National Asthma Education and Prevention Program 2020 Guideline Update: Where Do We Go from Here?
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ABSTRACT:
SUBMITTER: Krishnan JA
PROVIDER: S-EPMC7874432 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:A rigorous process was undertaken to develop these evidence-based guidelines. The Agency for Healthcare Research and Quality's (AHRQ) Evidence-Based Practice Centers conducted systematic reviews on these topics, which were used by the Expert Panel Working Group as a basis for developing recommendations and guidance. The Expert Panel used GRADE (Grading of Recommendations, Assessment, Development and Evaluation), an internationally accepted framework, in consultation with an experienced methodology team for determining the certainty of evidence and the direction and strength of recommendations based on the evidence. Practical implementation guidance for each recommendation incorporates findings from NHLBI-led patient, caregiver, and clinician focus groups. To assist clincians in implementing these recommendations into patient care, the new recommendations have been integrated into the existing Expert Panel Report-3 (EPR-3) asthma management step diagram format.
| S-EPMC7924476 | biostudies-literature
Project description: Not available
| S-EPMC4264300 | biostudies-literature
Project description:Undergraduate subject pools are prevalent across disciplines in the United States. The Health Education Research Experience (HERE) Program was the first known course-based subject pool entirely managed and conducted online for online students enrolled in an introductory health education/health promotion course. The program was conducted within five semesters from Spring 2012 through Summer 2013. The HERE Program encompassed 13 studies embedded in two sections of an undergraduate online course at the University of Florida. The studies were all related to course topics and current research topics in health education/promotion (as identified through the Healthy People 2020 Framework). The topics ranged from the relatively less sensitive health aspects of college life (i.e., technology use) to studies assessing more sensitive health topics (i.e., intimate partner violence and sexual assault). In alignment with a best practice in survey design, the HERE Program's survey instruments included one metadata item embedded in each survey to identify which devices students used to complete the surveys. Understanding which devices students used for survey completion has ramifications for survey designers and survey researchers. In contrast to the relative uniformity of pen and paper surveys and control of the survey completion environment, online surveys may not look identical across personal devices and may be completed in increasingly varied environments. All studies, study procedures and protocols, and metadata collection procedures were approved by the university's Institutional Review Board. The data presented here were extracted from each survey's data files and aggregated. The aggregated metadata are available through Mendeley Data in a.csv file for widespread access. Descriptive statistics are presented in tables. The data provided in this article will benefit researchers interested in survey methodology, questionnaire design, modes of survey collection, and survey metadata. The data are hosted in the following Mendeley Data repository: https://data.mendeley.com/datasets/ht9jmd3cdt/2.
| S-EPMC7100622 | biostudies-literature
Project description: Not available
| S-EPMC9828999 | biostudies-literature
Project description:BACKGROUND AND PURPOSE:The National Diabetes Education Program created the Small Steps. Big Rewards. GAME PLAN. toolkit to deliver basic type 2 diabetes prevention information to individuals at risk. The purpose of this study is to test the impact of GAME PLAN on diabetes prevention knowledge and behavioral readiness in the vitamin D and type 2 diabetes (D2d) study and participant satisfaction with toolkit materials. METHODS:Three hundred sixty adults at risk for diabetes participating in the D2d study were enrolled. Participants took a pretest, were sent home with the GAME PLAN, then took a posttest at their next visit, 3 months later. The Wilcoxon-signed rank test was used to examine changes in knowledge and behavioral readiness between scale scores pre- and posttest. CONCLUSIONS:There were modest increases in composite diabetes prevention knowledge scores (p < .05) and behavioral readiness scores (p < .001) from pre- to posttest. Participants also reported at posttest that the toolkit materials were appropriate, comprehensive, and relevant. IMPLICATIONS FOR PRACTICE:The GAME PLAN health education materials improve knowledge and behavioral readiness among adults at risk for diabetes. Providers can use GAME PLAN as one component of diabetes prevention education.
