Evaluation Of Best Practices Research Articles

Emergency Psychiatrists Issue Guidelines for Treating Youth With Agitation

Emergency Psychiatrists Issue Guidelines for Treating Youth With Agitation

Impacts on the Student Experience in the Gross Anatomy Laboratory with the Introduction of Reciprocal Peer Teaching

Ongoing changes to medical education curricula in the United States require continued evaluation of best practices for maintaining and enhancing anatomical education in medical schools. The purpose of this study was to identify the impacts of incorporating reciprocal peer teaching in a human gross anatomy laboratory for students in the first year of medical school at Indiana University School of Medicine, Bloomington (IUSM‐BL). While previous studies have focused on the effects of reciprocal peer teaching on student achievement, this study concentrated on identifying and explaining the underlying changes to the student experience that can occur when introducing reciprocal peer teaching in the gross anatomy laboratory. The researcher used a grounded theory analysis of student interviews, instructor interviews, and student work to provide an in‐depth examination of the use of reciprocal peer teaching at IUSM‐BL from the fall of 2012 through the spring of 2016. All Interviews were recorded, transcribed, and analyzed and IRB consent (IRB Study #1404683093) was obtained for the study. Through the grounded theory analysis, the researcher developed a theory to explain the impacts of reciprocal peer teaching on the student experience at IUSM‐BL. The study found that there were 2 theoretical categories that best explain the changes to the student experience when incorporating reciprocal peer teaching. (1) Students' roles in the laboratory changed and there was new emphasis placed on the role of the student as a dissector, a team member, and a teacher. (2) New challenges were created resulting in an increase in conflicts between individuals and greater emphasis by the students on the importance of effective communication. In conclusion, the researcher determined reciprocal peer teaching at IUSM‐BL increased active dissection time, decreased intragroup conflict, generated new opportunities to develop teaching and communication skills, and increased efficiency in the anatomy laboratory classroom. These findings provide information for educators at IUSM‐BL as they continue to make revisions to meet curricular demands. Additionally, the information can be used more broadly to inform anatomy educators about benefits reciprocal peer teaching model, and considerations for its use in the anatomy laboratory.Support or Funding InformationThis study was unfunded.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry.

IntroductionAgitation in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, family and staff. We present consensus guidelines for management of agitation among pediatric patients in the ED, including non-pharmacologic methods and the use of immediate and as-needed medications.MethodsUsing the Delphi method of consensus, a workgroup comprised of 17 experts in emergency child and adolescent psychiatry and psychopharmacology from the the American Association for Emergency Psychiatry and the American Academy of Child and Adolescent Psychiatry Emergency Child Psychiatry Committee sought to create consensus guidelines for the management of acute agitation in children and adolescents in the ED.ResultsConsensus found that there should be a multimodal approach to managing agitation in the ED, and that etiology of agitation should drive choice of treatment. We describe general and specific recommendations for medication use.ConclusionThese guidelines describing child and adolescent psychiatry expert consensus for the management of agitation in the ED may be of use to pediatricians and emergency physicians who are without immediate access to psychiatry consultation.

Better governance of urban mobility by exchange of experience and evaluation of best practices

Better governance of urban mobility by exchange of experience and evaluation of best practices

Response to "Environmental scan and evaluation of best practices for online systematic review resources".

Comment on Parker RMN, Boulos L, Visintini S, Ritchie K, Hayden J. Environmental scan and evaluation of best practices for online systematic review resources. J Med Libr Assoc. 2018 Apr;106(2):208–17. DOI: http://dx.doi.org/10.5195/jmla.2018.241.

Educational Strategies of Diabetes Group Medical Visits: A Review.

