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Prevenção cardiovascular abrangente em pacientes com doença arterial coronária: implementação das diretrizes na prática clínica.; Cardiovascular prevention in coronary heart disease patients: guidelines implementation in clinical practice

Brasil, Clarisse Kaoru Ogawa Indio do
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 02/07/2013 PT
Relevância na Pesquisa
66%
Introdução: apesar das recomendações de todas as diretrizes sobre a doença arterial coronária e das evidências científicas de que o tratamento medicamentoso otimizado acrescido de intervenção sobre os fatores de risco e a melhoria do estilo de vida reduzem eventos cardiovasculares fatais não-fatais, essa terapêutica de prevenção secundária continua a ser subutilizada na prática clínica. Objetivos: Primário: demonstrar que a utilização de um programa de otimização da prática clínica em pacientes com doença arterial coronária estável aumenta a prescrição de medicamentos comprovadamente eficazes na prevenção secundária desta doença. Secundários: a) documentar a prática clínica vigente em termos de terapia medicamentosa e de medidas para a mudança do estilo de vida b) identificar as ferramentas utilizadas na estratégia para a otimização da prática clínica quanto à eficácia e aderência à medicação prescrita. Métodos: trata-se de um estudo de corte transversal para documentar a prática clínica vigente, seguido de componente longitudinal em que a utilização das ferramentas para a otimização da prática clínica foi avaliada por meio de novo corte transversal, com nova coleta de dados. Foram identificados retrospectivamente através dos prontuários...

Representation of clinical practice guideline components in OWL

Oliveira, Tiago José Martins; Novais, Paulo; Neves, José
Fonte: Springer Publicador: Springer
Tipo: Conferência ou Objeto de Conferência
Publicado em //2013 ENG
Relevância na Pesquisa
65.87%
Serie : Advances in intelligent systems and computing, ISSN 2194-5357, vol. 221; The main purpose to attain with the advent of clinical decision sup-port systems is either to improve the quality of patient care or to reduce the oc-currence of clinical malpractice, such as medical errors and defensive medicine. It is therefore necessary a machine-readable support to integrate the recommen-dations of Clinical Practice Guidelines in such systems. CompGuide is a Com-puter-Interpretable Guideline model developed under Ontology Web Language that offers support for administrative information concerning a guideline, work-flow procedures, and the definition of clinical and temporal constraints. When compared to other models of the same type, besides having a comprehensive task network model, it introduces new temporal representations and the possi-bility of reusing pre-existing knowledge and integrating it in a guideline.

Developmentand Population of an Elaborate Formal Ontology for Clinical Practice Knowledge Representation

Mendes, David; Rodrigues, Irene Pimenta; Baeta, Carlos
Fonte: Scitepress Publicador: Scitepress
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
65.88%
The Ontology for General Medical Science (OGMS) complemented with the Computer-Based Patient Record Ontology (CPR)is based on several upper ontologies which may have formal ontological relations according to the OBO Foundry principles. These ontologies accordant to the underlying Ontological Realism render a structure with reasoning capabilities that reach further than those possible with logical formalisms alone. We propose to extend carefully the OGMS taking into account the diverse ontological relations found in the recently proposed Basic Formal Ontology V2, FMA and SNOMED-CT as foundational ontologies in order to extract axioms for ontology enrichment from natural language text. With these cautions in mind, using careful instantiation we improve largely the reasoning capabilities over the resulting OWL knowledge base. Most of the clinical practice knowledge is currently recorded in SOAP text format. We extend the OGMS with the CPR structure into an Ontology for General Clinical Practice (OGCP) for the generation of adequate ontologically rich axioms from the SOAP text segments.)

