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Detchou D, Darko K, Barrie U. Practical pearls for management of cranial injury in the developing world. Neurosurg Rev 2024; 47:579. [PMID: 39251507 DOI: 10.1007/s10143-024-02822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Revised: 08/25/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024]
Abstract
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality, with approximately 69 million individuals affected globally each year, particularly in low- and middle-income countries (LMICs) where neurosurgical resources are limited. The neurocognitive consequences of TBI range from life-threatening conditions to more subtle impairments such as cognitive deficits, impulsivity, and behavioral changes, significantly impacting patients' reintegration into society. LMICs bear about 70% of the global trauma burden, with causes of TBI differing from high-income countries (HICs). The lack of equitable neurosurgical care in LMICs exacerbates these challenges. Improving TBI care in LMICs requires targeted resource allocation, neurotrauma registries, increased education, and multidisciplinary approaches within trauma centers. Reports from successful neurotrauma initiatives in low-resource settings provide valuable insights into safe, adaptable strategies for managing TBI when "gold standard" protocols are unfeasible. This review discusses common TBI scenarios in LMICs, highlighting key epidemiological factors, diagnostic challenges, and surgical techniques applicable to resource-limited settings. Specific cases, including epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and cerebrospinal fluid leaks, are explored to provide actionable insights for improving neurosurgical outcomes in LMICs.
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Affiliation(s)
- Donald Detchou
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kwadwo Darko
- Department of Neurosurgery, Korle Bu Teaching Hospital, Accra, Ghana
| | - Umaru Barrie
- Department of Neurosurgery, New York University Grossman School of Medicine, New York City, NYC, USA
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2
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Chiaravalloti N, Alexander A. Strengthening the connection between clinical research and clinical practice of cognitive rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1084071. [PMID: 37476474 PMCID: PMC10354336 DOI: 10.3389/fresc.2023.1084071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/05/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Nancy Chiaravalloti
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ, United States
| | - Aubree Alexander
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ, United States
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Bragge P, Wright B, Grundy E, Goodwin D, Gozt A, Clynes L, Calabritto M, Fitzgerald M. What Happens Next? Traumatic Brain Injury in the Community. J Head Trauma Rehabil 2023; 38:279-282. [PMID: 36121684 DOI: 10.1097/htr.0000000000000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Traumatic brain injury (TBI) continues to substantially impact the lives of millions of people around the world annually. Community-based prevention and support of TBI are particularly challenging and underresearched aspects of TBI management. Ongoing cognitive, emotional, and other effects of TBI are not immediately obvious in community settings such as schools, workplaces, sporting clubs, aged care facilities, and support agencies providing homelessness or domestic violence support. This is compounded by a lack of guidance and support materials designed for nonmedical settings. Connectivity Australia, a not-for-profit organization promoting TBI awareness, research, and support, responded to this need by conducting a national survey and series of roundtables to deepen understanding of TBI awareness, challenges, and support needs across the community. The 48 survey respondents and 22 roundtable participants represented Australian departments of health; correctional services; homelessness and housing; Aboriginal and Torres Strait Islander health; community, school, and professional sports; allied healthcare and rehabilitation providers; insurance; and work health and safety. Three key themes were identified: Accessible, nationally consistent plain-language guidelines ; Building research literacy ; and Knowing your role in TBI identification and management . This commentary briefly describes these themes and their implications based on a publicly available full report detailing the study findings ( www.connectivity.org.au/resources-for-researchers/connectivity-research ).
