The current evidence-based management of distal radial fractures: UK perspectives

2019 ◽  
Vol 44 (5) ◽  
pp. 450-455 ◽  
Author(s):  
Nick A. Johnson ◽  
Joseph Dias
Keyword(s):  
Best Practice ◽  
Expert Knowledge ◽  
Guideline Development ◽  
National Standards ◽  
Current Evidence ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Best Practice Guidelines ◽  
The United Kingdom ◽  
Optimum Management

Distal radial fractures are extremely common injuries, yet many basic questions remain unanswered about their optimum management. Recently in the United Kingdom several guideline development groups have produced national standards and best-practice guidelines based on review of the best available evidence and expert knowledge. All guideline groups agree that when surgery is needed for dorsally displaced distal radial fractures, that can be reduced closed, K-wire fixation and cast immobilization, should be offered. Further research questions have been identified. The important findings and recommendations are summarized in this article.

scholarly journals Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Lynn Cockburn ◽  
Timothy N. Fanfon ◽  
Alexa Bramall ◽  
Eta M. Ngole ◽  
Pius Kuwoh ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Practice Guidelines ◽  
Stroke Rehabilitation ◽  
Best Practice ◽  
Guideline Development ◽  
Front Line ◽  
African Countries ◽  
Practice Recommendations ◽  
Best Practice Guidelines ◽  
Successes And Challenges

Background: Although the adherence to stroke guidelines in high-income countries has been shown to be associated with improved patient outcomes, the research, development and implementation of rehabilitation related guidelines in African countries is lacking.Objectives: The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG) for the management and rehabilitation of stroke in adult patients in Cameroon.Method: A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context.Results: The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group’s recommendations aimed at encouraging others to consider similar projects.Conclusion: This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.

scholarly journals Dysphagia Therapy in Adults with a Tracheostomy: A Scoping Review Protocol

2021 ◽  
Author(s):  
Waiza Kadri ◽  
Rhiannon Halfpenny ◽  
Breege Whiten ◽  
Christina Smith ◽  
Siofra Mulkerrin
Keyword(s):  
Scoping Review ◽  
Best Practice ◽  
Data Extraction ◽  
Grey Literature ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Future Research ◽  
Limited Information ◽  
Best Practice Guidelines ◽  
Dysphagia Therapy

Abstract Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice.Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually.Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.

scholarly journals Bog Bodies in Context: Developing a Best Practice Approach

2019 ◽  
Vol 23 (2) ◽  
pp. 227-249 ◽  
Author(s):  
Henry Chapman ◽  
Roy van Beek ◽  
Ben Gearey ◽  
Ben Jennings ◽  
David Smith ◽  
...  
Keyword(s):  
Cultural Landscape ◽  
Best Practice ◽  
Spatial And Temporal Scales ◽  
Best Practice Guidelines ◽  
The United Kingdom ◽  
Current State ◽  
Starting Point ◽  
Practice Approach ◽  
State Of Research ◽  
Bog Body

Bog bodies are among the best-known archaeological finds worldwide. Much of the work on these often extremely well-preserved human remains has focused on forensics, whereas the environmental setting of the finds has been largely overlooked. This applies to both the ‘physical’ and ‘cultural’ landscape and constitutes a significant problem since the vast spatial and temporal scales over which the practice appeared demonstrate that contextual assessments are of the utmost importance for our explanatory frameworks. In this article we develop best practice guidelines for the contextual analysis of bog bodies, after assessing the current state of research and presenting the results of three recent case studies including the well-known finds of Lindow Man in the United Kingdom, Bjældskovdal (Tollund Man and Elling Woman) in Denmark, and Yde Girl in the Netherlands. Three spatial and chronological scales are distinguished and linked to specific research questions and methods. This provides a basis for further discussion and a starting point for developing approaches to bog body finds and future discoveries, while facilitating and optimizing the re-analysis of previous studies, making it possible to compare deposition sites across time and space.