Clinical practice guidelines for the management of hypothyroidism

Brenta,Gabriela; Vaisman,Mario; Sgarbi,José Augusto; Bergoglio,Liliana Maria; Andrada,Nathalia Carvalho de; Bravo,Pedro Pineda; Orlandi,Ana Maria; Graf,Hans
Fonte: Sociedade Brasileira de Endocrinologia e Metabologia Publicador: Sociedade Brasileira de Endocrinologia e Metabologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
Relevância na Pesquisa
65.87%
INTRODUCTION: Hypothyroidism has long been known for its effects on different organ systems, leading to hypometabolism. However, subclinical hypothyroidism, its most prevalent form, has been recently related to cardiovascular risk and also to maternal-fetal complications in pregnant women. OBJECTIVES: In these clinical practice guidelines, several aspects of this field have been discussed with the clear objectives of helping physicians treat patients with hypothyroidism, and of sharing some of our Latin American-based clinical experience. MATERIALS AND METHODS: The Latin American Thyroid Society commissioned a Task Force on Hypothyroidism to develop evidence-based clinical guidelines on hypothyroidism. A systematic review of the available literature, focused on the primary databases of MedLine/PubMed and Lilacs/SciELO was performed. Filters to assess methodological quality were applied to select the best quality studies. The strength of recommendation on a scale from A-D was based on the Oxford Centre for Evidence--based Medicine, Levels of Evidence 2009, allowing an unbiased opinion devoid of subjective viewpoints. The areas of interest for the studies comprised diagnosis, screening, treatment and a special section for hypothyroidism in pregnancy. RESULTS: Several questions based on diagnosis...

Metastatic non-small cell lung cancer in Brazil: treatment heterogeneity in routine clinical practice

Naime,Fauzia F.; Younes,Riad Naim; Kersten,Bruno G.; Anelli,Agnaldo; Beato,Carlos Augusto M.; Andrade,Rogério M.; Carrara,Marcella P.; Gross,Jefferson Luiz
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2007 EN
Relevância na Pesquisa
65.86%
ABSTRACT: Lung cancer is one of the main causes of cancer related deaths. Approximately three quarters of these tumors are non-small cell carcinomas. When diagnosed the majority of patients show the disease locally advanced or metastatic. The chemotherapy is the chosen therapy for patients with advanced lung cancer. The majority of published studies with chemotherapy are performed in academic centers under a strict control of research protocols. PURPOSE: The aim of this study is to evaluate the usual management of metastatic NSCLC patients outside of a clinical trial setting in three different oncologic centers in Brazil. METHODS: This is a retrospective study of patients with metastatic non-small cell lung cancer admitted for treatment in three different Cancer Centers in Brazil. 564 patients from Brazilian public heath system and private/health insurance system were considered for the present study. RESULTS: Among 564 patients in this study, 335 (59.4%) received chemotherapy. For all patients, 47 different regimens of chemotherapy were identified. The median follow-up time was eight months and the overall median survival of all patient population submitted to chemotherapy was 9.7 months. DISCUSSION: There was a great heterogeneity in the regimens of drugs to treat metastatic NSCLC patients. The overall survival was significantly better for patients treated with first line chemotherapy compared to patients that only received best supportive care. Results of prospective randomized clinical trials should be carefully analyzed before transferred to the daily clinical practice.

Academy of Medicine-Ministry of Health Clinical Practice Guidelines: Assessment and Management of Infertility at Primary Healthcare Level

Loh, Seong Feei; Agarwal, Rachna; Chan, Jerry; Chia, Sing Joo; Cho, Li Wei; Lim, Lean Huat; Lau, Matthew Sie Kuei; Loh, Sheila Kia Ee; Hendricks, Marianne Sybille; Nair, Suresh; Quah, Joanne Hui Min; Tan, Heng Hao; Wong, PC; Yeong, Cheng Toh; Yu, Su Ling
Fonte: Singapore Medical Association Publicador: Singapore Medical Association
Tipo: Artigo de Revista Científica
Publicado em /02/2014 EN
Relevância na Pesquisa
65.88%
The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_ medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

Ministry of Health Clinical Practice Guidelines: Diabetes Mellitus

Goh, Su Yen; Ang, Seng Bin; Bee, Yong Mong; Chen, Richard YT; Gardner, Daphne; Ho, Emily; Adaikan, Kala; Lee, Alvin; Lee, Chung Horn; Lim, Fong Seng; Lim, Hwee Boon; Lim, Su Chi; Seow, Julie; Soh, Abel Wah Ek; Sum, Chee Fang; Tai, E Shyong; Thai, Ah Chuan
Fonte: Singapore Medical Association Publicador: Singapore Medical Association
Tipo: Artigo de Revista Científica
Publicado em /06/2014 EN
Relevância na Pesquisa
65.88%
The Ministry of Health (MOH) have updated the clinical practice guidelines on Diabetes Mellitus to provide doctors and patients in Singapore with evidence-based treatment for diabetes mellitus. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Diabetes Mellitus, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

