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1.
Anticancer Res ; 41(11): 5377-5391, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732407

RESUMO

BACKGROUND/AIM: To assess the quantity and quality of systematic reviews of in vitro cancer studies. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, Web of Knowledge and PROSPERO databases were searched. Articles described as systematic reviews of in vitro studies, focused on or relevant to cancer and published in English were selected and appraised using an adapted version of AMSTAR 2 'critical domains'. RESULTS: From 4,021 records, 41 reviews described as systematic and cancer-related were identified. Publication dates indicate increasing frequency of systematic review conduct. Mean number of databases searched was three (range=1-8). Thirty-six reviews (88%) reported search methods, 35 (85%) specified inclusion criteria, 26 (63%) reported study selection methods, and 21 (51%) used reporting guidelines. Only 13 reviews (32%) involved formal quality assessment. CONCLUSION: Detailed investigation of reviews of cancer-relevant in vitro studies indicates need for further development and use of robust search strategies, appropriate quality assessment tools, and researchers with relevant skills.


Assuntos
Pesquisa Biomédica/normas , Confiabilidade dos Dados , Oncologia/normas , Publicações Periódicas como Assunto/normas , Projetos de Pesquisa/normas , Revisões Sistemáticas como Assunto/normas , Animais , Guias como Assunto/normas , Humanos , Controle de Qualidade
2.
Intern Emerg Med ; 16(8): 2277-2296, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34609677

RESUMO

Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist. High heterogeneity between different guidelines has been reported. Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians. The three most relevant guidelines published on cervical spine trauma in the last 10 years were selected screening websites of the main scientific societies and through the comparison of a normalized Google Scholar and SCOPUS citation index. We compared the selected guidelines through seven a-priori defined questions. In case of disagreement between the guidelines or if the quality of evidence appeared low, evidence from published systematic reviews on the topic was added to build an evidence-based algorithm for approach to spinal trauma in the ED. The three selected guidelines were: NICE 2016, Eastern Association for the Surgery of Trauma 2009 and American Association of Neurological Surgeons and Congress of Neurological Surgeons 2013. We found complete agreement on one question, partial agreement for one questions, no agreement for two questions, while agreement was not assessable for 3 questions. The agreement between different guidelines and the evidence on which recommendations are based is low. An attempt to build an evidence-based algorithm has been made. More studies are needed on many topics.


Assuntos
Medula Cervical/lesões , Guias como Assunto/normas , Ferimentos e Lesões/terapia , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/normas , Humanos , Padrões de Referência , Ferimentos e Lesões/complicações
3.
PLoS Med ; 18(10): e1003793, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34665805

RESUMO

BACKGROUND: The importance of infectious disease epidemic forecasting and prediction research is underscored by decades of communicable disease outbreaks, including COVID-19. Unlike other fields of medical research, such as clinical trials and systematic reviews, no reporting guidelines exist for reporting epidemic forecasting and prediction research despite their utility. We therefore developed the EPIFORGE checklist, a guideline for standardized reporting of epidemic forecasting research. METHODS AND FINDINGS: We developed this checklist using a best-practice process for development of reporting guidelines, involving a Delphi process and broad consultation with an international panel of infectious disease modelers and model end users. The objectives of these guidelines are to improve the consistency, reproducibility, comparability, and quality of epidemic forecasting reporting. The guidelines are not designed to advise scientists on how to perform epidemic forecasting and prediction research, but rather to serve as a standard for reporting critical methodological details of such studies. CONCLUSIONS: These guidelines have been submitted to the EQUATOR network, in addition to hosting by other dedicated webpages to facilitate feedback and journal endorsement.