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Affiliation(s)
- Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton Campus, Melbourne, Victoria, Australia (Drs Bragge, Wright, and Goodwin and Ms Grundy); Connectivity Traumatic Brain Injury Australia, Perth, Western Australia (Drs Gozt and Fitzgerald); Research Australia, the national peak body for Australian health and medical research, Sydney, Melbourne, and Canberra, Australia (Mss Clynes and Calabritto); Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia (Dr Fitzgerald); and Perron Institute for Neurological and Translational Science, Perth, Western Australia (Dr Fitzgerald)
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4
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The Future of INCOG (Is Now). J Head Trauma Rehabil 2023; 38:103-107. [PMID: 36594862 DOI: 10.1097/htr.0000000000000836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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5
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INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: What's Changed From 2014 to Now? J Head Trauma Rehabil 2023; 38:1-6. [PMID: 36594855 DOI: 10.1097/htr.0000000000000826] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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6
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Latulippe K, LeBlanc A, Gagnon MP, Boivin K, Lavoie P, Dufour J, Raynard EP, Richard E, Lamontagne MÈ. Organizational knowledge translation strategies for allied health professionals in traumatology settings: realist review protocol. Syst Rev 2021; 10:255. [PMID: 34556170 PMCID: PMC8461924 DOI: 10.1186/s13643-021-01793-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 08/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge translation (KT) is an important means of improving the health service quality. Most research on the effectiveness of KT strategies has focused on individual strategies, i.e., those directly targeting the modification of allied health professionals' knowledge, attitudes, and behaviors, for example. In general, these strategies are moderately effective in changing practices (maximum 10% change). Effecting change in organizational contexts (e.g., change readiness, general and specific organizational capacity, organizational routines) is part of a promising new avenue to service quality improvement through the implementation of evidence-based practices. The objective of this study will be to identify why, how, and under what conditions organizational KT strategies have been shown to be effective or ineffective in changing the (a) knowledge, (b) attitudes, and (c) clinical behaviors of allied health professionals in traumatology settings. METHODS This is a realist review protocol involving four iterative steps: (1) Initial theory formulation, (2) search for Evidence search, (3) knowledge extraction and synthesis, and (4) recommendations. We will search electronic databases such as PubMed, Embase, CINHAL, Cochrane Library, and Conference Proceedings Citation Index - Science. The studies included will be those relating to the use of organizational KT strategies in trauma settings, regardless of study designs, published between January 1990 and October 2020, and presenting objective measures that demonstrate change in allied health professionals' knowledge, attitudes, and clinical behaviors. Two independent reviewers will select, screen, and extract the data related to all relevant sources in order to refine or refute the context-mechanism-outcome (CMO) configurations developed in the initial theory and identify new CMO configurations. DISCUSSION Using a systematic and rigorous method, this review will help guide decision-makers and researchers in choosing the best organizational strategies to optimize the implementation of evidence-based practices. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020216105.
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Affiliation(s)
- Karine Latulippe
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Pavillon Lindsay de l'IURDPM, 6363, Chemin Hudson, Montréal, Québec, H3S 1M9, Canada
| | - Annie LeBlanc
- Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Pavillon Ferdinand-Vandry, Université Laval, 1050 av. de la Médecine, Québec, Québec, G1V 0A6, Canada
| | - Marie-Pierre Gagnon
- Chaire de recherche du Canada en technologies et pratiques en santé, Faculté des sciences infirmières, Pavillon Ferdinand-Vandry, Université Laval, Canada, 1050 av. de la Médecine, Québec, Québec, G1V 0A6, Canada
| | - Katia Boivin
- Direction de l'enseignement et des affaires universitaires, CHU de Québec-Université Laval, 2705 Boulevard Laurier, Québec, Québec, G1V 4G2, Canada
| | - Pascale Lavoie
- Direction de l'enseignement et des affaires universitaires, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 525, boul. Wilfrid Hamel, Québec, Québec, G1M 2S8, Canada
| | - Joëlle Dufour
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Institut de réadaptation en déficience physique de Québec, 525 boul. Wilfrid-Hamel, Québec, Québec, G1M 2S8, Canada
| | | | - Eve Richard
- Bibliothèque de l'Université Laval, 2345, allée des Bibliothèques, Québec, Québec, G1V 0A6, Canada
| | - Marie-Ève Lamontagne
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Institut de réadaptation en déficience physique de Québec, 525 boul. Wilfrid-Hamel, Québec, Québec, G1M 2S8, Canada.
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Lynch EA, Lassig C, Turner T, Churilov L, Hill K, Shrubsole K. Prioritizing guideline recommendations for implementation: a systematic, consumer-inclusive process with a case study using the Australian Clinical Guidelines for Stroke Management. Health Res Policy Syst 2021; 19:85. [PMID: 34022906 PMCID: PMC8140744 DOI: 10.1186/s12961-021-00734-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Implementation of evidence-based care remains a key challenge in clinical practice. Determining "what" to implement can guide implementation efforts. This paper describes a process developed to identify priority recommendations from clinical guidelines for implementation, incorporating the perspectives of both consumers and health professionals. A case study is presented where the process was used to prioritize recommendations for implementation from the Australian Stroke Clinical Guidelines. METHODS The process was developed by a multidisciplinary group of researchers following consultation with experts in the field of implementation and stroke care in Australia. Use of the process incorporated surveys and facilitated workshops. Survey data were analysed descriptively; responses to ranking exercises were analysed via a graph theory-based voting system. RESULTS The four-step process to identify high-priority recommendations for implementation comprised the following: (1) identifying key implementation criteria, which included (a) reliability of the evidence underpinning the recommendation, (b) capacity to measure change in practice, (c) a recommendation-practice gap, (d) clinical importance and (e) feasibility of making the recommended changes; (2) shortlisting recommendations; (3) ranking shortlisted recommendations and (4) reaching consensus on top priorities. The process was applied to the Australian Stroke Clinical Guidelines between February 2019 and February 2020. Seventy-five health professionals and 16 consumers participated. Use of the process was feasible. Three recommendations were identified as priorities for implementation from over 400 recommendations. CONCLUSION It is possible to implement a robust process which involves consumers, clinicians and researchers to systematically prioritize guideline recommendations for implementation. The process is generalizable and could be applied in clinical areas other than stroke and in different geographical regions to identify implementation priorities. The identification of three clear priority recommendations for implementation from the Australian Stroke Clinical Guidelines will directly inform the development and delivery of national implementation strategies.
