This document discusses evidence-based practice in healthcare. It begins by asking whether evidence-based practice or practice-based evidence is more important. It then discusses the need for evidence to make informed healthcare decisions and defines what counts as strong evidence, such as results from randomized controlled trials. The document examines where strong evidence can be found, such as in systematic reviews and meta-analyses of multiple studies. It emphasizes using the best available evidence to make decisions that suit each individual patient.
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
Janet Schnall's presentation about Evidence Based Nursing Resources at our free monthly webcast. Recording available at https://webmeeting.nih.gov/p96958659/
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
Janet Schnall's presentation about Evidence Based Nursing Resources at our free monthly webcast. Recording available at https://webmeeting.nih.gov/p96958659/
At the end of this presentation you will be able to:
Define evidence-based practice
Describe process & outline steps of EBP
Understand PICO elements & search strategy
Identify resources to support EBP
The focus of this presentation is nursing practice, although it is still of value to physicians and other health care professionals.
Mentorship for Medical and Healthcare Careers: obstetrics & gynecologyVandna Jerath, MD
Vandna Jerath, MD discusses how to obtain a mentor in medicine to optimize your chances of getting into medical or osteopathic school, physician assistant school, or nursing school.
Learning Objectives:
Learn why it is a privilege to be a physician and a general overview of obstetrics & gynecology.
Learn the pros and cons of a career in medicine and obstetrics & gynecology.
Learn the education and training required for a career in medicine.
Learn how to cultivate a passion and purpose that will begin a career path in medicine and healthcare.
Learn how to pick ideal mentors, shadowing experiences, develop essential skills, and maximize mentorships.
Learn the basic medical career options, appropriate healthcare questions to ask, current healthcare hot topics, benefits of research, how to engage with helpful medical mentors, and importance of building relationships.
Learn how to share your authentic selves in the application and interview process to optimize chances of acceptance to medical school, osteopathic school, physician assistant school, dental school, or nursing school.
Clinical Questions types .
A Hierarchy of Preprocessed Evidence.
EBM definition and value.
Knowledge and Skills Necessary for Optimal Evidence-Based Practice.
Basic computer and internet knowledge for electronic searching of the literature
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
Siloed thinking, practices and technology greatly undermines potential to advance research, treatments and cures for most diseases. This is a shot at a vision to address this challenge, starting with a disease called primary ciliary dyskinesia (PCD).
Medical and scientific advances and ethicskeshavpodanobp
Medical science is the branch of science focused on understanding how the human body works, preventing and diagnosing diseases, and finding ways to treat illnesses and injuries. It involves studying the body's systems, cells, and molecules to develop treatments that can help people live healthier lives. Medical advancements include things like new medicines, vaccines, surgical techniques, and diagnostic tools that help doctors provide better care for their patients. Overall, medical science aims to improve people's health and well-being by finding ways to prevent, diagnose, and treat diseases and injuries.
At the end of this presentation you will be able to:
Define evidence-based practice
Describe process & outline steps of EBP
Understand PICO elements & search strategy
Identify resources to support EBP
The focus of this presentation is nursing practice, although it is still of value to physicians and other health care professionals.
Mentorship for Medical and Healthcare Careers: obstetrics & gynecologyVandna Jerath, MD
Vandna Jerath, MD discusses how to obtain a mentor in medicine to optimize your chances of getting into medical or osteopathic school, physician assistant school, or nursing school.
Learning Objectives:
Learn why it is a privilege to be a physician and a general overview of obstetrics & gynecology.
Learn the pros and cons of a career in medicine and obstetrics & gynecology.
Learn the education and training required for a career in medicine.
Learn how to cultivate a passion and purpose that will begin a career path in medicine and healthcare.
Learn how to pick ideal mentors, shadowing experiences, develop essential skills, and maximize mentorships.
Learn the basic medical career options, appropriate healthcare questions to ask, current healthcare hot topics, benefits of research, how to engage with helpful medical mentors, and importance of building relationships.
Learn how to share your authentic selves in the application and interview process to optimize chances of acceptance to medical school, osteopathic school, physician assistant school, dental school, or nursing school.
Clinical Questions types .
A Hierarchy of Preprocessed Evidence.
EBM definition and value.
Knowledge and Skills Necessary for Optimal Evidence-Based Practice.
Basic computer and internet knowledge for electronic searching of the literature
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
Siloed thinking, practices and technology greatly undermines potential to advance research, treatments and cures for most diseases. This is a shot at a vision to address this challenge, starting with a disease called primary ciliary dyskinesia (PCD).
Medical and scientific advances and ethicskeshavpodanobp
Medical science is the branch of science focused on understanding how the human body works, preventing and diagnosing diseases, and finding ways to treat illnesses and injuries. It involves studying the body's systems, cells, and molecules to develop treatments that can help people live healthier lives. Medical advancements include things like new medicines, vaccines, surgical techniques, and diagnostic tools that help doctors provide better care for their patients. Overall, medical science aims to improve people's health and well-being by finding ways to prevent, diagnose, and treat diseases and injuries.
. Evidence-based dentistry (EBD) is the integration and interpretation of the available current research evidence, combined with personal experience. It allows dentists, as well as academics researchers, to keep update of the new developments and to make decisions that should improve their clinical practice.
