Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

• MeSH
• behaviorální vědy * metody   trendy   MeSH
• COVID-19 * epidemiologie   etnologie   prevence a kontrola   MeSH
• komunikace MeSH
• kultura MeSH
• lékařská praxe založená na důkazech * metody   MeSH
• lidé MeSH
• pandemie * prevence a kontrola   MeSH
• sociální normy MeSH
• veřejné zdravotnictví metody   trendy   MeSH
• vůdcovství MeSH
• vytváření politiky * MeSH
• zdravotní politika * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Delírium je univerzálna patologická reakcia mozgu na rôzne nepriaznivé činitele, pričom u kriticky chorých pacientov existuje vysoké riziko vzniku delíria. Nemusí to byť iba prechodný a očakávaný stav s minimálnymi následkami, ale môže viesť k predĺženiu pobytu v nemocnici a kognitívnemu deficitu po prepustení z pracoviska intenzívnej starostlivosti. Vyžaduje multimodálnu stratégiu, komplexný ošetrovateľský, lekársky prístup. Dôležitá je diagnostika delíria, nefarmakologické opatrenia, farmakologická prevencia a v prípade ich zlyhania farmakologická liečba. Správnymi liečebno – preventívnymi opatreniami môžeme znížiť výskyt delíria o jednu tretinu.

Delirium is a universal pathological response of the brain to various adverse factors. The risk of developing delirium is high in critically ill patients. It may not only be a transient and predicted condition with minimal consequences, but may lead to prolonged hospital stay and to cognitive deficit after discharge from intensive care unit. The condition requires multimodal strategy, complex nursing and medical approach. Imperative interventions involve the diagnosis of delirium, non-pharmacological measures, pharmacological prevention and, them failing, pharmacological treatment. Correct treatment and preventive measures can help reduce the incidence of delirium by one third.

• MeSH
• delirium diagnóza   klasifikace   ošetřování   prevence a kontrola   terapie   MeSH
• medicína založená na důkazech MeSH
• ošetřovatelská péče o pacienty v kritickém stavu MeSH
• rizikové faktory MeSH

Background: Charcot neuro-osteoarthropathy (CNO) is a rare but devastating complication of diabetes associated with high rates of morbidity; yet, many nonfoot specialists are unaware of it, resulting in missed and delayed diagnosis. Clinical practice guidelines (CPGs) have proven useful in improving quality of care and standardizing practice in diabetes and diabetic foot care. However, little is known about the consistency in recommendations for identification and management of active CNO. Aim: The aim of this study is to review European national diabetes CPGs for the diagnosis and management of active CNO and to assess their methodological rigor and transparency. Methods: A systematic search was performed to identify diabetes national CPGs across Europe. Guidelines in any language were reviewed to explore whether they provided a definition for active CNO and recommendations for diagnosis, monitoring, and management. Methodological rigor and transparency were assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) tool, which comprises 23 key items organized within six domains with an overall guideline assessment score of ≥ 60% considered to be of adequate quality to recommend use. Each guideline was assessed by two reviewers, and inter-rater agreement (Kendall's W) was calculated for AGREE-II scores. Results: Seventeen CPGs met the inclusion criteria. Breadth of CNO content varied across guidelines (median (IQR) word count: 327; Q1 = 151; Q3 = 790), and 53% provided a definition for active CNO. Recommendations for diagnosis and monitoring were provided by 82% and 53%, respectively, with offloading being the most common management recommendation (88%). Four guidelines (24%) reached threshold for recommendation for use in clinical practice (≥ 60%) with the scope and purpose domain scoring highest (mean (SD): 67%, ± 23%). The remaining domains had average scores ranging between 19% and 53%. Inter-rater agreement was strong (W = 0.882; p < 0.001). Conclusions: European national CPGs for diabetes provide limited recommendations on active CNO. All guidelines showcased deficits in their methodology, suggesting that more rigorous methods should be employed for diabetes CPG development across Europe.