| S-EPMC5673101 | biostudies-literature
Project description:BackgroundAs the pandemic wanes, there is an opportunity to reevaluate resultant changes in graduate medical education (GME), particularly from the viewpoints of those affected most. We aimed to assess both trainee and faculty perceptions on the educational changes and innovations resulting from the pandemic to inform future educational planning.MethodsWe surveyed trainees and core education faculty at three New York City children's hospitals. Surveys assessed perceived changes to educational activities, skills, scholarship, effectiveness of virtual teaching, future desirability, and qualitative themes.ResultsThe survey was completed by 194 participants, including 88 (45.4%) faculty and 106 (54.6%) trainees. Trainees were more likely to report a negative impact of the pandemic compared with faculty (75.5% vs. 50%, p < 0.01). Most respondents reported a decrease in formal educational activities (69.8%), inpatient (77.7%) and outpatient (77.8%) clinical teaching. Despite this, most perceived clinical and teaching skills to have stayed the same. Most (93.4%) participated in virtual education; however, only 36.5% of faculty taught virtually. Only 4.2% of faculty had extensive training in virtual teaching and 28.9% felt very comfortable teaching virtually. In the future, most (87.5%) prefer a hybrid approach, particularly virtual didactic conferences and virtual grand rounds. Faculty themes included challenges to workflows and increased empathy for trainees, while trainee themes included increased work/life balance and support, but increased burnout.ConclusionMany changes and innovations resulted from the pandemic. Hospital systems and GME programs should consider this data and incorporate viewpoints from trainees and faculty when adapting educational strategies in the future.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-023-01737-8.
| S-EPMC9900559 | biostudies-literature
Project description:The National Toxicology Program (NTP) receives requests to evaluate chemicals with potential to cause adverse health effects, including developmental neurotoxicity (DNT). Some recent requests have included classes of chemicals such as flame retardants, polycyclic aromatic compounds, perfluoroalkyl substances, and bisphenol A analogs with approximately 20-50 compounds per class, many of which include commercial mixtures. However, all the compounds within a class cannot be tested using traditional DNT animal testing guideline studies due to resource and time limitations. Hence, a rapid and biologically relevant screening approach is required to prioritize compounds for further in vivo testing. Because neurodevelopment is a complex process involving multiple distinct cellular processes, one assay will unlikely address the complexity. Hence, the NTP sought to characterize a battery of in vitro and alternative animal assays to quantify chemical effects on a variety of neurodevelopmental processes. A culmination of this effort resulted in a NTP-hosted collaborative project with approximately 40 participants spanning across domains of academia, industry, government, and regulatory agencies; collaborators presented data on cell-based assays and alternative animal models that was generated using a targeted set of compounds provided by the NTP. The NTP analyzed the assay results using benchmark concentration (BMC) modeling to be able to compare results across the divergent assays. The results were shared with the contributing researchers on a private web application during the workshop, and are now publicly available. This article highlights the overview and goals of the project, and describes the NTP's approach in creating the chemical library, development of NTPs data analysis strategy, and the structure of the web application. Finally, we discuss key issues with emphasis on the utility of this approach, and knowledge gaps that need to be addressed for its use in regulatory decision making.
| S-EPMC6657567 | biostudies-literature
Project description: Not available
| S-EPMC6175624 | biostudies-literature
Project description:Since publication of the first randomized controlled trial describing rapid antidepressant effects of ketamine, several reports have confirmed the potential utility of this dissociative anesthetic medication for treatment of major depressive episodes, including those associated with bipolar disorder and resistant to other medications and electroconvulsive therapy. These reports have generated several questions with respect to who might respond to ketamine, how, and for how long. To start answering these questions. We used PubMed.gov and ClinicalTrials.gov to perform a systematic review of all available published data on the antidepressant effects of ketamine and of all recently completed, ongoing, and planned studies. To date, 163 patients, primarily with treatment-resistant depression, have participated in case studies, open-label investigations, or controlled trials. All controlled trials have used a within-subject, crossover design with an inactive placebo as the control. Ketamine administration has usually involved an anaesthesiologist infusing a single, subanesthetic, intravenous dose, and required hospitalization for at least 24 hours postinfusion. Response rates in the open-label investigations and controlled trials have ranged from 25% to 85% at 24 hours postinfusion and from 14% to 70% at 72 hours postinfusion. Although adverse effects have generally been mild, some patients have experienced brief changes in blood pressure, heart rate, or respiratory rate. Risk-benefit analyses support further research of ketamine for individuals with severe mood disorders. However, given the paucity of randomized controlled trials, lack of an active placebo, limited data on long-term outcomes, and potential risks, ketamine administration is not recommended outside of the hospital setting.
| S-EPMC3438349 | biostudies-literature
Project description:Oxidative stress (OxS) is one of the main processes related to aging and a common denominator of many different chronic/degenerative diseases (e.g., cardiovascular and neurodegenerative conditions and cancer). Thus, its potential modulation by supplementation/pharmacological therapy caused a lot of interest. However, these expectations have been mitigated by the obtainment of controversial results (beneficial, null, or adverse effects) following antioxidant interventions. Here, we discuss the current understanding of OxS assessment in health and disease, challenges and the potential of its evaluation in clinical practice, and available and future development for supplementation and pharmacologic strategies targeting OxS.
| S-EPMC7321135 | biostudies-literature