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1.
Support Care Cancer ; 32(2): 131, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38270678

RESUMO

PURPOSE: Colorectal cancer (CRC) is among the three most commonly diagnosed cancers globally, after breast and lung cancer, with an estimated 2 million new cases each year, comprising ten per cent of all cancers worldwide. CRC has a complex aetiology associated with several nutrition-related risk factors. Cancer survivors frequently report alterations to their dietary habits and nutritional intake, with related adverse impacts on health-related quality of life (QOL). Whilst nutrition-related factors are recognised as survivor priorities and embedded in survivor care policies, dietary support is frequently not the standard of care in practice. METHODS AND RESULTS: In this Commentary, we present details of a critical policy-practice gap for CRC survivors across the spectrum of nutrition care that we have seen growing in the literature, in hospitals, community and private practice. CONCLUSION: As these nutrition concerns can adversely impact QOL and morbidity and mortality risks, we hope to raise awareness of these issues to provide a basis of future work in this area, so that policymakers and clinicians can improve support and outcomes for CRC survivors and their families.


Assuntos
Sobreviventes de Câncer , Neoplasias Colorretais , Humanos , Qualidade de Vida , Lacunas da Prática Profissional , Políticas
2.
Oper Dent ; 49(2): 127-135, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38196080

RESUMO

OBJECTIVES: This study was designed to: 1) evaluate and compare the evidence-practice gap (EPG) in minimal intervention dentistry (MID) in Japan and Brazil by measuring concordance between dentists' clinical practice and published evidence; and 2) identify dentists' factors associated with the EPG in both countries. METHODS: We performed a cross-sectional study using a web-delivered questionnaire among 136 Japanese and 110 Brazilian dentists. The questionnaire consisted of three questions concerning "restoration diagnosis and treatment," "deep caries diagnosis and treatment," and "caries risk assessment" regarding MID. A chi-square test was used to analyze differences in concordance among clinical practice and evidence from the literature between Japanese and Brazilian dentists. Logistic regression analyses were performed to analyze dentists' factors associated with overall concordance for all three questions. RESULTS: Overall concordance was significantly higher in Brazil (55%) than in Japan (38%) (p<0.01). Concerning how evidence was obtained, textbooks, nonacademic journals, and seminars and workshops were used as information sources more frequently by Japanese than Brazilian dentists (p<0.001), whereas scientific journal articles in English were used more frequently by Brazilian dentists (p<0.001). On logistic regression analysis, overall concordance was higher for Japanese dentists who frequently obtained evidence from scientific journal articles in English (p<0.05), whereas Brazilian dentists who frequently obtained evidence from the Internet were associated with lower overall concordance (p<0.05). CONCLUSIONS: Because overall concordance was significantly higher in Brazil than in Japan, Japan may have a greater EPG in MID practice. Specific characteristics of Japanese and Brazilian dentists showed significant associations with overall concordance.


Assuntos
Cárie Dentária , Lacunas da Prática Profissional , Humanos , Japão , Brasil , Estudos Transversais , Padrões de Prática Odontológica , Cárie Dentária/terapia , Inquéritos e Questionários , Odontólogos , Odontologia
4.
Infect Dis Poverty ; 13(1): 3, 2024 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-38191468

RESUMO

BACKGROUND: Brucellosis is a zoonotic affliction instigated by bacteria belonging to the genus Brucella and is characterized by a diverse range of pervasiveness, multiple transmission routes, and serious hazards. It is imperative to amalgamate the current knowledge and identify gaps pertaining to the role of ticks in brucellosis transmission. METHODS: We systematically searched China National Knowledge Infrastructure (CNKI), WanFang, Google Scholar, and PubMed on the topic published until April 23, 2022. The procedure was performed in accordance with the Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The selected articles were categorized across three major topic areas, and the potential data was extracted to describe evidence-practice gaps by two reviewers. RESULTS: The search identified 83 eligible studies for the final analyses. The results highlighted the potential capacity of ticks in brucellosis transmission as evidenced by the detection of Brucella in 16 different tick species. The pooled overall prevalence of Brucella in ticks was 33.87% (range: 0.00-87.80%). The review also revealed the capability of Brucella to circulate in parasitic ticks' different developmental stages, thus posing a potential threat to animal and human health. Empirical evidence from in vitro rodent infection experiments has revealed that ticks possess the capability to transmit Brucella to uninfected animals (range: 45.00-80.00%). Moreover, significant epidemiological associations have been found between the occurrence of brucellosis in animals and tick control in rangelands, which further suggests that ticks may serve as potential vectors for brucellosis transmission in ruminants. Notably, a mere three cases of human brucellosis resulting from potential tick bites were identified in search of global clinical case reports from 1963 to 2019. CONCLUSIONS: It is imperative to improve the techniques used to identify Brucella in ticks, particularly by developing a novel, efficient, precise approach that can be applied in a field setting. Furthermore, due to the lack of adequate evidence of tick-borne brucellosis, it is essential to integrate various disciplines, including experimental animal science, epidemiology, molecular genetics, and others, to better understand the efficacy of tick-borne brucellosis. By amalgamating multiple disciplines, we can enhance our comprehension and proficiency in tackling tick-borne brucellosis.