Diabetes is a demanding disease that is growing in prevalence. Improved outcomes for patients with diabetes are highly dependent on self-management skills and the ability to make lifestyle changes. Innovative healthcare approaches are necessary to meet these specific patient needs. A group care medical visit (GMV) combines diabetes check-ups with diabetes education in a supportive and patient centered environment that promotes effective self-management. GMVs are associated with improved diabetes outcomes including hemoglobin A1C, weight, and self-efficacy; however details of the methods by which content is delivered to achieve these outcomes remain vague. Improved GMV diabetes outcomes may be the result of specific processes used in group care models. We seek to describe educational strategies, content, and qualities of facilitators that contribute to successful outcomes associated with diabetes GMVs. A review of the literature was conducted focusing on diabetes GMVs, specifically the educational strategies implemented, topics discussed, and facilitator qualities that contribute to successful outcomes. We identified 260 citations containing information about GMVs in patients with diabetes. A total of 7 citations met inclusion criteria and additional 5 were found through reference lists and relevant papers. Diabetes GMV educational topics comprise standard themes of disease process, medication, nutrition, and exercise. Several programs, however, target the development and realization of individualized patient goals, giving the patient more involvement in the session. Methods for facilitation may hold the key to successfully activating patients to reach meaningful behavior change goals. In addition to using expert clinical skills in diabetes care, effective facilitators provide support, and empower patients to take ownership of their diabetes. Rigorous evaluation of best practices for both the type and methods of delivering content in GMVs is lacking. Translational research to evaluate the relative effectiveness of educational strategies can be leveraged toward the successful scale and spread of this innovative primary care model.

Environmental scan and evaluation of best practices for online systematic review resources.

ObjectiveOnline training for systematic review methodology is an attractive option due to flexibility and limited availability of in-person instruction. Librarians often direct new reviewers to these online resources, so they should be knowledgeable about the variety of available resources. The objective for this project was to conduct an environmental scan of online systematic review training resources and evaluate those identified resources.MethodsThe authors systematically searched for electronic learning resources pertaining to systematic review methods. After screening for inclusion, we collected data about characteristics of training resources and assigned scores in the domains of (1) content, (2) design, (3) interactivity, and (4) usability by applying a previously published evaluation rubric for online instruction modules. We described the characteristics and scores for each training resource and compared performance across the domains.ResultsTwenty training resources were evaluated. Average overall score of online instructional resources was 61%. Online courses (n=7) averaged 73%, web modules (n=5) 64%, and videos (n=8) 48%. The top 5 highest scoring resources were in course or web module format, featured high interactivity, and required a longer (>5hrs) time commitment from users.ConclusionThis study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons’ needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment.

CLSI Methods Development and Standardization Working Group Best Practices for Evaluation of Antimicrobial Susceptibility Tests.

Effective evaluations of antimicrobial susceptibility tests (ASTs) require robust study design. The Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing has recognized that many published studies reporting the performance of commercial ASTs (cASTs) suffer from major design and/or analysis flaws, rendering the results difficult or impossible to interpret. This minireview outlines the current consensus of the Methods Development and Standardization Working Group of the CLSI Subcommittee on Antimicrobial Susceptibility Testing regarding best practices for systematic evaluation of the performance of an AST, including the analysis and presentation of essential data intended for publication.

Best practices in evaluation of the magnetocaloric effect from bulk magnetization measurements

Conventional magnetometry is irreplaceable in evaluating bulk magnetization of materials over broad temperature and field ranges. The technique is also effective in quantifying hysteresis that may be associated with magnetic and structural phase transitions that occur during the magnetizing/demagnetizing cycling, and the derived magnetic field-induced isothermal entropy change – one of the most important properties in the field of magnetocalorics. Both systematic and random errors present during the measurements of magnetization, however, may lead to erroneous conclusions. Using two well-known materials – elemental Gd and intermetallic Gd5Si2Ge2 as examples, we consider best practices in performing reliable and rapid magnetization measurements for proper characterization of magnetocaloric properties.

Variation in length of hospital stay after lung cancer surgery in the Netherlands.

