Cone‐Beam Computed Tomography and Interdisciplinary Dentofacial Therapy: An American Academy of Periodontology Best Evidence Review Focusing on Risk Assessment of the Dentoalveolar Bone Changes Influenced by Tooth Movement

Background: The aim of this systematic review is to evaluate whether cone‐beam computed tomography (CBCT) imaging can be used to assess dentoalveolar anatomy critical to the periodontist when determining risk assessment for patients undergoing orthodontic therapy using fixed or removable appliances. Methods: Both observational and interventional trials reporting on the use of CBCT imaging assessing the impact of orthodontic/dentofacial orthopedic treatment on periodontal tissues (i.e., alveolar bone) were included. Changes in the alveolar bone thickness and height around natural teeth as well as treatment costs were evaluated. MEDLINE (via PubMed) and EMBASE databases were searched for articles published in the English language, up to and including July 2016, and extracted data were organized into evidence tables. Results: Thirteen studies were included in this systematic review describing the positive or deleterious changes on the alveolar bone surrounding natural teeth undergoing orthodontic tooth movement or influenced by orthopedic forces through fixed appliances. Clinical recommendation summaries presenting the strengths and weaknesses of the evidence in terms of benefits and harms were generated. Conclusions: CBCT imaging can improve the periodontal diagnostic acumen regarding alveolar bone alterations influenced by orthodontic tooth movement and can help determine risk assessment prior to such intervention. Clinicians are also better informed to determine risk assessment and develop preventative or plan interceptive periodontal augmentation (soft tissue and/or bone augmentation) therapies for patients undergoing orthodontic tooth movement. These considerations are recognized as being especially critical for treatment approaches in patients where buccal tooth movement (expansion) is planned in the anterior mandible or involving the maxillary premolars.     

护士信息素养及循证护理能力对创新行为的影响研究

目的 提升护理管理学实践教学质量.方法 选择本科护理专业学生75人为研究对象,对护理管理学实践教学进行改革,即成立实践教学改革小组,明确实习目标和内容,采取业务讲座法、护理查房法、小组座谈法、案例讨论法、文件阅读法、走访护士法、情景模拟法等进行实践教学.结果 75名学生均认为教学改革有助于加深对护理管理学理论知识的理解,80%以上的学生认为教学改革增强了他们的学习兴趣、可促进自主学习、学会主动查阅资料、实习效果显著等.结论 护理管理学实践教学改革模式,可以加深学生对理论教学的理解,使实践教学与理论教学相辅相成,教学效果显著.     

护理人员预防术中获得性压力性损伤最佳证据应用障碍的质性研究

目的 深入了解护士应用预防术中获得性压力性损伤最佳证据的障碍因素,为实施压力性损伤干预提供参考。 方法 采用描述性质性研究方法,选取西部地区6所三级甲等医院手术室11名护士为研究对象,基于理论域框架制定访谈提纲,进行半结构式深度访谈,采用定向内容分析法对访谈资料进行分析。 结果 护士应用最佳证据的障碍因素分别为知识（最佳证据相关知识不足）;环境因素（特殊手术体位辅助工具不足、医院信息系统智能性欠佳）;动力和目标（患者及家属对预防压力性损伤的重视度较低,影响手术室护士积极性）;行为规范（工作流程有待完善）;结果的期望（手术室护士对实施最佳证据的效果缺乏信心）。 结论 影响术中获得性压力性损伤最佳证据在临床应用的障碍因素较多,需要科室在明确障碍因素的基础上,推进术中获得性压力性损伤最佳证据的临床应用。     

Best Practice Information Sheet: The Joanna Briggs Institute Best Practice Information Sheet: Nurse‐led interventions to reduce cardiac risk factors in adults

This Best Practice Information Sheet updates and supersedes an earlier publication of the Joanna Briggs Institute in 2005. The information that is contained in this publication is based upon a systematic review of six randomized clinical trials. Additional information has been derived from a second systematic review; thus, in total, the information is derived from 22 randomized controlled trials. The original references can be sourced from the systematic reviews. Coronary heart disease (CHD) is the major cause of illness in Western society and it is becoming increasingly important to establish effective strategies in order to reduce the incidence of CHD. Nurse‐led clinics are becoming more prominent in community settings and the importance of nurse interventions in the management of CHD and risk factor reduction is recognized in terms of improved health outcomes for patients. However, the variation in outcome measures and inconsistent findings between some studies make it difficult to draw firm conclusions.