Life • Heart failure Trend toward improvement in patients receiving SCBC • COPD Significant improvement in patients receiving SCBC Part 3: Intermediate Care in Family Practice—Evidence-Based Analysis Five randomized controlled trials were identified comparing SCBC to usual care in family practice. Inclusion criteria were 1) the presence of multiple chronic conditions, and 2) interventions that included 2 or more health care professions. The GRADE quality of the evidence was assessed as low for all outcomes due to the inconsistency and indirectness of the results. Limitations This review did not look at disease-specific studies on intermediate care in family practice. Conclusions Specialized community-based care effectively improves outcomes in patients with heart failure, COPD, and diabetes. The effectiveness of SCBC in family practice is unclear. PMID:23226812

2012-01-01

324

Disruptive Innovations for Designing and Diffusing Evidence-based Interventions  

PubMed Central

The numbers of evidence-based interventions (EBIs) have been growing exponentially, both therapeutic and prevention programs. Yet, EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically re-examine our scientific conventions and norms. Innovation may be spurred by re-examining the biomedical model for validating EBIs and the compartmentalization of EBIs as disease-specific, institutionally-based, counseling programs. The model of Disruptive Innovations suggests that we re-engineer EBIs based on their most robust features in order to reach more people in less time and at lower cost. Four new research agendas will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. PMID:22545596

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F.

2013-01-01

325

Pediatric nerve blocks: an evidence-based approach.  

PubMed

Successful injury management is often dependent upon optimal pain control. Many injuries do not require procedural sedation or systemic analgesia, and emergency clinicians have used peripheral nerve blocks for several decades for these injuries. Nerve blocks deliver anesthetic to the nerve that corresponds to the sensory innervation of the area where the wound or injury is located. In the pediatric setting, some nerve block modalities require modification to the approach and techniques commonly used in adult patients due to the age and weight of the child, the ability of the patient to cooperate, and the ability of the emergency clinician to observe pain response. Peripheral nerve blocks have a high rate of success for effective local anesthesia and a low rate of complications, making them an attractive option for analgesia in the management of some injuries. This evidence-based review summarizes the advantages and disadvantages of peripheral nerve blocks, reviews commonly used local anesthetics, describes the landmark technique for the most common nerve blocks used in pediatric emergency medicine, and presents literature on ultrasound-guided technology. PMID:24191378

Duchicela, Sacha; Lim, Anthoney

2013-10-01

326

Evidence-based control of plaque and gingivitis.  

PubMed

Most adults brush and floss inadequately, and constant education and/or reinforcement is often required. Bacteria are usually left behind with mechanical oral health routines, and chemotherapeutic agents may have a key role as adjuncts to daily home-care. To date, two antiseptic mouthwashes have received the ADA Seal of Acceptance: Peridex (Zila Pharmaceuticals, Phoenix, AZ, USA; CHX, chlorhexidine) and Listerine (Pfizer Consumer Healthcare, Morris Plains, NJ, USA; essential oil (EO) mouthwash). CHX has a strong affinity for tooth and tissue surfaces, but can cause brown staining on the teeth and tongue. Patients must also wait until all traces of toothpaste are removed before rinsing with CHX. Long-term use of an EO mouthwash is microbiologically safe, with no changes observed in the bacterial composition of supragingival plaque, and no evidence of antimicrobial resistance. A number of trials have demonstrated the long-term plaque- and gingivitis-reducing properties of both CHX and EO mouthwashes. These studies clearly demonstrate that these agents have lasting efficacy, and can access hard-to-reach areas. PMID:12787197

Santos, A

2003-01-01

327

A new challenge for malaria control in Brazil: asymptomatic Plasmodium infection - a review  

Microsoft Academic Search

The evolution of malaria in Brazil, its morbidity, the malaria control programs, and the new challenges for these programs in the light of the emergence of asymptomatic infection in the Amazon region of Brazil were reviewed. At least six Brazilian research groups have demonstrated that asymptomatic infection by Plasmodium is an important impediment to malaria control, among mineral prospectors in

José Rodrigues Coura; Martha Suárez-Mutis; Simone Ladeia-Andrade

2006-01-01

328

Expanding the Domains of Attitudes Towards Evidence-Based Practice: The Evidence Based Practice Attitude Scale50  

Microsoft Academic Search

Mental health and social service provider attitudes toward evidence-based practice have been measured through the development\\u000a and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61–74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership.\\u000a However, the EBPAS assesses only four domains of attitudes toward EBP. The current

Gregory A. AaronsGuy; Guy Cafri; Lindsay Lugo; Angelina Sawitzky

329

Comparison of four teaching methods on Evidence-based Practice skills of postgraduate nursing students.  

PubMed

The aim of this study was to compare four teaching methods on the evidence-based practice knowledge and skills of postgraduate nursing students. Students enrolled in the Evidence-based Nursing (EBN) unit in Australia and Hong Kong in 2010 and 2011 received education via either the standard distance teaching method, computer laboratory teaching method, Evidence-based Practice-Digital Video Disc (EBP-DVD) teaching method or the didactic classroom teaching method. Evidence-based Practice (EBP) knowledge and skills were evaluated using student assignments that comprised validated instruments. One-way analysis of covariance was implemented to assess group differences on outcomes after controlling for the effects of age and grade point average (GPA). Data were obtained from 187 students. The crude mean score among students receiving the standard+DVD method of instruction was higher for developing a precise clinical question (8.1±0.8) and identifying the level of evidence (4.6±0.7) compared to those receiving other teaching methods. These differences were statistically significant after controlling for age and grade point average. Significant improvement in cognitive and technical EBP skills can be achieved for postgraduate nursing students by integrating a DVD as part of the EBP teaching resources. The EBP-DVD is an easy teaching method to improve student learning outcomes and ensure that external students receive equivalent and quality learning experiences. PMID:23107585

Fernandez, Ritin S; Tran, Duong Thuy; Ramjan, Lucie; Ho, Carey; Gill, Betty

2014-01-01

330

Immune control strategies for vaccinia virus-related laboratory-acquired infections.  

PubMed

While presenting biological characteristics of vaccinia virus and laboratory-acquired infections during related research processes, this paper focuses on benefits and risks of vaccinia virus immunization in relation to laboratory-acquired infections, describes characteristics and the adaptation of vaccinia virus vaccine, analyses the role vaccinia virus immunization plays in the prevention and control of laboratory-acquired infections, and finally proposes solutions and countermeasures to further promote and implement immune control strategies. The problem related to immune strategy and laboratory- acquired infections which is being raised, analyzed and explored plays an active and instructive role in vaccinia virus related researches and laboratory- acquired infections, and also helps to recommend and develop relevant immune strategy for future vaccine control of such infections. PMID:24625408

Wei, Qiang; Jiang, Meng Nan; Han, Jun; Wang, Zi Jun

2014-02-01

331

Risk factors for acquisition of gentamicin-resistant enterococcal infection: a case-controlled study  

PubMed Central

High-level gentamicin-resistant enterococci present problems in the treatment of infected patients, especially as synergy between penicillin and gentamicin is lost. Previous studies have suggested various risk factors for the acquisition of these enterococci. A case-controlled study was performed on 17 patients infected with resistant enterococci and 26 infected with sensitive strains who attended a London hospital. The key risk factors for acquisition of infection with high-level gentamicin-resistant enterococci were found to be prior prolonged antibiotic treatment, use of five or more antibiotics, and the presence of a urinary catheter. It is proposed that infection control measures should be targeted at patients at higher risk. In addition, control of antibiotic usage in a hospital may help to prevent acquisition and spread of these organisms.???Keywords: gentamicin-resistant enterococci; enterococcal infection PMID:10435168

Viagappan, M; Holliman, R

1999-01-01

332

Evidence based prevention of acute injuries during physical exercise in a WHO safe community  

Microsoft Academic Search

Objective—To evaluate a community based programme for evidence based prevention of injuries during physical exercise. Design—Quasi-experimental evaluation using an intervention population and a non-random control population. Participants—Study municipality (popula- tion 41 000) and control municipality (population 26 000) in Sweden. Main outcome measures—Morbidity rate for sports related injuries treated in the health care system; severity classification according to the abbreviated

T Timpka; K Lindqvist

2001-01-01

333

An Evidence Base for Human Spaceflight Risks in Wikipedia  

NASA Technical Reports Server (NTRS)

NASA's Human Research Program (HRP) is focused on understanding and mitigating thirty two risks to crew health and performance in exploration missions beyond low Earth orbit. The HRP has developed an evidence report for each of the risks. Most evidence reports are a brief review article describing the evidence related to a specified risk, written at a level appropriate for the scientifically educated, non-specialist reader. Each evidence report captured the current state of knowledge from both research and operations. Two limitations of the evidence reports have become apparent: 1) they are updated infrequently and 2) they do not take full advantage of the expertise available in other space agencies and in related fields of terrestrial research. Therefore, the HRP is experimenting with the use of Wikipedia articles as a repository for evidence. Wikipedia's accessibility to the international space flight community and researchers in related terrestrial fields creates the opportunity to generate a more timely and comprehensive evidence base. Initial Wikipedia articles were populated for seven risks using a subset of the information in the HRP-approved evidence reports: Fatigue and Sleep Loss, Treating An Ill or Injured Crew Member, Radiation Carcinogenesis, Visual Impairment and Intracranial Pressure, Renal Stone Formation, Team Cohesion, and Intervertebral Disc Damage. Since the initial articles were created, there have been additions to these Wikipedia articles, including content from sources outside the HRP, and editorial changes to the pages. We will report on the nature of the contributions made after the initial articles were created, the comprehensiveness of the resulting Wikipedia articles, and the effort required to maintain quality control of the content. The Wikipedia approach will also be compared to wiki efforts that exert more traditional editorial control of content prior to posting.

Kundrot, Craig; Steil, Jennifer; Lumpkins, Sarah; Pellis, Neal

2013-01-01

334

Synchronized Infection of Cell Cultures by Magnetically Controlled Virus  

PubMed Central

To override the diffusion-limited adsorption step of viral infection, we magnetically synchronized cell attachment. Human immunodeficiency virus type 1-based lentivirus preparations were rendered magnetically reactive by association with magnetite nanoparticles, 50 nm in diameter. Application of a magnetic field resulted in immediate redistribution of the viral inoculum to the cell-associated state and completion of the productive adsorption process within 1 min. Independent of adsorption time, viral concentration, and diffusion rate, infection subsequently progressed by the receptor-mediated entry mechanism. Synchronization of this rate-limiting step of infection may now be applied to analyze isolated events in the viral replication sequence. PMID:15596857

Haim, Hillel; Steiner, Israel; Panet, Amos

2005-01-01

335

Surgeon's garb and infection control: what's the evidence?  

