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----- Original Message ----- From: Sent by NCBI To: ibra@zadar.net Sent: Saturday, July 15, 2006 8:15 PM Subject: pubmed Search Results This message contains search results from the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM). Do not reply directly to this message. Sender's message: Sent on Saturday, 2006 Jul 15 GMT Select 16 document(s) Entrez pubmed Results Items 1 - 16 of 16 1: BMC Fam Pract. 2006 Jul 12;7(1):44 [Epub ahead of print] Related Articles, Books, LinkOut Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM) cluster randomized controlled trial. Dubey V, Mathew R, Iglar K, Moinnedin R, Glazier R. ABSTRACT: BACKGROUND: To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. METHODS: A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR) of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. RESULTS: Randomly-selected charts were reviewed at baseline (n=509) and post-intervention (n=608). Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing) to 93% (blood pressure measurement), similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p=0.0001), and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p<0.05) in favor of the intervention (adjusted RR (95% C.I.)): counseling on brushing/flossing teeth (9.2 (4.3-19.6)), folic acid counseling (7.5 (2.7-20.8)), fecal occult blood testing (6.7 (1.9-24.1)), smoking cessation counseling (3.9 (2.2-7.2)), tetanus immunization (3.0 (1.7-5.2)), history of alcohol intake (1.33 (1.2-1.5)), history of smoking habits (1.28 (1.2-1.4)) and blood pressure measurement (1.05 (1.00-1.10)). CONCLUSIONS: This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates of the Preventive Care Checklist Forms will allow a feasible and easy-to-use tool for primary care physicians to provide evidence-based preventive health services to adults at routine health check-ups. The forms can also be incorporated into an electronic health record. The Preventive Care Checklist Forms are accessible in English and French at: www.cfpc.ca. PMID: 16836761 [PubMed - as supplied by publisher] -------------------------------------------------------------------------------- 2: Biomed Digit Libr. 2006 Jul 12;3(1):8 [Epub ahead of print] Related Articles, Books, LinkOut Purchasing online journal access for a hospital medical library: how to identify value in commercially available products. Carter TP, Carter AO, Broomes G. ABSTRACT: BACKGROUND: Medical practice today requires evaluating large amounts of information which should be available at all times. This information is found most easily in a digital form. Some information has already been evaluated for validity (secondary sources) and some is in unevaluated form (primary sources). In order to improve access to digital information, the School of Clinical Medicine and Research at the University of the West Indies and Queen Elizabeth Hospital decided to enhance the library by offering online full text medical articles and evidence based medicine sources. The aim of this paper is to describe how we evaluate the relative value of online journal commercial products available for a small hospital and medical school library. METHODS: Three reference standards were chosen to represent the ideal list of core publications for a broad range of medical care: Brandon/Hill selected list of journals for the small medical library and the academic medical library core journal collection chosen for the Florida State University College of Medicine Medical Library. Six commercially available collections were compared to the reference standards and to the current paper journal subscription list as regards to number of journals matched and cost per journal matched. Ease of use and presence of secondary sources were also considered. RESULTS: The cost per journal matched ranged from US$ 81 to $3194. Because of their low subscription prices, the Biomedical Reference Collection and Proquest products were the most cost beneficial. However, they provided low coverage of the ideal lists.(12 -17% and 21-32% respectively) and contained significant embargoes on current editions, were not user friendly and contained no secondary sources. The Ovid products overcame these difficulties, providing higher coverage of the ideal lists(14-47%) but were in a much higher cost -benefit range. CONCLUSIONS: After considering costs, benefits, ease of use, embargoes, presence of secondary sources (ACP Journal Club, DARE), the Ovid Brandon Hill Plus Collection was the best choice for our hospital considering our budget . However; the option to individually select our own journal list from Ovid and pay per journal has a certain appeal as well. PMID: 16836760 [PubMed - as supplied by publisher] -------------------------------------------------------------------------------- 3: J Gen Intern Med. 2006 Jul 7; [Epub ahead of print] Related Articles, Books, LinkOut Impacts of Evidence-Based Quality Improvement on Depression in Primary Care. Rubenstein LV, Meredith LS, Parker LE, Gordon NP, Hickey SC, Oken C, Lee ML. VA