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Mardle Simon - - 2004
In determining the importance of criteria in the management of fisheries, two key issues stand out-the definition of a succinct set of criteria and the determination of which interest groups play a defining role in the management development process. This is indeed the case for all natural resource management problems, ...
McNaughton Molly Ann - - 2004
The intention of the clinical practice guideline (CPG) column has included increasing readers' familiarity with the range of available evidence-based recommendations, while stimulating dialogue regarding application of those recommendations in practice. This column introduces the first article in a series of three written to describe a framework in which the ...
Lui Hoi-Shun HS Sch. of Inf. Technol. & Electr. Eng., Queensland Univ., - - 2004
Ultra wideband (UWB) radar has been extensively investigated both theoretically and practically for the identification buried artifacts. Ground probe radar (GPR) concentrates on the identification of lightly buried land mines, unexploded ordnance (UXO) and archeological targets. The same technology is proposed in a similar context for the rapid identification of ...
Pelletier Kenneth R - - 2004
Ambulatory medicine is a frequent clinical setting where practitioners can effectively apply Mind-body interventions ranging from basic stress management therapies to the sophisticated biomedical instrumentation of clinical biofeedback. Given the rather extensive and growing body of clinical research in this area, the intent of this article is to provide an ...
Rosen Clifford J - - 2004
The diagnosis and management of osteoporosis have become increasingly more complex as new drugs enter the marketplace and meta-analyses of randomized trials with "other" agents become more prolific. We describe five common clinical scenarios encountered in the practice of osteoporosis medicine and various road maps that could lead to successful ...
Heufelder A - - 2004
In recent years, medical practice has evolved towards greater reliance on evidence-based medicine. Societies and reimbursement agencies often publish recommendations for treatment based on literature review and trial data. Despite this, growth hormone (GH) replacement therapy in adults varies substantially from region to region. The reasons for this include differing ...
Yadao Melissa A - - 2004
Osteochondritis dissecans of the elbow is a localized condition of the articular surface that is commonly seen in the young athlete. This disorder refers primarily to lesions of the capitellum and can be difficult to treat. Although trauma and ischemia play significant roles, the exact etiology remains unknown. The natural ...
Plouffe Jannell - - 2004
Evidence-based clinical practice is a goal of professional nursing. Linking research to the clinical realm appears logical and sounds simplistic, yet frequently our preconceived thoughts and ideas of ease of change do not equate with the reality of the situation. The research exists, the need is there, but "how shall ...
Manikandan R - - 2004
OBJECTIVE: To analyse current practice in the management of acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH) in the UK, and to assess how much of this is evidence-based. METHODS: In all, 410 consultant urologists practising in UK hospitals were sent a questionnaire about the management of AUR ...
Dvorkin Lana - - 2004
Due to the growing use of herbs and dietary supplements by consumers, pharmacists now need a basic knowledge of this topic for their professional practices. To meet this need, an elective course on herbs and dietary supplements is being taught at the Massachusetts College of Pharmacy and Health Science. The ...
Amarilys Zaldúa Triana
&lt;p&gt;The author analysis the current semiothic concepts of Occidental Medicine, that culminated in the idea of Medicine Based on Evidences, demonstrating that this practice improves the distance between doctor and patient. The author also recovers the concept of interview to demonstrate the importance of interaction doctor-patient.&lt;/p&gt;
Dunning Joel - - 2003
Cardiothoracic surgeons are faced with the dilemma that many clinical questions in their daily practice to do not have universally agreed answers, but patients increasingly demand the 'best practice' from their doctors. In addition time pressures mean that clinicians are unable to keep up with the full spectrum of published ...
Essock Susan M - - 2003
After nearly 20 years of progress in general medicine, the evidence-based practice movement is becoming the central theme for mental health care reform in the first decade of 2000. Several leaders in the movement met to discuss concerns raised by six stakeholder groups: consumers, family members, practitioners, administrators, policy makers, ...
Canty S J - - 2003
Clinical governance requires our clinical practice to be evidence based. We wished to see if British Orthopaedic surgeons are using the current evidence with regards to the use of drains in knee arthroplasty. A questionnaire was faxed to all UK members of BASK to ascertain their current practice regarding the ...
Goolsby Mary Jo - - 2003
Migraine headaches are the source of significant disability for many individuals and their management can present a considerable clinical challenge. The American Academy of Family Physicians (AAFP) and American College of Physicians--American Society of Internal Medicine (ACP-ASIM) "Pharmacologic Management of Acute Attacks of Migraine and Prevention of Migraine Headaches," provides ...
Gerrard G E - - 2003
The aim of the study was to determine current U.K. neuro-oncology practice. A questionnaire was sent to all U.K. clinical oncologists who treat primary brain tumours. Results were distributed to these doctors with an invitation to attend a workshop in September 2000 to debate areas of differing practice and to ...