PubMed

Surgical site infections are an important complication resulting from surgery. Before the 20th century a significant number of surgeries resulted in death from sepsis. One of the rituals resulting from efforts to reduce infection is the donning of surgical garb. A large body of literature has developed on the efficacy of these specialized garments. The available evidence for the efficacy of each individual garb at reducing surgical site infections will be explored. The relevance of this evidence to the outpatient dermatologic surgery setting will also be discussed. PMID:20850894

Eisen, Daniel B

2011-05-01

336

Combining Biofilm-Controlling Compounds and Antibiotics as a Promising New Way to Control Biofilm Infections  

PubMed Central

Many bacteria grow on surfaces forming biofilms. In this structure, they are well protected and often high dosages of antibiotics cannot clear infectious biofilms. The formation and stabilization of biofilms are mediated by diffusible autoinducers (e.g. N-acyl homoserine lactones, small peptides, furanosyl borate diester). Metabolites interfering with this process have been identified in plants, animals and microbes, and synthetic analogues are known. Additionally, this seems to be not the only way to control biofilms. Enzymes capable of cleaving essential components of the biofilm matrix, e.g. polysaccharides or extracellular DNA, and thus weakening the biofilm architecture have been identified. Bacteria also have mechanisms to dissolve their biofilms and return to planktonic lifestyle. Only a few compounds responsible for the signalling of these processes are known, but they may open a completely novel line of biofilm control. All these approaches lead to the destruction of the biofilm but not the killing of the pathogens. Therefore, a combination of biofilm-destroying compounds and antibiotics to handle biofilm infections is proposed. In this article, different approaches to combine biofilm-controlling compounds and antibiotics to fight biofilm infections are discussed, as well as the balance between biofilm formation and virulence.

Estrela, Andreia Bergamo; Abraham, Wolf-Rainer

2010-01-01

337

Evidence-based reproductive medicine: a critical appraisal  

PubMed Central

Evidence-based medicine has become the golden standard of good medical practice. I analysed meta-analyses and systematic reviews, the cornerstones of evidence-based medicine, pertaining to two important problems in in vitro fertilization: failed implantation and poor ovarian response to ovarian stimulation. Numerous interventions and procedures have been tried to facilitate implantation and to enhance the ovarian response to stimulation. Notwithstanding the fact that many clinical trials have been performed, very few procedures can as yet stand the critical test of evidence-based medicine. A plea is made for co-ordination between clinicians and reviewers and co-operation between infertility centres to combine their efforts to set up sufficiently powered clinical trials to arrive at more solid evidence for a number of interventions in in vitro fertilization programmes. PMID:24753948

Dhont, M.

2013-01-01

338

Model for Implementing Evidence Based Health Care System in Iran  

PubMed Central

Background: Regarding the role and importance of paradigm of evidence based practice and its remarkable impact on the effectiveness and efficiency of clinical services and healthcare, development of an integrated system seems necessary in order to manage dispersed data and ensure using evidence in clinical decision making, thus the aim of this study was designing a model for implementing national system of evidence based health care in Iran. Methodos: This paper is a study of comparative type which has been written in three stages: investigation of structure and process of evidence based practice in selected countries, investigation and analysis of current status in Iran in this regard and recommendation of strategies which make model implementation feasible in the country. Such methods as review of literature, focus group discussion and Delphi technique were used for investigation. Results: According to studies, insuring an evidence based practice culture in the country requires a system called National Evidence Based Health Care System which consists of three subsystems including national system of clinical knowledge management, national evidence-based practice system and integrated national network of clinical effectiveness. Conclusion: The ultimate goal of health care system in every country is maintaining and improving community health. Achievement of this goal depends on effectiveness of delivered services and consistency of the services with national and local priorities. In order to achieve clinical effectiveness, the best practice should be realized in the country, implementation of which requires a set of macro and micro strategies enabling facilitation, promotion or guaranteeing clinical knowledge application in the country. PMID:24427754

MANAVI, Saeed; OLYAEE MANESH, Alireza; YAZDANI, Shahram; SHAMS, Lida; NASIRI, Taha; SHIRVANI, Armin; EMAMI RAZAVI, Hasan

2013-01-01

339

Reduction of inequalities in health: assessing evidence-based tools  

PubMed Central

Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the goal of equitable health development. PMID:17005046

Tugwell, Peter; O'Connor, Annette; Andersson, Neil; Mhatre, Sharmila; Kristjansson, Elizabeth; Jacobsen, Mary Jane; Robinson, Vivian; Hatcher-Roberts, Jan; Shea, Beverley; Francis, Daniel; Beardmore, Jil; Wells, George A; Losos, Joe

2006-01-01

340

[Ethical problems in clinical practice of evidence-based medicine].  

PubMed

Ethical problems as consequences of evidence-based medicine (EBM) have insufficiently been investigated and discussed. EBM--as initially intended--is usually interpreted as an attempt to treat patients individually with respect to their personal preferences and the present situation according to the best available clinical evidence. This practice is in line with accepted medical ethics. Therefore, it does not appear to be a relevant issue for discussion at first sight. However, between the theoretical concept and the practical use (or misuse) of this approach discrepancies exist which require some considerations. In particular the practical use of EBM generates a number of ethical problems: EBM is increasingly misused as an instrument of resource-allocation. Based on randomized controlled trials (RCTs) for very specific patient groups, the general access to medical supply is regulated and limited. The recurrence to general ("supra-individual") external evidence may additionally be in strong contrast to the individual patients' intentions and will and leads to conflicts for therapy decisions. If no longer the individual preferences and the patients' will are in the center of therapy decisions but a so called "general welfare", the mutual trust between patient and doctor is eroded. The utilitaristic approach of a primacy of this general welfare in opposition to the individual welfare is favored by the present interpretation and use of EBM. This conflicts with the perception of the doctor as a patient's advocate. However, the doctor being the patient's advocate is the basis of the traditional medical ethos. We should take care that we do not completely lose the basis of our medical ethos. PMID:19585442

Rogler, G; Fröhlich, G

2009-07-01

341

Mental Health Clinicians' Experiences of Implementing Evidence-Based Treatments  

PubMed Central

Implementation research has tremendous potential to bridge the research-practice gap; however, we know more about barriers to evidence-based care than the factors that contribute to the adoption and sustainability of evidence-based treatments (EBTs). This qualitative study explores the experiences of clinicians (N = 11) who were implementing EBTs, highlighting the factors that they perceived to be most critical to successful implementation. The clinicians’ narratives reveal many leverage points that can inform administrators, clinical supervisors, and clinicians who wish to implement EBTs, as well as other stakeholders who wish to develop and test strategies for moving EBTs into routine care. PMID:24066630

Powell, Byron J.; Hausmann-Stabile, Carolina; McMillen, J. Curtis

2013-01-01

342

Application of meta-analysis in evidence-based oncology  

Microsoft Academic Search

The Cochrane Collaboration is an international not-for-profit and independent organization, dedicated to providing up-to-date\\u000a evidence-based information about the effects of healthcare in the form of systematic reviews. Meta-analysis is a statistical\\u000a tool to prepare the systematic reviews. This paper briefly introduces the above terms and how to apply evidence-based oncology.\\u000a Recent findings by using meta-analysis for cancers of the breast,

Xiaoping Lin; Qingsheng Wang

2008-01-01

343

Evidence-based topical management of chronic wounds according to the T.I.M.E. principle.  

PubMed

The number of patients suffering from chronic wound healing disorders in Germany alone is estimated to be 2.5-4 million. Therapy related expenses reach 5-8 billion Euros annually. This number is partially caused by costly dressing changes due to non-standardized approaches and the application of non-evidence-based topical wound therapies. The purpose of this paper is to elucidate a straightforward principle for the management of chronic wounds, and to review the available evidence for the particular therapy options. The T.I.M.E.-principle (Tissue management, Inflammation and infection control, Moisture balance, Epithelial [edge] advancement) was chosen as a systematic strategy for wound bed preparation. Literature was retrieved from the PubMed and Cochrane Library databases and subjected to selective analysis. Topical wound management should be carried out according to a standardized principle and should further be synchronized to the phases of wound healing. Despite the broad implementation of these products in clinical practice, often no benefit exists in the rate of healing, when evaluated in meta-analyses or systematic reviews. This insufficient evidence is additionally limited by varying study designs. In case of non-superiority, the results suggest to prefer relatively inexpensive wound dressings over expensive alternatives. Arbitrary endpoints to prove the effectiveness of wound dressings, contribute to the random use of such therapies. Defining rational endpoints for future studies as well as the deployment of structured therapy strategies will be essential for the economical and evidence-based management of chronic wounds. PMID:23848976

Klein, Silvan; Schreml, Stephan; Dolderer, Juergen; Gehmert, Sebastian; Niederbichler, Andreas; Landthaler, Michael; Prantl, Lukas

2013-09-01

344

Azithromycin is able to control Toxoplasma gondii infection in human villous explants  

PubMed Central

Background Although Toxoplasma gondii infection is normally asymptomatic, severe cases of toxoplasmosis may occur in immunosuppressed patients or congenitally infected newborns. When a fetal infection is established, the recommended treatment is a combination of pyrimethamine, sulfadiazine and folinic acid (PSA). The aim of the present study was to evaluate the efficacy of azithromycin to control T. gondii infection in human villous explants. Methods Cultures of third trimester human villous explants were infected with T. gondii and simultaneously treated with either PSA or azithromycin. Proliferation of T. gondii, as well as production of cytokines and hormones by chorionic villous explants, was analyzed. Results Treatment with either azithromycin or PSA was able to control T. gondii infection in villous explants. After azithromycin or PSA treatment, TNF-?, IL-17A or TGF-?1 levels secreted by infected villous explants did not present significant differences. However, PSA-treated villous explants had decreased levels of IL-10 and increased IL-12 levels, while treatment with azithromycin increased production of IL-6. Additionally, T. gondii-infected villous explants increased secretion of estradiol, progesterone and HCG?+??, while treatments with azithromycin or PSA reduced secretion of these hormones concurrently with decrease of parasite load. Conclusions In conclusion, these results suggest that azithromycin may be defined as an effective alternative drug to control T. gondii infection at the fetal-maternal interface. PMID:24885122

2014-01-01

345

[Prevention of nosocomial infections by bundles. Evidence and practical implementation].  

PubMed

There are numerous guidelines for the prevention of hospital-acquired infections; however, adherence to these guidelines is only limited. The bundle concept was developed to facilitate the implementation by prioritizing certain measures. A bundle contains 3-5 evidence-based key interventions. The bundle concept has been successfully applied to reduce central catheter-related bloodstream infections and ventilation-associated pneumonia whereby only strict compliance can help to reduce infections; therefore, the right implementation strategy is essential. This means accurate planning, delegation of responsibilities, education, control of compliance and infection surveillance. PMID:23361107

Gebhardt, F E; Wantia, N

2013-03-01

346

Airway epithelial control of Pseudomonas aeruginosa infection in cystic fibrosis  

PubMed Central

Defective expression or function of the cystic fibrosis transmembrane conductance regulator (CFTR) underlies the hypersusceptibility of cystic fibrosis (CF) patients to chronic airway infections, particularly with Pseudomonas aeruginosa. CFTR is involved in the specific recognition of P. aeruginosa, thereby contributing to effective innate immunity and proper hydration of the airway surface layer (ASL). In CF, the airway epithelium fails to initiate an appropriate innate immune response, allowing the microbe to bind to mucus plugs that are then not properly cleared because of the dehydrated ASL. Recent studies have identified numerous CFTR-dependent factors that are recruited to the epithelial plasma membrane in response to infection and that are needed for bacterial clearance, a process that is defective in CF patients hypersusceptible to infection with this organism. PMID:18262467

Camp?donico, Victoria L; Gadjeva, Mihaela; Paradis-Bleau, Catherine; Uluer, Ahmet; Pier, Gerald B

2013-01-01

347

Emerging Patterns of HIV Infection and Control in the Philippines  

PubMed Central

A total of 50 carriers of the human immunodeficiency virus (HIV), 46 of them female prostitutes, have been detected through seroprevalence surveys by the Department of Health, Manila. Infection rates are highest in two small cities near foreign military bases and in the tourist district of MetroManila. Nine patients with the acquired immunodeficiency syndrome (AIDS) who contracted the disease outside the country have been reported, with opportunistic infections being the major clinical feature. Public information measures heavily utilize the mass media, and there is anecdotal evidence that awareness of the disease among the urban population is increasing. The National AIDS Committee foresees that a large proportion of the cases seen in the Philippines over the next few years will be returning nationals who were infected abroad. Images PMID:3433757

Dayrit, Manuel M.; Monzon, Ofelia T.; Basaca-Sevilla, Virginia; Hayes, Curtis G.

