scholarly journals Evidence-based, ethically justified counseling for fetal bilateral renal agenesis

2017 ◽  
Vol 45 (5) ◽  
Author(s):  
Alana N. Thomas ◽  
Laurence B. McCullough ◽  
Frank A. Chervenak ◽  
Frank X. Placencia
Keyword(s):  
Pregnant Women ◽  
Literature Search ◽  
Renal Agenesis ◽  
Single Case ◽  
Ethical Analysis ◽  
Medical Community ◽  
Evidence Based ◽  
Obstetric Management ◽  
History Of ◽  
Responsibility Model

AbstractBackground:Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition.Aim:To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis.Study design:A systematic literature search was performed using multiple databases. We deploy an ethical analysis of the results of the literature search on the basis of the professional responsibility model of obstetric ethics.Results:Eighteen articles met the inclusion criteria for review. With the exception of a single case study using serial amnioinfusion, there has been no other case of survival following dialysis and transplantation documented. Liveborn babies die during the neonatal period. Counseling pregnant women about management of pregnancies complicated by bilateral renal agenesis should be guided by beneficence-based judgment informed by evidence about outcomes.Conclusions:Based on the ethical analysis of the results from this review, without experimental obstetric intervention, neonatal mortality rates will continue to be 100%. Serial amnioinfusion therefore should not be offered as treatment, but only as approved innovation or research.

scholarly journals Practical Guidelines for Nursing and Midwifery Diabetes care – 2020 A position of the Polish Federation for Education in Diabetology

2020 ◽  
Vol 19 (3) ◽  
pp. 184-207
Author(s):  
Alicja Szewczyk ◽  
Natasza Tobiasz-Kałkun ◽  
Anna Stefanowicz-Bielska ◽  
Ewa Kobos ◽  
Mirosława Młynarczuk ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Scientific Evidence ◽  
Medical Community ◽  
Diabetic Patients ◽  
Nursing Interventions ◽  
Evidence Based ◽  
Randomized Controlled Clinical Trials ◽  
Practical Guidelines ◽  
History Of ◽  
Meta Analyses

AbstractIntroduction. The history of recommendations by the Polish Federation for Education in Diabetology dates back to 2006, when guidelines for nurses/midwifes working with diabetic patients were first drawn up. However, the development of nurses and midwifes? competences requires stronger actions that foster a transition from experience-based towards evidence-based practice.Aim. The aim of this publication is to present a set of procedures describing nursing interventions in diabetes care, including currently available scientific evidence and clinical experience of specialists involved in the care of diabetic patients.Material and methods. The study involved a literature review of selected areas of nursing practice in diabetes care. When compiling the material, the priority was to use data from (in order of significance): randomized controlled clinical trials and their meta-analyses, observational studies and other studies with an adequate scientific status.Results. This joint study yielded 11 procedures describing selected aspects of nursing interventions in diabetic patients. Each of the procedures details key recommendations on diabetes care, arranged in accordance of the significance ascribed to the scientific evidence analyzed.Conclusions. The 2020 PFED guidelines on nursing and midwifery diabetes care are the effect of the evaluation of the previous versions and comprise a considerably more extensive, comprehensive and evidence-based set of practices. The major asset of these guidelines is their interdisciplinarity, reflected in the fact that the final version of the publication was approved by consultants in numerous nursing fields, a consultant in diabetology, and the President of the Polish Federation for Education in Diabetology, who all represent the medical community. The authors experience gained during work on international recommendations (New Insulin Delivery Recommendations) played an important role when formulating the present guidelines.

A Practitioner’s Guide to Understanding the Evidence

2019 ◽  
pp. 29-49
Author(s):  
John L. Davis
Keyword(s):  
Empirical Research ◽  
Evidence Based Practice ◽  
Single Case ◽  
Critical Element ◽  
Evidence Based ◽  
Single Case Design ◽  
High Quality Research ◽  
Evidence Based Practices ◽  
History Of ◽  
Case Design

A critical element in bridging the research to practice gap is by enhancing practitioner’s ability to identify evidence-based practices. The term evidence-based refers to any practice, intervention, or strategy that is derived from or informed by empirical or data based research. The evidence-based practice model of intervention and decision-making is an approach where practitioners make recommendations based on high-quality research evidence to support the needs of students and teachers to effect positive change. The chapter describes the history of the evidence-based practice movement with respect to educational policy. Next, an overview of empirical research is provided. The description of empirical research includes various types of research designs utilized in school settings (e.g., single-case design, group design) and accompanying quality indicators. The chapter also provides a discussion of the relative strengths of single-case design in identifying evidence-based practice. Finally, the chapter describes the use of resources that practitioners may consult when determining the empirical basis for intervention strategies.

scholarly journals Diabetes Mellitus Among Workers Exposed to Perfluorooctanoic acid

2021 ◽  
Vol 1 (2) ◽  
pp. 107-13
Author(s):  
Spadini Putri ◽  
Muhammad Ilyas
Keyword(s):  
Diabetes Mellitus ◽  
Occupational Diseases ◽  
Literature Search ◽  
Health Workers ◽  
Perfluorooctanoic Acid ◽  
Perfluoroalkyl Substances ◽  
Evidence Based ◽  
Exclusion Criteria ◽  
History Of ◽  
Based Medicine