Length of stay (LOS) in the hospital after lung cancer surgery is influenced by patient characteristics, tumour characteristics, surgical technique and perioperative care. Our objective was to determine whether there were variation in LOS between hospitals that could not be accounted for by these known parameters. Residual variation in LOS would suggest important differences in perioperative care protocols and discharge criteria. This study analysed data from the Netherlands National Cancer Registry (NNCR) on 10195 anatomical lung resections for primary lung cancer from 2010 to 2015. Multivariable analysis was performed for multiple factors, using hierarchical linear regression analysis of the mean LOS. Information on comorbidity and socio-economic status was not available. Association between LOS and postoperative mortality was evaluated in multivariable logistic regression. The median LOS was 7 days (interquartile range 5-10 days), and the mean LOS was 8.3 days. LOS was negatively affected by larger resections, open surgery and advancing age. Histology and tumour stage had little influence. Overall, 30-day and 90-day mortality were 2.1% and 3.8%, respectively; 1.7% and 3.3% (not significant) in the group of hospitals with shorter LOS. After case-mix correction, residual between-hospital variation in the mean LOS was observed, ranging from 1.5 days shorter to almost 2.5 days longer. A clinically relevant between-hospital variation in LOS after lung cancer surgery is observed in the Netherlands. Although residual confounding by comorbidity or socio-economic status cannot be excluded, this variation is deemed to be largely due to differences in perioperative care protocols. Evaluation of best practices can help to improve perioperative care for lung surgery patients and optimize LOS.

Management of Complicated Pneumonia in Childhood: A Review of Recent Literature.

Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. The aim was to review recently published literature to inform the clinician about the most up to date management of complicated pneumonia in children. Using Medline, a search of the medical literature was conducted in order to find relevant clinical trials and review articles published in the last 5 years. Narrow spectrum antibiotics including ampicillin and azithromycin remain important first line agents, but directed therapy towards causative pathogens is the ideal standard practice. Novel DNA isolation technologies hold promise for raising the diagnostic yield of pleural fluid. Surgical interventions are often required and new literature further supports the use of fibrinolytics and minimally invasive chest tube thoracostomy. Not to be overlooked is the importance of supportive measures including oxygen therapy and adequate fluid, electrolyte and nutrition support. The use of other adjunctive therapies such as steroids in pediatric complicated pneumonia remains controversial. Recent studies have shown promise in establishing best practices for evaluation and management of complicated pneumonia in children. Despite these robust efforts however, many areas are in need of future inquiry and prospective studies could help to better understand the optimal therapeutic and diagnostic options for children with this common and persistent childhood illness.

Expert opinions on good practice in evaluation of health promotion and primary prevention measures related to children and adolescents in Germany

BackgroundDetermining what constitutes “good practice” in the measurement of the costs and effects of health promotion and disease prevention measures is of particular importance. The aim of this paper was to gather expert knowledge on (economic) evaluations of health promotion and prevention measures for children and adolescents, especially on the practical importance, the determinants of project success, meaningful parameters for evaluations, and supporting factors, but also on problems in their implementation. This information is targeted at people responsible for the development of primary prevention or health promotion programs.MethodsPartially structured open interviews were conducted by two interviewers and transcribed, paraphrased, and summarized for further use. Eight experts took part in the interviews.ResultsThe interviewed experts saw evaluation as a useful tool to establish the effects of prevention programs, to inform program improvement and further development, and to provide arguments to decision making. The respondents’ thought that determinants of a program’s success were effectiveness with evidence of causality, cost benefit relation, target-group reach and sustainability. It was considered important that hard and soft factors were included in an evaluation; costs were mentioned only by one expert. According to the experts, obstacles to evaluation were lacking resources, additional labor requirements, and the evaluators’ unfamiliarity with a program’s contents. It was recommended to consider evaluation design before a program is launched, to co-operate with people involved in a program and to make use of existing structures.ConclusionWhile in in this study only a partial view of expert knowledge is represented, it could show important points to consider when developing evaluations of prevention programs. By considering these points, researchers could further advance towards a more comprehensive approach of evaluation targeting measures in children and adolescents.