1987-01-01

348

The future of HIV prevention: control of sexually transmitted infections and circumcision interventions  

Microsoft Academic Search

Prevention and control of sexually transmitted infections (STIs) has proven effective in reducing HIV infection when treatment is available promptly for symptomatic persons in conditions of an emerging epidemic. Biologically, it is assumed that reduced genital tract inflammation reduces infectiousness for HIV as well as reducing susceptibility in HIV-uninfected persons. Male circumcision has been demonstrated effective in reducing risk for

Vikrant V. Sahasrabuddhe; Sten H. Vermund

2007-01-01

349

Protecting health care workers from SARS and other respiratory pathogens: A review of the infection control  

Microsoft Academic Search

Methods: This paper presents a review of the current scientific knowledge with respect to the efficacy of personal protective equipment in preventing the transmission of respiratory infections. The effectiveness of infection control polices and procedures used in clinical practice is examined. Results: Literature searches were conducted in several databases for articles published in the last 15 years that related to

Bruce Gamage; David Moore; Ray Copes; Annalee Yassi; Elizabeth Bryce

350

Appraisal of recommended respiratory infection control practices in primary care and emergency department  

Microsoft Academic Search

Background: The severe acute respiratory syndrome (SARS) epidemic and concern about pandemic influenza prompted the Cen- ters for Disease Control and Prevention (CDC) to develop guidelines to prevent the transmission of all respiratory infections in health care settings during first contact with a potentially infected person. The extent to which health care workers and institutions use these CDC recommended practices

Wayne Turnberg; William Daniell; Noah Seixas; Terri Simpson; Jude Van Buren; Edward Lipkin; Jeffery Duchin

351

Infection!  

NSDL National Science Digital Library

Play Infection! the game where you're the germ. And while you play, learn about the way your body fights infections.The game works best in Netscape 4 and Internet Explorer 4 or later. You will need to download Shockwave, but don't worry, you can do that right from the site.

York, Amercian M.

352

Long-term follow-up outcomes of perinatally HIV-infected adolescents: infection control but school failure.  

PubMed

Perinatally human immunodeficiency virus (HIV)-infected children are fighting acquired immune deficiency syndrome (AIDS) and becoming adolescents. The objective of this study was to examine long-term outcomes among perinatally HIV-1-infected adolescents. Cross-sectional clinical and laboratory data were collected for 49 perinatally HIV-infected adolescents followed at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP's) Hospital from 1987 to 2007. The mean age of these adolescents was 12.5 years, the majority were female (73.5%) with a mean follow-up duration of 9.0 years, 71.4% of adolescents had no signs of HIV infection, 81.6% had normal CD4(+) lymphocyte count, and 53.1% had undetectable HIV viral load. HIV disclosure to the adolescent was reported in 31 (63.3%) participants. The majority were in school (89.8%) but failure and drop-out were reported by 51% and 28.6% of the subjects, respectively. All five domains of quality of life (QOL) measured revealed high scores. The majority of long-term adolescent survivors showed HIV-infection control and high scores of QOL, but with problems in schooling functioning that need early detection and intervention. PMID:20167634

Souza, Edvaldo; Santos, Nicole; Valentini, Sophia; Silva, Gerlane; Falbo, Ana

2010-12-01

353

Toward an Evidence-Based Assessment of Pediatric Bipolar Disorder  

ERIC Educational Resources Information Center

This article outlines a provisional evidence-based approach to the assessment of pediatric bipolar disorder (PBD). Public attention to PBD and the rate of diagnosis have both increased substantially in the past decade. Accurate diagnosis is crucial to avoid harm due to mislabeling or unnecessary medication exposure. Because there are no proven…

Youngstrom, Eric A.; Findling, Robert L.; Kogos Youngstrom, Jen; Calabrese, Joseph R.

2005-01-01

354

Evidence-Based Psychosocial Treatments for Child and Adolescent Depression  

Microsoft Academic Search

The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines, the cognitive-behavioral

Corinne David-Ferdon; Nadine J. Kaslow

2008-01-01

355

Evidence-Based Clinical Voice Assessment: A Systematic Review  

ERIC Educational Resources Information Center

Purpose: To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method: The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language…

Roy, Nelson; Barkmeier-Kraemer, Julie; Eadie, Tanya; Sivasankar, M. Preeti; Mehta, Daryush; Paul, Diane; Hillman, Robert

2013-01-01

356

Commentary: evidence-based practice and forensic psychiatry.  

PubMed

A diverse sampling of articles was considered as a landscape against which evidence-based practice has been and should be a part of forensic psychiatry. Caveats were identified, limitations suggested, and recommendations made as to how such a marriage might work. PMID:20018998

Schneider, Richard D

2009-01-01

357

Organizing for Evidence-Based Decision Making and Improvement  

ERIC Educational Resources Information Center

In today's accountability climate, regional accrediting bodies are requiring colleges and universities to develop and sustain a culture of evidence-based decision making and improvement. But two-thirds of college presidents in a 2011 "Inside Higher Ed" survey said their institutions are not particularly strong at using data for making decisions.…

Leimer, Christina

2012-01-01

358

Barriers and Enablers to Evidence-Based Practices  

ERIC Educational Resources Information Center

The importance of educational practices based on evidence is well-supported in the literature, however barriers to their implementation in classrooms still exist. This paper examines the phenomenon of evidence-based practice in education highlighting enablers and barriers to their implementation with particular reference to RTLB practice.

Foster, Robyn

2014-01-01

359

The Concept of Evidence in Evidence-Based Practice  

ERIC Educational Resources Information Center

There exists a vast literature on evidence-based practice (EBP) in education. The debate branches out in several directions, for example, what EBP entails for the nature of educational practice, what it entails for the teaching profession, what counts as use and abuse of evidence, and what educational research could or should contribute to a what…

Kvernbekk, Tone

2011-01-01

360

Unraveling Evidence-Based Practices in Special Education  

ERIC Educational Resources Information Center

Evidence-based practices (EBPs) are instructional techniques that meet prescribed criteria related to the research design, quality, quantity, and effect size of supporting research, which have the potential to help bridge the research-to-practice gap and improve student outcomes. In this article, the authors (a) discuss the importance of clear…

Cook, Bryan G.; Cook, Sara Cothren

2013-01-01

361

What Is "Evidence-Based Practice" in Geography Education?  

ERIC Educational Resources Information Center

Educationalists developed the concept of "evidence-based practice" during the 1990s because of concern about the relevance of educational research to practitioners and about its impact on their practice. This article outlines the different kinds of research evidence related to geographical education, which might inform practice. It then discusses…

Roberts, Margaret

2010-01-01

362

Evidence-Based Practices and Implementation Science in Special Education  

ERIC Educational Resources Information Center

Establishing a process for identifying evidence-based practices (EBPs) in special education has been a significant advance for the field because it has the potential for generating more effective educational programs and producing more positive outcomes for students with disabilities. However, the potential benefit of EBPs is bounded by the…

Cook, Bryan G.; Odom, Samuel L.

2013-01-01

363

Making the Case for Evidence-Based Practice  

ERIC Educational Resources Information Center

Evidence-based practice is the collection, interpretation, and use of data, such as collection statistics or assessment results, that measure the effectiveness of a library media program. In this article, the authors will present various forms of evidence and show that any library media specialist can use data to make informed decisions that…

Bates, Joanne; McClure, Janelle; Spinks, Andy

2010-01-01

364

Disseminating Evidence-Based Practices in Secondary Transition  

ERIC Educational Resources Information Center

As educators move into a new era of educational reform, it becomes imperative that teachers use evidence-based instructional practices shown to be effective for students with disabilities. One area that plays a role in this process is secondary transition. The National Secondary Transition Technical Assistance Center has identified 63…

Mustian, April; Mazzotti, Valerie L.; Test, David W.

2013-01-01

365

Evidence-Based Practice in the Social Services  

Microsoft Academic Search

Evidence-based practice integrates individual practitioner expertise with the best available evidence while also considering the values and expectations of clients. Research can be categorized into two broad areas: primary (experiments, clinical trials, and surveys) and secondary research (overviews of major studies, practice guidelines, and decision and economic analyses). One of the major challenges to incorporating research evidence into organizational life

Michelle Johnson; Michael J. Austin

2008-01-01

366

Evidence-Based Practice: Beyond Empirically Supported Treatments  

Microsoft Academic Search

Must the clinician choose between a practice that is strictly objective and data based and one that is purely subjective and experience based? Optimally, practitioners need to follow a model of evidence-based psychotherapy practice, such as the disciplined inquiry or local clinical scientist model, that encompasses a theoretical formulation, empirically supported treatments (ESTs), empirically supported therapy relationships, clinicians' accumulated practical

Stanley B. Messer

2004-01-01

367

Developing the skills required for evidence-based practice  

Microsoft Academic Search

The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research

Beverley French

1998-01-01

368

Qualitative research in evidence-based practice: a valuable partnership  

Microsoft Academic Search

Purpose – The purpose of this paper is to discuss the nature of the qualitative research paradigm, with a particular emphasis on the marginalization of qualitative approaches within the current discourse of evidence-based librarianship. Design\\/methodology\\/approach – The paper presents examples of qualitative research in the field of library and information studies, reviews the discourse of EBL as it relates to

Lisa Given

2006-01-01

369

How Evidence-Based Practices Contribute to Community Integration  

Microsoft Academic Search

Since the groundbreaking work of the Robert Wood Johnson Conference in 1998 identifying six evidence-based practices (EBPs) for people with severe mental illness (SMI), the mental health field has moved in the direction of re-examination and redesign of service systems. Surprisingly, one area that has not been fully explicated is the role that EBPs play in promoting community integration. In

Gary R. Bond; Michelle P. Salyers; Angela L. Rollins; Charles A. Rapp; Anthony M. Zipple

2004-01-01

370

Evidence-Based Practice in the Early Childhood Field  

ERIC Educational Resources Information Center

Evidence-based practice is a decision-making process that integrates the best available scientific research evidence with family and professional wisdom and values. The editors argue that it has the potential to transform the services provided to children and families because it incorporates the "different ways of knowing" that characterize early…

Buysse, Virginia, Ed.; Wesley, Patricia W., Ed.

