Sample records for acs evidence based

  1. Composite Based EHV AC Overhead Transmission Lines

    Sørensen, Thomas Kjærsgaard

    Overhead lines at transmission level are the backbone of any national power grid today. New overhead line projects however are at the same time subject to ever greater public resistance due to the lines environmental impact. As full undergrounding of transmission lines at extra high voltage (EHV......) levels are still not seen as possibility, the future expansion of transmission grids are dependent on new solutions with lessened environment impact, especially with regard to the visual impact. In the present Thesis, composite materials and composite based overhead line components are presented...... and analysed with regard to the possibilities, limitations and risks widespread application of composite materials on EHV AC overhead transmission lines may present. To form the basis for evaluation of the useability of composite materials, dierent overhead line projects aimed at reducing the environmental...

  2. Development of a hardware-based AC microgrid for AC stability assessment

    Swanson, Robert R.

    As more power electronic-based devices enable the development of high-bandwidth AC microgrids, the topic of microgrid power distribution stability has become of increased interest. Recently, researchers have proposed a relatively straightforward method to assess the stability of AC systems based upon the time-constants of sources, the net bus capacitance, and the rate limits of sources. In this research, a focus has been to develop a hardware test system to evaluate AC system stability. As a first step, a time domain model of a two converter microgrid was established in which a three phase inverter acts as a power source and an active rectifier serves as an adjustable constant power AC load. The constant power load can be utilized to create rapid power flow transients to the generating system. As a second step, the inverter and active rectifier were designed using a Smart Power Module IGBT for switching and an embedded microcontroller as a processor for algorithm implementation. The inverter and active rectifier were designed to operate simultaneously using a synchronization signal to ensure each respective local controller operates in a common reference frame. Finally, the physical system was created and initial testing performed to validate the hardware functionality as a variable amplitude and variable frequency AC system.

  3. Speed Control of DC Motor using AC/AC/DC Converter Based on Intelligent Techniques

    Rakan Kh Antar


    Full Text Available    This paper describes the application of ac/ac/dc and ac/dc converters to control the speed of a separately excited DC motor. Artificial neural network and PI controller are trained to select the desired values of firing angles for triggering thyristors of the ac/ac/dc and ac/dc bridge converters in order to control the speed of the dc motor at a desired value with constant and different load torques in order to obtain the best speed response. Simulation results show that the rising time for ac/dc and ac/ac/dc converters at 250rpm are reduced about 79% and 89% respectively, while delay time it reduced about 69% and 64% respectively. Therefore, speed response of the dc motor is more efficient for closed loop system compared with open loop also the response of ac/ac/dc converter is better than ac/dc converter.

  4. [Evidence-based physiotherapy].

    Bender, Tamás


    This article on physiotherapy presents some current evidence stating the strengths and weaknesses of the physiotherapeutic procedures. In the area of physiotherapy empirical data obtained during decades were overtaken by evidence from current studies. The author points out the great problem of physiotherapy, namely the heterogeneity of the applied parameters. Knowledge of current evidence may be very important and helpful for the physicians, but the author proposes, from the practical point of view, that physiotherapeutical procedures based on exprience and used for many years should not be entirely neglected. Nowadays physiotherapy plays an important role in the treament of locomotor diseases but its use is increasing in other fields of medicine, as well.

  5. Evidence-Based Development

    Hertzum, Morten; Simonsen, Jesper


    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  6. A Switched Capacitor Based AC/DC Resonant Converter for High Frequency AC Power Generation

    Cuidong Xu


    Full Text Available A switched capacitor based AC-DC resonant power converter is proposed for high frequency power generation output conversion. This converter is suitable for small scale, high frequency wind power generation. It has a high conversion ratio to provide a step down from high voltage to low voltage for easy use. The voltage conversion ratio of conventional switched capacitor power converters is fixed to n, 1/n or −1/n (n is the switched capacitor cell. In this paper, A circuit which can provide n, 1/n and 2n/m of the voltage conversion ratio is presented (n is stepping up the switched capacitor cell, m is stepping down the switching capacitor cell. The conversion ratio can be changed greatly by using only two switches. A resonant tank is used to assist in zero current switching, and hence the current spike, which usually exists in a classical switching switched capacitor converter, can be eliminated. Both easy operation and efficiency are possible. Principles of operation, computer simulations and experimental results of the proposed circuit are presented. General analysis and design methods are given. The experimental result verifies the theoretical analysis of high frequency AC power generation.

  7. Evidence-based dentistry.

    Chambers, David W


    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  8. An Ac transposon system based on maize chromosome 4S for isolating long-distance-transposed Ac tags in the maize genome.

    Wang, Fei; Li, Zhaoying; Fan, Jun; Li, Pengfei; Hu, Wei; Wang, Gang; Xu, Zhengkai; Song, Rentao


    Transposon tagging is an important tool for gene isolation and functional studies. In maize, several transposon-tagging systems have been developed, mostly using Activator/Dissociation (Ac/Ds) and Mutator systems. Here, we establish another Ac-based transposon system with the donor Ac tightly linked with sugary1 (su1) on maize chromosome 4S. Newly transposed Ac (tr-Acs) were detected based on a negative dosage effect, and long-distance-transposed Ac events were identified and isolated from the donor Ac by a simple backcross scheme. In this study, we identified 208 independent long-distance-transposed Ac lines. Thirty-one flanking sequences of these tr-Acs were isolated and localized in the maize genome. As found in previous studies, the tr-Acs preferentially inserted into genic sequences. The distribution of tr-Acs is not random. In our study, the tr-Acs preferentially transposed into chromosomes 1, 2, 9 and 10. We discuss the preferential distribution of tr-Acs from Ac systems. Our system is complementary to two other Ac-based regional-mutagenesis systems in maize, and the combined use of these systems will achieve an even and high-density distribution of Ac elements throughout the maize genome for functional-genomics studies.

  9. Aragonite coating solutions (ACS) based on artificial seawater

    Tas, A. Cuneyt, E-mail:


    Graphical abstract: - Highlights: • Developed completely inorganic solutions for the deposition of monolayers of aragonite spherules (or ooids). • Solutions mimicked the artificial seawater. • Biomimetic crystallization was performed at the tropical sea surface temperature of 30 °C. - Abstract: Aragonite (CaCO{sub 3}, calcium carbonate) is an abundant biomaterial of marine life. It is the dominant inorganic phase of coral reefs, mollusc bivalve shells and the stalactites or stalagmites of geological sediments. Inorganic and initially precipitate-free aragonite coating solutions (ACS) of pH 7.4 were developed in this study to deposit monolayers of aragonite spherules or ooids on biomaterial (e.g., UHMWPE, ultrahigh molecular weight polyethylene) surfaces soaked in ACS at 30 °C. The ACS solutions of this study have been developed for the surface engineering of synthetic biomaterials. The abiotic ACS solutions, enriched with calcium and bicarbonate ions at different concentrations, essentially mimicked the artificial seawater composition and started to deposit aragonite after a long (4 h) incubation period at the tropical sea surface temperature of 30 °C. While numerous techniques for the solution deposition of calcium hydroxyapatite (Ca{sub 10}(PO{sub 4}){sub 6}(OH){sub 2}), of low thermodynamic solubility, on synthetic biomaterials have been demonstrated, procedures related to the solution-based surface deposition of high solubility aragonite remained uncommon. Monolayers of aragonite ooids deposited at 30 °C on UHMWPE substrates soaked in organic-free ACS solutions were found to possess nano-structures similar to the mortar-and-brick-type botryoids observed in biogenic marine shells. Samples were characterized using SEM, XRD, FTIR, ICP-AES and contact angle goniometry.

  10. Ac Synchronous Servo Based On The Armature Voltage Prediction Model

    Hoshino, Akihiro; Kuromaru, Hiroshi; Kobayashi, Shinichi


    A new control method of the AC synchro-nous servo-system (Brushless DC servo-system) is discussed. The new system is based on the armature voltage prediction model. Without a resolver-digital-conver-ter nor a tachometer-generator, the resolver provides following three signals to the system immediately, they are the current command, the induced voltage, and the rotor speed. The new method realizes a simple hardware configuration. Experimental results show a good performance of the system.

  11. Materials for Powder-Based AC-Electroluminescence

    Hubert Schulze Dieckhoff


    Full Text Available At present, thick film (powder based alternating current electroluminescence (AC-EL is the only technology available for the fabrication of large area, laterally structured and coloured light sources by simple printing techniques. Substrates for printing may be based on flexible polymers or glass, so the final devices can take up a huge variety of shapes. After an introduction of the underlying physics and chemistry, the review highlights the technical progress behind this development, concentrating on luminescent and dielectric materials used. Limitations of the available materials as well as room for further improvement are also discussed.

  12. Research on the Plasma Anemometer Based on AC Glow Discharge

    Bing Yu


    Full Text Available A new plasma anemometer based on AC glow discharge is designed in this article. Firstly, theoretical analysis of plasma anemometer working principle is introduced to prove the feasibility of the experimental measurement method. Then the experiments are carried out to study the effects of different parameters on the static discharge characteristics of the plasma anemometer system, by which the system optimization methods are obtained. Finally, several groups of appropriate parameters are selected to build the plasma anemometer system based on resistance capacitance coupling negative feedback AC glow discharge, and different airflow speeds are applied to obtain the achievable velocity measurement range. The results show that there is a linear relationship between airflow velocity and discharge current in an allowable error range, which can be applied for airflow velocity measurement. Negative feedback coupling module, which is composed of the coupling resistance and the coupling capacitance, has good effects on improving the system stability. The measurement range of the airflow velocity is significantly increased when the electrode gap is 3 mm, coupling resistance is 470 Ω, and coupling capacitance is 220 pF.

  13. Evidence-Based Laboratory Medicine

    Christopher P Price


    @@ Whilst there have been several definitions of Evidence-Based Medicine (EBM), the one given by David Sackett is probably the most accurate and well accepted; he stated that "evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients"[1].

  14. Power Electronic Transformer based Three-Phase PWM AC Drives

    Basu, Kaushik

    A Transformer is used to provide galvanic isolation and to connect systems at different voltage levels. It is one of the largest and most expensive component in most of the high voltage and high power systems. Its size is inversely proportional to the operating frequency. The central idea behind a power electronic transformer (PET) also known as solid state transformer is to reduce the size of the transformer by increasing the frequency. Power electronic converters are used to change the frequency of operation. Steady reduction in the cost of the semiconductor switches and the advent of advanced magnetic materials with very low loss density and high saturation flux density implies economic viability and feasibility of a design with high power density. Application of PET is in generation of power from renewable energy sources, especially wind and solar. Other important application include grid tied inverters, UPS e.t.c. In this thesis non-resonant, single stage, bi-directional PET is considered. The main objective of this converter is to generate adjustable speed and magnitude pulse width modulated (PWM) ac waveforms from an ac or dc grid with a high frequency ac link. The windings of a high frequency transformer contains leakage inductance. Any switching transition of the power electronic converter connecting the inductive load and the transformer requires commutation of leakage energy. Commutation by passive means results in power loss, decrease in the frequency of operation, distortion in the output voltage waveform, reduction in reliability and power density. In this work a source based partially loss-less commutation of leakage energy has been proposed. This technique also results in partial soft-switching. A series of converters with novel PWM strategies have been proposed to minimize the frequency of leakage inductance commutation. These PETs achieve most of the important features of modern PWM ac drives including 1) Input power factor correction, 2) Common

  15. Evidence based practice

    Hjørland, Birger


    making that is established in research as well as an optimization of every link in documentation and search processes. EBP is based on the philosophical doctrine of empiricism and, therefore, it is subject to the criticism that has been raised against empiricism. The main criticism of EBP...

  16. Evidence-based guidelines

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar


    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  17. Antifriction coatings based on a-C for biomedicine applications

    Yurjev, Y. N.; Kiseleva, D. V.; Zaitcev, D. A.; Sidelev, D. V.; Korneva, O. S.


    This article reports on the investigation of mechanical properties of carbon films deposited by dual magnetron sputtering system with closed and mirror magnetic field. There is shown that a-C films with predominantly sp2-phase have relatively high hardness (up to 20 GPa) and low friction index (∼0.01). The influence of magnetic field on friction index is determined. The analysis of experimental data shows the obtained a-C samples can be used for biomedicine applications.

  18. Evidence-based clinical practice

    Gluud, Christian


    Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may be...

  19. Evidence-based policy

    Vohnsen, Nina Holm


    A current ambition in welfare states as diverse as Denmark, the UK, and in the USA is to base political decision making on rigorous research (Cartwright et al 2009; Mulgan 2009; Bason 2010). Sound as this might seem the ambition has nevertheless been problematized by both policy-makers and the re......A current ambition in welfare states as diverse as Denmark, the UK, and in the USA is to base political decision making on rigorous research (Cartwright et al 2009; Mulgan 2009; Bason 2010). Sound as this might seem the ambition has nevertheless been problematized by both policy...... a full account, see Vohnsen 2011). These insights will be relevant for the anthropological researcher of legislative processes who wishes to move beyond a merely discursive approach to the study of policy and politics....

  20. Characterization of an Ac transposon system based on apt1-m1 (Ac) on the long arm of maize chromosome 9.

    Wang, Fei; Li, Pengfei; Tang, Yuanping; Fan, Jun; Xu, Dabin; Guo, Shengming; Xu, Zhengkai; Song, Rentao


    Activator/Dissociation (Ac/Ds) transposable elements have been used in maize insertional mutagenesis as a complement to Mutator (Mu). In this study, to further improve the efficiency of the Ac/Ds mutagenesis system, we adopted apt1-m1 (Ac) on the long arm of chromosome 9 (9L) as a donor Ac to create an Ac insertion library. This system is based on the negative selection pressure against the donor Ac, and it was highly efficient for isolating new transposition events. We obtained 9,625 transposition events from 1083 F1 ears with an average transposition rate of 8.66 % (rates ranged from 1.11 to 29.73 %). We also adopted a modified PCR-based genome walking strategy to improve the efficiency of the new method for isolating transposon-flanking sequences. This method is more efficient than the Southern-based method that was used in previous studies. A validation step was developed to distinguish transposon tags derived from newly transposed Ac or Ds elements. Using this PCR-based method, we isolated 67 inheritable flanking sequences from the apt1-m1 (Ac) transposition library; of these, 51 were confirmed as tr-Ac-flanking sequences and 11 were tr-Ds-flanking sequences. Similar to other Ac donors from different loci, the apt1-m1 (Ac) system also exhibited a preference for short distance transposition. In this study, we have further improved the Ac mutagenesis system in maize for gene isolation and functional genomics studies.

  1. Evidence-Based Cancer Imaging

    Khorasani, Ramin


    With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.

  2. Neural network based PWM AC chopper fed induction motor drive

    Venkatesan Jamuna


    Full Text Available In this paper, a new Simulink model for a neural network controlled PWM AC chopper fed single phase induction motor is proposed. Closed loop speed control is achieved using a neural network controller. To maintain a constant fluid flow with a variation in pressure head, drives like fan and pump are operated with closed loop speed control. The need to improve the quality and reliability of the drive circuit has increased because of the growing demand for improving the performance of motor drives. With the increased availability of MOSFET's and IGBT's, PWM converters can be used efficiently in low and medium power applications. From the simulation studies, it is seen that the PWM AC chopper has a better harmonic spectrum and lesser copper loss than the Phase controlled AC chopper. It is observed that the drive system with the proposed model produces better dynamic performance, reduced overshoot and fast transient response. .

  3. Active Power Regulation based on Droop for AC Microgrid

    Li, Chendan; Coelho, Ernane A. A.; Firoozabadi, Mehdi Savaghebi


    In this paper, two different control strategies are proposed to address the active power regulation issue in AC microgrids. The principle of power regulation in the droop controller is firstly introduced. Frequency scheduling and droop gain scheduling on top of droop control is proposed to succes......In this paper, two different control strategies are proposed to address the active power regulation issue in AC microgrids. The principle of power regulation in the droop controller is firstly introduced. Frequency scheduling and droop gain scheduling on top of droop control is proposed...

  4. Evidence-Based Psychological Assessment.

    Bornstein, Robert F


    In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

  5. Evidence-based playground design

    Refshauge, Anne Dahl; Stigsdotter, Ulrika K.; Lamm, Bettina;


    This paper develops, explores and evaluates an evidence-based approach to playground design, with a public park playground (playlab Cph) in Copenhagen as a case study. In the increasingly urbanised world, park playgrounds are valuable places that support healthy child development by providing opp...

  6. Evidence-Based IT Development

    Simonsen, Jesper; Hertzum, Morten


    Evidence-based IT development aims at developing a new commercial contract model for IT projects where the cus-tomers payment is dependent on measurable effects of using the vendors system. The idea is to establish a strategic part-nership in which customer and IT vendor share the responsi-bility...

  7. A Series-LC-Filtered Active Damper for AC Power Electronics Based Power Systems

    Wang, Xiongfei; Blaabjerg, Frede; Loh, Poh Chiang


    This paper proposes an active damper with a series LC-filter for suppressing resonances in an ac power electronics based power system. The added filter capacitor helps to lower the voltage stress of the converter to be used for implementing the damper. Unlike active filters for the compensation...... is built, where the damper is integrated into a grid-connected converter. The results obtained from the experiments demonstrate the stability enhancement of ac power electronics based power systems by the active damper....

  8. Evidence-Based Radiology (EBR

    Mansoor Fatehi


    Full Text Available   "nRecent increase in scientific advancements has led to inability to cover many scientific data and remain “up-to-date”. Nowadays doubling time of scientific data production is remarkably reduced, so that there is no adequate time to find this information and it seems inevitable to use resources which periodically assess most published papers or web-based data in that particular field to finally provide evidence-based knowledge, namely “Evidence-Based Medicine (EBM” in medical sciences. EBM is the systematic, scientific and explicit use of current best evidence in making decisions about the care of individual patients. Medical practice is largely based on clinical anecdotes, uncontrolled investigations and expert opinion. In radiology, the situation is especially problematic. "nRadiologists require to be able to evaluate studies in the literature, i.e., how reliable is this information and does it apply to patients in the radiologist’s practice? "nWe may find that our textbooks are out of date, guidelines are non-specific and there are conflicting "nor unreliable reports in the literature. Expert opinions vary from centre to centre. "nWhen we go to the literature ourselves, the first problem we encounter is the volume of literature being published and the next (at least for most of us is lack of training in how to separate good studies from weak ones. Evidence-based radiology (EBR can be a solution. "nThere are 5 steps in applying an approach as a solution: "n1. Ask - Information needs relevant to individual patients are converted into ‘answerable’ or ‘focused’ questions. "n2. Search - A comprehensive literature search is performed to find the best evidence to help answer these questions. "n3. Appraise - The evidence must then be critically appraised, in an explicit and structured manner, in order to establish its validity, reliability and usefulness in practice. "n4. Apply - The results of this critical appraisal are then

  9. Evidence-based librarianship: searching for the needed EBL evidence.

    Eldredge, J D


    This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

  10. Multiplexed sensing based on Brownian relaxation of magnetic nanoparticles using a compact AC susceptometer

    Park, Kyoungchul; Sonkusale, Sameer [Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155 (United States); Harrah, Tim; Goldberg, Edward B [Department of Molecular Biology and Microbiology, Tufts University, Boston, MA 02111 (United States); Guertin, Robert P, E-mail: [Department of Physics and Astronomy, Tufts University, Medford, MA 02155 (United States)


    A novel multiplexed sensing scheme based on the measurement of the magnetic susceptibility of the affinity captured target molecules on magnetic nanoparticles in liquid suspension is proposed. The AC magnetic susceptibility provides a measurement of Brownian relaxation behavior of biomolecules bound to magnetic nanoparticles (MNPs) that is related to its hydrodynamic size. A room temperature, compact AC susceptometer is designed and developed to measure complex AC magnetic susceptibility of such magnetic nanoparticles. The AC susceptometer exhibits high sensitivity in magnetic fields as low as 10 {mu}T for 1 mg ml{sup -1} concentration and 5 {mu}l volume, and is fully software programmable. The capability of biological sensing using the proposed scheme has been demonstrated in proof of principle using the binding of biotinylated horseradish peroxidase (HRP) to streptavidin-coated MNPs. The proposed technique and instrument are readily compatible with lab-on-chip applications for point-of-care medical applications.

  11. Evidence Locator: sources of evidence-based dentistry information.

    Frantsve-Hawley, Julie


    Multiple resources are available to help practitioners access the latest scientific evidence. Evidence-based dentistry (EBD) is an approach to clinical decision making that incorporates the most current and comprehensive scientific evidence with the practitioner's judgment and the patient's needs and preferences. One challenge in implementing this approach is access to evidence, and there are multiple online resources that can be used in this endeavor. This article presents the Evidence Locator, a list of Web sites that provide access to "secondary sources" of evidence. Such "secondary sources" are typically summaries of systematic reviews and evidence-based clinical recommendations or guidelines. Also presented is a list of other Web sites that may be useful to the practitioner in implementing EBD.

