In Slovenia, children with special needs have been included to primary schools since 1998. Since then, teachers have had a lot of work to be done. Every year they have to prepare an individualized programme for each c...In Slovenia, children with special needs have been included to primary schools since 1998. Since then, teachers have had a lot of work to be done. Every year they have to prepare an individualized programme for each child with special needs. They have to set goals that each child with special needs has to achieve at a particular subject. Pupils have different teachers every year and to make their work easier, the author is considering making a website database with basic information about them. This database would state the goals that the pupil achieved in the past year, which strategy of teaching proved to be the best for him or her and what the areas he or she needs help with are. Teachers would be collecting this data during the primary education, after the final evaluation this database would also be made available to the secondary school of the pupil in concern. This database should be located on the website of Ministry of Education, Science, Culture and Sports. It would be available to primary schools, but protected by a password which would grant the school access to the data of their students only. In secondary schools, teachers could also access to the information, so they would not have to be discovering appropriate teaching strategies that worked for a pupil in the past all over again. This would enable better conditions and a successful education for pupils with special needs.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
Background:The use of antidepressants in the treatment of bipolar depression remains controversial due to concerns about their potential to induce mood polarity switches.This multinational observational study aims to ...Background:The use of antidepressants in the treatment of bipolar depression remains controversial due to concerns about their potential to induce mood polarity switches.This multinational observational study aims to examine the association between the use of antidepressants and the risk of hypomanic/manic switch among bipolar depressive patients.Methods:Four electronic health record databases(IQVIA Disease Analyzer Germany,IQVIA Disease Analyzer France,IQVIA US Hospital Charge Data Master,and Beijing Anding Hospital)and one administrative claims database(IQVIA US Open Claims)were analyzed,and the study period covered from January 2013 until December 2017.Treatment patterns of patients with bipolar depression were collected.The hazard ratio(HR)was calculated by comparing the incidence of hypomanic/manic switch in patients who received antidepressants(AD group)with that in those who did not receive any antidepressant(non-AD group)in 730 days after the date of the first diagnosis of bipolar depression.Results:The analysis included a total of 122,843 patients from the 5 databases;60.6% of them received antidepressants for bipolar depression.Across the 5 data sources,the mean age at index date ranged from 37.50(15.72)to 52.10(16.22)years.After controlling potential confounders by propensity score matching,the AD group’s manic switch risk was not significantly higher than the non-AD group’s(HR 1.04[95%CI,0.96 to 1.13];P=0.989).Additionally,no statistically significant difference was observed between patients prescribed antimanic drugs and those who were not(HR 0.69[95%CI,0.38 to 1.25];P=0.535).Conclusions:This study indicated that antidepressants were widely used in clinical settings for managing bipolar depression.The use of antidepressants was not associated with the risk of mania/hypomania switch when compared to non-antidepressants treatment.Therefore,antidepressants could be considered a treatment option for bipolar depression.展开更多
文摘In Slovenia, children with special needs have been included to primary schools since 1998. Since then, teachers have had a lot of work to be done. Every year they have to prepare an individualized programme for each child with special needs. They have to set goals that each child with special needs has to achieve at a particular subject. Pupils have different teachers every year and to make their work easier, the author is considering making a website database with basic information about them. This database would state the goals that the pupil achieved in the past year, which strategy of teaching proved to be the best for him or her and what the areas he or she needs help with are. Teachers would be collecting this data during the primary education, after the final evaluation this database would also be made available to the secondary school of the pupil in concern. This database should be located on the website of Ministry of Education, Science, Culture and Sports. It would be available to primary schools, but protected by a password which would grant the school access to the data of their students only. In secondary schools, teachers could also access to the information, so they would not have to be discovering appropriate teaching strategies that worked for a pupil in the past all over again. This would enable better conditions and a successful education for pupils with special needs.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
基金partially supported by the Beijing Municipal Administration of Hospitals Incubating Program(PX20211903 and PX2019071)Capital’s Funds for Health Improvement and Research(2024-4-2129)+1 种基金the Beijing Municipal Science&Technology Commission(Z221100007422010)the Beijing High Level Public Health Professionals Training Plan(xuekegugan-01-12).
文摘Background:The use of antidepressants in the treatment of bipolar depression remains controversial due to concerns about their potential to induce mood polarity switches.This multinational observational study aims to examine the association between the use of antidepressants and the risk of hypomanic/manic switch among bipolar depressive patients.Methods:Four electronic health record databases(IQVIA Disease Analyzer Germany,IQVIA Disease Analyzer France,IQVIA US Hospital Charge Data Master,and Beijing Anding Hospital)and one administrative claims database(IQVIA US Open Claims)were analyzed,and the study period covered from January 2013 until December 2017.Treatment patterns of patients with bipolar depression were collected.The hazard ratio(HR)was calculated by comparing the incidence of hypomanic/manic switch in patients who received antidepressants(AD group)with that in those who did not receive any antidepressant(non-AD group)in 730 days after the date of the first diagnosis of bipolar depression.Results:The analysis included a total of 122,843 patients from the 5 databases;60.6% of them received antidepressants for bipolar depression.Across the 5 data sources,the mean age at index date ranged from 37.50(15.72)to 52.10(16.22)years.After controlling potential confounders by propensity score matching,the AD group’s manic switch risk was not significantly higher than the non-AD group’s(HR 1.04[95%CI,0.96 to 1.13];P=0.989).Additionally,no statistically significant difference was observed between patients prescribed antimanic drugs and those who were not(HR 0.69[95%CI,0.38 to 1.25];P=0.535).Conclusions:This study indicated that antidepressants were widely used in clinical settings for managing bipolar depression.The use of antidepressants was not associated with the risk of mania/hypomania switch when compared to non-antidepressants treatment.Therefore,antidepressants could be considered a treatment option for bipolar depression.