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Affiliation(s)
- Elizabeth A. Lynch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Campus, GPO Box 2100, Adelaide, SA 5001 Australia
- Adelaide Nursing School, University of Adelaide, Level 4 AHMS Building, Adelaide, 5005 Australia
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, 245 Burgundy St, Heidelberg, VIC 3084 Australia
| | - Chris Lassig
- Stroke Foundation, Level 7/461 Bourke St, Melbourne, VIC 3000 Australia
| | - Tari Turner
- Cochrane Australia, Level 4/553 St Kilda Rd, Melbourne, VIC 3004 Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, VIC 3010 Australia
| | - Kelvin Hill
- Stroke Foundation, Level 7/461 Bourke St, Melbourne, VIC 3000 Australia
| | - Kirstine Shrubsole
- Southern Cross University, Bilinga, QLD 4225 Australia
- The Queensland Aphasia Research Centre, The University of Queensland, Brisbane, QLD Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
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i-Rebound after Stroke-Eat for Health: Mediterranean Dietary Intervention Co-Design Using an Integrated Knowledge Translation Approach and the TIDieR Checklist. Nutrients 2021; 13:nu13041058. [PMID: 33805076 PMCID: PMC8064089 DOI: 10.3390/nu13041058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/11/2021] [Accepted: 03/21/2021] [Indexed: 02/07/2023] Open
Abstract
Lifestyle interventions to reduce second stroke risk are complex. For effective translation into practice, interventions must be specific to end-user needs and described in detail for replication. This study used an Integrated Knowledge Translation (IKT) approach and the Template for Intervention Description and Replication (TIDieR) checklist to co-design and describe a telehealth-delivered diet program for stroke survivors. Stroke survivors and carers (n = 6), specialist dietitians (n = 6) and an IKT research team (n = 8) participated in a 4-phase co-design process. Phase 1: the IKT team developed the research questions, and identified essential program elements and workshop strategies for effective co-design. Phase 2: Participant co-design workshops used persona and journey mapping to create user profiles to identify barriers and essential program elements. Phase 3: The IKT team mapped Phase 2 data to the TIDieR checklist and developed the intervention prototype. Phase 4: Co-design workshops were conducted to refine the prototype for trial. Rigorous IKT co-design fundamentally influenced intervention development. Modifications to the protocol based on participant input included ensuring that all resources were accessible to people with aphasia, an additional support framework and resources specific to outcome of stroke. The feasibility and safety of this intervention is currently being pilot tested (randomised controlled trial; 2019/ETH11533, ACTRN12620000189921).
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Pilar MR, Proctor EK, Pineda JA. Development, implementation, and evaluation of a novel guideline engine for pediatric patients with severe traumatic brain injury: a study protocol. Implement Sci Commun 2020; 1:31. [PMID: 32885190 PMCID: PMC7427929 DOI: 10.1186/s43058-020-00012-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Severe traumatic brain injury (TBI) is a leading cause of death and disability for children. The Brain Trauma Foundation released evidence-based guidelines, a series of recommendations regarding care for pediatric patients with severe TBI. Clinical evidence suggests that adoption of guideline-based care improves outcomes in patients with severe TBI. However, guideline implementation has not been systematic or consistent in clinical practice. There is also a lack of information about implementation strategies that are effective given the nature of severe TBI care and the complex environment in the intensive care unit (ICU). Novel technology-based strategies may be uniquely suited to the fast-paced, transdisciplinary care delivered in the ICU, but such strategies must be carefully developed and evaluated to prevent unintended consequences within the system of care. This challenge presents a unique opportunity for intervention to more appropriately implement guideline-based care for pediatric patients with severe TBI. METHODS This mixed-method study will develop a novel technology-based bedside guideline engine (the implementation strategy) to facilitate uptake of evidence-based guidelines (the intervention) for management of severe TBI. Group model building and systems dynamics will inform the guideline engine design, and bedside functionality will be initially assessed through patient simulation. Using the Promoting Action on Research Implementation in Health Services (PARIHS) framework, we will determine the feasibility of incorporating the guideline engine in the ICU. Study participants will include pediatric patients with severe TBI and providers at three trauma centers. Quantitative data will include measures of guideline engine acceptance and organizational readiness for change. Qualitative data will include semi-structured interviews from clinicians. We will test the feasibility of incorporating the guideline engine in "real life practice" in preparation for a future clinical trial that will assess clinical and implementation outcomes, including feasibility, acceptability, and adoption of the guideline engine. DISCUSSION This study will lead to the development and feasibility testing of an adaptable strategy for implementing guideline-based care for severe TBI, a strategy that meets the needs of individual critical care environments and patients. A future study will test the adaptability and impact of the bedside guideline engine in a randomized clinical trial.