Background: One of the health problems that can be caused by Perfluorooctanoic acid (PFOA) is Diabetes mellitus (DM). However, the causal relationship between Perfluorooctanoic acid and DM is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also equipped with a seven-step assessment of occupational diseases therefore it can assist occupational health doctors who find patients with DM and have a history of exposure to glutaraldehyde. Methods: Literature search using Pubmed, Cochrane and JSTOR databases. The keywords used are “PFOA” OR “perfluoroalkyl substances” OR “perfluorooctanoic acid” AND “diabetes mellitus”. Article selection was performed using the defined inclusion and exclusion criteria. Selected articles will be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: It was in 5 selected articles that met the inclusion and exclusion criteria. The main finding after a critical review was that PFOA may increase the risk of DM. Conclusion: There is a relationship between PFOA and the incidence of DM in health workers. To establish the diagnosis of occupational diseases in health workers who are exposed to PFOA, seven steps of diagnosis of occupational diseases are used.

Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

2013 ◽  
Vol 18 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rik Lemoncello ◽  
Bryan Ness
Keyword(s):  
Evidence Based Practice ◽  
Single Case ◽  
Quality Data ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
High Quality ◽  
Randomized Controlled Clinical Trials ◽  
Relative Paucity ◽  
Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

Comparative Analysis: The State of Colorado Study, Part II

2004 ◽  
Vol 9 (2) ◽  
pp. 1-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Douglas Van Zet ◽  
Debra J. Northrup ◽  
Edward B. Whitney ◽  
...  
Keyword(s):  
Daily Living ◽  
Scientific Evidence ◽  
Pain Syndrome ◽  
Evidence Based ◽  
Clinical Assessments ◽  
Physician Judgment ◽  
History Of ◽  
Key Terms ◽  
Causation Analysis ◽  
Work Interference

Abstract [Continued from the January/February 2004 issue of The Guides Newsletter.] To understand discrepancies in reviewers’ ratings of impairments based on different editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), users can usefully study the history of the revisions as successive editions attempted to provide a comprehensive, valid, reliable, unbiased, and evidence-based system. Some shortcomings of earlier editions have been addressed in the AMA Guides, Fifth Edition, but problems remain with each edition, largely because of the limited scientific evidence available. In the context of the history of the different editions of the AMA Guides and their development, the authors discuss and contextualize a number of key terms and principles including the following: definitions of impairment and normal; activities of daily living; maximum medical improvement; impairment percentages; conversion of regional impairments; combining impairments; pain and other subjective complaints; physician judgment; and causation analysis; finally, the authors note that impairment is not synonymous with disability or work interference. The AMA Guides, Fifth Edition, contrasts impairment evaluations and independent medical evaluations (this was not done in previous editions) and discusses impairment evaluations, rules for evaluations, and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome).

Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour
Keyword(s):  
Pregnant Women ◽  
Maternal Employment ◽  
Controlled Trial ◽  
Role Play ◽  
Intervention Group ◽  
Control Group ◽  
Maternal Behaviour ◽  
Infant Attachment ◽  
Significant Difference ◽  
History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

A LOOK INTO THE HISTORY OF THE PREPARATION OF LOCAL PROFESSIONALS IN THE INDUSTRY

2019 ◽  
Vol 26 (2) ◽  
pp. 4-8
Author(s):  
Toshkentboy Pardaev ◽  
◽  
Zhavli Tursunov
Keyword(s):  
Evidence Based ◽  
Local Policy ◽  
Soviet Government ◽  
Policy Makers ◽  
History Of

In the article : In the second half of the 20 century the process of preparation of local experts in South Uzbekistan industry changes in this field a clear evidence-based analysis of the problematic processes that resulted from the discriminatory policy toward the Soviet government-dominated local policy makers

scholarly journals Computed Tomography Colonography as a Sensible Option for Colorectal Cancer Screening: Evidence Based on Metanalysis

2021 ◽  
Vol 41 (01) ◽  
pp. 087-095
Author(s):  
Ingrid Chaves de Souza Borges ◽  
Natália Costa Resende Cunha ◽  
Amanda Marsiaj Rassi ◽  
Marcela Garcia de Oliveira ◽  
Jacqueline Andréia Bernardes Leão-Cordeiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Cancer Screening ◽  
Literature Search ◽  
Web Of Science ◽  
Screening Method ◽  
Colorectal Polyp ◽  
Evidence Based ◽  
Polyp Detection ◽  
Computed Tomography Colonography

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3–95.7%, coefficient of variation [CV] = 28.5%) and the estimated specificity was 73.6% (47.4–100.0%, CV = 37.5%). For lesions up to 9 mm, the sensitivity was 82.5% (62.0–99.9%, CV = 25.1%) and the specificity was 79.2% (32.0–98.0%, CV = 22.9%). For lesions > 9 mm, the sensitivity was 90.2% (64.0–100.0%, CV = 7.4%) and the specificity was 94.7% (80.0–100.0%, CV = 6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p = 0.0958); however, the specificity was higher for lesions > 9 mm (p < 0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.

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