Challenging Behaviours in People with Intellectual Disabilities

Oxford Textbook of the Psychiatry of Intellectual Disability ◽

10.1093/med/9780198794585.003.0016 ◽

2020 ◽

pp. 159-168

Author(s):

Glynis H. Murphy ◽

Peter McGill

Keyword(s):

Challenging Behavior ◽

Biomedical Science ◽

Evidence Based ◽

Evidence Based Practices ◽

High Risk Factors ◽

Problem Behaviours ◽

The Individual ◽

Challenging Behaviours

Challenging behavior is not a diagnosis. It is behaviour of such an intensity, frequency or duration as to threaten the quality of life and/or the physical safety of the individual or others and is likely to lead to responses that are restrictive, aversive or result in exclusion. This definition is less pejorative, makes fewer assumptions about causality and reminds us that such behaviour is a challenge to services. Challenging behavior is more prevalent in those with an intellectual disability than those without with overall prevalence figures of 10–15% in those known to services. A number of long term high risk factors have been identified and evidence based interventions have included parent training and behavioural interventions. Positive Behavioural Support (PBS) is an intervention technology based on social, behavioural, educational, and biomedical science that combines evidence-based practices with formal systems change strategies, focused on both improving the valued lifestyle options available for an individual and reducing problem behaviours.

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When a Baby Is Sent Away: Evidence to Support Best Practice After Neonatal Transport

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.37.3.178 ◽

2018 ◽

Vol 37 (3) ◽

pp. 178-181

Author(s):

Sabrina Schwartz ◽

Deborah A. Raines

Keyword(s):

Best Practice ◽

Care Center ◽

Bonding Process ◽

Evidence Based ◽

Evidence Based Practices ◽

Neonatal Transport ◽

Child Relationship ◽

The Hours ◽

Mother Child Relationship

Every day neonates are transported from the birth hospital to a tertiary neonatal care center. Separation of mother and neonate in the hours immediately following birth interrupts the bonding process and can have long-term implications for the mother–child relationship. This article synthesizes the literature focused on mothers’ experiences with a neonate being transported to a tertiary NICU and identifies evidence-based practices specific to these situations.

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Type 2 diabetes in women of reproductive age

Women’s Healthcare: A Clinical Journal for NPs ◽

10.51256/whc042108 ◽

2021 ◽

Vol 9 (2) ◽

Author(s):

Donna M. Williams ◽

Kathryn Evans Kreider

Keyword(s):

Type 2 Diabetes ◽

Nurse Practitioners ◽

Diabetes Management ◽

Reproductive Age ◽

Current Evidence ◽

Evidence Based ◽

Women Of Reproductive Age

The prevalence of type 2 diabetes in women of reproductive age ranges from 3% to 7%. Due to the common nature of this condition, it is imperative for nurse practitioners who care for women to understand evidence-based methods of diabetes management. The aim of this article is to describe current screening and diagnostic criteria for type 2 diabetes, discuss current evidence-based management and patient education necessary to prevent long-term complications, and provide the tools for a healthy reproductive plan in women with type 2 diabetes from puberty until menopause. Diabetes management extends well beyond glucose control, and nurse practitioners should be attuned to all factors that can impact cardiovascular risk and quality of life.

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Implementation Science, Professional Development, and Autism Spectrum Disorders

Council review ◽

10.1177/0014402913079002081 ◽

2013 ◽

Vol 79 (2) ◽

pp. 233-251 ◽

Cited By ~ 1

Author(s):

Samuel L. Odom ◽

Ann W. Cox ◽

Matthew E. Brock

Keyword(s):

Professional Development ◽

Autism Spectrum Disorders ◽

Implementation Science ◽

Autism Spectrum ◽

Evidence Based ◽

Evidence Based Practices ◽

Science Professional Development ◽

Spectrum Disorders ◽

Development Center

The increased prevalence of autism spectrum disorders (ASD) has intensified the need for high-quality special education services designed for children and youth with ASD and their families. Implementation science provides guidance for moving innovation, such as utilizing evidence-based practices for students with ASD, into regular practice in schools. The National Professional Development Center on ASD (NPDC) incorporated the principles of implementation science, the scientific knowledge about evidence-based practices, and the measurement of program quality into an intervention approach for students with ASD. This article presents the NPDC model as an example of using implementation science to build systems of professional development that increase the quality of services and promote teachers’ use of evidence-based practices.

