Introduction: Ireland's Health Service Executive is developing a new national integrated low back pain (LBP) pathway spanning primary and secondary care to improve LBP healthcare. Clinical pathways are frequently employed to optimise clinical outcomes and resource use but are challenging to implement. Context-specific implementation planning, leveraging implementation science and its conceptual frameworks, should inform successful implementation.
View Article and Find Full Text PDFIntroduction: Symptomatic malrotation requires urgent Ladd procedure. Patients with incidental or indeterminate findings have historically been managed with observation or operatively. Fluoroscopic identification of the duodenojejunal junction (DJJ) and ileocecal junction (ICJ) can guide operative decision-making, but algorithms have not been validated.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
November 2024
Implement Sci Commun
September 2024
Background: Implementation science scholars have made significant progress identifying factors that enable or obstruct the implementation of evidence-based interventions, and testing strategies that may modify those factors. However, little research sheds light on how or why strategies work, in what contexts, and for whom. Studying implementation mechanisms-the processes responsible for change-is crucial for advancing the field of implementation science and enhancing its value in facilitating equitable policy and practice change.
View Article and Find Full Text PDFIntroduction: Professional caregivers' perspectives on dementia and on people living with dementia (PlwD) can influence their feelings, judgements and behaviours in work situations, for example, how they think about symptoms, disease progression and the impact on a person's quality of life. Their individual dementia mindset, which can be investigated with the 12-item Dementia Mindset Scale (DMS), might influence job satisfaction, work-related well-being and person-centred care. The aim of the proposed replication study is to confirm the results of the original study of the DMS and to test whether a malleable mindset is correlated with higher levels of caregiver education, dementia-specific professional experience/competence and dementia knowledge.
View Article and Find Full Text PDFBackground: Implementation support practitioners (ISPs) are professionals that support others to implement evidence-informed practices, programs, and policies in various service delivery settings to achieve population outcomes. Measuring the use of competencies by ISPs provides a unique opportunity to assess an understudied facet of implementation science-how knowledge, attitudes, and skills used by ISPs affects sustainable change in complicated and complex service systems. This study describes the development and validation of a measure-the Implementation Support Competencies Assessment (ISCA)-that assesses implementation support competencies, with versatile applications across service contexts.
View Article and Find Full Text PDFYoung people who transition to adulthood from out-of-home care (OOHC) are more likely to experience a range of poorer outcomes relative to their same-age peers in the community. This systematic review assessed the effectiveness of policies or interventions (hereafter "interventions") aimed at improving housing, health, education, economic, and psychosocial outcomes for youth leaving OOHC (hereafter "care leavers"). Eleven databases of published literature were reviewed along with gray literature.
View Article and Find Full Text PDFThree-dimensionally printed phantoms are increasingly used in medical imaging and research due to their cost-effectiveness and customizability, offering valuable alternatives to commercial phantoms. The purpose of this study was to assess the computed tomography (CT) attenuation characteristics of 27 resin materials from Formlabs, a 3D printing equipment and materials manufacturer. Cube phantoms (both solid and hollow constructions) produced with each resin were subjected to CT scanning under varying tube current-time products with attenuation measurements recorded in Hounsfield units (HU).
View Article and Find Full Text PDFIntroduction: Dementia care management is a complex intervention intended to support persons with dementia and their (caring) relatives in home-based care arrangements. Dementia care management was developed in the federal state of Mecklenburg-Western Pomerania in Germany and subsequently adapted for the German region of Siegen-Wittgenstein, where it will now be implemented. Four different service providers will carry out the implementation process.
View Article and Find Full Text PDFBackground: With a high mortality of 12.6% of all cancer cases, colorectal cancer (CRC) accounts for substantial burden of disease in Europe. In the past decade, more and more countries have introduced organized colorectal cancer screening programs, making systematic screening available to entire segments of a population, typically based on routine stool tests and/or colonoscopy.