Case management helps prevent criminal justice recidivism for people with serious mental illness

PurposeThe purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism.Design/methodology/approachExamples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented.FindingsCurrently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management.Originality/valueProviding effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

Best Practices for Evaluation and Optimization of Patients Undergoing Abdominal Wall Reconstruction and Large Hernia Repairs in a Community Hospital Setting: A Review of Literature

Best Practices for Evaluation and Optimization of Patients Undergoing Abdominal Wall Reconstruction and Large Hernia Repairs in a Community Hospital Setting: A Review of Literature

A Scientific Rationale to Improve Resistance Training Prescription in Exercise Oncology.

To date, the prevailing evidence in the field of exercise oncology supports the safety and efficacy of resistance training to attenuate many oncology treatment-related adverse effects, such as risk for cardiovascular disease, increased fatigue, and diminished physical functioning and quality of life. Moreover, findings in the extant literature supporting the benefits of exercise for survivors of and patients with cancer have resulted in the release of exercise guidelines from several international agencies. However, despite research progression and international recognition, current exercise oncology-based exercise prescriptions remain relatively basic and underdeveloped, particularly in regards to resistance training. Recent publications have called for a more precise manipulation of training variables such as volume, intensity, and frequency (i.e., periodization), given the large heterogeneity of a cancer population, to truly optimize clinically relevant patient-reported outcomes. Indeed, increased attention to integrating fundamental principles of exercise physiology into the exercise prescription process could optimize the safety and efficacy of resistance training during cancer care. The purpose of this article is to give an overview of the current state of resistance training prescription and discuss novel methods that can contribute to improving approaches to exercise prescription. We hope this article may facilitate further evaluation of best practice regarding resistance training prescription, monitoring, and modification to ultimately optimize the efficacy of integrating resistance training as a supportive care intervention for survivors or and patients with cancer.

Calibration bias of experimentally determined chlorine isotope enrichment factors: the need for a two-point calibration in compound-specific chlorine isotope analysis.

The recent development of compound-specific online chlorine isotope analysis (37 Cl-CSIA) methods has fostered dual chlorine-carbon isotope studies to gain better insights into sources and environmental transformation reactions of chlorinated ethenes. One-point and two-point calibration schemes are currently used to convert raw data to the international δ37 ClSMOC scale, but a critical evaluation of best practices to arrive at reliable δ37 ClSMOC signatures and enrichment factors was missing and is presented here. Aqueous solutions of neat perchloroethylene and trichloroethylene (TCE) and aqueous samples from a TCE biodegradation experiment with pure cultures of Desulfitobacterium hafniense Y51 were analysed for their chlorine isotope ratios using GC/qMS and GC/IRMS. The δ37 ClSMOC values were obtained using one-point and two-point calibration schemes. Chlorine isotope enrichment factors, εCl , were calculated using both approaches and the corresponding bias of δ37 ClSMOC values introduced by the different types of calibration was determined. Different calibration methods resulted in significant differences (up to 30%) in both δ37 Cl signatures and εCl values. Our results demonstrate that a two-point calibration together with comprehensive information on reference materials is indispensable and should become standard practice for reliable 37 Cl-CSIA of organic compounds. Copyright © 2016 John Wiley & Sons, Ltd.

Improving Evaluation to Address the Unintended Consequences of Health Information Technology:. a Position Paper from the Working Group on Technology Assessment & Quality Development.

With growing use of IT by healthcare professionals and patients, the opportunity for any unintended effects of technology to disrupt care health processes and outcomes is intensified. The objectives of this position paper by the IMIA Working Group (WG) on Technology Assessment and Quality Development are to highlight how our ongoing initiatives to enhance evaluation are also addressing the unintended consequences of health IT. Review of WG initiatives Results: We argue that an evidence-based approach underpinned by rigorous evaluation is fundamental to the safe and effective use of IT, and for detecting and addressing its unintended consequences in a timely manner. We provide an overview of our ongoing initiatives to strengthen study design, execution and reporting by using evaluation frameworks and guidelines which can enable better characterization and monitoring of unintended consequences, including the Good Evaluation Practice Guideline in Health Informatics (GEP-HI) and the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI). Indicators to benchmark the adoption and impact of IT can similarly be used to monitor unintended effects on healthcare structures, processes and outcome. We have also developed EvalDB, a web-based database of evaluation studies to promulgate evidence about unintended effects and are developing the content for courses to improve training in health IT evaluation. Evaluation is an essential ingredient for the effective use of IT to improve healthcare quality and patient safety. WG resources and skills development initiatives can facilitate a proactive and evidence-based approach to detecting and addressing the unintended effects of health IT.