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Affiliation(s)
- Meagan R. Pilar
- Washington University in St. Louis, Brown School, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Enola K. Proctor
- Washington University in St. Louis, Brown School, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Jose A. Pineda
- Children’s Hospital Los Angeles/University of Southern California, Keck School of Medicine, 4650 Sunset Blvd, Los Angeles, CA 90027 USA
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Poulin V, Jean A, Lamontagne MÈ, Pellerin MA, Viau-Guay A, Ouellet MC. Identifying clinicians' priorities for the implementation of best practices in cognitive rehabilitation post-acquired brain injury. Disabil Rehabil 2020; 43:2952-2962. [PMID: 32045534 DOI: 10.1080/09638288.2020.1721574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To identify clinicians' perceptions of current levels of implementation of cognitive rehabilitation best practices, as well as individual and consensual group priorities for implementing cognitive rehabilitation interventions as part of a multi-site integrated knowledge translation initiative. METHOD A two-step consensus-building methodology was used, that is the Technique for Research of Information by Animation of a Group of Experts (TRIAGE), including a cross-sectional electronic survey followed by consensual in-person group discussions to identify implementation priorities from a list of evidence-based practices for cognitive rehabilitation following traumatic brain injury and stroke. Thirty-eight professionals from three rehabilitation teams (n = 9, 13 and 16) participated, including neuropsychologists, occupational therapists, speech-language pathologists, educators, clinical coordinators and program managers. Descriptive statistics were used to document the perceived levels of implementation as well as individual and consensual group priorities. RESULTS Most of the best practices (81-100%) were perceived as at least partially implemented by a minimum of 50% of the participants but only 20-25% of the practices were considered fully implemented. Findings suggest that current practices are mostly consistent with general cognitive rehabilitation principles suggested in guidelines but that further efforts are needed to support the application of specific cognitive rehabilitation strategies and interventions. Executive function and self-awareness retraining, as well as interventions promoting the generalization of skills, were among the highest implementation priorities. Consensual in-person group discussions, included as part of the TRIAGE process, also helped to define and operationalize these best practices into more specific intervention components according to the teams' needs and priorities. CONCLUSIONS TRIAGE consensus-building methodology can be used to engage stakeholders and support clinicians' decision-making regarding the identification of implementation priorities in cognitive rehabilitation post-ABI in order to tailor the implementation process to local needs.IMPLICATIONS FOR REHABILITATIONThe Technique for Research of Information by Animation of a Group of Experts (TRIAGE) can be used to support clinicians' decision-making regarding the identification of implementation priorities in cognitive rehabilitation post-ABI.The combination of individual consultations followed by consensual in-person group discussions, as part of the TRIAGE process, may help clinicians in defining and operationalizing best practices into more specific intervention components to implement.Effective implementation strategies are needed to support the use of specific cognitive rehabilitation interventions in prioritized areas, such as executive function and self-awareness retraining, as well as generalization of skills.Some differences in clinicians' perceived priorities point up the importance of tailoring implementation to local needs and contexts from the early stages in the process.
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Affiliation(s)
- Valérie Poulin
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Québec, Canada
| | - Alexandra Jean
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Marie-Ève Lamontagne
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Québec, Canada.,Department of Rehabilitation, Université Laval, Québec, Canada
| | - Marc-André Pellerin
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Québec, Canada.,Department of Rehabilitation, Université Laval, Québec, Canada.,Faculty of Education Sciences, Université Laval, Québec, Canada
| | - Anabelle Viau-Guay
- Faculty of Education Sciences, Université Laval, Québec, Canada.,Centre de Recherche et d'intervention sur la Réussite Scolaire, Université Laval, Québec, Canada
| | - Marie-Christine Ouellet
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), Québec, Canada.,School of Psychology, Université Laval, Québec, Canada
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Eng JJ, Bird ML, Godecke E, Hoffmann TC, Laurin C, Olaoye OA, Solomon J, Teasell R, Watkins CL, Walker MF. Moving Stroke Rehabilitation Research Evidence into Clinical Practice: Consensus-Based Core Recommendations From the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2019; 33:935-942. [PMID: 31660783 DOI: 10.1177/1545968319886485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke.