  12. Equal pulse width chopping control based on plugged pulse principle in three-phase AC/AC system%基于脉冲阻塞原理的三相AC/AC系统等脉宽斩波控制

    郑诗程; 陈玲; 曹小虎


    A circuit topology of three-phase AC/AC system is presented,which needs only six power devices to realize the three-phase AC/AC frequency conversion. The traditional phase-shifted control strategy is replaced by the equal pulse width chopping control strategy based on plugged pulse principle to regulate the amplitude and frequency of output voltage separately or simultaneously. The equal pulse width chopping control strategy is analyzed in detail and the mathematic expression of duty cycle is deduced based on the area equivalent rule according to different frequency and amplitude of anticipant output voltage. Under the environment of PSPICE,the three-phase AC/AC system with the equal pulse width chopping control strategy is simulated. Its main circuit and FPGA-based control circuit are designed and tested. The experimental results are consistent with the simulative results,completely same as the theoretical analysis,which verifies the correctness and feasibility of the introduced control strategy.%针对传统的三相AC/AC变频电路特点,提出了一种新的电路拓扑,仅用6个功率器件即可实现三相AC/AC变频功能.提出基于脉冲阻塞原理的等脉宽斩波控制策略,取代传统的移相控制策略施加于该电路拓扑,实现了三相输出电压幅值、频率分别可调或同时可调.对等脉宽斩波控制策略进行了详细的理论分析.根据期望输出电压的不同频率和幅值.利用面积等效原则,推导出相应占空比的数学表达式.在PSPICE环境下根据脉冲阻塞原理.对三相AC/AC系统进行等脉宽斩波控制仿真.并设计了三相AC/AC系统主电路和基于FPGA的控制电路,完成了相关实验.仿真和实验结果一致,与文中的理论分析结果也完全一致,验证了该AC/AC变频控制策略的正确性及可行性.

  13. Artificial Cooperative Search Algorithm based Load Frequency Control of Interconnected Power Systems with AC-DC Tie-lines

    S. Ramesh kumar


    Full Text Available A maiden effort for optimal tuning of load frequency controller parameters using Artificial Cooperative Search (ACS algorithm for a two area interconnected power system with AC-DC parallel tie-lines has been presented in this paper. ACS is a recent swarm intelligence algorithm developed for solving numerical optimization problems. The swarm intelligence philosophy behind ACS algorithm is based on the migration of two artificial superorganisms as they biologically interact to achieve the global minimum value pertaining to the problem. The HVDC link in parallel with AC tie-line is used as system interconnection to effectively damp the frequency oscillations of the AC system. An integral square error criterion (ISE has been used as performance index to design the optimal parameters. A comparative study of tuned values has been presented to show the effectiveness of the Artificial Cooperative Search algorithm. The results demonstrate the success of ACS algorithm in solving Load frequency control (LFC optimization problem.

  14. Evidence-based Science Communication

    Kahan, D.


    This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

  15. Harmonic detection an AC excited generation system based on in-phase correlation filtering

    贺益康; 孙丹; 王文举; 石赟


    The paper reports results of investigation on the harmonic detection technique of a complicated power supply system such as an AC excited generation system, which has a variable fundamental frequency and low order harmonics with rich sub-harmonics whose frequencies are lower than the fundamental one. The in-phase correlation filtering technique, based on the frequency shifting principle, is proposed in this paper.Theoretical analysis and experimental results validate the effectiveness of this technique for the harmonic detections of AC excited generation systems.

  16. Research and Development of Bi-2223-Based AC Power Cables in Russia

    Vysotsky, Vitaly; Fetisov, Sergey; Sytnikov, Viktor

    The Russian program for R&D of AC power cables has been started in 2005. During the program, the several 5m prototypes and witness samples of Bi-2223 based cables have been tested, as along with the 30m experimental three phase cable. Eventually 200m full size AC power cable with ratings 20 kV 1.5/2kA and 50/70MVA has been developed and successfully tested. The review of cable designs and test results is presented.

  17. Harmonic detection an AC excited generation system based on in-phase correlation filtering


    The paper reports results of investigation on the harmonic detection technique of a complicated power supply system such as an AC excited generation system, which has a variable fundamental frequency and low order harmonics with rich sub-harmonics whose frequencies are lower than the fundamental one. The in-phase correlation filtering technique, based on the frequency shifting principle, is proposed in this paper. Theoretical analysis and experimental results validate the effectiveness of this technique for the harmonic detections of AC excited generation systems.

  18. Zigzag Connected Autotransformer-Based 24-pulse AC-DC Converter

    Xiao-qiang, Chen; Hao, Qiu


    In this paper, a zigzag connected autotransformer-based 24-pulse AC-DC converter is designed, modeled and simulated to feed direct torque controlled induction motor drives. Winding arrangements and parameters of the autotransformer and interphase reactor are given. Moreover, the design procedure of the autotransformer is modified to make it suitable for retrofit applications. Simulation results indicate that the system is capable of eliminating up to 21st harmonics in the ac mains current. The effect of load variation and load character is also studied to demonstrate the performance and effectiveness of the proposed 24-pulse converters. A set of power quality indices at ac mains and dc side are presented to compare the performance of 6-, 12- and 24-pulse converters.

  19. Modeling and Analysis of Harmonic Stability in an AC Power-Electronics-Based Power System

    Wang, Xiongfei; Blaabjerg, Frede; Wu, Weimin


    This paper addresses the harmonic stability caused by the interactions among the wideband control of power converters and passive components in an AC power-electronicsbased power system. The impedance-based analytical approach is employed and expanded to a meshed and balanced threephase network...

  20. An estimator-based distributed voltage-predictive control strategy for ac islanded microgrids

    Wang, Yanbo; Chen, Zhe; Wang, Xiongfei


    This paper presents an estimator-based voltage predictive control strategy for AC islanded microgrids, which is able to perform voltage control without any communication facilities. The proposed control strategy is composed of a network voltage estimator and a voltage predictive controller for ea...

  1. Power Balance Control in an AC/DC/AC Converter for Regenerative Braking in a Two-Voltage-Level Flywheel-Based Driveline

    Janaína G. Oliveira


    Full Text Available The integration of a flywheel as a power handling can increase the energy storage capacity and reduce the number of battery charge/discharge cycles. Furthermore, the ability of recovering energy of the vehicle during breaking can increase the system efficiency. The flywheel-based all-electric driveline investigated here has its novelty in the use of a double-wound flywheel motor/generator, which divides the system in two different voltage levels, enhancing the efficiency of the electric driveline. The connection of two AC electrical machines (i.e., the flywheel and the wheel motor with different and variable operation frequency is challenging. A power matching control applied to an AC/DC/AC converter has been implemented. The AC/DC/AC converter regenerates the electric power converted during braking to the flywheel machine, used here as power handling device. By controlling the power balance, the same hardware can be used for acceleration and braking, providing the reduction of harmonics and robust response. A simulation of the complete system during braking mode has been performed both in Matlab and Simulink, and their results have been compared. The functionality of the proposed control has been shown and discussed, with full regeneration achieved. A round-trip efficiency (wheel to wheel higher than 80% has been obtained.

  2. Evidence-Based Practice: Management of Vertigo

    Nguyen-Huynh, Anh T.


    The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented.

  3. Evidence-based practice voor verpleegkundigen

    Cox, C.M.M.; Louw, D.C.P. de; Verhoef, J.; Kuiper, C.


    Om goede en verantwoorde zorg te kunnen bieden, streeft de verpleegkundige naar evidence-based practice. Evidence-based practice is het gewetensvol, expliciet en oordeelkundig gebruik van het huidige beste bewijsmateriaal om beslissingen te nemen voor individuele patiënten. De praktijk van evidence-

  4. Emergency operation of a 3AC 50Hz power grid in the Loetschberg base tunnel; Notbetrieb der Energieversorgung 3AC 50Hz im Loetschberg-Basistunnel

    Stadelmann, M. [BLS AG, Ressort Bahnstrom, Bern (Switzerland); Boss, J. [BKW FMB Energie AG, Spiez (Switzerland)


    At latest after 90 min after tripping of the normal supply a special isle grid energized from the power plant of Kandergrund feeds the numerous users in the base tunnel with 3 AC 50 hz. This prevents them from damages and train operation can be assured immediately after return of normal grid voltage. (orig.)

  5. Audit-based Compliance Control (AC2) for EHR Systems

    Dekker, M.A.C.; Hartog, den J.I.; Etalle, S.


    Traditionally, medical data is stored and processed using paper-based files. Recently, medical facilities have started to store, access and exchange medical data in digital form. The drivers for this change are mainly demands for cost reduction, and higher quality of health care. The main concerns

  6. Micro pumping methods based on AC electrokinetics and Electrorheologically actuated PDMS valves

    Soni, Gaurav; Squires, Todd; Meinhart, Carl


    We have developed 2 different micropumping methods for transporting ionic fluids through microchannels. The first method is based on Induced Charge Electroosmosis (ICEO) and AC flow field-effect. We used an AC electric field to produce a symmetric ICEO flow on a planar electrode, called `gate'. In order to break the symmetry of ICEO, we applied an additional AC voltage to the gate electrode. Such modulation of the gate potential is called field effect and produces a unidirectional pumping over the gate surface. We used micro PIV to measure pumping velocities for a range of ionic concentration, AC frequency and gate voltage. We have also conducted numerical simulations to understand the deteriorating effect of lateral conduction of surface charge on the pumping velocities. The second method is based on vibration of a flexible PDMS diaphragm actuated by an electrorheological (ER) fluid. ER fluid is a colloidal suspension exhibiting a reversible liquid-to-solid transition under an electric field. This liquid-to-solid transition can yield very high shear stress and can be used to open and close a PDMS valve. Three such valves were fabricated and actuated in a peristaltic fashion in order to achieve positive displacement pumping of fluids.

  7. Critical current density measurement of thin films by AC susceptibility based on the penetration parameter h

    Li Xiaofen, E-mail: [Materials Research Division, Riso National Laboratory for Sustainable Energy, Technical University of Denmark, Frederiksborgvej 399, DK-4000 Roskilde (Denmark); Grivel, Jean-Claude; Abrahamsen, Asger B.; Andersen, Niels H. [Materials Research Division, Riso National Laboratory for Sustainable Energy, Technical University of Denmark, Frederiksborgvej 399, DK-4000 Roskilde (Denmark)


    We have numerically proved that the dependence of AC susceptibility {chi} of a E(J) power law superconducting thin disc on many parameters can be reduced to one penetration parameter h, with E the electric field and J the current density. Based on this result, we propose a way of measuring the critical current density J{sub c} of superconducting thin films by AC susceptibility. Compared with the normally used method based on the peak of the imaginary part, our method uses a much larger range of the AC susceptibility curve, thus allowing determination of the temperature (T) dependence of J{sub c} from a normally applied {chi}(T) measurement. A fitting equation J{sub c} = 1.9H{sub a} Divides {chi} Prime Divides {sup 0.69}/d, -0.4 < {chi} Prime < -0.001 derived from the critical state case (Bean model) can be used in most situations, where H{sub a} is the amplitude of the applied AC field, {chi} Prime is the real part of the normalized susceptibility and d is the thickness of the film. The method is valid for the cases where the film is fully penetrated. We also discuss how the finite London penetration depth affects the susceptibility when the film is screened. Measurements with varying T, H{sub a} and DC background field H{sub dc} are performed to support the arguments.

  8. Critical current density measurement of thin films by AC susceptibility based on the penetration parameter h

    Li, Xiao-Fen; Grivel, Jean-Claude; Abrahamsen, Asger B.; Andersen, Niels H.


    We have numerically proved that the dependence of AC susceptibility χ of a E(J) power law superconducting thin disc on many parameters can be reduced to one penetration parameter h, with E the electric field and J the current density. Based on this result, we propose a way of measuring the critical current density Jc of superconducting thin films by AC susceptibility. Compared with the normally used method based on the peak of the imaginary part, our method uses a much larger range of the AC susceptibility curve, thus allowing determination of the temperature (T) dependence of Jc from a normally applied χ(T) measurement. A fitting equation Jc = 1.9Ha∣χ‧∣0.69/d, -0.4 Bean model) can be used in most situations, where Ha is the amplitude of the applied AC field, χ‧ is the real part of the normalized susceptibility and d is the thickness of the film. The method is valid for the cases where the film is fully penetrated. We also discuss how the finite London penetration depth affects the susceptibility when the film is screened. Measurements with varying T, Ha and DC background field Hdc are performed to support the arguments.

  9. Evidence-based practice of periodontics.

    Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana


    Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

  10. Psiquiatria baseada em evidências Evidence-based psychiatry

    Maurício S de Lima


    Full Text Available Em psiquiatria, observa-se grande variabilidade de práticas clínicas, muitas vezes desnecessária. Essas variações podem estar relacionadas à ausência de evidência científica confiável ou ao desconhecimento das evidências de boa qualidade disponíveis. A medicina baseada em evidências (MBE é uma combinação de estratégias que busca assegurar que o cuidado individual do paciente seja baseado na melhor informação disponível, a qual deve ser incorporada à prática clínica. Neste artigo, conceitos de MBE são discutidos com relação a aspectos e desafios no tratamento de pacientes com distimia, bulimia nervosa e esquizofrenia. A partir de resultados de três revisões sistemáticas recentemente publicadas, conclui-se que a prática de psiquiatria baseada em evidências acrescenta qualidade à prática psiquiátrica tradicional.The unnecessary variability often seen in the clinical practice can be related to both the absence of reliable evidence and unawareness of the existence of good quality evidence. Evidence-Based Medicine (EBM is a set of linked strategies designed to assist clinicians in keeping themselves up-to-date with the best available evidence. Such evidence must be incorporated into the clinical practice. EBM concepts are discussed here through common aspects and challenges doctors face when treating patients with dysthymia, bulimia nervosa, and schizophrenia. In the light of some results from three systematic reviews it is concluded that Evidence-Based Psychiatry strategies, rather than replacing the traditional ones, may be a valuable tool to improving quality in a good clinical practice.

  11. From evidence-based to evidence-reflected practice

    Lystbæk, Christian Tang

    “Knowledge” is of the utmost significance for professional practice and learning. Today, though, the established knowledge base is changing in all areas of the labour market (Alvesson, 2004). Work and society are dominated by commitment to demands for high levels of demonstrable accountability......, cost-efficiency and measurable quality. Thus, today, evidence-based practice has become an expectation and fashion, often used to emphasize the grounding of practice in research based knowledge that provides measurable evidence for best practice. But at the same time, there is a growing distrust...

  12. Persuasive Evidence: Improving Customer Service through Evidence Based Librarianship

    Wendy A. Abbott


    Full Text Available Objective - To demonstrate how evidence based practice has contributed to informaing decisions and resolving issues if concern in service delivery at Bond University Librray. Methods - This paper critically analyses three evidence based research projects conducted at Bond University Library. Each project combined a range of research methods including surveys, literature reviews and the analysis of internal performance data to find solutions to problems in library service delivery. The first research project investigated library opening hours and the feasability of twenty-four hour opening. Another project reseached questions about the management of a collection of feature films on DVD and video. The thrd project investigated issues surrounding the teaching of EndNote to undergarduate students. Results - Despite some deficiencies in the methodologies used, each evidence based research project had positive outcomes. One of the highlights asn an essential feature of the process at Bond University Library was the involvement of stakeholders. The ability to build consensus and agree action plans with stakeholders was an important outcome of that process. Conclusion - Drawing on the experience of these research projects, the paper illustrates the benefits of evidence based information practice to stimulate innovation and improve library services. Librarians, like most professionals, need to continue to develop the skills and a culture to effectively carry out evidence based practice.

  13. AC Versus DC Link Comparison Based on Power Flow Analysis of a Multimachine Power System

    Mohammed Abdeljalil DJEHAF


    Full Text Available Deregulation and privatization is posing new challenges on high voltage transmission and on distributions systems as well. An increasingly liberalized market will encourage trading opportunities to be identified and developed. High voltage power electronics, such as HVDC (High Voltage Direct Current and FACTS (Flexible AC Transmission Systems provide the necessary features to avoid technical problems in heavily loaded power systems; HVDC offers most advantages: it can be used for system interconnection and for control of power flow as well. The major benefit of HVDC is its incorporated ability for fault-current blocking, which is not possible with synchronous AC links. In addition, HVDC can effectively support the surrounding AC systems in case of transient fault conditions and it serves as firewall against cascading disturbances. This paper presents a comparison between HVDC link and an HVAC link in a 29 Bus multimachine system, based on load flow analysis using Newton-Raphson method for the AC link case, and sequential method for the HVDC link case.

  14. DSP Based Control Implementation of an AC/DC Converter with Improved Input Current Distortion



    Full Text Available This paper presents a digital signal processor based control of an AC/DC converter with nearly unity power factor. Normally, the output voltage of a single-phase AC/DC converter comprises a voltage ripple with twice line-frequency. This affects the voltage control loop and leads to the converter input current distortion. The purposed method is designed to avoid the effect of the output voltage ripple. To verify the proposed control method, MATLAB/Simulink is used for system simulation. A hardware prototype is setup. A low cost digital signal processing chip dsPIC30F4011 is employed as a digital controller to control a CUK AC/DC converter. The converter specifications are 48V output voltage and 250W output power. From the simulation and the experimental results shown that the input current distortion of the purposed system is reduced and lower than the AC/DC converter that controlled by the conventional proportional-integral controller.

  15. Fully digital controlled A.C. servo engraving machine based on DEC4DA

    Shu, Zhibing; Chen, Xianfeng; Zhang, Hairong; Huang, Yiqun; Yan, Caizhong


    A novel engraving machine (NUT-1A) is presented, in which fully digital controlled AC system based on DEC4DA was used to improve the machining precision and sensitivity. This engraving machine was constructed around AC servo motor with encoder, controlled by a servo motor control card - DEC4DA. As the upper unit of AC servo motor, DEC4DA was a numerical control generator, which received pulses form CPU by ISA bus, and these pulses were amplified and converted to drive AC servo actuator. This novel engraving machine can achieve a higher positioning accuracy of +/-0.01mm and positioning repetition of +/-0.005mm, and its resolution is 0.001mm/0.0001mm. Moreover, because of multi-closed loops were used in the system, the steady and transient performances are more excellent. This system ensures a much quicker current regulation in closed-loop operation, of acceleration and braking in both directions, as well as stable speed characteristics. Amplifier boards are protected against excessive current, excessive temperature and short circuiting of the motor supply cables.

  16. Evidence-based dentistry: a clinician's perspective.

    Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard


    Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

  17. Robust Timing Synchronization for AC-OFDM Based Optical Wireless Communications

    Ranjha, Bilal A; Kavehrad, Mohsen; Deng, Peng


    Visible light communications (VLC) have recently attracted a growing interest and can be a potential solution to realize indoor wireless communication with high bandwidth capacity for RF-restricted environments such as airplanes and hospitals. Optical based orthogonal frequency division multiplexing (OFDM) systems have been proposed in the literature to combat multipath distortion and intersymbol interference (ISI) caused by multipath signal propagation. In this paper, we present a robust timing synchronization scheme suitable for asymmetrically clipped (AC) OFDM based optical intensity modulated direct detection (IM/DD) wireless systems. Our proposed method works perfectly for ACO-OFDM, Pulse amplitude modulated discrete multitone (PAM-DMT) and discrete Hartley transform (DHT) based optical OFDM systems. In contrast to existing OFDM timing synchronization methods which are either not suitable for AC OFDM techniques due to unipolar nature of output signal or perform poorly, our proposed method is suitable for...

  18. 76 FR 4649 - ACS Energy Services, Inc.; Supplemental Notice That Initial Market-Based Rate Filing Includes...


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission ACS Energy Services, Inc.; Supplemental Notice That Initial Market-Based... supplemental notice in the above-referenced proceeding, ACS Energy Services, Inc.'s application for...

  19. A mechanism-based potent sirtuin inhibitor containing Nε-thiocarbamoyl-lysine (TuAcK)


    In the current study, we have identified Nε-thiocarbamoyl-lysine (TuAcK) as a general sirtuin inhibitory warhead which was shown to be able to confer potent sirtuin inhibition. This inhibition was also shown to be mechanism-based in that the TuAck residue was able to be processed by a sirtuin enzyme with the formation of a stalled S-alkylamidate intermediate.

  20. Evidence-based diagnosis in patch testing

    van der Valk, PGM; Devos, SA; Coenraads, PJ


    Evidence-based medicine (EBM) is defined as the integration of the best research evidence with clinical expertise and patient values. Based on the principles of EBM, we can conclude that patch testing is cost-effective only if patients are selected on the basis of a clear-cut clinical suspicion of c

  1. Three-phase AC-AC power converters based on matrix converter topology matrix-reactance frequency converters concept

    Szczesniak, Pawel


    AC voltage frequency changes is one of the most important functions of solid state power converters. The most desirable features in frequency converters are the ability to generate load voltages with arbitrary amplitude and frequency, sinusoidal currents and voltages waveforms; the possibility of providing unity power factor for any load; and, finally, a simple and compact power circuit. Over the past decades, a number of different frequency converter topologies have appeared in the literature, but only the converters with either a voltage or current DC link are commonly used in industrial app

  2. Virtual Impedance Based Fault Current Limiters for Inverter Dominated AC Microgrids

    Lu, Xiaonan; Wang, Jianhui; Guerrero, Josep M.


    virtual impedance control loops. The proposed VI-FCL features flexible and low-cost implementation and can effectively suppress the fault current and the oscillation in the following fault restoration process in AC microgrids. The systematic model of the inverter dominated AC microgrid is derived......In this paper, a virtual impedance based fault current limiter (VI-FCL) is proposed for islanded microgrids comprised of multiple inverter interfaced distributed generators (DGs). Considering the increased fault current capability induced by high penetration of renewable energy sources (RESs), FCLs...... are employed to suppress the fault current and the subsequent oscillation and even instability in the modern distribution network with microgrids. In this study, rather than involving extra hardware equipment, the functionality of FCL is achieved in the control diagram of DG inverters by employing additional...

