scholarly journals Preconception Care: A New Standard of Care within Maternal Health Services

2016 ◽  
Vol 2016 ◽  
pp. 1-30 ◽  
Author(s):  
Stephen J. Genuis ◽  
Rebecca A. Genuis
Keyword(s):  
Health Professionals ◽  
Preconception Care ◽  
Lifestyle Modification ◽  
Scientific Evidence ◽  
Standard Of Care ◽  
Maternal Health Services ◽  
Research Literature ◽  
Patient Choice ◽  
Medical Community ◽  
Prenatal Factors

Emerging research suggests that much pediatric affliction has origins in the vulnerable phase of fetal development. Prenatal factors including deficiency of various nutrients and exposure to assorted toxicants are major etiological determinants of myriad obstetrical complications, pediatric chronic diseases, and perhaps some genetic mutations. With recent recognition that modifiable environmental determinants, rather than genetic predestination, are the etiological source of most chronic illness, modification of environmental factors prior to conception offers the possibility of precluding various mental and physical health conditions. Environmental and lifestyle modification through informed patient choice is possible but evidence confirms that, with little to no training in clinical nutrition, toxicology, or environmental exposures, most clinicians are ill-equipped to counsel patients about this important area. With the totality of available scientific evidence that now exists on the potential to modify disease-causing gestational determinants, failure to take necessary precautionary action may render members of the medical community collectively and individually culpable for preventable illness in children. We advocate for environmental health education of maternity health professionals and the widespread adoption and implementation of preconception care. This will necessitate the translation of emerging knowledge from recent research literature, to health professionals, to reproductive-aged women, and to society at large.

scholarly journals 1112. #EducationInTheTimeofCOVID: Using Twitter to Disseminate Evidence-Based Medicine during a Pandemic

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S586-S587
Author(s):  
Caroline G Coleman ◽  
Timothy T Daugherty ◽  
Yooree G Chung ◽  
Angel X Xiao ◽  
Amy C Sherman ◽  
...  
Keyword(s):  
Medical Students ◽  
Health Professionals ◽  
High Volume ◽  
Clinical Syndrome ◽  
Medical Community ◽  
Accurate Information ◽  
Teaching Aids ◽  
Twitter Analytics ◽  
Large Audience ◽  
Based Medicine

Abstract Background The medical community has used Twitter as a learning tool during the COVID-19 pandemic to digest the high volume of rapidly evolving literature. However, Twitter contains educational content of varying quality and accuracy. To address this issue, we created and disseminated visual abstracts of COVID-19 literature on Twitter to educate health professionals. Methods Fellows and faculty members from multiple institutions collaborated with Emory University medical students to create visual abstracts of published COVID-19 literature (Figure 1). ID fellows and faculty identified and summarized 10-15 high-impact COVID-19 articles each week. Medical students created visual abstracts for each article, which fellows or faculty reviewed for accuracy. We disseminated them on Twitter (@JenniferSpicer4, 4,373 followers) and our website (Figure 2). We measured engagement with tweets using Twitter Analytics. Figure 1: COVID-19 Visual Abstract Example Figure 2: Website hosting COVID-19 weekly literature summaries and visual abstracts (https://med.emory.edu/departments/medicine/divisions/infectious-diseases/covid19-roundup/) Results Since March 2020, we have created, reviewed, and disseminated 139 graphics with 116 student authors and 33 fellow/faculty reviewers across three academic institutions (Table 1). Topics included public health & prevention, virology & basic science, epidemiology, transmission & infection control, clinical syndrome, diagnostics, therapeutics, vaccinology, and ethics & policy. Tweets had a median of 9,300 impressions (interquartile range [IQR] 5,432-13,233) with 766 engagements (IQR 432-1,288) and an engagement rate of 8.6% (IQR 7.1%-10.0%) (Table 2). Each tweet had a median of 25 retweets (IQR 17-38) and 55 likes (IQR 34-81). A few tweets had significantly higher metrics; maximum values were 84,257 impressions, 9,758 engagements, 19.0% engagement rate, 239 retweets, and 381 likes. In addition to disseminating graphics on Twitter, we received requests to use them as teaching aids from multiple health professionals worldwide, and the visual abstracts have been translated into Spanish and disseminated on Twitter and Instagram via @MEdSinFrontera. Table 1: Descriptive Statistics of COVID-19 Visual Series Table 2: Twitter Metrics for COVID-19 Visual Series (as of 6/10/2020) Conclusion Engagement rates with our visual abstracts were high, demonstrating the power of Twitter. ID educators can use visual abstracts to summarize and disseminate accurate information to a large audience on social media, which is especially important in the setting of an emerging infection. Disclosures All Authors: No reported disclosures

The prevalence of the technocratic model in obstetric care from the perspective of health professionals

