scholarly journals Optometric Care of the Patient with Diabetes 2008: A Core Document of the Canadian Association of Optometrists

2008 ◽  
Vol 70 (6) ◽  
Author(s):  
Len Koltun
Keyword(s):  
Cost Effective ◽  
Morbidity And Mortality ◽  
Evidence Based ◽  
Eye Care ◽  
Patient Centered ◽  
Healthcare Burden ◽  
Canadian Association ◽  
Effective Role

The objective of this document is to provide the reader with an overview of the epidemic of diabetes currently facing Canada and the morbidity and mortality associated with this growing healthcare burden. Specifically, an evidence based, patient centered, cost effective role of the optometrist in the eye care of Canadians with diabetes will be presented.

scholarly journals Recommendations for the Management of Incidental Pancreatic Findings in Adults by the Canadian Association of Radiologists Incidental Findings Working Group

2021 ◽  
pp. 084653712110210
Author(s):  
Christopher I. Fung ◽  
David L. Bigam ◽  
Clarence K. W. Wong ◽  
Casey Hurrell ◽  
Jeffery R. Bird ◽  
...  
Keyword(s):  
Working Group ◽  
Incidental Findings ◽  
Practice Patterns ◽  
Cost Effective ◽  
Pancreatic Cysts ◽  
Canadian Association ◽  
Pancreatic Calcifications ◽  
Fatty Atrophy ◽  
Anatomic Variants

The Canadian Association of Radiologists Incidental Findings Working Group consists of both academic subspecialty and general radiologists and is tasked with adapting and expanding upon the American College of Radiology incidental findings white papers to more closely apply to Canadian practice patterns, particularly more comprehensively dealing with the role of ultrasound and pursuing more cost-effective approaches to the workup of incidental findings without compromising patient care. Presented here are the 2021 Canadian guidelines for the management of pancreatic incidental findings. Topics covered include anatomic variants, fatty atrophy, pancreatic calcifications, ductal ectasia, and management of incidental pancreatic cysts.

The Role of Novel Bone Forming Agents in the Treatment of Osteoporosis

2020 ◽  
pp. 089719002096122
Author(s):  
Hansita B. Patel ◽  
Lynsie J. Lyerly ◽  
Cheryl K. Horlen
Keyword(s):  
Elderly Population ◽  
Cost Effective ◽  
The Elderly ◽  
Bisphosphonate Therapy ◽  
Evidence Based ◽  
First Line ◽  
Treatment Of Osteoporosis ◽  
Cost Effective Treatment

Osteoporosis is a growing epidemic that leads to significant morbidity and mortality among the elderly population due to associated fractures that lead to disabilities and reduced quality of life. Bisphosphonates are well-established as a first-line and cost-effective treatment for osteoporosis. Unfortunately, clinicians are often uncertain as to how to select treatments when bisphosphonates are ineffective as initial treatment or contraindicated. Romosozumab and abaloparatide are 2 alternative agents that have been recently FDA approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture or patients who have failed or are intolerant to other osteoporosis therapies. Currently, the National Osteoporosis Foundation (NOF) has no formal recommendations in regard to these 2 novel agents. The purpose of this review is to help guide pharmacists on how to ensure appropriate utilization of these 2 novel bone-forming agents as potential alternatives to bisphosphonate therapy by providing evidence-based recommendations according to the current literature and key counseling points.

scholarly journals The Morbidity and Mortality Conference: A Unique Opportunity for Teaching Empathic Communication

2010 ◽  
Vol 2 (4) ◽  
pp. 505-507 ◽  
Author(s):  
Neil S. Prose ◽  
Haywood Brown ◽  
Gwendolyn Murphy ◽  
Angel Nieves
Keyword(s):  
Communication Skills ◽  
Morbidity And Mortality ◽  
Patient Centered ◽  
Doctor Patient Communication ◽  
Reflective Listening ◽  
American Medicine ◽  
Empathic Communication ◽  
Morbidity And Mortality Conference ◽  
Mortality Conference

Abstract Background The morbidity and mortality conference is an educational tradition in American medicine that dates to the early 20th century. Traditionally, this conference has focused entirely on issues of diagnosis and treatment, in the context of a disappointing clinical outcome. Intervention We report on a new method for teaching empathic doctor-patient communication skills at an obstetrics and gynecology morbidity and mortality conference. For each case presented, we identified the communications challenges and allowed faculty and residents to “practice” the discussion they would have with the patient and the patient's family in that situation. In some sessions, actors assumed the role of the patient. Following the discussion of the case, we offered didactic presentations on how we communicate with patients and their families. These focused on techniques for being patient centered and included the use of body language, open-ended questioning, reflective listening before offering to explain, and the importance of naming and validating emotions. Results The majority of participants felt the sessions to be helpful, and after one month many were able to identify a positive change in their interactions with patients. Conclusions We believe that this unique teaching format allows learners to refine their communication skills in the context of situations that they know to be both realistic and important.