  3. Interior point algorithm-based power flow optimisation of a combined AC and DC multi-terminal grid

    Farhan Beg


    Full Text Available The high cost of power electronic equipment, lower reliability and poor power handling capacity of the semiconductor devices had stalled the deployment of systems based on DC (multi-terminal direct current system (MTDC networks. The introduction of voltage source converters (VSCs for transmission has renewed the interest in the development of large interconnected grids based on both alternate current (AC and DC transmission networks. Such a grid platform also realises the added advantage of integrating the renewable energy sources into the grid. Thus a grid based on DC MTDC network is a possible solution to improve energy security and check the increasing supply demand gap. An optimal power solution for combined AC and DC grids obtained by the solution of the interior point algorithm is proposed in this study. Multi-terminal HVDC grids lie at the heart of various suggested transmission capacity increases. A significant difference is observed when MTDC grids are solved for power flows in place of conventional AC grids. This study deals with the power flow problem of a combined MTDC and an AC grid. The AC side is modelled with the full power flow equations and the VSCs are modelled using a connecting line, two generators and an AC node. The VSC and the DC losses are also considered. The optimisation focuses on several different goals. Three different scenarios are presented in an arbitrary grid network with ten AC nodes and five converter stations.

  4. AC electric field induced dipole-based on-chip 3D cell rotation.

    Benhal, Prateek; Chase, J Geoffrey; Gaynor, Paul; Oback, Björn; Wang, Wenhui


    The precise rotation of suspended cells is one of the many fundamental manipulations used in a wide range of biotechnological applications such as cell injection and enucleation in nuclear transfer (NT) cloning. Noticeably scarce among the existing rotation techniques is the three-dimensional (3D) rotation of cells on a single chip. Here we present an alternating current (ac) induced electric field-based biochip platform, which has an open-top sub-mm square chamber enclosed by four sidewall electrodes and two bottom electrodes, to achieve rotation about the two axes, thus 3D cell rotation. By applying an ac potential to the four sidewall electrodes, an in-plane (yaw) rotating electric field is generated and in-plane rotation is achieved. Similarly, by applying an ac potential to two opposite sidewall electrodes and the two bottom electrodes, an out-of-plane (pitch) rotating electric field is generated and rolling rotation is achieved. As a prompt proof-of-concept, bottom electrodes were constructed with transparent indium tin oxide (ITO) using the standard lift-off process and the sidewall electrodes were constructed using a low-cost micro-milling process and then assembled to form the chip. Through experiments, we demonstrate rotation of bovine oocytes of ~120 μm diameter about two axes, with the capability of controlling the rotation direction and the rate for each axis through control of the ac potential amplitude, frequency, and phase shift, and cell medium conductivity. The maximum observed rotation rate reached nearly 140° s⁻¹, while a consistent rotation rate reached up to 40° s⁻¹. Rotation rate spectra for zona pellucida-intact and zona pellucida-free oocytes were further compared and found to have no effective difference. This simple, transparent, cheap-to-manufacture, and open-top platform allows additional functional modules to be integrated to become a more powerful cell manipulation system.

  5. Evidence-Based ACL Reconstruction



    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  6. Evidence-based dentistry: what's new?

    Ballini, A; Capodiferro, S; Toia, M; Cantore, S; Favia, G; De Frenza, G; Grassi, F R


    The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. Nowadays the practice of dentistry is becoming more complex and challenging because of the continually changing in dental materials and equipments, an increasingly litigious society, an increase in the emphasis of continuing professional development, the information explosion and the consumer movement associated with advances on the Internet. The need for reliable information and the electronic revolution have come together to allow the "paradigm shift" towards evidence-based health care. Recent years have seen an increase in the importance of evidence-based dentistry, aiming to reduce to the maximum the gap between clinical research and real world dental practice. Aim of evidence-based practice is the systematic literature review, which synthesizes the best evidences and provides the basis for clinical practice guidelines. These practice guidelines give a brief review of what evidence-based dentistry is and how to use it.

  7. Evidence-based policymaking: a critique.

    Greenhalgh, Trisha; Russell, Jill


    The idea that policy should be based on best research evidence might appear to be self-evident. But a closer analysis reveals a number of problems and paradoxes inherent in the concept of "evidence-based policymaking." The current conflict over evidence-based policymaking parallels a long-standing "paradigm war" in social research between positivist, interpretivist, and critical approaches. This article draws from this debate in order to inform the discussions over the appropriateness of evidence- based policymaking and the related question of what is the nature of policymaking. The positivist, empiricist worldview that underpins the theory and practice of evidence-based medicine (EBM) fails to address key elements of the policymaking process. In particular, a narrowly "evidence-based" framing of policymaking is inherently unable to explore the complex, context-dependent, and value-laden way in which competing options are negotiated by individuals and interest groups. Sociolinguistic tools such as argumentation theory offer opportunities for developing richer theories about how policymaking happens. Such tools also have potential practical application in the policymaking process: by enhancing participants' awareness of their own values and those of others, the quality of the collective deliberation that lies at the heart of policymaking may itself improve.

  8. Evidence-Based Dentistry: What's New?

    A. Ballini, S. Capodiferro, M. Toia, S. Cantore, G. Favia, G. De Frenza, F.R. Grassi


    Full Text Available The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. Nowadays the practice of dentistry is becoming more complex and challenging because of the continually changing in dental materials and equipments, an increasingly litigious society, an increase in the emphasis of continuing professional development, the information explosion and the consumer movement associated with advances on the Internet. The need for reliable information and the electronic revolution have come together to allow the “paradigm shift” towards evidence-based health care. Recent years have seen an increase in the importance of evidence-based dentistry, aiming to reduce to the maximum the gap between clinical research and real world dental practice. Aim of evidence-based practice is the systematic literature review, which synthesizes the best evidences and provides the basis for clinical practice guidelines. These practice guidelines give a brief review of what evidence-based dentistry is and how to use it.

  9. Practice-Based Evidence: Delivering What Works

    Brendtro, Larry K.; Mitchell, Martin L.


    Many methods claim to be Evidence-Based Practices. Yet success comes not from a particular practice, but principles that underlie all effective helping. This article uses the principle of consilience to tap knowledge from science, values, and practical experience.

  10. Evidence-Based Dentistry: What's New?

    A. Ballini, S. Capodiferro, M. Toia, S. Cantore, G. Favia, G. De Frenza, F.R. Grassi


    The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care ...

  11. Evidence-based Management of Glaucoma

    Yangfan Yang; Minbin Yu


    Purpose: The evidence-based medicine (EBM) is a new medical mode that is completely different from traditional experience-based medicine. The core of EBM is that decision-making during clinical practices must be based on objective research results.With the rapid development of modern ophthalmology, some former viewpoints according to experience-based medicine face challenges. Evidence-based ophthalmology (EBO) is imperative under the situation. Glaucoma, as a disease resulting in blindness, which can not be cured by operation, is thought more and more of by medical management officials and doctors. One challenge for ophthalmologists entering the 21st century will be to make clinical decisions based on valid information or evidence rather than intuition, hearsay, or peer practice. How can we do? Here reviews the application of EBM in medical management of glaucoma since EBM' s naissance and give a reference.

  12. Eminence-based medicine versus evidence-based medicine: level V evidence in sports medicine.

    Tjoumakaris, Fotios P; Ganley, Theodore J; Kapur, Rahul; Kelly, John; Sennett, Brian J; Bernstein, Joseph


    cannot replace individual judgment and certainly does not trump the primary medical literature. Yet when better evidence is lacking, expert opinion is valuable for even the staunchest practitioner of evidence-based medicine.

  13. A multiplexer for the ac/dc characterization of TES based bolometers and microcalorimeters

    Gottardi, Luciano; Bruijn, Marcel; Gao, Jan R; Hartog, Roland den; Hijmering, Richard; Hoevers, Henk; Khosropanah, Pourya; van der Kuur, Jan; van der Linden, Anoton; Lindeman, Marcel; Ridder, Marcel


    At SRON we are developing the Frequency Domain Multiplexing (FDM) for the read-out of the TES-based detector array for the future infrared and X-ray space mission. We describe the performances of a multiplexer designed to increase the experimental throughput in the characterisation of ultra-low noise equivalent power (NEP) TES bolometers and high energy resolving power X-ray microcalorimeters arrays under ac and dc bias. We discuss the results obtained using the TiAu TES bolometers array fabricated at SRON with measured dark NEP below $5\\cdot 10^{-19}W/Hz^{1/2}$ and saturation power of several fW

  14. Optimizing efficiency on conventional transformer based low power AC/DC standby power supplies

    Nielsen, Nils


    This article describes the research results for simple and cheap methods to reduce the idle- and load-losses in very low power conventional transformer based power supplies intended for standby usage. In this case "very low power" means 50 Hz/230 V-AC to 5 V-DC@1 W. The efficiency is measured...... on two common power supply topologies designed for this power level. The two described topologies uses either a series (or linear) or a buck regulation approach. Common to the test power supplies is they either are using a standard cheap off-the-shelf transformer, or one, which are loss optimized by very...

  15. Evidence-based equine dentistry: preventive medicine.

    Carmalt, James L


    Dental problems are some of the most common reasons for a horse to be presented to an equine veterinarian. Despite the importance of anecdotal evidence as a starting point, the science of equine dentistry (especially prophylactic dentistry) has remained poorly supported by evidence-based approaches to diagnosis and treatment. In the 21st century, veterinarians have an ethical responsibility to promote and use the results of evidence-based research and not propagate statements attesting to the purported benefits of intervention without supporting research. Consider also that society is becoming more litigious and therefore is basing treatment plans and advice on published research, which protects the profession from legal challenges concerning our professional conduct. This article reviews the current published evidence concerning the role of equine dentistry in feed digestibility and performance.

  16. Professionalism and evidence-based practice

    Rasmussen, Palle


    The idea of evidence- based practice is influential in public welfare services, including education. The idea is controversial, however, not least because it involves a poten tial redefinition of the relation ship between knowledge, authority and professionalism. This is discussed based on a study...... of evidence- based methods in Danish pre-school education and care. The management sees the use of these methods as strengthening pre- school teacher professionalism, but the actual practices in the day-careinstitutions are ambiguous. In some cases, using the methods becomes an end in itself and tends...

  17. Prediction of Pollution Flashover Voltage Based on Leakage Current Under AC Operating Voltage

    MEI Hongwei; WANG Liming; GUAN Zhicheng; MAO Yingke


    This paper presented a model to predict the AC flashover voltage of contaminated suspension insulators.The prediction method is based on the maximum leakage current under AC operating voltage.Three kinds of widely used suspension insulators were tested in various contamination states such as pollution layers with different equivalent salt deposit density(ESDD),different composition of the conductive components,different non-soluble deposit density(NSDD) and different pollution distribution states to simulate the contamination states in nature.The effective ESDD was proposed and calculated.Influences of contamination states to maximum leakage current and flashover voltage were studied.Then,the relationships between flashover voltage and leakage current in these states were presented.Finally,considering the difference of insulator profiles,a new parameter is defined and a model to estimate the flashover voltage based on this parameter is developed.The model could be used in all kinds of suspension insulators in different contamination states and was validated by the test results.

  18. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    Li, Chendan; Savaghebi, Mehdi; Guerrero, Josep M.


    Recently, microgrids are attracting increasing research interest as promising technologies to integrate renewable energy resources into the distribution system. Although many works have been done on droop control applied to microgrids, they mainly focus on achieving proportional power sharing based...... on the power rating of the power converters. With various primary source for the distributed generator (DG), factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper......, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully...

  19. The fallacy of evidence based policy

    Saltelli, Andrea


    The use of science for policy is at the core of a perfect storm generated by the insurgence of several concurrent crises: of science, of trust, of sustainability. The modern positivistic model of science for policy, known as evidence based policy, is based on dramatic simplifications and compressions of available perceptions of the state of affairs and possible explanations (hypocognition). This model can result in flawed prescriptions. The flaws become more evident when dealing with complex issues characterized by concomitant uncertainties in the normative, descriptive and ethical domains. In this situation evidence-based policy may concur to the fragility of the social system. Science plays an important role in reducing the feeling of vulnerability of humans by projecting a promise of protection against uncertainties. In many applications quantitative science is used to remove uncertainty by transforming it into probability, so that mathematical modelling can play the ritual role of haruspices. This epistem...

  20. The religion of evidence-based practice

    Wigram, Tony; Gold, Christian


    , and discusses autism spectrum disorders and EBP. The chapter concludes that, based on last sixty years of the development of music therapy as a recognized and relevant intervention, there is no doubt that the honeymoon period is over, and EBP is here to stay. Despite examples of attrition in music therapy......This chapter begins by outlining the challenges of preparing a chapter on evidence-based practice (EBP) to underpin the use of music as a therapeutic tool in treatment, in the overall frame of music, health, and wellbeing. It then reviews the terminology of EBP and evidence-based medicine...... practice as health, education, and social services tighten their belts and the demand on their resources grows, there is increasing interest in the value of music for health and wellbeing, despite even less ‘hard’ evidence that it is effective against illness and disability....

  1. Tribological properties of AC44200 based composites strenghead with AlB2BOB3 Bparticles

    J.W. Kaczmar


    Full Text Available The paper presents a research on abrasion resistance of aluminium-based composites consisting of EN AC-44200 matrix reinforcedwith AlB2BOB3B particles. The examinations revealed that wear intensity of the composites decreased with increasing volume fraction of the particles. Much more intensive abrasive wear was observed on the first kilometre in comparison to the wear on the subsequent distances, i.e. from 1 to 3.5 km and from 3.5 to 8.5 km of the wear distance. Microscopic examinations permitted determining the way and type of wear occurring in the examined materials. In the case of the AC-44200 matrix, typical adhesive wear is observed. In composite materials however, abrasive wear prevails over adhesive wear. Increased volume fraction of AlB2BOB3B particles in composite materials results in increasing friction factor in average by 0.250 per each 10 vol.%. Wear of the cast-iron counterspecimen is also strongly dependent on volume fraction of the reinforcing particles. The counterspecimen demonstrates the largest wear when working in contact with a composite material containing 40 vol.% of AlB2BOB3B particles.

  2. A self-powered AC magnetic sensor based on piezoelectric nanogenerator.

    Yu, Aifang; Song, Ming; Zhang, Yan; Kou, Jinzong; Zhai, Junyi; Lin Wang, Zhong


    An AC magnetic field, which is a carrier of information, is distributed everywhere and is continuous. How to use and detect this field has been an ongoing topic over the past few decades. Conventional magnetic sensors are usually based on the Hall Effect, the fluxgate, a superconductor quantum interface or magnetoelectric or magnetoresistive sensing. Here, a flexible, simple, low-cost and self-powered active piezoelectric nanogenerator (NG) is successfully demonstrated as an AC magnetic field sensor at room temperature. The amplitude and frequency of a magnetic field can both be accurately sensed by the NG. The output voltage of the NG has a good linearity with a measured magnetic field. The detected minute magnetic field is as low as 1.2 × 10(-7) tesla, which is 400 times greater than a commercial magnetic sensor that uses the Hall Effect. In comparison to the existing technologies, an NG is a room-temperature self-powered active sensor that is very simple and very cheap for practical applications.

  3. The Single-phase AC Regulator on Base of Bidirectional IGBT Switches

    Cimanis, Vladimirs; Hramcovs, Vladimirs; Rankis, Ivars


    In the work one of the methods for regulation of sinus shape AC voltage for middle-power loads with activeinductive character is observed. Such a regulator keeping output voltage of sinus shape must be fast-reacting and work in closed-loop system. It's shown, that for providing such features Buck and Boost pulse regulators can be applied. The only difference from DC pulse converters is that electronic switches in the system must be with bidirectional conductivity. For this reason an IGBT transistors can be applied with implemented in structure reverse diodes and if such two transistors are connected in series and with contrary conductivity then at activating both one of them will be in on-state. Realization of AC regulators with such switches is described in the work. Results of computer modeling also are given. Output voltage ripples are investigated on subject of their range and efficiency of filtering equipment on LC base. Such regulators can be applied for instance in electrical transport self supply systems.

  4. Low frequency and low temperature behavior of ZnO-based varistor by ac impedance measurements

    Al Abdullah, K.; Bui, A.; Loubiere, A.


    This paper reports on an original work on the study of the behavior of ZnO-based varistor by ac impedance measurements. The measurements of complex impedance response to small ac signals applied to samples have been achieved in the frequency range 10-3-7×106 Hz and a temperature range -196-145 °C. In the temperature range below -120±10 °C, a complete semicircular relaxation phenomenon has been observed, which is in good agreement with the Debye model. In the temperature range above -120±10 °C, the appearance of the depression angle θ may arise from the heterogeneity of the barriers of the ceramic varistor. A Cole-Cole distribution function of the relaxation time constants was used to characterize the response of the ceramic device as a function of temperature. No observable influence in the response was introduced by either the space charge or the electrode. Using the leakage resistance measurements from the complex plane, two values of the activation energies were observed; 0.36±0.02 eV and 0.01±0.001 eV. Similarly, the boundary layer equivalent capacitance measurements detect two other energy levels: 0.06±0.005 eV and about 0 eV.

  5. Crime prevention: more evidence-based analysis.

    Garrido Genovés, Vicente; Farrington, David P; Welsh, Brandon C


    This paper introduces a new section of Psicothema dedicated to the evidence-based approach to crime prevention. Along with an original sexual-offender-treatment programme implemented in Spain, this section presents four systematic reviews of important subjects in the criminological arena, such as sexual offender treatment, the well-known programme, the effectiveness of custodial versus non-custodial sanctions in reoffending and the fight against terrorism. We also highlight some of the focal points that scientists, practitioners and governments should take into account in order to support this evidence-based viewpoint of crime prevention.

  6. FPGA-based genetic algorithm implementation for AC chopper fed induction motor

    Mahendran, S.; Gnanambal, I.; Maheswari, A.


    Genetic algorithm (GA)-based harmonic elimination technique is proposed for designing AC chopper. GA is used to calculate optimal firing angles to eliminate lower order harmonics in output voltage. Total harmonic distortion of output voltage is taken for the fitness function used in the GA. Thus, the ratings of the load are not mandatory to be known for calculating the switching angles using proposed technique. For the performance assessment of GA, Newton-Raphson (NR) method is applied in this present work. Simulation results show that the proposed technique is better in terms of less computational complexity and quick convergence. Simulation results were verified by field programmable gate array controller-based prototype. Simulation study and experimental investigations show that the proposed GA method is superior to the conventional methods.

  7. A Corpus for Evidence Based Medicine Summarisation

    Diego Mollá Aliod


    Full Text Available Background Automated text summarisers that find the best clinical evidence reported in collections of medical literature are of potential benefit for the practice of Evidence Based Medicine (EBM. Research and development of text summarisers for EBM, however, is impeded by the lack of corpora to train and test such systems. Aims To produce a corpus for research in EBM summarisation. Method We sourced the “Clinical Inquiries” section of the Journal of Family Practice (JFP and obtained a sizeable sample of questions and evidence based summaries. We further processed the summaries by combining automated techniques, human annotations, and crowdsourcing techniques to identify the PubMed IDs of the references. Results The corpus has 456 questions, 1,396 answer components, 3,036 answer justifications, and 2,908 references. Conclusion The corpus is now available for the research community at

  8. Time for evidence-based cytology

    Dey Pranab


    Full Text Available Abstract Evidence-based medicine (EBM is a fashionable and an extremely hot topic for clinicians, patients and the health service planners. Evidence-based cytology (EBC is an offshoot of EBM. The EBC is concerned with generating a reproducible, high quality and clinically relevant test result in the field of cytology. This is a rapidly evolving area with high practical importance. EBC is based entirely on research data. The various professional bodies on cytology design and recommend guidelines on the basis of evidences. Once the guideline is implemented and practiced then the experiences of the practicing cytopathologists may be used as a feed back to alter the existing guideline. The various facets of EBC are sampling and specimen adequacy, morphological identification and computer based expert system, integrated reporting, identification of the controversial areas and high quality researches for evidences. It is the duty of the individuals and institutions to practice EBC for better diagnosis and management of the patients. In this present paper, the various aspects of EBC have been discussed.

  9. Evidence-Based Classroom Behaviour Management Strategies

    Parsonson, Barry S.


    This paper reviews a range of evidence-based strategies for application by teachers to reduce disruptive and challenging behaviours in their classrooms. These include a number of antecedent strategies intended to help minimise the emergence of problematic behaviours and a range of those which provide positive consequences for appropriate student…

  10. Patient autonomy in evidence-based dentistry.

    Ritwik, Priyanshi


    Evidence-based dentistry is the judicious integration of scientific information relating to the patient's oral health and medical condition with the dentist's clinical expertise and the patient's own treatment needs and preferences. In this triad of factors, we (the dentists) are least likely to be formally trained in recognizing our patient's preferences. Do we understand what shapes these preferences?