2021 ◽  
Vol 74 (suppl 4) ◽  
Author(s):  
Marli Therezinha Stein Backes ◽  
Karini Manhães de Carvalho ◽  
Larissa Nascimento Ribeiro ◽  
Tamiris Scoz Amorim ◽  
Evanguelia Kotzias Atherino dos Santos ◽  
...  
Keyword(s):  
Health Professionals ◽  
Scientific Evidence ◽  
Obstetric Care ◽  
Ethics Committees ◽  
Obstetric Nurses ◽  
Data Collection And Analysis ◽  
Maternity Hospitals ◽  
Theoretical Sampling ◽  
Centered Care ◽  
Nursing Professionals

ABSTRACT Objectives: to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals. Methods: Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration. Results: the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff. Final Considerations: obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.

The 2016 RANZCP Guidelines for the Management of Schizophrenia and Related Disorders – what’s next?

2017 ◽  
Vol 25 (6) ◽  
pp. 600-602 ◽  
Author(s):  
Assen Jablensky ◽  
David J Castle ◽  
Frances Dark ◽  
Verity Humberstone ◽  
Eoin Killackey ◽  
...  
Keyword(s):  
Mental Health ◽  
Scientific Evidence ◽  
Standard Of Care ◽  
Mental Health Research ◽  
Response To Treatment ◽  
Clinical Expertise ◽  
The Public ◽  
Measuring Outcomes ◽  
Treatment Plans ◽  
Personalised Treatment

Objectives: The recently published RANZCP guidelines for schizophrenia and related disorders reviewed recent scientific evidence, and, where lacking, referred to clinical expertise to supply a template for raising the standard of care. This paper builds on the guidelines and recommends how they might be used to improve outcomes. Methods: The guidelines call for evidence-based mental health policies, inclusive of mobilising affected families, communities and the public in support of policies that ensure better care and protect the wellbeing of people with severe mental disorders. The process of preparing the guidelines highlighted the limits of our scientific understanding of schizophrenia and shortcomings in the care currently provided. Results: Writing the guidelines evinced the need for a culture of measuring outcomes and response to treatment, and harnessing such data to monitoring and optimising patient care. Conclusions: We recommend creation of a national case cohort for mental health research involving a collaborative network of clinical research centres, using the guidelines and generating scientific evidence for translation into clinical practice protocols that enable personalised treatment plans for patients and criteria for the performance of clinical services.

Adapting Standards of Care Under Extreme Conditions

2009 ◽  
Vol 3 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Kristine M. Gebbie ◽  
Cheryl A. Peterson ◽  
Italo Subbarao ◽  
Kathleen M. White
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Control Policy ◽  
Standard Of Care ◽  
White Paper ◽  
Ethical Framework ◽  
Standards Of Care ◽  
State Legislation ◽  
Routine Tasks ◽  
Criminal Charges

ABSTRACTThe filing of criminal charges against a group of clinicians in New Orleans for failure to meet expected standards of care following the hurricanes of 2005 made the growing concern among health professionals about care provided during extreme emergencies or disasters all too real. Questions about what may lead to censure, penalties from licensing boards, or lawsuits have come from nurses, physicians, and many other licensed health professionals. A panel convened by the American Nurses Association that included representatives of medical, public health, hospital, and government agencies considered the ethical, professional, and practical aspects of meeting standards of care in such circumstances. Clinicians are reminded that in emergencies, it is only the circumstances that change (perhaps radically); neither the individual’s professional competency nor the basic professional standard of care is different. In making prioritized decisions under such circumstances, the individual’s ethical framework is utilitarian, and there are 3 areas for action, even when some routine tasks are set aside: maintain worker and patient safety; maintain airway, breathing, and circulation; and establish or maintain infection control. Policy recommendations such as state legislation for the adoption of comprehensive immunity for volunteer health care workers, and the establishment of a medical review panel as arbitration board are also suggested. The resulting white paper summarizes the issues and provides guidance to individual professionals, institutions in which they work, and emergency planners. (Disaster Med Public Health Preparedness. 2009;3:111–116)

scholarly journals Contenção mecânica nos serviços de urgência e emergência

2020 ◽  
Vol 14 ◽  
Author(s):  
Ana Carolina Siqueira de Carvalho ◽  
Patricia De Fatima Augusto Barros ◽  
Romulo DelValle ◽  
Rosimere Ferreira Santana
Keyword(s):  
Health Professionals ◽  
Emergency Services ◽  
Scientific Evidence ◽  
Rating System ◽  
Educational Strategies ◽  
Level Of Evidence ◽  
Mechanical Restraint ◽  
Intervention Treatment ◽  
Nursing Health ◽  
Perception Of Health

