scholarly journals Cuidados para a prevenção de complicações em pacientes traqueostomizados

2019 ◽  
Vol 13 (1) ◽  
pp. 169
Author(s):  
Daniel De Macêdo Rocha ◽  
Elaine Carininy Lopes da Costa ◽  
Cliciane Furtado Rodrigues ◽  
Jucileide Gomes Matia Gomes Matias ◽  
Sandra Maria Gonçalves Bezerra ◽  
...  
Keyword(s):  
English Language ◽  
Critical Evaluation ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Health Team ◽  
Endotracheal Aspiration ◽  
Study Type ◽  
Skin Cleansing ◽  
Management Of Care ◽  
Surgical Stomas

ABSTRACT Objective: to analyze the evidences of care for the prevention of complications in tracheostomized patients. Method: this is a bibliographical study, type integrative review, with analysis of articles published between 2000 and 2017, carried out in the databases MEDLINE, LILACS, CINAHL and BDENF. The sample was composed by 22 primary studies in English, Portuguese and Spanish. A critical evaluation of the studies was carried out through the level of evidence and classification in relation to the topics addressed. Results: it was verified the predominance of international productions published in English language and level of evidence VII. The care that involved tracheostomy aspiration, saline humidification, dressing replacement, skin and tube cleaning, and education of the health team, the patient, and the caregiver were identified. Conclusion: it was evidenced that factors related to endotracheal aspiration, tube and skin cleansing and health education represented the main strategies that minimize the risk of complications. It is hoped to contribute to the consolidation of evidence-based practice and to the management of care with safety, quality and effectiveness. Descriptors: Surgical Stomas; Tracheostomy; Postoperative Complications; Disease Prevention; Atención de Enfermería; Nursing Care; Nursing.RESUMO Objetivo: analisar as evidências de cuidados para a prevenção de complicações em pacientes traqueostomizados. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, com análise de artigos publicados entre 2000 a 2017, realizada nas bases de dados MEDLINE, LILACS, CINAHL e BDENF. Compôs-se a amostra por 22 estudos primários nos idiomas inglês, português e espanhol. Realizou-se a avaliação crítica dos estudos por meio do nível de evidência e classificação em relação às temáticas abordadas. Resultados: verificou-se o predomínio de produções internacionais publicadas em idioma inglês e com nível de evidência VII. Identificaram-se os cuidados que envolveram a aspiração da traqueostomia, a umidificação com solução salina, a troca do curativo, a limpeza da pele e do tubo e a educação da equipe de saúde, do paciente e do cuidador. Conclusão: evidenciou-se que fatores relacionados à aspiração endotraqueal, à limpeza do tubo e da pele e à educação em saúde representaram as principais estratégias que minimizam o risco de complicações. Espera-se contribuir para a consolidação da prática baseada em evidências e para o gerenciamento do cuidado com segurança, qualidade e efetividade. Descritores: Estomas Cirúrgicos; Traqueostomia; Complicações Pós-Operatórias; Prevenção de Doenças; Cuidados de Enfermagem; Enfermagem.RESUMEN Objetivo: analizar las evidencias de cuidados para la prevención de complicaciones en pacientes traqueostomizados. Método: se trata de un estudio bibliográfico, tipo revisión integrativa, con análisis de artículos publicados entre 2000 a 2017, realizada en las bases de datos MEDLINE, LILACS, CINAHL y BDENF. La muestra se compone de 22 estudios primarios en Inglés, portugués y español. Se realizó la evaluación crítica de los estudios por medio del nivel de evidencia y clasificación en relación a las temáticas abordadas. Resultados: se verificó el predominio de producciones internacionales publicadas en idioma inglés y con nivel de evidencia VII. Se identificaron los cuidados que involucraron la aspiración de la traqueostomía, la humidificación con solución salina, el cambio del vendaje, la limpieza de la piel y del tubo y la educación del equipo de salud, del paciente y del cuidador. Conclusión: Se evidenció que factores relacionados a la aspiración endotraqueal, a la limpieza del tubo y de la piel y a la educación en salud representaron las principales estrategias que minimizan el riesgo de complicaciones. Se espera contribuir a la consolidación de la práctica basada en evidencias y para la gestión del cuidado con seguridad, calidad y efectividad. Descriptores: Estomas Quirúrgicos; Traqueostomía; Complicaciones Posoperatorias; Prevención de Enfermedades; Enfermería.

