Combination Of Guidelines Research Articles

Exploring the Experiences of Family Members When a Patient Is Admitted to the ICU with a Severe Traumatic Brain Injury: A Scoping Review.

The needs of family members of patients in the intensive care unit (ICU) with a severe traumatic brain injury (TBI) remain unmet. To date, no review has been performed to explore the experiences of relatives of adults who have been admitted to the ICU for treatment of a TBI. The aim of this scoping review is to explore and map the evidence of the experiences of family members when an adult relative is admitted to an ICU with a severe TBI. This review follows a combination of guidelines from Arksey and O'Malley and the Joanna Briggs Institute. Five electronic databases, Medline, Emcare, Embase, CINAHL, and PsycInfo were searched in February 2023, as were a number of grey literature sources. The population, concepts, and context framework were used to define the inclusion and exclusion criteria. From 4077 records, nine studies were retained, which represented seven discrete studies. The experiences of family members were thematically analyzed. The narrative synthesis of findings revealed three themes: communication with the clinical team, uncertainty, and involvement in care. These results offer richness and depth of understanding to clinicians regarding the experiences of families during this traumatic time. This review provides direction for targeted interventions aimed at supporting family members while in the ICU.

Translation, cultural adaptation and validation of the Somatic Symptom Scale-8 (SSS-8) for the Brazilian Portuguese language

BackgroundAssessment tools are commonly used in different fields of health to assist in the diagnosis, the evaluation of the response to treatment, the measurement of quality of life and the establishment of the prognosis.ObjectivesTranslate, culturally adapt and perform the psychometric validation of the Somatic Symptom Scale (SSS-8) for use in the Brazilian population.MethodsCross-cultural adaptation followed a combination of guidelines and for psychometric evaluation a sample of 300 patients was recruited. All recommended measurement properties by the Consensus-based Standards for the selection of health status Measurement Instruments were evaluated, including analysis by an expert committee and analysis by the target public. The Skindex-16 was used for the evaluation of convergent validity and Cronbach’s alpha was used for the determination of the internal consistency of the translated version of the SSS-8.ResultsThe final version received approval from five experts and the agreement index was 100% for all items. During the pretest, the scale was administered to 300 patients with psoriasis and none of the items needed to be altered. A moderate correlation was found between the Skindex-16 and SSS-8-BRA. In the analysis of internal consistency, Cronbach’s alpha for the SSS-8-BRA was 0.81.ConclusionThe SSS-8 is a valid and reliable tool for the assessment of somatic symptoms in the Brazilian population.

Pancreatic Cystic Lesions and Malignancy: Assessment, Guidelines, and the Field Defect.

The widespread use of high-spatial-resolution cross-sectional imaging has led to an increase in detection of incidental pancreatic cystic lesions. These lesions are a diverse group, ranging from indolent and premalignant lesions to invasive cancers. The diagnosis of several of these lesions can be suggested on the basis of their imaging appearance, while many other lesions require follow-up imaging and/or aspiration. The smaller cystic lesions, often branch-duct intraductal papillary mucinous neoplasms, have overlapping imaging characteristics that make diagnostic assessment of the natural history and malignancy risk confusing. Expert panels have developed societal guidelines, based on a consensus, for surveillance of these lesions. However, these guidelines are often inconsistent and are constantly evolving as additional scientific data are accumulated. Identification of features associated with increased risk of malignancy is important for proper management. The concept of field defect, whereby pancreatic adenocarcinoma develops at a site different from the site of the pancreatic cyst, adds to the complexity of screening guidelines. As a result of the differences in guidelines, key stakeholders (eg, radiologists, gastroenterologists, and surgeons) must review and come to a consensus regarding which guideline, or combination of guidelines, to follow at their individual institutions. Standardized reporting and macros are helpful for ensuring the uniformity of interpretations. Radiologists play a critical role in the detection and characterization of pancreatic cystic lesions, in the follow-up recommendations for these lesions, and in the detection of associated cancer. An invited commentary by Zaheer is available online. Online supplemental material is available for this article. ©RSNA, 2021.

Fournier's gangrene as Amyand's hernia complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

Does compliance with healthy lifestyle behaviours cluster within individuals in Australian primary school-aged children?