scholarly journals Nutritional Recommendations for Physique Athletes

2020 ◽  
Vol 71 (1) ◽  
pp. 79-108 ◽  
Author(s):  
Brandon M Roberts ◽  
Eric R Helms ◽  
Eric T Trexler ◽  
Peter J Fitschen
Keyword(s):  
Weight Loss ◽  
Best Practice ◽  
Negative Impact ◽  
Recovery Period ◽  
Energy Restriction ◽  
Fat Free Mass ◽  
Current Evidence ◽  
Nutrient Timing ◽  
Best Practice Guidelines ◽  
To Come

AbstractThe popularity of physique sports is increasing, yet there are currently few comprehensive nutritional guidelines for these athletes. Physique sport now encompasses more than just a short phase before competition and offseason guidelines have recently been published. Therefore, the goal of this review is to provide an extensive guide for male and female physique athletes in the contest preparation and recovery period. As optimal protein intake is largely related to one’s skeletal muscle mass, current evidence supports a range of 1.8-2.7 g/kg. Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the “energy budget” to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. For nutrient timing, we recommend consuming four or five protein boluses per day with one consumed near training and one prior to sleep. During competition periods, slower rates of weight loss (≤0.5% of body mass per week) are preferable for attenuating the loss of fat-free mass with the use of intermittent energy restriction strategies, such as diet breaks and refeeds, being possibly beneficial. Additionally, physiological and psychological factors are covered, and potential best-practice guidelines are provided for disordered eating and body image concerns since physique athletes present with higher incidences of these issues, which may be potentially exacerbated by certain traditional physique practices. We also review common peaking practices, and the critical transition to the post-competition period.

scholarly journals Seismic retrofitting of Māori wharenui in Aotearoa New Zealand

2019 ◽  
Vol 377 (2155) ◽  
pp. 20190003 ◽  
Author(s):  
Ambrosia Crum ◽  
Deidre Brown ◽  
Tūmanako Fa'aui ◽  
Naomi Vallis ◽  
Jason M. Ingham
Keyword(s):  
Best Practice ◽  
Current Practice ◽  
Expert Knowledge ◽  
Knowledge Bases ◽  
Seismic Retrofitting ◽  
Theme Issue ◽  
Best Practice Guidelines ◽  
Aotearoa New Zealand ◽  
Dual Interpretation ◽  
Level Analysis

The design of Māori wharenui (meeting houses), refined over the last 180 years, has given rise to a distinctive typology that demonstrates an understanding of tectonic-narrative expression. It is a visual codex designed to be read. Set within the context of pre-disaster readiness, this current study investigated the resilience of Māori buildings and communities through a dual interpretation of seismic, regulatory and historical frameworks. The literature on Māori building technologies scarcely addresses matters of resilience and there is currently no formalized methodology to guide wharenui seismic retrofit practice. Through a macro level analysis of recently completed retrofit projects, this current study identified issues present in current practice. The resulting research presented a pathway for the future development of an approach (to inform methodologies) and strategy (to build capability) founded on the recognition of wharenui as a new category of building within building regulations. It is also recommended that research continues to develop alternative engineered solutions, expert knowledge bases and best practice guidelines. This article is part of the theme issue ‘Environmental loading of heritage structures’.

scholarly journals P117 Changes in prescription of home non-invasive ventilation (NIV) in Southern Adelaide Local Health Network (SALHN) from 2016 – 2020

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A59-A59
Author(s):  
F Raja Mohamed ◽  
S Krishnan ◽  
K Bassett ◽  
V Aiyappan ◽  
C Chai-Coetzer
Keyword(s):  
Best Practice ◽  
Neuromuscular Disorders ◽  
Relevant Information ◽  
Current Evidence ◽  
Local Health ◽  
Best Practice Guidelines ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
Hypoventilation Syndrome