Academy of Medicine-Ministry of Health Clinical Practice Guidelines: Attention Deficit Hyperactivity Disorder

Fung, Daniel SS; Lim, Choon Guan; Wong, John Chee Meng; Ng, Koon Hock; Cheok, Christopher Cheng Soon; Kiing, Jennifer Sie Hee; Chong, Shang Chee; Lou, June; Daniel, Mary Lourdes; Ong, Desmond; Low, Charity; Aljunied, Sharifah Mariam; Choi, Pui Meng; Mehro
Fonte: Singapore Medical Association Publicador: Singapore Medical Association
Tipo: Artigo de Revista Científica
Publicado em /08/2014 EN
Relevância na Pesquisa
65.88%
The Academy of Medicine (AMS) and the Ministry of Health (MOH) have developed the clinical practice guidelines on Attention Deficit Hyperactivity Disorder (ADHD) to provide doctors and patients in Singapore with evidence-based treatment for ADHD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on ADHD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

The Saudi Clinical Practice Guideline for the treatment of venous thromboembolism: Outpatient versus inpatient management

Al-Hameed, Fahad M.; Al-Dorzi, Hasan M.; Al-Momen, Abdulkarim M.; Algahtani, Farjah H.; Al-Zahrani, Hazzaa A.; Al-Saleh, Khalid A.; Al-Sheef, Mohammed A.; Owaidah, Tarek M.; Alhazzani, Waleed; Neumann, Ignacio; Wiercioch, Wojtek; Brozek, Jan; Schünemann,
Fonte: Saudi Medical Journal Publicador: Saudi Medical Journal
Tipo: Artigo de Revista Científica
Publicado em /08/2015 EN
Relevância na Pesquisa
65.89%
Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is commonly encountered in daily clinical practice. After diagnosis, its management frequently carries significant challenges to the clinical practitioner. Treatment of VTE with the inappropriate modality and/or in the inappropriate setting may lead to serious complications and have life-threatening consequences. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia, an expert panel led by the Saudi Association for Venous Thrombo-Embolism (a subsidiary of the Saudi Thoracic Society) and the Saudi Scientific Hematology Society with the methodological support of the McMaster University Guideline working group, this clinical practice guideline was produced to assist health care providers in VTE management. Two questions were identified and were related to the inpatient versus outpatient treatment of acute DVT, and the early versus standard discharge from hospital for patients with acute PE. The corresponding recommendations were made following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.

Clinical practice guidelines: Particular reference to the management of pain in the lumbosacral spine

Steven, I.; Fraser, R.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Artigo de Revista Científica
Publicado em //1996 EN
Relevância na Pesquisa
65.88%
Clinical practice guidelines and protocols are a seductive way of trying to improve the standard of clinical practice. If these are to be most effective, they must evaluate rigorously the evidence supporting a particular management strategy and make appropriate recommendations based on this information. This process needs to be objective, should engage and obtain endorsement from the disciplines that are involved in providing the care, and be accompanied by appropriate implementation strategies. Subsequently, the impact of these strategies should be measured. Existing guidelines for the management of lumbosacral pain largely conform to criteria for guidelines development. It can therefore be expected that they will benefit practitioners and the community.; Steven, Ian D., Fraser, Robert D.