Greater Los Angeles, Los Angeles, CA, USA. Previous studies testing continuous quality improvement (CQI) for depression showed no effects. Methods for practices to self-improve depression care performance are needed. We assessed the impacts of evidence-based quality improvement (EBQI), a modification of CQI, as carried out by 2 different health care systems, and collected qualitative data on the design and implementation process. Evaluate impacts of EBQI on practice-wide depression care and outcomes. Practice-level randomized experiment comparing EBQI with usual care. Six Kaiser Permanente of Northern California and 3 Veterans Administration primary care practices randomly assigned to EBQI teams (6 practices) or usual care (3 practices). Practices included 245 primary care clinicians and 250,000 patients. Researchers assisted system senior leaders to identify priorities for EBQI teams; initiated the manual-based EBQI process; and provided references and tools. Five hundred and sixty-seven representative patients with major depression. Appropriate treatment, depression, functional status, and satisfaction. Depressed patients in EBQI practices showed a trend toward more appropriate treatment compared with those in usual care (46.0% vs 39.9% at 6 months, P=.07), but no significant improvement in 12-month depression symptom outcomes (27.0% vs 36.1% poor depression outcome, P=.18). Social functioning improved significantly (mean score 65.0 vs 56.8 at 12 months, P=.02); physical functioning did not. Evidence-based quality improvement had perceptible, but modest, effects on practice performance for patients with depression. The modest improvements, along with qualitative data, identify potential future directions for improving CQI research and practice. PMID: 16836631 [PubMed - as supplied by publisher] -------------------------------------------------------------------------------- 4: Int J Palliat Nurs. 2006 May;12(5):234-40. Related Articles, Books, LinkOut Barriers to implementing an integrated care pathway for the last days of life in nursing homes. Watson J, Hockley J, Dewar B. St Columbas Hospice, Boswall Road, Edinburgh, EH5 3RW. Aim: this paper explores the barriers that needed to be overcome during the process of implementing an integrated care pathway for the last days of life as a way of developing quality end-of-life care in nursing homes. Methods: an action research methodology underpinned the study. Qualitative and quantitative data were collected in eight nursing homes before, during and after the implementation of the care pathway. Findings: six main barriers were identified: a lack of knowledge of palliative care drugs and control of symptoms at the end of life; lack of preparation for approaching death; not knowing when someone is dying or understanding the dying process; lack of multidisciplinary team working in nursing homes; lack of confidence in communicating about dying; some nursing homes are not ready or able to change. These findings highlight a functional 'rehabilitative' culture that may not be so appropriate in the current context of nursing home care, and one that makes implementing an integrated care pathway for the last days of life less straightforward than in other settings. Conclusion: it cannot be presumed that the implementation of a care pathway for the last days of life in nursing homes is straightforward. This study suggests that an action research framework was extremely useful in highlighting and overcoming some obstacles when developing evidence-based practice. Action at both local and public policy level is required to fully address barriers that prevent quality end-of-life care in nursing homes. PMID: 16835564 [PubMed - in process] -------------------------------------------------------------------------------- 5: Br J Nurs. 2006 Jun 22-Jul 12;15(12):645-8. Related Articles, Books, LinkOut Integrated healthcare: herbal remedies for menopausal symptoms. Tiran D. Expectancy Ltd, London. Women approaching the menopause frequently resort to complementary therapies and natural remedies, especially herbal medicines. Nurses working with mature women, both in the community and in hospital, may find themselves drawn into a debate about these remedies, yet may feel unable to answer women's questions, or be unsure where to find information. However, with the increased use of complementary therapies generally, it is imperative that nurses recognize the parameters of their personal practice and appreciate the possible problems which may arise from ill-informed use of natural remedies, such as herb-drug interactions. This article provides an overview of herbal remedies popularly self-administered by women in the peri-menopausal period. The effects and safety of several remedies are explored to facilitate nurses to offer accurate, comprehensive and evidence-based information to patients. The issue of integration of herbal medicine into mainstream management of menopausal symptoms is also debated as a means of providing optimum and safe care to women at this time. PMID: 16835538 [PubMed - in process] -------------------------------------------------------------------------------- 6: Health Aff (Millwood). 