View Article and Find Full Text PDFBackground and purpose Gadolinium-based contrast agents (GBCAs) have been administered clinically since 1988. They are remarkably well tolerated by children and result in dose-dependent tissue deposition, even in patients with normal renal function. No adverse effects of gadolinium deposition in patients with normal renal function have been established.
View Article and Find Full Text PDFBackground: The most prevalent infections encountered in neonatal care are healthcare-associated infections. The majority of healthcare-associated infections are considered preventable with evidence-based infection prevention and control (IPC) practices. However, substantial knowledge gaps exist in IPC implementation in neonatal care.
View Article and Find Full Text PDFA 13-year-old male patient with intermittent asthma and joint hypermobility presented to the ED in acute hypoxemic respiratory distress. He reported experiencing cough, increased work of breathing, and worsening chest pain for 3 days before presentation. He also reported fatigue and decreased appetite for 2 weeks.
View Article and Find Full Text PDFBackground: A female patient aged 49 years with a rectal adenocarcinoma underwent tumor resection and multiple follow-up surgical operations whilst receiving compassionate therapy with polyvalent immunoglobulins derived from bovine colostrum (KMP01), a potential modulator of the pro-tumor inflammatory response.
Aims: Assessment of safety of the treatment, effect on tumor recurrence, and effect on parameters associated with the pro-tumor inflammatory response.
Materials And Methods: The dose of KMP01 varied from 72 g daily in the perioperative period to 12 - 24 g daily thereafter.
The online 2021 Asian-Pacific Heart and Brain Summit was organized to present and discuss experiences within leading Asian-Pacific centers with regard to institutional heart and brain teams managing the diagnosis, treatment, and follow-up of cryptogenic stroke (CS) patients with patent foramen ovale (PFO). This manuscript presents a narrative review of presentations and discussions during the summit meeting. Percutaneous PFO closure is an established therapy for CS patients in whom PFO is considered to be causal.
View Article and Find Full Text PDFTailoring strategies to target the salient barriers to and enablers of implementation is considered a critical step in supporting successful delivery of evidence based interventions in healthcare. Theory, evidence, and stakeholder engagement are considered key ingredients in the process however, these ingredients can be combined in different ways. There is no consensus on the definition of tailoring or on a single method for tailoring strategies to optimize impact, ensure transparency, and facilitate replication.
View Article and Find Full Text PDFBackground: Patients who had a cryptogenic stroke (CS) suspected to be causally related to a patent foramen ovale (PFO) are candidates for percutaneous PFO closure. In such patients, it is important to screen for atrial fibrillation (AF). Limited guidance is available regarding AF monitoring strategies in CS patients with PFO addressing optimal monitoring technology and duration.
View Article and Find Full Text PDFL-type transposition of the great vessels is a rare congenital heart disease in which both the great arteries and the ventricular chambers are reversed. Because this condition preserves a physiologic circulatory pathway, it can be challenging to diagnose in infants with no concurrent cardiac abnormalities. Early detection is essential, however, because these patients will eventually experience severe complications, as the structural right ventricle is unable to function long-term in the systemic position.
View Article and Find Full Text PDFThree-dimensional (3D) printing has applications in many fields and has gained substantial traction in medicine as a modality to transform two-dimensional scans into three-dimensional renderings. Patient-specific 3D printed models have direct patient care uses in surgical and procedural specialties, allowing for increased precision and accuracy in developing treatment plans and guiding surgeries. Medical applications include surgical planning, surgical guides, patient and trainee education, and implant fabrication.
View Article and Find Full Text PDFBackground: Normalization Process Theory (NPT) identifies mechanisms that have been demonstrated to play an important role in implementation processes. It is now widely used to inform feasibility, process evaluation, and implementation studies in healthcare and other areas of work. This qualitative synthesis of NPT studies aims to better understand how NPT explains observed and reported implementation processes, and to explore the ways in which its constructs explain the implementability, enacting and sustainment of complex healthcare interventions.
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