scholarly journals Advocating for evidence in birth

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Andrea Ford
Keyword(s):  
Patient Outcomes ◽  
Boundary Object ◽  
Power Dynamics ◽  
Evidence Based ◽  
Patient Centered ◽  
Medical Authority ◽  
Authoritative Knowledge ◽  
Medical Protocols

The notion of ‘evidence’ circulates in two realms of current maternity care: biomedical ‘evidence-based’ obstetrics and efforts to reform conventional obstetric practices. I observed that in California’s childbearing culture, ‘evidence’ is a boundary object that allows diverse actors to engage in related conversations despite fundamentally different assumptions about what evidence is or does. Sometimes these actors form productive hybrids and other times they talk past one another. This article uses recent work from the history and philosophy of science to distinguish the biomedical use of evidence, which is based on controlled experiments to prove cause and effect, from reformists’ use of evidence, which foregrounds patient outcomes. Using Stengers’s classification of doctors, charlatans, and curers, I discuss the role of rationality and experience in producing authoritative knowledge. Reformists’ use of evidence, in effect, challenges medical power dynamics on what they perceive to be the terms of medical authority itself; in doing so, it has the potential to fundamentally alter who is the primary beneficiary of medical protocols. The challenge is continuing to use evidence in a way that doesn’t simply ossify a new set of norms, but becomes increasingly capacious, flexible, specific, and patient centered.

ICT-Based Learning

2011 ◽  
pp. 39-54 ◽  
Author(s):  
Hakikur Rahman
Keyword(s):  
Social Inclusion ◽  
End Users ◽  
Fundamental Question ◽  
Education For All ◽  
Evidence Based ◽  
Mediated Learning ◽  
Learning Mechanisms ◽  
Depth Analysis ◽  
Effective Role

ICT mediated learning provides utilities for achieving the goal of education for all, and in turn acts as an enabler in reducing the digital divide, reducing poverty, and promoting social inclusion. However, the integration of ICTs in education deserves considerable investment in time and resources. Consequently, during planning to integrate ICTs in evidence-based information for making sound decisions by the end users incorporate extensive research and sharing of critical information along different phases of planning. Furthermore, implementation of ICT based learning demands in depth analysis and intelligent feedback of the processes. Technology does not improve learning in a straight way and the fundamental question remains always unanswered, in assessing the effectiveness of ICTs or assessing the effectiveness of instructional treatments that were initially (and effectively) less than perfect. This chapter has tried to critically analyze the effective role of ICT methods in learning and put forwards several success cases of learning mechanisms that assisted in socioeconomic empowerment and at the same time, provided a few futuristic recommendations in establishing similar endeavors in promising economies.

Role of Bronchoalveolar Lavage in Hospitalized Pediatric Patients

1996 ◽  
Vol 105 (11) ◽  
pp. 863-867 ◽  
Author(s):  
Michelle R. Yagoda ◽  
Joseph Stavola ◽  
Charlotte Steinberg ◽  
Robert Ward ◽  
Jacqueline Jones
Keyword(s):  
Bronchoalveolar Lavage ◽  
Diagnostic Tool ◽  
Retrospective Review ◽  
Diagnostic Procedure ◽  
Pediatric Patients ◽  
Cost Effective ◽  
Hospitalized Children ◽  
Oral Antibiotics ◽  
Effective Role

Bronchoalveolar lavage (BAL) has been shown to be a rapid, relatively safe, and relatively noninvasive diagnostic procedure. Theoretically, BAL can be performed on all children hospitalized for pneumonia resistant to oral antibiotics, though practically and economically, this is not feasible. A 1-year retrospective review was conducted to define a cost-effective role for BAL in the management of hospitalized children with resistant pneumonia. The data revealed identification of at least one pathogen in 87% of sputum samples and in 95% of BAL specimens. Sputum samples provided the same information as the more invasive BAL technique in 60% of patients who had both sputum and BAL obtained for culture. Recommendations are made for the use of BAL as a diagnostic tool in the hospitalized child with resistant pneumonia.

