scholarly journals Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice?

2018 ◽  
Vol 32 (9) ◽  
pp. 751-761 ◽  
Author(s):  
Elizabeth A. Lynch ◽  
Brigit M. Chesworth ◽  
Louise A. Connell
Keyword(s):  
Clinical Practice ◽  
Stroke Rehabilitation ◽  
Evaluation Research ◽  
Well Being ◽  
Professional Associations ◽  
Evidence Base ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Rehabilitation Research

Despite the exponential growth in the evidence base for stroke rehabilitation, there is still a paucity of knowledge about how to consistently and sustainably deliver evidence-based stroke rehabilitation therapies in clinical practice. This means that people with stroke will not consistently benefit from research breakthroughs, simply because clinicians do not always have the skills, authority, knowledge or resources to be able to translate the findings from a research trial and apply these in clinical practice. This “point of view” article by an interdisciplinary, international team illustrates the lack of available evidence to guide the translation of evidence to practice in rehabilitation, by presenting a comprehensive and systematic content analysis of articles that were published in 2016 in leading clinical stroke rehabilitation journals commonly read by clinicians. Our review confirms that only a small fraction (2.5%) of published stroke rehabilitation research in these journals evaluate the implementation of evidence-based interventions into health care practice. We argue that in order for stroke rehabilitation research to contribute to enhanced health and well-being of people with stroke, journals, funders, policy makers, researchers, clinicians, and professional associations alike need to actively support and promote (through funding, conducting, or disseminating) implementation and evaluation research.

scholarly journals Implementation Science: Ensuring the Return on Our Research Investment

2018 ◽  
Vol 32 (9) ◽  
pp. 762-764
Author(s):  
Elaine H. Morrato
Keyword(s):  
Health Care ◽  
Stroke Rehabilitation ◽  
Practice Patterns ◽  
Health Interventions ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Improve Population Health ◽  
Health Care Practice ◽  
Research Investment

Implementation is the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns. In their article, “Implementation—the missing link in the research translation pipeline,” Lynch et al1 report that only a small fraction of published stroke rehabilitation research in leading clinical journals evaluates the implementation of evidence-based interventions into health care practice. Their findings are a wake-up call. If we are to achieve the end goals of our research investment and improve population health, then we need to also ensure that the evidence we generate is translated into real-world use.

American Academy of Pediatrics Textbook of Pediatric Care

2008 ◽  
Keyword(s):  
Clinical Practice ◽  
American Academy ◽  
Evidence Base ◽  
Pediatric Care ◽  
Editorial Team ◽  
Care Practice ◽  
Evidence Based ◽  
Current Clinical Practice ◽  
Cultural Issues ◽  
American Academy Of Pediatrics

For more than 75 years, the American Academy of Pediatrics has been the nation’s leading and most trusted child health expert. The all-new full color AAP Textbook continues the tradition by providing a wealth of expert guidance spanning every aspect of current clinical practice and sets a new standard for one-stop pediatric references! Directed by a distinguished editorial team, and featuring contributions from experienced clinicians nationwide, the new AAP Textbook of Pediatric Care is a resource you’ll use with complete confidence. Look here for expert guidance spanning every aspect of current clinical practice. Comprehensive scope: Covers screening, pathophysiology, diagnosis, treatment, management, prevention, critical care, practice management, ethical and legal concerns and much more. Practical focus: Directly addresses day-to-day practice concerns for efficient patient problem-solving. Essential clinical guidance: Step-by-step recommendations on what to do, when and how to do it, when to admit, and when to refer. Evidence-based approach: State-of-the-art approach includes the evidence base for recommendations and lists detailed references within each chapter. Topical coverage: Highlights new priorities for 21st century practice: evidence-based medicine, environmental concerns, electronic health records, quality improvement, community-wide health approaches, confidentiality, cultural issues, and psychosocial issues.

The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

2021 ◽  
Author(s):  
Alaine E Reschke-Hernández
Keyword(s):  
Clinical Practice ◽  
Music Therapy ◽  
Behavioral Interventions ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Intervention Development ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

Which psychosocial interventions improve sex worker well-being? A systematic review of evidence from resource-rich countries

2021 ◽  
pp. bmjsrh-2021-201028
Author(s):  
Kevin Turner ◽  
Jane Meyrick ◽  
Danny Miller ◽  
Laura Stopgate
Keyword(s):  
Sex Workers ◽  
Real Life ◽  
Qualitative Evaluation ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Evidence Base ◽  
Vulnerable Groups ◽  
Cochrane Library ◽  
Evidence Based ◽  
Eligibility Criteria