Evidence based decision making in periodonticsHardi Gandhi
INTRODUCTION TO EVIDENCE BASED DENTISTRY
EVIDENCE BASED PERIODONTOLOGY
NEED, PRINCIPLES, GOALS AND ADVANTAGES OF EBDM
SKILLS NEEDED FOR EBDM
ASSESING THE EVIDENCE
INCORPORATING INTO THE PRACTICE
This presentation focuses on informed decision making in clinical practice making use of evidence based practice. It addresses the use of PICO to formulate clinical question, searching the evidence/literature, critically appraising the evidence, and application of the evidence to improve the quality of clinical practice
Concise explaining of Evidence-Based Medicine and discussing the following: 1-What is Evidence-Based Medicine?
2-Why Evidence-based Medicine?
3-Options for changing clinicians' practice behaviour
4- EBM Process- Five Steps
5-Seven alternatives to evidence-based medicine
April 28, 2017
Transparency is a relatively new concept to the world of health and health care, considering that just a few short decades ago we were still in the throes of a “doctor-knows-best” model. Today, however, transparency is found on almost every short list of solutions to a variety of health policy problems, ranging from conflicts of interest to rising drug costs to promoting efficient use of health care resources, and more. Doctors are now expected to be transparent about patient diagnoses and treatment options, hospitals are expected to be transparent about error rates, insurers about policy limitations, companies about prices, researchers about data, and policymakers about priorities and rationales for health policy intervention. But a number of important legal and ethical questions remain. For example, what exactly does transparency mean in the context of health, who has a responsibility to be transparent and to whom, what legal mechanisms are there to promote transparency, and what legal protections are needed for things like privacy, intellectual property, and the like? More specifically, when can transparency improve health and health care, and when is it likely to be nothing more than platitude?
This conference aimed to: (1) identify the various thematic roles transparency has been called on to play in American health policy, and why it has emerged in these spaces; (2) understand when, where, how, and why transparency may be a useful policy tool in relation to health and health care, what it can realistically be expected to achieve, and when it is unlikely to be successful, including limits on how patients and consumers utilize information even when we have transparency; (3) assess the legal and ethical issues raised by transparency in health and health care, including obstacles and opportunities; (4) learn from comparative examples of transparency, both in other sectors and outside the United States. In sum, we hope to reach better understandings of this health policy buzzword so that transparency can be utilized as a solution to pressing health policy issues where appropriate, while recognizing its true limitations.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/2017-annual-conference
Evidence-Based Medicine - Overview
- How to be a good doctor - A step in Health promotion
- By Ibrahim A. Abdelhaleem - Zagazig Medical Research Society (ZMRS)
Workshop for Family Medicine Residents at the University of Calgary on Evidence-Based Medicine, the PICO approach to critical appraisal, and the need for skepticism
Traditional RCT
Quasi-experiments
Cohort studies
Case Control Studies
Pragmatic trials
Non-inferiority trials
Complex interventions
The Trend statement
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
19. Evidence-based pratice
• Why do we need evidence?
• What is evidence?
• What counts as evidence?
• Where do we find evidence?
20. Why do we need evidence?
• Opinion
• Experience
• Authority
• Expertise
• Commercial companies
• Budgets
21.
22. We used to be certain about
• Blood letting
• Grommets for “glue ear”
• Episiotomy
• Lignocaine to prevent cardiac arrest post heart attack
• Egg white and Oxygen to heal pressure sores
• Vigorous rubbing of the buttocks with alcohol to prevent pressure sores
31. What is evidence?
• a thing or things helpful in forming a conclusion or judgment
• that which tends to prove or disprove something; ground for
belief; proof.
• something that makes plain or clear; an indication or sign
32. What counts as evidence?
• The outcome of systematic enquiry
39. Meta analysis
• Meta-analysis is a statistical procedure that integrates the
results of several independent studies considered to be
“combinable.”
• Well conducted meta-analyses allow a more objective
appraisal of the evidence than traditional narrative reviews,
provide a more precise estimate of a treatment effect, and
may explain heterogeneity between the results of individual
studies.
• Ill conducted meta-analyses, on the other hand, may be
biased owing to exclusion of relevant studies or inclusion of
inadequate studies.
42. Regression towards the mean
• In statistics, regression toward (or to) the mean is the
phenomenon that if a variable is extreme on its first
measurement, it will tend to be closer to the average on its
second measurement—and if it is extreme on its second
measurement, it will tend to have been closer to the
average on its first.
43.
44.
45.
46. Evidence-based practice
• the practice of health care in which the practitioner
systematically finds, appraises, and uses the most
current and valid research findings as the basis for
clinical decisions. The term is sometimes used to
denote evidence-based medicine specifically but can
also include other specialties, such as evidence-
based nursing, pharmacy, and dentistry.
47. Evidence-based medicine
• The judicious use of the best current evidence in making
decisions about the care of the individual patient.
48. Acceptable definition of EBP?
• an approach to decision making in which the clinician uses
the best evidence available, in consultation with the patient,
to decide upon the option which suits the patient best. (Muir
Gray)
49. Where do we find evidence?
• Evidence synthesis databases