3,974 research outputs found
Editor's Choice -- European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma
No full textOBJECTIVE: The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with vascular trauma with the aim of assisting physicians in selecting the optimal management strategy.METHODS: The guidelines are based on scientific evidence completed with expert opinion. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated. The recommendations are graded according to the ESVS evidence grading system, where the strength (class) of each recommendation is graded from I to III, and the letters A to C mark the level of evidence.RESULTS: A total of 105 recommendations have been issued on the following topics: general principles for vascular trauma care and resuscitation including technical skill sets, bleeding control and restoration of perfusion, graft materials, and imaging; management of vascular trauma in the neck, thoracic aorta and thoracic outlet, abdomen, and upper and lower extremities; post-operative considerations after vascular trauma; and paediatric vascular trauma. In addition, unresolved vascular trauma issues and the patients' perspectives are discussed.CONCLUSION: The ESVS clinical practice guidelines provide the most comprehensive, up to date, evidence based advice to clinicians on the management of vascular trauma
Incorporating patient preferences in the management of multiple long-term conditions: is this a role for clinical practice guidelines?
No full textBackground: Clinical practice guidelines provide an evidence-based approach to managing single chronic conditions, but their applicability to multiple conditions has been actively debated. Incorporating patient-preference recommendations and involving consumers in guideline development may enhance their applicability, but further understanding is needed. Objectives: To assess guidelines that include recommendations for comorbid conditions to determine the extent to which they incorporate patient-preference recommendations; use consumer-engagement processes during development, and, if so, whether these processes produce more patient-preference recommendations; and meet standard quality criteria, particularly in relation to stakeholder involvement. Design: A review of Australian guidelines published from 2006 to 2014 that incorporated recommendations for managing comorbid conditions in primary care. Document analysis of guidelines examined the presence of patient-preference recommendations and the consumer-engagement processes used. The Appraisal of Guidelines for Research and Evaluation instrument was used to assess guideline quality. Results: Thirteen guidelines were reviewed. Twelve included at least one core patient-preference recommendation. Ten used consumer-engagement processes, including participation in development groups (seven guidelines) and reviewing drafts (ten guidelines). More extensive consumer engagement was generally linked to greater incorporation of patient-preference recommendations. Overall quality of guidelines was mixed, particularly in relation to stakeholder involvement. Conclusions: Guidelines do incorporate some patient-preference recommendations, but more explicit acknowledgement is required. Consumer-engagement processes used during guideline development have the potential to assist in identifying patient preferences, but further research is needed. Clarification of the consumer role and investment in consumer training may strengthen these processes.Journal of Comorbidity 2015;5(1):122–13
Metastatic non-small cell lung cancer:ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
No full textEditor's Choice – Management of Descending Thoracic Aorta Diseases:Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)
No full textClinical Practice Guidelines of the European Society for Vascular Surgery (ESVS) for the Management of Descending Thoracic Aorta Disease
Linking law: practical guidelines for delivering law to rural Victoria using e-learning technologies
No full textProvides information, analysis and practical tips for organisations seeking to use digital technologies to enhance general and professional legal education for people living in remote, rural and regional (RRR) Victoria.
Introduction
These guidelines provide information, analysis and practical tips for organisations seeking to use digital technologies to enhance general and professional legal education for people living in remote, rural and regional (RRR) Victoria. Given the difficulties people living in RRR areas still face in having to take time away from work and home and travel long distances to attend many legal educational events, it makes sense to explore these options. However, it can be particularly difficult for organisations seeking to engage with RRR people to choose between educational technologies and techniques, given the considerable hype and movement in the field at present. Options are plentiful and complex, with multiple practical and organisational considerations attached to each, and the situation changes frequently as technologies improve. The increasing reach of high-speed internet and mobile networks is creating opportunities for different and more engaging educational methods to be used in most regional and rural areas, but fast internet is not the be-all and end-all. There is much that can be achieved with intelligent use of a range of lower-tech options including low-speed internet, phone, DVD and regional site-based educational technologies.
These guidelines aim to identify a range of practical, digitally based options that are available for different educational purposes, and provide sets of protocols for implementing these options so that RRR people can gain maximum educational benefit and organisations can access guidance on best practice. In many cases, standard good practice in the use of these technologies is all that is needed to include people living in RRR areas effectively in community and professional education. Many metropolitan participants can also benefit from the availability of low-bandwidth options, recordings, provision for individual online access to videoconferenced events and so on.
This document begins with an overview of the landscape for digitally based legal community and professional education in RRR Victoria. The requirements of RRR people for legal information and assistance have been described well in recent publications. There is no doubt that digital technologies can help address some of these needs, but technical and non-technical barriers exist, and section 3, ‘Needs, capabilities and barriers in the legal digital education landscape’, sets out briefly what the relevant capabilities and barriers are for RRR people in Victoria.
