Evidence-Base Practice: Screening for Depression and Suicidality in High Functioning Autistic Spectrum Disorder Adolescents

Research regarding assessing for suicide and depression in high-functioning autistic spectrum disorders (HFASDs) is very limited. An extensive literature review focusing on HFASDs was conducted, which resulted in adolescents with HFASDs are likely to experience depression and suicidality compared to those who are neurotypical or those not diagnosed with an autistic spectrum disorder (ASD) because of limited social and communication skills. These deficits put these individuals at risk for depression, therefore, suicidality. PubMed, SCOPUS, PsychiatryOnline. and Cumulative Index to Nursing and Allied Health Literature (C1NAHL) were used to research information for this independent study. Implications for psychiatric nurse practitioners and other clinicians are to screen HFASDs adolescents more often for depression and suicidality because of the complication of having limited communication and social skills as well as. difficulty developing meaningful relationships

Evaluation of evidence-base practice among eye care practitioners in Saudi Arabia : a cross sectional survey study

Background: The importance of evidence-based optometry practice in the current era of expanding role of optometry cannot be overemphasized. With many optometrists being involved in the diagnosis, management and co-management of various eye diseases, there is need to assess the quality of evidence-based used in their clinical decision making. Methods: A self-administered survey that was made available via emails was administered to practicing optometrists in Saudi Arabia. Responses were analyzed descriptively and Chi squared test was performed to determine the level of association between practitioner characteristics and sources of evidence. Results: A hundred and fourteen optometrists (62% men, 38% females) aged 31.0 ± 7.1 years with an average of 7.2 years of experience completed the survey (response rate 53%). The four most important factors they identified which underpinned their clinical decision making in their order of ranking were; patients’ signs and symptoms (86%), knowledge and information gained during the postgraduate training/continuing education (64%), undergraduate optometry training (46%) and internet databases such as Pubmed and Medline (45%). About 45% indicated that they did not read scientific journals regularly, but depended on text books for information. For those who often read peer reviewed journals, Optometry and Vision Science (42%), Saudi Ophthalmology Journal (19%) and Clinical and Experimental Optometry (18%), journals were the most common. Approximately, 68% had made some modifications in their clinical decisions based on new evidence from literatures gleaned from test books, within the last two years especially in the nature of their soft contact lens practice and subjective refraction. Only 59% completed the minimum hours of continuous education required for license renewal and for about two-third of the respondents (68%), this was primarily sourced from local seminars offered by the Saudi Association of Optometry and Vision Scientist. Conclusion: Saudi optometrists appear to use evidence that is not “up to date” or ‘high level’ and that does not support evidence-based practice. The findings suggest the need to re-educate Saudi Optometrists on how and where to search for, and the importance of using current evidence rather than being dependent on information provided by their educators

Extracorporeal Cardiopulmonary Resuscitation

Extracorporeal cardiopulmonary resuscitation (ECPR) is a method of resuscitation in which venoarterial (VA) extracorporeal membrane oxygenation(ECMO) is initiated during refractory cardiac arrest. ECPR promises to enhance outcomes after cardiac arrest by minimizing neurological deficits, stabilizing the patient for early reperfusion and hypothermia, and serving as a bridge to treatment or transplant. ECPR must be initiated according to structured guidelines and protocols, which are based on the patient’s age, comorbidities, code status, neurological baseline, no flow time, and low flow time. If a patient achieves return of spontaneous circulation on ECMO, the patient will receive post cardiac arrest care which includes but is not limited to therapeutic hypothermia, early reperfusion, intra-aortic balloon pump insertion, tight glycemic control, and low ventilation. While ECPR has been shown to improve outcomes, multiple complications including bleeding, infection, renal failure, limb ischemia, and stroke can result from the treatment. Nurses play a key role in monitoring these critical patients and achieving therapeutic outcomes. As ECPR is expensive, carries high risk of complications, and can not always be performed under informed consent, thus there are ethical implications. A review of the literature indicates that low flow time, age, percutaneous intervention, and sustained ventricular fibrillation are independent factors that directly impact patient outcomes. With advances in ECPR and its use in the clinical setting, it is evident that randomized control trials and uniform ECPR protocols and guidelines are essential to improve evidence base practice and patient outcomes

Strategy for improvement of maternal health in Nepal

Maternal death is a public health problem in like Nepal. Still women have been facing the pregnancy related problems due to inaccessible and poor quality health service as well as a less available health service from skilled health workers. This is due to lack of essential knowledge about pregnancy and its complications. The main aim of this article is to evaluate and synthesize the current public health issues of maternal health of women in Nepal. Syntheses the problems, challenges and issues regarding maternal health and what can be done for the improvement of those problems with the evidence base practice. There should be making such a kind of policy, program, approaches and strategy from the state or the stockholder to tackle the health problem

Non Invasive Pain Management in Post Partum Mother Withevidence Based Practice Approach

