با سلام خدمت کاربران در صورتی که با خطای سیستم پرداخت بانکی مواجه شدید از طریق کارت به کارت (6037997535328901 بانک ملی ناصر خنجری ) مقاله خود را دریافت کنید (تا مشکل رفع گردد).
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Pain management for infants – Myths, misconceptions, barriers; knowledge and knowledge gaps
مدیریت درد برای نوزادان - افسانه ها، باورهای غلط، موانع؛ دانش و شکاف دانش-2021 Twelve years ago, the paper ‘Oral sucrose for pain management in infants: Myths and misconceptions’ was
published in the Journal of Neonatal Nursing. At this time, eight myths or misconceptions were addressed. Since
this time there has been more than 100 studies published reporting on analgesic effects of sweet solutions in
newborns, which have been synthesised and included in systematic reviews. There has also been a growth of
literature to support analgesic effects of breastfeeding and skin-to-skin care as well as concerning evidence of
adverse long-term neurobehavioural outcomes associated with painful procedures. Yet, ongoing studies of pain
management practices continue to report inconsistent use of these strategies during painful procedures. We are
therefore at a cross-roads of evidence – there is knowledge of effective treatments, knowledge of harm of untreated pain, yet sick, premature as well as healthy infants are continuing to be exposed to painful procedures
with no effective treatment. There are however ongoing myths, misconceptions, and practical barriers to using
the evidence as well as ongoing knowledge gaps. This paper will therefore highlight existing myths, misconceptions, barriers and current knowledge gaps to using the three key evidence-based pain management
strategies of breastfeeding, skin-to-skin care and sweet solutions, in the hope that this will bring to light newborn
infant pain treatment practices that can be improved.
keywords: پرستاری | نوزاد تازه | درد | درمان درد | شیر دادن | ساکاروز | پوست به پوست | نوزاد | ترجمه دانش | پژوهش | Nursing | Newborn | Pain | Pain treatment | Breastfeeding | Sucrose | Skin-to-skin | Neonate | Knowledge translation | Research |
مقاله انگلیسی |
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Time management: Improving the timing of post-prostatectomy radiotherapy, clinical trials, and knowledge translation
مدیریت زمان: بهبود زمان رادیوتراپی پس از پروستاتکتومی، آزمایشات بالینی و ترجمه دانش-2021 Background: Management of prostate cancer after surgery is controversial. Past studies on adjuvant radiotherapy
(aRT) for higher-risk features have had conflicting results. Through the collaborative conversations of the global
radiation oncology Twitter-based journal club (#RadOnc #JC), we explored this complex topic to share recent
advances, better understand what the global radiation oncology community felt was important and inspire next
steps.
Methods: We selected the recent publication of a landmark international randomized controlled trial (RCT)
comparing immediate and salvage radiotherapy for prostate cancer, RADICALS-RT, for discussion over the
weekend of January 16 to 17, 2021. Coordination included open access to the article and an asynchronous
portion to decrease barriers to participation, cooperation of study authors (CP, MS) who participated to share
deeper insights including a live hour, and curation of related resources and tweet content through a blog post and
Wakelet journal club summary.
Discussion of Results: Our conversations created 2,370,104 impressions over 599 tweets with 51 participants
spanning 11 countries and 5 continents. A quarter of the participants were from the US (13/51) followed by 10%
from the UK (5/51). Clinical or Radiation Oncologists comprised 59% of active participants (16/27) with 62%
(18/29) reporting giving aRT within the last 5 years. Discussion was interdisciplinary with three urologists
(11%), three trainees (11%), and two physiotherapists (7%). Four months after the journal club its article Altmetric
score had increased by 7% (214 to 229). Thematic analysis of tweet content suggested participants wanted
clarification on definitions of adjuvant (aRT) and salvage radiotherapy (sRT) including indications, timing, and
decision-making tools including guidelines; more interdisciplinary and cross-sectoral collaboration including
with patients for study design including survivorship and meaningful outcomes; more effective knowledge
translation including faster clinical trials; and more data including mature results of current trials, particular
high-risk features (Gleason Group 4+, pT4b+, and margin-positive disease), implications of newer technologies
such as PSMA-PET and genomic classifiers, and better explanations for practice pattern variations including
underutilization of radiotherapy. This was further explored in the context of relevant literature.
Conclusion: Together, this global collaborative review on the postoperative management of prostate cancer
suggested a stronger signal for the uptake of early salvage radiation treatment with careful PSA monitoring, more
sensitive PSA triggers, and expected access to radiotherapy. Questions still remain on potential exceptions and barriers to use. These require better decision-making tools for all practice settings, consideration of newer
technologies, more pragmatic trials, and better use of social media for knowledge translation.
Keywords: Prostate radiotherapy | Adjuvant radiation | Salvage radiation | Journal club |
مقاله انگلیسی |
3 |
Chronic Liver Diseases and the Microbiome-Translating Our Knowledge of Gut Microbiota to Management of Chronic Liver Disease
بیماری های مزمن کبدی و میکروبیوم - ترجمه دانش ما از میکروبیوتا روده به مدیریت بیماری مزمن کبدی-2021 Chronic liver disease is reaching epidemic proportions with
the increasing prevalence of obesity, nonalcoholic liver
disease, and alcohol overuse worldwide. Most patients are
not candidates for liver transplantation even if they have
end-stage liver disease. There is growing evidence of a gut
microbial basis for many liver diseases, therefore, better
diagnostic, prognostic, and therapeutic approaches based
on knowledge of gut microbiota are needed. We review the
questions that need to be answered to successfully translate
our knowledge of the intestinal microbiome and the changes
associated with liver disease into practice.
Keywords: Cirrhosis | Hepatic Encephalopathy | Fecal Microbial Transplant | Diet. |
مقاله انگلیسی |