2006-01-01

371

INTEGRATING EVIDENCE-BASED PRACTICE AND SOCIAL WORK FIELD EDUCATION  

Microsoft Academic Search

The social work academic community is currently considering and critiquing the idea of evidence-based practice (EBP). Given the vital part that practicum education plays in the social work profession, understanding the views of field instructors on this subject is essential. The George Warren Brown School of Social Work at Washington University surveyed 283 field instructors within 180 agencies and found

Tonya Edmond; Deborah Megivern; Cynthia Williams; Estelle Rochman; Matthew Howard

2006-01-01

372

Evidence-Based Interprofessional Practice: Learning and Behaviour  

ERIC Educational Resources Information Center

The purpose of this journal article is to investigate evidence-based practice (EBP) or He Ritenga Whaimohio, as one of the seven principles outlined in the "Resource Teacher: Learning and Behaviour (RTLB) Toolkit" (2011) that guides RTLB practice; and to critique the principle of EBP through practical reflection. (Contains 2 tables and 2…

Littek, Celeste

2013-01-01

373

Need for evidence-based practice in prosthodontics  

Microsoft Academic Search

Statement Of Problem. Patients, their insurers, the courts, and the scientific community are demanding more evidence to support the effectiveness of health care strategies. Purpose. This article describes evidence-based practice, its origins, and value as a way of addressing the demand for evidence of treatment effectiveness in maxillofacial prosthetics. Material And Methods. A limited review of maxillofacial prosthetics literature was

James D. Anderson

2000-01-01

374

Integration of Evidence-Based Practice into the University Clinic  

ERIC Educational Resources Information Center

The author explains different principles, which can be used for the integration of evidence-based practice into the university clinic. Research literature, systematic reviews and practice guidelines are shown to work as the evidence for the teachers, as well as the students.

Goldstein, Brian A.

2008-01-01

375

Evidence-Based Practices in Special Education: Some Practical Considerations  

ERIC Educational Resources Information Center

A major tenet of both the Individuals with Disabilities Education Act and the No Child Left Behind Act is the identification and use of evidence-based practices, or those instructional techniques shown by research as most likely to improve student outcomes meaningfully. However, much confusion exists regarding the meaning and potential…

Cook, Bryan G.; Tankersley, Melody; Cook, Lysandra; Landrum, Timothy J.

2008-01-01

376

Evidence-Based Practice: A Framework for Making Effective Decisions  

ERIC Educational Resources Information Center

The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…

Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.

2012-01-01

377

An introduction to evidence-based practice for hand therapists  

Microsoft Academic Search

Evidence-based practice (EBP) is a methodologic approach to clinical practice in which evidence is used to reach an informed decision when making a diagnosis, selecting a diagnostic test, picking an intervention, or determining a prognosis. Finding the best evidence through searching and critical appraisal of the methodologic quality of clinical evidence are essential steps. Matching clinical recommendations to the level

Joy C. MacDermid

2004-01-01

378

Is there an evidence-based practice for burns?  

Microsoft Academic Search

Doublts and questions about clinical decision making need to be answered. Evidence-based medicine aims to provide answers by systematically finding information from the vast assortmment of research papers in the literature and bringing it together to use in everyday practice and in the best interests of the patient. Although clinical (and experimental) studies have a variety of methodologics, ranging from

Charmaine Childs

1998-01-01

379

Developing Research Competence to Support Evidence-Based Practice  

Microsoft Academic Search

This article describes one step in the process that was undertaken to prepare for the introduction of evidence-based practice (EBP) into the curriculum across the Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Philosophy pro- grams, as well as the programs that were under development, Clinical Nurse Leader and Doctor of Nursing Practice, at the

Lora E. Burke; Elizabeth A. Schlenk; Susan M. Sereika; Susan M. Cohen; Mary Beth Happ; Janice S. Dorman

2005-01-01

380

Critical Thinking: Knowledge and Skills for Evidence-Based Practice  

ERIC Educational Resources Information Center

Purpose: I respond to Kamhi's (2011) conclusion in his article "Balancing Certainty and Uncertainty in Clinical Practice" that rational or critical thinking is an essential complement to evidence-based practice (EBP). Method: I expand on Kamhi's conclusion and briefly describe what clinicians might need to know to think critically within an EBP…

Finn, Patrick

2011-01-01

381

Interteaching: An Evidence-Based Approach to Instruction  

ERIC Educational Resources Information Center

This paper describes "interteaching" as an evidence-based method of instruction. Instructors often rely on more traditional approaches, such as lectures, as means to deliver instruction. Despite high usage, these methods are ineffective at achieving desirable academic outcomes. We discuss an innovative approach to delivering instruction…

Brown, Thomas Wade; Killingsworth, Kenneth; Alavosius, Mark P.

2014-01-01

382

Toward Evidence-Based Practice with Domestic Violence Perpetrators  

Microsoft Academic Search

This review examines the policy and practice of interventions with male perpetrators of domestic violence in light of the widely accepted principles of evidence-based practice. Thus far, these policies and practices have enjoyed immunity from the external, empirical accountability available through implementing the findings from evaluations research and other empirical practice analyses. This immunity is supported by a policy framework

Kenneth Corvo; Donald Dutton; Wan-Yi Chen

2008-01-01

383

Why isn't more injury prevention evidence-based?  

Microsoft Academic Search

The focus on evidence-based practice is critical to addressing the issue of injuries, yet advances in the science of injury prevention have not always led to advances in practice. Effective approaches are not always adopted, or when adopted and transferred from one setting to another, they do not always achieve expected results. These challenges were the basis of two breakout

J. Morag MacKay; Joanne Vincenten

2009-01-01

384

Meeting the information needs of an evidence-based world  

Microsoft Academic Search

There are many new and exciting health information developments in Australia today. However, there are also many gaps and problems in the information available to support evidence-based decision-making. For example, computerisation in health lags behind other industries. However, these problems should not prevent us using the available data to manage individual care and the health care system more effectively. It

BETH REID

1997-01-01

385

Need to Address Evidence-Based Practice in Educational Administration  

Microsoft Academic Search

Purpose: This article presents a case for addressing evidence-based practice (EBP) in educational administration. Content is arranged around four objectives: (a) summarizing the status of educational administration as a profession, (b) defining evidence and the model, (c) explaining EBP's social and professional merit, and (d) identifying barriers that may prevent the concept from being understood correctly, accepted philosophically, and implemented

Theodore Kowalski

2009-01-01

386

Combining Performance Feedback and Evidence-based Educational Resources  

Microsoft Academic Search

Objective: This study is intended to advance patient safety by demonstrating the effectiveness of coupling surveillance report performance feedback with evidence-based educational materials and other communications that help hospitals identify priorities and methods for medical injury prevention. Methods: Medical injury surveillance findings are reported semiannually to hospitals to support their quality improvement efforts. We developed educational manuals for five priority

John R. Meurer; Linda N. Meurer; Jean Grube; Karen J. Brasel; Chris McLaughlin; Stephen Hargarten; Peter M. Layde

387

Evidence-based toxicology: a comprehensive framework for causation  

Microsoft Academic Search

This paper identifies deficiencies in some current practices of causation and risk evaluation by toxicologists and formulates an evidence-based solution. The practice of toxicology focuses on adverse health events caused by physical or chemical agents. Some relations between agents and events are identified risks, meaning unwanted events known to occur at some frequency. However, other relations that are only possibilities

Philip S Guzelian; Michael S Victoroff; N Christine Halmes; Robert C James; Christopher P Guzelian

2005-01-01

388

Evidence-based psychiatric nursing practice: Rhetoric or reality  

Microsoft Academic Search

The most desirable basis to substantiate clinical practice is the evidence of well-established research findings. Developing evidence-based care involves defining the clinical question, finding the evidence, analyzing the evidence, using the evidence, and evaluating the outcome. Practice guidelines and clinical algorithms are useful tools for applying research findings in a practical way. Other mental health professionals are actively incorporating an

Gail W. Stuart

2001-01-01

389

Putting evidence into practice: evidence-based interventions for anxiety  

Microsoft Academic Search

Anxiety is a common form of distress that oncology nurses often observe in their patients. The incidence of anxiety may be as high as 50% in recently diagnosed patients and may persist into survivorship. How nurses respond to patients experiencing distress and anxiety influences further assessment of the patient's concerns, identification of anxiety, and the initiation of appropriate interventions. Evidence-based

Lisa Kennedy Sheldon; Susan Swanson; Amy Dolce; Kathleen Marsh; Julie Summers

2008-01-01

390

Building evidence-based practice with staff nurses through mentoring  

Microsoft Academic Search

Evidence- based practice (EBP) is an effective way for nurses to improve patient outcomes. Although EBP has gained popularity, barriers to implementation exist. This study explored whether mentoring neonatal intensive care unit (NICU) nurses in EBP would increase their participation in EBP. A sample of 20 nurses were mentored in an EBP project. The EBP Beliefs Scale and EBP Implementation

Kathleen DiGaudio Mariano; Linda M. Caley; Linda Eschberger; Ann Woloszyn; Patricia Volker; Michael S. Leonard; Ying Tung

2009-01-01

391

Desired Attributes of Evidence Assessments for Evidence-based Practices  

Microsoft Academic Search

In this paper we describe three approaches to assessing evidence for stakeholders interested in evidence-based practices: narrative reviews, systematic reviews (including meta-analyses), and registries. We then compare the approaches in terms of the degree to which they posses desired attributes of evidence assessments. Our review suggests that hybrid approaches that combined the best features of all three should be pursued

H. Stephen Leff; Jeremy A. Conley

2006-01-01

392

Teaching Evidence-Based Medicine: A Regional Dissemination Model.  

ERIC Educational Resources Information Center

Described and evaluated an interactive course designed to create a cadre of medical school faculty in New York who could integrate evidence-based medicine into their training programs. Findings for representatives of 30 internal medicine residency programs show the usefulness of the regional dissemination model used. (SLD)

Leipzig, Rosanne M.; Wallace, Eleanor Z.; Smith, Lawrence G.; Sullivant, Jean; Dunn, Kathel; McGinn, Thomas

2003-01-01

393

Teaching Evidence-based Medicine: Caveats and Challenges.  

ERIC Educational Resources Information Center

Discusses three caveats to the evidence-based paradigm in medical education: (1) detection of abnormalities that may not ever be overtly expressed inflates apparent diagnostic test performance; (2) probability revision is valuable primarily as an exercise to gain qualitative insights; and (3) patients are likely to be interested in more than just…

Welch, H. Gilbert; Lurie, Jon D.

2000-01-01

394

Teaching Evidence-based Medicine Using Literature for Problem Solving.  