The 3 "movement behaviours" of sleep, screen time, and physical activity are associated with a wide range of health outcomes in children. This study examined whether these behaviours cluster together within individuals in Australian primary school children. Three datasets including 4,449 9- to 11-year-old children were interrogated-(a) Obesity Prevention and Lifestyle (OPAL), (b) the International Study of Children, Obesity, Lifestyle and Environment (ISCOLE), and (c) the National Children's Nutrition and Physical Activity Survey (NCNPAS). The surveys measured movement behaviours using different instruments (accelerometry, use of time recall, and questionnaires) and different operationalizations of compliance. Observed frequencies of compliance with various combinations of guidelines were compared with expected frequencies based on the assumption of independence, using chi-square tests. Compliance with the sleep guidelines was relatively high (72%, 75%, and 79% in the OPAL, ISCOLE, and NCNPAS datasets, respectively), and compliance with the screen (18%, 35%, and 22%) and physical activity (33%, 57%, and 87%) guidelines was generally lower. Against expectation, there was no evidence of clustering in any of the datasets (p>.99). Compliance with movement behaviour guidelines does not cluster within individuals in 9- to 11-year-old Australian children. It may be unlikely that fostering compliance with one guideline will have a flow-on effect to the others. Temporal trade-offs (i.e., the need to choose one movement behaviour above another) in the 24-hr day may contribute to the lack of clustering.

Professional interventions for general practitioners on the management of musculoskeletal conditions.

Professional interventions for general practitioners on the management of musculoskeletal conditions.

MP39-01 USE OF PSA SCREENING GUIDELINES AMONG PRIMARY CARE PHYSICIANS

You have accessJournal of UrologyProstate Cancer: Detection & Screening V1 Apr 2016MP39-01 USE OF PSA SCREENING GUIDELINES AMONG PRIMARY CARE PHYSICIANS Matt Rosenberg, David Crawford, Jay Newmark, and Mitch Steiner Matt RosenbergMatt Rosenberg More articles by this author , David CrawfordDavid Crawford More articles by this author , Jay NewmarkJay Newmark More articles by this author , and Mitch SteinerMitch Steiner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.126AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Widespread implementation of prostate specific antigen (PSA) based prostate cancer screening has resulted in the detection of both clinically significant and insignificant cancer. In 2012 the United States Preventive Services Task Force (USPSTF) recommended that screening should not be offered to men unless there was shared decision making. Other guidelines have recommended PSA screening but for only limited circumstances. As 90% of the PSA testing ordered in the United States is by primary care providers (PCP), we sought to determine their opinions about several aspects of prostate cancer and PSA. METHODS A questionnaire was constructed and a pilot evaluation performed at the annual American Academy of Family Practice (AAFP) meeting in the fall of 2015. Participants were chosen randomly for the survey as they visited the exhibit hall. Questions were included to identify demographics, the use of PSA, and impressions of significant values of the laboratory test as well as basic understanding of prostate cancer. RESULTS 153 clinicians were surveyed. 35 (22.9%) respondents stated that they do not recommend PSA based screening. 118 (78.1%) offer PSA screening, with 59 (50%) starting at age 45 and 48 (41%) at age 55. For those that screen, the average age to start was 48.5 years. Respondents referenced several guidelines to support their screening decisions: USPSTF (68), AAFP (30), American Urological Association (AUA) (13), National Comprehensive Cancer Network (NCCN) (1), combination of guidelines (19), their own (3) or none (18). Providers who did not recommend PSA testing referenced USPSTF (19), AAFP (3), AUA (6) or a combination of guidelines (8) to support their decision. When asked what they considered a suspicious PSA level, the responses the providers offered varied from 1.5-12ng/ml, depending on patient age. 149 (97%) respondents believed that some prostate cancers were more lethal than others. 134 (90%) stated they would use a pre-biopsy test to differentiate aggressive from non-aggressive cancers. CONCLUSIONS There are many guidelines available for primary care providers regarding prostate cancer screening. What is apparent is the tremendous confusion and disconnect caused by these messages. It is also apparent that the providers do not want to abandon screening the correct patient. This creates an educational opportunity to help those at the front lines of patient care in regards to management of screening and appropriate pathways for referral. As the specialists in prostate disease, urologists should be the leading these endeavors. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e541 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Matt Rosenberg More articles by this author David Crawford More articles by this author Jay Newmark More articles by this author Mitch Steiner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Charts for surveillance of antibiotic usage

There is a strong association between the use of antibiotics and the emergence of hospital-acquired antibiotic resistant bacteria. It is therefore important that hospitals have sound systems for the prescription and delivery of these drugs. This involves a combination of guidelines, restrictions and resistance monitoring.