Talwalkar Jayant A - - 2003
Previous articles in this series have examined the critical appraisal of isolated structured clinical questions using the framework of evidence-based medicine. When patients are identified with a disease-specific process, however, an integrated approach for addressing multiple questions is required. This article, the sixth in the evidence-based medicine series for this ...
Branum Kay - - 2003
Much has been written about the management of chronic heart failure (HF) and there is strong evidence from many controlled, multicenter trials to support a specific strategy for management of compensated HF. There is little evidence and limited guidance for the management of patients during a period of decompensation. The ...
Roddy Edward - - 2003
Because of different methodology the ACR and EULAR guidelines differ significantly in their recommendations despite an identical evidence base. Guidelines that use a strictly evidence-based approach are less likely to incur bias than those that rely more on expert consensus. Although expert consensus is useful in areas in which there ...
Cundari Alan D - - 2003
The authors investigated the extent to which colleges of osteopathic medicine include evidence-based medicine education in their curricula. Information was obtained through a questionnaire survey, including a Likert scale. The survey was sent to 19 colleges of osteopathic medicine for completion. Twelve responses were received within the time limits of ...
Wilcox R A - - 2003
There is accumulating evidence that point-of-care delivery of clinical information such as evidence-based medicine, practice guidelines and drug information can streamline clinical practice and reduce preventable errors. In Australia, hospital-based physicians have -generally been slow to fully use these resources to enhance their clinical practice. Here we provide an introduction ...
Krugman Mary - - 2003
Knowledge and use of evidence-based practice are essential to ensure best practices and safe patient outcomes. Staff development specialists must be leaders in this initiative to support clinical nurses toward improved practice outcomes. This article describes the background for understanding the historical evolution from research utilization to evidence-based practice, defines ...
Finkler Steven A - - 2003
This article explores the current state of the creation and use of evidence by managers for cost containment in hospitals. We assert that hospitals do not know enough about what things cost, and until they get evidence on costs, it is not likely that much can be done to narrow ...
Khan Karim - - 2003
Tendon conditions cause a great deal of morbidity in both elite and recreational athletes, and outcome of treatment is often unsatisfactory. Evidence that the common clinical conditions (e.g., Achilles, patellar, elbow and rotator cuff tendinopathies) are due to tendinosis has been present for many years, yet the misnomer "tendinitis" is ...
Doig Gordon Stuart - - 2003
BACKGROUND: Efficient literature searching and the application of formal rules of evidence in evaluating the clinical literature are the two key skills defining the practice of evidence-based medicine. Although clinicians embrace the concepts of evidence-based medicine, most identify limited personal time as the major barrier towards its implementation into daily ...
Lee Linda Yin King - - 2003
Evidence-based practice has been widely discussed in the literature, but it is not common or well adopted in nursing practice, both in Hong Kong and other countries. This article aims to examine the relationships between three important elements of evidence-based practice: systematic reviews, clinical guidelines and protocols. Current issues associated ...
Goh L - - 2003
BACKGROUND: Low back pain and sciatica are common complaints that affect a major proportion of the population at some time in their lives. The treatment and management of this condition may vary widely. OBJECTIVE: The present paper aims to provide an evidence-based approach to the management of low back pain ...
Burak William E WE - - 2003
The conflicting results of randomized studies have led to confusion over the proper management of patients with esophageal adenocarcinoma. Although there is no firm evidence that neoadjuvant chemoradiation improves survival, because of the shortcomings of these trials, this method of treatment is practiced at many centers. Without the results of ...
Bhatara Vinod V Department of Psychiatry, University of South Dakota School of Medicine, 1400 W. 22nd St., Sioux Falls, SD 57105-3329, USA. - - 2003
Best practices research identifies and disseminates effective clinical strategies developed and refined by clinicians for their practices. As opposed to the content of health care, medical students and residents are typically not trained in the process of its provision. This paper illustrates a best practices approach to development of a ...
Yu S L - - 2003
INTRODUCTION: Investigations play a pivotal role in the workup for infertility. The results must be interpreted carefully as these assess dynamic function. Evidence-based guidelines are useful in the selection of appropriate tests. MATERIALS AND METHODS: A review of current evidence-based guidelines for the investigation and management of the infertile couple ...
Mills Ann E - - 2003
Evidence-based medicine purports to be the integration of three prongs; best research evidence, clinical expertise, and patient values and preferences. Controversy still surrounds the application of evidence-based medicine and undoubtedly controversy will persist in the treatment of specific diseases, thus allowing for some flexibility in decision-making. Yet, the idea that ...
Bates David W - - 2003
While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing this gap will be information systems ...
Watson Margaret C - - 2003
In the UK, there has been a rapid increase in the reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sales list (GSL) status. This means that community pharmacy staff have a greater range of non-prescription medicines to recommend for the treatment of minor illness. Strategies are ...
Lorence D P - - 2003
The growing acceptance of evidence-based decision-support systems in healthcare organizations has resulted in recognition of information accuracy as a key area of organizational management. In the United States, rigid data mandates related to information management have met with some resistance from healthcare provider groups, who have traditionally found little relevance ...