ERIC Educational Resources Information Center

Evidence-based medicine--the process of using research findings systematically as the basis for clinical decisions--can be taught using problem-solving teaching methods. Evaluates whether it was possible to motivate students to use the original literature by giving them selected patient problems to solve. (Author/ASK)

Mottonen, Merja; Tapanainen, Paivi; Nuutinen, Matti; Rantala, Heikki; Vainionpaa, Leena; Uhari, Matti

2001-01-01

395

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine  

E-print Network

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2012 of Medicinal Plant Knowledge in the Andean Highlands: A Case Study from Peru and Bolivia Sarah-Lan Mathez a study of patterns in the distribution and transmission of medicinal plant knowledge in rural Andean

Richner, Heinz

396

Educating the Millennial Generation for evidence based information practice  

Microsoft Academic Search

Purpose – The purpose of this paper is to consider how library education can best incorporate the profession's emerging interest in evidence-based practice (EBP) whilst ensuring that the educational experience is meaningful to the contemporary library student. Design\\/methodology\\/appraoch – A learning and teaching model developed by the Queensland University of Technology will be presented as a case study on how

Helen Partridge; Gillian Hallam

2006-01-01

397

Evidence-based Management Strategies for Treatment of Chronic Wounds  

Microsoft Academic Search

The care and management of patients with chronic wounds and their far-reaching effects challenge both the patient and the practitioner. Further complicating this situation is the paucity of evidence-based treatment strategies for chronic wound care. After searching both MEDLINE and Cochrane databases, we reviewed currently available articles con- cerning chronic wound care. Utilizing this information, we have outlined a review

Frank Werdin; Hans-Eberhardt Schaller; Hans-Oliver Rennekampff

398

Evidence-Based Practice and Evaluation: From Insight to Impact  

ERIC Educational Resources Information Center

With the growing emphasis on accountability and evidence-based practice, evaluation has become increasingly important in the contexts in which educational psychologists (EPs) practice. This paper describes a Target Monitoring and Evaluation (TME) system, derived from Goal Attainment Scaling (GAS) which was developed to evaluate outcomes of a wide…

Dunsmuir, Sandra; Brown, Emma; Iyadurai, Suzi; Monsen, Jeremy

2009-01-01

399

Evidence-Based Psychosocial Treatments for Child and Adolescent Depression  

ERIC Educational Resources Information Center

The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and…

David-Ferdon, Corinne; Kaslow, Nadine J.

2008-01-01

400

Evidence-Based Practice for Conduct Disorder Symptoms  

ERIC Educational Resources Information Center

Patients exhibiting symptoms associated with conduct disorder present challenges in assessment and treatment. The difficulties are not only the complexities of correct identification and appropriate intervention, but also that the knowledge is rapidly growing. Evidence-based practice (EBP) provides a useful framework for dealing with these issues.…

Thomas, Christopher R.

2006-01-01

401

Evidence Based Education Request Desk. EBE #833A  

ERIC Educational Resources Information Center

Over the past decade, research on dropout prevention has become focused on using evidence-based practice, and data-driven decisions, to mitigate students' dropping out of high school and instead, support and prepare students for career and college. Early warning systems or on-track indicators, in which readily available student-level data are used…

Regional Educational Laboratory Southeast, 2011

2011-01-01

402

Determining Evidence-Based Practices in Special Education  

ERIC Educational Resources Information Center

Determining evidence-based practices is a complicated enterprise that requires analyzing the methodological quality and magnitude of the available research supporting specific practices. This article reviews criteria and procedures for identifying what works in the fields of clinical psychology, school psychology, and general education; and it…

Cook, Bryan G.; Tankersley, Melody; Landrum, Timothy J.

2009-01-01

403

Evidence-based Practice and the Endeavor of Psychotherapy  

Microsoft Academic Search

Many of us who are clinicians want to broaden the discussion of evidence-based psychotherapy. We want to move beyond the basics of the easy to measure efficacy studies, and into a more complex realm. In today's climate, it is a challenge for practicing psychologists to balance the needs to develop and maintain a personally effective therapeutic voice, translate multiple streams

Carol Goodheart

404

Original research in pathology: judgment, or evidence-based medicine?  

Microsoft Academic Search

Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has

James M Crawford

2007-01-01

405

An Examination of the Bases of Evidence-Based Interventions.  

ERIC Educational Resources Information Center

School psychology has proposed a system to aid in the identification of evidence-based interventions (Kratochwill & Stoiber, this issue; Lewis-Snyder, Stoiber, & Kratochwill, this issue; Shernoff, Kratochwill, & Stoiber, this issue). In this commentary, issues related to the politics of exclusion, design and theory, methods, and multiculturalism…

Wampold, Bruce E.

2002-01-01

406

Evidence-Based Laboratory Medicine: Is It Working in Practice?  

PubMed Central

The principles of Evidence-Based Medicine have been established for about two decades, with the need for evidence-based clinical practice now being accepted in most health systems around the world. These principles can be employed in laboratory medicine. The key steps in evidence-based practice, namely (i) formulating the question; (ii) searching for evidence; (iii) appraising evidence; (iv) applying evidence; and (v) assessing the experience are all accepted but, as yet, translation into daily clinical and laboratory practice has been slow. Furthermore, the demand for evidence-based laboratory medicine (EBLM) has been slow to develop. There are many contrasting observations about laboratory medicine, for example (i) there is too much testing vs insufficient testing; (ii) testing is expensive vs laboratories are expected to generate income; and (iii) test results have little impact on outcomes vs test results are crucial to clinical decision making. However, there is little evidence to support any of these observations. Integrating the principles of EBLM into routine practice will help to resolve some of these issues by identifying (a) where laboratory medicine fits into the care pathway; (b) where testing is appropriate; (c) the nature and quality of evidence required to demonstrate the clinical utility of a test; (d) how the test result impacts on clinical actions; (e) where changes in the care pathway will occur; and (f) where benefit/value can be achieved. These answers will help to establish the culture of EBLM in clinical and laboratory practice. PMID:22363094

Price, Christopher P

2012-01-01

407

Evidence-based Software Production James Kirby, Jr.  

E-print Network

. For example, Gawande describes how, in 1900, over 40% of a family's income in the U.S. went to food. Farming, Design, Reliability, Experimentation, Verification. Keywords Evidence-based, software production, data and improvement of software production. Such evidence should be based on standardized, widely collected data

Lutz, Robyn R.

408

Dissemination of Evidence-Based Standards of Care  

PubMed Central

Standards of care pertain to crafting and implementing patient-centered treatment interventions. Standards of care must take into consideration the patient's gender, ethnicity, medical and dental history, insurance coverage (or socioeconomic level, if a private patient), and the timeliness of the targeted scientific evidence. This resolves into a process by which clinical decision-making about the optimal patient-centered treatment relies on the best available research evidence, and all other necessary inputs and factors to provide the best possible treatment. Standards of care must be evidence-based, and not merely based on the evidence – the dichotomy being critical in contemporary health services research and practice. Evidence-based standards of care must rest on the best available evidence that emerges from a concerted hypothesis-driven process of research synthesis and meta-analysis. Health information technology needs to become an every-day reality in health services research and practice to ensure evidence-based standards of care. Current trends indicate that user-friendly methodologies, for the dissemination of evidence-based standards of care, must be developed, tested and distributed. They should include approaches for the quantification and analysis of the textual content of systematic reviews and of their summaries in the form of critical reviews and lay-language summaries. PMID:22355229

Barkhordarian, Andre; Hacker, Brett; Chiappelli, Francesco

2011-01-01

409

Evidence-Based Teaching: Now and in the Future  

ERIC Educational Resources Information Center

The purpose of assembling this "New Directions in Teaching and Learning" volume was to introduce college and university teachers to a broad range of approaches that reflect evidence-based teaching (EBT). As each of the preceding chapters has shown, EBT not only can increase student learning across a variety of measures, it also can increase…

Buskist, William; Groccia, James E.

2011-01-01

410

Evidence-Based Therapies for Oppositional Behavior in Young Children  

Microsoft Academic Search

The primary purpose of this chapter is to present and critically evaluate current evidence-based interventions for oppositional behavior (OB) in young children. Children with OB are typically described by parents and teachers as argumentative, disobedient, disruptive, demanding, and defiant. We have operationalized “young children” as including children between the ages of 3 and 8, thus encompassing the preschool and early

Robert J. McMahon; Julie S. Kotler

411

Urticaria: an evidence-based update. Conference report.  

PubMed

Summary Evidence-based update meetings are held annually by the Centre of Evidence Based Dermatology, University of Nottingham. Topics are chosen by delegates at the previous year's conference and in the past have included blistering disorders, psoriasis, hair disorders and skin cancers. Once the topic is identified, a trials database search is undertaken with the aim of including speakers who are actively involved in trials that address the subject in question. This year, the eighth Evidence Based Update meeting focused on urticaria and took place in Loughborough University on 14 May 2009. The latest data on the diagnosis and management of acute and chronic urticaria, including cold and solar urticaria, and the impact of food intolerance on chronic urticaria, were presented by an international panel of renowned speakers, who sometimes expressed different viewpoints. The highlights of the meeting included an informal atmosphere, an international perspective, and a practical question and answer session. Over 70% of the delegates stated that they would be changing their clinical practice following on from the meeting. The evidence-based update meeting in 2010 will be devoted to eczema. PMID:20666769

Alexandroff, A B; Harman, K E

2010-08-01

412

Evidence-based Laboratory Medicine: Supporting Decision-Making  

Microsoft Academic Search

There is an implicit acceptance that an evidence-based culture underpins the practice of laboratory medicine, in part because it is perceived as the scientific foundation of medicine. However, several reviews of specific test procedures or technologies have shown that the evi- dence base is limited and in many cases flawed. One of the key deficiencies in the scientific literature on

Christopher P. Price

2000-01-01

413

Evidence-Based Practices in Outpatient Treatment for Eating Disorders  

ERIC Educational Resources Information Center

This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

Schaffner, Angela D.; Buchanan, Linda Paulk

2010-01-01

414

Integrating Evidence-Based Practice and Social Work Field Education  

ERIC Educational Resources Information Center

The social work academic community is currently considering and critiquing the idea of evidence-based practice (EBP). Given the vital part that practicum education plays in the social work profession, understanding the views of field instructors on this subject is essential. The George Warren Brown School of Social Work at Washington University…

Edmond, Tonya; Megivern, Deborah; Williams, Cynthia; Rochman, Estelle; Howard, Matthew

2006-01-01

415

Evidence-Based Practice and Policy: Choices Ahead  

Microsoft Academic Search

Choices about how to view evidence-based practice (EBP) are being made by educators, practitioners, agency administrators, and staff in a variety of organizations designed to promote integration of research and practice such as clearinghouses on EBP. Choices range from narrow views of EBP such as use of empirically based guidelines and treatment manuals to the broad philosophy and evolving process

Eileen Gambrill

2006-01-01

416

EVIDENCE - BASED MEDICINE/PRACTICE IN SPORTS PHYSICAL THERAPY  

PubMed Central

A push for the use of evidence?based medicine and evidence?based practice patterns has permeated most health care disciplines. The use of evidence?based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision?making. In this era of health care utilization sports physical therapists are expected to integrate clinical experience with conscientious, explicit, and judicious use of research evidence in order to make clearly informed decisions in order to help maximize and optimize patient well?being. One of the more common reasons for not using evidence in clinical practice is the perceived lack of skills and knowledge when searching for or appraising research. This clinical commentary was developed to educate the readership on what constitutes evidence?based practice, and strategies used to seek evidence in the daily clinical practice of sports physical therapy. PMID:23091778

Lehecka, B.J.