  11. Evidence Based Education Request Desk. EBE #359

    Regional Educational Laboratory Southeast, 2008


    This Evidence Based Education (EBE) response describes characteristics of graduation coach initiatives in three states (Georgia, Alabama, and California). Regional Educational Laboratory (REL) Southeast has received over 19 requests for information on various initiatives, programs or research related to improving graduation rates. For example, the…

  12. Evidence Based Education Request Desk. EBE #555

    Regional Educational Laboratory Southeast, 2009


    This Evidence Based Education (EBE) Request seeks to provide an overview of recent research regarding school improvement and reform with special concentration on turning around chronically low-performing schools. The response is divided into four main sections: Research on Effective Methods for Turning Around Low-Performing Schools, Frameworks for…

  13. Evidence Based Education Request Desk. EBE #510

    Regional Educational Laboratory Southeast, 2009


    This Evidence Based Education (EBE) request focused on research-supported vocabulary interventions for middle elementary students. Limited vocabulary is an important factor in underachievement of children in disadvantaged homes. Children with larger vocabularies find reading easier, read more widely, and do better in school (Lubliner & Smetana,…

  14. Evidence Based Education Request Desk. EBE #741

    Regional Educational Laboratory Southeast, 2010


    This Evidence Based Education (EBE) request asks for information relating to funding for virtual schools. The EBE Request Desk was asked to provide a scan of states for information on how they fund virtual schools and what the current funding levels are (most current year for which such data is available). This paper provides answers to this…

  15. Evidence Based Education Request Desk. EBE #798

    Regional Educational Laboratory Southeast, 2011


    Evidence Based Education (EBE) #555 was in response to the request "Is there any new compelling research for turning around low-performing schools?" The articles included in that document are on target, but include articles through 2009. This EBE Request seeks to provide an updated review of recent research (2009-present) regarding school…

  16. Evidence-based Medicine in Animal Reproduction.

    Arlt, S P; Heuwieser, W


    With new knowledge being generated and published daily, the importance of evidence-based approaches in veterinary medicine is obvious. Clinicians must stay current or risk making poor decisions that clients may challenge. Especially in animal reproduction, several new substances and procedures to diagnose or treat reproductive disorders have been introduced in the last years. On the other hand, a closer look at the quality of published literature on animal reproduction reveals major deficits in methodology and reporting of many clinical trials. We strongly recommend systematically assessing the quality of scientific information when reading journal papers before using the given information in practice. The aim of evidence-based medicine (EBM) is to base the decisions in the practice of medicine on valid, clinically relevant research data. Therefore, we suggest that students should become familiar with the concepts of evidence-based veterinary medicine (EBVM) at the beginning of their veterinary education. Concepts and supporting tools such as checklists for literature assessment have been developed and validated. The purpose of this article is to review and discuss the importance of incorporating EBVM in animal reproduction. The need for further research that produces strong evidence in different fields of animal reproduction and better reporting of relevant study information is obvious.

  17. Evidence-Based Education in Plastic Surgery.

    Johnson, Shepard P; Chung, Kevin C; Waljee, Jennifer F


    Educational reforms in resident training have historically been driven by reports from medical societies and organizations. Although educational initiatives are well intended, they are rarely supported by robust evidence. The Accreditation Council for Graduate Medical Education recently introduced competency-based training, a form of outcomes-based education that has been used successfully in nonmedical professional vocations. This initiative has promise to advance the quality of resident education, but questions remain regarding implementation within plastic surgery. In particular, how will competency-based training impact patient outcomes, and will the methodologies used to assess competencies (i.e., milestones) be accurate and validated by literature? This report investigates resident educational reform and the need for more evidence-based educational initiatives in plastic surgery training.

  18. Isolation of sequences flanking Ac insertion sites by Ac casting.

    Wang, Dafang; Peterson, Thomas


    Localizing Ac insertions is a fundamental task in studying Ac-induced mutation and chromosomal rearrangements involving Ac elements. Researchers may sometimes be faced with the situation in which the sequence flanking one side of an Ac/Ds element is known, but the other flank is unknown. Or, a researcher may have a small sequence surrounding the Ac/Ds insertion site and needs to obtain additional flanking genomic sequences. One way to rapidly clone unknown Ac/Ds flanking sequences is via a PCR-based method termed Ac casting. This approach utilizes the somatic transposition activity of Ac during plant development, and provides an efficient means for short-range genome walking. Here we describe the principle of Ac casting, and show how it can be applied to isolate Ac macrotransposon insertion sites.

  19. The Evidence-Based Manifesto for School Librarians

    Todd, Ross


    School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

  20. Stability Analysis for Isolated AC Microgrids Based on PV-Active Generators

    Aldana, Nelson Leonardo Diaz; Coelho, Ernane A. A.; Quintero, Juan Carlos Vasquez;


    The current trend in isolated microgrids is oriented to distributed renewable energy generators, such as photovoltaic (PV) generators and their corresponding distributed energy storage systems (ESS) as an unit denoted as active generator (PV+ESS). In an isolated microgrid, every distributed...... for all the distributed generators. In particular, ESS’s based on batteries require at least two different mode of charge. As consequence, the topological operation mode of the microgrid is affected by the changes of the operation mode of each distributed generator. Typically, droop control loops are used...... for interconnecting several different distributed generators in parallel to a common bus, whose parameters determine the stability and damping of the microgrid operation. In this paper, a small-signal stability analysis is applied to an isolated AC microgrid composed of (PV+ESS) active generators, regarding three...

  1. Evidence Based Practice: Science? Or Art? (Editorial

    Denise Koufogiannakis


    Full Text Available Evidence based library and information practice (EBLIP is a strategy to bridge research and practice. Generally EBLIP is seen as a movement to encourage and give practitioners the means to incorporate research into their practice, where it previously may have been lacking. The widely accepted definition of EBLIP (Booth, 2000 stresses three aspects that contribute to a practice that is evidence based: 1 "the best available evidence;" 2 "moderated by user needs and preferences;" 3 "applied to improve the quality of professional judgements." The area that the EBLIP movement has focused on is how to create and understand the best available research evidence. CE courses, critical appraisal checklists, and many articles have been written to address a need for librarian education in this area, and it seems that strides have been made.But very little in the EBLIP literature talks about how we make professional judgements, or moderate evidence based on our user needs and preferences. Likewise, how do we make good evidence based decisions when our evidence base is weak. These things seem to be elements we just take for granted or can’t translate into words. It is in keeping with tacit knowledge that librarians just seem to have or acquire skills with education and on the job experience. Tacit knowledge is "knowledge that is not easily articulated, and frequently involves knowledge of how to do things. We can infer its existence only by observing behaviour and determining that this sort of knowledge is a precondition for effective performance" (Patel, Arocha, & Kaufman, 1999, p.78. It is something that is difficult to translate into an article or guideline for how we work. I think of this area as the "art" of evidence based practice. And the art is crucial to being an evidence based practitioner.Science = systematized knowledge, explicit research, methodological examination, investigation, dataArt = professional knowledge of your craft, intuition

  2. ACS: ALMA Common Software

    Chiozzi, Gianluca; Šekoranja, Matej


    ALMA Common Software (ACS) provides a software infrastructure common to all ALMA partners and consists of a documented collection of common patterns and components which implement those patterns. The heart of ACS is based on a distributed Component-Container model, with ACS Components implemented as CORBA objects in any of the supported programming languages. ACS provides common CORBA-based services such as logging, error and alarm management, configuration database and lifecycle management. Although designed for ALMA, ACS can and is being used in other control systems and distributed software projects, since it implements proven design patterns using state of the art, reliable technology. It also allows, through the use of well-known standard constructs and components, that other team members whom are not authors of ACS easily understand the architecture of software modules, making maintenance affordable even on a very large project.

  3. Observation, Sherlock Holmes, and Evidence Based Medicine.

    Osborn, John


    Sir Arthur Conan Doyle, the creator of the fictional detective Sherlock Holmes, studied medicine at the University of Edinburgh between 1876 and 1881 under Doctor Joseph Bell who emphasised in his teaching the importance of observation, deduction and evidence. Sherlock Holmes was modelled on Joseph Bell. The modern notions of Evidence Based Medicine (EBM) are not new. A very brief indication of some of the history of EBM is presented including a discussion of the important and usually overlooked contribution of statisticians to the Popperian philosophy of EBM.

  4. Evidence Based Education: un quadro storico

    Giuliano Vivanet


    Full Text Available Nel corso dell’ultimo decennio, nel pensiero pedagogico anglosassone, si è affermata una cultura dell’evidenza cui ci si riferisce con l’espressione “evidence based education” (EBE. Secondo tale prospettiva, le decisioni in ambito educativo dovrebbero essere assunte sulla base delle conoscenze che la ricerca empirica offre in merito alla minore o maggiore efficacia delle differenti opzioni didattiche. Si tratta di un approccio (denominato “evidence based practice” che ha origine in ambito medico e che in seguito ha trovato applicazione in differenti domini delle scienze sociali. L’autore presenta un quadro introduttivo all’EBE, dando conto delle sue origini e dei differenti significati di cui è portatrice.

  5. Evidence-based management of ANCA vasculitis.

    Carruthers, David; Sherlock, Jonathan


    The vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs) present to and are managed by a wide spectrum of physicians, reflecting the multi-organ nature of the conditions. Treatment strategies for these primary inflammatory vascular diseases have varied based on the outcomes of different clinical trials and practice reviews. The individual drugs used and their route of administration, dose, and duration of therapy have varied and have been the source of much debate. Advances in our understanding of disease immunopathogenesis, clinical assessment and outcome have formed the basis for several recent good-quality clinical trials. Now, with the results of these large-scale multicentre collaborative studies, there is a firmer evidence base to guide management decisions for individual patients. This evidence base, reviewed here, has led to the publication of treatment guidelines which importantly encompass many of the broader aspects of disease management.

  6. Evidence-based policymaking: A review

    Karen Nortje


    Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence it more effectively. Similarly, policymakers need to understand the complexities of the scientific process to improve their interaction with the scientific sphere. This literature review addresses those factors that influence the uptake of scientific evidence into policymaking, the barriers to using science in policymaking, as well as recommendations for improved science–policymaking interaction. A visual diagram of the gears of a car is used to convey the message of the complexities around the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised.

  7. Teaching evidence based medicine in family medicine

    Davorka Vrdoljak


    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  8. How evidence-based are the recommendations in evidence-based guidelines?

    Finlay A McAlister


    Full Text Available BACKGROUND: Treatment recommendations for the same condition from different guideline bodies often disagree, even when the same randomized controlled trial (RCT evidence is cited. Guideline appraisal tools focus on methodology and quality of reporting, but not on the nature of the supporting evidence. This study was done to evaluate the quality of the evidence (based on consideration of its internal validity, clinical relevance, and applicability underlying therapy recommendations in evidence-based clinical practice guidelines. METHODS AND FINDINGS: A cross-sectional analysis of cardiovascular risk management recommendations was performed for three different conditions (diabetes mellitus, dyslipidemia, and hypertension from three pan-national guideline panels (from the United States, Canada, and Europe. Of the 338 treatment recommendations in these nine guidelines, 231 (68% cited RCT evidence but only 105 (45% of these RCT-based recommendations were based on high-quality evidence. RCT-based evidence was downgraded most often because of reservations about the applicability of the RCT to the populations specified in the guideline recommendation (64/126 cases, 51% or because the RCT reported surrogate outcomes (59/126 cases, 47%. CONCLUSIONS: The results of internally valid RCTs may not be applicable to the populations, interventions, or outcomes specified in a guideline recommendation and therefore should not always be assumed to provide high-quality evidence for therapy recommendations.

  9. Can Scholarly Communication be Evidence Based? (Editorial

    Denise Koufogiannakis


    Full Text Available This issue of Evidence Based Library and Information Practice includes three papers from the Evidence Based Scholarly Communication Conference (EBSCC that took place in March 2010i. Kroth, Philips and Eldredge have written a commentary that gives an overview of the conference, and introduces us to the research papers that were presented. As well, two research presentations from the conference appear in this issue, an article by Donahue about a potential new method of communicating between scholars, and a paper by Gilliland in our Using Evidence in Practice section, detailing a library’s Open Access Day preparations.Kroth, Philips and Eldredge note that “The EBSCC brought together librarians and information specialists to share evidence-based strategies for developing effective local scholarly communication support and training and, hopefully, form new coalitions to address this topic at a local and national level.” (p 108. This conference focused on translational medicine, and looked at how to promote new methods of scholarly communication, partially through the inclusion of research papers at the conference.The inclusion of these articles and the evidence based focus of the EBSCC conference, made me ask myself, can scholarly communication be evidence based? At its core, scholarly communication is anything but a scientific issue. It is charged with emotion; from authors, publishers, librarians and others involved in the business of publishing. The recent shift to look at new models of scholarly communication has been a threat to many of the established models and sparked much debate in the academic world, especially in relation to open access. In her 2006 EBLIP commentary on evidence based practice and open access, Morrison notes, “Open Access and evidence based librarianship are a natural combination” (p. 49, and outlines her perspective on many of the reasons why. Debate continues to rage, however, regarding how authors should

  10. Evidence-based pathology: umbilical cord coiling.

    Khong, T Y


    The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

  11. Evidence-Based Chinese Medicine for Hypertension

    Jie Wang


    Full Text Available Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM. Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go.

  12. Evidence-based recommendation on toothpaste use

    Jaime Aparecido Cury


    Full Text Available Toothpaste can be used as a vehicle for substances to improve the oral health of individuals and populations. Therefore, it should be recommended based on the best scientific evidence available, and not on the opinion of authorities or specialists. Fluoride is the most important therapeutic substance used in toothpastes, adding to the effect of mechanical toothbrushing on dental caries control. The use of fluoride toothpaste to reduce caries in children and adults is strongly based on evidence, and is dependent on the concentration (minimum of 1000 ppm F and frequency of fluoride toothpaste use (2'/day or higher. The risk of dental fluorosis due to toothpaste ingestion by children has been overestimated, since there is no evidence that: 1 fluoride toothpaste use should be postponed until the age of 3-4 or older, 2 low-fluoride toothpaste avoids fluorosis and 3 fluorosis has a detrimental effect on the quality of life of individuals exposed to fluoridated water and toothpaste. Among other therapeutic substances used in toothpastes, there is evidence that triclosan/copolymer reduce dental biofilm, gingivitis, periodontitis, calculus and halitosis, and that toothpastes containing stannous fluoride reduce biofilm and gingivitis.

  13. Evidence-based recommendation on toothpaste use.

    Cury, Jaime Aparecido; Tenuta, Livia Maria Andalo


    Toothpaste can be used as a vehicle for substances to improve the oral health of individuals and populations. Therefore, it should be recommended based on the best scientific evidence available, and not on the opinion of authorities or specialists. Fluoride is the most important therapeutic substance used in toothpastes, adding to the effect of mechanical toothbrushing on dental caries control. The use of fluoride toothpaste to reduce caries in children and adults is strongly based on evidence, and is dependent on the concentration (minimum of 1000 ppm F) and frequency of fluoride toothpaste use (2'/day or higher). The risk of dental fluorosis due to toothpaste ingestion by children has been overestimated, since there is no evidence that: 1) fluoride toothpaste use should be postponed until the age of 3-4 or older, 2) low-fluoride toothpaste avoids fluorosis and 3) fluorosis has a detrimental effect on the quality of life of individuals exposed to fluoridated water and toothpaste. Among other therapeutic substances used in toothpastes, there is evidence that triclosan/copolymer reduce dental biofilm, gingivitis, periodontitis, calculus and halitosis, and that toothpastes containing stannous fluoride reduce biofilm and gingivitis.

  14. Design of Three Phase Solar-Based 4.5kw Ac Power Inverter Station

    Dr.J.C. Onuegbu


    Full Text Available The design model of a 4.50Kilowatt, 3-phase, 50 hertz solar-based power generating station was examined by the paper. The power station is a dual source input generating station using 8 series connected 100A, 12V batteries per phase as backup, the solar panels being the main frame. An inverter of 12Volt direct current input voltage was incorporated to supply an output of 3-phase, 220Volts and 50 hertz alternating current. A charging circuit was installed to monitor charging level and to preserve the accumulator’s life span. The paper also looked into the solar-based power station component design model. The batteries therein are back-up and the system will ensure 24-hours reliable power supply. The setup has a normally closed switching relay ready to pickup the auxiliary battery supply within a few milliseconds after the solar source voltage drops below a stipulated level. The three phase a.c. voltage was achieved using standby on-line circuit with cascaded 741-based flip-flop at the base of the transistor drivers of the 3-phase power transformer. This model circuit reduced the load on each phase winding and facilitated reliable and uninterruptible power supply. The delta-wyeconnected transformer will guarantee proper phase shift of 120 degrees that will emulate alternating current voltage similar to the conventional generator voltage.

  15. ACS algorithm-based adaptive fuzzy PID controller and its application to CIP-Ⅰ intelligent leg

    TAN Guan-zheng; DOU Hong-quan


    Based on the ant colony system (ACS) algorithm and fuzzy logic control, a new design method for optimal fuzzy PID controller was proposed. In this method, the ACS algorithm was used to optimize the input/output scaling factors of fuzzy PID controller to generate the optimal fuzzy control rules and optimal real-time control action on a given controlled object. The designed controller, called the Fuzzy-ACS PID controller, was used to control the CIP-Ⅰ intelligent leg. The simulation experiments demonstrate that this controller has good control performance. Compared with other three optimal PID controllers designed respectively by using the differential evolution algorithm, the real-coded genetic algorithm, and the simulated annealing, it was verified that the Fuzzy-ACS PID controller has better control performance. Furthermore, the simulation results also verify that the proposed ACS algorithm has quick convergence speed, small solution variation, good dynamic convergence behavior, and high computation efficiency in searching for the optimal input/output scaling factors.

  16. Creative teaching an evidence-based approach

    Sale, Dennis


    This book contains an evidence-based pedagogic guide to enable any motivated teaching/training professional to be able to teach effectively and creatively. It firstly summarises the extensive research field on human psychological functioning relating to learning and how this can be fully utilised in the design and facilitation of quality learning experiences. It then demonstrates what creativity actually 'looks like' in terms of teaching practices, modelling the underpinning processes of creative learning design and how to apply these in lesson planning. The book, having established an evidence-based and pedagogically driven approach to creative learning design, extensively focuses on key challenges facing teaching professionals today. These include utilising information technologies in blended learning formats, differentiating instruction, and developing self-directed learners who can think well. The main purpose of the book is to demystify what it means to teach creatively, explicitly demonstrating the pr...

  17. Large-Signal Lyapunov-Based Stability Analysis of DC/AC Inverters and Inverter-Based Microgrids

    Kabalan, Mahmoud

    Microgrid stability studies have been largely based on small-signal linearization techniques. However, the validity and magnitude of the linearization domain is limited to small perturbations. Thus, there is a need to examine microgrids with large-signal nonlinear techniques to fully understand and examine their stability. Large-signal stability analysis can be accomplished by Lyapunov-based mathematical methods. These Lyapunov methods estimate the domain of asymptotic stability of the studied system. A survey of Lyapunov-based large-signal stability studies showed that few large-signal studies have been completed on either individual systems (dc/ac inverters, dc/dc rectifiers, etc.) or microgrids. The research presented in this thesis addresses the large-signal stability of droop-controlled dc/ac inverters and inverter-based microgrids. Dc/ac power electronic inverters allow microgrids to be technically feasible. Thus, as a prelude to examining the stability of microgrids, the research presented in Chapter 3 analyzes the stability of inverters. First, the 13 th order large-signal nonlinear model of a droop-controlled dc/ac inverter connected to an infinite bus is presented. The singular perturbation method is used to decompose the nonlinear model into 11th, 9th, 7th, 5th, 3rd and 1st order models. Each model ignores certain control or structural components of the full order model. The aim of the study is to understand the accuracy and validity of the reduced order models in replicating the performance of the full order nonlinear model. The performance of each model is studied in three different areas: time domain simulations, Lyapunov's indirect method and domain of attraction estimation. The work aims to present the best model to use in each of the three domains of study. Results show that certain reduced order models are capable of accurately reproducing the performance of the full order model while others can be used to gain insights into those three areas of

  18. Nanomaterial-assisted PCR based on thermal generation from magnetic nanoparticles under high-frequency AC magnetic fields

    Higashi, Toshiaki; Minegishi, Hiroaki; Echigo, Akinobu; Nagaoka, Yutaka; Fukuda, Takahiro; Usami, Ron; Maekawa, Toru; Hanajiri, Tatsuro


    Here the authors present a nanomaterial-assisted PCR technique based on the use of thermal generation from magnetic nanoparticles (MNPs) under AC magnetic fields. In this approach, MNPs work as internal nano thermal generators to realize PCR thermal cycling. In order to suppress the non-specific absorption of DNA synthetic enzymes, MNPs are decorated with bovine serum albumin (BSA), forming BSA/MNP complexes. Under high-frequency AC magnetic fields, these complexes work as internal nano thermal generators, thereby producing the typical temperature required for PCR thermal cycling, and perform all the reaction processes of PCR amplification in the place of conventional PCR thermal cyclers.

  19. Evidence based psychosocial interventions in substance use

    Sonali Jhanjee


    Full Text Available In recent years, there has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence. A literature review was undertaken using the several electronic databases (PubMed, Cochrane Database of systemic reviews and specific journals, which pertain to psychosocial issues in addictive disorders and guidelines on this topic. Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users. The evidence base for psychological treatment needs to be expanded and should also include research on optimal combinations of psychological therapies and any particular matching effects, if any. Psychological interventions are an essential part of the treatment regimen and efforts should be made to integrate evidence-based interventions in all substance use disorder treatment programs.

  20. Containment and Consensus-based Distributed Coordination Control for Voltage Bound and Reactive Power Sharing in AC Microgrid

    Han, Renke; Meng, Lexuan; Ferrari-Trecate, Giancarlo


    This paper offers a highly flexible and reliable control strategy to achieve voltage bounded regulation and accurate reactive power sharing coordinately in AC Micro-Grids. A containment and consensus-based distributed coordination controller is proposed, by which each output voltage magnitude can...