Barriers and facilitators to evaluation of health policies and programs: Policymaker and researcher perspectives

Our research sought to identify the barriers and facilitators experienced by policymakers and evaluation researchers in the critical early stages of establishing an evaluation of a policy or program. We sought to determine the immediate barriers experienced at the point of initiating or commissioning evaluations and how these relate to broader system factors previously identified in the literature.We undertook 17 semi-structured interviews with a purposive sample of senior policymakers (n=9) and senior evaluation researchers (n=8) in Australia.Six themes were consistently raised by participants: political influence, funding, timeframes, a ‘culture of evaluation’, caution over anticipated results, and skills of policy agency staff. Participants also reflected on the dynamics of policy-researcher relationships including different motivations, physical and conceptual separation of the policy and researcher worlds, intellectual property concerns, and trust.We found that political and system factors act as macro level barriers to good evaluation practice that are manifested as time and funding constraints and contribute to organisational cultures that can come to fear evaluation. These factors then fed into meso and micro level factors. The dynamics of policy-researcher relationship provide a further challenge to evaluating government policies and programs.

Quality of Health IT Evaluations.

Health IT evaluation studies have often been found to be of limited quality. To address this problem, several guidelines and frameworks have been developed as tools to support improvement of the quality of evaluation studies. In this contribution, we review available guidelines and then present the Good Evaluation Practice Guideline in Health Informatics (GEP-HI) in more detail. GEP-HI is a comprehensive guideline which supports especially planning and execution of a health IT evaluation study. The GEP-HI guideline helps to overcome the quality problems related to weak study planning and methodological study design. We also discuss application of GEP-HI on an evaluation project and discuss the need to publish systematically following the recognised publication guidelines. Finally we discuss the future trend on multi-method evaluation approaches.

Managing Agitation Associated with Schizophrenia and Bipolar Disorder in the Emergency Setting

IntroductionPatient agitation represents a significant challenge in the emergency department (ED), a setting in which medical staff are working under pressure dealing with a diverse range of medical emergencies. The potential for escalation into aggressive behavior, putting patients, staff, and others at risk, makes it imperative to address agitated behavior rapidly and efficiently. Time constraints and limited access to specialist psychiatric support have in the past led to the strategy of “restrain and sedate,” which was believed to represent the optimal approach; however, it is increasingly recognized that more patient-centered approaches result in improved outcomes. The objective of this review is to raise awareness of best practices for the management of agitation in the ED and to consider the role of new pharmacologic interventions in this setting.DiscussionThe Best practices in Evaluation and Treatment of Agitation (BETA) guidelines address the complete management of agitation, including triage, diagnosis, interpersonal calming skills, and medicine choices. Since their publication in 2012, there have been further developments in pharmacologic approaches for dealing with agitation, including both new agents and new modes of delivery, which increase the options available for both patients and physicians. Newer modes of delivery that could be useful in rapidly managing agitation include inhaled, buccal/sublingual and intranasal formulations. To date, the only formulation administered via a non-intramuscular route with a specific indication for agitation associated with bipolar or schizophrenia is inhaled loxapine. Non-invasive formulations, although requiring cooperation from patients, have the potential to improve overall patient experience, thereby improving future cooperation between patients and healthcare providers.ConclusionManagement of agitation in the ED should encompass a patient-centered approach, incorporating non-pharmacologic approaches if feasible. Where pharmacologic intervention is necessary, a cooperative approach using non-invasive medications should be employed where possible.