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Community pharmacists' involvement in smoking cessation: implementation of the National smoking cessation guideline in Finland.

BMC Public Health. 2010 Jul 29;10(1):444

Authors: Kurko T, Linden K, Pietila K, Sandstrom P, Airaksinen M

ABSTRACT: BACKGROUND: Guidelines on smoking cessation (SC) emphasize healthcare cooperation and community pharmacists' involvement. This study explored the familiarity and implementation of the national SC Guideline in Finnish community pharmacies, factors relating to Guideline familiarity, implementation and provision of SC services. METHODS: A nationwide mail survey was sent to a systematic, sample of community pharmacy owners and staff pharmacists (total n=2291). Response rate was 54% (n=1190). Factors related to the SC Guideline familiarity were assessed by bivariate and multivariate analysis. RESULTS: Almost half (47%) of the respondents (n=1190) were familiar with the SC Guideline and familiarity enhanced Guideline implementation. The familiarity was associated with the respondents' perceptions of their personal SC skills and knowledge (OR 3.8); of customers' value of counseling on nicotine replacement therapy (NRT) (OR 3.3); and regular use of a pocket card supporting SC counseling (OR 3.0). Pharmacists' workplaces' characteristics, such as size and geographical location were not associated with familiarity. In addition to recommending NRT, the pharmacists familiar with the Guideline used more frequently other Guideline-based SC methods, such as recommended non-pharmacological SC aids, compared to unfamiliar respondents. CONCLUSIONS: SC Guideline familiarity and implementation is crucial for community pharmacists' involvement in SC actions in addition to selling NRT products. Pharmacists can constitute a potential public health resource in SC easily accessible throughout the country.

PMID: 20670409 [PubMed - as supplied by publisher]

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[Sedation in palliative medicine: Guidelines for the use of sedation in palliative care : European Association for Palliative Care (EAPC).]

Schmerz. 2010 Jul 28;

Authors: Alt-Epping B, Sitte T, Nauck F, Radbruch L

The European Association for Palliative Care (EAPC) considers sedation to be an important and necessary therapy option in the care of selected palliative care patients with otherwise refractory distress. Prudent application of this approach requires due caution and good clinical practice. Inattention to potential risks and problematic practices can lead to harmful and unethical practice which may undermine the credibility and reputation of the responsible clinicians and institutions as well as the discipline of palliative medicine more generally. Procedural guidelines are helpful to educate medical providers, set standards for best practice, promote optimal care and convey the important message to staff, patients and families that palliative sedation is an accepted, ethical practice when used in appropriate situations. EAPC aims to facilitate the development of such guidelines by presenting a 10-point framework that is based on the pre-existing guidelines and literature and extensive peer review.

PMID: 20661593 [PubMed - as supplied by publisher]

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[Nothing is more damaging to a new truth than an old error : Conformity of new guidelines on opioid administration for chronic pain with the effect prognosis of the DGSS S3 guidelines LONTS (long-term administration of opioids for non-tumor pain).]

Schmerz. 2010 Jul 28;

Authors: Sorgatz H, Maier C

PMID: 20661594 [PubMed - as supplied by publisher]

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Ratification of IATSIC/WHO's Guidelines for Essential Trauma Care Assessment in the South American Region.

World J Surg. 2010 Jul 27;

Authors: Aboutanos MB, Mora F, Rodas E, Salamea J, Parra MO, Salgado E, Mock C, Ivatury R

BACKGROUND: The purpose of the present study was to evaluate the usefulness of the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO)'s Guidelines for Essential Trauma Care (EsTC Guidelines) in providing an internationally applicable and standardized template to assess trauma care capabilities in the South American Region. METHODS: Field assessment was conducted in seven provinces (urban and rural, pop. 2,239,509) and 24 facilities (5 large hospitals (LH); 15 small hospitals (SH); 4 basic hospitals (BH)) in Ecuador using EsTC criteria. A total of 260 individual items in Human Resources (HR- availability, clinical knowledge, skills) and physical resources (PR) were evaluated via inspection, review of local statistics, and administrative and staff interviews. EsTC was evaluated on a scale as follows: 0 (absent); 1(inadequate; < 50%); 2 (partly adequate > 50%); 3 (adequate-100%). RESULTS: 210,045 Emergency Department (ED) visits and 61,365 (29%) ED trauma visits were recorded (incidence rate 2,740/100,000 population). Deficits were noted in prehospital trauma care (inadequate coordination, communication), education and training (ATLS < 30%, TNCC 0%), facility based trauma care (poor physical resources [PR] and human resources [HR]), and quality assurance (1/27 hospitals). CONCLUSIONS: The IATSIC/WHO EsTC Guidelines provide a simple and useful template to assess trauma care capability in variable facilities and international settings, and they could serve as a valuable tool for trauma system development. Endorsement of EsTC Guidelines by the Panamerican Health Organization and lead trauma societies (the Panamerican Trauma Society) should be considered.

PMID: 20661563 [PubMed - as supplied by publisher]

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Preoperative Verification of Timely Antimicrobial Prophylaxis Does Not Improve Compliance with Guidelines.