From Clinical Trials to Clinical Practice: An International Survey of Oncologists on Health-Related Quality of Life Outcomes

Rouette, JULIE
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
66.04%
Background: Health-related quality of life (HRQL) outcomes have been increasingly used in phase III randomized controlled trials to characterize the benefits or risks of a cancer treatment. HRQL outcomes from clinical trials can also inform clinical practice in oncology settings. Previous qualitative research suggests that oncologists value HRQL outcomes but challenges to their clinical application exist. Little quantitative research has been conducted to examine these barriers. This study describes the opinions of oncologists toward HRQL outcomes, the ways in which HRQL outcomes can be presented, and the importance of suggested reporting standards for HRQL outcomes in clinical trials. It further examines the association between attitudinal and demographic factors associated with the self-reported current use and achievable use of HRQL outcomes in clinical practice. Methods: This study is a cross-sectional survey of oncologists. A web-based questionnaire was disseminated in Canada, United Kingdom, and Australia/New Zealand. The study included oncologist members of the NCIC Clinical Trials Group, the NCRI Clinical Studies Groups, and the Australasian Cancer Clinical Trials Groups. Respondents were asked to report their opinions toward HRQL outcomes and the factors associated with the use of these outcomes in clinical practice. Demographic characteristics were also collected. Chi-square tests were used to compare the proportion of responses between countries. Logistic regression was used to identify factors associated with the use of HRQL outcomes in clinical practice. Results: A total of 344 oncologists completed the survey. Most oncologists (65.9%) reported having a good knowledge of HRQL outcomes and 72% perceived HRQL outcomes to be useful. High current use of HRQL outcomes in clinical practice was associated with more medical practice experience; perceiving HRQL outcomes to be useful; perceiving HRQL measurements to be reliable; and reporting lack of understanding to rarely be a barrier to using HRQL outcomes. High achievable use of HRQL outcomes in clinical practice was associated with being a male oncologist...

The Uses of Emotion Maps in Research and Clinical Practice with Families and Couples: Methodological Innovation and Critical Inquiry

Gabb, Jacqui; Singh, Reenee
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
65.88%
We explore how “emotion maps” can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively “see” the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians’ repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children's perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy.

Can research influence clinical practice?

Jiménez, Juan Pablo
Fonte: Institute of Psychoanalysis Publicador: Institute of Psychoanalysis
Tipo: Artículo de revista
EN
Relevância na Pesquisa
65.89%
After briefl y reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefi ts to clinical practice of analysts being involved in research activities, the author examines whether the fi ndings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specifi c condition of the patient and the relationship that the individual establishes with the analyst. He argues that research fi ndings can infl uence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specifi city of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.

Caring people with cognitive disorders: difficulties of students in clinical practice

Melo, Rosa Cândida de Carvalho Pereira de
Fonte: Escola Superior de Enfermagem de Coimbra Publicador: Escola Superior de Enfermagem de Coimbra
Tipo: Conferência ou Objeto de Conferência
Publicado em 20/11/2015 ENG
Relevância na Pesquisa
65.9%
Introduction: The nursing students reveal communication difficulties, due to the complexity of the care and their inexperience (Benner, 2001). Objectives: To know the main difficulties, for students of the Licentiate Degree Course in Nursing (LDCN), that are in Clinical Practice (CP), and identify the main causes for the difficulties experienced and how they were overcome. Materials and Methods: A descriptive and qualitative approach study. The sample consisted of 21 students of the 2nd year of LDCN in a Portuguese Nursing School, who were in clinical practice (CP). Data collection was conducted through descriptive reports of students on these difficulties and their causes at the beginning of CE (3rd week) and how they were overcome later in the CP (10 weeks). It was performed a content analysis of the information (Bardin, 2004). Results and Discussion: Most of the students were female (85.71%) between 19-22 years old. At the beginning of CP students presented the following difficulties: communicating with agitated / aggressive / confused and non-responsive patients; refusal of care; and understand what patients say. The causes identified of these difficulties were: knowledge and communication techniques deficit; putting theory into practice; shyness and insecurity; inexperience; and dealing with elderly people with cognitive disorders. To overcome these difficulties were highlighted as very positive the discussion meetings and training provided on the Methodology of Care Humanitude (MCH) (Salgueiro...