2006 Jul-Aug;25(4):969-78. Related Articles, Books, LinkOut Promoting evidence-based public health policy: can we have better evidence and more action? Fielding JE, Briss PA. Los Angeles County Department of Health Services, USA. jfielding@ladhs.org Evidence-based approaches (those explicitly linked to the best available scientific evidence and reflecting community preferences and feasibility) are increasingly used to inform health policy decision making on the burden of a disease attributable to particular causes, interventions and policies that might work to confront those causes, and issues of community fit and feasibility. This paper introduces several tools for evidence-based public health: the health impact assessment, the systematic review, and a portfolio for assuring community fit and feasibility. Discussion of these tools serves as a springboard to consider how to better bring scientific evidence to bear on real-life health issues. PMID: 16835176 [PubMed - in process] -------------------------------------------------------------------------------- 7: Int J Nurs Pract. 2006 Aug;12(4):232-40. Related Articles, Books, LinkOut Analysis of the impact of a national initiative to promote evidence-based nursing practice. Ring N, Coull A, Howie C, Murphy-Black T, Watterson A. Lecturer, Department of Nursing and Midwifery, University of Stirling, Stirling, UK. Best Practice Statements (BPS) are designed to facilitate evidence-based practice. This descriptive, exploratory study evaluated the impact of five of these statements in Scotland. A postal survey of 1278 registered nurses was undertaken to determine use of these statements and their perceived benefits (response rate: 42%). Use of the BPS differed across clinical sites and some statements were more likely to be used than others. Identified barriers and drivers to their use were similar to factors known to encourage or hinder evidence-based practice generally. Although approximately 25% of clinical respondents reported using the BPS, most respondents reported perceived benefits to patients usually through quality improvement. Results highlight the importance of facilitation and supportive contexts in encouraging clinical use of these statements. Findings suggest that variation in clinical implementation of the BPS need to be addressed locally and nationally if their benefits are to be maximized. PMID: 16834584 [PubMed - in process] -------------------------------------------------------------------------------- 8: Nurs Res. 2006 July/August;55(4 Suppl 1):S44-S50. Related Articles, Books, LinkOut Using Evidence-based Educational Strategies to Increase Knowledge and Skills in Tobacco Cessation. Heath J, Andrews J. Janie Heath, PhD, APRN, BC-ANP, ACNP, is Assistant Professor and Director, Acute Care Nurse Practitioner and Critical Care Clinical Nurse Specialist Program, School of Nursing and Health Studies, Georgetown University, Washington, DC. Jeannette Andrews, PhD, APRN, BC-FNP, ACNP, is Assistant Professor, Department of Health Environments and Systems Community Nursing, Medical College of Georgia, School of Nursing, Augusta. Jeannette Andrews, PhD, APRN, BC-FNP, ACNP, is Assistant Professor, Department of Health Environments and Systems Community Nursing, School of Nursing, Medical College of Georgia, Augusta. To meet the demand for improved patient outcomes and accountability for healthcare delivery, nurses must embrace a culture of evidence-based practice (EBP). Integrating EBP for tobacco cessation in nursing practice is particularly important for the 44.5 million smokers in the United States who contribute to $157 billion of healthcare costs annually. Unfortunately, studies reveal that healthcare providers are not aware of what is considered the best evidence, the United States Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence, resulting in missed opportunities to promote optimal health outcomes for individuals wanting to quit smoking. Fortunately, leading healthcare authorities such as the Joint Commission of Accreditation for Healthcare Organizations and Centers for Medicare and Medicaid Services now require providers to offer tobacco cessation services. The challenges and opportunities to do this effectively are many and with limited resources it will be increasingly important to ensure that nurses have the necessary knowledge and skills to improve tobacco cessation outcomes. For tobacco cessation interventions to become a standard of nursing practice, strategic efforts must be directed at advancing nursing research that evaluates best educational strategies for promoting tobacco cessation interventions within nursing curricula. In this article, a framework to help address nursing strategies to bridge the gap between EBP and tobacco cessation will be described. PMID: 16829776 [PubMed - as supplied by publisher] -------------------------------------------------------------------------------- 9: Nurs Stand. 