Sound Therapy for Tinnitus Management: Practicable Options

2014 ◽  
Vol 25 (01) ◽  
pp. 062-075 ◽  
Author(s):  
Derek J. Hoare ◽  
Grant D. Searchfield ◽  
Amr El Refaie ◽  
James A. Henry
Keyword(s):  
Clinical Practice ◽  
Point Of Care ◽  
Empirical Studies ◽  
Evidence Base ◽  
Management Plan ◽  
Care Patient ◽  
Therapy Options ◽  
Sound Therapy ◽  
Therapy Option ◽  
General Guide

Background: The authors reviewed practicable options of sound therapy for tinnitus, the evidence base for each option, and the implications of each option for the patient and for clinical practice. Purpose: To provide a general guide to selecting sound therapy options in clinical practice. Intervention: Practicable sound therapy options. Data Collection and Analysis: Where available, peer-reviewed empirical studies, conference proceedings, and review studies were examined. Material relevant to the purpose was summarized in a narrative. Results: The number of peer-reviewed publications pertaining to each sound therapy option reviewed varied significantly (from none to over 10). Overall there is currently insufficient evidence to support or refute the routine use of individual sound therapy options. It is likely, however, that sound therapy combined with education and counseling is generally helpful to patients. Conclusions: Clinicians need to be guided by the patient’s point of care, patient motivation and expectations of sound therapy, and the acceptability of the intervention both in terms of the sound stimuli they are to use and whether they are willing to use sound extensively or intermittently. Clinicians should also clarify to patients the role sound therapy is expected to play in the management plan.

scholarly journals Novel molecular biomarkers and diagnosis of acute appendicitis in children

2021 ◽  
Author(s):  
Sarah VL Hodge ◽  
Beata Mickiewicz ◽  
Matthew Lau ◽  
Craig N Jenne ◽  
Graham C Thompson
Keyword(s):  
Clinical Practice ◽  
Precision Medicine ◽  
Patient Outcomes ◽  
Point Of Care ◽  
Management Plan ◽  
Diagnostic Strategy ◽  
Laboratory Studies ◽  
Suspected Appendicitis ◽  
Diagnosis And Prognosis ◽  
Diagnostic Sensitivity And Specificity

Reliable and efficient diagnosis of pediatric appendicitis is essential for the establishment of a clinical management plan and improvement of patient outcomes. Current strategies used to diagnose a child presenting with a suspected appendicitis include laboratory studies, clinical scores and diagnostic imaging. Although these modalities work in conjunction with each other, one optimal diagnostic strategy has yet to be agreed upon. The recent introduction of precision medicine techniques such as genomics, transcriptomics, proteomics and metabolomics has increased both the diagnostic sensitivity and specificity of appendicitis. Using these novel strategies, the integration of precision medicine into clinical practice via point-of-care technologies is a plausible future. These technologies would assist in the screening, diagnosis and prognosis of pediatric appendicitis.

Physician Reentry into Clinical Practice: Regulatory Challenges

2011 ◽  
Vol 97 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Gretchen P. Kenagy ◽  
Barbara S. Schneidman ◽  
Barbara Barzansky ◽  
Claudette E. Dalton ◽  
Carl A. Sirio ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Empirical Studies ◽  
Clinical Activity ◽  
Central Importance ◽  
Regulatory Policies ◽  
Physician Competence ◽  
Leave Of Absence ◽  
Increasing Demand ◽  
State Medical Boards ◽  
Regulatory Challenges

ABSTRACT Physician reentry to clinical practice is fast becoming recognized as an issue of central importance in discussions about the physician workforce. While there are few empirical studies, existing data show that increasing numbers of physicians take a leave of absence from practice at some point during their careers; this trend is expected to continue. The process of returning to clinical practice is coming under scrutiny due to the public's increasing demand for transparency regarding physician competence. Criteria for medical licensure often do not include an expectation of ongoing clinical activity. Physicians who maintain a license but do not practice for a period of time, therefore, may be reentering the workforce with unknown competency to practice. This paper: (1) presents survey data on current physician reentry policies of state medical boards; (2) discusses the findings from the survey within the context of regulatory challenges that impact physician-reentry; and (3) offers recommendations to facilitate the development of comprehensive, coordinated regulatory policies on physician reentry.