Surg Infect (Larchmt). 2010 Jul 27;

Authors: Nemeth TA, Beilman GJ, Hamlin CL, Chipman JG

Abstract Background: Surgical site infections are reduced by appropriate and timely antimicrobial prophylaxis. Consensus guidelines recommend that antimicrobial infusion begin within 60 min prior to creation of the incision. An internal audit of our institution suggested poor guideline compliance. We hypothesized that the addition of a oral antibiotic verification to the routine preoperative patient identification, operation, and surgical site verification would increase compliance. To this end, we compared compliance with the guidelines before and after the addition of a verification of antibiotic administration to the routine preoperative protocol. Methods: We performed a retrospective medical record review of operations during two five-day periods, one prior to and one after the addition of the antibiotic verification. We identified operative procedure, time of antibiotic administration, time of incision, and the patient's preoperative inpatient or outpatient status. We excluded from analysis patients whose procedure did not require antibiotic prophylaxis, inpatients, and patients without complete records. Administration of antimicrobial prophylaxis was considered timely (60 min prior to incision), late (beginning after incision), or not given (no antibiotic administered). Comparisons were made using the chi(2) statistic for noncontinuous variables with significance defined as p

PMID: 20662740 [PubMed - as supplied by publisher]

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Recommended Guidelines for the Conduct and Evaluation of Prognostic Studies in Veterinary Oncology.

Vet Pathol. 2010 Jul 27;

Authors: Webster JD, Dennis MM, Dervisis N, Heller J, Bacon NJ, Bergman PJ, Bienzle D, Cassali G, Castagnaro M, Cullen J, Esplin DG, Peña L, Goldschmidt MH, Hahn KA, Henry CJ, Hellmén E, Kamstock D, Kirpensteijn J, Kitchell BE, Amorim RL, Lenz SD, Lipscomb TP, McEntee M, McGill LD, McKnight CA, McManus PM, Moore AS, Moore PF, Moroff SD, Nakayama H, Northrup NC, Sarli G, Scase T, Sorenmo K, Schulman FY, Shoieb AM, Smedley RC, Spangler WL, Teske E, Thamm DH, Valli VE, Vernau W, von Euler H, Withrow SJ, Weisbrode SE, Yager J, Kiupel M

There is an increasing need for more accurate prognostic and predictive markers in veterinary oncology because of an increasing number of treatment options, the increased financial costs associated with treatment, and the emotional stress experienced by owners in association with the disease and its treatment. Numerous studies have evaluated potential prognostic and predictive markers for veterinary neoplastic diseases, but there are no established guidelines or standards for the conduct and reporting of prognostic studies in veterinary medicine. This lack of standardization has made the evaluation and comparison of studies difficult. Most important, translating these results to clinical applications is problematic. To address this issue, the American College of Veterinary Pathologists' Oncology Committee organized an initiative to establish guidelines for the conduct and reporting of prognostic studies in veterinary oncology. The goal of this initiative is to increase the quality and standardization of veterinary prognostic studies to facilitate independent evaluation, validation, comparison, and implementation of study results. This article represents a consensus statement on the conduct and reporting of prognostic studies in veterinary oncology from veterinary pathologists and oncologists from around the world. These guidelines should be considered a recommendation based on the current state of knowledge in the field, and they will need to be continually reevaluated and revised as veterinary oncology continues to progress. As mentioned, these guidelines were developed through an initiative of the American College of Veterinary Pathologists' Oncology Committee, and they have been reviewed and endorsed by the World Small Animal Veterinary Association.

PMID: 20664014 [PubMed - as supplied by publisher]

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Clinically Useful Spirometry in Preschool-Aged Children: Evaluation of the 2007 American Thoracic Society Guidelines.

J Asthma. 2010 Jul 26;

Authors: Gaffin JM, Shotola NL, Martin TR, Phipatanakul W

Rationale. In 2007 the American Thoracic Society (ATS) recommended guidelines for acceptability and repeatability for assessing spirometry in preschool children. The authors aim to determine the feasibility of spirometry among children in this age group performing spirometry for the first time in a busy clinical practice. Methods. First-time spirometry for children age 4 to 5 years old was selected from the Children's Hospital Boston Pulmonary Function Test (PFT) database. Maneuvers were deemed acceptable if ( 1 ) the flow-volume loop showed rapid rise and smooth descent; ( 2 ) the back extrapolated volume (V(be)), the volume leaked by a subject prior to the forced maneuver, was

PMID: 20653495 [PubMed - as supplied by publisher]

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Sins of omission and obfuscation: IQWIG's guidelines on economic evaluation methods.

Health Econ. 2010 Jul 26;

Authors: Sculpher M, Claxton K

PMID: 20662107 [PubMed - as supplied by publisher]

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[On the significance of guidelines for managing sedation at the end of life.]

Schmerz. 2010 Jul 25;

Authors: Neitzke G

PMID: 20658250 [PubMed - as supplied by publisher]

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Adherence to the dietary guidelines for Americans and endometrial cancer risk.

Cancer Causes Control. 2010 Jul 23;

Authors: Chandran U, Bandera EV, Williams-King MG, Sima C, Bayuga S, Pulick K, Wilcox H, Zauber AG, Olson SH

The Healthy Eating Index (HEI) was developed by the US Department of Agriculture with the goal of quantifying adherence to the Dietary Guidelines for Americans. The purpose of this study was to evaluate the impact of the HEI-2005 score and each of its components on endometrial cancer risk in a population-based case-control study in New Jersey. A total of 424 cases and 398 controls completed a Food Frequency Questionnaire, which was used to derive the HEI-2005 score. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression while adjusting for potential covariates, which included all major endometrial cancer risk factors. The adjusted OR for women in the highest quartile when compared to the lowest quartile was 0.83 (95% CI: 0.52-1.34). For the meat and beans component comprising meat, eggs, poultry, fish, and beans, the OR was 0.70 (95% CI: 0.45-1.11; p for trend: 0.07), with little evidence of an association with any of the individual foods. There was no indication of an association for any of the other components of the HEI or of effect modification by body mass index. This study suggested limited value for the HEI-2005 in predicting endometrial cancer risk.

PMID: 20652737 [PubMed - as supplied by publisher]

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