scholarly journals Diagnostics of mechanical asphyxia – experience of foreign countries (literature review)

2021 ◽  
pp. 45-49
Author(s):  
Iryna Yakovtsova ◽  
Olexandr Hurov ◽  
Vadym Nikonov ◽  
Sergii Kursov ◽  
Dmytro Hladkykh ◽  
...  
Keyword(s):  
Research Methods ◽  
Evidence Based Medicine ◽  
Alcohol Intoxication ◽  
Morphological Features ◽  
The Body ◽  
Immunohistochemical Method ◽  
Evidence Based ◽  
Morphological Studies ◽  
Based Medicine ◽  
Mechanical Asphyxia

The aim of this study is to establish modern, global trends in the diagnosis of mechanical asphyxia. Materials and methods: search and bibliographic method (theoretical analysis, systematization and classification of library catalogues, printed and electronic sources on mechanical asphyxia) from open anchor databases Scopus preview, Web of Science and using information retrieval systems Google Scholar, Open Ukrainian Citation Index (OUCI), ScienceDirect on the Internet. Results: mechanical asphyxia, as one of the most common types of violent death, ranks first among deaths from mechanical injuries. Its study is of great interest among medical scientists in various fields, especially for resuscitators and forensic experts. Establishing the causes of asphyxia, clinical and morphological manifestations, and the consequences that unfortunately most often lead to death. With the rapid development of society, science is also developing rapidly, and the latest sensitive methods of diagnosing diseases are emerging. However, unfortunately, in the post-Soviet space, the diagnosis of most pathological conditions, including asphyxia, is determined by experience and sensory organs, which are determined using instrumental research methods in compliance with the requirements of evidence-based medicine. Given the peculiarities of the pathophysiological processes of the asphyxiation state and their manifestations in the body, doctors should rely primarily on general knowledge about hypoxic and asphyxiation disorders, which are determined using instrumental research methods in compliance with the requirements of evidence-based medicine. Conclusions: at present, the diagnosis of asphyxia consists of many morphological features. Failure to take into account the state of the body, the presence of chronic diseases, and drug or alcohol intoxication at the time of asphyxiation complicate the diagnosis. Detection of individual clinical manifestations or morphological features does not allow asserting its lifelong origin. Therefore, it is necessary to use modern research methods that should expand the possibilities of forensic diagnosis of the viability of injuries in terms of evidence-based medicine and provide forensic experts with a scientific basis for their results. One such method is immunohistochemical, which is gaining popularity and consolidating its position in the EU, China, Japan and America. In addition, this method is well-established and widespread in morphological studies of differential diagnosis of tumours. Some scientific works prove the expediency of using the immunohistochemical method to solve the problems of forensic expert practice, which is an actual scientific and practical task

scholarly journals Online training in evidence-based medicine and research methods for GP Registrars: a mixed-methods evaluation of engagement and impact

2021 ◽  
Author(s):  
Hania Rahimi-Ardabili ◽  
Catherine Spooner Spooner ◽  
Mark F Harris ◽  
Parker Magin ◽  
Chun Wah Michael Tam ◽  
...  
Keyword(s):  
Data Collection ◽  
Online Education ◽  
Research Methods ◽  
Teaching Methods ◽  
Evidence Based Medicine ◽  
Vocational Training ◽  
Work Place ◽  
Evidence Based ◽  
Based Medicine ◽  
The Impact

Abstract Background Evidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients’ care. Online EBM education could improve clinicians’ skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among GP registrars (trainees in specialist general practice). We aimed to explore GP registrars’ experience with an online interactive course that was a compulsory component of their vocational training. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods). Methods Mixed-method data collection was conducted after individual registrars’ completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016–2020 were invited to complete an online survey asking about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews. A thematic analysis approach was used to analyse the data from qualitative interviews. Results The data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen’s d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences. Conclusions This study showed that an online education program was able to improve GP registrars’ knowledge, confidence, skill and practice of EBM over the period of three months. It also highlights the supervisor’s role on GP registrars’ ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.

Navigating research methods: evidence-based medicine (EBM)

2016 ◽  
Keyword(s):  
Research Methods ◽  
Evidence Based Medicine ◽  
Evidence Base ◽  
Healthcare Research ◽  
Evidence Based ◽  
Historical Overview ◽  
Based Medicine

This chapter defines evidence based medicine (EBM) and discusses the rationale behind it. It provides a brief historical overview of the evolution of EBM. It discusses the importance of clinical and healthcare research in continuing to strengthen the evidence base for clinical and healthcare practices.

scholarly journals Online training in evidence-based medicine and research methods for GP registrars: a mixed-methods evaluation of engagement and impact

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hania Rahimi-Ardabili ◽  
Catherine Spooner ◽  
Mark F. Harris ◽  
Parker Magin ◽  
Chun Wah Michael Tam ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Data Collection ◽  
Research Methods ◽  
Teaching Methods ◽  
Evidence Based Medicine ◽  
Online Course ◽  
Work Place ◽  
Evidence Based ◽  
Based Medicine ◽  
The Impact

Abstract Background Evidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients’ care. Online EBM education could improve clinicians’ skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among general practitioner (GP) registrars (trainees in specialist general practice). We aimed to describe and evaluate the acceptability, utility, satisfaction and applicability of the GP registrars experience with the online course. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods). Methods Mixed-method data collection was conducted after individual registrars’ completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016–2020 were invited to complete an online survey about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews about their experience with the course and the impact of the course on clinical practice. A thematic analysis approach was used to analyse the data from qualitative interviews. Results The data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen’s d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences. Conclusions This study showed that GP registrars who attended the online course reported that it improved their knowledge, confidence, skill and practice of EBM over the period of three months. The study highlights the supervisor’s role on GP registrars’ ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.

