scholarly journals Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 4
Author(s):  
Carol A. Fairfield ◽  
David G. Smithard
Keyword(s):  
Acute Phase ◽  
Best Practice ◽  
Evidence Base ◽  
Post Stroke ◽  
Effortful Swallow ◽  
The Us ◽  
Screening Assessment ◽  
The Uk ◽  
Management Of Dysphagia ◽  
The Impact

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

Infection control: current status. risks, research, rules and recycling

2021 ◽  
Vol 14 (2) ◽  
pp. 59-66
Author(s):  
Jennifer Haworth ◽  
Jonathan Sandy ◽  
Anthony J Ireland
Keyword(s):  
Infection Control ◽  
Best Practice ◽  
Mainland China ◽  
Current Status ◽  
Infectious Agents ◽  
Emerging Infections ◽  
Healthcare Waste ◽  
Control Procedures ◽  
The Uk ◽  
The Impact

We are living through a period of immense change following the outbreak of the COVID-19 pandemic in mainland China in December 2019. Even before the pandemic, the cost of managing healthcare-associated infections in the UK was considerable. The risk of acquiring any infection from the dental environment must be reduced to a minimum. As we have observed in recent years, new infectious agents emerge frequently, and the dental profession must be ready to respond appropriately and quickly. Orthodontic practice presents unique challenges in relation to infection control procedures. The impact of healthcare waste on the environment must also be considered. CPD/Clinical Relevance: This paper describes the range of infectious agents posing a risk to dental team members and patients. The aim is to place the recent coronavirus pandemic in the context of other recent emerging infections. Some of the latest research regarding infection control procedures is reviewed. Current best practice is described.

Countering Violent Extremism in Canada and Abroad

2018 ◽  
Author(s):  
Nora Abdelrahman Ibrahim
Keyword(s):  
Best Practice ◽  
Unintended Consequences ◽  
Lessons Learned ◽  
Policy And Practice ◽  
Far Right ◽  
Significant Development ◽  
The Us ◽  
Violent Extremism ◽  
Recent Trends ◽  
The Uk

Terrorism and violent extremism have undoubtedly become among the top security concerns of the 21st century. Despite a robust agenda of counterterrorism since the September 11, 2001 attacks, the evolution of global terrorism has continued to outpace the policy responses that have tried to address it. Recent trends such as the foreign fighter phenomenon, the rampant spread of extremist ideologies online and within communities, and a dramatic increase in terrorist incidents worldwide, have led to a recognition that “traditional” counterterrorism efforts are insufficient and ineffective in combatting these phenomena. Consequently, the focus of policy and practice has shifted towards countering violent extremism by addressing the drivers of radicalization to curb recruitment to extremist groups. Within this context, the field of countering violent extremism (CVE) has garnered attention from both the academic and policy-making worlds. While the CVE field holds promise as a significant development in counterterrorism, its policy and practice are complicated by several challenges that undermine the success of its initiatives. Building resilience to violent extremism is continuously challenged by an overly securitized narrative and unintended consequences of previous policies and practices, including divisive social undercurrents like Islamophobia, xenophobia, and far-right sentiments. These by-products make it increasingly difficult to mobilize a whole of society response that is so critical to the success and sustainability of CVE initiatives. This research project addresses these policy challenges by drawing on the CVE strategies of Canada, the US, the UK, and Denmark to collect best practice and lessons learned in order to outline a way forward. 

scholarly journals Post QALY: Scientific Approaches to Real World Formulary Decision Making

2020 ◽  
Vol 11 (2) ◽  
pp. 19
Author(s):  
Paul Langley ◽  
Stephen McKenna
Keyword(s):  
Decision Making ◽  
Medical Devices ◽  
Evidence Base ◽  
Pharmaceutical Products ◽  
Normal Science ◽  
Value Assessment ◽  
Scientific Methods ◽  
Article Type ◽  
The Us ◽  
The Uk

The purpose of this anniversary supplement for Innovations in Pharmacy is to consider and / or propose modern, scientific methods for determining the evidence base for the fair pricing and accessibility of pharmaceutical products and medical devices. At present, such decisions are based on the construction of imaginary value assessment models that fail to meet the standards of normal science. Such a business model has been adopted by the Institute for Clinical and Economic Review (ICER) in the US, NICE in the UK and in a number of other countries.   Article Type: Call for Papers

Minimising medical litigation: a review of key tort and legal reforms

2009 ◽  
Vol 5 (2) ◽  
pp. 179-233 ◽  
Author(s):  
Harold Tan
Keyword(s):  
Medical Malpractice ◽  
Developed Countries ◽  
Economic Sustainability ◽  
Legal Reforms ◽  
The Us ◽  
Tort System ◽  
Medical Litigation ◽  
Tort Reforms ◽  
The Uk ◽  
The Impact

The traditional tort system in medical malpractice is increasingly perceived as being incapable of addressing the mismatch between claims and negligent injuries. Tort reforms have been introduced in various developed countries in an attempt to bring about greater fairness and economic sustainability in the compensation of medical injuries and to reduce the overall rate of medical litigation. This paper reviews the key tort reforms that have been used in various countries, notably the US and the UK, and discusses the arguments that had been put forth by advocates and opponents of such reforms. The impact of these tort reforms, where studied and available, is also reviewed and discussed in the paper.