The Role of Pharmacists in Addressing Vaccine Hesitancy and the Measles Outbreak

2019 ◽  
pp. 089719001989543
Author(s):  
Katelin M. Lisenby ◽  
Kruti N. Patel ◽  
Michelle T. Uichanco
Keyword(s):  
Cost Effective ◽  
The United States ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Evidence Based ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreak ◽  
The World ◽  
Health Organization

Vaccine hesitancy has been identified as a top threat to global health by the World Health Organization. The current measles outbreak in the United States places even greater emphasis on the relevance of this topic. Vaccination is one of the most cost-effective methods to avoid preventable disease and associated complications. Safety concerns and lack of education commonly contribute to vaccination refusals. By providing patients evidence-based facts and education, pharmacists have the opportunity to address common misconceptions influencing the antivaccination movement and prevent future outbreaks of vaccine-preventable diseases.

scholarly journals Canadian Association of Radiologists White Paper on Artificial Intelligence in Radiology

2018 ◽  
Vol 69 (2) ◽  
pp. 120-135 ◽  
Author(s):  
An Tang ◽  
Roger Tam ◽  
Alexandre Cadrin-Chênevert ◽  
Will Guest ◽  
Jaron Chong ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Patient Care ◽  
Working Group ◽  
White Paper ◽  
Patient Centered ◽  
Computing Power ◽  
Implementation Phase ◽  
Early Adoption ◽  
Canadian Association

Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada.

scholarly journals Critical Thinking Tools for Quality Improvement Projects

2021 ◽  
Vol 41 (2) ◽  
pp. e1-e9
Author(s):  
Kimberly Whiteman ◽  
Jason Yaglowski ◽  
Kimberly Stephens
Keyword(s):  
Quality Improvement ◽  
Critical Thinking ◽  
Evidence Based Practice ◽  
Cost Effective ◽  
Evidence Based ◽  
Nursing Process ◽  
Patient Centered ◽  
Pareto Chart ◽  
Quality Issues ◽  
Thinking Tools

Topic This article explores the use of 4 quality improvement tools and 2 evidence-based practice tools that, when used within the nursing process, encourage critical thinking about quality issues. Clinical Relevance Patients and families expect to receive patient-centered, high-quality, and cost-effective care. Caring for critically ill patients is challenging and requires nurses to engage in quality improvement efforts to ensure that they provide evidence-based care. Purpose of Paper To explore the use of critical thinking tools and evidence-based practice tools in assessing and diagnosing quality issues in the clinical setting. Content Covered The nursing process serves as the framework for problem solving. Some commonly used critical thinking tools for assessing and diagnosing quality issues are described, including the Spaghetti Diagram, the 5 Whys, the Cause and Effect Diagram, and the Pareto chart.

scholarly journals The cost effective role of Eschmarch tourniquet and psychosocial awareness of disease as a key factor in decompressive therapy of filarial lymphedema

2019 ◽  
Vol 6 (8) ◽  
pp. 2895
Author(s):  
Arun Y. Mane ◽  
Narendra G. Naik
Keyword(s):  
Job Insecurity ◽  
Cost Effective ◽  
Secondary Lymphedema ◽  
The People ◽  
Key Factor ◽  
Effective Role ◽  
The Cost ◽  
Pitting Edema

Background: The filiariasis is the most common cause of secondary lymphedema of the lower limb. Due to poor awareness of this disease in the people of the lower socioeconomic strata, the patient understands the importance of conservative modality of therapy very late. The cutaneous changes and its complications develop in patient due to unawareness about the nature of noncurable progressive disease. The self-negligence to their own limb also contributes to increase in the morbidity of the disease. The article discusses about cost effective role of Eschmarch tourniquet as a decompressive therapy. The disease causes socioeconomic impairments, stigmatization due to elephantiasis and job insecurity due to cosmetic and functional disability.Methods: This was a retrospective study done in 28 cases of filarial lymphedema. All patients received limb elevation and decompressive therapy by Eschmarch tourniquet.Results: Out of 28 cases, 14 cases in study group of filarial lymphedema with pitting edema (71.42%) and non-pitting edema feet with minimal cutaneous changes (28.57%) showed significant reduction in size of limb girth and satisfactory fluctuating limb girth during the follow up period in OPD respectively, by adequate limb elevation, elastic stockinet and decompressive therapy by Eschmarch tourniquet as compared to the remaining 14 patients of control who received only limb elevation. The better follow up results are noticed by proper guidance to the patient about the disease and its conservative modality of treatment.Conclusions: It is a challenge for the treating consultant to create early awareness about the nature of the filarial disease and early guidance about the conservative treatment which helps to restrict the rapid growth of limb size in filiariatic lymphedema. The eschmarch tourniquet is one of the cost effective decompressive therapy. 

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