2012-01-01

417

Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem  

ERIC Educational Resources Information Center

Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny

2013-01-01

418

Organizing mental health services: an evidence-based approach  

Microsoft Academic Search

Background and Aims. Health policy makers and program developers seek evidence-based guidance on how to organize and finance mental health services. The Swedish Council on Technology Assessment in Health Care (SBU) commissioned a conceptual framework for thinking about health care services as a medical technology. The following framework was developed, citing empirical research from mental health services research as the

Howard H. Goldman; Sten Thelander

2000-01-01

419

Evidence-Based Psychotherapy Practice in College Mental Health  

ERIC Educational Resources Information Center

This lead off article to the special volume on evidence-based psychotherapy (EBP) in college and university counseling and mental health centers presents an overview of the topic and outlines the structure of this publication. A focus on EBP research and practice generally, and in institutions of higher education specifically, is provided for…

Cooper, Stewart E.

2005-01-01

420

Evidence-Based Medicine, the Essential Role of Systematic Reviews,  

E-print Network

-based personalized medicine becomes standard practice, it will be even Permission to make digital or hard copiesEvidence-Based Medicine, the Essential Role of Systematic Reviews, and the Need for Automated Text-based Medicine (EBM). EBM is dependent upon the wide availability and coverage of accurate, objective syntheses

Meng, Weiyi

421

Single-Subject Experimental Design for Evidence-Based Practice  

ERIC Educational Resources Information Center

Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…

Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.

2012-01-01

422

Infection control link professionals' knowledge of Clostridium difficile  

Microsoft Academic Search

lostridium difficile is a common cause of diarrhoea in hospitalised patients. It can result in longer hospital stays and due to the need for strict isolation procedures can add significantly to nursing workload. Additionally, it can be very distressing for the patient and if patients are vulnerable to infection it can have serious health consequences. Cross-transmission can be limited by

N. Vaughan; J. Randle; G. Adams

2006-01-01

423

Detection and control of rotavirus infections in zoo animals.  

PubMed

Fecal specimens from 15 exotic animal species, with and without diarrhea, were examined for the presence of rotavirus, bacterial enteropathogens, and intestinal parasites. A commercial enzyme-linked immunosorbent assay was used to detect antigens of rotavirus. Rotavirus was detected in the feces of 20 (57%) of 35 of the animals, which included addax (Addax nasomaculatus), nyala (Tragelaphus angasi), saiga (Saiga tatarica), white-tailed gnu (Connochaetus gnou), greater kudu (Tragelaphus strepsiceros), sitatunga (Tragelaphus spekei), Grant's gazelle (Gazella granti roosevelti), sable antelope (Hippotragus niger niger), kob (Kobus kob leucotis), pygmy marmoset (Callithrix pygmaea), bush dog (Speothos venaticus), grizzly bear (Ursus arctos horribilis), and red kangaroo (Megaleia rufa). Bacterial pathogens were found in 8 animals, 5 of which had concurrent rotavirus infections. Most (60%) of the animals with rotavirus infection were less than 2 weeks old; however, rotavirus also was detected in feces from adult animals. Although most of the cases of rotavirus infection were detected in nursery-reared animals, exhibit-reared animals also were infected with rotavirus. PMID:6315660

Baumeister, B M; Castro, A E; McGuire-Rodgers, S J; Ramsay, E C

1983-12-01

424

Can quality circles improve hospital-acquired infection control?  

Microsoft Academic Search

It is a fundamental principle of continuous quality improvement (CQI) that processes should be the objects of quality improvement. The objective of this study was to improve process quality concerning the prevention of hospital-acquired infections in surgical departments and intensive care units by a continuous quality improvement (CQI) approach based mainly on quality circles. This approach was evaluated in a

D. H Forster; G Krause; P Gastmeier; W Ebner; A Rath; N Wischnewski; M Lacour; H Rüden; F. D Daschner

2000-01-01

425

Infection Control in the Long Term Care Facility.  

ERIC Educational Resources Information Center

This booklet is intended to increase the awareness of persons working in long-term care facilities regarding the danger of infectious disease and the ways in which it can be spread. Materials in this booklet include: (1) a brief discussion of historical events in the study of microorganisms; (2) information about how microorganisms cause infection

Morris, Sara

426

Advancing the evidence base in cancer: psychosocial multicenter trials  

PubMed Central

Background The diagnosis and treatment of cancer is associated with significant distress and psychosocial morbidity. Although psychosocial interventions have been developed in an attempt to improve psychosocial outcomes in cancer patients and survivors, there is continued debate about whether there is adequate high-level evidence to establish the effectiveness of these interventions. The evidence base is limited as a result of numerous challenges faced by those attempting to conduct psychosocial intervention trials within the health system. Barriers include insufficient participant recruitment, difficulty generalizing from single-trial studies, difficulty in building and managing research teams with multidisciplinary expertise, lack of research design expertise and a lack of incentives for researchers conducting intervention research. To strengthen the evidence base, more intervention studies employing methodologically rigorous research designs are necessary. Methods In order to advance the evidence base of interventions designed to improve psychosocial outcomes for cancer patients and survivors, we propose the formation of a collaborative trials group that conducts multicenter trials to test the effectiveness of such interventions. Results Establishment of such a group would improve the quality of the evidence base in psychosocial research in cancer patients, by increasing support for conducting intervention research and providing intervention research training opportunities. A multidisciplinary collaborative group conducting multicenter trials would have the capacity to overcome many of the barriers that currently exist. Conclusions A stronger evidence base is necessary to identify effective psychosocial interventions for cancer patients. The proposed formation of a psycho-oncology collaborative trials group that conducts multicenter trials to test the effectiveness of psychosocial interventions would assist in achieving this outcome. PMID:22992443

2012-01-01

427

How-to-Do-It: Infection Control Guidelines for Blood Typing & Blood Smear Labs.  

ERIC Educational Resources Information Center

Provides a set of guidelines for infection control of the Acquired Immune Deficiency Syndrome and the serum hepatitis viruses during blood typing procedures. Emphasizes that disposal of blood contaminated materials should comply with local health department recommendations. (RT)

Vetter, Edwin A.

1989-01-01

428

Strengths and Limitations of Evidence-Based Dermatology  

PubMed Central

The need for understanding and reflecting on evidence-based dermatology (EBD) has never been greater given the exponential growth of new external evidence to inform clinical practice. Like any other branch of medicine, dermatologists need to acquire new skills in constructing answerable questions, efficiently searching electronic bibliographic databases, and critically appraising different types of studies. Secondary summaries of evidence in the form of systematic reviews (SR), that is, reviews that are conducted in a systematic, unbiased and explicit manner, reside at the top of the evidence hierarchy, because they are less prone to bias than traditional expert reviews. In addition to providing summaries of the best external evidence, systematic reviews and randomized controlled trials (RCTs) are also powerful ways of identifying research gaps and ultimately setting the agenda of future clinical research in dermatology. But like any paradigm, EBD can have its limitations. Wrong application, misuse and overuse of EBD can have serious consequences. For example, mindless pooling together of data from dissimilar studies in a meta-analysis may render it a form of reductionism that does not make any sense. Similarly, even highly protocolised study designs such as SRs and RCTs are still susceptible to some degree of dishonesty and bias. Over-reliance on randomized controlled trials (RCT) may be inappropriate, as RCTs are not a good source for picking up rare but important adverse effects such as lupus syndrome with minocycline. A common criticism leveled against SRs is that these frequently conclude that there is lack of sufficient evidence to inform current clinical practice, but arguably, such a perception is grounded more on the interpretation of the SRs than anything else. The apparent absence of evidence should not paralyze the dermatologist to adopt a state of therapeutic nihilism. Poor primary data and an SR based on evidence that is not up-to-date are also limitations that can only improve with better primary studies and updated reviews such as those done by the Cochrane Collaboration. Most dermatologists are interested in integrating the best external evidence with the care of individual patients and have been practicing good EBD without realizing it. PMID:24700929

Williams, Hywel C

2014-01-01

429

Recent advances in understanding the biology, epidemiology and control of chlamydial infections in koalas.  

PubMed

The koala (Phascolarctos cinereus) is recognised as a threatened wildlife species in various parts of Australia. A major contributing factor to the decline and long-term viability of affected populations is disease caused by the obligate intracellular bacteria, Chlamydia. Two chlamydial species infect the koala, Chlamydia pecorum and Chlamydia pneumoniae, and have been reported in nearly all mainland koala populations. Chlamydial infections of koalas are associated with ocular infections leading to blindness and genital tract infections linked to infertility, among other serious clinical manifestations. Diagnosis can be based on clinical presentation alone, however, it is complicated by the observation that many koala chlamydial infections occur with no overt signs of clinical disease. Instead, accurate diagnosis requires detailed clinical assessment and confirmatory testing by a range of PCR-based assays. Antibiotic treatment for koala chlamydial infection is possible, however, results on its success are mixed. A more practical solution for the protection of diseased populations is the application of a koala Chlamydia vaccine, with recent trials indicating promising results. Interestingly, molecular epidemiology studies of koala C. pecorum infections and recent comparative genomic analyses of koala C. pneumoniae have revealed potential differences in their origin that will have wider ramifications for our understanding of human chlamydial infections and host adaptation of the chlamydiae. This review summarises changes to the taxonomy of koala chlamydial infections and recent advances in our understanding of the epidemiology, diagnosis, treatment, control and evolution of Chlamydia infections in this iconic wildlife species. PMID:23523170

Polkinghorne, Adam; Hanger, Jon; Timms, Peter

2013-08-30

430

Mental Health Provider Attitudes Toward Adoption of Evidence-Based Practice: The Evidence-Based Practice Attitude Scale (EBPAS)  

Microsoft Academic Search

Mental health provider attitudes toward organizational change have not been well studied. Dissemination and implementation of evidence-based practices (EBPs) into real-world settings represent organizational change that may be limited or facilitated by provider attitudes toward adoption of new treatments, interventions, and practices. A brief measure of mental health provider attitudes toward adoption of EBPs was developed and attitudes were examined

Gregory A. Aarons

2004-01-01

431

School Psychology: A Public Health Framework: I. From Evidence-Based Practices to Evidence-Based Policies.  

ERIC Educational Resources Information Center

Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…

Hoagwood, Kimberly; Johnson, Jacqueline

2003-01-01

432

[Infection control systems in the United States: its history and problems].  