The Speech-Language Assessment of English Language Learning Students: A Non-Standardized Approach

2013 ◽  
Vol 14 (4) ◽  
pp. 95-101 ◽  
Author(s):  
Robert Kraemer ◽  
Allison Coltisor ◽  
Meesha Kalra ◽  
Megan Martinez ◽  
Bailey Savage ◽  
...  
Keyword(s):  
Language Learning ◽  
Language Impairment ◽  
Specific Language Impairment ◽  
English Language ◽  
Language Assessment ◽  
The United States ◽  
English Language Learning ◽  
Assessment Practices ◽  
Evidence Based ◽  
English Speaking

English language learning (ELL) children suspected of having specific-language impairment (SLI) should be assessed using the same methods as monolingual English-speaking children born and raised in the United States. In an effort to reduce over- and under-identification of ELL children as SLI, speech-language pathologists (SLP) must employ nonbiased assessment practices. This article presents several evidence-based, nonstandarized assessment practices SLPs can implement in place of standardized tools. As the number of ELL children SLPs come in contact with increases, the need for well-trained and knowledgeable SLPs grows. The goal of the authors is to present several well-establish, evidence-based assessment methods for assessing ELL children suspected of SLI.

Chaitanya

2019 ◽  
Author(s):  
Amiya P. Sen
Keyword(s):  
Graduate Students ◽  
English Language ◽  
Critical Evaluation ◽  
Significant Part ◽  
Dynamic Relationship ◽  
Iconic Figure

This is a short yet critical biography of a major religious figure from Hindu Bengal, Krishna Chaitanya (1486–1533), based on extant hagiographical sources from medieval Bengal as also recent scholarly studies. It relies on both Bengali and English language sources, creating a dialogic and dynamic relationship between the two. The book primarily addresses graduate students and interested general readers in an easily accessible and intelligible manner, without taking recourse to copious notes and citations. The intention of this project was to produce a narrative that was both gripping and enjoyable. However, there is also ample material in this book that will interest and motivate the researcher as well. A significant part of this work is a critical evaluation of just how Chaitanya has been perceived and understood after his time, particularly in colonial Bengal where he has come to assume the place of an iconic figure. Interested readers will find the painstakingly compiled appendices quite useful.

scholarly journals Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

2021 ◽  
Author(s):  
Carol J. Peden ◽  
Geeta Aggarwal ◽  
Robert J. Aitken ◽  
Iain D. Anderson ◽  
Nicolai Bang Foss ◽  
...  
Keyword(s):  
High Risk ◽  
English Language ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Preoperative Care ◽  
Surgical Patient ◽  
Emergency Laparotomy ◽  
Emergency General Surgery ◽  
Optimal Care ◽  
Level Of Evidence

Abstract Background Enhanced Recovery After Surgery (ERAS) protocols reduce length of stay, complications and costs for a large number of elective surgical procedures. A similar, structured approach appears to improve outcomes, including mortality, for patients undergoing high-risk emergency general surgery, and specifically emergency laparotomy. These are the first consensus guidelines for optimal care of these patients using an ERAS approach. Methods Experts in aspects of management of the high-risk and emergency general surgical patient were invited to contribute by the International ERAS® Society. Pubmed, Cochrane, Embase, and MEDLINE database searches on English language publications were performed for ERAS elements and relevant specific topics. Studies on each item were selected with particular attention to randomized controlled trials, systematic reviews, meta-analyses and large cohort studies, and reviewed and graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Recommendations were made on the best level of evidence, or extrapolation from studies on non-emergency patients when appropriate. The Delphi method was used to validate final recommendations. The guideline has been divided into two parts: Part 1—Preoperative Care and Part 2—Intraoperative and Postoperative management. This paper provides guidelines for Part 1. Results Twelve components of preoperative care were considered. Consensus was reached after three rounds. Conclusions These guidelines are based on the best available evidence for an ERAS approach to patients undergoing emergency laparotomy. Initial management is particularly important for patients with sepsis and physiological derangement. These guidelines should be used to improve outcomes for these high-risk patients.