ObjectiveTo establish the state of the evidence base around psychosocial interventions that support well-being in sex workers in order to inform policy and practice within a resource-rich geographical context.MethodsPublished and unpublished studies were identified through electronic databases (PsychINFO, CINHAL Plus, MEDLINE, EMBASE, The Cochrane Library and Open Grey), hand searching and contacting relevant organisations and experts in the field. Studies were included if they were conducted in high-income settings with sex workers or people engaging in exchange or transactional sex, and evaluated the effect of a psychosocial intervention with validated psychological or well-being measures or through qualitative evaluation.ResultsA total of 19 202 studies were identified of which 10 studies met the eligibility criteria. The heterogeneity found dictated a narrative synthesis across studies. Overall, there was very little evidence of good quality to make clear evidence-based recommendations. Despite methodological limitations, the evidence as it stands suggests that peer health initiatives improve well-being in female street-based sex workers. Use of ecological momentary assessment (EMA), a diary-based method of collecting real-life behavioural data through the use of twice-daily questionnaires via a smartphone, increased self-esteem and behaviour change intentions.ConclusionsWork with sex workers should be based on an evidence-based approach. Limitations to the existing evidence and the constraints of this work with vulnerable groups are recognised and discussed.

Stroke rehabilitation research translation in Australia: a survey of clinical trialists

2020 ◽  
pp. 1-7
Author(s):  
Laura Jolliffe ◽  
Tammy Hoffmann ◽  
Kate Laver ◽  
Annie McCluskey ◽  
Natasha A. Lannin
Keyword(s):  
Stroke Rehabilitation ◽  
Research Translation ◽  
Rehabilitation Research

scholarly journals Navigating complexity of child abuse through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Care Practice ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines

Abstract Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. In these contexts, CYHC-practitioners use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are necessary in healthcare. This study aims to unravel how intuition is perceived and used by Dutch CYHC-practitioners when identifying and working with cases of child abuse, and how this relates to their evidence-based guidelines.Methods: A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-physicians focused on perceptions on intuition, which were followed by a survey amongst CYHC-practitioners on the recognition and use of the concept.Results: The majority of CYHC-practitioners recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition to 1) sense that something is ‘off’, 2) differentiate between ‘normal’ and ‘abnormal’, 3) assess risks, 4) weigh secondary information and 5) communicate with parents. At the same time, they warn of its dangers, as it may lead to ‘tunnel vision’ and false accusations. Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is understood as particularly useful in cases of child abuse, which are inherently complex, as signs and evidence of abuse are often hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. There is an opportunity for guidelines to support reflection and intuition as a ‘good care’ practice.

The Pharmacological Treatment of Refractory OCD

2017 ◽  
Author(s):  
Christopher Pittenger
Keyword(s):  
Clinical Practice ◽  
Pharmacological Treatment ◽  
Evidence Base ◽  
Evidence Based ◽  
Second Line ◽  
First Line ◽  
Substantial Fraction ◽  
Meaningful Improvement ◽  
Residual Symptoms ◽  
Glutamate Neurotransmission

Evidence-based interventions for OCD, both psychotherapeutic and pharmacological, are of benefit to many. However, even when optimally deployed, first- and second-line treatments leave a substantial fraction of patients—perhaps as many as 20% to 25%—without meaningful improvement. Furthermore, many who are classified as “responders” to first- and second-line treatments continue to have substantial residual symptoms and attendant morbidity. This chapter reviews various pharmacological strategies that have been used for the treatment of refractory OCD, including agents targeting serotonin, dopamine, and glutamate neurotransmission. Although the evidence base supporting the use of these agents is not as robust as it is for first-line interventions, many have shown promise in some studies. The prevalence of refractory OCD symptoms means that such pharmacological strategies must frequently be considered in clinical practice, despite the lack of definitive guidance from controlled studies.

scholarly journals Improving the Development, Monitoring and Reporting of Stroke Rehabilitation Research: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable

2017 ◽  
Vol 31 (10-11) ◽  
pp. 877-884 ◽  
Author(s):  
Marion F. Walker ◽  
Tammy C. Hoffmann ◽  
Marian C. Brady ◽  
Catherine M. Dean ◽  
Janice J. Eng ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Clinical Care ◽  
Research Community ◽  
Stroke Recovery ◽  
Evidence Based ◽  
Stroke Patients ◽  
International Partnership ◽  
Rehabilitation Research ◽  
Complete Reporting

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations, the group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention call into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless, the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence-based clinical care, we urge the research community to endorse and adopt our recommendations.

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