Assuntos
Pesquisa Biomédica/normas , COVID-19/epidemiologia , Lista de Checagem/normas , Epidemias , Guias como Assunto/normas , Projetos de Pesquisa , Pesquisa Biomédica/métodos , Lista de Checagem/métodos , Doenças Transmissíveis/epidemiologia , Epidemias/estatística & dados numéricos , Previsões/métodos , Humanos , Reprodutibilidade dos Testes
7.
J Prev Alzheimers Dis ; 8(4): 398-410, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34585212

RESUMO

Aducanumab has been approved by the US Food and Drug Administration for treatment of Alzheimer's disease (AD). Clinicians require guidance on the appropriate use of this new therapy. An Expert Panel was assembled to construct Appropriate Use Recommendations based on the participant populations, conduct of the pivotal trials of aducanumab, updated Prescribing Information, and expert consensus. Aducanumab is an amyloid-targeting monoclonal antibody delivered by monthly intravenous infusions. The pivotal trials included patients with early AD (mild cognitive impairment due to AD and mild AD dementia) who had confirmed brain amyloid using amyloid positron tomography. The Expert Panel recommends that use of aducanumab be restricted to this population in which efficacy and safety have been studied. Aducanumab is titrated to a dose of 10 mg/kg over a 6-month period. The Expert Panel recommends that the aducanumab be titrated to the highest dose to maximize the opportunity for efficacy. Aducanumab can substantially increase the incidence of amyloid-related imaging abnormalities (ARIA) with brain effusion or hemorrhage. Dose interruption or treatment discontinuation is recommended for symptomatic ARIA and for moderate-severe ARIA. The Expert Panel recommends MRIs prior to initiating therapy, during the titration of the drug, and at any time the patient has symptoms suggestive of ARIA. Recommendations are made for measures less cumbersome than those used in trials for the assessment of effectiveness in the practice setting. The Expert Panel emphasized the critical importance of engaging in a process of patient-centered informed decision-making that includes comprehensive discussions and clear communication with the patient and care partner regarding the requirements for therapy, the expected outcome of therapy, potential risks and side effects, and the required safety monitoring, as well as uncertainties regarding individual responses and benefits.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Guias como Assunto/normas , Amiloide/efeitos dos fármacos , Anticorpos Monoclonais Humanizados/farmacologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Infusões Intravenosas , Imageamento por Ressonância Magnética , Estados Unidos
10.
Nat Methods ; 18(8): 837, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34354284
12.
J Virol ; 95(18): e0111221, 2021 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-34319158

RESUMO

Starting work in a virology research laboratory as a new technician, graduate student, or postdoc can be complex, intimidating, confusing, and stressful. From laboratory logistics to elemental expectations to scientific specifics, there is much to learn. To help new laboratory members adjust and excel, a series of guidelines for working and thriving in a virology laboratory is presented. While guidelines may be most helpful for new laboratory members, everyone, including principal investigators, is encouraged to use a set of published guidelines as a resource to maximize the time and efforts of all laboratory members. The topics covered here are safety, wellness, balance, teamwork, integrity, reading, research, writing, speaking, and timelines.


Assuntos
Guias como Assunto/normas , Laboratórios/normas , Projetos de Pesquisa/normas , Pesquisadores/normas , Virologia/normas , Humanos
13.
BMC Pregnancy Childbirth ; 21(1): 528, 2021 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-34303351

