scholarly journals Buyang Huanwu Decoction for Healthcare: Evidence-Based Theoretical Interpretations of Treating Different Diseases with the Same Method and Target of Vascularity

2014 ◽  
Vol 2014 ◽  
pp. 1-17 ◽  
Author(s):  
Ji-huang Li ◽  
Ai-ju Liu ◽  
Hui-qin Li ◽  
Yan Wang ◽  
Hong-Cai Shang ◽  
...  

Buyang Huanwu Decoction (BHD) is a famous herbal prescription that has been used to treat stroke for centuries. Recent studies reported that the use of BHD had been extended to treat various kinds of disorders according to the TCM syndrome theory of Treating Different Diseases with the Same Method (TDDSM). Here, an overview of systematic reviews (SRs) of BHD for healthcare was conducted to interpret the TCM theory of TDDSM and its target of vascularity in an evidence-based manner. Literature searches were carried out in 5 databases to search SRs of BHD for any indication up to August 2013. Thirteen eligible SRs were identified which reported a wide range of vascular conditions. Based on the Overview Quality Assessment Questionnaire scores, the quality of included SRs was varied, with an average score of 4 points. We found that there is premature evidence for the use of BHD for healthcare, whereas BHD was well tolerable in all patients. BHD can be used to treat many disorders with the same therapeutic principle of invigorating Qi to activate blood circulation, which is essentially a manifestation of the TDDSM and is likely to account for targeting the specific pathogenesis of vascular diseases.

Author(s):  
Carmen Ricós ◽  
Pilar Fernández-Calle ◽  
Elisabet Gonzalez-Lao ◽  
Margarida Simón ◽  
Jorge Díaz-Garzón ◽  
...  

AbstractObjectivesNumerous biological variation (BV) studies have been performed over the years, but the quality of these studies vary. The objectives of this study were to perform a systematic review and critical appraisal of BV studies on glycosylated albumin and to deliver updated BV estimates for glucose and HbA1c, including recently published high-quality studies such as the European Biological Variation study (EuBIVAS).MethodsSystematic literature searches were performed to identify BV studies. Nine publications not included in a previous review were identified; four for glycosylated albumin, three for glucose, and three for HbA1c. Relevant studies were appraised by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Global BV estimates were derived by meta-analysis of BIVAC-compliant studies in healthy subjects with similar study design.ResultsOne study received BIVAC grade A, 2B, and 6C. In most cases, the C-grade was associated with deficiencies in statistical analysis. BV estimates for glycosylated albumin were: CVI=1.4% (1.2–2.1) and CVG=5.7% (4.7–10.6), whereas estimates for HbA1c, CVI=1.2% (0.3–2.5), CVG=5.4% (3.3–7.3), and glucose, CVI=5.0% (4.1–12.0), CVG=8.1% (2.7–10.8) did not differ from previously published global estimates.ConclusionsThe critical appraisal and rating of BV studies according to their methodological quality, followed by a meta-analysis, generate robust, and reliable BV estimates. This study delivers updated and evidence-based BV estimates for glycosylated albumin, glucose and HbA1c.


2021 ◽  
pp. 206-212
Author(s):  
Maria Denise Pessoa Silva ◽  
Fiona Rolls ◽  
Lynne White ◽  
Tamsin Longley ◽  
Jane Murphy ◽  
...  

Occupational therapy in palliative care aims to help patients achieve their optimum independence for as long as possible in activities that are important to them. There is a wide range of difficulties and symptoms experienced by palliative patients with which occupational therapy can intervene, which may include physical disabilities and functional impairments, extreme fatigue, anxiety, shortness of breath, and cognitive deficits. This chapter describes the broad range of areas in which the occupational therapist works in palliative care together with the multidisciplinary team. They take a key role in assessing and treating functional difficulties, organizing and facilitating safe discharge and care at home, with the aim of achieving best quality of life and avoiding admission to hospital whenever possible. The occupational therapist analyses and assesses specific problems and provides a treatment programme or solution to help the patient remain as independent as possible, using clinical reasoning and evidence-based practice.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ling-yan Lu ◽  
Guo-qing Zheng ◽  
Yan Wang

Shenmai injection (SMI) is widely applied in clinical practice as an organ protector. This overview is to evaluate the current evidence from systematic reviews (SRs) of SMI for healthcare. The literature searches were carried out in 6 databases without language restrictions until December 2012. The quality of the primary studies from the respective SRs was evaluated by using Jadad score. The overview quality assessment questionnaire (OQAQ) was used to evaluate the methodological quality of all included SRs. Twenty eligible SRs were identified. They reported a wide range of conditions, including SMI for cardio/cerebrovascular diseases, viral myocarditis, tumor chemotherapy, and adverse drug reactions. Most of the primary studies were of good quality only in 1 SR of non-small-cell lung cancer. According to the OQAQ scores, the quality of included SRs was variable and six reviews were of high quality with a score of 5 points. Two SRs showed that SMI had low adverse drug reaction occurrence. In conclusion, there is mixed evidence to support efficacy of SMI for an adjunct therapy to tumor chemotherapy and premature evidence for the use of SMI for cardio/cerebrovascular disorders and viral myocarditis. SMI seems generally safe for clinical application. Further large sample-size and well-designed RCTs are needed.


