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At least 343 records · Page 19Linked to original sources
PubMed2003

The British standard series of contact dermatitis allergens: validation in clinical practice and value for clinical governance.

BACKGROUND: All centres use an empirically determined set of 'standard' test allergens for patch testing that contain the commoner environmental sensitizers. Objectives To assess the validity of the British standard series of 12 allergens used in addition to the 23 already in the European standard series. PATIENTS AND METHODS: Results for 3062 consecutive patients patch tested in seven centres across the United Kingdom during the year 2000 were analysed. RESULTS: The additional allergens from the British series and positive rates were: methyl dibromoglutaronitrile 2.4%, carba mix 1.6%, tixocortol pivalate 1.5%, ethylenediamine 1.3%, cetearyl alcohol 0.8%, 2-bromo-2-nitropane-1,3-diol 0.8%, diazolidinyl urea 0.7%, chlorocresol 0.6%, budesonide 0.6%, fusidic acid 0.5%, imidazolidinyl urea 0.5%, and chloroxylenol 0.4%. The allergens with the lowest positive rate in the European standard series were primin at 0.6% and isopropyl-phenyl-para-phenylenediamine at 0.4%. CONCLUSIONS: The 12 allergens in the British series should continue being tested as a standard addition to the European series within the U.K. The collection of data in this manner to allow comparisons between centres shows differences that reflect selection criteria and interpretation of results, and offers a useful tool for audit and clinical governance. Testing fewer than 1 : 2150 population may indicate underprovision of service. Similarly, rates of sensitization for nickel contact allergy above 26% and for fragrance mix above 16% (the upper 95% confidence intervals) should stimulate inquiry into the reasons behind this.

Allergens↗
PubMedDate not supplied

Facilitating the use of evidence in practice: evaluating and adapting clinical practice guidelines for local use by health care organizations.

This article describes a framework for evaluating and adapting existing practice guidelines for local use by health care organizations and groups. The framework presents the major issues related to guideline adaptation and breaks them down into manageable steps. Many steps of the framework are illustrated using the process used by the Registered Nurses Association of Ontario to develop best practice guidelines for breastfeeding.

Benchmarking↗
PubMed2004

Polymer therapeutics - Sixth International Symposium: from laboratory to clinical practice. Industrial development and clinical evaluation.

This biannual conference was organized, as is now customary, by Professor Ruth Duncan of the Welsh School of Pharmacy and focused on novel technology and pharmaceutical compounds in the area of polymer therapeutics. This meeting has established itself as an important interface between discovery research and preclinical and clinical development in this field. Sufficient time was allocated for informal interaction between the delegates, which allowed for plenty of discussion and initiation of collaboration. The emphasis in most presentations was on the use of polymers and dendrimers as active ingredients, or for conjugation with other entities for the purpose of improving drug properties such as pharmacodynamic (PD) and pharmacokinetic (PK) profile, drug handling, or targeting and delivery. Several talks and posters focused on novel and proven techniques for the biophysical characterization of polymer constructs and their metabolites. To date, the most successful therapeutic class are conjugates of polymers to protein drugs; six drugs are approved and approximately a dozen are in various stages of clinical development. However, several covalent and non-covalent conjugates of small-molecule cancer chemotherapy agents are now in more advanced clinical trials, and several other polymer constructs and dendrimers are in early clinical trials. This meeting clearly demonstrated that there are many promising approaches for the application of a variety of polymers, but that the viability of many of the approaches still needs to be proven in late-stage clinical trials as well as in the market place.

Animals↗
PubMed2005

Novices in clinical practice settings: student nurses stories of learning the practice of nursing.

Drawing on 24 stories of clinical practice in an apprenticeship context of training in Israel, this qualitative study examined student nurses' perspectives towards learning to become a nurse, as revealed through the language and content of their written stories of clinical practice. As our findings suggest, student nurses' stories of learning to become a nurse in practice settings, are characterized by procedural language, by medical rather than nursing terminology, and by a focus on actions rather than on interactions. We have learned that, despite the rich content that characterizes clinical practice settings, the apprenticeship orientation of the training program, combined with student nurses' state of being a novice, yielded representations of the experience of learning to nurse which were characterized by an instrumental perspective towards the practice. We interpret these findings through four interrelated insights that emerge from the study: (1) an 'instrumental practice' orientation in the setting of caring, (2) knowledge of clinical facts-not knowledge of clinical principles, (3) the fragmented character of novices' learning to nurse in practice, and (4) rich content of practice alone does not yield rich content of learning.

Adaptation, Psychological↗
PubMed1999

Development of clinical practice guidelines: surgical perspective.

Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. The implications of this definition are that: the methodologic perspective and operations for systematic development must be specified, a strategy is needed to account for the patient's perspective in the CPG development process and the clinical decision, and a mechanism is required to determine how appropriateness ought to be conceptualized and defined. Addressing these issues, we review models of CPG development, outline challenges to evidence-based approaches to CPG development, address unique factors relevant to the development of guidelines for the surgical community, introduce an Ontario practice guidelines strategy that uses complementary methods of CPG development, and summarize the feedback provided by the surgical community regarding the practice guidelines produced in Ontario's cancer system.

Breast Neoplasms↗