Strong governance: a result of evolutionary and revolutionary processes

2014 ◽  
Vol 4 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Lorna Collins ◽  
Ken McCracken ◽  
Barbara Murray ◽  
Martin Stepek
Keyword(s):  
Family Business ◽  
Best Practice ◽  
Family Dynamics ◽  
Family Businesses ◽  
Formal Structure ◽  
Governance Mechanisms ◽  
Content Type ◽  
The Family ◽  
The Uk ◽  
The Impact

Purpose – This paper is the first in a regular series of articles in JFBM that will share “a conversation with” thought leaders who are active in the family business space. The world of family business is, like many other arenas, constantly evolving and as the authors learn more about how and why families “do business” the approaches and tools for working with them also evolve. The purpose of this paper is to stimulate further new research in areas that practically affect family businesses and to “open the door” to practical insights that will excite researchers and provide impetus for new and exciting study. The specific purpose of this paper is to explore “what is strong governance.” There has been much interest in governance lately yet there is a tendency to treat governance in a formulaic way such that, at the moment, the notion that every family business must have a family council or a formal structure in order to be considered “effective” and “successful” predominates. The authors’ panel challenges and discusses this notion drawing on the experience and knowledge as family business advisors, consultants and owners. Design/methodology/approach – The impetus for this particular conversation is a result of a brainstorming conversation that Lorna Collins and Barbara Murray held in February 2014 where they focussed on “how JFBM can encourage and stimulate researchers to engage in aspects of research that makes a difference to the family business in a practical way.” This paper reports a conversation between Barbara Murray (Barbara), Ken McCracken (Ken) and Martin Stepek (Martin), three leading lights in the UK family business advising space, all of whom have been involved in running or advising family businesses for more than three decades, held in August 2015. The conversation was held via telephone and lasted just over 60 minutes. Lorna Collins acted as moderator. Findings – Strong governance is not just about instituting a “family council” or embedding formal governance mechanisms in a family business. Evolutionary adaption by family members usually prevails such that any mechanism is changed and adapted over time to suit and fit the needs of the family business. Many successful family businesses do not have recognized “formal” governance mechanisms but, it is contended, they are still highly successful and effective. Future areas of research in governance are also suggested. Originality/value – This paper contributes to the family business discourse because the debate it reports challenges the basic assumptions upon which much consulting and advisory practice is conducted. It also challenges the notion of “best practice” and what is “new best practice” and how is it that any “best practice” is determined to be “best.” Furthermore, the panel provides insights in to the “impact of family dynamics on governance” and “the impact of family dynamics on advisors.” The paper content is original in that it provides an authentic and timely narrative between active family business practitioners who are also scholars and owners.

scholarly journals Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN

ESMO Open ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. e000258 ◽  
Author(s):  
Elena Pallari ◽  
Anthony W Fox ◽  
Grant Lewison
Keyword(s):  
Practice Guidelines ◽  
Western Europe ◽  
Statistical Tests ◽  
Geographic Location ◽  
Basic Research ◽  
Research Impact ◽  
Evidence Base ◽  
Effective Decision Making ◽  
The Uk ◽  
The Impact

BackgroundThis is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).MethodsA total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.ResultsESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.ConclusionsWe showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

Early Intervention

2016 ◽  
Author(s):  
Michael Schillig
Keyword(s):  
Early Intervention ◽  
Financial Institutions ◽  
Financial Stability ◽  
Corrective Action ◽  
Viable Alternative ◽  
Prompt Corrective Action ◽  
Systemic Risks ◽  
The Us ◽  
The Uk ◽  
The Impact

The Financial Stability Board recommended that all national supervisors should have the mandate and powers to identify risks and intervene early in order to prevent unsound practices and take appropriate measures to reduce the impact of potential stresses on financial institutions and to safeguard against systemic risks. Accordingly, the BRRD and SRM contain new powers for the competent authorities to intervene early before an institution’s financial and economic situation has deteriorated to a point where resolution is the only viable alternative. The chapter starts with some theoretical reflections, focusing on the incentives of the actors involved. It then discusses the early intervention framework under BRRD and SRM and national transposition in the UK and Germany. It also covers the US prompt corrective action framework and early remediation under Dodd–Frank.

Sources of Increasing Inequality

2021 ◽  
pp. 172-190
Author(s):  
Francis Teal
Keyword(s):  
Two Dimensions ◽  
Labour Markets ◽  
Living Standards ◽  
The Political ◽  
Poor Countries ◽  
Unskilled Labour ◽  
The Us ◽  
The Uk ◽  
Rich Countries ◽  
The Impact

While all the evidence we have points to the rising living standards for most of the very poorest, the wages of unskilled labour in poor countries remain a fraction of those in rich countries. Those potential workers are seen as a threat to the living standards of the unskilled in rich countries and the political impetus to limit their access to those labour markets has been, and remains, one of the most potent issue in the politics of rich countries. This aversion to immigration as a threat to the wages of the unskilled often transmutes into a hostility to trade, as goods, which use a lot of unskilled labour, can be imported more cheaply. Both immigration and trade are seen as a threat to the unskilled. Two dimensions of this threat are examined in this chapter—the impact of Chinese exports on wages in the US and the impact of immigration on the UK economy.

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