Tobacco Treatment Specialists: A New Profession

2007 ◽  
Vol 2 (S1) ◽  
pp. 2-7 ◽  
Author(s):  
John R. Hughes
Keyword(s):  
Professional Identity ◽  
Tobacco Cessation ◽  
Professional Organizations ◽  
Clinical Activity ◽  
Evidence Based ◽  
High Quality ◽  
Tobacco Treatment ◽  
Cessation Treatment ◽  
Prevention Activity ◽  
Based Medicine

AbstractTobacco treatment specialists (TTS) are essential to developing an adequate system of treatment for smoking. Tobacco cessation treatment should be seen, not solely as a public health or prevention activity, but rather as a clinical activity. TTS should increase their professionalism by embracing evidence-based medicine. TTS should form professional organizations and credentialing bodies to insure a high quality professional identity.

Evidence-based approaches to psychiatry

2017 ◽  
pp. 119-134
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Patient Experience ◽  
Meta Analysis ◽  
Psychiatric Research ◽  
Evidence Based ◽  
High Quality ◽  
Qualitative Methodologies ◽  
Meta Analyses ◽  
Based Medicine ◽  
Quality Evidence

‘Evidence-based approaches to psychiatry’ describes the application of evidence-based medicine (EBM) to psychiatric practice. The chapter covers the key processes in EBM, including the formulation of a clinically relevant question, the systematic search for high-quality evidence and the meta-analytic synthesis of data. It demonstrates how evidence-based approaches to psychiatry have led to important developments showing quantitative effects of different treatments through advanced meta-analysis of data from randomized trials. This has underpinned the development of clinical guidelines that have the aim of improving the reliability and quality of treatments that patients receive. The chapter also describes how meta-analyses should be critically reviewed, as well as their problems and limitations. Not all relevant questions in psychiatric research are susceptible to the quantitative approach offered by EBM, and the chapter also outlines how qualitative methodologies can play a key role in answering important questions related, for example, to the patient experience.

scholarly journals Combination antifungal therapy for breakthrough invasive mould disease in patients with haematological malignancies: when management reasoning eclipses evidence-based medicine

2020 ◽  
Vol 75 (11) ◽  
pp. 3096-3098
Author(s):  
C Garcia-Vidal ◽  
R E Lewis ◽  
D P Kontoyiannis
Keyword(s):  
Antifungal Therapy ◽  
Antifungal Prophylaxis ◽  
Definitive Diagnosis ◽  
Quality Data ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Data ◽  
Risk Patients ◽  
Sound Management ◽  
Based Medicine

Abstract Timely diagnosis and treatment of invasive mould disease is challenging in severely immunocompromised patients, particularly for patients who develop breakthrough infections while on antifungal prophylaxis. Currently, there are no high-quality data on how to best diagnose and treat these infections. Many essential decisions affecting the management of breakthrough mould disease are made before a definitive diagnosis is established. In this scenario, sound management reasoning often favours the use of combination antifungal therapy, especially when antifungal resistance, suspicion of undetected sites of infection or pharmacokinetic/pharmacodynamic limitations at the site of infection are likely. In these scenarios, pre-emptive use of antifungal combination therapy with frequent re-evaluation with an aim of de-escalation could be justified for many high-risk patients.

scholarly journals Nootropic drugs for correction of cognitive functions through the focus of evidence-based medicine (literature review)

2021 ◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Literature Review ◽  
Cognitive Functions ◽  
Evidence Based Medicine ◽  
Randomized Trials ◽  
Evidence Based ◽  
Nootropic Drugs ◽  
High Quality ◽  
Based Medicine

Relevance. In today's world, the first cause of death is pathology of the cardiovascular system. Vascular disease is influenced by many factors: lack of sleep, physical inertia, poorly balanced diet, obesity, heart disease. The fast pace of life forces a person to be in permanent stress, so as not to miss anything and have time for all the goals. This is why there is a demand for excipients and substances that could improve the peak of human cognitive abilities, maintain psychological stability. Today, the pharmaceutical market offers drugs that, according to pharmaceutical marketers, have solutions to the problems outlined above. These substances are classified to group of nootropic drugs (racetams). Objective. Review of high quality research on the effectiveness of nootropic drugs. Materials and methods. The literature review was performed using such scientometric databases as: PubMed, Cochrane Library, Scopus, BMJ Evidence-Based Medicine, Ingecta, Web of Science, UpToDate. The review included studies of randomized trials, placebo-controlled randomized trials, meta-analyzes, and systematic reviews. Data meet criteria A and B of evidence-based medicine. In the absence of high quality studies, studies with a lower level of evidence were selected. The search was made by topics: improving of cognitive functions, improving ability to work, improving sleep, improving mood, treatment of mental and psychiatric pathologies (Alzheimer's disease, dementia with various etiologies, depression), application in pediatrics. Results. The literature review included more than 40 high quality studies, but no conclusive evidence was found on the effectiveness of any drug. Conclusions. Data on the undeniable efficacy in relation to the cognitive functions of any of these nootropic drugs were not found in any study. In the treatment of Alzheimer's disease, some (Cerebrolysin, Nicergoline) drugs show controversial results of efficacy and safety. They require continued clinical research and they need to be approved by the FDA.

