How to diagnose and treat work‑related asthma. Key messages for clinical practice from the American College of Chest Physicians Consensus Statement

2009 ◽  
Vol 119 (10) ◽  
pp. 660-666 ◽  
Author(s):  
Susan M. Tarlo ◽  
Gary M. Liss ◽  
Paul D. Blanc
Keyword(s):  
Clinical Practice ◽  
Consensus Statement ◽  
Work Related

scholarly journals Conflicts of Interest in Clinical Practice Guidelines: Accelerating an Evolution. An Endocrine Society Consensus Statement*

2018 ◽  
Vol 103 (12) ◽  
pp. 4339-4342 ◽  
Author(s):  
Christopher R McCartney ◽  
Clifford J Rosen
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Development Process ◽  
Consensus Statement ◽  
Conflicts Of Interest ◽  
Best Interests ◽  
Endocrine Society ◽  
Open Payments

Abstract An analysis of the Endocrine Society’s clinical practice guidelines (CPGs) published from 2010 to 2017—presented by Irwig et al. in the current issue of The Journal of Endocrinology and Metabolism—suggested that the Endocrine Society met five of seven National Academy of Medicine (NAM) standards concerning financial conflicts of interest in CPGs. As current contributors to the Endocrine Society’s CPG efforts, we offer additional context related to the 2011 NAM standards and the current environment concerning industry support in medicine, and we comment on the nature of industry support received by the Society’s CPG authors according to Irwig and colleagues’ analysis of the Centers for Medicare and Medicaid Services’ Open Payments database. Perhaps most importantly, we outline the Society’s recent and ongoing efforts to enhance the value of its CPGs. Such efforts include a 2016 revision of CPG author conflict of interest rules—a change that was invisible to the investigatory methods used by Irwig et al.—in addition to other processes designed to enhance CPG objectivity. We conclude our commentary by recognizing that good-faith attempts to enhance transparency and to reduce conflicts of interest (real or apparent) in CPGs will ultimately serve the best interests of patients and providers; we confirm the Endocrine Society’s resolute commitment to providing high-quality, evidence-based clinical guidance via a CPG development process that faithfully accords with current CPG best practices.

scholarly journals 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S410-S411
Author(s):  
Ronald G Nahass ◽  
Angelo Giordano ◽  
Edward J McManus
Keyword(s):  
Clinical Practice ◽  
Nursing Facilities ◽  
Research Support ◽  
Skilled Nursing ◽  
Vaccination Rates ◽  
Epidemic Curve ◽  
Work Related ◽  
Molecular Tests ◽  
Provider Practice ◽  
The Waves

Abstract Background ID Care (IDC) is a large, 43 physician, 74 provider, practice that treats patients in 16 acute care hospitals (ACH) and 120 skilled nursing facilities (SNF) in NJ. March 4, 2021 was the first day a patient with COVID19 seen by IDC. Over the subsequent year IDC evaluated, treated, and tested over 23,000 persons for COVID19. Patients were seen in 2 distinct times - wave 1 (W1) March 5-August 31 and wave 2 (W2) September 1 to March 4. We compare the experience of these 2 waves and report on the year of COVID19 at IDC. Methods The administrative data base for IDC was queried for demographic, visit and testing information. A survey of providers was performed to capture incidence of COVID19 and vaccination rates. Daily census logs were used to create epi curves. Comparisons between waves were performed using student T Test or X2. Results Table 1 provides the comparisons between waves. More patients were seen in W2, however, the number of visits per patient was less, consistent with a shorter length of stay. Fewer patients were seen in SNF in W2 compared to W1. The age and sex distribution between the waves were the same. A total of 8741 molecular tests were performed. Test positivity peaked the week of December 31 at 6.99% and dropped to 0% by May 1 consistent with vaccination and the NJ epidemic curve. During the year of COVID19, 6/74 (8%) clinicians were infected with SARSCoV2. All recovered. Infections in providers were not clearly work-related exposures. 73/74 clinicians were vaccinated. Table 1. Demographics For the Year in COVID19 at ID Care Figure 1. Test Positivity Rate for ID Care Conclusion The year of COVID19 occurred in 2 distinct waves. W1 was short and intense. The age and gender distributions were the same between the waves. Even though wave 2 was numerically greater, the cases in SNF were statistically less than the first wave likely from improved IP practice initiated in W1. The numbers of visits per patient, a surrogate for LOS, was statistically less in W2. The decline in test positivity paralleled deployment of vaccination. Despite an intensity of exposure of 158 patients/provider or 1198 visits/provider to SARSCoV2 infected persons only 8% of the clinician staff were infected. ID clinical practice can use electronic databases to help describe regional outbreaks of transmissible disease giving additional perspective across the care continuum. A more usable standard tool would enhance this capacity. Disclosures Ronald G. Nahass, MD, Abbvie (Grant/Research Support, Speaker's Bureau)Alkermes (Grant/Research Support)Gilead (Grant/Research Support, Speaker's Bureau)Merck (Grant/Research Support, Speaker's Bureau)

scholarly journals Diagnosing and managing work‐related mental health conditions in general practice: new Australian clinical practice guidelines