  1. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    Chendan Li


    Full Text Available Recently, microgrids are attracting increasing research interest as promising technologies to integrate renewable energy resources into the distribution system. Although many works have been done on droop control applied to microgrids, they mainly focus on achieving proportional power sharing based on the power rating of the power converters. With various primary source for the distributed generator (DG, factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully designed consensus algorithm by using sparse communication links only among neighbouring agents. Experimental results for different cases verified that the proposed control strategy can effectively reduce the operation cost.

  2. Research of Three-Phase AC/DC Converter Based on Matrix Converter%矩阵式AC/DC变换器研究

    许柏宏; 葛红娟; 张文彬; 李后春


    A new type three-phase AC/DC converter topology is achieved by transforming 3-phase to 3-phase matrix converter. The current-source space vector modulation strategy is adopted to analyze in detail. Expressions of output voltage under this modulation strategy are derived. By adding a resonant inductor and a blocking capacitor, it is possible to a-chieve soft commutation for most of the semiconductor elements, and the process of commutation is given in detail. Meanwhile, the control method is proposed to be built in dq synchronous rotating frame based on the grid voltage vector , which increases power factor of input by changing the modulation vector. Simulation results validate correctness and feasibility of the theory and control strategy proposed in this paper.%对三相/三相矩阵变换器进行变换,得到一种衍生的AC/DC变换器拓扑.采用电流型空间矢量调制策略,推导出在该调制策略下的输出电压的表达式.通过在拓扑中加入一个谐振电感和隔直电容,使得双向开关器件可以实现软开关换流,并详细分析了换流过程.将控制算法建立在以电源电压矢量定向的dq同步旋转坐标系中,改变调制矢量实现功率因数调节.仿真结果验证了理论和控制方案的正确性和可行性.

  3. [Acupressure and Evidence-Based Nursing].

    Chen, Li-Li; Lin, Jun-Dai


    Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.

  4. Evidence-Based Interactive Management of Change

    Albert Fleischmann


    Full Text Available Evidence-based interactive management of change means hands-on experience of modified work processes, given evidence of change. For this kind of pro-active organizational development support we use an organisational process memory and a communication-based representation technique for role-specific and task-oriented process execution. Both are effective means for organizations becoming agile through interactively modelling the business at the process level and re-constructing or re-arranging process representations according to various needs. The tool allows experiencing role-specific workflows, as the communication-based refinement of work models allows for executable process specifications. When presenting the interactive processes to individuals involved in the business processes, changes can be explored interactively in a context-sensitive way before re-implementing business processes and information systems. The tool is based on a service-oriented architecture and a flexible representation scheme comprising the exchange of message between actors, business objects and actors (roles. The interactive execution of workflows does not only enable the individual reorganization of work but also changes at the level of the entire organization due to the represented interactions.

  5. How to teach evidence-based surgery.

    Fingerhut, Abe; Borie, Frédéric; Dziri, Chadli


    The objectives of teaching evidence-based surgery (EBS) are to inform and convince that EBS is a method of interrogation, reasoning, appraisal, and application of information to guide physicians in their decisions to best treat their patients. Asking the right, answerable questions, translating them into effective searches for the best evidence, critically appraising evidence for its validity and importance, and then integrating EBS with their patients' values and preferences are daily chores for all surgeons. Teaching and learning EBS should be patient-centered, learner-centered, and active and interactive. The teacher should be a model for students to become an expert clinician who is able to match and take advantage of the clinical setting and circumstances to ask and to answer appropriate questions. The process is multistaged. Teaching EBS in small groups is ideal. However, it is time-consuming for the faculty and must be clearly and formally structured. As well, evidence-based medicine (EBM) courses must cater to local institutional needs, must receive broad support from the instructors and the providers of information (librarians and computer science faculty), use proven methodologies, and avoid scheduling conflicts. In agreement with others, we believe that the ideal moment to introduce the concepts of EBM into the curriculum of the medical student is early, during the first years of medical school. Afterward, it should be continued every year. When this is not the case, as in many countries, it becomes the province of the surgeon in teaching hospitals, whether they are at the university, are university-affiliated, or not, to fulfill this role.

  6. Evidence and guidelines in otorhinolaryngology: the merits of evidence-based case reports

    Aarts, M.C.J.


    Evidence-based medicine refers to the conscientious, explicit and judicious use of the current best evidence to support decision making at point of care. To facilitate the transition of evidence into daily practice several evidence-based otorhinolaryngology guidelines have been developed. In this th

  7. HST/ACS Coronagraphic Observations of the HD 163296 Circumstellar Disk: Evidence of Time-Variable Self-Shadowing?

    Wisniewski, J.; Dowling, Lorraine; Clampin, Mark; Grady, C.; Ardila, D.; Golimowski, D.; Illingworth, G.; Krist, J.


    We present Hubble Space Telescope Advanced Camera for Surveys (HST/ACS) coronagraphic observations of the Herbig Ae star HD 163296. HD 163296's scattered light disk was resolved in the F606W and F814W filters in observations obtained In 2003 and in the F435W filter in observations obtained in 2004. Analysis of single-epoch data indicates that the disk (V-I) color is redder than the observed stellar (V-I) color. This spatially uniform red disk color might be indicative of either an evolution in the grain size distribution (i.e. grain growth) and/or composition. Both of these processes would be consistent with the observed flat geometry of the outer disk, as diagnosed by the observed r$(exp -3)$ power law behavior of its median azimuthally averaged disk surface brightness, which suggest that grain evolution is occurring. Comparison of ACS and STIS epoch scattered light data reveals differences in the observed disk surface brightnesses, of order 1 mag arcsec$(exp -2)$, in both V and white-light filter bandpasses. Along with the observed variability in the visibility and surface brightness of the ansa(e) in the disk, and spectropolarimetric variability of the system, these results suggest that the resolved scattered light disk is variable, a phenomenon not previously observed in any other Herbig protoplanetary system We speculate that the observed behavior might be attributable to the variable inflation of the scale height of the inner disk wall, which results in variable self-shadowing of the outer disk.

  8. Empirical methods for systematic reviews and evidence-based medicine

    van Enst, W.A.


    Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. Systematic reviews have become the cornerstone of evidence-based medicine, which is reflected in the position systematic reviews have in the pyramid of evidence-based medicine. Systematic

  9. sAC from aquatic organisms as a model to study the evolution of acid/base sensing.

    Tresguerres, Martin


    Soluble adenylyl cyclase (sAC) is poised to play multiple physiological roles as an acid/base (A/B) sensor in aquatic organisms. Many of these roles are probably similar to those in mammals; a striking example is the evolutionary conservation of a mechanism involving sAC, carbonic anhydrase and vacuolar H⁺-ATPase that acts as a sensor system and regulator of extracellular A/B in shark gills and mammalian epididymis and kidney. Additionally, the aquatic environment presents unique A/B and physiological challenges; therefore, sACs from aquatic organisms have likely evolved distinct kinetic properties as well as distinct physiological roles. sACs from aquatic organisms offer an excellent opportunity for studying the evolution of A/B sensing at both the molecular and whole organism levels. Moreover, this information could help understand and predict organismal responses to environmental stress based on mechanistic models.This article is part of a Special Issue entitled "The Role of Soluble Adenylyl Cyclase in Health and Disease," guest edited by J. Buck and L. R. Levin.

  10. Toward an evidence-based toxicology.

    Hoffmann, S; Hartung, T


    The increasing demands on toxicology of large-scale risk assessment programmes for chemicals and emerging or expanding areas of chemical use suggest it is timely to review the toxicological toolbox. Like in clinical medicine, where an evidence-based medicine (EBM) is critically reviewing traditional approaches, toxicology has the opportunity to reshape and enlarge its methodology and approaches on the basis of compounded scientific knowledge. Such revision would have to be based on structured reviews of current practice, ie, assessment of test performance characteristics, mechanistic understanding, extended quality assurance, formal validation and the use of integrated testing strategies. This form of revision could optimize the balance between safety, costs and animal welfare, explicitly stating and, where possible, quantifying uncertainties. After a self-critical reassessment of current practices and evaluation of the thus generated information, such an evidence-based toxicology (EBT) promises to make better use of resources and to increase the quality of results, facilitating their interpretation. It shall open up hazard and also risk assessments to new technologies, flexibly accommodating current and future mechanistic understanding. An EBT will be better prepared to answer the continuously growing safety demands of modern societies.

  11. [Prevention of atopic eczema. Evidence based guidelines].

    Schäfer, T


    With an estimated prevalence of 12% for preschool children and 3% for adults, atopic eczema is a serious public health problem. This disease severely jeopardizes quality of life and is associated with considerable costs. Since there is still no causal therapy, primary and secondary prevention are especially important. Here the evidence basis for recommendations on prevention of atopic eczema is discussed on the basis of the first evidence-based consensus guideline (S3) on allergy prevention. This recommends that babies should be breastfed exclusively for at least 4 months and exposure to passive smoking be avoided even during pregnancy; restriction of the maternal diet during pregnancy has no influence, though during breastfeeding it can lower the incidence of eczema among babies at risk. Thereby this measure should be balanced with potential consequences of malnutrition. There seems to be a positive correlation between keeping small rodents (rabbits, guinea pigs), and possibly cats, and the occurrence of atopic eczema, while keeping dogs has no effect or even a protective effect. Avoidance of an unfavorable indoor climate is probably also helpful in preventing eczema. There is no evidence to support deviating from the current recommendations of the standing committee for vaccination.

  12. Design of IRIG-B(AC) code decoder Based on CPLD%基于CPLD的IRIG-B(AC)时间码解调器研制

    王留全; 霍建华



  13. Electrospun TiO2 nanofibre-based gas sensors fabricated by AC electrophoresis deposition

    E Z Karimi; J Esmaeilzadeh; E Marzbanrad


    In this paper, gas sensing properties of the sensor based on titanium dioxide (TiO2) nanofibres are reported. These nanofibres were synthesized through electrospinning of polyvinyl pyrrolidone (PVP) / titanium tetra isopropoxide. Calcination of the obtained amorphous PVP/TiO2 nanofibres resulted in nanofibres of TiO2 with the same morphology. In this step, scanning electron microscopy and X-ray diffraction were applied in order to analyse these nanofibres. Then, nanofibres of TiO2 were deposited selectively by AC electrophoretic deposition on interdigitated electrodes and exposed to different concentrations of NO2 (8–50 p.p.m.) at 450–550°C. Gas sensing measurements illustrated that this sensor had adequate response to target gas at 450°C. The maximum response of gas sensors, (the ratio of sensor resistances $S = R_{\\text{gas}}/R_{\\text{N2}}$), achieved was around 30 for 50 p.p.m. NO2 at 450°C.

  14. Ethical reflections on Evidence Based Medicine

    S. Corrao


    Full Text Available BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM. DISCUSSION EBM represents a new paradigm that introduces new concepts to guide medical-decision making and health-care planning. Its principles are deeply rooted in clinical research methodology since information are derived from sound studies of strong quality. Health-care professionals have to deal with methodological concepts for critical appraisal of literature and implementation of evidences in clinical practice and healthcare planning. The central role of EBM in medical ethics is obvious, but a risk could be possible. The shift from Hippocratic point of view to community-centred one could lose sight of the centrality of the patient. CONCLUSION Both EBM principles and the needs to adequately response to economic restrictions urge a balance between individual and community ethics. All this has to represent an opportunity to place the patient at the centre of medical action considering at the same time community ethics as systemic aim, but without forgetting the risk that economic restrictions push towards veterinary ethics where herd is central and individual needs do not exist.

  15. A Transient Fault Recognition Method for an AC-DC Hybrid Transmission System Based on MMC Information Fusion

    Jikai Chen


    Full Text Available At present, the research is still in the primary stage in the process of fault disturbance energy transfer in the multilevel modular converter based high voltage direct current (HVDC-MMC. An urgent problem is how to extract and analyze the fault features hidden in MMC electrical information in further studies on the HVDC system. Aiming at the above, this article analyzes the influence of AC transient disturbance on electrical signals of MMC. At the same time, it is found that the energy distribution of electrical signals in MMC is different for different arms in the same frequency bands after the discrete wavelet packet transformation (DWPT. Renyi wavelet packet energy entropy (RWPEE and Renyi wavelet packet time entropy (RWPTE are proposed and applied to AC transient fault feature extraction from electrical signals in MMC. Using the feature extraction results of Renyi wavelet packet entropy (RWPE, a novel recognition method is put forward to recognize AC transient faults using the information fusion technology. Theoretical analysis and experimental results show that the proposed method is available to recognize transient AC faults.

  16. Debris-flow runout predictions based on the average channel slope (ACS)

    Prochaska, A.B.; Santi, P.M.; Higgins, J.D.; Cannon, S.H.


    Prediction of the runout distance of a debris flow is an important element in the delineation of potentially hazardous areas on alluvial fans and for the siting of mitigation structures. Existing runout estimation methods rely on input parameters that are often difficult to estimate, including volume, velocity, and frictional factors. In order to provide a simple method for preliminary estimates of debris-flow runout distances, we developed a model that provides runout predictions based on the average channel slope (ACS model) for non-volcanic debris flows that emanate from confined channels and deposit on well-defined alluvial fans. This model was developed from 20 debris-flow events in the western United States and British Columbia. Based on a runout estimation method developed for snow avalanches, this model predicts debris-flow runout as an angle of reach from a fixed point in the drainage channel to the end of the runout zone. The best fixed point was found to be the mid-point elevation of the drainage channel, measured from the apex of the alluvial fan to the top of the drainage basin. Predicted runout lengths were more consistent than those obtained from existing angle-of-reach estimation methods. Results of the model compared well with those of laboratory flume tests performed using the same range of channel slopes. The robustness of this model was tested by applying it to three debris-flow events not used in its development: predicted runout ranged from 82 to 131% of the actual runout for these three events. Prediction interval multipliers were also developed so that the user may calculate predicted runout within specified confidence limits. ?? 2008 Elsevier B.V. All rights reserved.

  17. Evidence Based Practice Outside the Box (Editorial

    Lindsay Glynn


    Full Text Available I love food. I love cooking, baking, testing, and eating. I read about food preparation, food facts, and food service. Over the years I’ve developed my fair share of knowledge about cooking and I’m a decent cook, but I’m no chef. I guess I’m what you’d call a “foodie”. However, I have the good fortune to have a friend who is a chef and owns one of the best, and certainly the most innovative, restaurants in town. During this summer I hosted a cooking class in my home for my family with my chef friend as instructor. The Tex-Mex barbecue theme was a big hit (you can contact me for recipes, if you like, but much more fascinating was the explanation of the science behind the cooking. It turns out that there is a term for this: molecular gastronomy. Another term, and hence the genesis of my “Eureka!” moment of the summer, is evidence based cooking. Good cooking is not just following a recipe (not all of which are evidence based but at its best is the culmination of heaps of tested information regarding why and how chemical and environmental factors work together to result in a gastronomical delight. For example, will brining or marinating a pork chop make it moister? And, if brining, what temperature should the water be, how long should it soak, and how much salt is needed? Why does pounding meat increase its tenderness? What will keep guacamole from browning better – the pit or lime juice? What does baking soda do in a chocolate cake? Eggs or no eggs in fresh pasta? Like most librarians, I tend not to take information at face value. I want to know where information comes from and whether or not it is valid, based on specific factors. I’ve come to notice that evidence based, or evidence informed, practice is everywhere and has a tremendous impact on our lives. Why do you rotate the tires on your car? Evidence shows that the front tires wear more quickly (think about all those 3-pointturns, the braking, etc and therefore

  18. Teaching strategies to support evidence-based practice.

    Winters, Charlene A; Echeverri, Rebecca


    Evidence-based practice is an expected core competency of all health care clinicians regardless of discipline. Use of evidence-based practice means integrating the best research with clinical expertise and patient values to achieve optimal health outcomes. Evidence-based practice requires nurses to access and appraise evidence rapidly before integrating it into clinical practice. Role modeling and integrating the skills necessary to develop evidence-based practice into clinical and nonclinical courses is an important part in developing positive attitudes toward evidence-based practice, an essential first step to using evidence to guide practice decisions. The step-by-step approach to evidence-based practice proposed by Melnyk and colleagues provides an excellent organizing framework for teaching strategies specifically designed to facilitate nurses' knowledge and skill development in evidence-based practice.

  19. Why be an evidence-based dentistry champion?

    Clarkson, Jan E; Bonetti, Debbie


    Evidence-based dentistry champions are committed to improving the quality, effectiveness, and appropriateness of dental care through the application of evidence-based principles and tools. They share knowledge and skills to promote evidence-based dentistry (EBD) in practice, guiding colleagues, patients and policy makers in the application of critical thinking skills and evidence-based decision-making. Being an evidence-based champion requires furthering an understanding of the full process and the challenges of evidence based dentistry, including the development of an evidence base, evidence synthesis and summary, the creation of best practice guidelines, as well as evidence implementation. Efforts to improve the quality, effectiveness, and appropriateness of dental care need to occur at, and be coordinated across, multiple levels of dentistry, including the patient, clinician, team, organization, and policy.

  20. Evidence-based neuroethics for neurodevelopmental disorders.

    Racine, Eric; Bell, Emily; Di Pietro, Nina C; Wade, Lucie; Illes, Judy


    Many neurodevelopmental disorders affect early brain development in ways that are still poorly understood; yet, these disorders can place an enormous toll on patients, families, and society as a whole and affect all aspects of daily living for patients and their families. We describe a pragmatic, evidence-based framework for engaging in empiric ethics inquiry for a large consortium of researchers in neurodevelopmental disorders and provide relevant case studies of pragmatic neuroethics. The 3 neurodevelopmental disorders that are at the focus of our research, cerebral palsy (CP), autism spectrum disorder (ASD), and fetal alcohol spectrum disorder (FASD), bring unique and intersecting challenges of translating ethically research into clinical care for children and neonates. We identify and discuss challenges related to health care delivery in CP; neonatal neurological decision making; alternative therapies; and identity, integrity, and personhood.


    S. R. Gilyarevski


    Full Text Available Data of the negative effect of high concentrations of aldosterone in the blood for cardiovascular disease, which served as the theoretical basis for wider use in clinical practice of the drugs belonging to the class of aldosterone receptor blockers is presented. Evidence-based data on efficacy and safety of aldosterone receptor blockers, which were obtained in the course of several randomized clinical trials is performed. Particular attention is paid to aspects of the clinical use of selective aldosterone receptor blocker eplerenone, including current data, which makes reasonable extension of indications for its use in treating patients with chronic heart failure. Data on indications of eplerenone use in patients with hypertension, especially in the case of associated target organ damage is presented.

  2. Sepsis management: An evidence-based approach.

    Baig, Muhammad Akbar; Shahzad, Hira; Jamil, Bushra; Hussain, Erfan


    The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care units are not adequately equipped and financial concerns limit implementation of expensive treatment strategies. Healthcare policy-makers should be notified in order to alleviate financial restrictions and ensure delivery of standard care to septic patients.

  3. OXYCOAL-AC: Towards an integrated coal-fired power plant process with ion transport membrane-based oxygen supply

    Kneer, R.; Toporov, D.; Forster, M.; Christ, D.; Broeckmann, C.; Pfaff, E.; Zwick, M.; Engels, S.; Modigell, M. [Rhein Westfal TH Aachen, Aachen (Germany). Inst. of Heat & Mass Transfer


    The cooperative project OXYCOAL-AC aims at the development of a zero-CO{sub 2}-emission coal combustion process for power generation. The scope of the research comprises a multitude of aspects. This article focuses on membrane-based air separation modules and their design for oxycoal conditions, the specifics of coal combustion in a CO{sub 2}/O{sub 2} atmosphere including related burner design as well as the cleaning of hot flue gas from oxycoal combustion.

  4. Evidence Based Cataloguing: Moving Beyond the Rules

    Kathy Carter


    Full Text Available Cataloguing is sometimes regarded as a rule-bound, production-based activity that offers little scope for professional judgement and decision-making. In reality, cataloguing involves challenging decisions that can have significant service and financial impacts. The current environment for cataloguing is a maelstrom of changing demands and competing visions for the future. With information-seekers turning en masse to Google and their behaviour receiving greater attention, library vendors are offering “discovery layer” products to replace traditional OPACs, and cataloguers are examining and debating a transformed version of their descriptive cataloguing rules (Resource Description and Access or RDA. In his “Perceptions of the future of cataloging: Is the sky really falling?” (2009, Ivey provides a good summary of this environment. At the same time, myriad new metadata formats and schema are being developed and applied for digital collections in libraries and other institutions. In today’s libraries, cataloguing is no longer limited to management of traditional AACR and MARC-based metadata for traditional library collections. And like their parent institutions, libraries cannot ignore growing pressures to demonstrate accountability and tangible value provided by their services. More than ever, research and an evidence based approach can help guide cataloguing decision-making.

