scholarly journals Using the vignette methodology to measure access

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
E Van Ginneken
Keyword(s):  
Best Practice ◽  
Clinical Judgments ◽  
User Friendliness ◽  
Systematic Analysis ◽  
Recommended Care ◽  
Care Plans ◽  
Best Practice Guidelines ◽  
Case Vignettes ◽  
Comparability Of Results ◽  
Selection Of

Abstract Background A vignette is a short description of a person or situation designed to simulate key features of a real- world scenario. Usually this vignette is then presented to relevant professionals to solicit their hypothetical response or behaviour. In medical literature, vignettes are mostly used to study clinical judgments, compare hospital prices, self-assess health or examine how age, sex, socioeconomic or insurance status affects chosen treatment. Methods We aimed to develop a method to utilize case vignettes to gain a better understanding of health access challenges. To this end, we studied available access indicators and frameworks and vignette applications as well as possible ways to include internationally recommended care plans to increase comparability of results across countries. Results We developed a five-step approach consisting of (1) selection of vignettes, (2) drafting of vignettes and a questionnaire based on available access framework and best practice guidelines for treatment, (3) expert validation, (4) application of vignette in country context, and (5) systematic analysis of country feedback. Four detailed pilots were carried out for dental care, stroke, depression and palliative care, in up to 12 European countries. Conclusions The vignette approach has the potential to identify gaps in coverage and access as well as differences in treatment and quality. Four detailed pilots have provided valuable insights in the challenges and limitations of the method that can be addressed in future applications. These include suggestions to improve user friendliness, scope, expert selection and complementing the survey with more specific and quantitative questions.

scholarly journals Voluntary industry initiatives to promote healthy diets: a case study on a major European food retailer

2018 ◽  
Vol 21 (18) ◽  
pp. 3469-3476
Author(s):  
Peter von Philipsborn ◽  
Jan Marcel Stratil ◽  
Thomas Leonhard Heise ◽  
Rüdiger Landgraf ◽  
Hans Hauner ◽  
...  
Keyword(s):  
Best Practice ◽  
Qualitative Content Analysis ◽  
Population Level ◽  
Monitoring And Evaluation ◽  
Added Sugar ◽  
Best Practice Guidelines ◽  
Healthy Diets ◽  
Food Retailer ◽  
Selection Of

AbstractObjectiveTo analyse the scope and content of the nutrition pledge announced by Lidl.DesignWe applied the approach recommended by the private-sector module of the INFORMAS (International Network for Food and Obesity Research, Monitoring and Action Support) food environment monitoring framework and qualitative content analysis to Lidl’s nutrition pledge.SettingGlobal.SubjectsThe nutrition pledge of Lidl, Europe’s largest food retailer.ResultsLidl pledges to reduce the average sales-weighted content of added sugar and added salt in its own-brand products by 20 % until 2025, using 2015 as a baseline, starting in Germany. Moreover, it vows to reduce the saturated and trans-fatty acid contents of its own-brand products, without specifying targets or timelines. To achieve these targets, it pledges to apply a number of approaches, including reformulation, promotion of healthier products, reduction of package and portion sizes, and provision of nutrition information and education. Strengths of Lidl’s pledge are its extensive scope, the quantification of some targets, and its partially evidence-based approach to the selection of targets and interventions. Key limitations include the vagueness of many targets, a lack of transparency and the absence of independent monitoring and evaluation.ConclusionsLidl’s pledge, while commendable for its scope, does not meet current best practice guidelines. Given their current limitations, industry initiatives of this kind are likely to fall short of what is needed to improve population-level nutrition.

Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711581
Author(s):  
Charlotte Greene ◽  
Alice Pearson
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Base ◽  
High Dose ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Best Practice Guidelines

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.

scholarly journals Introducing New Guidelines on Geoheritage Conservation in Protected and Conserved Areas

Geoheritage ◽  
2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Roger Crofts ◽  
Dan Tormey ◽  
John E. Gordon
Keyword(s):  
Practice Guidelines ◽  
Best Practice ◽  
Communication To The Public ◽  
The Public ◽  
Best Practice Guidelines ◽  
The World ◽  
New Guidelines ◽  
The Many ◽  
Ethical Basis ◽  
Improve Practice