PubMed

The purpose of this study is to review recent literature regarding the role of the infection control nurse in the United States. Recent relevant literature, published between 1982 and 1995, was selected by using a computerized literature search, cumulative index to nursing and allied health literature (CINAHL). Four major points in the development of infection control practitioners (ICPs) were identified from the literature review: (1) Since the late 1960s the number of ICPs had increased continuously, through the Center for Disease control training programs, and through training programs developed by members of the Association for Professionals in Infection Control and Epidemiology (APIC) at the national, regional and local chapter levels. (2) The ICPs became certified upon receiving satisfactory results on the infection of 2 years of work in the field of infection control, and then are authorized to use the title "CIC". The certification was valid for five years and is renewed after the ICP passed a re-examination. (3) Six duties of the ICP were identified: management, prevention, surveillance, identification, education, and research. (4) The cost of health care was constantly restructuring the health care delivery system in the United States. The ICPs also were influenced by these changes. New challenges facing ICPs today were, a) the integration of resources to be shared by infection control and quality assurance, b) the change of role from specialist to generalist, c) the expansion of their roles in the area of epidemiology. PMID:9282009

Senda, Y

1996-01-01

433

Development of a Clinical Data Warehouse for Hospital Infection Control  

PubMed Central

Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

2003-01-01

434

Multiresistant pathogens in geriatric nursing - infection control in residential facilities for geriatric nursing in Germany  

PubMed Central

Background: The increase of multidrug-resistant organisms (MDROs) causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff. Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs. Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution. Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

Peters, Claudia; Schablon, Anja; Bollongino, Kirsten; Maass, Monika; Kass, Dietmar; Dulon, Madeleine; Diel, Roland; Nienhaus, Albert

2014-01-01

435

Onchocerciasis infection in children born during 14 years of Simulium control in West Africa.  

PubMed

The incidence of onchocerciasis infection in children born since the start of vector control is one of the indicators used in the epidemiological evaluation of the Onchocerciasis Control Programme in West Africa (OCP). Though initially of littel value, after a decade of control it has become a sensitive indicator of residual transmission. The results of 14 years of control are reported. In 179 villages parasitological surveys were undertaken at intervals of 3-4 years. 15,286 children were examined and 110 were found to be infected, compared to an expected number of 2467 infected had there been no control. There was considerable geographical variation in the results. In the large central OCP area the results were excellent. Of 12,172 children examined in 127 villages, only 23 were found to be infected compared to an expected number of 1960 without control. This suggests that larviciding had achieved a 99% reduction in the incidence of infection in children. Additional surveys in 2 foci in the central OCP area where transmission had relapsed showed that these problems were very localized. Most villages with infected children were found in OCP border areas in the east and west, which had been reinvaded by infective vectors from elsewhere, and in the intermediate area between forest and savanna in Côte d'Ivoire where there had been partial control failures because of resistance. The incidence of infection in children was reduced by an estimated 68% in the eastern reinvaded area, by 87% in the western reinvaded area, and by 84% in the intermediate area. PMID:1949145

De Sole, G; Remme, J

1991-01-01

436

Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care  

PubMed Central

Background Chiropractors must continue to learn, develop themselves professionally throughout their careers, and become self-directed and lifelong learners. Using an evidence-based approach increases the probability of optimal patient outcomes. But most chiropractors lack knowledge and interest in evidence-based approaches. The purpose of this study was to develop and measure the effectiveness of evidence-based training for chiropractic practitioners in a continuing education setting. Methods We developed and evaluated a continuing education workshop on evidence-based principles and methods for chiropractic practitioners. Forty-seven chiropractors participated in the training and testing. The course consisted of 12.5 hours of training in which practitioners learned to develop focused questions, search electronic data bases, critically review articles and apply information from the literature to specific clinical questions. Following the workshop, we assessed the program performance through the use of knowledge testing and anonymous presentation quality surveys. Results Eighty-five percent of the participants completed all of the test, survey and data collection items. Pretest knowledge scores (15-item test) were low (47%). Post intervention scores (15-item test) improved with an effect size of 2.0. A 59-item knowledge posttest yielded very good results (mean score 88%). The quality of presentation was rated very good, and most participants (90%) would "definitely recommend" or "recommend" the workshop to a colleague. Conclusion The results of the study suggest that the continuing education course was effective in enhancing knowledge in the evidence-based approach and that the presentation was well accepted. PMID:16930482

Feise, Ronald J; Grod, Jaroslaw P; Taylor-Vaisey, Anne

2006-01-01

437

The barriers to achieving an evidence base for bitemark analysis.  

PubMed

Forensic dentistry is the union of two scientific disciplines, both of which are undergoing a renewed scientific rigor. In forensic science the advent of the Daubert ruling has required that judges assess the forensic value of 'expert testimony' ensuring that techniques, methodologies and practices are not only commonly accepted (as was the previous hurdle during the Frye era) but that error rates, assessment of reliability and validation studies are published to support their use. This new degree of judicial scrutiny has been mirrored in the field of dentistry itself, where organisations search and summarise randomised controlled trials in order to recommend best practice and devise clinical care pathways that are firmly grounded in proven scientific research. Despite the obvious drive from both of these professions, forensic dentistry, and in particular the sub-discipline of bitemark analysis, has been remarkably slow to address the obvious deficiencies in the evidence base that underpins this element of forensic science. Reviews of the literature reveal that the vast majority of published works are case reports, and very little primary literature exists. This paper reviews those studies that have assessed aspects of bitemark analysis including the crucial issue of the uniqueness of the human dentition; the application of transparent overlays and the application of statistical probabilities in bitemark conclusions. There are numerous barriers to undertaking high quality research in the field of bitemark analysis, the most important of which is the use of a gold-standard that is acceptable both in terms of diagnostic research but is also forensically relevant. If bitemark analysis is to continue to play a role in the judicial process then there is an urgent need for high quality studies that meet the levels of forensic and scientific scrutiny applied to other disciplines within the criminal justice system. Studies are required to determine not that the human dentition is unique, but how this asserted uniqueness is represented on human skin and other substrates. The error rates associated with the analysis of bitemarks are required on a procedural level as well as an individual practitioner basis and scales and interpretative indices of bitemark severity and forensic significance should be validated and introduced into common use. PMID:16540273

Pretty, Iain A

2006-05-15

438

Impact of an evidence-based medicine curriculum based on adult learning theory  

Microsoft Academic Search

Objective  To develop and implement an evidence-based medicine (EBM) curriculum and determine its effectiveness in improving residents’\\u000a EBM behaviors and skills.\\u000a \\u000a \\u000a \\u000a Design  Description of the curriculum and a multifaceted evaluation, including a pretest-posttest controlled trial.\\u000a \\u000a \\u000a \\u000a Setting  University-based primary care internal medicine residency program.\\u000a \\u000a \\u000a \\u000a Participants  Second-and third-year internal medicine residents (N=34).\\u000a \\u000a \\u000a \\u000a Interventions  A 7-week EBM curriculum in which residents work through the steps of evidence-based decisions

Michael L. Green; Peter J. Ellis

1997-01-01

439

Simulation Shows Hospitals That Cooperate On Infection Control Obtain Better Results Than Hospitals Acting Alone  

PubMed Central

Efforts to control life-threatening infections, such as with methicillin-resistant Staphylococcus aureus (MRSA), can be complicated when patients are transferred from one hospital to another. Using a detailed computer simulation model of all hospitals in Orange County, California, we explored the effects when combinations of hospitals tested all patients at admission for MRSA and adopted procedures to limit transmission among patients who tested positive. Called “contact isolation,” these procedures specify precautions for health care workers interacting with an infected patient, such as wearing gloves and gowns. Our simulation demonstrated that each hospital’s decision to test for MRSA and implement contact isolation procedures could affect the MRSA prevalence in all other hospitals. Thus, our study makes the case that further cooperation among hospitals—which is already reflected in a few limited collaborative infection control efforts under way—could help individual hospitals achieve better infection control than they could achieve on their own. PMID:23048111

Lee, Bruce Y.; Bartsch, Sarah M.; Wong, Kim F.; Yilmaz, S. Levent; Avery, Taliser R.; Singh, Ashima; Song, Yeohan; Kim, Diane S.; Brown, Shawn T.; Potter, Margaret A.; Platt, Richard; Huang, Susan S.

2013-01-01

440

Biofilms and persistent wound infections in United States military trauma patients: a case-control analysis  

PubMed Central

Background Complex traumatic injuries sustained by military personnel, particularly when involving extremities, often result in infectious complications and substantial morbidity. One factor that may further impair patient recovery is the persistence of infections. Surface-attached microbial communities, known as biofilms, may play a role in hindering the management of infections; however, clinical data associating biofilm formation with persistent or chronic infections are lacking. Therefore, we evaluated the production of bacterial biofilms as a potential risk factor for persistent infections among wounded military personnel. Methods Bacterial isolates and clinical data from military personnel with deployment-related injuries were collected through the Trauma Infectious Disease Outcomes Study. The study population consisted of patients with diagnosed skin and soft-tissue infections. Cases (wounds with bacterial isolates of the same organism collected 14 days apart) were compared to controls (wounds with non-recurrent bacterial isolates), which were matched by organism and infectious disease syndrome. Potential risk factors for persistent infections, including biofilm formation, were examined in a univariate analysis. Data are expressed as odds ratios (OR; 95% confidence interval [CI]). Results On a per infected wound basis, 35 cases (representing 25 patients) and 69 controls (representing 60 patients) were identified. Eight patients with multiple wounds were utilized as both cases and controls. Overall, 235 bacterial isolates were tested for biofilm formation in the case–control analysis. Biofilm formation was significantly associated with infection persistence (OR: 29.49; CI: 6.24-infinity) in a univariate analysis. Multidrug resistance (OR: 5.62; CI: 1.02-56.92), packed red blood cell transfusion requirements within the first 24 hours (OR: 1.02; CI: 1.01-1.04), operating room visits prior to and on the date of infection diagnosis (OR: 2.05; CI: 1.09-4.28), anatomical location of infected wound (OR: 5.47; CI: 1.65-23.39), and occurrence of polymicrobial infections (OR: 69.71; CI: 15.39-infinity) were also significant risk factors for persistent infections. Conclusions We found that biofilm production by clinical strains is significantly associated with the persistence of wound infections. However, the statistical power of the analysis was limited due to the small sample size, precluding a multivariate analysis. Further data are needed to confirm biofilm formation as a risk factor for persistent wound infections. PMID:24712544

2014-01-01

441

IKK? in Myeloid Cells Controls the Host Response to Lethal and Sublethal Francisella tularensis LVS Infection  

PubMed Central

Background The NF-?B activating kinases, IKK? and IKK?, are key regulators of inflammation and immunity in response to infection by a variety of pathogens. Both IKK? and IKK? have been reported to modulate either pro- or anti- inflammatory programs, which may be specific to the infectious organism or the target tissue. Here, we analyzed the requirements for the IKKs in myeloid cells in vivo in response to Francisella tularensis Live Vaccine Strain (Ft. LVS) infection. Methods and Principal Findings In contrast to prior reports in which conditional deletion of IKK? in the myeloid lineage promoted survival and conferred resistance to an in vivo group B streptococcus infection, we show that mice with a comparable conditional deletion (IKK? cKO) succumb more rapidly to lethal Ft. LVS infection and are unable to control bacterial growth at sublethal doses. Flow cytometry analysis of hepatic non-parenchymal cells from infected mice reveals that IKK? inhibits M1 classical macrophage activation two days post infection, which has the collateral effect of suppressing IFN-?+ CD8+ T cells. Despite this early enhanced inflammation, IKK? cKO mice are unable to control infection; and this coincides with a shift toward M2a polarized macrophages. In comparison, we find that myeloid IKK? is dispensable for survival and bacterial control. However, both IKK? and IKK? have effects on hepatic granuloma development. IKK? cKO mice develop fewer, but well-contained granulomas that accumulate excess necrotic cells after 9 days of infection; while IKK? cKO mice develop numerous micro-granulomas that are less well contained. Conclusions Taken together our findings reveal that unlike IKK?, IKK? has multiple, contrasting roles in this bacterial infection model by acting in an anti-inflammatory capacity at early times towards sublethal Ft. LVS infection; but in spite of this, macrophage IKK? is also a critical effector for host survival and efficient pathogen clearance. PMID:23349802

Samaniego, Sylvia; Marcu, Kenneth B.