RESUMO

BACKGROUND: Antepartum stillbirth, i.e., intrauterine fetal death (IUFD) above 24 weeks of gestation, occurs with a prevalence of 2.4-3.1 per 1000 live births in Central Europe. In order to ensure highest standards of treatment and identify causative and associated (risk) factors for fetal death, evidence-based guidelines on clinical practice in such events are recommended. Owing to a lack of a national guideline on maternal care and investigations following stillbirth, we, hereby, sought to assess the use of institutional guidelines and clinical practice after IUFD in Austrian maternity units. METHODS: A national survey with a paper-based 12-item questionnaire covering demographic variables, local facilities and practice, obstetrical care and routine post-mortem work-up following IUFD was performed among all Austrian secondary and tertiary referral hospitals with maternity units (n = 75) between January and July 2019. Statistical tests were conducted using Chi2 and Fisher's Exact test, respectively. Univariate logistic regression analyses were performed to calculate odds ratio (OR) with a 95% confidence interval (CI). RESULTS: 46 (61.3%) obstetrical departments [37 (80.4%) secondary; 9 (19.6%) tertiary referral hospitals] participated in this survey, of which 17 (37.0%) have implemented an institutional guideline. The three most common investigations always conducted following stillbirth are placental histology (20.9%), fetal autopsy (13.1%) and maternal antibody screen (11.5%). Availability of an institutional guideline was not significantly associated with type of hospital, on-site pathology department, or institutional annual live and stillbirth rates. Post-mortem consultations only in cases of abnormal investigations following stillbirth were associated with lower odds for presence of such guideline [OR 0.133 (95% CI 0.018-0.978); p = 0.047]. 26 (56.5%) departments consider a national guideline necessary. CONCLUSIONS: Less than half of the surveyed maternity units have implemented an institutional guideline on maternal care and investigations following antepartum stillbirth, independent of annual live and stillbirth rate or type of referral centre.


Assuntos
Guias como Assunto/normas , Instalações de Saúde/normas , Serviços de Saúde Materna/normas , Natimorto/epidemiologia , Áustria , Autopsia , Feminino , Idade Gestacional , Humanos , Idade Materna , Placenta , Gravidez , Fatores de Risco , Inquéritos e Questionários
14.
PLoS One ; 16(6): e0252688, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138889

RESUMO

Advanced Driver Assistance Systems (ADAS) are being developed and installed in increasing numbers. Some of the most popular ADAS include blind spot monitoring and cruise control which are fitted in the majority of new vehicles sold in high-income countries. With more drivers having access to these technologies, it is imperative to develop policy and strategies to guarantee the safe uptake of ADAS. One key issue is that ADAS education has been primarily centred on the user manual which are not widely utilised. Moreover, it is unclear if user manuals are an adequate source of education in terms of content and readability. To address this research gap, a content analysis was used to assess the differences in ADAS-related content and readability among the manuals of the highest selling vehicles in Australia. The qualitative findings showed that there are seven themes in the user manuals: differences between driving with and without ADAS, familiarisation requirements, operational limits of the ADAS, potential ADAS errors, behaviour adaptation warnings, confusion warnings, and malfunction warnings. The quantitative analysis found that some of the manuals require several years of education above the recommended for a universal audience (>8 years) to be understood. Additionally, there is a notable number of text diversions and infographics which could make comprehension of the user manual difficult. This investigation shows that there is a lack of standardisation of ADAS user manuals (in both content and delivery of information) which requires regulatory oversight. Driver ADAS education needs to be prioritised by policymakers and practitioners as smart technology continues to increase across the transport system. It seems that current strategies based on user manuals are insufficient to achieve successful adoption and safe use of these technologies.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Equipamentos de Proteção/estatística & dados numéricos , Tecnologia/estatística & dados numéricos , Acidentes de Trânsito/prevenção & controle , Condução de Veículo/educação , Condução de Veículo/normas , Guias como Assunto/normas , Humanos , Veículos Automotores/classificação , Veículos Automotores/normas , Equipamentos de Proteção/normas , Reprodutibilidade dos Testes , Segurança/normas , Tecnologia/métodos , Tecnologia/normas
15.
PLoS One ; 16(6): e0252877, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34161358