Author(s):  
Julian Wangler ◽  
Michael Jansky

SummaryMedical guidelines aim to ensure that care processes take place in an evidence-based and structured manner. They are especially relevant in outpatient primary care due to the wide range of symptoms and clinical pictures. In German-speaking countries, there is a lack of current findings documenting general practitioners’ opinions and experiences regarding guidelines, their expectations and their views on what improvements could be made to increase the use of this type of evidence-based instrument in the primary care setting. Between April and August 2020, a total of 3098 general practitioners were surveyed in the states of Baden–Württemberg, Hesse and Rhineland–Palatinate via an online questionnaire. Alongside the descriptive evaluation, t‑testing was used to determine significant differences between two independent sampling groups. A factor analysis was also used to cluster the expectations of those surveyed regarding the fulfilment of requirements relating to guidelines. A total of 52% of those surveyed have a positive view of guidelines. Overall, guidelines are associated with an increased evidence-based approach (69%), standardisation of diagnosis and treatment (62%) and a reduction in overprovision or underprovision of care (57%). In all, 62% of the physicians who implemented guidelines observed positive effects on the quality of care provided, and 67% reported that the implementation of guidelines improved the quality of their diagnostic or therapeutic skills. However, implementation is often seen as being complicated (43%) and restricting the physician’s ability to act independently (63%). Survey participants suggested that guidelines could be optimised by giving greater consideration to nondrug alternatives (46%), focusing on issues related to quality of life (42%) and offering a comparative assessment of various treatment options (39%). In order to further promote the attractiveness of guidelines for primary care the design of guidelines should be oriented more towards their application; they should be well-presented to make them easier to implement. The scope of action available to the physician should be stressed. The guidelines should provide recommendations on opportunities for the delegation of tasks within practice teams.


2021 ◽  
Vol 1 (2) ◽  
pp. 122-126
Author(s):  
Pallavi Patro ◽  
Durga Prasanna Misra

Systematic reviews are considered as the highest rung in the ladder of evidence-based medicine. They are bound by a pre-defined structure and requirement for extensive literature searches, when compared with the more liberal format of narrative reviews. Systematic review protocols should ideally be pre-registered to avoid duplication or redundancy. After defining clear review question(s), thorough literature searches form the basis of systematic reviews. Presentation of results should be qualitative or quantitative (meta-analysis) if the data is homogenous enough to permit pooling across multiple studies. Quality of individual studies by Cochrane risk of bias 2 tool for interventional studies and other suitable scales for observational studies, as well as appropriate assessment of publication bias are recommended. Certainty of outcomes should be assessed by the GRADE profiler. Finally, systematic reviews should conclude with recommendations for future research, based on their findings.


2021 ◽  
Author(s):  
Aydanur AYDIN ◽  
Ayla GÜRSOY

Abstract Aim: This study aimed to evaluate the functionality and quality of breast cancer-related apps which can be accessed from Turkey. Methods: The research covers 707 mobile applications, which were searched using the keywords "cancer", "oncology" and "breast cancer" in Google and App store stores between January and June 2019. The quality of apps was assessed with the user version of the Mobile App Rating Scale (MARS). Results: Mobile applications focus on communication, education and treatment order / plan categories. The average MARS quality score for applications in all of the two stores was determined as 3.42. According to the average score of the scale sub-dimensions; It was seen that they were ranked as functionality, aesthetics, information quality and participation. MARS scale sub-groups were listed as functionality, aesthetics, knowledge quality, and participation. Conclusion: e-Health is a subject that has just started to be used actively in health. Although basic information about breast cancer was used, information on prevention, early diagnosis and precautions was relatively limited and was not personalized. Support from healthcare professionals and further efforts should be made to develop evidence-based breast cancer knowledge and innovative technology and applications regarding cancer. Implications for practice: e-Health technologies are a good tool in breast cancer, but appear to lack evidence-based content and individual specific areas such as age and education level.


Author(s):  
Andrew Hodgkiss

A wide range of therapeutic strategies to manage cancer-related psychopathology are described. Evidence-based interventions include: surgery (e.g. oophorectomy for anti-NMDAR limbic encephalitis), radiotherapy, immunotherapy, anti-glucocorticoids, correction of electrolyte abnormalities, correction of vitamin or endocrine deficiencies, and the use of carefully selected antidepressant or antipsychotic medication. Particular attention is paid to the management of cancer-related delirium and mania, and to the depressive phenomena provoked by systemic cancer treatments. The quality of the evidence-base for these treatments is critically reviewed.


2007 ◽  
Vol 23 (3) ◽  
pp. 128-136 ◽  
Author(s):  
Susan Adams ◽  
Ann Marie McCarthy

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 and other health care workers to have research information collected, analyzed, and condensed into specific practice recommendations by experts. This article defines EBP guidelines and discusses the process of guideline development, including identification of topics, systematic literature searches, and evaluation and rating of research. Criteria for determining the quality of existing guidelines are reviewed. The steps needed to develop EBP guidelines specifically for school nursing are discussed.


2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.


2013 ◽  
Author(s):  
Kimberly D. Becker ◽  
Dana Darney ◽  
Celene Domitrovich ◽  
Catherine Bradshaw ◽  
Nicholas S. Ialongo

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