2013-01-01

442

Gender inequities in sexually transmitted infections: implications for HIV infection and control in Lagos State, Nigeria  

PubMed Central

Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multistage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD) were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STI’s before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STI’s was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STI’s between the sexual partners; to reduce the spread of sexually transmitted diseases within the nation. PMID:24470905

Adeyemi, Ezekiel Oluwagbemiga

2011-01-01

443

Using evidence-based management in a medical practice.  

PubMed

Evidence-based management (EBMa) is the application of the evidence-based medicine process to making management decisions. EBMa has been described in a number of publications, which note the advantages of utilizing EBMa and offer generic guidance on the nature of EBMa evidence. This paper provides a specific EBMa pathway for physician practice and health system mangers to use to conduct EBMa database searches. It provides an example of conducting an EBMa search for a practice-based management problem. It describes how to do database searches using Advance Google Scholar, PubMed, and other data sources. It discusses challenges to conducting quality searches, including access to paid subscription databases, and offers suggestions to improve searches. Finally, the paper discusses the importance of establishing a culture of inquiry and using rapid cycle improvement methods to develop organizational EBMa support so health systems will devote adequate resources to information acquisition. PMID:20222263

Solomon, Robert J

2010-01-01

444

Family-centered, evidence-based phototherapy delivery.  

PubMed

Jaundice develops in most newborn infants and is one of the most common reasons infants are rehospitalized after birth. American Academy of Pediatrics clinical practice guidelines strongly support the recommendation that clinicians promote and support breastfeeding. Recognizing that the disruptions associated with phototherapy interfere with breastfeeding, the challenge often faced by clinicians is how to provide effective phototherapy while supporting evidence-based practices, such as rooming-in, skin-to-skin contact, and breastfeeding. We report here on a case that reflects a common clinical scenario in newborn medicine in order to describe a technique for providing phototherapy while maintaining evidence-based practices. This approach will assist clinicians in providing best-practices and family-centered care. PMID:23669526

Szucs, Kinga A; Rosenman, Marc B

2013-06-01

445

A framework for disseminating evidence-based health promotion practices.  

PubMed

Wider adoption of evidence-based, health promotion practices depends on developing and testing effective dissemination approaches. To assist in developing these approaches, we created a practical framework drawn from the literature on dissemination and our experiences disseminating evidence-based practices. The main elements of our framework are 1) a close partnership between researchers and a disseminating organization that takes ownership of the dissemination process and 2) use of social marketing principles to work closely with potential user organizations. We present 2 examples illustrating the framework: EnhanceFitness, for physical activity among older adults, and American Cancer Society Workplace Solutions, for chronic disease prevention among workers. We also discuss 7 practical roles that researchers play in dissemination and related research: sorting through the evidence, conducting formative research, assessing readiness of user organizations, balancing fidelity and reinvention, monitoring and evaluating, influencing the outer context, and testing dissemination approaches. PMID:22172189

Harris, Jeffrey R; Cheadle, Allen; Hannon, Peggy A; Forehand, Mark; Lichiello, Patricia; Mahoney, Eustacia; Snyder, Susan; Yarrow, Judith

2012-01-01

446

An Evidence-based Elective on Dietary Supplements  

PubMed Central

Objective To implement and evaluate the effectiveness of a pharmacy elective on dietary supplements that emphasized evidence-based care. Design A 3-credit elective that employed both traditional lectures and a variety of active-learning exercises was implemented. The course introduction provided a background in dietary supplement use and evidence-based medicine principles before addressing dietary supplements by primary indication. Assessment Student learning was assessed through quizzes, case assignments, discussion board participation, and completion of a longitudinal group project. Precourse and postcourse surveys were conducted to assess students' opinions, knowledge, and skills related to course objectives. Conclusion The course was an effective way to increase students' knowledge of dietary supplements and skills and confidence in providing patient care in this area. PMID:19777095

Caron, Whitney; Zeolla, Mario

2009-01-01

447

Single-Subject Experimental Design for Evidence-Based Practice  

PubMed Central

Purpose Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method The authors discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout. Conclusion SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders. PMID:23071200

Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.

2014-01-01

448

Bridging Ayurveda with evidence-based scientific approaches in medicine.  

PubMed

This article reviews contemporary approaches for bridging Ayurveda with evidence-based medicine. In doing so, the author presents a pragmatic assessment of quality, methodology and extent of scientific research in Ayurvedic medicine. The article discusses the meaning of evidence and indicates the need to adopt epistemologically sensitive methods and rigorous experimentation using modern science. The author critically analyzes the status of Ayurvedic medicine based on personal observations, peer interactions and published research. This review article concludes that traditional knowledge systems like Ayurveda and modern scientific evidence-based medicine should be integrated. The author advocates that Ayurvedic researchers should develop strategic collaborations with innovative initiatives like 'Horizon 2020' involving predictive, preventive and personalized medicine (PPPM). PMID:25395997

Patwardhan, Bhushan

2014-01-01

449

Evidence-Based Behavioral Interventions for Repetitive Behaviors in Autism  

PubMed Central

Restricted and repetitive behaviors (RRBs) are a core symptom of autism spectrum disorders (ASD). There has been an increased research emphasis on repetitive behaviors; however, this research primarily has focused on phenomenology and mechanisms. Thus, the knowledge base on interventions is lagging behind other areas of research. The literature suggests there are evidence-based practices to treat “lower order” RRBs in ASD (e.g., stereotypies); yet, there is a lack of a focused program of intervention research for “higher order” behaviors (e.g., insistence on sameness). This paper will (a) discuss barriers to intervention development for RRBs; (b) review evidence-based interventions to treat RRBs in ASD, with a focus on higher order behaviors; and (c) conclude with recommendations for practice and research. PMID:21584849

McDonough, Stephen G.; Bodfish, James W.

2013-01-01

450

Clinical practice guidelines to inform evidence-based clinical practice  

Microsoft Academic Search

Background  With the volume of medical research currently published, any one practitioner cannot independently review the literature to\\u000a determine best evidence-based medical care. Additionally, non-specialists usually do not have the experience to know best\\u000a practice for all of the frequent clinical circumstances for which there is no good evidence. Clinical practice guidelines\\u000a (CPGs) help clinicians to address these problems because they

J. Stuart Wolf; Heddy Hubbard; Martha M. Faraday; John B. Forrest

2011-01-01

451

What is an evidence-based appropriate workup?  

PubMed Central

At the present time, there is no evidence-based guidance available for workup of stress urinary incontinence (SUI). In the absence of such evidence, we must rely on expert consensus, which dictates that a workup should typically include documentation of SUI, assessment of impact on the patient, and information on voiding function. Typical assessment may need to be adjusted for more complicated populations (e.g., those with mixed incontinence, those who have failed previous treatment). PMID:23092769

Zimmern, Philippe E.

2012-01-01

452

Practitioner Attitudes Toward Evidence-based Practice: Themes and Challenges  

Microsoft Academic Search

 Abstract  The widespread successful implementation of evidence-based practices (EBPs) into community mental health settings will require\\u000a a thorough understanding of practitioner attitudes toward these approaches. This study reports on the results of two community\\u000a mental health practitioner focus groups investigating attitudes toward EBPs, perceived challenges to implementing EBPs, and\\u000a recommendations for researchers interested in facilitating EBP use in community settings. The

Timothy D. Nelson; Ric G. Steele; Jennifer A. Mize

2006-01-01

453

Common Processes in Evidence-Based Adolescent HIV Prevention Programs  

Microsoft Academic Search

Dissemination of evidence-based HIV prevention programs for adolescents will be increased if community interventionists are\\u000a able to distinguish core, essential program elements from optional, discretionary ones. We selected five successful adolescent\\u000a HIV prevention programs, used a qualitative coding method to identify common processes described in the procedural manuals,\\u000a and then compared the programs. Nineteen common processes were categorized as structural

Barbara L. Ingram; Diane Flannery; Amy Elkavich; Mary Jane Rotheram-Borus

2008-01-01

454

The Promises And Pitfalls Of Evidence-Based Medicine  

Microsoft Academic Search

ABSTRACT: Evidence-based medicine,(EBM) aims to address,the persistent problem,of clinical practice variation with the help of various tools, including standardized practice guidelines. While advocates welcome the stronger scientific foundation of such guidelines, critics fear that they will lead to “cookbook medicine.” Studies show, however, that few guidelines lead to consistent changes in provider behavior. The hopes, fears, and mixed re- cord

Stefan Timmermans; Aaron Mauck

2005-01-01

455

Whither our art? Clinical wisdom and evidence-based medicine  

Microsoft Academic Search

The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute.\\u000a For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other,\\u000a human elements, and to threaten the art of medicine. Clinical wisdom always remains open to question. We want to know why\\u000a particular beliefs are held,

Malcolm Parker

2002-01-01

456

Evidence-based medicine training in internal medicine residency programs  

Microsoft Academic Search

To characterize evidence-based medicine (EBM) curricula in internal medicine residency programs, a written survey was mailed\\u000a to 417 program directors of U.S. internal medicine residency programs. For programs offering a freestanding (dedicated curricular\\u000a time) EBM curriculum, the survey inquired about its objectives, format, curricular time, attendance, faculty development,\\u000a resources, and evaluation. All directors responded to questions regarding integrating EBM teaching

Michael L. Green

2000-01-01

457

Global health: the importance of evidence-based medicine  

PubMed Central

Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes. PMID:24228722

2013-01-01

458

Putting evidence into practice: evidence-based interventions for depression.  

PubMed

Depression is a distressing emotion that occurs during various times of the cancer trajectory. Depression often goes unrecognized and untreated, which can significantly affect cost, quality of life, and treatment adherence. The Oncology Nursing Society's Putting Evidence Into Practice depression project team reviewed current literature to identify evidence-based interventions to reduce depression in people with cancer. Pharmacologic and nonpharmacologic interventions were evaluated, and opportunities for nurses to integrate recommendations into practice are offered in this article. PMID:25427607

Fulcher, Caryl D; Kim, Hee-Ju; Smith, Patsy R; Sherner, Tammie L

2014-12-01

459

Using motivational interviewing: through evidence-based health coaching.  

PubMed

To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short. PMID:25268529

Huffman, Melinda

2014-10-01

460

Protecting generalism: moving on from evidence-based medicine?  

PubMed Central

Quality of decision making in modern health care is defined with reference to evidence-based medicine. There are concerns that this approach is insufficient for, and may thus threaten the future of, generalist primary care. We urgently need to extend our account of quality of knowledge use and decision making in order to protect and develop the discipline. Interpretive medicine describes an alternative framework for use in generalist care. Priorities for clinical practice and research are identified. PMID:20594443

Reeve, Joanne

2010-01-01