• MeSH
• diabetická noha terapie   diagnóza   MeSH
• diabetické neuropatie terapie   diagnóza   MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• neuropatická artropatie * terapie   diagnóza   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION: Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed. METHODS: The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed. RESULTS: The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0-10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work. CONCLUSIONS: The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.

• MeSH
• artróza kolenních kloubů * terapie   rehabilitace   MeSH
• artróza kyčelních kloubů * terapie   rehabilitace   MeSH
• hmotnostní úbytek MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• pomůcky pro sebeobsluhu MeSH
• self-management metody   MeSH
• terapie cvičením * metody   MeSH
• vzdělávání pacientů jako téma metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Evropa MeSH

Úvod: Depresivní porucha, jako jedno z nejčastějších duševních onemocnění, nepříznivě ovlivňuje životy a zdravotní stav mnoha lidí po celém světě. Vyskytuje se v jakémkoliv věku, nejčastěji však mezi 20. a 40. rokem života. Celosvětově trpí každoročně depresivními poruchami přibližně 100 milionů lidí, přičemž u řady jedinců je terapie doprovázena částečnou léčebnou odpovědí nebo přímo rezistencí k léčbě, což trvale zvyšuje potřebu hledání efektivních strategií prevence a léčby, ale také průběžné monitorování a vyhodnocování aktuálně využívaných přístupů v běžné klinické praxi. Materiály a metody: Šířeji koncipovaná studie s pracovním názvem UMBRELLA byla neintervenční, observační, multicentrická studie, jejíž první etapa je zaměřená na tzv. "real world evidence" důvodů pro změnu psychofarmakologické léčby a jejího detailního charakteru u pacientů trpících depresivní epizodou periodické depresivní poruchy. Do závěrečného vyhodnocení byla zařazena data 267 pacientů léčených v psychiatrických ambulancích v České republice, které na sondě mapující reálnou klinickou praxi participovaly. Výsledky: Analyzována byla data od 74 mužů (27,7 %) a 193 žen (72,3 %) s průměrným věkem 49 let. Změny léčby byly prováděny lékařem na základě vyhodnocení přítomných reziduálních příznaků onemocnění, přičemž nejčastějšími problémy byly perzistující depresivní nálada, únava a anhedonie. Nejčastěji používané léčivé přípravky zahrnovaly antidepresiva (např. escitalopram, venlafaxin, sertralin), atypická antipsychotika (např. quetiapin) a klasická antipsychotika (např. chlorprothixen). Úprava farmakologické léčby byla nejčastěji provedena manipulací s antidepresivy, změnou účinné látky či úpravami jejich denních dávek. Diskuse a závěr: Předkládaná naturalistická observační studie zmapovala důvody pro změnu farmakologického přístupu a vlastní charakter nově zvolené léčebné strategie. Zjištěná heterogenita způsobů manipulace s farmakologickou léčbou potvrzuje, že léčba depresivních epizod v klinické praxi probíhá individualizovaným postupem u každého jednotlivého pacienta. Zde narážíme na snahu po uplatňování doporučených postupů v léčbě tohoto rozšířeného duševního onemocnění, které velmi efektivně popisují léčbu iniciálních epizod a v případě opakovaných epizod by také měly obsahovat základní principy terapeutického přístupu k řešení této problematiky. Zjištění, že i v rámci opakovaných epizod periodické depresivní poruchy lze efektivně zasáhnout zvýšením dávky antidepresiva nebo jeho změnou, podporuje snahu po edukaci specialistů i praktických lékařů v těchto bazálních postupech léčby. Celkově studie přináší informace reflektující běžnou klinickou praxi a podtrhuje význam iniciace strategie změny farmakologického přístupu u každého pacienta, v kterékoliv etapě léčby tohoto duševního onemocnění.