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Acupuncture in Neurological Disorders: An Evidence-Based Overview

Integrative Neurology ◽

10.1093/med/9780190051617.003.0016 ◽

2020 ◽

pp. 449-494

Author(s):

Alexandra Dimitrova

Keyword(s):

Neurological Disorders ◽

Large Scale ◽

Healthcare Providers ◽

Evidence Based ◽

Tunnel Syndrome ◽

Meta Analyses ◽

New Evidence ◽

Common Misconceptions

Over the past 20 years acupuncture has been rapidly gaining in popularity both in clinical practice and in research. New evidence for the benefits of acupuncture in various disorders is emerging seemingly every week, and recent large-scale systematic reviews and meta-analyses have suggested that acupuncture’s benefits in pain conditions can be maintained long term. At present the strongest evidence for acupuncture in the treatment of neurological disorders is in the fields of migraine, tension headaches, diabetic neuropathy, carpal tunnel syndrome, and Bell’s palsy. Recent trials suggest that acupuncture may be used as an adjunct in stroke rehabilitation and in improving the quality of life in patients with Parkinson’s disease and dementia. Despite recent mechanistic research advances, much remains unknown about acupuncture’s mechanism of action and there are common misconceptions about the origins of modern-day acupuncture. As acupuncture is being rapidly integrated into mainstream medical practice and increasingly being sought by patients, healthcare providers and neurologists in particular need to be educated about its applications and benefits for various neurological disorders. Our hope is that this chapter will serve toward this educational goal.

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Pearls for Interpreting Neurosurgical Systematic Reviews and Meta-Analyses: Lessons From a Collaborative Effort

Neurosurgery ◽

10.1093/neuros/nyaa027 ◽

2020 ◽

Vol 87 (3) ◽

pp. 435-441 ◽

Cited By ~ 2

Author(s):

Victor M Lu ◽

Christopher S Graffeo ◽

Avital Perry ◽

Michael J Link ◽

Fredric B Meyer ◽

...

Keyword(s):

Systematic Reviews ◽

Evidence Based Medicine ◽

Lessons Learned ◽

Evidence Based ◽

Cranial Neuralgia ◽

The Individual ◽

Meta Analyses ◽

Based Medicine ◽

Over Time

Abstract Systematic reviews and meta-analyses in the neurosurgical literature have surged in popularity over the last decade. It is our concern that, without a renewed effort to critically interpret and appraise these studies as high or low quality, we run the risk of the quality and value of evidence-based medicine in neurosurgery being misinterpreted. Correspondingly, we have outlined 4 major domains to target in interpreting neurosurgical systematic reviews and meta-analyses based on the lessons learned by a collaboration of clinicians and academics summarized as 4 pearls. The domains of (1) heterogeneity, (2) modeling, (3) certainty, and (4) bias in neurosurgical systematic reviews and meta-analyses were identified as aspects in which the authors’ approaches have changed over time to improve robustness and transparency. Examples of how and why these pearls were adapted were provided in areas of cranial neuralgia, spine, pediatric, and neuro-oncology to demonstrate how neurosurgical readers and writers may improve their interpretation of these domains. The incorporation of these pearls into practice will empower neurosurgical academics to effectively interpret systematic reviews and meta-analyses, enhancing the quality of our evidence-based medicine literature while maintaining a critical focus on the needs of the individual patients in neurosurgery.

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Standard Evidence-Based Pharmacological Treatment for OCD

10.1093/med/9780190228163.003.0040 ◽

2017 ◽

Author(s):

Jemma E Reid ◽

Samar Reghunandanan ◽

Ann Roberts ◽

Naomi A Fineberg

Keyword(s):

Quality Of Life ◽

Pharmacological Treatment ◽

Selective Serotonin Reuptake Inhibitors ◽

Evidence Based ◽

Health Related Quality ◽

Pharmacological Treatments ◽

Related Quality ◽

Health Related

This chapter reviews standard pharmacological treatments for OCD and the evidence supporting them. Selective serotonin reuptake inhibitors (SSRIs) remain the pharmacological treatment of choice and are associated with improved health-related quality of life. Improvements are usually sustained over time as long as treatment is continued. Discontinuation is associated with relapse and loss of quality of life, implying that treatment should continue long-term. A substantial minority of patients who fail to respond to SSRIs may benefit from dose elevation, switch to clomipramine, or adjunctive antipsychotic, though long-term trials validating the effectiveness and tolerability of these strategies are relatively lacking.