Assuntos
Brucella , Brucelose , Carrapatos , Animais , Humanos , Lacunas da Prática Profissional , Brucelose/epidemiologia , China/epidemiologia
7.
J Nurses Prof Dev ; 40(1): 49-54, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37713591

RESUMO

Data indicate a widening academic-practice gap. Utilizing a single-group pre-post interventional design, the purpose of this project was to determine if repeated participation in Sentinel U Patient Management and Delegation virtual simulations influenced new graduate nurses' prioritization and delegation. Increased confidence in ability to complete patient care assignments on time and transferability of learning outcomes to practice were identified. There may be value in nurses receiving virtual simulations within their residency program to close the academic-practice gap.


Assuntos
Internato e Residência , Humanos , Projetos Piloto , Competência Clínica , Aprendizagem , Lacunas da Prática Profissional
8.
J Nurses Prof Dev ; 40(1): E41-E45, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38071643

RESUMO

A successful pilot program served as a model for how educators in healthcare organizations can reduce the academic-practice gap by supporting preceptors. Preceptors received enhanced training using self-paced online modules and an asynchronous online problem-based learning. Statistically significant increases in self-efficacy and satisfaction with training were reported. Preceptor training included strategies for teaching prioritization, communication, and clinical judgment. Preceptors experienced sustained resilience, increased awareness of well-being, and more engagement in the precepting role.


Assuntos
Aprendizagem Baseada em Problemas , Lacunas da Prática Profissional , Humanos , Inquéritos e Questionários , Preceptoria
9.
Epidemiol Psychiatr Sci ; 32: e68, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38053411

RESUMO

This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This article explores variations among advance statements, such as psychiatric advance directives (PADs), joint crisis plans (JCPs) and self-binding directives (SBDs), highlighting their content, development process and legal status. We outline the benefits of advance statements, including empowerment, early intervention, improved therapeutic relationships and reduced compulsory admissions. We then draw attention to the challenges that may contribute to their lack of implementation, including legal complexities, communication issues, cultural factors, potential inequities, healthcare provider knowledge, changing preferences, resource constraints, crisis responses, data privacy, family involvement, and long-term evaluation. In conclusion, advance statements offer significant benefits but require addressing these critical aspects to ensure ethical and effective use. Bridging the evidence-to-practice gap is essential, with a focus on implementation science. Integrating these tools into routine clinical practice can significantly benefit individuals with severe mental disorders and mental health systems.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Humanos , Lacunas da Prática Profissional , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Diretivas Antecipadas/psicologia , Saúde Mental
10.
PLoS One ; 18(11): e0294319, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38033017

RESUMO

BACKGROUND: Bioscience subjects are essential as they allow nurses to have a clear understanding of the patient's condition and ultimately allow them to provide appropriate and timeous care. However, these subjects remain a significant problem in the endeavour to produce highly competent nurses. AIM: The study aimed to investigate the nursing students' self-reported depth of understanding of bioscience and its relevance to clinical practice. METHODS: A quantitative research approach using a descriptive survey design was employed. The sample (n = 211) included second-, third- and fourth-year undergraduate nursing students. A three-part self-administered questionnaire was adapted and used to collect the data. Data were analysed using IBM Statistical Package for Social Sciences software version 25.0 (IBM SPSS-25). Descriptive statistics and Chi-squared test were performed to describe the relationship among the study variables. RESULTS: Participants rated their understanding of the application of Human Biology (n = 86, 40.76%) and Pharmacology (n = 88, 41.71%) as good, while Physics (n = 80, 37.91%) and Chemistry (n = 85, 40.28%) were rated as adequate. Most participants rated Human Biology (n = 175, 83.73%) and Pharmacology (n = 181, 86.19%) as essential, while Physics (n = 129, 61.72%) and Chemistry (n = 133, 63.64%) were rated as relevant to clinical practice. Physics (n = 112, 60.54%; n = 95, 50.53%) and Chemistry (n = 126, 68.85%; n = 113 61.41%) were rated as not relevant to monitoring a patient's heart rate and blood pressure. Participants' perception of the relevance of Chemistry in monitoring a patient's blood pressure was statistically significant (χ2 = 6.871 (df 2), p<0.05). Most participants (n = 57, 41.91%) performed at Task specific on Akinsanya's Bionursing model, suggesting an overall understanding of the foundational concepts and principles of bioscience. CONCLUSION: The findings of the study provided evidence of the students' self-reported depth of understanding and perception of the relevance of bioscience and indicate a need for more emphasis on the importance of bioscience integration in clinical practice.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Autorrelato , Lacunas da Prática Profissional , Inquéritos e Questionários
11.
J Cachexia Sarcopenia Muscle ; 14(6): 2779-2792, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37897129