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Affiliation(s)
- Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Marie-Louise Bird
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
| | | | - Olumide A Olaoye
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - John Solomon
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Robert Teasell
- Parkwood Institute Research, Lawson Health Research Institute and Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Caroline L Watkins
- University of Central Lancashire, Preston, UK and Australian Catholic University, Sydney, Australia
| | - Marion F Walker
- School of Medicine, University of Nottingham, Nottingham, UK
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Eng JJ, Bird ML, Godecke E, Hoffmann TC, Laurin C, Olaoye OA, Solomon J, Teasell R, Watkins CL, Walker MF. Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Int J Stroke 2019; 14:766-773. [PMID: 31564224 DOI: 10.1177/1747493019873597] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke.
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Affiliation(s)
- Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Marie-Louise Bird
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
| | | | - Olumide A Olaoye
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - John Solomon
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Robert Teasell
- Parkwood Institute Research, Lawson Health Research Institute and Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Caroline L Watkins
- University of Central Lancashire, Preston, UK and Australian Catholic University, Sydney, Australia
| | - Marion F Walker
- School of Medicine, University of Nottingham, Nottingham, UK
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Agoston DV, Vink R, Helmy A, Risling M, Nelson D, Prins M. How to Translate Time: The Temporal Aspects of Rodent and Human Pathobiological Processes in Traumatic Brain Injury. J Neurotrauma 2019; 36:1724-1737. [PMID: 30628544 PMCID: PMC7643768 DOI: 10.1089/neu.2018.6261] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Traumatic brain injury (TBI) triggers multiple pathobiological responses with differing onsets, magnitudes, and durations. Identifying the therapeutic window of individual pathologies is critical for successful pharmacological treatment. Dozens of experimental pharmacotherapies have been successfully tested in rodent models, yet all of them (to date) have failed in clinical trials. The differing time scales of rodent and human biological and pathological processes may have contributed to these failures. We compared rodent versus human time scales of TBI-induced changes in cerebral glucose metabolism, inflammatory processes, axonal integrity, and water homeostasis based on published data. We found that the trajectories of these pathologies run on different timescales in the two species, and it appears that there is no universal "conversion rate" between rodent and human pathophysiological processes. For example, the inflammatory process appears to have an abbreviated time scale in rodents versus humans relative to cerebral glucose metabolism or axonal pathologies. Limitations toward determining conversion rates for various pathobiological processes include the use of differing outcome measures in experimental and clinical TBI studies and the rarity of longitudinal studies. In order to better translate time and close the translational gap, we suggest 1) using clinically relevant outcome measures, primarily in vivo imaging and blood-based proteomics, in experimental TBI studies and 2) collecting data at multiple post-injury time points with a frequency exceeding the expected information content by two or three times. Combined with a big data approach, we believe these measures will facilitate the translation of promising experimental treatments into clinical use.
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Affiliation(s)
- Denes V. Agoston
- Department of Anatomy, Physiology and Genetics, Uniformed Services University, Bethesda, Maryland
| | - Robert Vink
- Division of Health Science, University of South Australia, Adelaide, Australia
| | - Adel Helmy
- Division of Neurosurgery, Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Mårten Risling
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - David Nelson
- Department of Physiology and Pharmacology, Section of Perioperative Medicine and Intensive Care, Karolinska Institutet, Stockholm, Sweden
| | - Mayumi Prins
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California
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A Systematic Critical Appraisal of Evidence-Based Clinical Practice Guidelines for the Rehabilitation of Children With Moderate or Severe Acquired Brain Injury. Arch Phys Med Rehabil 2019; 100:711-723. [DOI: 10.1016/j.apmr.2018.05.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/23/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022]
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Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting. Dimens Crit Care Nurs 2018; 37:144-155. [PMID: 29596291 DOI: 10.1097/dcc.0000000000000301] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. PURPOSE The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. DESIGN A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. METHODS A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A semistructured debriefing guided by the TENTS tool highlighted important aspects of teamwork. Participants took knowledge and Teamwork Skills Scale (TSS) pretests, posttests, and 1-month posttests. Mean scores were calculated for each time point (pre, post, and 1-month post), and paired t tests were used to evaluate changes. RESULTS Mean knowledge test and TSS scores both significantly increased after the simulation and remained significantly elevated at 1-month follow-up. Participants recommended retraining intervals of 3 to 6 months. Cost of each simulation was estimated to be $324.44. Analysis of nursing turnover rates did not demonstrate a statistically significant reduction in turnover; however, confounding factors were not controlled for. CONCLUSION Significant improvements on both knowledge test and TSS scores demonstrate the effectiveness of the intervention, and retention of the information gained and teamwork skills learned. Participants valued the intervention and recommended to increase the frequency of training. Future studies should develop a framework for "best practice" IPS, analyze the relationship with nursing turnover, and ultimately seek correlations between IPS and improved patient outcomes.