AbstractThis paper introduces newly published guidelines on geoheritage conservation in protected and conserved areas within the “IUCN WCPA Best Practice Guidelines” series. It explains the need for the guidelines and outlines the ethical basis of geoheritage values and geoconservation principles as the fundamental framework within which to advance geoheritage conservation. Best practice in establishing and managing protected and conserved areas for geoconservation is described with examples from around the world. Particular emphasis is given to the methodology and practice for dealing with the many threats to geoheritage, highlighting in particular how to improve practice for areas with caves and karst, glacial and periglacial, and volcanic features and processes, and for palaeontology and mineral sites. Guidance to improve education and communication to the public through modern and conventional means is also highlighted as a key stage in delivering effective geoconservation. A request is made to geoconservation experts to continue to share best practice examples of developing methodologies and best practice in management to guide non-experts in their work. Finally, a number of suggestions are made on how geoconservation can be further promoted.

scholarly journals Development of the “Hamburg Best Practice Guidelines for ICV−Enzyme Replacement therapy (ERT) in CLN2 Disease” Based on 6 Years Treatment Experience in 48 Patients

2021 ◽  
pp. 088307382198915
Author(s):  
Christoph Schwering ◽  
Gertrud Kammler ◽  
Eva Wibbeler ◽  
Martin Christner ◽  
Johannes K.-M. Knobloch ◽  
...  
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Practice Guidelines ◽  
Best Practice ◽  
Vision Loss ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Enzyme Replacement ◽  
Best Practice Guidelines

Intracerebroventricular enzyme replacement therapy (ICV-ERT) for CLN2 disease represents the first approved treatment for neuronal ceroid lipofuscinosis (NCL) diseases. It is the first treatment where a recombinant lysosomal enzyme, cerliponase alfa, is administered into the lateral cerebral ventricles to reach the central nervous system, the organ affected in CLN2 disease. If untreated, CLN2 children show first symptoms such as epilepsy and language developmental delay at 2-4 years followed by rapid loss of motor and language function, vision loss, and early death. Treatment with cerliponase alfa has shown to slow the rapid neurologic decline. However, the mode of administration by 4 hour-long intracerebroventricular infusions every 14 days represents a potentially greater risk of infection compared to intravenous enzyme replacement therapies. The Hamburg NCL Specialty Clinic was the first site worldwide to perform intracerebroventricular enzyme replacement therapy in children with CLN2 disease. In order to ensure maximum patient safety, we analysed data from our center from more than 3000 intracerebroventricular enzyme replacement therapies in 48 patients over 6 years with regard to the occurrence of device-related adverse events and device infections. Since starting intracerebroventricular enzyme replacement therapy, we have also developed and continuously improved the “Hamburg Best Practice Guidelines for ICV–Enzyme Replacement Therapy (ERT) in CLN2 Disease.” Results from this study showed low rates for device-related adverse events and infections with 0.27% and 0.33%, respectively. Therefore, following our internal procedural guidelines has shown to improve standardization and patient safety of intracerebroventricular enzyme replacement therapy for CLN2 disease.

scholarly journals Artistic Freedom or Animal Cruelty? Contemporary Visual Art Practice That Involves Live and Deceased Animals

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 812
Author(s):  
Ellie Coleman ◽  
Rebecca Scollen ◽  
Beata Batorowicz ◽  
David Akenson
Keyword(s):  
Best Practice ◽  
Animal Cruelty ◽  
Art Practice ◽  
Animal Protection ◽  
Ethical Implications ◽  
High Profile ◽  
Unethical Practices ◽  
Artistic Freedom ◽  
Legal Guidelines ◽  
Selection Of

This paper examines a selection of 21st-century international examples of exhibited visual artworks involving live or deceased animals. It seeks to reveal the risks and benefits of unique encounters with animals through art and to consider the ethical implications of artwork deploying animals. Australian and international animal protection laws are not explicit when it comes to the sourcing of animals for art nor for the direct inclusion of animals in artworks. This lack leads to a variety of artistic practices, some considered ethical while others are viewed as controversial, bordering on animal cruelty. Artwork selection is determined by a focus on high-profile artists who intentionally use animals in their practice and whose reputation has been fostered by this intention. The study provides insight into how the intentional use of ethically sourced animals within art practice can be a method of addressing hierarchal human–animal imbalances. Further, this study identifies unethical practices that may be best avoided regardless of the pro-animal political statements the artists put forward. Recommendations of how to better determine what is an acceptable use of animals in art with a view to informing legal guidelines and artistic best practice are presented.

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