Abstract Background Long term NIV is established therapy for patients with chronic type 2 respiratory failure (T2RF) due to neuromuscular disorders and obesity hypoventilation syndrome (OHS) without significant OSA. There is emerging evidence that COPD patients with T2RF also benefit from NIV. In our centre, there appears to be an increase in the prescription of long term NIV to patients over time, with 60% of all active long term NIV patients commencing therapy from 2017 onwards. In this study we will determine if (i) there has been increased provision of long term NIV to ward patients recovering from acute T2RF, (ii) there has been an increase in patients with COPD and T2RF commenced on long term NIV, (iii) there are patients with OHS and comorbid OSA who can be changed from NIV to CPAP and (iv) there is adequate follow up for patients who initiated NIV in the ward acutely. Methods Retrospective, observational study using a pre-existing database of all current and previous patients commenced on NIV from July 2016 to July 2020. Progress to date All active long term NIV patients have been identified and a database (n= 220) created containing all relevant information including date and place of NIV initiation and indication. Intended outcome and impact This audit will objectively assess the growth of our NIV service to facilitate better allocation of resources. It will also determine if our commencement and management of those on long term NIV is aligned with current evidence and best practice guidelines.

scholarly journals Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 2017

2017 ◽  
Vol 12 (8) ◽  
pp. 886-895 ◽  
Author(s):  
Dylan Blacquiere ◽  
M Patrice Lindsay ◽  
Norine Foley ◽  
Colleen Taralson ◽  
Susan Alcock ◽  
...  
Keyword(s):  
Best Practice ◽  
Healthcare Providers ◽  
Occupational Therapists ◽  
Remote Access ◽  
Stroke Recovery ◽  
Current Evidence ◽  
Virtual Rehabilitation ◽  
Practice Recommendations ◽  
Best Practice Guidelines ◽  
Ischemic Attack

Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services. While these latter areas of Telestroke application are newer, they are rapidly developing, with new opportunities that are yet unrealized. Virtual rehabilitation therapies offer patients the opportunity to participate in rehabilitation therapies, supervised by physical and occupational therapists. While not without its limitations (e.g., access to telecommunications in remote areas, fragmentation of care), the evidence-to-date sets the foundation for improving access to care and management for patients during both the acute phase and now through post stroke recovery.

Impacts of Environmental Regulation on Sustainable Economic Growth

2018 ◽  
Vol 9 (9) ◽  
pp. 749-773
Author(s):  
Jonathan Fisher
Keyword(s):  
Economic Growth ◽  
Environmental Regulation ◽  
Technical Change ◽  
Best Practice ◽  
Environmental Regulations ◽  
The European Union ◽  
Porter Hypothesis ◽  
The United Kingdom ◽  
Environment Agency ◽  
Sustainable Economic Growth

There is considerable concern and debate about the economic impacts of environmental regulations. Jonathan Fisher, former Economics Manager at the Environment Agency in England and Wales, reviews the available evidence on this subject. Section 2 presents estimates of the costs and benefits of environmental regulations. Section 3 examines the impacts of environmental regulations on economic growth, innovation and technical change as well as impacts on competitiveness and any movement of businesses to less pollution havens. He questions call for greater certainty regarding future environmental regulations, whereas in fact there should be calls for less uncertainty. This section then suggests how this could be achieved. This section then finishes with an overview of the available evidence. This includes an examination of the Porter Hypothesis that environmental regulations can trigger greater innovation that may partially or more than fully offset the compliance costs. Section 4 then sets out principles for how better environmental regulation can improve its impacts on sustainable economic growth and illustrates how the European Union (EU) Water Framework Directive is a good example of the application of these principles in practice. Section 5 reviews current and recent political perspectives regarding developments in environmental regulations across the EU and shows how the United Kingdom (UK) has successfully positively managed to influence such developments so that EU environmental regulations now incorporate many of these principles to improve their impacts on economic growth. Section 5.1 then examines the implications of Brexit for UK environmental regulations. Finally, Section 6 sets out some best practice principles to improve the impacts of environmental regulation on sustainable economic growth, innovation and technical change.

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