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ABSTRACT: BACKGROUND: A thorough understanding of the literature generated from research in care homes is required to support evidence-based commissioning and delivery of healthcare. So far this research has not been compiled or described. We set out to describe the extent of the evidence base derived from randomized controlled trials conducted in care homes. METHODS: A systematic mapping review was conducted of the randomized controlled trials (RCTs) conducted in care homes. Medline was searched for "Nursing Home", "Residential Facilities" and "Homes for the Aged"; CINAHL for "nursing homes", "residential facilities" and "skilled nursing facilities"; AMED for "Nursing homes", "Long term care", "Residential facilities" and "Randomized controlled trial"; and BNI for "Nursing Homes", "Residential Care" and "Long-term care". Articles were classified against a keywording strategy describing: year and country of publication; randomization, stratification and blinding methodology; target of intervention; intervention and control treatments; number of subjects and/or clusters; outcome measures; and results. RESULTS: 3226 abstracts were identified and 291 articles reviewed in full. Most were recent (median age 6 years) and from the United States. A wide range of targets and interventions were identified. Studies were mostly functional (44 behaviour, 20 prescribing and 20 malnutrition studies) rather than disease-based. Over a quarter focussed on mental health. CONCLUSIONS: This study is the first to collate data from all RCTs conducted in care homes and represents an important resource for those providing and commissioning healthcare for this sector. The evidence-base is rapidly developing. Several areas - influenza, falls, mobility, fractures, osteoporosis - are appropriate for systematic review. For other topics, researchers need to focus on outcome measures that can be compared and collated. 相似文献
23.
Purpose
Chance fractures are an uncommon spine injury in the paediatric population. As such there is a relative paucity of evidence in the literature to guide management decisions. We present our single centre experience in the operative management of these injuries.Methods
All patients presenting to a tertiary paediatric trauma centre between 2000 and 2008 were included. Retrospective analysis of clinical (SRS-22 and Oswestry) and radiological outcomes was undertaken.Results
Twelve patients underwent operative stabilization of a Chance type injury. Radiological and clinical outcome measures demonstrated excellent outcomes in the majority of patients with no significant complications.Conclusions
Operative management of paediatric chance injuries with instrumentation results in excellent clinical and radiological outcomes. 相似文献24.
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Pierre‐Antoine Gourraud PhD Roland G. Henry PhD Bruce A. C. Cree MD PhD MAS Jason C. Crane PhD Antoine Lizee MS Marram P. Olson BS Adam V. Santaniello BSc Esha Datta MS Alyssa H. Zhu MSc Carolyn J. Bevan MD MS Jeffrey M. Gelfand MD MAS Jennifer S. Graves MD PhD Douglas S. Goodin MD Ari J. Green MD MCR H.‐Christian von Büdingen MD Emmanuelle Waubant MD PhD Scott S. Zamvil MD PhD Elizabeth Crabtree‐Hartman MD Sarah Nelson PhD Sergio E. Baranzini PhD Stephen L. Hauser MD 《Annals of neurology》2014,76(5):633-642
We present a precision medicine application developed for multiple sclerosis (MS): the MS BioScreen. This new tool addresses the challenges of dynamic management of a complex chronic disease; the interaction of clinicians and patients with such a tool illustrates the extent to which translational digital medicine—that is, the application of information technology to medicine—has the potential to radically transform medical practice. We introduce 3 key evolutionary phases in displaying data to health care providers, patients, and researchers: visualization (accessing data), contextualization (understanding the data), and actionable interpretation (real‐time use of the data to assist decision making). Together, these form the stepping stones that are expected to accelerate standardization of data across platforms, promote evidence‐based medicine, support shared decision making, and ultimately lead to improved outcomes. Ann Neurol 2014;76:633–642 相似文献
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Alexander J. Blood Christina M. Fischer Liliana E. Fera Taylor E. MacLean Katelyn V. Smith Jacqueline R. Dunning Joshua W. Bosque-Hamilton Samuel J. Aronson Thomas A. Gaziano Calum A. MacRae Lina S. Matta Ana A. Mercurio-Pinto Shawn N. Murphy Benjamin M. Scirica Kavishwar Wagholikar Akshay S. Desai 《Clinical cardiology》2020,43(1):4-13
28.
Girish M. Nair Pablo B. Nery Calum J. Redpath Buu-Khanh Lam David H. Birnie 《The Canadian journal of cardiology》2014
The purpose of this review is to understand the epidemiology, clinical features, etiopathogenesis, and management of atrioesophageal fistula (AEF) after atrial fibrillation (AF) ablation. The incidence of AEF after AF ablation is 0.015%-0.04%. The principal clinical features include fever, dysphagia, upper gastrointestinal bleeding, sepsis, and embolic strokes. The close proximity of the esophagus to the posterior left atrial wall is responsible for esophageal injury during ablation. Prophylactic proton pump inhibitors, esophageal temperature monitoring, visualization of the esophagus during catheter ablation, esophageal protection devices, and avoidance of energy delivery in close proximity to the esophagus play an important role in preventing esophageal injury. Early surgical repair or esophageal stenting are the mainstay of treatment. Eliminating esophageal injury during AF ablation is of utmost importance in preventing AEF. A high index of suspicion and early intervention is necessary to prevent fatal outcomes. 相似文献
29.
Javier I Quezada-Marín Alfred K Lam Atsushi Ochiai Robert D Odze Kay M Washington Masashi Fukayama Massimo Rugge David S Klimstra Iris D Nagtegaal Puay-Hoon Tan Mark J Arends John R Goldblum Ian A Cree Manuel Salto-Tellez 《Histopathology》2020,77(3):340-350
Molecular biomarkers have come to constitute one of the cornerstones of oncological pathology. The method of classification not only directly affects the manner in which patients are diagnosed and treated, but also guides the development of drugs and of artificial intelligence tools. The aim of this article is to organise and update gastrointestinal molecular biomarkers in order to produce an easy-to-use guide for routine diagnostics. For this purpose, we have extracted and reorganised the molecular information on epithelial neoplasms included in the 2019 World Health Organization classification of tumours. Digestive system tumours, 5th edn. 相似文献