RESUMO

BACKGROUND: Small-area estimation models are regularly commissioned by public health bodies to identify areas of greater inequality and target areas for intervention in a range of behaviours and outcomes. Such local modelling has not been completed for diet consumption in England despite diet being an important predictor of health status. The study sets out whether aspects of adult diet can be modelled from previously collected data to define and evaluate area-level interventions to address obesity and ill-health. METHODS: Adults aged 16 years and over living in England. Consumption of fruit, vegetables, and sugar-sweetened beverages (SSB) are modelled using small-area estimation methods in English neighbourhoods (Middle Super Output Areas [MSOA]) to identify areas where reported portions are significantly different from recommended levels of consumption. The selected aspects of diet are modelled from respondents in the National Diet and Nutrition Survey using pooled data from 2008-2016. RESULTS: Estimates indicate that the average prevalence of adults consuming less than one portion of fruit, vegetables or 100% juice each day by MSOA is 6.9% (range of 4.3 to 14.7%, SE 0.06) and the average prevalence of drinking more than 330ml/day of SSB is 11.5% (range of 5.7 to 30.5%, SE 0.03). Credible intervals around the estimates are wider for SSB consumption. The results identify areas including regions in London, urban areas in the North of England and the South coast which may be prioritised for targeted interventions to support reduced consumption of SSB and/or an increase in portions of fruit and vegetables. CONCLUSION: These estimates provide valuable information at a finer spatial scale than is presently feasible, allowing for within-country and locality prioritisation of resources to improve diet. Local, targeted interventions to improve fruit and vegetable consumption such as subsidies or voucher schemes should be considered where consumption of these foods is predicted to be low.


Assuntos
Dieta , Comportamento Alimentar , Guias como Assunto/normas , Inquéritos Nutricionais/estatística & dados numéricos , Adolescente , Adulto , Idoso , Bebidas , Inglaterra , Feminino , Frutas , Sucos de Frutas e Vegetais/análise , Humanos , Masculino , Pessoa de Meia-Idade , Verduras , Adulto Jovem
16.
Adv Skin Wound Care ; 34(7): 372-378, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34125727

RESUMO

OBJECTIVE: To propose a first-aid management protocol for myiasis in neglected cutaneous squamous cell carcinoma (SCC) in the ED based on a recent literature review. DATA SOURCES: PubMed. STUDY SELECTION: Inclusion criteria were all series and case reports of primary/secondary cutaneous SCC with myiasis of the head and neck, including orbital SCC cases, published after 2005. DATA EXTRACTION: A total of 14 articles including 15 patients were included. DATA SYNTHESIS: Demographics, socioeconomic situation, site of the lesion, larvae species with bacterial suprainfection, and first-aid treatment options were discussed. Two representative cases are described. CONCLUSIONS: Large, ulcerated, necrotic, myiasis-burdened SCC lesions in the head and neck area present a challenge for treatment, and to date, no consensus regarding first-aid management exists. The authors' proposed four-pillar first-aid management scheme may be a valid option to rapidly improve wound condition through disinfection, pain relief, and malodor and discharge eradication as a bridge to surgery.


Assuntos
Miíase/etiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Guias como Assunto/normas , Humanos , Masculino , Miíase/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Tempo para o Tratamento
17.
Am J Emerg Med ; 49: 233-239, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34146922

RESUMO

OBJECTIVES: The purpose of this study was to describe the design and impact of a point-of-care ultrasound (PoCUS) workflow integrated into the electronic medical record (EMR) on PoCUS utilization, documentation compliance, and resultant revenue potential. METHODS: This was a single-center retrospective study at an academic center. The study period spanned from December 1, 2018 to June 30, 2019 (pre-implementation) to August 1, 2019 to February 29, 2020 (post-implementation). The implementation date was July 11, 2019 at which time a PoCUS workflow was integrated into the EMR in the emergency department without the purchase of middleware. Prior to this new workflow, a non-automated workflow was in place. PoCUS scan data were extracted from the EMR and archived examinations. The mean number of PoCUS examinations performed per month per 100 ED visits before and after implementation of the new workflow were compared using an unpaired t-test, stratified by all health care professionals, and attending physicians alone. The rate of documentation compliance before and after implementation of the new workflow were compared using a chi square contingency test. Potential revenue was calculated for each period by multiplying the number of eligible examinations by the respective 2020 Medicare conversion factor Relative Value Units. RESULTS: Utilization of PoCUS from pre-implementation to post-implementation increased 28.7% from 5.01 to 6.45 mean examinations per month per 100 ED visits by all health care professionals (p = 0.063), and 75.1% from 2.01 to 3.52 by attending physicians (p = 0.0001). Examinations in compliance with workflow requirements increased from 153 (14.7%) to 1307 (94.0%). The rate of workflow compliance improved from 14.7% to 94.0% of examinations (p < 0.0001). Potential revenue increased from $546.01 to $22,014.47. CONCLUSIONS: The implementation of a middleware-free PoCUS workflow at our institution was associated with increased PoCUS utilization, documentation compliance, and potential revenue.


