Lessons learned as a student of craniofacial biology: What this might mean for orthodontic professional education and clinical practice in the 21st century

The 21st century has been revolutionary for the field of clinical genomics, with major advancements and breakthroughs over the years. It is now considered an instrumental tool in clinical and preventive medicine and has been used on a day-to-day basis to complement current clinical practice. However, with advancements in genomics comes greater bioethical concerns, which becomes increasingly complex with more cutting-edge technology. Some of the major ethical concerns include obtaining informed consent, possibility for genetic enhancements and eugenics, genomic equity and potential discrimination and cloning. It is imperative that we appreciate the benefits of genomic medicine in complementing traditional practices, identify and address the ethical concerns with relation to the practice of genomic medicine, and to ensure a common goal of improving human lives. With these in mind, the practice of genomics can have maximum impact in the collective health of the population, with greater benefit to all.

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Lessons learned from the delivery of virtual integrative oncology interventions in clinical practice and research during the COVID-19 pandemic

Supportive Care in Cancer ◽

10.1007/s00520-021-06174-0 ◽

2021 ◽

Author(s):

Robert Knoerl ◽

Carolyn S. Phillips ◽

Juliana Berfield ◽

Heather Woods ◽

Meghan Acosta ◽

...

Keyword(s):

Clinical Practice ◽

Lessons Learned ◽

Integrative Oncology

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Overcoming Obstacles to Breast-Feeding in a Large Municipal Hospital: Applications of Lessons Learned

PEDIATRICS ◽

10.1542/peds.80.3.423 ◽

1987 ◽

Vol 80 (3) ◽

pp. 423-433

Author(s):

Beverly Winikoff ◽

Deborah Myers ◽

Virginia Hight Laukaran ◽

Richard Stone

Keyword(s):

Breast Feeding ◽

Professional Education ◽

Routine Care ◽

Control Site ◽

Lessons Learned ◽

Pediatric Care ◽

Institutional Constraints ◽

Municipal Hospital ◽

Intervention Site ◽

Intensive Training

A project to overcome institutional constraints to breast-feeding was implemented in a large municipal hospital. Interventions included staff education, intensive training of a team of physicians and nurses, development of user-tested educational materials, and day and evening staffing by a breast-feeding counselor. A nearby hospital served as a control. Project evaluation entailed chart reviews at the intervention site and a control hospital (n = 812); interviews with mothers during their postpartum hospital stay and at return clinic visits (n = 180); and field observations in all areas of the hospital that provided prenatal, intrapartum, postpartum, and pediatric care. Comparisons of the incidence and pattern of breast-feeding were made before, midway through, and after the project. At the intervention site, the incidence of breast-feeding increased from 15% to 56%, and exclusive breast-feeding for more than 3/4 of feedings increased from 0% to 15%. At the control site, the respective changes were from 28% to 41% and from 5% to 7%. Formula use by breast-feeding women decreased but was nonetheless extensive, and the usual reason given by breast-feeding women for supplementation was a perceived insufficiency of breast milk. This may be due, in part, to the fact that bedside assistance to breast-feeding mothers was not integrated into the routine care provided by staff nurses but was relegated to the lactation nurse/counselors who were not available at all times. It is concluded that the process to overcome institutional constraints to breast-feeding is difficult but feasible. Repeated and extensive professional education helps create the context whereby clinical and administrative staff can reassess routines and policies.

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Genomic Science—From 2001 to Present Day: What School Nurses Need to Know

NASN School Nurse ◽

10.1177/1942602x18810790 ◽

2018 ◽

Vol 34 (4) ◽

pp. 235-239 ◽

Cited By ~ 1

Author(s):

Elizabeth Barnby ◽

Mark Reynolds ◽

Pamela O’Neal

Keyword(s):

Clinical Practice ◽

Best Practices ◽

21St Century ◽

School Nurses ◽

Student Population ◽

Medically Fragile ◽

Genetic Science ◽

Genomic Science ◽

Genomic Sciences ◽

Information And Technology

Genetic science has made remarkable advances in the 21st century. As genetic and genomic sciences continue to expand, school nurses will become thoroughly immersed in data, information, and technology. As new diseases, treatments, and therapies are discovered, school nurses will need to implement and assess best practices for the complex and medically fragile student population. This article will discuss the top 10 recent discoveries in genomic science and how school nurses can use this information in clinical practice.