RESUMO

BACKGROUND: Anorexia of aging is a common geriatric syndrome that includes loss of appetite and/or reduced food intake, with associated undernutrition, unintended weight loss, sarcopenia, functional decline, loss of independence and other adverse health outcomes. Anorexia of aging can have multiple and severe consequences and is often overlooked by healthcare professionals (HCPs). Even more concerningly, clinicians commonly accept anorexia of aging as an inevitable part of 'normal' aging. The aim of this assessment was to identify current gaps in professional knowledge and practice in identifying and managing older persons with anorexia. Results may guide educational programmes to fill the gaps identified and therefore improve patient outcomes. METHODS: This international assessment was conducted using a mixed-methods approach, including focus group interviews with subject matter experts and an electronic survey of practicing HCPs. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in-country collaborating organizations. RESULTS: A quantitative survey of 26 multiple-choice questions was completed by physicians, dietitians and other HCPs (n = 1545). Most HCPs (56.8%) recognize a consistent definition of anorexia of aging as a loss of appetite and/or low food intake. Cognitive changes/dementia (91%) and dysphagia (87%) are seen as the biggest risk factors. Most respondents were confident to give nutritional (62%) and physical activity (59.4%) recommendations and engaged caregivers such as family members in supporting older adults with anorexia (80.6%). Most clinicians assessed appetite at each visit (66.7%), although weight is not measured at every visit (41.5%). Apart from the Mini-Nutritional Assessment Short Form (39%), other tools to screen for appetite loss are not frequently used or no tools are used at all (29.4%). A high number of respondents (38.7%) believe that anorexia is a normal part of aging. Results show that treatment is focused on swallowing disorders (78%), dentition issues (76%) and increasing oral intake (fortified foods [75%] and oral nutritional supplements [74%]). Nevertheless, the lack of high-quality evidence is perceived as a barrier to optimal treatment (49.2%). CONCLUSIONS: Findings from this international assessment highlight the challenges in the care of older adults with or at risk for anorexia of aging. Identifying professional practice gaps between individual HCPs and team-based gaps can provide a basis for healthcare education that is addressed at root causes, targeted to specific audiences and developed to improve individual and team practices that contribute to improving patient outcomes.


Assuntos
Envelhecimento , Anorexia , Idoso , Idoso de 80 Anos ou mais , Humanos , Anorexia/diagnóstico , Pessoal de Saúde , Lacunas da Prática Profissional , Sarcopenia/complicações
12.
J Nurses Prof Dev ; 39(5): E168-E173, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37683222

RESUMO

For decades, nursing graduates have exhibited a gap between theory and practice. Healthcare organizations have implemented transition programs to support successful entry into practice. Nurse educators can restructure residency programs to help graduates develop the confidence and competence needed for practice by identifying the gaps between theory and practice for nursing graduates. This study's findings support continual process improvement through evaluation and contribute to the literature about the challenges new nurses encounter.


Assuntos
Competência Clínica , Lacunas da Prática Profissional , Humanos
13.
Lang Speech Hear Serv Sch ; 54(3): 815-830, 2023 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-37276454

RESUMO

PURPOSE: Dyslexia is increasingly being defined, assessed, diagnosed, and treated in the educational system. The purpose of this clinical focus article is to elucidate ways in which speech-language pathologists (SLPs) can rethink how to implement literacy interventions to incorporate best practices from multisensory structured language (MSL) approaches and how they can be influential participants in the conversations of how to define and implement services for students who have written language disorders, including dyslexia, in the school setting. METHOD: This clinical focus article provides an operational definition of dyslexia, discusses the various roles and responsibilities of SLPs with respect to dyslexia, and describes the well-established evidence-based practices of MSL approaches as a means of rethinking literacy intervention. RESULTS: Using a case study scenario based on an individual diagnosed with dyslexia, this clinical focus article presents similarities and differences between traditional speech-language pathology intervention approaches and MSL approaches to literacy intervention. CONCLUSIONS: MSL strategies may be considered in literacy intervention as a means to optimize the academic gains of children with dyslexia in a school setting. Furthermore, SLPs should be considered integral participants in discussions of policies and practices related to the diagnosis and treatment of literacy disorders, including dyslexia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23228483.