Foot and Ankle Injections in Athletes

2021 ◽  
pp. 194173812110036
Author(s):  
Jonathan K. Ochoa ◽  
Christopher E. Gross ◽  
Robert B. Anderson ◽  
Andrew R. Hsu
Keyword(s):  
English Language ◽  
Platelet Rich Plasma ◽  
Empirical Studies ◽  
Autologous Blood ◽  
Case Series ◽  
Placental Tissue ◽  
Ankle Injuries ◽  
Extensive Literature ◽  
Foot And Ankle ◽  
Level Of Evidence

Context: Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. Evidence Acquisition: An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. Study Design: Clinical review. Level of Evidence: Level 4. Results: Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. Conclusions: Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.

scholarly journals Diagnosis of Anosmia and Hyposmia: A Systematic Review

2021 ◽  
Vol 12 ◽  
pp. 215265672110265
Author(s):  
Abdul K. Saltagi ◽  
Mohamad Z. Saltagi ◽  
Amit K. Nag ◽  
Arthur W. Wu ◽  
Thomas S. Higgins ◽  
...  
Keyword(s):  
English Language ◽  
Viral Infections ◽  
Original Data ◽  
Olfactory Dysfunction ◽  
Imaging Modalities ◽  
Diagnostic Tools ◽  
Validity And Reliability ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Smell Tests

Background Anosmia and hyposmia have many etiologies, including trauma, chronic sinusitis, neoplasms, and respiratory viral infections such as rhinovirus and SARS-CoV-2. We aimed to systematically review the literature on the diagnostic evaluation of anosmia/hyposmia. Methods PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990 using terms combined with Medical Subject Headings (MeSH). We included articles evaluating diagnostic modalities for anosmia, written in the English language, used original data, and had two or more patients. Results A total of 2065 unique titles were returned upon the initial search. Of these, 226 abstracts were examined, yielding 27 full-text articles meeting inclusion criteria (Level of evidence ranging from 1 to 4; most level 2). The studies included a total of 13,577 patients. The most utilized diagnostic tools were orthonasal smell tests (such as the Sniffin’ Sticks and the UPSIT, along with validated abridged smell tests). Though various imaging modalities (including MRI and CT) were frequently mentioned in the workup of olfactory dysfunction, routine imaging was not used to primarily diagnose smell loss. Conclusion The literature includes several studies on validity and reliability for various smell tests in diagnosing anosmia. Along with a thorough history and physical, validated orthonasal smell tests should be part of the workup of the patient with suspected olfactory dysfunction. The most widely studied modality was MRI, but criteria for the timing and sequence of imaging modalities was heterogenous.

scholarly journals Intelligibility in English as a lingua franca – The interpreters’ perspective

2020 ◽  
Vol 9 (2) ◽  
pp. 173-193
Author(s):  
Karin Reithofer
Keyword(s):  
English Language ◽  
Language Skills ◽  
Background Knowledge ◽  
Evidence Based ◽  
Training Methods ◽  
Lingua Franca ◽  
Factors Affecting ◽  
Specialist Knowledge ◽  
Written Questions ◽  
Subordinate Role