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Case reports designed as an aid to professional education A personal experience of brittle diabetes Lessons learned and lessons still to learn

Practical Diabetes International ◽

10.1002/pdi.1960130213 ◽

1996 ◽

Vol 13 (2) ◽

pp. 61-63 ◽

Cited By ~ 1

Author(s):

JM Steel ◽

IW Campbell

Keyword(s):

Professional Education ◽

Personal Experience ◽

Case Reports ◽

Lessons Learned ◽

Brittle Diabetes

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Wiki-Based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma: A New Paradigm in Sarcoma Evidence

Sarcoma ◽

10.1155/2015/614179 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

S. J. Neuhaus ◽

D. Thomas ◽

J. Desai ◽

C. Vuletich ◽

J. von Dincklage ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Guideline Development ◽

Lessons Learned ◽

Evidence Based ◽

Adult Onset ◽

New Paradigm ◽

Software Application ◽

Evidence Based Guidelines

In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.

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Quality Care in Survivorship: Lessons Learned From the ASCO Quality Oncology Practice Initiative

JCO Oncology Practice ◽

10.1200/op.21.00290 ◽

2021 ◽

pp. OP.21.00290

Author(s):

Charles L. Shapiro ◽

Nicole Zubizarreta ◽

Erin Moshier ◽

Julia P. Brockway ◽

John Mandeli ◽

...

Keyword(s):

Smoking Cessation ◽

Clinical Practice ◽

Negative Binomial ◽

Scientific Evidence ◽

Lessons Learned ◽

Negative Binomial Regression Model ◽

Smoking Cessation Counseling ◽

Curative Intent ◽

Oncology Practice ◽

Over Time

PURPOSE: The ASCO Quality Oncology Practice Initiative (QOPI) project was established to evaluate the influence of guideline recommendations on routine clinical practice. METHODS: QOPI provided summary data from 839 unique practices in which data were collected every six months from the Fall of 2015 to the Spring of 2019. From these data, six items were chosen based on their relationship to domains of survivorship. A zero-inflated negative binomial regression model was used to test for trends in QOPI measures adherence rates over time. The models were adjusted for the time period, region, practice-ownership, multispecialty site, fellowship program, and hospital type. RESULTS: Smoking cessation counseling recommended and smoking cessation counseling administered or referred both increased over time, 50%-61% (adjusted incidence rate ratios (IRR), 1.028; 95% CI, 1.016 to 1.040; P < .001) and 34%-49% (adjusted IRR, 1.052; 95% CI, 1.035 to 1.070; P < .001), respectively. Infertility risks discussed before chemotherapy increased from 36% to 53% (adjusted IRR, 1.056; 95% CI, 1.035 to 1.078; P < .001) and fertility options discussed or referred to specialists increased from 23% to 38% (adjusted IRR, 1.074; 95% CI, 1.046 to 1.102; P < .001). Twenty-nine percent documented a positron emission tomography, computed tomography, or bone scan within the first 12 months for women diagnosed with early breast cancer treated for curative intent (adjusted IRR, 1.000; 95% CI, 0.977 to 1.024; P = .971). Tumor marker surveillance within 12 months increased from 78% to 87% (adjusted IRR, 1.018; 95% CI, 1.002 to 1.033; P = .023). CONCLUSION: As scientific evidence to guide cancer survivorship care grows, the role of guideline recommendations permeating clinical practice using quality metrics will become increasingly important.

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