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At least 811 records · Page 45Linked to original sources
PubMed2003

Clear-cut?: facilitating health librarians to use information research in practice.

In 1999, staff at the universities of Sheffield and Oxford commenced an unfunded project to examine whether it is feasible to apply critical appraisal to daily library practice. This aimed to establish whether barriers experienced when appraising medical literature (such as lack of clinical knowledge, poor knowledge of research methodology and little familiarity with statistical terms) might be reduced when appraising research within a librarian's own discipline. Innovative workshops were devised to equip health librarians with skills in interpreting and applying research. Critical Skills Training in Appraisal for Librarians (CRISTAL) used purpose-specific checklists based on the Users' Guides to the Medical Literature. Delivery was via half-day workshops, based on a format used by the Critical Appraisal Skills Programme. Two pilot workshops in Sheffield and Oxford were evaluated using a brief post-workshop form. Participants recorded objectives in attending, their general understanding of research, and whether they had read the paper before the workshop. They were asked about the length, content and presentation of the workshop, the general format, organization and learning environment, whether it had been a good use of their time and whether they had enjoyed it. Findings must be interpreted with caution. The workshops were enjoyable and a good use of time. Although the scenario selected required no clinical knowledge, barriers remain regarding statistics and research methodology. Future workshops for librarians should include sessions on research design and statistics. Further developments will take forward these findings.

Feasibility Studies↗
PubMed2002

Improving communication between health professionals and women in maternity care: a structured review.

OBJECTIVE: To review trials of the effectiveness of interventions aimed at improving communication between health professionals and women in maternity care. SEARCH STRATEGY: The electronic databases Medline, PsycLit, The Cochrane Library, BIDS Science and Social Science Indexes, Cinahl and Embase were searched. Final searches were carried out in April 2000. INCLUSION CRITERIA: Controlled trials of interventions explicitly aimed at improving communication between health professionals and women in maternity care were included. Other trials were included where two reviewers agreed that this was at least part of the aim. DATA EXTRACTION AND SYNTHESIS: 95 potentially eligible papers were identified, read by one reviewer and checked against the inclusion criteria. The 11 included trials were read, assessed for quality and summarized in a structured tabular form. RESULTS: The included trials evaluated interventions to improve the presentation of information about antenatal testing, to promote informed choice in maternity care, woman-held maternity records and computer-based history taking. Four trials in which women were provided with extra information about antenatal testing in a variety of formats suggested that this was valued by women and may reduce anxiety. Communication skills training for midwives and doctors improved their information giving about antenatal tests. The three trials of woman-held maternity records suggested that these increase women's involvement in and control over their care. CONCLUSIONS: The trials identified by this review addressed limited aspects of communication and focused solely on antenatal care. Further research is required in several areas, including trials of communication skills training for health professionals in maternity care and other interventions to improve communication during labour and in the postnatal period.

Communication↗
PubMed2002

Integrating medical communication skills with library skills curricula among first year medical students at the University of the West Indies, St. Augustine.

A two-year study designed to integrate the medical communication skills and library skills curricula at the University of the West Indies, St. Augustine is reported. Given that an integrated approach to curriculum development offers benefits to learners and staff. The objective of this study was to explore the feasibility of implementing this approach among Year 1 pre-clinical students in 1997 and 1998. Student performance on an essay question that integrated the application of students' knowledge of written communication and library skills in a final examination performance was assessed. Pre- and post-test results of students' library skills were compared within each year. anova analysis indicated that there was a significant increase in mean scores from pre-test to post-test which suggests that students performed better on a test of their knowledge and application of library skills after instruction, but the unavailability of a control group made this finding inconclusive. The findings are discussed in relation to practical and intellectual issues in curriculum integration. It is concluded that this type of curriculum integration is feasible, creates linkages in the curriculum and does not increase demand on student time.

Cohort Studies↗
PubMed2005

Pseudoachalasia: a case series and analysis of the literature.