AbstractThis article aims at examining the topic of ELF intelligibility from the interpreters’ perspective. Therefore, the focus is put on listener factors affecting intelligibility in settings typical for interpreting i.e. monologic settings. Data from various intelligibility studies are compared with results from a study that tested an ELF user’s intelligibility in a conference-like ELF setting and examined the influence of listener variables such as background knowledge, familiarity with ELF use or proficiency in English. In this study, an Italian speaker gave an impromptu speech in English to participants who subsequently were asked to answer written questions on the topic. The results showed that listeners with more experience in ELF settings reached the highest score in the test, while participants with specialist knowledge were unable to profit from it. The participants’ English language skills played a rather subordinate role. The findings of this study may prove useful for considerations in interpreter training and can contribute to the development of concrete, evidence-based training methods for interpreters in the interpreting sub-skill of comprehension.

scholarly journals Current status of wet lab and cadaveric simulation in urological training: A systematic review

2020 ◽  
Vol 14 (11) ◽  
Author(s):  
Ahmed Al-Jabir ◽  
Abdullatif Aydin ◽  
Hussain Al-Jabir ◽  
M. Shamim Khan ◽  
Prokar Dasgupta ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
In Vivo Studies ◽  
Current Status ◽  
Level Of Evidence ◽  
Cadaveric Simulation ◽  
Randomized Controlled Studies ◽  
Wet Lab ◽  
Urological Training

Introduction: We undertook a systematic review of the use of wet lab (animal and cadaveric) simulation models in urological training, with an aim to establishing a level of evidence (LoE) for studies and level of recommendation (LoR) for models, as well as evaluating types of validation. Methods: Medline, EMBASE, and Cochrane databases were searched for English-language studies using search terms including a combination of surgery, surgical training, and medical education. These results were combined with wet lab, animal model, cadaveric, and in-vivo. Studies were then assigned a LoE and LoR if appropriate as per the education-modified Oxford Centre for Evidence-Based Medicine classification. Results: A total of 43 articles met the inclusion criteria. There was a mean of 23.1 (±19.2) participants per study with a median of 20. Overall, the studies were largely of low quality, with 90.7% of studies being lower than 2a LoE (n=26 for LoE 2b and n=13 for LoE 3). The majority (72.1%, n=31) of studies were in animal models and 27.9% (n=12) were in cadaveric models. Conclusions: Simulation in urological education is becoming more prevalent in the literature, however, there is a focus on animal rather than cadaveric simulation, possibly due to cost and ethical considerations. Studies are also predominately of a low LoE; more higher LoEs, especially randomized controlled studies, are needed.

2014 Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack

2017 ◽  
Vol 12 (3) ◽  
pp. 302-320 ◽  
Author(s):  
Yongjun Wang ◽  
Ming Liu ◽  
Chuanqiang Pu
Keyword(s):  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Stroke Recurrence ◽  
Evidence Based ◽  
Cerebrovascular Disorder ◽  
Level Of Evidence ◽  
Vascular Stenosis ◽  
Ischemic Attack

Ischemic stroke and transient ischemic attack (TIA) are the most common cerebrovascular disorder and leading cause of death in China. The Effective secondary prevention is the vital strategy for reducing stroke recurrence. The aim of this guideline is to provide the most updated evidence-based recommendation to clinical physicians from the prior version. Control of risk factors, intervention for vascular stenosis/occlusion, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke are all recommended, and the prevention of recurrent stroke in a variety of uncommon causes and subtype provided as well. We modified the level of evidence and recommendation according to part of results from domestic RCT in order to facility the clinical practice.