Critical thinking in the context of clinical practice: The need to reinvent pharmacy education; Critical thinking in the context of clinical practice: The need to reinvent pharmacy education; El pensamiento crítico en el contexto de la práctica clínica: la necesidad de reinventar la educación farmacéutica

de Freitas, Erika Lourenço; Ramalho-de-Oliveira, Djenane
Fonte: Instituto de Educação da Universidade do Minho Publicador: Instituto de Educação da Universidade do Minho
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; article Formato: application/pdf
Publicado em 04/12/2015 POR
Relevância na Pesquisa
65.88%
Com o objetivo de compreender como as práticas pedagógicas influenciam o desenvolvimento de competências clínicas em estudantes de farmácia, os autores conduziram uma etnografia crítica utilizando os métodos de observação participante, grupos focais e entrevistas em profundidade com estudantes e professores de uma das dez maiores Faculdades de Farmácia dos Estados Unidos. Os resultados que emergiram de dois semestres de pesquisa de campo mostram que o conhecimento farmacêutico tradicionalmente ensinado não é suficiente para preparar os estudantes para a prática clínica. A incorporação de experiências práticas e da filosofia e arcabouço teórico da atenção farmacêutica no currículo é necessária para preparar os estudantes para o cuidado direto das pessoas. Os resultados deste estudo poderão contribuir para a construção de atividades de ensino que efetivamente desenvolvam competências essenciais nos futuros cuidadores.; In order to understand how pedagogical practices influence pharmacy students’ development of critical thinking skills, we used critical ethnography and the methods of participant observation, focus groups and in-depthinterviews with students and faculty from one of the top ten Colleges of Pharmacy in the United States. The results that emerged from two semesters of fieldwork engagement suggested that the traditionally taught pharmaceutical knowledge isn’t enough to prepare pharmacy students for clinical practice. Besides the ability to retrieve information...

Defining "elderly" in clinical practice guidelines for pharmacotherapy

Singh,Shamsher; Bajorek,Beata
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2014 ENG
Relevância na Pesquisa
65.89%
Objective: To identify how "elderly" patients are defined and considered within Australian clinical guidelines for the use of pharmacotherapy. Method: Guidelines pertaining to the use of pharmacotherapy, focusing on conditions described in National Health Priority Areas, were identified using databases (Medline, Google Scholar) and organisation websites (Department of Health and Ageing, National Heart Foundation, National Health and Medical Research Council). Guidelines were reviewed and qualitatively analysed to identify any references or definitions of "elderly" persons. Results: Among the 20 guidelines reviewed, 3 defined "elderly" by chronological age (i.e., years since birth) while the remaining 17 guidelines did not define "elderly" in any way. All 20 guidelines used the term "elderly", whilst some guidelines provided age (chronological)-based dosage recommendations suggesting an ageist or generalist approach in their representation of "elderly", for which rationale was seldom provided. Thematic analysis of the statements revealed five key themes regarding how "elderly" was considered within the guidelines, broadly describing "elderly" persons as being frail and with altered pharmacology. Some guidelines also highlighted the limited evidence base to direct clinical decision-making. A continuum of perceptions of ageing also emerged out of the identified themes. Conclusion: Clinical practice guidelines currently do not adequately define "elderly" persons and provide limited guidance on how to apply treatment recommendations to older persons. The representation of "elderly" in guidelines needs to be less based on chronological age or generic definitions focusing more on establishing a direct link between an individual patient´s characteristics and the pharmacology of their prescribed medication. Clinical guidelines that do not offer any practical descriptions of the features of ageing that are specifically related to the use of pharmacotherapy...

Variability in the clinical practice of maintaining the patency of peripheral intravenous catheters

Cabrero,Julio; Orts,M. Isabel; López-Coig,M. Luisa; Velasco,M. Luisa; Richart,Miguel
Fonte: Gaceta Sanitaria Publicador: Gaceta Sanitaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/08/2005 ENG
Relevância na Pesquisa
65.98%
Objective: To establish variations in clinical practice associated with maintaining the patency of peripheral intravenous catheters (PIC) and to determine to what extent such clinical practice falls within the limits of the available scientific evidence, based on a random sample of Spanish public hospitals. Methods: A cross-sectional, descriptive study was carried out in non-psychiatric public hospitals and their associated medical and surgical units. Cluster (hospitals), stratified (hospital size), and single-stage (all units) sampling was applied. A questionnaire was mailed to all of the units involved. Results: A sample of 341 valid questionnaires was analysed (response rate 54.5%). Only one praxis-modality was carried out in the majority of units. Intermittent flushing and heparin saline versus normal saline was the most frequent modality employed, over those of continuous flushing and non-heparinised saline. There was a high degree of variation in the quantity of heparin administered: 81.7% when flushing was carried out with heparinised saline and 48.2% when it was conducted with concentrated heparin. About 40% of this variation was associated with the hospital in question, rather than with the unit. The clinical practice fell within the limits of available scientific evidence in fewer than half of the units studied. Conclusions: There was a high degree of variability in the practice of maintaining PIC patency. A significant part of this variation was attributable to the hospital in which the practice was carried out. Moreover...