  5. Evidence-based treatment of metabolic myopathy

    Yan LIN


    Full Text Available Objective To evaluate the current treatments and possible adverse reactions of metabolic myopathy, and to develop the best solution for evidence-based treatment.  Methods Taking metabolic myopathy, mitochondrial myopathy, lipid storage myopathy, glycogen storage diseases, endocrine myopathy, drug toxicity myopathy and treatment as search terms, retrieve in databases such as PubMed, Cochrane Library, ClinicalKey database, National Science and Technology Library (NSTL, in order to collect the relevant literature database including clinical guidelines, systematic reviews (SR, randomized controlled trials (RCT, controlled clinical trials, retrospective case analysis and case study. Jadad Scale was used to evaluate the quality of literature.  Results Twenty-eight related articles were selected, including 6 clinical guidelines, 5 systematic reviews, 10 randomized controlled trials and 7 clinical controlled trials. According to Jadad Scale, 23 articles were evaluated as high-quality literature (≥ 4, and the remaining 5 were evaluated as low-quality literature (< 4. Treatment principles of these clinical trials, efficacy of different therapies and drug safety evaluation suggest that: 1 Acid α-glycosidase (GAA enzyme replacement therapy (ERT is the main treatment for glycogen storage diseases, with taking a high-protein diet, exercising before taking a small amount of fructose orally and reducing the patient's physical activity gradually. 2 Carnitine supplementation is used in the treatment of lipid storage myopathy, with carbohydrate and low fat diet provided before exercise or sports. 3 Patients with mitochondrial myopathy can take coenzyme Q10, vitamin B, vitamin K, vitamin C, etc. Proper aerobic exercise combined with strength training is safe, and it can also enhance the exercise tolerance of patients effectively. 4 The first choice to treat the endocrine myopathy is treating primary affection. 5 Myopathies due to drugs and toxins should

  6. Operationalizing Evidence-Based Practice: The Development of an Institute for Evidence-Based Social Work

    Regehr, Cheryl; Stern, Susan; Shlonsky, Aron


    Although evidence-based practice (EBP) has received increasing attention in social work in the past few years, there has been limited success in moving from academic discussion to engaging social workers in the process of implementing EBP in practice. This article describes the challenges, successes, and future aims in the process of developing a…

  7. Evidence Based Dental Care: Integrating Clinical Expertise with Systematic Research


    Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the “gold standard” in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21st century, more and more p...

  8. Evidence-based practice. The role of staff development.

    Krugman, Mary


    Knowledge and use of evidence-based practice are essential to ensure best practices and safe patient outcomes. Staff development specialists must be leaders in this initiative to support clinical nurses toward improved practice outcomes. This article describes the background for understanding the historical evolution from research utilization to evidence-based practice, defines some key concepts related to evidence-based practice, and suggests essential components for building evidence-based practice programs in healthcare institutions.

  9. Where's the evidence? An innovative approach to teaching staff about evidence-based practice.

    Phillips, Janice M; Heitschmidt, Mary; Joyce, Mary Beth; Staneva, Ilianna; Zemansky, Peggy; Francisco, Mary Ann; Powell, Barbara; Kennedy, Terri; Kranzer, Susan French


    Preparing nurses to incorporate research and evidence-based findings into nursing practice is important to meet the needs of patients and their families in today's healthcare arena. This article highlights the use of a mock trial as an innovative approach to educating staff nurses on evidence-based practice and identifies future implications for educating staff nurses on incorporating evidence into nursing practice.

  10. Single-phase dynamic voltage restorer based on a new chopper AC/DC/AC conversion%一种新型斩波 AC/DC/AC 变换的单相 DVR

    巫付专; 侯婷婷; 韩梁; 冯占伟


    针对输入侧采用不可控整流AC/DC/AC结构的单相动态电压恢复器( DVR )输入侧功率因数低,谐波含量高等问题,提出了一种基于PWM斩波变换器的动态电压恢复器来补偿负载两端电压的跌落。该新型拓扑结构采用PWM斩波控制节省了直流侧电容,简化了滤波器设计,使输入侧线路中谐波含量降低,同时达到单位功率因数;电压检测采用单相信号构造成两相信号,利用瞬时无功理论对信号进行检测与处理,实时性高;搭建MATLAB/Simulink仿真和系统实验平台,验证其合理性和可行性。%In view of such problems as the low input side power factor of the single-phase dynamic voltage restorer ( DVR) with the structure of uncontrolled rectifier AC/DC/AC and high harmonic content , this paper proposed a DVR based on the PWM chopper to compensate for the voltage drop at the two load ends .The new topology , which a-dopted the PWM chopper control , saved the DC capacitor and simplified the filter design so that the harmonic content in the input-side circuit was reduced and the input side achieved the unit power factor .Single-phase signals were con-structed into two-phase signals to detect voltage and the instantaneous reactive power theory was used to detect and process the signals , which attained high real time .Finally, a MATLAB/Simulink simulation and experimental plat-form was constructed to verify the rationality and feasibility of the new structure .

  11. 基于Buck交-交斩波器的无功补偿器拓扑与控制方法设计%Topology and Control Strategy Design for Buck AC-AC Chopper Based Var Compensators

    武伟; 谢少军; 汤雨; 许津铭


    首先介绍了一种新的交流斩波型无功补偿器,无需直流储能环节,系统可靠性得到加强.以Buck型交流斩波无功补偿器为对象,分析了交流斩波无功补偿的基本原理和补偿特性,推导出占空比与补偿电流之间的关系,建立了系统分析模型.在此基础上,提出了基于广义积分的直接电流控制策略,并给出了参数设计准则,最后进行了仿真和实验验证.仿真和实验结果表明,基于直接电流控制的Buck型交流斩波无功补偿器可以实现对网侧无功功率的实时补偿.%A new AC-AC chopper based var compensator is proposed. It does not require the DC-link energy storage and can effectively enhance the system reliability. The basic principles and compensation characteristics of the Buck AC/AC chopper based var compensator are described, the relationship between duty ratio and compensation current is derived, and the system analysis model is developed. A new direct current control method based on the second order generalized integral is proposed for the var compensator with detailed design criteria as well. The experimental and simulation results demonstrate that the realtime compensation of reactive power in grid side can be realized by this var compensator based on a direct current controlled Buck AC/AC chopper.

  12. Evidence-Based Medicine in the Education of Psychiatrists

    Srihari, Vinod


    Objective: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. Methods: The author develops a broader conception of clinical…

  13. E-Learning and Evidence Based Practice in Schools

    Quong, Terrence


    JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…

  14. The ABCs of Evidence-Based Practice for Teachers

    Kretlow, Allison G.; Blatz, Sharon L.


    It is critical teachers adhere to federal policies regarding evidence-based practices. Quickly identifying and effectively using evidence-based programs and practices is particularly important for special educators, because students in special education often already have academic or behavioral deficits. Using evidence-based practices with…

  15. How to Reach Evidence-Based Usability Evaluation Methods.

    Marcilly, Romaric; Peute, Linda


    This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-based usability knowledge will help improve usability practice. Finally, it underlines that evaluation and evidence participate in a virtuous circle that will help improve scientific knowledge and evaluation practice.

  16. Characterization of flowreversal in anodically bonded glass-based AC electrokinetic micropumps

    Gregersen, Misha Marie; Olesen, Laurits Højgaard; Brask, Anders


    Microfluidic chips have been fabricated to study electrokinetic pumping generated by a low voltage AC signal applied to an asymmetric electrode array. A measurement procedure has been established and followed carefully resulting in a high degree of reproducibility of the measurements. Depending...

  17. How to understand and conduct evidence-based medicine


    Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.

  18. Harmonic analysis of AC/DC systems based on phase-domain multi-port network approach

    Gutierrez, O.; Fuerte-Esquivel, C.R. [Universidad Michoacana de San Nicolas de Hidalgo, Facultad de Ingenieria Electrica, Division de Estudios de Posgrado, Cuidad Universitaria, 58030 Morelia, Michoacan (Mexico); Rubio, J.A.; Guardado, J.L. [Instituto Tecnologico de Morelia, Av. Tecnologico 1500, 58120 Morelia, Michoacan (Mexico)


    This paper describes a phase-domain frequency domain technique to the harmonic analysis of a three-phase AC/DC system. The methodology is based on the harmonic multi-port network concept, expressed in terms of an ABCD parameter matrix which links voltage and current harmonics of different orders on both sides of the converter. Since the commutation angles are unknown, the harmonic interactions are computed by a sequential solution of the AC/DC system state variables, related by the ABCD matrix, and the updating of the commutation periods. A set of analytical equations has been derived to compute commutation times taking place in the converter. Test results are presented which demonstrate the effectiveness of the proposed methodology to assess harmonic interactions on both balanced and unbalanced operating conditions. The results are validated to those obtained by a time domain simulation. (author)

  19. Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice.

    Ross, Jacqueline


    Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas.

  20. [Searching for evidence-based data].

    Dufour, J-C; Mancini, J; Fieschi, M


    The foundation of evidence-based medicine is critical analysis and synthesis of the best data available concerning a given health problem. These factual data are accessible because of the availability on the Internet of web tools specialized in research for scientific publications. A bibliographic database is a collection of bibliographic references describing the documents indexed. Such a reference includes at least the title, summary (or abstract), a set of keywords, and the type of publication. To conduct a strategically effective search, it is necessary to formulate the question - clinical, diagnostic, prognostic, or related to treatment or prevention - in a form understandable by the research engine. Moreover, it is necessary to choose the specific database or databases, which may have particular specificity, and to analyze the results rapidly to refine the strategy. The search for information is facilitated by the knowledge of the standardized terms commonly used to describe the desired information. These come from a specific thesaurus devoted to document indexing. The most frequently used is MeSH (Medical Subject Heading). The principal bibliographic database whose references include a set of describers from the MeSH thesaurus is Medical Literature Analysis and Retrieval System Online (Medline), which has in turn become a subpart of a still more vast bibliography called PubMed, which indexes an additional 1.4 million references. Numerous other databases are maintained by national or international entities. These include the Cochrane Library, Embase, and the PASCAL and FRANCIS databases.

  1. Subjective evidence based ethnography: method and applications.

    Lahlou, Saadi; Le Bellu, Sophie; Boesen-Mariani, Sabine


    Subjective Evidence Based Ethnography (SEBE) is a method designed to access subjective experience. It uses First Person Perspective (FPP) digital recordings as a basis for analytic Replay Interviews (RIW) with the participants. This triggers their memory and enables a detailed step by step understanding of activity: goals, subgoals, determinants of actions, decision-making processes, etc. This paper describes the technique and two applications. First, the analysis of professional practices for know-how transferring purposes in industry is illustrated with the analysis of nuclear power-plant operators' gestures. This shows how SEBE enables modelling activity, describing good and bad practices, risky situations, and expert tacit knowledge. Second, the analysis of full days lived by Polish mothers taking care of their children is described, with a specific focus on how they manage their eating and drinking. This research has been done on a sub-sample of a large scale intervention designed to increase plain water drinking vs sweet beverages. It illustrates the interest of SEBE as an exploratory technique in complement to other more classic approaches such as questionnaires and behavioural diaries. It provides the detailed "how" of the effects that are measured at aggregate level by other techniques.

  2. Simulation Study of AC Contactor Dynamic Contacts Contact Pressure Based on ADAMS

    Gu Yungao


    Full Text Available A multi-body dynamics simulation model of CJ20-25 AC contactor was established with Pro/E(Pro/Engineerin this paper. A coupling simulation with machine, electric, magnetic on the contactor has been achieved in this model. Dynamic parameters which were called use the secondary development technology of ADAMS. The dynamic contact pressure signal of an AC contactor was obtained with ADAMS’s own simultaneous solution such as electromagnetic suction, kinematics and dynamics equations. The simulation results and actual measurement of contactor contact pressure signals are very similar. However, the complexity of the measured contacts vibration is greater than the simulation results because the actual working condition is more complex. This result provides a theoretical foundation to the dynamic contacts contact pressure test.

  3. Evidence-Based Practice in Rehabilitation Counseling: Perceptions and Practices

    Bezyak, Jill L.; Kubota, Coleen; Rosenthal, David


    This study describes certified rehabilitation counselors' attitudes (n=163) about evidence based practice, knowledge and skills related to obtaining and evaluating evidence, use of literature in practice, availability of information, and perceived barriers to evidence-based practice. Responses related to knowledge and skills were mixed with strong…

  4. AC Versus DC Link Comparison Based on Power Flow Analysis of a Multimachine Power System

    Mohammed Abdeljalil DJEHAF; Sid Ahmed ZIDI; Youcef DJILANI KOBIBI


    Deregulation and privatization is posing new challenges on high voltage transmission and on distributions systems as well. An increasingly liberalized market will encourage trading opportunities to be identified and developed. High voltage power electronics, such as HVDC (High Voltage Direct Current) and FACTS (Flexible AC Transmission Systems) provide the necessary features to avoid technical problems in heavily loaded power systems; HVDC offers most advantages: it can be used for system int...

  5. The Luminosity Functions of the Galaxy Cluster MS1054-0321 at z=0.83 based on ACS Photometry

    Goto, Tomotsugu; Postman, Marc; Cross, Nicholas J. G.; Illingworth, G. D.; Tran, K.; Magee, D.; Franx, M.; Benitez, N.; Bouwens, R J; Demarco, R.; Ford, H.C.; Homeier, N. L.; Martel, A. R.; Menanteau, F.; Clampin, M.


    We present new measurements of the galaxy luminosity function (LF) and its dependence on local galaxy density, color, morphology, and clustocentric radius for the massive z=0.83 cluster MS1054-0321. Our analyses are based on imaging performed with the ACS onboard the HST in the F606W, F775W and F850LP passbands and extensive spectroscopic data obtained with the Keck LRIS. Our main results are based on a spectroscopically selected sample of 143 cluster members with morphological classification...

  6. AC/DC Power Flow Computation Based on Improved Levenberg-Marquardt Method

    Cao, Jia; Yan, Zheng; Fan, Xiang; Xu, Xiaoyuan; Li, Jianhua; Cao, Lu


    Under the case of ill-conditioning system, this paper is concerned with the AC/DC power flow calculation. The improved Levenberg-Marquardt (ILM) method with adaptive damping factor selection is applied to solve the AC/DC power flow problem. The main purpose of this paper is as follows: one is to provide comparison reference between Newton method, classical LM method (CLM) and ILM method under the well-conditioning system; the other is to research what is the maximal load withstood by power system, under the case of ill-conditioning. Finally, those methods are tested on the 22-bus, the IEEE 118-bus AC/DC system, respectively. Numerical results indicate that the ILM method has the advantage of fast convergent speed. When expanding loads in a certain extent, ILM method can at least find least square solutions, whereas Newton method and CLM method would divergent, and the convergent property of Newton method can be improved by taking some measurements using the information of a least square solution obtained by ILM method.

  7. School Librarianship and Evidence Based Practice: Progress, Perspectives, and Challenges

    Ross J. Todd


    Full Text Available Objective – This paper provides an overview of progress and developments surrounding evidence based practice in school librarianship, and seeks to provide a picture of current thinking about evidence based practice as it relates to the field. It addresses current issues and challenges facing the adoption of evidence based practice in school librarianship.Methods – The paper is based on a narrative review of a small but growing body of literature on evidence based practice in school librarianship, set within a broader perspective of evidence based education. In addition, it presents the outcomes of a collaborative process of input from 200 school libraries leaders collected at a School Library summit in 2007 specifically to address the emerging arena of evidence based practice in this field.Results – A holistic model of evidence based practice for school libraries is presented, centering on three integrated dimensions of evidence: evidence for practice, evidence in practice, and evidence of practice.Conclusion – The paper identifies key challenges ahead if evidence based school librarianship is to develop further. These include: building research credibility within the broader educational environment; the need for ongoing review and evaluation of the diverse body of research in education, librarianship and allied fields to make quality evidence available in ways that can enable practicing school librarians to build a culture of evidence based practice; development of tools, strategies, and exemplars to use to facilitate evidence based decision-making; and, ensuring that the many and diverse advances in education and librarianship become part of the practice of school librarianship.

  8. A new high-performance AC/DC power factor correction switching converter based on one-cycle control technology and active floating-charge technology

    GAO Chao


    A new family of converters, high-performance AC/DC power factor correction (PFC) switching converters with one-cycle control technology and active floating-charge technology, was derived and experimentally verified. The topology of a single-phase CCM and DCM Boost-PFC switching converter was also analyzed. Its operating prniciples and control methods were expounded. Based on these, a new type of AC/DC switching converter circuits for PFC combined with one-cycle control technology was presented herein. The proposed AC/DC switching converter significantly helps improve the converter efficiency and its power factor value.

  9. Variation, Certainty, Evidence, and Change in Dental Education: Employing Evidence-based Dentistry in Dental Education.

    Marinho, Valeria Coelho Catao; Richards, Derek; Niederman, Richard


    Using a case-based dental scenario, presents systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. Also discusses barriers inhibiting these systematic approaches to evidence-based…

  10. Stored Energy Balance for Distributed PV-Based Active Generators in an AC Microgrid

    Aldana, Nelson Leonardo Diaz; Wu, Dan; Dragicevic, Tomislav


    storage unit with the smallest state of charge or force a faster discharge of the energy storage system with the biggest state of charge. The units are self-controlled by using local variables, hence, the microgrid can operate without relying on communication systems. The proposed strategy is completely...... expandable and can be applied to a several number of power generators interconnected in a microgrid. Frequency and voltage bus signaling is used in order to coordinate the control operation mode between units. Simulation results in a low-voltage, three-phase, islanded AC microgrid show the feasibility...

  11. Evidence based practice of chronic pain

    Rakesh Garg


    Full Text Available The patients with chronic pain are increasingly reporting to the physicians for its management. Chronic pain are associated with head, neck and shoulder pain, spinal pain, pain in the joints and extremities, complex regional pain syndrome and phantom pain. The chronic pain is being managed worldwide. The different specialty of medicine is producing a lot of evidence through the published literature but the same is not being published in the field of chronic pain management. Though some evidence is being reported as to different aspects of pain management from different parts of the world but same is lacking from Indian subcontinent. This is in contrast to much done clinical work in this field as well. We present here the available evidence in relation to chronic pain management.

  12. New weighting factors assignment of evidence theory based on evidence distance

    Chen Liangzhou; Shi Wenkang; Du Feng


    Evidence theory has been widely used in the information fusion for its effectiveness of the uncertainty reasoning. However, the classical DS evidence theory involves counter-intuitive behaviors when the high conflict information exists. Based on the analysis of some modified methods, Assigning the weighting factors according to the intrinsic characteristics of the existing evidence sources is proposed, which is determined on the evidence distance theory. From the numerical examples, the proposed method provides a reasonable result with good convergence efficiency. In addition, the new rule retrieves to the Yager's formula when all the evidence sources contradict to each other completely.

  13. Application of Evidence-based Prosthodontics in Practice

    雷雨; 朱智敏; CHAO Yong-lie; SHI Zong-dao; MENG Yu-kun


    The concepts and progress of evidence-based dentistry were introduced in this critical review. An extensive PubMed search was conducted to provide sound evidences for some frequently encountered problems in prosthodontic daily practice. Conlusively, it is important for prosthodontists to keep current by looking for efficient ways of interpreting high quality evidences to clinical practice.

  14. Integrating evidence-based perfusion into practices: the International Consortium for Evidence-Based Perfusion.

    Likosky, Donald S


    There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. "Research is the only hope that the future will be different than the past"- Daniel Mintz, MD "Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist.... It is ideas not vested interests which are dangerous for good or evil."-John Maynard Keynes.

  15. 3-V Solid-State Flexible Supercapacitors with Ionic-Liquid-Based Polymer Gel Electrolyte for AC Line Filtering.

    Kang, Yu Jin; Yoo, Yongju; Kim, Woong


    State-of-the-art solid-state flexible supercapacitors with sufficiently fast response speed for AC line filtering application suffer from limited energy density. One of the main causes of the low energy density is the low cell voltage (1 V), which is limited by aqueous-solution-based gel electrolytes. In this work, we demonstrate for the first time a 3-V flexible supercapacitor for AC line filtering based on an ionic-liquid-based polymer gel electrolyte and carbon nanotube electrode material. The flexible supercapacitor exhibits an areal energy density that is more than 20 times higher than that of the previously demonstrated 1-V flexible supercapacitor (0.66 vs 0.03 μWh/cm(2)) while maintaining excellent capacitive behavior at 120 Hz. The supercapacitor shows a maximum areal power density of 1.5 W/cm(2) and a time constant of 1 ms. The improvement of the cell voltage while maintaining the fast-response capability greatly improves the potential of supercapacitors for high-frequency applications in wearable and/or portable electronics.

  16. [Evidence-based management of medical disposable materials].

    Yang, Hai


    Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.