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Why Do We Need a New Clinical Practice Guideline for Moderate to Severe Traumatic Brain Injury? J Head Trauma Rehabil 2018; 33:285-287. [DOI: 10.1097/htr.0000000000000427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stamenova V, Levine B. Effectiveness of goal management training® in improving executive functions: A meta-analysis. Neuropsychol Rehabil 2018. [PMID: 29540124 DOI: 10.1080/09602011.2018.1438294] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Our objective was to review the literature and quantitatively summarise the effectiveness of Goal Management Training® (GMT) (alone or in combination with other training approaches) in improving executive functions in adult populations. Ovid, Scopus, Web of Science, and ProQuest Dissertations & Theses Global were searched for articles citing "goal management training". Any group trials (n > 3) in adults that used multiple-session GMT programmes were included in the analyses. Outcome variables were extracted and classified into one of nine cognitive measures domains: executive functioning tasks, everyday executive functioning tasks, subjective executive tasks rated by the patient, subjective executive tasks rated by proxy, working memory, speed of processing, long-term memory, instrumental activities of daily living and general mental health status questionnaires. A total of 21 publications, containing 19 separate treatment group samples were included in the final analyses. Significantly positive small to moderate effect sizes were observed in all cognitive measure domains (except speed of processing) with effects maintained at follow-up assessments for all followed-up outcome measures, except for subjective ratings by patients and proxy. The analysis suggests that GMT is an effective intervention, leading to moderate improvements in executive functions that are usually maintained at follow-up.
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Affiliation(s)
- Vessela Stamenova
- Women's College Hospital Institute for Health System Solutions and Virtual Care , Toronto , ON , Canada
| | - Brian Levine
- Rotman Research Institute at Baycrest, University of Toronto , Toronto , ON , Canada
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Priorities for Closing the Evidence-Practice Gaps in Poststroke Aphasia Rehabilitation: A Scoping Review. Arch Phys Med Rehabil 2017; 99:1413-1423.e24. [PMID: 28923500 DOI: 10.1016/j.apmr.2017.08.474] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 07/16/2017] [Accepted: 08/14/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify implementation priorities for poststroke aphasia management relevant to the Australian health care context. DATA SOURCES Using systematized searches of databases (CINAHL and MEDLINE), guideline and stroke websites, and other sources, evidence was identified and extracted for 7 implementation criteria for 13 topic areas relevant to aphasia management. These 7 priority-setting criteria were identified in the implementation literature: strength of the evidence, current evidence-practice gap, clinician preference, patient preference, modifiability, measurability, and health effect. STUDY SELECTION Articles were included if they were in English, related to a specific recommendation requiring implementation, and contained information pertaining to any of the 7 prioritization criteria. DATA EXTRACTION The scoping review methodology was chosen to address the broad nature of the topic. Evidence was extracted and placed in an evidence matrix. After this, evidence was summarized and then aphasia rehabilitation topics were prioritized using an approach developed by the research team. DATA SYNTHESIS Evidence from 100 documents was extracted and summarized. Four topic areas were identified as implementation priorities for aphasia: timing, amount, and intensity of therapy; goal setting; information, education, and aphasia-friendly information; and constraint-induced language therapy. CONCLUSIONS Closing the evidence-practice gaps in the 4 priority areas identified may deliver the greatest gains in outcomes for Australian stroke survivors with aphasia. Our approach to developing implementation priorities may be useful for identifying priorities for implementation in other health care areas.