OBJECTIVE: Pseudoachalasia frequently cannot be distinguished from idiopathic achalasia by manometry, radiologic examination or endoscopy. Mechanisms proposed to explain the clinical features of pseudoachalasia include a circumferential mechanical obstruction of the distal esophagus or a malignant infiltration of inhibitory neurons within the myenteric plexus. MATERIAL AND METHODS: Between January 1980 and December 2002, the clinical features of 5 patients with pseudoachalasia and 174 patients with primary achalasia, diagnosed in a single center, were compared. A literature analysis of the etiology of pseudoachalasia for the time period 1968 to December 2002 was performed. The search concentrated on the databases and online catalogues PubMed, Web of Science, Cochrane Library and Current Contents Connect. RESULTS: In our case series, patients with pseudoachalasia reported a shorter duration of symptoms and tended to be older than patients with primary achalasia. Conventional manometry, endoscopy and radiologic examination of the esophagus proved to be of little value in distinguishing between the diseases. In the majority of cases only surgical exploration revealed the underlying cause. A coincidence of primary achalasia and disorders of the gastroesophageal junction was excluded by showing return of peristalsis following treatment. The analysis of the literature showed a total of 264 cases of pseudoachalasia in 122 publications. Most cases of were due to malignant disease (53.9% primary and 14.9% secondary malignancy), followed by benign lesions (12.6%) and sequelae of surgical procedures at the distal esophagus or proximal stomach (11.9%). In rare instances, the disease was an expression of a paraneoplastic process due to distant neuronal involvement rather than to local invasion with destruction of the myenteric plexus (2.6%). CONCLUSIONS: The diagnosis of pseudoachalasia is difficult to establish by conventional diagnostic measures. The main distinguishing feature of secondary versus primary achalasia is the complete reversal of pathologic motor phenomena following successful therapy of the underlying disorder.

Adult↗
PubMed2026

Comparing the efficacy of chlorhexidine and povidone-iodine for surgical site disinfection: a systematic review and meta-analysis from randomized controlled trials.

BACKGROUND: Randomized controlled trials report conflicting evidence on the efficacy of different skin disinfectants for preventing surgical site infection (SSI). METHODS: We systematically searched PubMed, Web of Science, Cochrane Library, and Embase for RCTs published up to February 2025 comparing preoperative skin disinfection with povidone-iodine (PVI) versus chlorhexidine (CH). Primary outcomes were overall, superficial, deep, and organ/space SSI rates. Secondary outcomes included hospital stay, readmission, and reoperation. RESULTS: CH was superior to PVI in preventing overall SSI (26 studies, n = 29,356; RR: 0.89; 95% confidence interval [CI]: 0.80 to 0.99). The overall SSI incidence rate in the CH group was 7.1% (1,045/14,677), compared with 7.8% (1,152/14,679) in the PVI group, equating to an 11% reduction in relative risk and a 0.7% reduction in absolute risk. The number needed to treat to prevent one SSI was 143. CH demonstrated superiority over PVI in preventing superficial SSI (13 studies, n = 16,867; RR: 0.77; 95% CI: 0.64 to 0.92), but not for deep SSI (11 studies, n = 15,842; RR: 1.00; 95% CI: 0.77 to 1.29) or organ SSI (9 studies, n = 9,471; RR: 1.17; 95% CI: 0.89 to 1.53). No significant differences were found in hospital stay, readmission, or reoperation rates between the two groups. CONCLUSION: CH demonstrates statistical superiority over PVI in preventing overall and superficial SSI, though the absolute clinical benefit is modest. No significant differences were observed for deep or organ/space SSI, nor for secondary outcomes including hospital length of stay, readmission, or reoperation rates.

Humans↗
PubMed2001

Does poor communication contribute to stillbirths and infant deaths? A review.

BACKGROUND: Assessors from the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) have cited poor communication as a contributory factor in a proportion of such deaths. This review assesses what research evidence exists to support or explain this. METHODS: A structured review was carried out, including all studies of sub-optimal care in stillbirth or infant death and studies of litigation in perinatal care. The following databases were searched: MEDLINE, PsycLIT, The Cochrane Library, BIDS Science and Social Science Citation Indexes, Cinahl and Embase. For included studies, information was extracted on the type of study, the selection criteria and number of cases studied, other methods used and results relevant to the question. RESULTS: One hundred and four studies of potential relevance to the review were identified. Of these, 52 did not meet the inclusion criteria and were excluded. Of the remaining 52 studies, 11 considered communication failure explicitly as a factor in sub-optimal care leading to stillbirth or infant death. In three out of the four studies that presented their findings in terms of numbers of cases, communication failure was noted in between 24 and 29 per cent of cases. There was some consistency across different types of study in the types of communication problems noted. CONCLUSION: Poor communication may contribute to a proportion of stillbirths and infant deaths. However, given the small number of papers that looked explicitly at poor communication as a factor in sub-optimal care and the lack of comparative information on communication in cases that do not end in poor outcome, caution is needed in drawing conclusions based on the findings of these papers.

Communication↗