Objetivo: identificar evidências científicas sobre o uso da contenção mecânica em pacientes adultos e idosos nos serviços de urgências e emergências. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa da literatura, realizado nas bases de dados: Medline (via PubMed), CINAHL, Scopus e Lilacs, nos últimos cinco anos, 2014 a 2019. Avaliaram-se e classificaram-se os estudos quanto ao seu rigor científico, para a classificação do Nível de Evidência, por meio de um instrumento baseado na Rating System for the Hierachy of Evidence for Intervention/Treatment Question. Resultados: encontraram-se três estudos, no Havaí, Canadá e Austrália, produzidos em 2014 e 2016, sendo dois artigos com abordagem quantitativa e um artigo qualitativo, todos na língua inglesa. Informa-se que dois tratavam de implementação de estratégias de educação para reduzir o uso da contenção e um sobre a percepção dos profissionais de saúde sobre o uso da contenção. Conclusão: conclui-se que estratégias educacionais para profissionais de saúde são necessárias para reduzir o uso da contenção mecânica, evitando resultados deletérios não só para os pacientes, mas para a equipe. Descritores: Adultos; Idosos; Restrição Física; Serviços Médicos de Emergência; Enfermagem em Emergência; Saúde do Idoso.AbstractObjective: to identify scientific evidence on the use of mechanical restraint in adult and elderly patients in urgent and emergency services. Method: this is a bibliographic, descriptive, integrative review of the literature, carried out in the databases: MEDLINE (via PubMed), CINAHL, SCOPUS and LILACS, in the last five years, 2014 to 2019. They were evaluated and classified the studies are based on their scientific rigor, for the classification of the Level of Evidence, using an instrument based on the Rating System for the Hierachy of Evidence for Intervention / Treatment Question. Results: three studies were found, in Hawaii, Canada and Australia, produced in 2014 and 2016, two articles with a quantitative approach and one qualitative article, all in English. It is reported that two dealt with the implementation of education strategies to reduce the use of restraint and one about the perception of health professionals about the use of restraint. Conclusion: it is concluded that educational strategies for health professionals are necessary to reduce the use of mechanical restraint, avoiding deleterious results not only for patients, but for the team. Descriptors: Adults; Aged; Restraint, Physical; Emergency Medical Services; Emergency Nursing; Health of the Elderly.ResumenObjetivo: identificar evidencia científica sobre el uso de restricciones mecánicas en pacientes adultos y ancianos en servicios urgentes y de emergencia. Método: esta es una revisión bibliográfica, descriptiva, integradora de la literatura, realizada en las bases de datos: MEDLINE (a través de PubMed), CINAHL, SCOPUS y LILACS, en los últimos cinco años, 2014 a 2019. Fueron evaluados y clasificados los estudios en cuanto su rigor científico, para la clasificación del Nivel de Evidencia, utilizando un instrumento basado en el Rating System for the Hierachy of Evidence for Intervention/Treatment Question. Resultados: se encontraron tres estudios, en Hawai, Canadá y Australia, producidos en 2014 y 2016, dos artículos con un enfoque cuantitativo y un artículo cualitativo, todos en inglés. Se informa que dos se ocuparon de la implementación de estrategias educativas para reducir el uso de la contención y uno sobre la percepción de los profesionales de la salud sobre el uso de la contención. Conclusión: se concluye que las estrategias educativas para los profesionales de la salud son necesarias para reducir el uso de contención mecánica, evitando resultados nocivos no solo para los pacientes, sino también para el equipo. Descriptores: Adulto; Anciano; Restricción Física; Servicios Médicos de Urgencia; Enfermería de Urgencia; Salud del Anciano.

scholarly journals Compreensão Emocional da Morte Pelas Crianças em Idade Pré-escolar: Uma Dimensão Esquecida

2020 ◽  
Vol 33 (10) ◽  
pp. 649
Author(s):  
Filipa Martins Silva ◽  
Ana Filipa Lopes ◽  
Vânia Carneiro ◽  
Álvaro Campelo
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Scientific Evidence ◽  
Emotional Understanding ◽  
Priority Area ◽  
Care Network ◽  
Emotional Dimension ◽  
Hypothetical Scenario ◽  
A Priority ◽  
Depth View

Introduction: Scientific evidence regarding children’s understanding of the concept of death is scarce. This has recently been pointed out by the International Children’s Palliative Care Network as a priority area of research. In particular, the avoidance of emotion in this area of research is an important shortcoming. This study aims to develop an in-depth view of the emotional dimension of the child’s understanding of death, also seeking to relate it to the cognitive dimension.Material and Methods: We interviewed children (three to six years old) using a book illustrating a hypothetical scenario in which a child faced the death of a relative. We asked questions to assess the cognitive subconcepts of death and the emotional dimension (what the child would feel and what parents should say).Results: Of the 54 participants, the majority said that the child would feel sad (n = 46, 85%) and that parents should inform her/him (n = 47, 87%); these responses did not vary significantly with age. The cognitive understanding of the concept of death in children who reported sadness was significantly higher.Discussion: Even the youngest children feel death, and it is not possible to disconnect cognitive and emotional understanding. Additionally, children should be informed in order to foster a proper and multidimensional elaboration of death.Conclusion: This study provides valuable information to health professionals and other interested adults about the way preschoolers position themselves in relation to death.