Evidence-based medicine

2017 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Evidence Based Medicine ◽  
Binary Data ◽  
Statistical Significance ◽  
Number Needed To Treat ◽  
Evidence Based ◽  
High Quality ◽  
Relative Risks ◽  
High Quality Evidence ◽  
Based Medicine ◽  
Quality Evidence

This chapter provides a brief overview to the concept of evidence-based medicine (EBM) starting with a well-accepted definition. The importance of clinical significance over statistical significance is discussed. A number of useful tools are presented and described to enable the practitioner to become competent in recognizing high-quality evidence and to have the skills to critically appraise evidence that is potentially important to their practice. There is a brief description of some of the statistical tools commonly used in EBM including binary data tools such as odds ratios, number needed to treat, and relative risks.

scholarly journals Involving Family and Social Support Systems in Tobacco Cessation Treatment for Patients With Cancer

2021 ◽  
Vol 19 (Suppl_1) ◽  
pp. S8-S11
Author(s):  
_ _
Keyword(s):  
Social Support ◽  
Working Group ◽  
Tobacco Cessation ◽  
Support Systems ◽  
Support Network ◽  
Cancer Centers ◽  
Patients With Cancer ◽  
Tobacco Treatment ◽  
Cessation Treatment ◽  
Social Support Systems

Individuals from the family and social support network of patients with cancer can have a pivotal role in reinforcing patients’ efforts to become and remain tobacco-free. This support is critical along the entire continuum of cancer care. Although NCI-designated Cancer Centers across the United States are increasingly offering tobacco cessation services as a result of the NCI Cancer Center Cessation Initiative (C3I), engaging patients’ family and other support network in tobacco treatment is not yet a routine practice. To facilitate the consideration and involvement of patients’ social support systems (including family, peers, and non–healthcare provider caregivers), we formed the C3I Family and Social Support Systems Working Group. This paper describes the current practices and challenges among C3I cancer centers centers in engaging the support systems of patients with cancer in order to reduce tobacco use and/or secondhand smoke exposure. Building on this knowledge, this Working Group proposes a research agenda to facilitate support persons’ involvement in tobacco treatment as part of oncology care. The research priorities identified include establishing (1) evidence-based strategies for engaging family and social support systems in patients’ cessation efforts, (2) interventions to provide cessation treatment options to support persons, and (3) best practices to routinely identify and engage family and social support systems in patients’ cessation efforts.

scholarly journals Implementation Science to Improve Tobacco Cessation Services in Oncology Care

2021 ◽  
Vol 19 (Suppl_1) ◽  
pp. S12-S15
Author(s):  
_ _
Keyword(s):  
Implementation Science ◽  
Tobacco Use ◽  
Working Group ◽  
Tobacco Cessation ◽  
Common Interest ◽  
Evidence Based ◽  
Cancer Centers ◽  
Tobacco Treatment ◽  
Oncology Care ◽  
Science Working

Every patient with cancer deserves access to evidence-based tobacco cessation interventions as part of their routine oncology care. The NCI Cancer Moonshot funded the Cancer Center Cessation Initiative (C3I) to help establish and/or expand tobacco treatment programs at 52 NCI-designated Cancer Centers. Although this initiative has broadened the availability of tobacco treatment services across US cancer centers, the reach and utilization of these services remains low among patients. To help address the remaining gap between the availability and utilization of evidence-based treatments for tobacco use in the oncologic context, staff and investigators at C3I sites and the C3I Coordinating Center formed the C3I Implementation Science Working Group. The mission of this working group is to bring together clinicians, scientists, and policymakers who share a common interest in implementation science and treating tobacco use in the oncologic context to collaborate on projects aimed at shrinking the practice gap in this area. Through case study examples, we describe how the C3I Implementation Science Working Group is supporting efforts to identify effective ways to increase the utilization of evidence-based tobacco treatments within cancer treatment settings and promote the broader impact and long-term sustainability of C3I.