The major part of this document contains guidelines for choosing and implementing a wide range of digitally based education options. The guidelines highlight a range of factors reflecting important practical and pedagogical concerns, including access, cost, need for specialist IT support, cohort size, and ability to support particular learning designs and types of communication. A planning framework focusing on educational approaches is provided as a starting point in section 4, ‘Planning for learning using digital technologies’
Neonatologie/Pädiatrie – Leitlinie Parenterale Ernährung, Kapitel 13
No full textThere are special challenges in implementing parenteral nutrition (PN) in paediatric patients, which arises from the wide range of patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg, and their varying substrate requirements. Age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration along with the clinical situation during which PN is applied. The indication, the procedure as well as the intake of fluid and substrates are very different to that known in PN-practice in adult patients, e.g. the fluid, nutrient and energy needs of premature infants and newborns per kg body weight are markedly higher than of older paediatric and adult patients. Premature infants <35 weeks of pregnancy and most sick term infants usually require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated). Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. If energy and nutrient demands in children and adolescents cannot be met through enteral nutrition, partial or total PN should be considered within 7 days or less depending on the nutritional state and clinical conditions.Eine besondere Herausforderung bei der Durchführung parenteraler Ernährung (PE) bei pädiatrischen Patienten ergibt sich aus der großen Spannbreite zwischen den Patienten, die von extrem unreifen Frühgeborenen bis hin zu Jugendlichen mit einem Körpergewicht von mehr als 100 kg reicht, und ihrem unterschiedlichen Substratbedarf. Dabei sind alters- und reifeabhängige Veränderungen des Stoffwechsels sowie des Flüssigkeits- und Nährstoffbedarfs zu berücksichtigen sowie auch die klinische Situation, in der eine PE eingesetzt wird. Das Vorgehen unterscheidet sich deshalb ganz erheblich von der PE-Praxis bei erwachsenen Patienten, z.B. ist der Flüssigkeits-, Nährstoff- und Energiebedarf von Früh- und Neugeborenen pro kg Körpergewicht höher als bei älteren pädiatrischen und bei erwachsenen Patienten. In der Regel benötigen alle Frühgeborenen <35. SSW und alle kranken Reifgeborenen während der Phase des allmählichen Aufbaus der enteralen Nahrungszufuhr eine vollständige oder partielle PE. Die Zufuhrmengen der PE bei Neonaten müssen berechnet (nicht geschätzt) werden. Der Anteil der PE sollte zur Minimierung von Nebenwirkungen sobald wie möglich durch Einführung einer enteralen Ernährung vermindert (teilparenterale Ernährung) und schließlich komplett durch enterale Ernährung abgelöst werden. Eine unangemessene Substratzufuhr im frühen Säuglingsalter kann langfristig nachteilige Auswirkungen im Sinne einer metabolischen Programmierung des Krankheitsrisikos im späteren Lebensalter haben. Wenn bei älteren Kindern und Jugendlichen dagegen der Energie- und Nährstoffbedarf eines Patienten im Vorschul- oder Schulalter durch eine enterale Nährstoffzufuhr nicht gedeckt werden kann, ist abhängig von Ernährungszustand und klinischen Umständen spätestens innerhalb von 7 Tagen eine partielle oder totale PE zu erwägen
Compliance with pathology testing guidelines in Australian general practice: Protocol for a secondary analysis of electronic health record data
No full text© 2018 Author(s). Introduction In Australia, general practitioners usually are the first point of contact for patients with non-urgent medical conditions. Appropriate and efficient utilisation of pathology tests by general practitioners forms a key part of diagnosis and monitoring. However overutilisationand underutilisation of pathology tests have been reported across several tests and conditions, despite evidence-based guidelines outlining best practice in pathology testing. There are a limited number of studies evaluating the impact of these guidelines on pathology testing in general practice. The aim of our quantitative observational study is to define how pathology tests are used in general practice and investigate how test ordering practices align with evidence-based pathology guidelines. Methods and analysis Access to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient's age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: Full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing. Ethics and dissemination Ethics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17-008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums)
Leptomeningeal metastasis from solid tumours: EANO–ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
No full text• This Clinical Practice Guideline provides recommendations for managing leptomeningeal metastases from solid tumours.
• The guideline covers clinical, imaging and cytological diagnosis, staging and risk assessment, treatment and follow-up.
• A treatment and management algorithm is provided.
• The author panel encompasses a multidisciplinary group of experts from different institutions and countries in Europe.
• Recommendations are based on available scientific data and the authors’ collective expert opinion
数字时代的国家书目：指南和新方向
No full textThis is a Chinese translation of the Guidelines by the IFLA Bibliography Section:
National bibliographies in the digital age : guidance and new directions / IFLA Working Group on Guidelines for National Bibliographies ; edited by Maja Žumer. — München : Saur, 2009. — 140 p. : some ill. ; 25 cm. — (IFLA series on bibliographic control ; v. 39
National models for CPD: The challenges of C21st knowledge management
No full textTeacher quality is the most critical factor in improving educational outcomes (McKinsey, 2007). This paper proposes analytical frameworks for national models for continuing professional development (CPD). It examines the unacknowledged problem of the quality and extent of the evidence base underpinning teachers’ CPD. In the 21C through the use of ICTs the research and evidence base underpinning educational practice surely could be made accessible to all teachers and all providers of initial teacher training and CPD. The evidence base available internationally appears to be patchy. Yet this is taken for granted in the literature, and is rarely if ever acknowledged in the discourse about school and system improvement. This lack of research based professional knowledge, is a particular problem for subject specialist issues and is further compounded by the fact that research published in journals is not generally designed around questions teachers want answered. In short, the knowledge that is produced and the management of it within the education sector is lacking systemic organisation and dissemination. The paper outlines opportunities which exist for low cost interlinked national and international e-infrastructures to be developed to support knowledge sharing, but such collaboration may pose an insurmountable challenge for national and international agencies
- …
