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Medical imaging that uses ionizing radiation, such as CT, radiography, nuclear medicine, and fluoroscopy, is a cornerstone of the care of oncology patients and provides great benefit. Ionizing radiation at high doses is a known carcinogen.The exact degree of the risk of carcinogenesis from the lower doses of ionizing radiation used in medical imaging is less clear. The purpose of this review is to provide the oncology community with knowledge about the doses used in medical imaging, radiation-induced cancer risks from imaging, considerations to keep in mind when balancing imaging benefits and risks in pediatric and adult oncologic settings, dose reduction strategies, and the "Image Gently" and "Image Wisely" campaigns; the latter campaigns facilitate the translation of existing evidence into best practices for providers and patients.

Objective: Evidence-based medicine offers explicit methods to evaluate the evidence grades of literature. However, evidence grades do not meet all the practical needs of physicians. This study is aimed to develop a convenient method for evaluating the clinical value of medical literature from the perspective of the clinician. Methods: A literature applicability equation was formulated through the Delphi method and the analytic hierarchy process. A consistency check was used to ascertain the efficacy of the formula. Three senior clinicians assessed 30 articles based on their clinical experiences and subjective opinions, while one independent researcher performed independent assessments of the applicability of 30 articles using the evaluation formula. Results: The literature applicability equation was Y = 3.93X 1 + 11.78X 2 + 14.83X 3 + 44.53X 4 + 24.93X 5 , where Y = literature applicability, X 1 = years since publication, X 2 = target question covered or not, X 3 = sample size, X 4 = study type, and X 5 = journal quality. Consistency index (CI) values for the first-level indicator (“literature applicability”) and the second-level indicators (“pertinence and timeliness” and “quality of results”) were 0.0325, 0.0012, and 0.0001, respectively. The weights used to calculate the matrix indicators had satisfactory accordance (random coincidence coefficient = 0.056). A consistency check for the efficacy of the formula revealed kappa = 0.749 and P < .001. Conclusion: The developed and validated literature applicability evaluation formula may be a useful and convenient tool for identifying clinically valuable medical literature.

Systematic Review of Reviews without abstract. Authors' invited you to read the whole review article since it is short.

OBJETIVO: Identificar na literatura quais são as evidências científicas sobre os cuidados paliativos realizados pelos enfermeiros ao paciente com câncer. METODOLOGIA: Revisão integrativa da literatura, realizada nas bases de dados LILACS, BDENF, MEDLINE/PUBMED, CINAHL e Web of Science. Foram incluídos no estudo, artigos originais disponíveis na íntegra, publicados entre os anos de 2015 e 2019, nos idiomas português, inglês e espanhol. Foram utilizados descritores controlados: cuidados de enfermagem; cuidados paliativos; câncer; neoplasias e seus respectivos: nursing care; palliative care; neoplasms, RESULTADOS: Obteve-se uma amostra final de 16 artigos, dos quais o maior número de publicações foi no ano de 2017, com predominância de estudos qualitativos, nas bases de dados LILACS e BDENF. Quanto ao nível evidência, observou-se que a maioria dos estudos analisados apresentou avaliação IV. Os estudos foram selecionados de acordo com os autores, ano de publicação, periódicos, objetivos, título e nível de evidência. A partir da análise dos artigos foi possível observar a prevalência de cuidados paliativos relacionados ao alívio de dor e sintomas, como também de cuidados acerca da promoção da qualidade de vida dos pacientes com câncer sob cuidados paliativos. CONCLUSÃO: Foi possível verificar a necessidade de que o enfermeiro precisa ter conhecimentos suficientes para assistir de forma integral ao paciente com câncer sob cuidados paliativos e ainda oferecer suporte aos seus familiares, estando assim apto/capacitado para abordar, avaliar e cuidar com o intuito de garantir uma assistência de qualidade e efetiva a essa clientela.

Objective To investigate physicians' perceptions and practices towards Evidence-Based Medicine (EBM) and physicians perceived barriers in one institute of Saudi Arabia. Methods One hundred seventeen practicing physicians at King Abdulaziz University Hospital, Jeddah were included in the study. A validated questionnaire was used for collecting data. The questionnaire had four parts and included questions addressing perceptions and practices about EBM as well as associated variables and barriers to practicing it. Results The majority of the respondents had a positive attitude toward EBM. Only 23.9% of participants reported that they are incorporating EBM into their practice. Knowledge about EBM databases was not good. The most common "regularly" read journal was the New England Journal of Medicine (31.6%), followed by the British Medical Journal (12.0%). Some of the respondents had an understanding and were able to explain to others the technical terms use in EBM such as odds ratio (19.7%), relative risk (22.2%), absolute risk (23.9%) and others. The major perceived barriers to practicing EBM was the lack of free personal time (27.4%), availability and access to information (27.4%), difficulties in involving in whole practice (12.0%) and lack of investment by health authorities (12.8%). Conclusion The attitude of the practicing doctors towards EBM was good, but knowledge and practice were not up to the mark.

BACKGROUND: Evidence-based management (EBMgt) improves managerial decisions as a bridge from theory to practice. For reason that it has a critical impact on organization performance. The purpose of this study was to identify factors affecting EBMgtamong managers.METHODS: The following electronic databases were used: PubMed, Web of Science, Cochrane, ProQuest, Embase and Scopus. In addition, we searched Google Scholar, Emerald, Academy of Management (AOM), and the website for the Center nfor Evidence-Based Management (CEBMa) for articles related to EBMgt. We used data sources published up to September 2017, without language restriction. We appraised the methodologicalquality of studies using the checklists of SRQR and MMAT. The synthesis involved interpretative analysis based on the principles of meta-synthesis.RESULTS: Of 26,011 identified studies, 26 met the full inclusion criteria. Of the 26 studies assessed, the frequency of qualitative studies and mixed-methods were 20 and 6, respectively, and the quality of 3 studies was weak. A total of 23 studies from 7 countries were included: Canada (n=8), USA (n=6), Australia (n=4), UK (n=3), Iran (n=1, Brazil (n=1); none were from Africa. Meta-synthesis findings of 23 studies identified four main factors: facilitators (5 main themes), barriers (5 main themes), sources of evidence (4 main themes), and the process of decision making in EBMgt (1 main theme).CONCLUSIONS: EBMgt is crucial to improve the quality of management decisions, and hence, to improve service delivery, effectiveness and efficiency. Furthermore, to increase the benefit and utilization of EBMgt, training organizations and research institutes must more actively involve managers in setting research plans.