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Reconsidering the Moralization of Health: Practices Versus Concepts, and What We Can Learn from Evidence-based Research

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180119000069 ◽

2019 ◽

Vol 28 (02) ◽

pp. 215-224 ◽

Cited By ~ 1

Author(s):

S. JOSHUA THOMAS

Keyword(s):

Evidence Based ◽

Conceptual Level ◽

Competing Values ◽

Free Standing ◽

Health States ◽

Concept Of Health ◽

The Individual ◽

Individual Healthcare ◽

Practical Level

Abstract:This article aims to do two things. First, it argues that moralization of health occurs not only at the practical level of individual healthcare choices and health states, but also at the conceptual level of health itself. This is most evident in cases where the concept of health is presumed to possess the property of “overridingness” when compared to competing values and norms, that is, when it is treated as taking precedence over other values and norms it may come into conflict with. Second, the article makes a case for being critically skeptical of specific deployments of the concept of health when it has been moralized in this way. In such cases, what typically results is that some other personal value/norm, or set of values/norms, held by the individual is treated as intrinsically at odds with the concept of health, which is presumed, uncritically, to be superior, often because it is taken to be free-standing and self-justifying. Yet, a growing body of evidence-based research suggests that the role played by dimensions of personal meaningfulness in the quality of individuals’ overall health is quite underappreciated. It is useful to think of these dimensions of personal meaning and significance as representing the individual’s values. Thus, taking these data more seriously ought to lead to a reevaluation of the moralization of health at the conceptual level. In the first place, it is not obvious that if the concept of health runs afoul of other values/norms held by an individual, the latter should automatically yield. In the second place, they suggest that other values/norms held by an individual are not necessarily intrinsically opposed to the concept of health, but in fact may go a good distance in support of it.

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The Absence of Evidence-Based Practices (EBPs) in the Treatment of Sexual Abusers: Recommendations for Moving Toward the Use of a True EBP Model

Sexual Abuse ◽

10.1177/1079063219843897 ◽

2019 ◽

Vol 32 (6) ◽

pp. 679-705

Author(s):

Adam Deming ◽

Jerry L. Jennings

Keyword(s):

Mental Health ◽

Methodological Quality ◽

Treatment Effectiveness ◽

Current Status ◽

Evidence Based ◽

Evidence Based Practices ◽

Treatment Approaches ◽

Professional Discipline ◽

History Of

Despite a continued evolution of the field of sexual abuser treatment toward a distinct professional discipline with clinicians using an increasing variety of treatment approaches, there is no consensus regarding the strength of our various clinical interventions as evidence-based practices (EBPs). This article provides a brief history of the development and goals of EBPs in medicine and mental health, and a review of the earnest efforts of researchers within the field to establish treatment approaches with sexual abusers as evidence-based. An appraisal of the current status of EBP’s with sexual abusers is provided. Although there have been improvements in the methodological quality of treatment outcome research with sexual abusers, divergent opinions about treatment effectiveness remain, and the field has not yet agreed on a system or set of criteria for what constitutes “evidence.” We contend that clinical practice has been influenced as much, or more, by new paradigms that are intuitively meaningful and perceived as needed than it has by what has been determined to be scientifically efficacious. This trend and other processes in our field that seem to be slowing the development of EBPs with sexual abusers are discussed. Recommendations for conducting evidence-based reviews and moving the field of sexual abuser treatment toward the use of a true EBP model are provided.

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The Care Triangle: Determining the Gaps in the Management of Atopic Dermatitis

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2013.12119 ◽

2013 ◽

Vol 17 (4) ◽

pp. 276-282 ◽

Cited By ~ 5

Author(s):

Ashley O'Toole ◽

Bjorn Thomas ◽

Richard Thomas

Keyword(s):

Atopic Dermatitis ◽

Response To Treatment ◽

Care Process ◽

Evidence Based ◽

Previous Response ◽

Children And Young Adults ◽

The Individual ◽

Evidence Based Guidelines ◽

Based Medicine

Background: Atopic dermatitis (AD) is a chronic, relapsing, intensely pruritic dermatosis that usually affects infants, children, and young adults. The treatment of AD entails an individualized regimen that depends on the age of the patient, the stage and variety of lesions present, the sites and extent of involvement, the presence of infection, and the previous response to treatment. Objectives: To identify the evidence surrounding potential strategies for closing these gaps—ultimately improving the quality of care, the care process itself, and patient outcomes—and to encourage discussions that help develop tools to bridge the gap between suggested therapy and what is done by the patient. Methods: Review of the literature including searches on PubMed Central and Medline and in seminal dermatology texts. Results: There are several disconnections between the evidence-based guidelines in the management of AD, what the individual dermatologist recommends, and what the patient does. Conclusion: Applying the concept of the care triangle requires a balance of evidence-based medicine, the physician's experiences and the patient's needs and expectations in the decisions surrounding appropriate management of the disease.

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