Cholangiokarzinome

Praxis ◽  
2002 ◽  
Vol 91 (34) ◽  
pp. 1352-1356
Author(s):  
Harder ◽  
Blum
Keyword(s):  
Supportive Care ◽  
Evidence Based Medicine ◽  
Best Supportive Care ◽  
Evidence Based ◽  
Systemische Chemotherapie ◽  
Chirurgische Resektion ◽  
Multimodale Therapiekonzepte ◽  
Based Medicine

Cholangiokarzinome oder cholangiozelluläre Karzinome (CCC) sind seltene Tumoren des biliären Systems mit einer Inzidenz von 2–4/100000 pro Jahr. Zu ihnen zählen die perihilären Gallengangskarzinome (Klatskin-Tumore), mit ca. 60% das häufigste CCC, die peripheren (intrahepatischen) Cholangiokarzinome, das Gallenblasenkarzinom, die Karzinome der extrahepatischen Gallengänge und das periampulläre Karzinom. Zum Zeitpunkt der Diagnose ist nur bei etwa 20% eine chirurgische Resektion als einzige kurative Therapieoption möglich. Die Lebertransplantation ist wegen der hohen Rezidivrate derzeit nicht indiziert. Die Prognose von nicht resektablen Cholangiokarzinomen ist mit einer mittleren Überlebenszeit von sechs bis acht Monaten schlecht. Eine wirksame Therapie zur Verlängerung der Überlebenszeit existiert aktuell nicht. Die wichtigste Massnahme im Rahmen der «best supportive care» ist die Beseitigung der Cholestase (endoskopisch, perkutan oder chirurgisch), um einer Cholangitis oder Cholangiosepsis vorzubeugen. Durch eine systemische Chemotherapie lassen sich Ansprechraten von ca. 20% erreichen. 5-FU und Gemcitabine sind die derzeit am häufigsten eingesetzten Substanzen, die mit einer perkutanen oder endoluminalen Bestrahlung kombiniert werden können. Multimodale Therapiekonzepte können im Einzellfall erfolgreich sein, müssen jedoch erst in Evidence-Based-Medicine-gerechten Studien evaluiert werden, bevor Therapieempfehlungen für die Praxis formuliert werden können.

The Commitment of the Documentation Service of the Swiss Academy of Medical Sciences for the Impartment of Evidence Based Medicine

Swiss Surgery ◽  
1999 ◽  
Vol 5 (4) ◽  
pp. 183-185
Author(s):  
Bleuer
Keyword(s):  
Evidence Based Medicine ◽  
Cochrane Library ◽  
Evidence Based ◽  
Medical Sciences ◽  
Based Medicine

Die mit dem Aufkommen der elektronischen Medien einhergehende Informationsflut hat die Erwartungen an den Dokumentationsdienst (DOKDI) der Schweizerischen Akademie der Medizinischen Wissenschaften verändert: Insbesondere Evidence Based Medicine (EBM) verlangt nicht nur die Beschaffung von Information, sondern auch eine Selektion hinsichtlich Qualität und Relevanz: Die sich aus der klinischen Situation ergebende Frage fordert eine Antwort, die inhaltlich richtig ist und in der konkreten Situation auch weiterhilft. Dem Ideal, sich durch kritische Lektüre der Originalarbeiten ein Bild über die vorhandene Evidenz für die Richtigkeit eines bestimmten Prozederes zu verschaffen, stehen in der Praxis meist Zeitmangel und methodische Schwierigkeiten im Weg; man wird sich deshalb oft auf die durch andere erarbeitete Evidenz abstützen müssen und z.B. die Cochrane Library konsultieren. Der DOKDI engagiert sich sowohl bei der Erarbeitung von systematischen Übersichtsarbeiten als auch bei der Dissemination der gefundenen Evidenz, indem er seine Erfahrung in der Dokumentation mit elektronischen Medien und die entsprechende Infrastruktur zur Verfügung stellt. Als Ergänzung zu diesen Aktivitäten hat die Akademie einen Grant zur Ausbildung von EBM-Tutoren gesprochen. In einem einwöchigen Kurs in Oxford werden Kliniker zu EBM-Tutoren ausgebildet: Dies wird zukünftig ermöglichen, vermehrt EBM-Workshops in der Schweiz durchzuführen.

Stellenwert der Kinderneurologie im interdisziplinären Ansatz der Frühförderung

2003 ◽  
Vol 12 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Ingrid Müller
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine ◽  
Kosten Im Gesundheitswesen

Zusammenfassung. Die kinderneurologische Begleitung erfüllt zwei wesentliche Aufgaben innerhalb des interdisziplinären Konzepts der Frühförderung. Sie ist zum einen Teil des Diagnostik- und Therapieprozesses; dieser orientiert sich an der neurophysiologischen Erkenntnis, dass das Gehirn ein sich selbst organisierendes System ist und seine Funktionalität in der Interaktion mit dem Umfeld entwickelt. Heutige kinderneurologische Diagnostik basiert daher auf einem systemisch-ökologischen Ansatz. Zum anderen tragen entwicklungsneurologische Befunde, die sich zur prognostischen Beurteilung therapeutischer Maßnahmen eignen, wesentlich zur Qualitätssicherung und -kontrolle in der Frühförderung bei. In den letzten Jahren ist eine Inflation bei der Verordnung entwicklungsfördernder Maßnahmen zu beobachten. Um eine Explosion der Kosten im Gesundheitswesen zu verhindern, werden sich in Zukunft Kriterien der evidence-based medicine auch in der Frühförderung durchsetzen müssen.

Sign in / Sign up

Export Citation Format

Share Document