Lipp Allyson A School of Care Sciences, University of Glamorgan, Glyntaff, Pontypridd, - - 2003
This paper explores Habermas' knowledge constitutive interests as a basis for clinical effectiveness. Clinical effectiveness and evidence based practice are clarified and Habermas interpretation of critical theory is introduced as an instrument which could arguably fulfil the needs of both concepts. The knowledge constitutive interests have the capacity to encompass ...
Schünemann Holger J - - 2003
Evidence-based medicine has evolved from the need of solving clinical problems. In contrast to the traditional paradigm of clinical practice, evidence-based medicine acknowledges that intuition, clinical experience, and pathophysiologic rationale are not sufficient for making the best clinical decisions. Although evidence-based medicine recognizes the importance of clinical experience, it includes ...
Price Christopher P - - 2003
The principles of evidence-based medicine and the consequent search for robust evidence on outcomes plays a central role in the practice of laboratory medicine. The core of the evidence lies in an explicit recognition of the clinical question(s) that the test result can address. Studies that focus on the relevant ...
Trenti Tommaso - - 2003
BACKGROUND: Evidence-based medicine (EBM), defined as "the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of patients," seems a tool (a "new paradigm") able to meet individual clinical experience with robust observations. EBM has been driven by the need to manage information ...
Katz David L - - 2003
BACKGROUND: There is widespread concern regarding the adequacy of evidence for specific practices under the rubric of "complementary and alternative medicine" (CAM). OBJECTIVE: To map the evidence pertaining to many commonly used CAM practices. DESIGN: In 2000, the Yale Prevention Research Center was funded by the Centers for Disease Control ...
Maxvold Norma J - - 2003
Continuous renal replacement therapy is an effective means for fluid and solute management in ARF/MOSF. Prospective studies have examined issues of anticoagulation, the impact of replacement/dialysis, the effects of bicarbonate-versus lactate-based solutions, and nutritional and medication clearance. Speculation and bias exists concerning when and for what indications CRRT should be ...
Yusuf Shamil - - 2003
A relatively novel group of drugs that inhibit the funny current in the sinus node pacemaker cells, the so-called specific bradycardic agents, are likely to play a significant role in the management of a wide range of cardiovascular disorders, including the sinus tachyarrhythmias. This comprehensive review initially provides an insight ...
Ambalavanan Namasivayam - - 2003
Many therapies in neonatology persist without supportive evidence: some common therapies may actually be harmful. Evidence-based medicine is the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The best available evidence, however, is not always sound or valid evidence. Sometimes, ...
Albietz Julie - - 2003
PURPOSE: To review the incidence, underlying pathophysiology, and clinical features of filamentary keratitis and to identify evidence-based best-practice strategies for managing filamentary keratitis. METHODS: A comprehensive review of published literature was undertaken. Recommendations for best-practice management strategies were based on the available evidence. Three cases are presented to illustrate the ...
Leviton Laura C - - 2003
In many respects, obstetrics, perinatology, and neonatology have been at the forefront in the dissemination and uptake of evidence-based medicine. The work of the Cochrane Collaboration began largely with the need to systematize the evidence on these subjects. Among other organizations, the National Perinatal Information Service and the Vermont Oxford ...
McLaughlin Kristin J - - 2003
BACKGROUND: Repeat prenatal corticosteroids have been in common use worldwide, even though the National Institutes of Health recommends that 'Until data establish a favourable benefit-to-risk ratio, repeat courses of antenatal corticosteroids, including rescue therapy, should be reserved for patients enrolled in clinical trials.' OBJECTIVES: To describe the current use/recommendations for ...
George Jacob - - 2003
Management of lupus nephritis is relatively nonspecific and includes various immunosuppressive drugs, cytotoxic agents and other modalities directed against the aberrant immune response. Treatment decisions are influenced by the clinical features, histology, response to treatment, relapses, patient consent and tolerance to medications. Guidelines based on available evidence, as to how ...
Little Miles - - 2003
Evidence-based medicine (EBM) has achieved cult status in the last 10 years or so. It is an altogether admirable movement in medicine, capable of a great deal of good. Its privileged status, however, has prevented critics from being heard, and there are problems with EBM. Eight features need further discussion ...
Khan Aliya - - 2003
OBJECTIVE: To review evidence for current therapies for postmenopausal osteoporosis and to establish practical guidelines for management of osteoporosis by family physicians. QUALITY OF EVIDENCE: MEDLINE was searched from January 1990 to January 2003. Articles retrieved were graded by level of evidence (I to III). Recommendations for diagnosis and therapy ...
Damji Karim F - - 2003
There is an abundance of evidence from recent randomized clinical trials showing that lowering the IOP is beneficial to the optic nerve and visual field. Setting and achieving a target IOP range is in keeping with evidence-based medicine. The benefits of reaching this target must be weighed against the risks ...
Das Debasis - - 2003
A short cut review was carried out to establish whether asymptomatic cocaine body packers can be managed conservatively. Altogether 171 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study ...
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