2006 Jun 21-27;20(41):53-7. Related Articles, Books, LinkOut Strategies to reduce medication errors with reference to older adults. Joanna Briggs Institute. This information on best practice is based on a systematic review (Hodglkinson et a/ 2006) conducted by the Australian Centre for Evidence Based Aged Care, formerly a collaborating centre of the Joanna Briggs Institute (JBI). The primary references on which this information is based are available online via Blackwell Synergy: www.blackwell-synergy.com and to members of the institute via the web site: www.joannabriggs.edu.au. This information sheet discusses the following: Types and causes of medication errors. Interventions, including computerised systems, individual patient medication supply, education and training, use of pharmacists and nursing care models. Implications for practice and research. Recommendations. PMID: 16827204 [PubMed - in process] -------------------------------------------------------------------------------- 10: Stud Health Technol Inform. 2006;120:167-78. Related Articles, Books, LinkOut Sealife: a semantic grid browser for the life sciences applied to the study of infectious diseases. Schroeder M, Burger A, Kost kova P, Stevens R, Habermann B, Dieng-Kuntz R. TU Dresden, Germany. The objective of Sealife is the conception and realisation of a semantic Grid browser for the life sciences, which will link the existing Web to the currently emerging eScience infrastructure. The SeaLife Browser will allow users to automatically link a host of Web servers and Web/Grid services to the Web content he/she is visiting. This will be accomplished using eScience's growing number of Web/Grid Services and its XML-based standards and ontologies. The browser will identify terms in the pages being browsed through the background knowledge held in ontologies. Through the use of Semantic Hyperlinks, which link identified ontology terms to servers and services, the SeaLife Browser will offer a new dimension of context-based information integration.In this paper, we give an overview over the different components of the browser and their interplay. This SeaLife Browser will be demonstrated within three application scenarios in evidence-based medicine, literature & patent mining, and molecular biology, all relating to the study of infectious diseases. The three applications vertically integrate the molecule/cell, the tissue/organ and the patient/population level by covering the analysis of high-throughput screening data for endocytosis (the molecular entry pathway into the cell), the expression of proteins in the spatial context of tissue and organs, and a high-level library on infectious diseases designed for clinicians and their patients.For more information see http://www.biote.ctu-dresden.de/sealife. PMID: 16823135 [PubMed - in process] -------------------------------------------------------------------------------- 11: Am J Crit Care. 2006 Jul;15(4):356-8. Related Articles, Books, LinkOut Evidence-based practice is wonderful ... Sort of. Dracup K, Bryan-Brown CW. The School of Nursing, University of California, San Francisco, San Francisco, Calif. PMID: 16823009 [PubMed - in process] -------------------------------------------------------------------------------- 12: Postgrad Med J. 2006 Jul;82(969):429-37. Related Articles, Books, LinkOut Obesity in childhood and adolescence: evidence based clinical and public health perspectives. Reilly JJ. University Division of Developmental Medicine, University of Glasgow/ Yorkhill Hospitals Glasgow, 1st Floor Tower Block QMH, Yorkhill, Glasgow G3 8SJ, Scotland. jjr2y@clinmed.gla.ac.uk A global epidemic of paediatric obesity occurred in recent years, and prevalence of obesity is continuing to rise. In the developed world obesity is now the most common disease of childhood and adolescence. Paediatric obesity is not a cosmetic issue, being associated with a significant burden of ill health both for obese children and for adults who were obese as children. Health professionals tend to underestimate the impact of paediatric obesity, and lack the skills, knowledge, and time to treat it effectively. This short review aims to summarise recent systematic reviews on the origins, consequences, prevention, and treatment of paediatric obesity. PMID: 16822919 [PubMed - in process] -------------------------------------------------------------------------------- 13: J Am Acad Orthop Surg. 2006 Jul;14(7):397-405. Related Articles, Books, LinkOut Psychosocial factors and surgical outcomes: an evidence-based literature review. Rosenberger PH, Jokl P, Ickovics J . The influence of psychosocial factors on clinical outcomes after surgery has been investigated in several studies. This review is limited to surgical outcomes studies published between 1990 and 2004 that include (1) psychosocial variables (eg, depression, social support) as predictors of outcome and that focus on (2) clinical outcomes (eg, postoperative pain, functional recovery) using (3) specific multivariate analytic techniques with (4) relevant