Clinical Medicine for the MRCP PACES

2010 ◽  
Author(s):  
Gautam Mehta ◽  
Bilal Iqbal
Keyword(s):  
Clinical Evidence ◽  
Clinical Medicine ◽  
Good Reason ◽  
Evidence Based ◽  
High Quality ◽  
Case Presentation ◽  
Clinical Notes ◽  
Central Nervous Systems ◽  
Competency Based ◽  
Based Medicine

Volume 1 of a two volume MRCP text, this book includes cases which mimic the style and approach of the MRCP PACES exam. Clinical Medicine for MRCP PACES will equip the candidate attempting the MRCP examination with the skills and knowledge necessary for success, and will also provide an overview of evidence-based medicine for competency-based training. Throughout this and Volume 2, the authors explore all aspects of the candidate's performance, from clinical examination, to presentation, communication and medical ethics and up-to-date clinical evidence. Volume 1 includes over 150 cases and covers Stations 1, 3 and 5: Station 1 covers the respiratory and abdominal systems; Station 3 covers the cardiovascular and central nervous systems; Station 5 includes 20 Brief Clinical Consultations and supplementary cases covering ophthalmology, dermatology, endocrine and locomotor presentations. Throughout the book, the cases begin with the case presentation, followed by extensive clinical notes for each case. Each case also includes questions commonly asked by the examiners with suggested evidence-based answers and relevant bibliography. Station 5 Brief Clinical Consultations include a standardized approach to preparation and provide a concise summary of the focused history, examination, diagnosis and guidance on how to feedback to both the patient and the examiner. Visit our website for details of our range of titles for MRCP and more in the Oxford Specialty Training series at www.oup.com/uk/medicine/ost http://www.oup.com/uk/medicine/ost Advance praise for Clinical Medicine for MRCP PACES: "The authors have produced two volumes packed with the information needed to pass PACES and to practise high quality medicine. While written specifically for those aspiring to be physicians these volumes deserve to be widely read by all with an interest in clinical medicine. Candidates in particular and patients have good reason to welcome these volumes." Sir Graeme Catto

scholarly journals Integration of Tobacco Treatment Services into Cancer Care at Stanford

2020 ◽  
Vol 17 (6) ◽  
pp. 2101 ◽  
Author(s):  
Kathleen Gali ◽  
Brittany Pike ◽  
Matthew S. Kendra ◽  
Cindy Tran ◽  
Priya Fielding-Singh ◽  
...  
Keyword(s):  
Cancer Care ◽  
Tobacco Cessation ◽  
Cancer Center ◽  
Treatment Services ◽  
Tobacco Treatment ◽  
Cessation Treatment ◽  
Opt Out ◽  
Patient Reported ◽  
Delivery Options ◽  
One Year

As part of a National Cancer Institute Moonshot P30 Supplement, the Stanford Cancer Center piloted and integrated tobacco treatment into cancer care. This quality improvement (QI) project reports on the process from initial pilot to adoption within 14 clinics. The Head and Neck Oncology Clinic was engaged first in January 2019 as a pilot site given staff receptivity, elevated smoking prevalence, and a high tobacco screening rate (95%) yet low levels of tobacco cessation treatment referrals (<10%) and patient engagement (<1% of smokers treated). To improve referrals and engagement, system changes included an automated “opt-out” referral process and provision of tobacco cessation treatment as a covered benefit with flexible delivery options that included phone and telemedicine. Screening rates increased to 99%, referrals to 100%, 74% of patients were reached by counselors, and 33% of those reached engaged in treatment. Patient-reported abstinence from all tobacco products at 6-month follow-up is 20%. In July 2019, two additional oncology clinics were added. In December 2019, less than one year from initiating the QI pilot, with demonstrated feasibility, acceptability, and efficacy, the tobacco treatment services were integrated into 14 clinics at Stanford Cancer Center.

scholarly journals Come è cambiato il lavoro del pediatra al tempo del Covid

2021 ◽  
Vol 24 (4) ◽  
pp. 87-91
Author(s):  
Maria Gabriella Pediconi ◽  
Chiara Prinster ◽  
Laura Radice ◽  
Anna Saccaggi ◽  
Barbara Schiavo
Keyword(s):  
Professional Identity ◽  
Phase 1 ◽  
Clinical Work ◽  
Professional Activity ◽  
Clinical Activity ◽  
Italian Family ◽  
Anonymous Questionnaire ◽  
Family Paediatrician ◽  
Prevention Activity ◽  
The Impact

<b>Background -</b> International literature documents that children and adolescents infected with the coronavirus develop moderate symptoms and a favourable prognosis. However, the pandemic has had a major impact on children’s health and the paediatricians’ work. The clinical work of paediatricians has significantly changed. <br> <b>Aims, materials and methods -</b> A qualitative pilot research was conducted thanks to the participation of 13 privileged witnesses. Through an anonymous questionnaire, the present research detected the changes in the overall activity of the Italian family paediatrician and the impact of the pandemic on their professional activity during the lockdown. The thematic analysis of the answers made it possible to focus on the main changes of the paediatric profession and explore the characteristics of its resilience, highlighting the most significant difficulties that paediatricians faced during Phase 1. <br> <b>Results and discussion -</b> What was lost in the clinical activity, towards the patient with acute pathology or in the prevention activity, has been regained with a new use of known means, such as telephone and email, or thanks to the use of new tools such as WhatsApp and video (telemedicine): those that were subsidiary means before the pandemic have become effective and permanent endowments of the paediatrician after the lockdown. Together with the technical acquisition, the professional identity has been strengthened in terms of shared professionalism, especially as to relationships with colleagues and the collaboration of families.

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