Assuntos
Guias como Assunto/normas , Ultrassonografia/métodos , Fidelidade a Diretrizes , Humanos , Sistemas Automatizados de Assistência Junto ao Leito/economia , Sistemas Automatizados de Assistência Junto ao Leito/normas , Sistemas Automatizados de Assistência Junto ao Leito/estatística & dados numéricos , Ultrassonografia/economia , Ultrassonografia/instrumentação
18.
Res Nurs Health ; 44(4): 715-723, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34018217

RESUMO

Findings from qualitative research may make valuable contributions to the evidence informing healthcare practice. Qualitative research methodologies and methods, however, are less familiar to health researchers and research consumers when compared with quantitative methods. Qualitative research reporting guidelines and their merit have been hotly debated for at least two decades. Herein I discuss two sets of qualitative research reporting guidelines endorsed by many high tiered health research journals: Consolidated criteria for reporting qualitative research and Standards for reporting qualitative research. Six aspects of the two sets of guidelines are compared. The first aspect is the focus of the guidelines. The latter five aspects are items included in the guidelines: reflexivity, participant sampling and saturation, data collection, member checking, and data analysis. Except for reflexivity, these items were selected for comparison as they include features of, or strategies to, enhance the rigor of qualitative research that are applicable within some but not all qualitative methodologies. Reflexivity, a central feature of rigor within all qualitative research, is discussed for its suboptimal representation in both sets of reporting guidelines. Without regular and critical review of reporting guidelines, efforts to promote the design, conduct, and reporting of rigorous qualitative health research to support evidence-informed practice may be undermined. Moreover, for qualitative research reporting guidelines to be useful, they must be applied appropriately and in a flexible manner by researchers and reviewers. This paper has implications for researchers, journal editors, reviewers, and research consumers.


Assuntos
Guias como Assunto/normas , Pesquisa sobre Serviços de Saúde/normas , Pesquisa Qualitativa , Projetos de Pesquisa/normas , Humanos
19.
J Nurs Adm ; 51(6): 318-323, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34006803

RESUMO

OBJECTIVE: To investigate the strategies implemented at our institution to reduce medical restraint use. BACKGROUND: Restraints have been utilized to prevent agitation, self-extubations, and falls, although they are often associated with negative repercussions for nurses and patients. METHODS: The restraint data at our institution were compared with the National Database of Nursing Quality Indicators (NDNQI) benchmark. We also described the measures taken to improve restraint documentation. RESULTS: The number of patients in medical restraints, medical restraint hours, medical restraints/patient-days, and deaths in restraints at our institution all significantly decreased (P < 0.00001). There were 27 self-extubations of restrained patients compared with 11 self-extubations of nonrestrained patients. The percentage of inpatients with restraints in critical care and step-down areas declined and remained below the NDNQI benchmark. CONCLUSIONS: This study reports the processes implemented to reduce restraint use through enhanced communication and increased documentation. Further exploration into factors that may attain a restraint-free environment is warranted.


Assuntos
Guias como Assunto/normas , Restrição Física/métodos , Acidentes por Quedas/prevenção & controle , Documentação , Humanos , Indicadores de Qualidade em Assistência à Saúde , Restrição Física/instrumentação
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