scholarly journals Targeting Atherosclerotic Plaque in Avicenna’s View

2020 ◽  
pp. 1-11
Author(s):  
Sima Sadrai ◽  
Maryam Yakhchali ◽  
Mahdi Alizadeh Vaghasloo ◽  
Mehran Mirabzadeh Ardakani ◽  
Mahdi Vazirian ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Lifestyle Modification ◽  
Conventional Medicine ◽  
Scientific Evidence ◽  
Holistic Approach ◽  
Public Access ◽  
Historical Background ◽  
Treatment Modalities ◽  
Traditional Medicines ◽  
Alternative Medicines

Objective: Cardiovascular disease (CVD) including atherosclerosis is currently the most common cause of death in the world. Atherosclerosis can be treated by a vast variety of modalities: from lifestyle modification to invasive open surgical bypass procedures. Regarding the limitations of conventional medicine, worldwide attention to complementary and alternative medicines has increased because of their holistic approach, lower cost and better public access. In this move towards Integrative Medicine -besides other traditional schools of medicine-Persian Medicine (PM) with its long historical background should be considered as a suitable source for research. Method: In this study we investigated major traditional literature of PM, Avicenna’s “Al-Qanun fi al-Tibb” [The Canon of medicine], to find suitable treatment modalities of atherosclerosis in comparison to conventional methods. Result: In the quest for a concept close to atherosclerosis, “sodde” (meaning obstruction) seems to be equal to atherosclerosis and “Mofattehaat” as opener drugs with different types including “Mohallelaat” (dissolvers) and “Moghatteaat” (cutting agents) have been recommended to remove the obstructing materials. Recent studies indicate that many of the medicinal herbs which were introduced as opener drugs by Avicenna have potential pharmacological effects on managing atherosclerosis. Conclusion: Scientific evidence confirm the efficacy of traditional herbs for elimination of atheroma. Antiobstructive traditional medicines are similar to the conventional atherectomy in targeting atheroma by removing atherosclerotic plaque directly, but they are non-invasive, user-friendly, much cheaper and probably with less side effects.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

scholarly journals Diagnostics of Cognitive Function in Women of Menopausal Period at Level of Primary Health Care

2014 ◽  
Vol 3 ◽  
Author(s):  
N. Zhilgeldina ◽  
T. Ulykbassova
Keyword(s):  
Cognitive Function ◽  
Cognitive Deficits ◽  
Transition Period ◽  
Hormone Replacement ◽  
Standard Of Care ◽  
Medical Community ◽  
Adequate Treatment ◽  
Care Services ◽  
Menopausal Women ◽  
Definition Of

Introduction. In the medical community, there is no consensus on whether or not climacteric changes are pathologic and require treatment. One of the main problems related to menopause is misperception of menopause; consequently, there is no consensus on treatments for psychological dysfunction and cognitive deficits in menopausal women. Timely diagnosis and adequate treatment of psychological disorders and cognitive dysfunction are imperative and complicated. The purpose of this study was to evaluate physician perceptions of cognitive and psychological deficits in menopausal women in outpatient settings.Methods. 215 obstetricians-gynecologists working in out-patient services were surveyed using a multiple choice questionnaire assessing perceptions and knowledge of menopausal transition.Results. Of total respondents, 42.0% ± 2.5 of physicians found it hard to define menopausal period, and 67.5% ± 3.2 could not give a clear definition of hormone replacement therapy. On the question “cognitive function includes…,” 62.5% ± 2.1 of physicians selected “memory,” 32.3% ± 1.8 selected attention, 77.5% ± 3.2 selected mood and/or imagination, 37.4% selected intellect, 36.3% ± 3.1 of respondents selected character traits, and 6.2% ± 1.7 selected speech. Regarding the question “how do you study memory status function?” it was estimated that 71.2% ± 2.5 of study participants have studied the memory only on the basis of subjective complaints, and none of the respondents (100%) have ever used neuropsychological tests.Conclusion. The survey allows us to ascertain that primary medical care services lack the ability to appropriately recognize and diagnose cognitive deficits in women of menopausal age. Based on these data, we can assume that proper mental care is not provided. Thus, the study indicates a need to create training programs for general practitioners and other specialists (cardiologists, neurologists, and endocrinologists) to fulfill this need. Implementation of a standard of care, testing, and treatment of cognitive and psychological function, such as the use of neuropsychological tests and questionnaires, in an out-patient setting for menopausal women would improve the quality of life during a woman’s transition period.

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