Introduction: Depressive disorder, as one of the most common mental illnesses, adversely affects the lives and health of many people around the world. It occurs at any age, but most commonly between the ages of 20 and 40. Worldwide, approximately 100 million people suffer from depressive disorders each year, with many individuals experiencing partial treatment response or treatment resistance, which continually increases the need to find effective prevention and treatment strategies, as well as to monitor and evaluate currently used approaches in routine clinical practice. Materials and methods: The more broadly conceived study, working title UMBRELLA, was a non-interventional, observational, multicentre study, the first phase of which focused on the so-called "real world evidence? of reasons for changing psychopharmacological treatment and its detailed nature in patients suffering from a depressive episode of periodic depressive disorder. The final evaluation included data from 267 patients treated in psychiatric outpatient clinics in the Czech Republic that participated in the probe into their own clinical practice. Results: Data from 74 men (27.7%) and 193 women (72.3%) with a mean age of 49 years were analysed. Changes in treatment were made by the physician based on an assessment of the residual symptoms present, with persistent depressed mood, fatigue and anhedonia being the most common problems. The most commonly used medications included antidepressants (e.g., escitalopram, venlafaxine, sertraline), atypical antipsychotics (e.g., quetiapine), and classic antipsychotics (e.g., chlorprothixene). Adjustments to pharmacological treatment were most commonly made by manipulating antidepressants, changing the active ingredient, or modifying their daily doses. Discussion and conclusion: The present naturalistic observational study mapped the reasons for the change in pharmacological approach and the actual nature of the newly chosen treatment strategy. The observed heterogeneity of pharmacological treatment manipulation patterns confirms that the treatment of depressive episodes in clinical practice follows an individualized approach for each individual patient. Here, we encounter a desire for the application of recommended practices in the treatment of this widespread mental illness, which very effectively describe the treatment of initial episodes and, in the case of recurrent episodes, should provide the basic principles of a therapeutic approach to the management of this problem. The finding that, even in the context of recurrent episodes of periodic depressive disorder, effective intervention can be achieved by increasing the dose of antidepressant medication or changing it, supports the drive to educate specialists and practitioners in these basic treatment approaches. Overall, the study provides information that reflects common clinical practice and underscores the importance of initiating a strategy to change the pharmacological approach in any patient, at any stage of the treatment of this mental illness.

• MeSH
• ambulantní péče MeSH
• antidepresiva klasifikace   terapeutické užití   MeSH
• antipsychotika klasifikace   terapeutické užití   MeSH
• deprese nereagující na léčbu farmakoterapie   patofyziologie   prevence a kontrola   MeSH
• kombinovaná farmakoterapie MeSH
• lékařská praxe založená na důkazech MeSH
• lidé středního věku MeSH
• lidé MeSH
• revize medikace MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• multicentrická studie MeSH
• pozorovací studie MeSH

• MeSH
• klinická studie jako téma normy   statistika a číselné údaje   MeSH
• lidé MeSH
• medicína založená na důkazech * normy   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH

OBJECTIVES: This project aimed to improve the quality of antenatal and intrapartum care for women with gestational diabetes (GD) by increasing nursing and midwifery care compliance with best practice recommendations. INTRODUCTION: GD is one of the most common diseases that can lead to several important maternal and fetal complications. METHODS: This project was based on JBI's evidence implementation approach and included a baseline audit, the implementation of strategies, and a follow-up audit. The project was conducted in an obstetrics-gynecology department of a hospital in Bucharest, and the sample included 30 pregnant women with GD from that ward. RESULTS: Regarding antenatal care, the baseline audit revealed low compliance (63%-87%) for criterion 2 (specific education), criterion 3 (multidisciplinary team), criterion 4 (individualized care plan), criterion 5 (training on self-monitoring), criterion 8 (dietician consultation), and criterion 10 (physical exercise program). Compliance with criterion 9 (physiotherapist consultation) was nil. Higher compliance (90%-100%) was reported for criterion 1 (screening for GD), criterion 6 (self-monitoring), and criterion 7 (maintenance of glycemic values). The intrapartum care audit criteria regarding maintaining blood glucose levels had compliance rates of 97% (criteria 13 and 14), 73% (criterion 11), and 67% (criterion 12). As a result of implementing the most appropriate strategies, maximum improvement was observed for all 12 audit criteria found to be deficient in the baseline audit. CONCLUSIONS: Strategies were identified and applied to successfully implement the best practices (educational programs and improved procedures). However, specific actions, such as regular targeted audits and continuous monitoring, are needed to maintain long-term results.