Current Clinical Practice in Point-of-Care Ultrasound Use in the PICUs Across Europe

2020 ◽  
Vol 21 (9) ◽  
pp. e716-e722
Author(s):  
Martien H. Humblet ◽  
Yogen Singh ◽  
Cecile Tissot ◽  
Daniele De Luca ◽  
Piet L. Leroy
Keyword(s):  
Clinical Practice ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Current Clinical Practice

scholarly journals A systematic review of interventions to increase breakfast consumption: a socio-cognitive perspective

2021 ◽  
pp. 1-16
Author(s):  
Jessica A Harris ◽  
Julia E Carins ◽  
Sharyn Rundle-Thiele
Keyword(s):  
Empirical Studies ◽  
Eating Behaviour ◽  
Target Population ◽  
Evidence Base ◽  
Dietary Quality ◽  
Entire Study ◽  
Breakfast Consumption ◽  
Breakfast Skipping ◽  
Breakfast Eating ◽  
Theory Use

Abstract Objective: Regular breakfast skipping is related to unhealthy dietary behaviours, such as consuming an overall poorer quality diet and lower rates of physical activity, both of which are linked to a higher BMI. Adolescent breakfast skippers struggle with mental focus, sleep issues and lower grades. Solutions that can be implemented to overcome breakfast skipping are needed. Design: A systematic literature review was undertaken to identify programmes that aimed to increase breakfast eating. Following the PRISMA framework, studies were sourced to examine details of behaviour change, evidence of theory use and other important programme learnings and outcomes. Setting: Breakfast consumption empirical studies published from 2000 onwards. Participants: Nineteen empirical studies that aimed to improve breakfast eating behaviour. Results: Out of the nineteen studies examined, ten studies reported an increase in breakfast consumption frequency for the entire study group or subgroups. Seven studies found no change, one was inconclusive and one observed a decrease in breakfast frequency. Positive changes to the dietary quality of breakfast were observed in five of the studies that did not observe increased frequency of breakfast consumption. Only six studies reported using theory in the intervention. Conclusions: This evidence review points needed to extend theory application to establish a reliable evidence base that can be followed by practitioners seeking to increase breakfast eating rates in their target population.

scholarly journals Rapid point-of-care anti-infliximab antibodies detection in clinical practice: comparison with ELISA and potential for improving therapeutic drug monitoring in IBD patients

2021 ◽  
Vol 14 ◽  
pp. 175628482199990
Author(s):  
Sonia Facchin ◽  
Andrea Buda ◽  
Romilda Cardin ◽  
Nada Agbariah ◽  
Fabiana Zingone ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Point Of Care ◽  
Drug Clearance ◽  
Elisa Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Therapeutic Drug ◽  
Drug Concentrations ◽  
Inflammatory Bowel

Anti-drug antibodies can interfere with the activity of anti-tumor necrosis factor (TNF) agents by increasing drug clearance via direct neutralization. The presence of anti-drug antibodies is clinically relevant when trough drug concentrations are undetectable or sub-therapeutic. However, traditional immunoassay is not easily and rapidly accessible, making the translation of the results into treatment adjustment difficult. The availability of a point-of-care (POC) test for therapeutic drug monitoring (TDM) might represent an important step forward for improving the management of inflammatory bowel disease (IBD) patients in clinical practice. In this pilot study, we compared the results obtained with POC tests with those obtained by enzyme-linked immunosorbent assay (ELISA) in a group of IBD patients treated with Infliximab (IFX). We showed that POC test can reliably detect presence of antibody-to-IFX with 100% of specificity and 76% sensitivity, in strong agreement with the ELISA test ( k-coefficient = 0.84).

scholarly journals The Evolving Role of Catheter Ablation in Patients With Heart Failure and AF

2019 ◽  
Vol 8 (1) ◽  
pp. 47-53
Author(s):  
Sandeep Prabhu ◽  
Wei H Lim ◽  
Richard J Schilling
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Catheter Ablation ◽  
Patient Group ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Evidence Base ◽  
Patients With Heart Failure ◽  
Recent Developments

AF and heart failure are emerging epidemics worldwide. Several recent trials have provided a growing evidence base for the benefits of catheter ablation in this patient group, which are yet to be universally adopted in clinical practice guidelines. This paper provides a summary of recent developments in this field and provides pragmatic advice to the treating physician regarding the appropriate role of catheter ablation in the overall management of patients with comorbid AF and heart failure.

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