clinical variables (eg, presurgical health status) included as covariates. Twenty-nine studies met these criteria. Results indicate that psychosocial factors play a significant role in recovery and are predictive of surgical outcome, even after accounting for known clinical factors. Attitudinal and mood factors were strongly predictive; personality factors were least predictive. The results suggest that preoperative consideration of attitudinal and mood factors will assist the surgeon in estimating both the speed and extent of postoperative recovery. PMID: 16822887 [PubMed - in process] -------------------------------------------------------------------------------- 14: Curr Allergy Asthma Rep. 2006 Jul;6(4):334-41. Related Articles, Books, LinkOut Acute otitis media guidelines: review and update. Lieberthal AS. Keck School of Medicine, University of Southern California, Kaiser Permanente, Panorama City, CA 91402, USA. allan.s.lieberthal@kp.org In 2004, the Subcommittee on Management of Acute Otitis Media of the American Academy of Pediatrics and American Academy of Family Physicians published evidence-based clinical practice guidelines on the "Diagnosis and Management of Acute Otitis Media." The guidelines included a definition of acute otitis media (AOM) that included three components: 1) a history of acute onset of signs and symptoms; 2) the presence of middle-ear effusion; and 3) signs and symptoms of middle-ear inflammation. An option to observe selected children with AOM for 48 to 72 hours without initial antibiotic therapy was proposed. This option was based on age, severity of illness, and certainty of diagnosis. Despite the changing prevalence of bacterial pathogens and increasing resistance of Streptococcus pneumoniae, amoxicillin remains the first-line antibiotic for initial antibacterial treatment of AOM. The guideline also addresses the management of otalgia, choice of antibiotics after initial treatment failure, and methods for preventing AOM. PMID: 16822388 [PubMed - in process] -------------------------------------------------------------------------------- 15: BMC Public Health. 2006 Jul 5;6(1):175 [Epub ahead of print] Related Articles, Books, LinkOut Health system barriers to strengthening vaccine-preventable disease surveillance and response in the context of decentralization: evidence from Georgia. Hotchkiss DR, Eisele TP, Djibuti M, Silvestre EA, Rukhadze N. ABSTRACT: BACKGROUND: A critical challenge in the health sector in developing countries is to ensure the quality and effectiveness of surveillance and public health response in an environment of decentralization. In Georgia, a country where there has been extensive decentralization of public health responsibilities over the last decade, an intervention was recently piloted to strengthen district-level local vaccine-preventable disease surveillance and response activities through improved capacity to analyze and use routinely collected data. The purpose of the study is 1) to assess the effectiveness of the intervention on motivation and perceived capacity to analyze and use information at the district-level, and 2) to assess the role that individual- and system-level factors play in influencing the effectiveness of the intervention. METHODS: A pre-post quasi-experimental research design is used for the quantitative evaluation. Data come from a baseline and two follow-up surveys of district-level health staff in 12 intervention and 3 control Center of Public Health (CPH) offices. These data were supplemented by record reviews in CPH offices as well as focus group discussions among CPH and health facility staff. RESULTS: The results of the study suggest that a number of expected improvements in perceived data availability and analysis occurred following the implementation of the intervention package, and that these improvements in analysis could be attributable to the intervention package. However, the study results also suggest that there exist several health systems barriers that constrained the effectiveness of the intervention in influencing the availability of data, analysis and response. CONCLUSIONS: To strengthen surveillance and response systems in Georgia, as well as in other countries, donor, governments, and other stakeholders should consider how health systems factors influence investments to improve the availability of data, analysis, and response. Linking the intervention to broader health sector reforms in management processes and organizational culture will be critical to ensure that efforts designed to promote evidence-based decision-making are successful, especially as they are scaled up to the national level. PMID: 16822316 [PubMed - as supplied by publisher] -------------------------------------------------------------------------------- 16: Ter Arkh. 2006;78(4):83-7. Related Articles, Books, LinkOut [Evidence-based medicine: realities and perspectives] [Article in Russian] [No authors listed] PMID: 16821431 [PubMed - in process] --------------------------------------------------------------------------------