  17. Design of IRIG-B(AC)encoder based on FPGA%基于FPGA的IRIG-B(AC)编码器设计

    周彩亲; 李世中; 梁国强


    InterRange Instrumentation Group (IRIG-B(AC))code is usually used in the shooting range test for time information transmission and systems time synchronization.According to IRIG-B(AC)code format and modulation principle,this paper presents IRIG-B(AC)coding circuit design scheme based on field programmable gate array (FPGA).The B(AC)code signal is generated by AD7245,a digital-to-analog (D/A)converter.After amplified,the signal can be used directly for system time synchronization,and the amplitude of the signal can be adj usted according to different requirements.The IRIG-B(AC)encoder designed has been verified by test.The test results show that it can output accurate time information and has higher practicali-ty.%IRIG-B(AC)码常用于靶场试验中传递时间信息和同步各系统时间。根据 IRIG-B(AC)码的格式及调制原理,介绍了基于 FPGA的 IRIG-B(AC)编码电路的设计。利用 AD7245实现 D/A 转换转换产生 B (AC)码信号,信号经放大后可直接用于系统时间同步,而且信号幅度可根据不同的使用需求进行调节。经测试验证,本系统输出的时间信息准确无误,有较高的实用性。

  18. Justifying Physical Education Based on Neuroscience Evidence

    Berg, Kris


    Research has shown that exercise improves cognitive function and psychological traits that influence behavior (e.g., mood, level of motivation). The evidence in the literature also shows that physical education may enhance learning or that academic performance is at least maintained despite a reduction in classroom time in order to increase time…

  19. Evidence-Based Treatment of Maisonneuve Fractures

    S.A. Stufkens; M.P.J. van den Bekerom; J.N. Doornberg; C.N. van Dijk; P. Kloen


    The objective of the current study was to review the published clinical evidence available for the treatment of Maisonneuve fractures. Medline via PubMed, Orthopaedic Trauma Association (OTA) annual meetings' abstracts archives Web site, Embase, the Cochrane Database of Systematic Reviews, and the C

  20. Evidence Based Nursing. A new perspective for Greek Nursing

    Christina Ouzouni


    Full Text Available Despite the fact that nursing research has been developed in Greece, nevertheless the provision of nursing care is not based on current research findings, but rather on the knowledge gained by nurses during their undergraduate education. The transition of medicine in the last decade towards evidence based practice had definitely an impact on the nursing profession.The aim of this article is to briefly present evidence based nursing as a process and perspective to Greek nurses.Method: A literature search was performed in order to identify and review relevant articles concerning evidence based nursing.Conclusions: It has been supported that in the practice of evidence based nursing, a nurse has to decide whether the evidence is relevant for the individual patient. The incorporation of clinical expertise should balance the risks and benefits of a possible treatment and take into consideration the patient’s unique clinical circumstances and preferences. The stages to identify evidence for nursing practice follow firstly a question which must be addressed for a particular clinical problem. Then, a literature search is performed in order to access the evidence and critically appraise it and finally the best available evidence that fits into a particular case is utilized. Evidence based nursing bears benefits for patients, nurses and health care services, as well. In the process of implementing evidence based nursing in Greece there are several constraints. Taking these difficulties into consideration and until Greek nurses familiarize themselves with evidence based nursing care, it is necessary to constitute workgroups of nurse researchers aiming at forming clinical guidelines for nursing practice, which will based on the best available evidence.

  1. The Luminosity Functions of the Galaxy Cluster MS1054-0321 at z=0.83 based on ACS Photometry

    Goto, T; Cross, N J G; Illingworth, G D; Tran, K; Magee, D; Franx, M; Benítez, N; Bouwens, R J; Demarco, R; Ford, H C; Homeier, N L; Martel, A R; Menanteau, F; Clampin, M; Hartig, G F; Ardila, D R; Bartko, F; Blakeslee, J P; Bradley, L D; Broadhurst, T J; Brown, R A; Burrows, C J; Cheng, E S; Feldman, P D; Golimowski, D A; Gronwall, C; Holden, B; Infante, L; Jee, M J; Krist, J E; Lesser, M P; Mei, S; Meurer, G R; Miley, G K; Motta, V; Overzier, R; Rosati, P; Sirianni, M; Sparks, W B; Tran, H D; Tsvetanov, Z I; White, R L; Zheng, W; Zirm, A W; Goto, Tomotsugu; Postman, Marc; Cross, Nicholas J.G.


    We present new measurements of the galaxy luminosity function (LF) and its dependence on local galaxy density, color, morphology, and clustocentric radius for the massive $z=0.83$ cluster MS1054-0321. Our analyses are based on imaging performed with the ACS onboard the HST in the F606W, F775W and F850LP passbands and extensive spectroscopic data obtained with the Keck LRIS. Our main results are based on a spectroscopically selected sample of 143 cluster members with morphological classifications derived from the ACS observations. Our three primary findings are (1) the faint-end slope of the LF is steepest in the bluest filter, (2) the LF in the inner part of the cluster (or highest density regions) has a flatter faint-end slope, and (3) the fraction of early-type galaxies is higher at the bright end of the LF, and gradually decreases toward fainter magnitudes. These characteristics are consistent with those in local galaxy clusters, indicating that, at least in massive clusters, the common characteristics of ...

  2. Evidence-based dentistry resources for dental practitioners.

    Scarbecz, Mark


    The American Dental Association has taken an active role in support of an evidence-based approach to the practice of dentistry. This concept integrates clinically relevant scientific evidence into a clinician's decision-making process, along with the patient's oral and medical history, the dentist's own expertise and the patient's treatment needs and preferences. The purpose of this article is to assist dentists in locating and retrieving quality research reports and research evidence which can be integrated into the clinical decision making process. The research methodologies which constitute the foundation of evidence-based dentistry are described. The advantages and disadvantages associated with literature that summarizes research, such as the literature review, the systematic review and meta-analysis are described. Evidence-based resources for dentists are described, such as journals specializing in an evidence-based approach, online resources such as PubMed and the Cochrane Collaboration.

  3. A Miniature Magnetic-Force-Based Three-Axis AC Magnetic Sensor with Piezoelectric/Vibrational Energy-Harvesting Functions

    Hung, Chiao-Fang; Yeh, Po-Chen; Chung, Tien-Kan


    In this paper, we demonstrate a miniature magnetic-force-based, three-axis, AC magnetic sensor with piezoelectric/vibrational energy-harvesting functions. For magnetic sensing, the sensor employs a magnetic–mechanical–piezoelectric configuration (which uses magnetic force and torque, a compact, single, mechanical mechanism, and the piezoelectric effect) to convert x-axis and y-axis in-plane and z-axis magnetic fields into piezoelectric voltage outputs. Under the x-axis magnetic field (sine-wave, 100 Hz, 0.2–3.2 gauss) and the z-axis magnetic field (sine-wave, 142 Hz, 0.2–3.2 gauss), the voltage output with the sensitivity of the sensor are 1.13–26.15 mV with 8.79 mV/gauss and 1.31–8.92 mV with 2.63 mV/gauss, respectively. In addition, through this configuration, the sensor can harness ambient vibrational energy, i.e., possessing piezoelectric/vibrational energy-harvesting functions. Under x-axis vibration (sine-wave, 100 Hz, 3.5 g) and z-axis vibration (sine-wave, 142 Hz, 3.8 g), the root-mean-square voltage output with power output of the sensor is 439 mV with 0.333 μW and 138 mV with 0.051 μW, respectively. These results show that the sensor, using this configuration, successfully achieves three-axis magnetic field sensing and three-axis vibration energy-harvesting. Due to these features, the three-axis AC magnetic sensor could be an important design reference in order to develop future three-axis AC magnetic sensors, which possess energy-harvesting functions, for practical industrial applications, such as intelligent vehicle/traffic monitoring, processes monitoring, security systems, and so on. PMID:28208693

  4. A Miniature Magnetic-Force-Based Three-Axis AC Magnetic Sensor with Piezoelectric/Vibrational Energy-Harvesting Functions.

    Hung, Chiao-Fang; Yeh, Po-Chen; Chung, Tien-Kan


    In this paper, we demonstrate a miniature magnetic-force-based, three-axis, AC magnetic sensor with piezoelectric/vibrational energy-harvesting functions. For magnetic sensing, the sensor employs a magnetic-mechanical-piezoelectric configuration (which uses magnetic force and torque, a compact, single, mechanical mechanism, and the piezoelectric effect) to convert x-axis and y-axis in-plane and z-axis magnetic fields into piezoelectric voltage outputs. Under the x-axis magnetic field (sine-wave, 100 Hz, 0.2-3.2 gauss) and the z-axis magnetic field (sine-wave, 142 Hz, 0.2-3.2 gauss), the voltage output with the sensitivity of the sensor are 1.13-26.15 mV with 8.79 mV/gauss and 1.31-8.92 mV with 2.63 mV/gauss, respectively. In addition, through this configuration, the sensor can harness ambient vibrational energy, i.e., possessing piezoelectric/vibrational energy-harvesting functions. Under x-axis vibration (sine-wave, 100 Hz, 3.5 g) and z-axis vibration (sine-wave, 142 Hz, 3.8 g), the root-mean-square voltage output with power output of the sensor is 439 mV with 0.333 μW and 138 mV with 0.051 μW, respectively. These results show that the sensor, using this configuration, successfully achieves three-axis magnetic field sensing and three-axis vibration energy-harvesting. Due to these features, the three-axis AC magnetic sensor could be an important design reference in order to develop future three-axis AC magnetic sensors, which possess energy-harvesting functions, for practical industrial applications, such as intelligent vehicle/traffic monitoring, processes monitoring, security systems, and so on.

  5. Multiagent based Distributed Control for Operation Cost Minimization of Droop Controlled AC Microgrid Using Incremental Cost Consensus

    Li, Chendan; Firoozabadi, Mehdi Savaghebi; Quintero, Juan Carlos Vasquez


    Microgrid, as a promising technology to integrate renewable energy resources in the distribution system, is gaining increasing research interests recently. Although many previous works have been done based on the droop control in a microgrid, they mainly focus on achieving proportional power...... sharing based on the power rating. With various types of distributed generator (DG) units in the system, factors that closely related to the operation cost, such as fuel cost and efficiencies of the generator should be taken into account in order to improve the efficiency of the whole system....... In this paper, a multiagent based distributed method is proposed to minimize operation cost of the AC microgrid. Each DG is acting as an agent which regulates the power individually using proposed frequency scheduling method. Optimal power command is obtained through carefully designed consensus algorithm...

  6. Hysteresis Current Control Based Shunt Active Power Filter for Six Pulse Ac/Dc Converter

    Rakesh Kumar Pandey


    Full Text Available In this paper the simulation of Shunt Active power Filter using P-Q theory and PI controller has been presented. This SAPF compensates the harmonic currents drawn by three phase six pulse AC/DC converter. The process of compensation is done by calculating the instantaneous reactive power losses using p-q theory and the PI controller to reduce the ripple voltage of the dc capacitor of the PWM-VSI. This approach is different from conventional approach and provides very effective solution. In this simulation we use hysteresis band current controller (HCC for switching the VSI inverter. The simulation has been done for both steady state and transient conditions

  7. Vector Control Algorithm for Electric Vehicle AC Induction Motor Based on Improved Variable Gain PID Controller

    Gang Qin


    Full Text Available The acceleration performance of EV, which affects a lot of performances of EV such as start-up, overtaking, driving safety, and ride comfort, has become increasingly popular in recent researches. An improved variable gain PID control algorithm to improve the acceleration performance is proposed in this paper. The results of simulation with Matlab/Simulink demonstrate the effectiveness of the proposed algorithm through the control performance of motor velocity, motor torque, and three-phase current of motor. Moreover, it is investigated that the proposed controller is valid by comparison with the other PID controllers. Furthermore, the AC induction motor experiment set is constructed to verify the effect of proposed controller.

  8. Interverntion, evidence-based research and everyday life

    Dreier, Ole


    Intervention is a key concept in the technology of psychology and it plays a decisive role in evidence-based research. But analyses of this concept are remarkably sparse. Based on a critical analysis of the conception of intervention in the American Psychological Association’s guidelines for evid...

  9. Teaching Evidence-Based Physical Diagnosis: Six Bedside Lessons.

    McGee, Steven


    Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.

  10. Evidence-Based Treatment and Stuttering--Historical Perspective

    Prins, David; Ingham, Roger J.


    Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

  11. Behavioral Activation Is an Evidence-Based Treatment for Depression

    Sturmey, Peter


    Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier…

  12. An innovative clinical practicum to teach evidence-based practice.

    Brancato, Vera C


    A clinical practicum was successfully implemented for RN to BSN students to apply evidence-based practice to actual clinical problems affecting nursing practice. The author describes how this practicum was implemented and the requisite resources and support systems. This senior-level capstone course enabled students to understand and value a lifelong learning approach to evidence-based practice.

  13. Evidence-based Practice in libraries - Principles and discussions

    Johannsen, Carl Gustav


    The article examines problems concerning the introduction and future implementation of evidence-based practice (EBP) in libraries. It includes important conceptual distinctions and definitions, and it reviews the more controversial aspects of EBP, primarely based on experiences from Denmark...

  14. Evidence-based nursing practice: are we there yet?

    Ervin, Naomi E


    The volume of evidence for nursing practice has increased as a result of research and scientific discoveries. Yet we are still struggling with the dilemma of how to get evidence into nursing practice. Estimates are that it takes 20 years before innovations are fully put into use. Research is one type of knowledge to be used in practice. Nursing and patient care would benefit from moving more toward knowledge based on research and evidence. This article reviews barriers to and facilitators of using evidence in nursing practice and discusses a model for promoting the systematic use of evidence in practice. The author also offers suggestions for increasing the evidence base of nursing practice. Using evidence in nursing practice is important for all nurses, but requires more that the attention of the individual nurse.

  15. [Forensic evidence-based medicine in computer communication networks].

    Qiu, Yun-Liang; Peng, Ming-Qi


    As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks.

  16. Evidence-based treatments for cluster headache

    Gooriah R


    Full Text Available Rubesh Gooriah, Alina Buture, Fayyaz Ahmed Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK Abstract: Cluster headache (CH, one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition. Keywords: cluster headache, pathogenesis, vasoactive intestinal peptide, suprachiasmatic nucleus

  17. An effective electrical sensing scheme using AC electrothermal flow on a biosensor platform based on a carbon nanotube network

    Lee, Won Cheol; Lee, Hoseok; Lim, Jaeheung; Park, Young June


    We report a simple and efficient electrical sensing scheme that can be used to overcome the "diffusion limit" of affinity-based biosensors by incorporating the structural advantage of a concentric electrode biosensor platform and the microstirring effect of AC electrothermal flow (ACEF). To prove the effect of ACEF on the biosensor performance, we performed both simulations and experiments for the detection of cardiac troponin-I, which is a biomarker for acute myocardial infarction. The finite element simulation results indicate that AC bias to the electrode (which has a concentric structure in our device) can induce fast convection flow, which facilitates the transport of the target molecules to the binding region located between the two electrodes. In our device, the channel region made of a carbon nanotube network decorated with gold nanoparticles, which act as the attaching sites of the probe molecules, is used as a highly sensitive electrical channel. We find that the electrical sensing method exhibited extremely fast sensing speeds compared with those under no bias (diffusion-limited) conditions.

  18. NCLEX-RN success: evidence-based strategies.

    Thomas, Marie H; Baker, Susan Scott


    Evidence-based nursing requires that students think reflectively and use clinical inquiry to develop clinical reasoning and decision-making skills. Likewise, nursing students need a strategy to be successful in passing the NCLEX-RN. The authors identify strategies based on nursing research to facilitate student success. While learning the evidence-based nursing process, the student must begin to think like a nurse while answering clinical practice questions. Using the skills taught for evidence-based nursing can be a powerful tool to approach the NCLEX-RN and succeed.

  19. Lost in translation: bibliotherapy and evidence-based medicine.

    Dysart-Gale, Deborah


    Evidence-based medicine's (EBM) quantitative methodologies reflect medical science's long-standing mistrust of the imprecision and subjectivity of ordinary descriptive language. However, EBM's attempts to replace subjectivity with precise empirical methods are problematic when clinicians must negotiate between scientific medicine and patients' experience. This problem is evident in the case of bibliotherapy (patient reading as treatment modality), a practice widespread despite its reliance on anecdotal evidence. While EBM purports to replace such flawed practice with reliable evidence-based methods, this essay argues that its aversion to subjective language prevents EBM from effectively evaluating bibliotherapy or making it amenable to clinical and research governance.

  20. Course Redesign: An Evidence-Based Approach

    Kathy Nomme


    Full Text Available A first year non-majors biology course, with an enrollment of around 440 students, has been redesigned from a course of traditional content and teaching style to one that emphasizes biological concepts in current global issues and incorporates active learning strategies. We were informed by the education literature incorporating many aspects of established curriculum redesign principles and extended its application to a biology course. Systematic measurement of student attitudes and collection of student feedback through a series of surveys as well as focus group interviews proved to be invaluable in the course redesign process. The information gathered over a two-year period enabled us to fine-tune the course content and teaching strategies effectively to better meet the interests of students in the non-majors course as was documented by the evidence gathered in this research.

  1. 基于EPM7160S的IRIG-B(AC)码调制设计%Design of IRIG-B(AC)code modulation based on EPM7160S

    李亮; 李杰然; 张烨



  2. Evidence-based medicine in health care reform.

    Hughes, Gordon B


    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care.

  3. Evidence-based dentistry as it relates to dental materials.

    Bayne, Stephen C; Fitzgerald, Mark


    Evidence-based dentistry (EBD) is reviewed in depth to underscore the limitations for evidence-based dental materials information that exist at this time. Anecdotal estimates of evidence for dental practice are in the range of 8 percent to 10 percent. While the process of evaluating the literature base for dental evidence began 20 years ago, it was not practical to implement it until high-speed wireless connections, open access to journals, and omnipresent connections via smart phones became a reality. EBD includes five stages of information collection and analysis, starting with a careful definition of a clinical question using the PICO(T) approach. Clinical evidence in randomized control trials is considered the best. Clinical trial perspectives (prospective, cross-sectional, retrospective) and outcome designs (RCTs, SCTs, CCTs, cohort studies, case-control studies) are quite varied. Aggregation techniques (including meta-analyses) allow meaningful combinations of clinical data from trials with similar designs but with fewer rigors. Appraisals attempt to assess the entire evidence base without bias and answer clinical questions. Varying intensities to these approaches, Cochrane Collaboration, ADA-EBD Library, UTHSCSA CATs Library, are used to answer questions. Dental materials evidence from clinical trials is infrequent, short-term, and often not compliant with current guidelines (registration, CONSORT, PRISMA). Reports in current evidence libraries indicate less than 5 percent of evidence is related to restorative dental materials.

  4. Evidence-based laboratory medicine: is it working in practice?

    Price, Christopher P


    The principles of Evidence-Based Medicine have been established for about two decades, with the need for evidence-based clinical practice now being accepted in most health systems around the world. These principles can be employed in laboratory medicine. The key steps in evidence-based practice, namely (i) formulating the question; (ii) searching for evidence; (iii) appraising evidence; (iv) applying evidence; and (v) assessing the experience are all accepted but, as yet, translation into daily clinical and laboratory practice has been slow. Furthermore, the demand for evidence-based laboratory medicine (EBLM) has been slow to develop.There are many contrasting observations about laboratory medicine, for example (i) there is too much testing vs insufficient testing; (ii) testing is expensive vs laboratories are expected to generate income; and (iii) test results have little impact on outcomes vs test results are crucial to clinical decision making. However, there is little evidence to support any of these observations. Integrating the principles of EBLM into routine practice will help to resolve some of these issues by identifying (a) where laboratory medicine fits into the care pathway; (b) where testing is appropriate; (c) the nature and quality of evidence required to demonstrate the clinical utility of a test; (d) how the test result impacts on clinical actions; (e) where changes in the care pathway will occur; and (f) where benefit/value can be achieved. These answers will help to establish the culture of EBLM in clinical and laboratory practice.

  5. Modification of evidence theory based on feature extraction

    DU Feng; SHI Wen-kang; DENG Yong


    Although evidence theory has been widely used in information fusion due to its effectiveness of uncertainty reasoning, the classical DS evidence theory involves counter-intuitive behaviors when high conflict information exists. Many modification methods have been developed which can be classified into the following two kinds of ideas, either modifying the combination rules or modifying the evidence sources. In order to make the modification more reasonable and more effective, this paper gives a thorough analysis of some typical existing modification methods firstly, and then extracts the intrinsic feature of the evidence sources by using evidence distance theory. Based on the extracted features, two modified plans of evidence theory according to the corresponding modification ideas have been proposed. The results of numerical examples prove the good performance of the plans when combining evidence sources with high conflict information.

  6. Electrochemical Protease Biosensor Based on Enhanced AC Voltammetry Using Carbon Nanofiber Nanoelectrode Arrays.

    Swisher, Luxi Z; Syed, Lateef U; Prior, Allan M; Madiyar, Foram R; Carlson, Kyle R; Nguyen, Thu A; Hua, Duy H; Li, Jun


    We report an electrochemical method for measuring the activity of proteases using nanoelectrode arrays (NEAs) fabricated with vertically aligned carbon nanofibers (VACNFs). The VACNFs of ~150 nm in diameter and 3 to 5 μm in length were grown on conductive substrates and encapsulated in SiO2 matrix. After polishing and plasma etching, controlled VACNF tips are exposed to form an embedded VACNF NEA. Two types of tetrapeptides specific to cancer-mediated proteases legumain and cathepsin B are covalently attached to the exposed VACNF tip, with a ferrocene (Fc) moiety linked at the distal end. The redox signal of Fc can be measured with AC voltammetry (ACV) at ~1 kHz frequency on VACNF NEAs, showing distinct properties from macroscopic glassy carbon electrodes due to VACNF's unique interior structure. The enhanced ACV properties enable the kinetic measurements of proteolytic cleavage of the surface-attached tetrapeptides by proteases, further validated with a fluorescence assay. The data can be analyzed with a heterogeneous Michaelis-Menten model, giving "specificity constant" kcat /Km as (4.3 ± 0.8) × 10(4) M(-1)s(-1) for cathepsin B and (1.13 ± 0.38) × 10(4) M(-1)s(-1) for legumain. This method could be developed as portable multiplex electronic techniques for rapid cancer diagnosis and treatment monitoring.

  7. Hall-effect based semi-fast AC on-board charging equipment for electric vehicles.

    Milanés-Montero, María Isabel; Gallardo-Lozano, Javier; Romero-Cadaval, Enrique; González-Romera, Eva


    The expected increase in the penetration of electric vehicles (EV) and plug-in hybrid electric vehicles (PHEV) will produce unbalanced conditions, reactive power consumption and current harmonics drawn by the battery charging equipment, causing a great impact on the power quality of the future smart grid. A single-phase semi-fast electric vehicle battery charger is proposed in this paper. This ac on-board charging equipment can operate in grid-to-vehicle (G2V) mode, and also in vehicle-to-grid (V2G) mode, transferring the battery energy to the grid when the vehicle is parked. The charger is controlled with a Perfect Harmonic Cancellation (PHC) strategy, contributing to improve the grid power quality, since the current demanded or injected has no harmonic content and a high power factor. Hall-effect current and voltage transducers have been used in the sensor stage to carry out this control strategy. Experimental results with a laboratory prototype are presented.

