scholarly journals Management of asthma exacerbations in the paediatric population: a systematic review

2021 ◽  
Vol 30 (161) ◽  
pp. 200367
Author(s):  
Sara Manti ◽  
Amelia Licari ◽  
Salvatore Leonardi ◽  
Gian Luigi Marseglia
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Asthma Exacerbation ◽  
Healthcare Providers ◽  
Stakeholder Involvement ◽  
Paediatric Population ◽  
International Standards ◽  
Asthma Exacerbations ◽  
Definition Of ◽  
Primary Healthcare Providers

BackgroundAsthma exacerbations in children is one of the most common medical conditions requiring urgent visits to primary healthcare providers or emergency departments, and even hospitalisations. Currently, there is significant variation in the management of asthma exacerbations expressed in guideline recommendations versus clinical practice. This disconnect affects diagnostic and treatment decisions for the clinician and patient.ObjectiveWe systematically reviewed the available guidelines providing recommendations for diagnostic and therapeutic management of asthma exacerbations in the paediatric population.MethodsA systematic review of the literature for guidelines published between January 2009 and October 2019 was conducted, using a protocol registered with the international prospective register of systematic reviews (PROSPERO CRD42020221562).Results16 asthma exacerbation clinical practice guidelines for children were included. Despite general agreement between guidelines on the definition of asthma exacerbation, there was great variability in the definition of disease severity and assessment of asthma control. This systematic review also highlighted a paucity of recommendations for criteria for hospitalisation and discharge. Many guidelines scored poorly when measured for stakeholder involvement and editorial independence.ConclusionComprehensive and updated guidelines compliant with international standards for clinical guidelines may significantly improve clinical practice quality, promote evidence-based recommendations and provide uniformity of treatment between countries.

scholarly journals Evidence-based Clinical Practice Guidelines for the Periodic Eye Exam in Children Aged 0 to 5 Years in Canada

2019 ◽  
Vol 81 (4) ◽  
pp. 9-28
Author(s):  
Walter Delpero ◽  
Barbara Robinson ◽  
Rhona Lahey
Keyword(s):  
Clinical Practice ◽  
Early Detection ◽  
Practice Guidelines ◽  
School System ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Vision Screening ◽  
Eye Care ◽  
Timely Fashion ◽  
Primary Healthcare Providers

Vision screening performed by primary healthcare providers during routine well-baby/child visits and scheduled vaccinations is an essential part of the detection of ocular disease. However, this early detection potential is limited and a full oculovisual assessment is also recommended prior to the child entering the school system. If amblyopia, strabismus or other eye pathology is detected or suspected that is beyond the scope of the eye care professional examining the patient, a referral to the appropriate specialist can be made, allowing treatment to be initiated in a timely fashion.

scholarly journals Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

2019 ◽  
Vol 09 (03) ◽  
pp. 268-274 ◽  
Author(s):  
Minke Bergsma ◽  
Job N. Doornberg ◽  
Laurent Hendrickx ◽  
Batur Hayat ◽  
Gino M.M.J. Kerkhoffs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Soft Tissue ◽  
Meta Analysis ◽  
Optimal Location ◽  
Reference Points ◽  
Volar Plating ◽  
Bony Landmarks ◽  
Comprehensive Search ◽  
Definition Of

Objective The objective of this systematic review is to provide an overview of all interpretations of the definition of the watershed line used in literature. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed for this review. A comprehensive search was performed for definitions of the watershed line given in literature. A total of 32 studies giving an explicit interpretation of the definition of the watershed line or anatomical reference for plate positioning in writing and/or imaging were included. Results In 32 studies, we found eight different landmarks used to refer to the watershed line or correct plate positioning. Five studies used two different soft tissue landmarks. Six different bony landmarks were described in 24 studies. These could further be subdivided into three anatomical interpretations, described in seven studies, in which the term “watershed line” is explained as a distinguishable anatomical line, and two surgical interpretations, described in 15 studies, which are purely reflecting the optimal location of the volar plate. One interpretation of the watershed line described in two studies combined both anatomical and surgical landmarks. Conclusion The (mis)interpretation of the definition of the term “watershed line” as described by Orbay is subject to the type of landmarks and purpose used: soft tissue or bony landmarks and an anatomical or a surgical purpose. A clear distinction can be made between interpretations using bony landmarks, as the true watershed line is defined and definitions using soft tissue landmarks, which might represent the reference points surgeons use in clinical practice.

