Objective The purpose of this scoping review was to identify evidence describing benefits of interventions provided in ICU-survivor follow-up clinics. Background Advances in intensive care unit (ICU) treatments have increased the number of survivors who require specialized care for ICU-related sequelae. ICU survivor follow-up clinics exist yet little is known about the nature and impact of interventions provided in such clinics. A scoping review of publications about in-person post-ICU follow-up care was undertaken. Method Ten databases were searched yielding one-hundred eleven relevant unique publication titles and abstracts. Sample heterogeneity supported using a scoping review method. After excluding non-related publications, 33 reports were fully reviewed. Twenty international publications were included that described ICU follow-up clinic interventions and/or outcomes. Results Authors discussed very diverse interventions in 15 publications, and 9 reported some level of intervention effectiveness. Evidence was strongest that supported the use of prospective diaries as an intervention to prevent or improve psychological symptoms whereas evidence to support implementation of other interventions was weak. Conclusions Although ICU follow-up clinics exist, evidence for interventions and effectiveness of treatments in these clinics remains under-explored. Implications ICU survivor follow-up clinics provide a venue for further interdisciplinary intervention research that could lead to better health outcomes for ICU survivors.
We report our experience of the initial effects of a publicity campaign directed at early presentation of malignant melanoma in Leicestershire. The campaign resulted in a dramatic increase in workload and, at the pigmented lesion clinic, the numbers of new patients rose from 12.3 to 54.5 per clinic. There was a large rise in the number of new melanomas presenting in Leicestershire: from 1.02 per week before the campaign to 1.88 per week in the immediate post-publicity period. This was statistically significant (P less than 0.001). Although there was also an apparently encouraging rise in the percentage of thinner 'good prognosis' tumours, it was not possible to isolate this statistically from a pre-existing trend.
Given the vast proliferation of scientific research in the behavioral and social sciences, there is a growing need for psychologists to be able to access the most current, clinically relevant research quickly and efficiently and integrate this information into patient care. In response to a similar need within the field of medicine, evidence-based medicine took hold in the early 1990s to provide both a framework and set of skills for translating research into practice. Since then, this method has been adopted by every major health care profession including psychology, and is now widely known as evidence-based practice (EBP). In this article, the authors present a general overview of the skills required for EBP along with an introduction to some of the tools and resources that have been developed in other health care professions to support EBP. Using a case example, we illustrate how these tools and resources can be applied in psychological settings.
Since 2002, library faculty at the Indiana University School of Medicine have taught third-year medical students how to retrieve the best evidence from MEDLINE to address their clinical questions. In preparation for their Neurology, Medicine, and Psychiatry clerkships, students attended a review of evidence-based medicine principles and techniques for searching the literature. The session was team-taught by two faculty members, one from the Internal Medicine department and the other from the Library. The librarian reviewed important MEDLINE principles for constructing a good subject search and applying appropriate evidence-based filters. During the clerkships, students were asked to generate clinical questions arising from their patient encounters, searched MEDLINE for the best evidence, critiqued the results, and then applied them back to their patients' care. Library faculty provided individualized feedback on the student searches. A follow-up session two months later reinforced MEDLINE principles, used student searches as examples, and extended the discussion to other evidence-based, point-of-care resources. To add to the interactivity of the follow-up sessions, librarians used an audience response system to measure students' understanding of literature retrieval techniques and to gauge student preferences for information seeking on clinical topics. Overall, the sessions have been well-received by the students.
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