Infrared Thermography for the Evaluation of Inflammatory and Degenerative Joint Diseases: A Systematic Review

Cartilage ◽  
2021 ◽  
Vol 13 (2_suppl) ◽  
pp. 1790S-1801S
Author(s):  
Guglielmo Schiavon ◽  
Gianluigi Capone ◽  
Monique Frize ◽  
Stefano Zaffagnini ◽  
Christian Candrian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Progression ◽  
Infrared Thermography ◽  
Rheumatic Diseases ◽  
English Language ◽  
Response To Treatment ◽  
Cochrane Library ◽  
Joint Diseases ◽  
Level Of Evidence ◽  
Post Evaluation

Objective Inflammation plays a central role in the pathophysiology of rheumatic diseases as well as in osteoarthritis. Temperature, which can be quantified using infrared thermography, provides information about the inflammatory component of joint diseases. This systematic review aims at assessing infrared thermography potential and limitations in these pathologies. Design A systematic review was performed on 3 major databases: PubMed, Cochrane library, and Web of Science, on clinical reports of any level of evidence in English language, published from 1990 to May 2021, with infrared thermography used for diagnosis of osteoarthritis and rheumatic diseases, monitoring disease progression, or response to treatment. Relevant data were extracted, collected in a database, and analyzed for the purpose of this systematic review. Results Of 718 screened articles 32 were found to be eligible for inclusion, for a total of 2094 patients. Nine studies reported the application to osteoarthritis, 21 to rheumatic diseases, 2 on both. The publication trend showed an increasing interest in the last decade. Seven studies investigated the correlation of temperature changes with osteoarthritis, 16 with rheumatic diseases, and 2 with both, whereas 2 focused on the pre-post evaluation to investigate treatment results in patients with osteoarthritis and 5 in patients with rheumatic diseases. A correlation was shown between thermal findings and disease presence and stage, as well as the clinical assessment of disease activity and response to treatment, supporting infrared thermography role in the study and management of rheumatic diseases and osteoarthritis. Conclusions The systematic literature review showed an increasing interest in this technology, with several applications in different joints affected by inflammatory and degenerative pathologies. Infrared thermography proved to be a simple, accurate, noninvasive, and radiation-free method, which could be used in addition to the currently available tools for screening, diagnosis, monitoring of disease progression, and response to medical treatment.

scholarly journals An Evaluation of the Five Most Used Evidence Based Bedside Information Tools in Canadian Health Libraries

2008 ◽  
Vol 3 (2) ◽  
pp. 3 ◽  
Author(s):  
Alison Farrell
Keyword(s):  
Electronic Mail ◽  
Clinical Evidence ◽  
Resource Assessment ◽  
Ease Of Use ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Information Tools ◽  
Canadian Health ◽  
Clinical Questions

Objective – This project sought to identify the five most used evidence based bedside information tools used in Canadian health libraries, to examine librarians’ attitudes towards these tools, and to test the comprehensiveness of the tools. Methods – The author developed a definition of evidence based bedside information tools and a list of resources that fit this definition. Participants were respondents to a survey distributed via the CANMEDLIB electronic mail list. The survey sought to identify information from library staff regarding the most frequently used evidence based bedside information tools. Clinical questions were used to measure the comprehensiveness of each resource and the levels of evidence they provided to each question. Results – Survey respondents reported that the five most used evidence based bedside information tools in their libraries were UpToDate, BMJ Clinical Evidence, First Consult, Bandolier and ACP Pier. Librarians were generally satisfied with the ease of use, efficiency and informative nature of these resources. The resource assessment determined that not all of these tools are comprehensive in terms of their ability to answer clinical questions or with regard to the inclusion of levels of evidence. UpToDate was able to provide information for the greatest number of clinical questions, but it provided a level of evidence only seven percent of the time. ACP Pier was able to provide information on only 50% of the clinical questions, but it provided levels of evidence for all of these. Conclusion – UpToDate and BMJ Clinical Evidence were both rated as easy to use and informative. However, neither product generally includes levels of evidence, so it would be prudent for the practitioner to critically appraise information from these sources before using it in a patient care setting. ACP Pier eliminates the critical appraisal stage, thus reducing the time it takes to go from forming a clinical question to implementing the answer, but survey respondents did not rate it as high in terms of usability. There remains a need for user-friendly, comprehensive resources that provide evidence summaries relying on levels of evidence to support their conclusions.

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