• MeSH
• gestační diabetes * diagnóza   terapie   MeSH
• konziliární vyšetření a konzultace MeSH
• lékařská praxe založená na důkazech MeSH
• lidé MeSH
• nemocnice MeSH
• prenatální péče MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION AND AIMS: Czech music therapists lacked the skills and knowledge to adapt their practice to virtual music therapy (VMT) at the beginning of the COVID-19 pandemic, when physical contact was restricted. The aims of this project were to implement the best evidence-based recommendations concerning VMT in the practice of Czech music therapists and increase the number of therapists using VMT. METHODS: The project used the JBI Evidence Implementation Framework to promote change in the practice of participants. A baseline audit of 26 practitioners was conducted using questionnaires and interviews. The audit criteria consisted of 8 best practice recommendations, followed by the implementation of targeted strategies and a follow-up audit. RESULTS: Of the 26 music therapists, 18 began practicing VMT following the rollout of the implementation strategies. Strategies included educational workshops, instructional materials, technological support, individual counseling, and interactive training sessions. There was an increase in compliance with all audit criteria. The most critical barriers were lack of knowledge about VMT and lack of technical skills; lack of resources; technological challenges; low confidence of music therapists to provide VMT; and reduced need for VMT after the lockdown restrictions were relaxed. CONCLUSIONS: The implementation project helped to overcome temporary pandemic restrictions, increase the quality of VMT practice, develop strategies for VMT training, and identify reasons for using VMT during the pandemic and beyond.

• MeSH
• hudba * MeSH
• lékařská praxe založená na důkazech MeSH
• lidé MeSH
• muzikoterapie * MeSH
• pandemie prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Aim: To identify attitudes and barriers to evidence-based practice from the perspective of Portuguese nurses specialized in medical-surgical nursing. Design: Descriptive cross-sectional study. Methods: Data collection in 2022, via a digital form comprising a questionnaire on socio-professional characterization and the Portuguese version of the "Barriers to Evidence-Based Practice in Primary Care". Non-probability convenience sampling. Data analysis performed using the Statistical Package for the Social Sciences, version 24. The checklist used was "Strengthening the Reporting of Observational Studies in Epidemiology". Results: The final sample consisted of 218 specialist medical-surgical nurses working in clinical practice settings in Portugal, who showed a generally positive attitude towards evidence-based practice. The barriers to evidence-based practice highlighted were lack of incentives, support from expert colleagues, training, financing, and time. Conclusion: Specialist medical-surgical nurses value evidence-based practice and recognized its benefits, but also identified barriers that make its practical implementation a challenge. The identification of the attitudes and barriers allows for the identification of shortcomings and the making of tailored training plans, thereby increasing the integration of evidence into the practice of these renowned professionals.

• MeSH
• chirurgické ošetřovatelství * statistika a číselné údaje   MeSH
• kvalitativní výzkum MeSH
• ošetřovatelství založené na důkazech statistika a číselné údaje   MeSH
• postoj zdravotnického personálu * MeSH
• průzkumy a dotazníky MeSH
• sestry specialistky statistika a číselné údaje   MeSH
• Geografické názvy
• Portugalsko MeSH

• Klíčová slova
• projekt Enigma, software Floxgen,
• MeSH
• genetická terapie etika   MeSH
• genomika * etika   přístrojové vybavení   trendy   MeSH
• individualizovaná medicína trendy   MeSH
• lidé MeSH
• medicína založená na důkazech trendy   MeSH
• sekvenování celého genomu metody   přístrojové vybavení   MeSH
• úhradový mechanismus MeSH
• umělá inteligence MeSH
• vysoce účinné nukleotidové sekvenování metody   přístrojové vybavení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH
• rozhovory MeSH