scholarly journals An Insight into Acute Pericoronitis and the Need for an Evidence-Based Standard of Care

2019 ◽  
Vol 7 (3) ◽  
pp. 88 ◽  
Author(s):  
Chelsea Wehr ◽  
Gianncarlo Cruz ◽  
Simon Young ◽  
Walid D. Fakhouri
Keyword(s):  
Online Survey ◽  
Acute Infection ◽  
Third Molar ◽  
Standard Of Care ◽  
Evidence Based ◽  
Emergency Patients ◽  
Randomized Controlled Clinical Trials ◽  
Third Molar Extraction ◽  
Painful Sensation ◽  
Meta Analyses

Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis is common, there is no evidence-based standard-of-care for treatment of emergency patients with acute pericoronitis. Study Design: In this study, anonymous clinicians were asked to participate in an online survey with questions formulated to identify professional clinical background, emergency treatment preferred for acute pericoronitis, number of associated complications, frequency of third molar extraction, and patient satisfaction. Results and Conclusion: A statistical analysis of the collected data regarding the variance among different treatment plans and associated complications revealed little consensus in the treatment of pericoronitis. The lack of consistency of the responses focusing on the preferred treatment for emergency patients with acute pericoronitis reinforces the need for developing a standard-of-care to train future dental professionals based on well-designed randomized controlled clinical trials and meta-analyses. Practical Implications: The ultimate goal is developing a treatment option with the fewest complications to provide the best health care for patients with pericoronitis. This issue is seen not only as an acute infection but also has the potential to impact overall health.

scholarly journals Efficacy of laser monotherapy or non-surgical mechanical instrumentation in the management of untreated periodontitis patients. A systematic review and meta-analysis

2020 ◽  
Author(s):  
Zhikai Lin ◽  
Franz J. Strauss ◽  
Niklaus P. Lang ◽  
Anton Sculean ◽  
Giovanni E. Salvi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Controlled Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Clinical Benefits ◽  
Mean Differences ◽  
Patient Related Outcome ◽  
Meta Analyses

Abstract Objective To evaluate and compare the effects of laser monotherapy with non-surgical mechanical instrumentation alone in untreated periodontitis patients. Materials and methods A focused question was formulated based on the Population, Intervention, Comparison, Outcome, and Study design criteria (PICOS): in patients with untreated periodontitis, does laser mono-therapy provide adjunctive effects on pocket probing depth (PPD) changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. The results of the meta-analyses are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. Results The search yielded 1268 records, out of which 8 articles could be included. With respect to PPD changes, a meta-analysis including 5 articles (n = 148) failed to identify statistically significant differences in favor of laser monotherapy for PPD change (WMD = 0.14 mm; 95% CI: − 0.04/0.32; z = 1.51; p = 0.132) nor for clinical attachment level (CAL) (WMD = 0.04 mm; 95% CI: − 0.35/0.42; z = 0.19; p = 0.850). Data on cost-effectiveness are lacking. One study reported patient-related outcome measures (PROMS). Conclusions In untreated periodontitis patients, laser monotherapy does not yield superior clinical benefits compared with non-surgical mechanical instrumentation alone. Clinical relevance In untreated periodontitis patients, mechanical instrumentation with hand and/or ultrasonic instruments remains the standard of care.

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.

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.

Effect of Age, Gender, Side and Impaction Types on Surgical Difficulty During Mandibular Third Molar Extraction.

2018 ◽  
Vol 17 (2) ◽  
pp. 11
Author(s):  
Krishna Gopal Bhuju ◽  
Sujita Shrestha ◽  
Riwaj Karki ◽  
Sameer Aryal
Keyword(s):  
Third Molar ◽  
Objective Measure ◽  
Operation Time ◽  
Significance Level ◽  
Third Molar Extraction ◽  
Mandibular Third Molar ◽  
Duration Of Surgery ◽  
Surgical Difficulty ◽  
Effect Of Age ◽  
Molar Extraction

<p><strong>Aim</strong>: To study the effect of age, gender, side and impaction types on surgical difficulty during mandibular third molar extraction through the data collected over a period of one year by single maxillofacial surgeon. All the extractions were performed under the same environment and conditions.</p><p><strong>Methods</strong>: Descriptive clinical study of 401 patients was carried out between the ages of 16 to 45years. Age, gender, impaction side and impaction types (according to the winter classification) were recorded on proforma. Duration of surgery for each patient was recorded after starting incision to the completion of suture which was divided into less than 10 minutes (mild), 11 to 20 minutes (moderate) and above 21 minutes (severe). Pearson’s Chi-square test was used for data analysis and significance level was less than or equal to 0.05.</p><p><strong>Results</strong>: Among 401 participants, 225 (56.1%) were male and 176 (43.9%) were female. Mean age was 31.5 years and mean operation time was 17.59 minutes. After statistical analysis there was a significant correlation among gender and side of impaction where <em>p </em>value is 0.043 0.048 respectively.</p><p><strong>Conclusion</strong>: There is a statistically significant correlation between gender and side of impaction with duration of surgery which is considered as the objective measure of surgical difficulty whereas age and impaction types didn’t show any significant correlation. </p>

scholarly journals Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Healthcare Services ◽  
Interdisciplinary Teams ◽  
Evidence Based ◽  
Health Providers ◽  
Cross Sectional ◽  
The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

Championing Change to Save Lives: A Call to Action to Implement Reforms to Increase Use of Medications to Treat Opioid Use Disorder in Correctional Settings

2020 ◽  
pp. 073401682098162
Author(s):  
Sonia L. Canzater ◽  
Regina M. LaBelle
Keyword(s):  
Standard Of Care ◽  
Opioid Use Disorder ◽  
Correctional Facilities ◽  
Evidence Based ◽  
Opioid Use ◽  
Call To Action ◽  
Evidence Based Treatment ◽  
High Prevalence ◽  
Correctional Settings ◽  
Overdose Deaths

The disproportional rates of opioid use disorder (OUD) in U.S. correctional facilities make them prime intervention points to treat OUD utilizing medication to treat opioid use disorder (MOUD), the evidence-based clinical standard of care. MOUD has been shown to be effective to support recovery and reduce recurrence of OUD, overdose deaths, and recidivism for justice-involved persons both while incarcerated and once they reenter their communities. Despite the high prevalence, most jails and prisons do not offer MOUD. Litigation has spurred expanded access in more facilities, but widespread MOUD access can only become a reality through a comprehensive effort of corrections officials, medical experts, advocates, legislators, and other champions to raise awareness and affect ideological and policy change. It is a legal and ethical imperative that the lives of justice-involved persons not be jeopardized by the lack of evidence-based treatment for OUD in correctional settings.

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