2019 ◽  
Vol 211 (2) ◽  
pp. 76-81 ◽  
Author(s):  
Danielle Mazza ◽  
Samantha P Chakraborty ◽  
Bianca Brijnath ◽  
Heather Nowak ◽  
Cate Howell ◽  
...  
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Work Related

scholarly journals Advances in Clinical Decision Support: Highlights of Practice and the Literature 2015-2016

2017 ◽  
Vol 26 (01) ◽  
pp. 125-132
Author(s):  
R. A. Jenders
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Negative Impact ◽  
Clinical Care ◽  
Clinical Decision ◽  
Theory Approach ◽  
Research And Practice ◽  
Work Related ◽  
Active Research

Summary Introduction: Advances in clinical decision support (CDS) continue to evolve to support the goals of clinicians, policymakers, patients and professional organizations to improve clinical practice, patient safety, and the quality of care. Objectives: Identify key thematic areas or foci in research and practice involving clinical decision support during the 2015-2016 time period. Methods: Thematic analysis consistent with a grounded theory approach was applied in a targeted review of journal publications, the proceedings of key scientific conferences as well as activities in standards development organizations in order to identify the key themes underlying work related to CDS. Results: Ten key thematic areas were identified, including: 1) an emphasis on knowledge representation, with a focus on clinical practice guidelines; 2) various aspects of precision medicine, including the use of sensor and genomic data as well as big data; 3) efforts in quality improvement; 4) innovative uses of computer-based provider order entry (CPOE) systems, including relevant data displays; 5) expansion of CDS in various clinical settings; 6) patient-directed CDS; 7) understanding the potential negative impact of CDS; 8) obtaining structured data to drive CDS interventions; 9) the use of diagnostic decision support; and 10) the development and use of standards for CDS. Conclusions: Active research and practice in 2015-2016 continue to underscore the importance and broad utility of CDS for effecting change and improving the quality and outcome of clinical care.

An evidence-based consensus statement on the role and application of endosonography in clinical practice

Endoscopy ◽  
2009 ◽  
Vol 41 (11) ◽  
pp. 979-987 ◽  
Author(s):  
F. Maluf-Filho ◽  
C. Dotti ◽  
B. Halwan ◽  
A. Queiros ◽  
C. Kupski ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Consensus Statement ◽  
Evidence Based

Sexual Abuse Within Employment Settings: A Comparison of Work-Related, Intra- and Extra-Familial Child Molesters

Sexual Abuse ◽  
2017 ◽  
Vol 31 (5) ◽  
pp. 524-542
Author(s):  
Diana M. Falkenbach ◽  
Antonia Foehse ◽  
Elizabeth Jeglic ◽  
Cynthia Calkins ◽  
Linsey Raymaekers
Keyword(s):  
Sexual Abuse ◽  
Clinical Practice ◽  
Child Sexual Abuse ◽  
Sex Offenders ◽  
Child Molesters ◽  
Future Research ◽  
Victim Selection ◽  
Work Related ◽  
Institutional Settings ◽  
Similarities And Differences

Child sexual abuse (CSA) is a serious problem not only in the community but also in institutional settings such as youth-serving organizations, churches, and schools. Although research has started to examine the problem of abuse in institutional settings, there remains a dearth of information about the nature and context of CSA in different employment settings, including those that do not specifically cater to children. In addition, research on the similarities and differences between perpetrators who work with children and other sex offenders is scarce. As such, the present study compared offenders on variables relating to financial/employment lifestyle stability, risk/dangerousness level, abuse opportunity, and victim selection. Data revealed that child abusers who worked with children tended to be better educated, were less likely to be married, had fewer nonsexual convictions, and were more likely to abuse male post-pubescent children compared with intra- and extra-familial offenders who did not work with children. Implications for future research, prevention of CSA, and clinical practice are discussed.

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