scholarly journals Analysis of Nurses’ and Physicians’ Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12444
Author(s):  
Francisco Vicens Blanes ◽  
Rosa Miró Bonet ◽  
Jesús Molina Mula
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Health Professionals ◽  
Meta Analysis ◽  
Educational Programs ◽  
International Standards ◽  
Perceptions And Attitudes ◽  
Nurses And Physicians ◽  
Fever Management ◽  
Nurses Knowledge

Context: Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. Objective: To investigate whether doctors’ and nurses’ knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children’s fever. Data Sources: A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. Study selection: Articles examining health professionals’ (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. Data extraction: The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. Results: For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. Limitations: All of the included studies generally had a high risk of bias. Conclusion: According to the evidence reviewed, nurses’ and physicians’ perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.

scholarly journals Critical appraisal of clinical practice guidelines for the management of COVID-19: protocol for a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Thanansayan Dhivagaran ◽  
Umaima Abbas ◽  
Fahad Butt ◽  
Luckshann Arunasalam ◽  
Oswin Chang
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Healthcare Providers ◽  
World Health ◽  
High Quality ◽  
Agree Ii ◽  
Agree Ii Instrument

Abstract Background In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for a high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument. Methods The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. The MEDLINE, EMBASE, CINAHL, and Web of Science databases, as well as the Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, and the World Health Organization websites, will be searched from December 2019 onwards. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. To summarize and explain the findings related to the included CPGs, a narrative synthesis will also be provided. Discussion The results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences. Systematic review registration International Prospective Register for Systematic Reviews (PROSPERO)—CRD42020219944

scholarly journals Establishment of Lipid Profile Reference Intervals in a Sample Population of Halabja City, Kurdistan Region of Iraq

2021 ◽  
pp. 2855-2861
Author(s):  
Hardi Rafat Baqi ◽  
Tareq Hamaamin Abdullah ◽  
Dashty Aziz Ghafor ◽  
Salar Husein Karim
Keyword(s):  
Clinical Practice ◽  
Lipid Profile ◽  
Adult Population ◽  
Healthcare Providers ◽  
Age Groups ◽  
Reference Intervals ◽  
International Standards ◽  
Sample Population ◽  
Kurdistan Region ◽  
Study Population

     Every laboratory needs to establish its own community-based reference intervals for the achievement of the optimal and true diagnosis in the clinical practice. However, such vital experimentations are not been conducted sufficiently in Halabja city and Kurdistan region of Iraq as a whole. This study is an attempt to introduce for the first time a set of reference intervals of lipid profile variables that are based on the healthy and asymptomatic adult population of Halabja using international standards. The methodology recruited for this purpose is based on the IFCC, CLSI, and WHO’s standards, in which the study population was subjected to strict exclusion criteria for the sake of higher accuracy in the results.  The reference intervals are computed as the 95th percentile of the lipid profile variable values. The results are broken down based on the gender and age groups. All of the estimated intervals fall perfectly in the internationally known reference intervals. Even so, the outcome values are similar and sometimes higher than the currently used intervals by the laboratories and physicians for the diagnosis purposes. The out-turns from the study encourage us to demand the healthcare providers to reconsider the currently approved reference intervals for the lipid profile test (TC, TG, HDL-C, LDL-C, and VLDL-C) in the clinical practice and consider the results of this study for further diagnostic purposes.

scholarly journals Critical Appraisal of Clinical Practice Guidelines for the Management of COVID-19: Protocol for a Systematic Review

2020 ◽  
Author(s):  
Thanansayan Dhivagaran ◽  
Umaima Abbas ◽  
Fahad Rasool Butt ◽  
Luckshann Arunasalam ◽  
Oswin Chang
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Healthcare Providers ◽  
High Quality ◽  
Agree Ii ◽  
Agree Ii Instrument

Abstract BackgroundIn December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for the high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument. Methods‌The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. MEDLINE, EMBASE, CINAHL and Web of Science will be searched from December 2019 up to December 2020. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. DiscussionThe results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences. Systematic Review ‌Registration‌ ‌International‌ ‌Prospective‌ ‌Register‌ ‌for‌ ‌Systematic‌ ‌Reviews‌ ‌(PROSPERO)‌ ‌—‌ ‌CRD42020219944

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