Introduction: Pain is a sensation of discomfort that most post-partum mothers complain about, in the case of prolonged pain, the risk of post-partum blues is higher. The USAge of evidence based practice method gives a bigger opportunity for nurse and medical attendants to think more critically in making decisions and in performing the appropriate treatment in accordance with the patient\u27s problem and uniqueness. This research aimed to applicate management of non-invasive pain on post partum mother through the approach of evidence based practice. Method: This was a case-study, performed to client Mrs. A P1-1 A0 post sectio caesarea day 1 as there is an indication of suspect cepalo pelvis disproportion secondary arrest. Data were collected at maternity room, dr. Soebandi Regional General Hospital. Using interview, observation, and physical examination. Data analysis was conducted through a descriptive analysis. Result: Through a careful nursing, it is found out that pain location and spreading that generally spotted at the patient\u27s back during the contraction in the uterus, occurred around the shoulders when evidence-base practice is applied. The basic principle of applying an intervention to non invasive pain based on evidence–base practice are: cutaneous stimulation and distraction, while massaging area was set on the face, while the distraction media was interaction with the baby. Evaluation on evidence –based practice showed that pain is reduced to scale 2, while face and mobilitation become more relaxed. Discussion: Massage was intended to stimulated the production of endorphine and dinorphine that play an important roke to block the pain transmission through the descendent control system. Interaction with the baby was intended to function as a distraction media to dominate the incoming impuls into the ascendant control system,which further may close the gate of the pain transmitter. Both of the interventions were axpected to work synergically in reducing pain, since post-partum pain can be relieved more quickly when more than one technique are applied. Thus, to reduce post-partum pain, facial massage and interaction with the baby as non–invasive treatments are of important, respectively

Les interactions du quotidien comme ressources pour l’évaluation des capacités langagières

La démarche exposée, issue d’une méthodologie de type Evidence Base Practice (Durieux, Pasleau & Maillart, 2012 ; Maillart & Durieux, 2014, notamment) s’inscrit, à l’origine, dans une recherche personnelle d’efficience sur le plan des actes cliniques (bilans et thérapies des troubles du langage oral chez l’enfant) dans le contexte administratif suisse (canton de Fribourg)1. L’évaluation des capacités langagières de tout jeunes enfants confronte les interactants à des écueils de type contextuel que nous avons souhaité analyser (en référence au modèle d’analyse du discours : Bronckart, Bain, Schneuwly, Davaud & Pasquier, 1985), afin de les contourner. Dans ce cadre, nous décrivons un modèle d’évaluation des capacités langagières en 4 temps, en nous appuyant sur l’analyse d’interactions familiales. Nous exposons ensuite un mode d’interventions de type guidance, proposé aux parents. Nous concluons sur la nécessité pour le logopédiste/orthophoniste2 de définir une position méthodologique claire pour l’évaluation (Leloup, 2007) afin de conduire une démarche hypothético-déductive efficace menant à des hypothèses de diagnostic et des objectifs thérapeutiques

Stroke Outreach in the Lao Community

CNL Abstract A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern from SEA community leaders to qualify the need for resolutions. A two year-long, investigation and collaboration with inpatient and community healthcare resources resulted in no cost sustainable health fairs for the service area that focused on stroke, hypertension and heart failure education in multiple SEA languages. The goals were to 1) provide face to face stroke education, 2) educate patients on disease prevention and community resources, and 3) improve FAST stroke warning sign literacy to 75% in the service area. The implemented process is intended to serve as a model for future disparity health initiatives in this community and across the nation. The keywords used in the for this work included; hypertension management, health fairs, hypertension disparities, stroke disparities, healthcare literacy and language disparities

Using practice development methodology to develop children’s centre teams: Ideas for the future

The Children’s Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children’s Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children’s centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality

Using Organization Theory to Explore the Changing Role of Medical Libraries

This historical research review uses organization theory to describe and interpret the evolution of American hospitals, medical libraries, and the role of the professional librarian. Various organization theories are applied to explain changes in hospitals and medical libraries over time. The interaction between the organization and the environment as described in organization theory shaped the emergence of today\u27s information services. For readers unfamiliar with health sciences libraries, the study will provide a glimpse into the social forces that framed the development of this type of special library

Shifting pedagogical priorities in facilitating mixed methods research including postgraduate student’s reflections.

Teaching mixed methods research for quality improvement and translating evidence base practice to address meaningful change has become increasingly popular. In times of evidence-based and data-driven calls for improvement it is important to provide students with knowledge and skills about mixed methods research that will help with translation of research into practice. The literature identifies diverse pedagogical challenges that students face within mixed methods classrooms. Students are not usually equipped in both qualitative and quantitative approaches. The knowledge gap can result in deep pedagogical challenges compromising student’s ability to fully understand the mixed methods paradigm. Although we are shifting from a teacher centred (pedagogical) to a learner centred, self-directed approach (andragogical) student reluctance to engage with blackboard activities and critical appraisal of mixed methods design and papers persists.The present study explores the student perception about learning mixed methods research by collecting written reflections at the end of a mixed methods post graduate study day and across a post graduate module on mixed methods research. A reflective teaching-learning methodology was employed aligned to the self-inquiry model. Using a systematic framework for content data analysis, two distinct categories were revealed. These relate to ‘barriers’ and ‘enablers’ that influenced the quality of the learning event.  This yielded four themes including ‘grappling with mixed methods research’, ‘classroom challenges’ moving to ‘creative engagement with mixed methods’ and ‘pedagogic teacher –student interactions’. To tackle the myriad of challenges encountered, innovative teaching strategies and the sustainability of student centred approaches will be considered to lever up and empower the learning climate in mixed methods classrooms and build a pedagogical culture.