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Bennett S, Whitehead M, Eames S, Fleming J, Low S, Caldwell E. Building capacity for knowledge translation in occupational therapy: learning through participatory action research. BMC MEDICAL EDUCATION 2016; 16:257. [PMID: 27716230 PMCID: PMC5045617 DOI: 10.1186/s12909-016-0771-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/20/2016] [Indexed: 06/02/2023]
Abstract
BACKGROUND There has been widespread acknowledgement of the need to build capacity in knowledge translation however much of the existing work focuses on building capacity amongst researchers rather than with clinicians directly. This paper's aim is to describe a research project for developing a knowledge translation capacity building program for occupational therapy clinicians. METHODS Participatory action research methods were used to both develop and evaluate the knowledge translation capacity-building program. Participants were occupational therapists from a large metropolitan hospital in Australia. Researchers and clinicians worked together to use the action cycle of the Knowledge to Action Framework to increase use of knowledge translation itself within the department in general, within their clinical teams, and to facilitate knowledge translation becoming part of the department's culture. Barriers and enablers to using knowledge translation were identified through a survey based on the Theoretical Domains Framework and through focus groups. Multiple interventions were used to develop a knowledge translation capacity-building program. RESULTS Fifty-two occupational therapists participated initially, but only 20 across the first 18 months of the project. Barriers and enablers were identified across all domains of the Theoretical Domains Framework. Interventions selected to address these barriers or facilitate enablers were categorised into ten different categories: educational outreach; teams working on clinical knowledge translation case studies; identifying time blocks for knowledge translation; mentoring; leadership strategies; communication strategies; documentation and resources to support knowledge translation; funding a knowledge translation champion one day per week; setting goals for knowledge translation; and knowledge translation reporting strategies. Use of these strategies was, and continues to be monitored. Participants continue to be actively involved in learning and shaping the knowledge translation program across the department and within their specific clinical areas. CONCLUSION To build capacity for knowledge translation, it is important to involve clinicians. The action cycle of the Knowledge to Action framework is a useful guide to introduce the knowledge translation process to clinicians. It may be used to engage the department as a whole, and facilitate the learning and application of knowledge translation within specific clinical areas. Research evaluating this knowledge translation program is being conducted.
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Affiliation(s)
- Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, Chancellors Place, Brisbane, 4072 Australia
| | - Mary Whitehead
- Occupational Therapy Department, Princess Alexandra Hospital (Metro South Hospital and Health Service), 199 Ipswich Road, Woolloongabba, Australia
| | - Sally Eames
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, Chancellors Place, Brisbane, 4072 Australia
- Occupational Therapy Department, Princess Alexandra Hospital (Metro South Hospital and Health Service), 199 Ipswich Road, Woolloongabba, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, Chancellors Place, Brisbane, 4072 Australia
- Occupational Therapy Department, Princess Alexandra Hospital (Metro South Hospital and Health Service), 199 Ipswich Road, Woolloongabba, Australia
| | - Shanling Low
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, Chancellors Place, Brisbane, 4072 Australia
| | - Elizabeth Caldwell
- Occupational Therapy Department, Princess Alexandra Hospital (Metro South Hospital and Health Service), 199 Ipswich Road, Woolloongabba, Australia
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20
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Powell JM. Special Issue on Occupational Therapy for Adults With Traumatic Brain Injury. Am J Occup Ther 2016; 70:7003170010p1-4. [PMID: 27089284 DOI: 10.5014/ajot.2016.703002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Awareness of the incidence and consequences of traumatic brain injury (TBI) has increased in recent years, along with interest in knowing how best to treat this complex condition. This editorial provides an overview of the various factors that contribute to the complexity of TBI and introduces the six systematic reviews and one qualitative study included in this special issue of the American Journal of Occupational Therapy focusing on interventions for TBI from an occupational therapy perspective. Issues with the generation and interpretation of research evidence are discussed, along with the importance of valuing clinician expertise and client perspectives along with research findings in implementing evidence-based and evidence-informed practice.
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Affiliation(s)
- Janet M Powell
- Janet M. Powell, PhD, OTR/L, FAOTA, is Associate Professor and Head, Division of Occupational Therapy, University of Washington, Seattle;
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Miake-Lye IM, Hempel S, Shanman R, Shekelle PG. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev 2016; 5:28. [PMID: 26864942 PMCID: PMC4750281 DOI: 10.1186/s13643-016-0204-x] [Citation(s) in RCA: 314] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 02/02/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The need for systematic methods for reviewing evidence is continuously increasing. Evidence mapping is one emerging method. There are no authoritative recommendations for what constitutes an evidence map or what methods should be used, and anecdotal evidence suggests heterogeneity in both. Our objectives are to identify published evidence maps and to compare and contrast the presented definitions of evidence mapping, the domains used to classify data in evidence maps, and the form the evidence map takes. METHODS We conducted a systematic review of publications that presented results with a process termed "evidence mapping" or included a figure called an "evidence map." We identified publications from searches of ten databases through 8/21/2015, reference mining, and consulting topic experts. We abstracted the research question, the unit of analysis, the search methods and search period covered, and the country of origin. Data were narratively synthesized. RESULTS Thirty-nine publications met inclusion criteria. Published evidence maps varied in their definition and the form of the evidence map. Of the 31 definitions provided, 67 % described the purpose as identification of gaps and 58 % referenced a stakeholder engagement process or user-friendly product. All evidence maps explicitly used a systematic approach to evidence synthesis. Twenty-six publications referred to a figure or table explicitly called an "evidence map," eight referred to an online database as the evidence map, and five stated they used a mapping methodology but did not present a visual depiction of the evidence. CONCLUSIONS The principal conclusion of our evaluation of studies that call themselves "evidence maps" is that the implied definition of what constitutes an evidence map is a systematic search of a broad field to identify gaps in knowledge and/or future research needs that presents results in a user-friendly format, often a visual figure or graph, or a searchable database. Foundational work is needed to better standardize the methods and products of an evidence map so that researchers and policymakers will know what to expect of this new type of evidence review. SYSTEMATIC REVIEW REGISTRATION Although an a priori protocol was developed, no registration was completed; this review did not fit the PROSPERO format.