Behavioural therapy in the treatment of obesity (I): New directions for clinical practice

Garaulet,M.; Pérez de Heredia,F.
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2009 ENG
Relevância na Pesquisa
65.89%
Objectives: Behavioural therapy (BT) in obesity treatment helps individuals to develop skills to achieve healthier body weights. Instead of helping to decide what to change, it helps to identify how to change; lifestyle modification is essential for any treatment of obesity, be it dieting, medication, surgery, etc. Physicians often tend to be unwilling to use BT considering it time-consuming and skill-intensive. However, BT can be standardized and used more readily in clinical practice. Besides, new approaches have been developed which contribute to increase the success of the treatments, like non face-to-face techniques, or the new cognitive therapy. Setting: Classical knowledge on BT has been updated with recent publications and information on these new approaches, combined with our own experience in the clinical treatment of obesity. Results: Most research on BT has been conducted in university-based programs which, despite their importance, tell us little about its effectiveness in actual clinical practice. Future research might focus on determining how BT can be best applied in a real-world setting. Examples of new directions are increased maintenance periods, use of Internet, and new cognitive therapy. Besides, elucidating the genetic component in the prognosis of weight management -the nutrigenomic approach- could assist in the development of more effective and individually tailored therapeutic strategies; indeed...

Student nurses' experiences during clinical practice in the Limpopo Province

Mabuda,BT; Potgieter,E; Alberts,UU
Fonte: Curationis Publicador: Curationis
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2008 EN
Relevância na Pesquisa
65.93%
A qualitative, exploratory, descriptive and contextual study was conducted to explore student nurses' experiences during clinical practice at a nursing college in the Limpopo Province. Purposive sampling was used and phenomenological interviews were held with eleven (11) student nurses who were in their final year of the four year basic nursing programme. The interviews were analysed by using Tesch's method of data analysis for qualitative research. The findings indicate that there are aspects which impact negatively on student nurses' clinical learning experiences, such as lack of teaching and learning support, lack of opportunities for learning, poor theory-practice integration, and poor interpersonal relationships between the students, college tutors and ward staff. Recommendations to enhance the clinical learning experiences of student nurses were outlined.

Variability in the clinical practice of maintaining the patency of peripheral intravenous catheters

Cabrero,Julio; Orts,M. Isabel; López-Coig,M. Luisa; Velasco,M. Luisa; Richart,Miguel
Fonte: Ediciones Doyma, S.L. Publicador: Ediciones Doyma, S.L.
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2005 EN
Relevância na Pesquisa
65.98%
Objective: To establish variations in clinical practice associated with maintaining the patency of peripheral intravenous catheters (PIC) and to determine to what extent such clinical practice falls within the limits of the available scientific evidence, based on a random sample of Spanish public hospitals. Methods: A cross-sectional, descriptive study was carried out in non-psychiatric public hospitals and their associated medical and surgical units. Cluster (hospitals), stratified (hospital size), and single-stage (all units) sampling was applied. A questionnaire was mailed to all of the units involved. Results: A sample of 341 valid questionnaires was analysed (response rate 54.5%). Only one praxis-modality was carried out in the majority of units. Intermittent flushing and heparin saline versus normal saline was the most frequent modality employed, over those of continuous flushing and non-heparinised saline. There was a high degree of variation in the quantity of heparin administered: 81.7% when flushing was carried out with heparinised saline and 48.2% when it was conducted with concentrated heparin. About 40% of this variation was associated with the hospital in question, rather than with the unit. The clinical practice fell within the limits of available scientific evidence in fewer than half of the units studied. Conclusions: There was a high degree of variability in the practice of maintaining PIC patency. A significant part of this variation was attributable to the hospital in which the practice was carried out. Moreover...