Assuntos
Dislexia , Patologia da Fala e Linguagem , Criança , Humanos , Alfabetização , Lacunas da Prática Profissional , Dislexia/diagnóstico , Dislexia/terapia , Idioma , Estudantes , Patologia da Fala e Linguagem/métodos
15.
J Formos Med Assoc ; 122(12): 1282-1295, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37365099

RESUMO

BACKGROUND/PURPOSE: This study examined the practice rate of Anticipatory Guidance (AG) and the gap between knowledge and practice among caregivers. METHODS: We retrospectively collected data from caregivers who brought their children for seven age-based well-child visits (birth to 7 years old) and seven corresponding AG checklists for practice (each ranged from 16 to 19 guidance items, 118 items in total) between 2015 and 2017. Practice rates of guidance items and their association with children's sex, age, residence, and body mass index were collected and analyzed. RESULTS: We enrolled 2310 caregivers (330 per well-child visit). Average practice rates of guidance items in the seven AG checklists were 77.6%-95.1%, generally without significant differences between urban/rural or male/female children. However, lower (<80%) rates were observed for 32 items, including dental check-ups (38.9%), use of fluoride toothpaste (44.6%), screen time (69.4%), and drinking less sugar-sweetened beverages (SSBs) (75.5%), with corresponding knowledge-to-practice gap rates of 55.5%, 47.9%, 30.3%, and 23.8%, respectively. "Drinking less SSBs" was the only item with a higher obesity rate in the non-achieved group versus the achieved group (16.7% vs. 7.4%, p = 0.036; odds ratio: 3.509, 95% CI: 1.153-10.677, p = 0.027). CONCLUSION: Caregivers in Taiwan practiced most AG recommendations. However, dental check-ups, fluoride toothpaste use, drinking less SSBs, and limiting screen time were less executed items. A higher obesity rate was found among 3-7-year-old children whose caregivers failed to practice the "Drink less SSBs" guidance. Strategies to overcome the gap between knowledge and practice are needed to improve these less-achieved guidance items.


Assuntos
Bebidas , Cuidadores , Humanos , Masculino , Feminino , Pré-Escolar , Criança , Estudos Retrospectivos , Fluoretos , Lacunas da Prática Profissional , Taiwan , Cremes Dentais , Obesidade
17.
Nurse Educ Pract ; 69: 103624, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37018997

RESUMO

AIM: The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice. BACKGROUND: In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing. METHOD: This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis. RESULTS: 72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (ß = -0.125, p = 0.009), gender (ß = -0.134, p = 0.006), willingness to choose the profession (ß = 0.150, p = 0.002) and KABQ-EBP score (ß = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables. CONCLUSION: The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.


Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Estudos Transversais , Enfermagem Perioperatória , Lacunas da Prática Profissional , Enfermagem Baseada em Evidências , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Bacharelado em Enfermagem/métodos
18.
J Sch Psychol ; 97: 152-170, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36914363

RESUMO

Implementation support through coaching-such as with embedded fidelity assessment, performance feedback, modeling, and alliance building-has been empirically supported as a way to increase and sustain interventionists' fidelity levels. However, education research consistently shows that practitioners struggle to monitor and improve interventionists' fidelity using implementation support strategies. One explanation for this type of implementation research-to-practice gap is that evidence-based coaching strategies have significant limitations with respect to their usability, feasibility, and adaptability. This study is the first to experimentally evaluate an evidence-based set of adaptable materials and procedures designed to assess and support the intervention fidelity of school-based interventions. Using a randomized multiple-baseline-across-participants design, we examined the extent to which these materials and procedures would influence intervention adherence and quality of an evidence-based reading intervention. Across all nine interventionist participants, data revealed that the implementation strategies meaningfully improved intervention adherence and quality, and high levels of intervention fidelity maintained 1 month after removing the support procedures. Findings are discussed with respect to how these materials and procedures address a critical need within school-based research and practice as well as how they may help to inform and address the implementation research-to-practice gap in education.


Assuntos
Tutoria , Lacunas da Prática Profissional , Humanos , Lacunas de Evidências
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