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Affiliation(s)
- Isomi M. Miake-Lye
- />Evidence-based Synthesis Program (ESP) Center, Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA
- />Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 640 Charles E Young Dr S, Los Angeles, CA USA
| | - Susanne Hempel
- />Southern California Evidence-based Practice Center, RAND Corporation, 1776 Main St, Santa Monica, CA 90401 USA
| | - Roberta Shanman
- />Southern California Evidence-based Practice Center, RAND Corporation, 1776 Main St, Santa Monica, CA 90401 USA
| | - Paul G. Shekelle
- />Evidence-based Synthesis Program (ESP) Center, Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA
- />Southern California Evidence-based Practice Center, RAND Corporation, 1776 Main St, Santa Monica, CA 90401 USA
- />Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095 USA
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Abstract
Traumatic injury to the brain or spinal cord is one of the most serious public health problems worldwide. The devastating impact of 'trauma', a term used to define the global burden of disease related to all injuries, is the leading cause of loss of human potential across the globe, especially in low- and middle-income countries. Enormous challenges must be met to significantly advance neurotrauma research around the world, specifically in underserved and austere environments. Neurotrauma research at the global level needs to be contextualized: different regions have their own needs and obstacles. Interventions that are not considered a priority in some regions could be a priority for others. The introduction of inexpensive and innovative interventions, including mobile technologies and e-health applications, focused on policy management improvement are essential and should be applicable to the needs of the local environment. The simple transfer of a clinical question from resource-rich environments to those of low- and middle-income countries that lack sophisticated interventions may not be the best strategy to address these countries' needs. Emphasis on promoting the design of true 'ecological' studies that include the evaluation of human factors in relation to the process of care, analytical descriptions of health systems, and how leadership is best applied in medical communities and society as a whole will become crucial.
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Vaughn S, Mauk KL, Jacelon CS, Larsen PD, Rye J, Wintersgill W, Cave CE, Dufresne D. The Competency Model for Professional Rehabilitation Nursing. Rehabil Nurs 2015; 41:33-44. [PMID: 26395123 DOI: 10.1002/rnj.225] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND Rehabilitation nursing is practiced in various settings along the healthcare continuum. No framework is noted in the literature that defines the necessary competencies of the rehabilitation nurse. PURPOSE To develop a Competency Model for Professional Rehabilitation Nursing and its application to clinical and educational practice. METHOD/DESIGN A seven-member Association of Rehabilitation Nurses (ARN) task force was convened; conducted a literature review, reviewed current and historical ARN documents, including the Strategic Plan, and developed a Competency Model for Professional Rehabilitation Nursing practice. FINDINGS The Competency Model for Professional Rehabilitation Nursing delineates four domains of rehabilitation nursing practice and essential role competencies. CONCLUSION The Competency Model for Professional Rehabilitation Nursing addresses this diverse specialty practice in the current healthcare arena. This framework can be used to guide nurses practicing at different levels of proficiency in various settings. CLINICAL RELEVANCE The Competency Model can be used as a structure for staff orientation, evaluation tools, clinical ladder components, role descriptions and rehabilitation nursing courses.
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Affiliation(s)
- Stephanie Vaughn
- School of Nursing, California State University Fullerton, Fullerton, CA, USA
| | | | | | | | - Jill Rye
- Nursing, Avera McKennan Hospital & University Health Center, Sioux Falls, SD, USA
| | | | - Christine E Cave
- Rehabilitation, El Camino Hospital Los Gatos, Los Gatos, CA, USA
| | - David Dufresne
- Professional Development, Association of Rehabilitation Nurses, Chicago, IL, USA
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Moreno JA, das Nair R. Translating knowledge into practice: content analysis of online resources about sexual difficulties for individuals with traumatic brain injury. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1039937] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury. J Head Trauma Rehabil 2014; 29:290-306. [DOI: 10.1097/htr.0000000000000070] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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