  8. Real Time Wind Turbine Simulator Based On Frequency Controlled AC Servomotor

    Emil CEANGÃ


    Full Text Available This paper is a contribution to the development of a real time wind turbine simulator. The simulator is designed to generate wind power on its shaft, and provide the static and dynamic characteristics of a given turbine. The general structure of the simulator is composed of two subsystems: a “soft simulator” which realizes the real time simulation of the wind turbine, on the basis of the mathematical model, an electromechanical tracking system which receives the reference signal from the softsimulator, and provides a measurable output variable transmitted as response variable to the soft-simulator. The work concerns a wind turbine simulator using a tracking system realized on the basis on a frequency controlled AC servo-motor. This servo-motor is mechanically coupled with a pendulum machine, which realises the shaft torque of the electrical generator. The experimental system is built around the DS1103 PPC Controlled Board (dSPACE, which offers a rapid control prototyping, by Matlab-Simulink software tools. Experimental results from the real time WTS are presented.

  9. Hall-Effect Based Semi-Fast AC On-Board Charging Equipment for Electric Vehicles

    Eva González-Romera


    Full Text Available The expected increase in the penetration of electric vehicles (EV and plug-in hybrid electric vehicles (PHEV will produce unbalanced conditions, reactive power consumption and current harmonics drawn by the battery charging equipment, causing a great impact on the power quality of the future smart grid. A single-phase semi-fast electric vehicle battery charger is proposed in this paper. This ac on-board charging equipment can operate in grid-to-vehicle (G2V mode, and also in vehicle-to-grid (V2G mode, transferring the battery energy to the grid when the vehicle is parked. The charger is controlled with a Perfect Harmonic Cancellation (PHC strategy, contributing to improve the grid power quality, since the current demanded or injected has no harmonic content and a high power factor. Hall-effect current and voltage transducers have been used in the sensor stage to carry out this control strategy. Experimental results with a laboratory prototype are presented.

  10. [Evidence-based therapy of Raynaud's syndrome].

    Distler, M; Distler, J; Ciurea, A; Kyburz, D; Müller-Ladner, U; Reich, K; Distler, O


    Raynaud's syndrome has a prevalence of 3-5% in the general population. Despite its high frequency, the majority of available therapies have not been validated in randomized controlled trials. Effective therapies with a high level of evidence include the calcium channel blocker nifedipine. As analyzed by meta-analyses, nifedipine showed improvement of the peripheral circulation, as well as reduction of both the intensity and frequency of attacks in patients with primary and secondary Raynaud's syndrome as compared to placebo. Similar results in a metaanalysis were obtained for intravenous infusions of iloprost in patients with secondary Raynaud's phenomenon associated with systemic sclerosis. In addition, intravenous infusions of iloprost improved healing of fingertip ulcers in patients with systemic sclerosis. Therapies with significant effects in single randomized controlled trials include angiotensin II-receptor type 1 antagonists (losartan), the calcium channel blockers felodipine und amlodipine, serotonin-reuptake-inhibitors (fluoxetine) und phosphodiesterase-V-inhibitors (sildenafil, vardenafil). However, the results for these promising substances have to be confirmed in long-term trials with larger patient numbers.


    Bali Yogitha


    Full Text Available The concepts of EBM empower us to formulate appropriate clinical questions, appraise the literature using the hierarchy of evidence and apply the study results to their practice. With the ever increasing demands to adopt EBM in practice, healthcare providers require educational resources that present the concepts of the EBM, research methodology and guides to publishing medical research in a simple and easy to understand format. EBM also promotes critical thinking by clinicians. It requires that clinicians have the open-mindedness to look for and try new methods scientifically supported by the literature and it asks the clinical interventions be scrutinized and proven effective. In addition, EBM offers ways to critically evaluate the enormous amount of medical literature for value. In this way, clinical interventions and treatments are not just accepted because someone speaks of their anecdotal effectiveness, but a rigorous standard is applied to scientific data to determine whether the information has merit and applicability. Ayurveda is an Ancient Asian practice. It’s a traditional medical system used by a majority of India’s 1.1 billion populations. Ayurveda is being seen as a rich resource for new drug development by modern day pharmacologists. Ayurveda, the science of life is a branch of Atharvanaveda. It has eight specialized branches such as kayachikitsa (internal medicine, Salakya (ENT, salya tantra (ayurvedic surgery, Agada tantra (toxicology and forensic medicine, bhuta vidya (treatment of psychic diseases, kaumarabhrutya (paediatrics,rasayana tantra (rejuvenation treatments and vajikarana (aphrodisiacs.

  12. [Evidence-Based Knowledge Translation: From Scientific Evidence to Clinical Nursing Practice].

    Chen, Kee-Hsin; Kao, Ching-Chiu; Chen, Chiehfeng


    In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.

  13. Challenges and solutions in medically managed ACS in the Asia-Pacific region: expert recommendations from the Asia-Pacific ACS Medical Management Working Group.

    Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I


    Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations.

  14. Evidence Based Education Request Desk. EBE #652

    Regional Educational Laboratory Southeast, 2010


    Which states are using which turnaround models, as represented in the recent U.S. Department of Education's "Blueprint for Reform: The Reauthorization of the Elementary and Secondary Education Act?" A search for state-level policies on turnaround models was completed based on the targeted states list provided. According to US Department of…

  15. Evidence Based Education Request Desk. EBE #492

    Regional Educational Laboratory Southeast, 2009


    As attention to ninth grade transitions has grown, so has the need to carefully gauge the impacts of efforts to improve student outcomes. The What Works Clearinghouse (WWC), supported by the Institute for Education Sciences at the US Department of Education, sorts interventions based on the quality and the outcomes of the scientifically based…

  16. Evidence Based Education Request Desk. EBE #791

    Regional Educational Laboratory Southeast, 2011


    Would anyone in your network be aware of any states that might provide differentiated funding for virtual programs based on the model used--for example, curriculum-in-a-box vs. one with high student-teacher interaction? Are you aware of any research that examines what factors to consider when developing this type of differentiated funding? This…

  17. Organizational change tactics: the evidence base in the literature.

    Packard, Thomas; Shih, Amber


    Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.

  18. Evidence-based dentistry: fundamentals for the dentist.

    Bauer, Janet; Chiappelli, Francesco; Spackman, Sue; Prolo, Paolo; Stevenson, Richard


    This article explains the fundamentals of evidence-based dentistry for the dentist. Evidence-based dentistry is a discipline whose primary participant is the translational researcher. Recent developments have emphasized the importance of this discipline (clinical and translational research) for improving health care. The process of evidence-based dentistry is the reciprocation of new and existing evidence between dentists and quantitative and qualitative researchers, facilitated by the translational researcher. The product of this reciprocation is the clinical practice guideline, or best evidence, that provides the patient options in choosing treatments or services. These options are quantified and qualified by decision, utility, and cost data. Using shared decision-making, the dentist and patient arrive at a mutual understanding of which option best meets an acceptable and preferred treatment course that is cost effective. This option becomes the clinical decision.

  19. American Dental Association's Resources to Support Evidence-Based Dentistry.

    Aravamudhan, K; Frantsve-Hawley, Julie


    Time and access have often been cited as barriers to implementing Evidence-Based Dentistry (EBD). This paper describes a new web-based resource launched by the American Dental Association to enable practitioners to incorporate evidence into treatment planning. The website offers a database of systematic reviews, critical summaries of systematic reviews, evidence-based clinical recommendations and links to external resources to enable practitioners to access evidence at the point of care. In addition the site offers an online space for clinicians to suggest clinical scenarios where evidence is lacking. This could potentially be a source of topics to drive future research. With the explosion in the use of information technology within a dental office, this web-site will serve as the one-stop resource for credible scientific information for practitioners.

  20. A Series-LC-Filtered Active Damper with Grid Disturbance Rejection for AC Power-Electronics-Based Power Systems

    Wang, Xiongfei; Pang, Ying; Loh, Poh Chiang;


    damper. Unlike an active power filter for mitigating low-frequency harmonics, the proposed damper dampens resonances at higher frequencies, whose values are dependent on interactions among multiple grid-connected converters and reactive elements of the system. Its control requirements are, therefore......-order resonant controller, in addition to the second-order resonant controller used for resonance damping. Experimental results obtained have confirmed the effectiveness of these controllers, and hence, the feasibility of the active damper.......This letter proposes an active damper with a series LC filter for suppressing resonances in an ac power-electronics-based power system. The added series filter capacitor helps to withstand most of the system voltage, hence, allowing a lower rated converter to be used for implementing the active...

  1. Striving for excellence with evidence-based dentistry.

    Gillette, Jane


    With an explosion of published dental research, experienced dental practitioners may desire to update their clinical knowledge. Evidence-based dentistry provides a unique opportunity for dental practitioners to strive for excellence of scientific knowledge through evidence-finding processes that are not only simple, but have a significant potential to improve patient health care outcomes.

  2. Need to Address Evidence-Based Practice in Educational Administration

    Kowalski, Theodore


    Purpose: This article presents a case for addressing evidence-based practice (EBP) in educational administration. Content is arranged around four objectives: (a) summarizing the status of educational administration as a profession, (b) defining evidence and the model, (c) explaining EBP's social and professional merit, and (d) identifying barriers…

  3. Design of AC Regulator Based on Buck-Boost Converter%基于Buck-Boost的AC/AC变换器设计

    张超华; 汤雨; 谢少军


    利用Buck-Boost电路输出电压理论上可以在零到无穷大之间变化的特点,将Buck- Boost斩波电路应用于交流电压变换,提出了一种变比可以连续变化的固态变压器.与传统的自耦调压器相比,基于Buck-Boost变换器的固态变压器具有输出电压范围宽、体积小的特点,并且由于采用了电压反馈控制,使得其输出电压不受负载变化的影响,外特性较硬.针对四象限开关存在的换流问题,提出了该变换器的换流策略,在理论分析的基础上,设计制作了一台AC/AC调压器,实验结果验证了该变换器的可行性.

  4. Evidence that consumers are skeptical about evidence-based health care.

    Carman, Kristin L; Maurer, Maureen; Yegian, Jill Mathews; Dardess, Pamela; McGee, Jeanne; Evers, Mark; Marlo, Karen O


    We undertook focus groups, interviews, and an online survey with health care consumers as part of a recent project to assist purchasers in communicating more effectively about health care evidence and quality. Most of the consumers were ages 18-64; had health insurance through a current employer; and had taken part in making decisions about health insurance coverage for themselves, their spouse, or someone else. We found many of these consumers' beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as "medical evidence" or "quality guidelines." Most believed that more care meant higher-quality, better care. The gaps in knowledge and misconceptions point to serious challenges in engaging consumers in evidence-based decision making.

  5. CDMBE: A Case Description Model Based on Evidence

    Jianlin Zhu


    Full Text Available By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE, which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users’ ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model.

  6. Implementing evidence-based practices in an emergency department

    Kirk, Jeanette W.; Nilsen, Per


    and screening routines provided a flow stop. Four associated contradictions were identified: insufficient time to implement guidelines; guilty conscience due to perceived nonadherence to evidence-based practices; newcomers having different priorities; and conflicting views of what constituted being...

  7. Stroboscopy for benign laryngeal pathology in evidence based health care

    Printza, A; Triaridis, S; Themelis, C; Constantinidis, J


    Background and Aims: Voice disorders are common. The aim of this study is to evaluate the diagnostic value of stroboscopy for voice disorders related with benign pathology and apply results in evidence based health care.

  8. Towards Trustable Digital Evidence with PKIDEV: PKI Based Digital Evidence Verification Model

    Uzunay, Yusuf; Incebacak, Davut; Bicakci, Kemal

    How to Capture and Preserve Digital Evidence Securely? For the investigation and prosecution of criminal activities that involve computers, digital evidence collected in the crime scene has a vital importance. On one side, it is a very challenging task for forensics professionals to collect them without any loss or damage. On the other, there is the second problem of providing the integrity and authenticity in order to achieve legal acceptance in a court of law. By conceiving digital evidence simply as one instance of digital data, it is evident that modern cryptography offers elegant solutions for this second problem. However, to our knowledge, there is not any previous work proposing a systematic model having a holistic view to address all the related security problems in this particular case of digital evidence verification. In this paper, we present PKIDEV (Public Key Infrastructure based Digital Evidence Verification model) as an integrated solution to provide security for the process of capturing and preserving digital evidence. PKIDEV employs, inter alia, cryptographic techniques like digital signatures and secure time-stamping as well as latest technologies such as GPS and EDGE. In our study, we also identify the problems public-key cryptography brings when it is applied to the verification of digital evidence.

  9. Evidence-based intervention in physical activity

    Heath, Gregory W; Parra, Diana C; Sarmiento, Olga L


    -wide and mass media campaigns, and short physical activity messages targeting key community sites are recommended. Behavioural and social approaches are effective, introducing social support for physical activity within communities and worksites, and school-based strategies that encompass physical education......, classroom activities, after-school sports, and active transport. Recommended environmental and policy approaches include creation and improvement of access to places for physical activity with informational outreach activities, community-scale and street-scale urban design and land use, active transport...... policy and practices, and community-wide policies and planning. Thus, many approaches lead to acceptable increases in physical activity among people of various ages, and from different social groups, countries, and communities....

  10. AC Voltage Control of DC/DC Converters Based on Modular Multilevel Converters in Multi-Terminal High-Voltage Direct Current Transmission Systems

    Rui Li


    Full Text Available The AC voltage control of a DC/DC converter based on the modular multilevel converter (MMC is considered under normal operation and during a local DC fault. By actively setting the AC voltage according to the two DC voltages of the DC/DC converter, the modulation index can be near unity, and the DC voltage is effectively utilized to output higher AC voltage. This significantly decreases submodule (SM capacitance and conduction losses of the DC/DC converter, yielding reduced capital cost, volume, and higher efficiency. Additionally, the AC voltage is limited in the controllable range of both the MMCs in the DC/DC converter; thus, over-modulation and uncontrolled currents are actively avoided. The AC voltage control of the DC/DC converter during local DC faults, i.e., standby operation, is also proposed, where only the MMC connected on the faulty cable is blocked, while the other MMC remains operational with zero AC voltage output. Thus, the capacitor voltages can be regulated at the rated value and the decrease of the SM capacitor voltages after the blocking of the DC/DC converter is avoided. Moreover, the fault can still be isolated as quickly as the conventional approach, where both MMCs are blocked and the DC/DC converter is not exposed to the risk of overcurrent. The proposed AC voltage control strategy is assessed in a three-terminal high-voltage direct current (HVDC system incorporating a DC/DC converter, and the simulation results confirm its feasibility.

  11. An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

    Fitch, Dale


    This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

  12. Putting the practice into evidence-based dentistry.

    Coulter, Ian D


    Whenever a new field emerges in health care, a period is experienced in which the field tries to define itself. This is the position evidence-based dental practice finds itself in at the moment. In this paper, it is argued that, for dentistry to enter into the brave new world of evidence-based practice, it will require some rethinking of the research enterprise in the profession.

  13. A new fusion approach based on distance of evidences

    CHEN Liang-zhou; SHI Wen-kang; DENG Yong; ZHU Zhen-fu


    Based on the framework of evidence theory, data fusion aims at obtaining a single Basic Probability Assignment (BPA) function by combining several belief functions from distinct information sources. Dempster's rule of combination is the most popular rule of combinations, but it is a poor solution for the management of the conflict between various information sources at the normalization step. Even when it faces high conflict information, the classical Dempster-Shafer's (D-S) evidence theory can involve counter-intuitive results. This paper presents a modified averaging method to combine conflicting evidence based on the distance of evidences; and also gives the weighted average of the evidence in the system. Numerical examples showed that the proposed method can realize the modification ideas and also will provide reasonable results with good convergence efficiency.

  14. Evidence-based quality improvement: the state of the science.

    Shojania, Kaveh G; Grimshaw, Jeremy M


    Routine practice fails to incorporate research evidence in a timely and reliable fashion. Many quality improvement (QI) efforts aim to close these gaps between clinical research and practice. However, in sharp contrast to the paradigm of evidence-based medicine, these efforts often proceed on the basis of intuition and anecdotal accounts of successful strategies for changing provider behavior or achieving organizational change. We review problems with current approaches to QI research and outline the steps required to make QI efforts based as much on evidence as the practices they seek to implement.

  15. [Principles of evidence-based medicine applied to dentistry].

    Stegenga, B; Dijkstra, P U


    During the past decades, major methodological developments have taken place with regard to the clinical domains of etiology, diagnosis, prognosis and therapy. As a result scientific journals set increasingly high standards for publications and the research designs on which they are based. The development of evidence based guidelines for clinical practice in oral health care has increased as well. An evidence based programme for clinical practice consists of a number of steps, the first of which is a search strategy which will lead to the identification of relevant publications, based on an answerable clinical question. After a critical evaluation of such publications according to their validity, reliability and applicability, the evidence can be judged. This evidence is subsequently incorporated in the formulation of an answer to the clinical question and its application to the individual patient. As a result of social developments, the increasing assertiveness of the patient as a clinical consumer and economizing in recent years on the part of (the Dutch) government and insurance companies, the impact of evidence derived from medical and oral health literature on clinical practice has increased enormously. It is, nevertheless, the clinician who makes the judgements, takes the decisions and accepts responsibility for them, on the basis of the available evidence and the quality of that evidence, the preferences and values of the patient, the specific clinical situation and social developments.

  16. The vanishing mother: Cesarean section and "evidence-based obstetrics".

    Wendland, Claire L


    The philosophy of "evidence-based medicine"--basing medical decisions on evidence from randomized controlled trials and other forms of aggregate data rather than on clinical experience or expert opinion--has swept U.S. medical practice in recent years. Obstetricians justify recent increases in the use of cesarean section, and dramatic decreases in vaginal birth following previous cesarean, as evidence-based obstetrical practice. Analysis of pivotal "evidence" supporting cesarean demonstrates that the data are a product of its social milieu: The mother's body disappears from analytical view; images of fetal safety are marketing tools; technology magically wards off the unpredictability and danger of birth. These changes in practice have profound implications for maternal and child health. A feminist project within obstetrics is both feasible and urgently needed as one locus of resistance.

  17. Reduction of inequalities in health: assessing evidence-based tools

    Shea Beverley


    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  18. Development of the ACS+OPC UA based control system for a CTA medium size telescope prototype

    Behera, Bagmeet; Oya, Igor; Birsin, Emrah; Köppel, Hendryk; Melkumyan, David; Schlenstedt, Stefan; Schmidt, Torsten; Schwanke, Ullrich; Wegner, Peter; Wiesand, Stephan; Winde, Michael


    The Cherenkov Telescope Array (CTA) is the next generation Very High Energy (VHE, defined as > 50GeV to several 100TeV) telescope facility, currently in the design and prototyping phase, and expected to come on-line around 2016. The array would have both a Northern and Southern hemisphere site, together delivering nearly complete sky coverage. The CTA array is planned to have ~100 telescopes of several different sizes to fulfill the sensitivity and energy coverage needs. Each telescope has a number of subsystems with varied hardware and control mechanisms; a drive system that gets commands and inputs via OPC UA (OPC Unified Architecture), mirror alignment systems based on XBee/ZigBee protocol and/or CAN bus, weather monitor accessed via serial/Ethernet ports, CCD cameras for calibration, Cherenkov camera, and the data read out electronics, etc. Integrating the control and data-acquisitions of such a distributed heterogeneous system calls for a framework that can handle such a multi-platform, multi-protocol scenario. The CORBA based ALMA Common software satisfies these needs very well and is currently being evaluated as the base software for developing the control system for CTA. A prototype for a Medium Size Telescope (MST, ~12m) is being developed and will be deployed in Berlin, by end of 2012. We present the development being carried out to integrate and control the various hardware subsystems of this MST prototype using ACS.

  19. Using AC Motors in Robotics

    Hosein Marzi


    Full Text Available It has been proven that fuzzy controllers are capable of controlling non-linear systems where it is cumbersome to develop conventional controllers based on mathematical modeling. This paper describes designing fuzzy controllers for an AC motor run mechanism. It also compares performance of two controllers designed based on Mamdani and Takagi-Sugeno with the conventional control scheme in a short track length, following a high disturbance. Fine and rapid control of AC motors have been a challenge and the main obstacle in gaining popularity in use of AC motors in robots actuators. This chapter reviews how use of intelligent control scheme can help to solve this problem.

  20. Evidence-Based Practice: The Psychology of EBP Implementation.

    Rousseau, Denise M; Gunia, Brian C


    Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.

  1. Evidence-based assessment: no more pride or prejudice.

    Munro, Nancy


    Evidence-based practice is an important force in healthcare today. Its impact on the practice of the advanced practice nurse (APN) is becoming more apparent with the development of practice guidelines and protocols. The phrase, "That's the way I've always done it," is being replaced by, "This practice is evidence based." The philosophy of supporting practice with scientific evidence is not new but has been revitalized and emphasized as protocols have been developed to "mold" practice to achieve successful outcomes. This revolution is being applied to all areas of healthcare practice. Assessment of the patient is usually the first contact the APN has with the patient. It is an important time to gather information from the patient interview, physical examination, laboratory data, and test interpretation. Scientific evidence, properly interpreted, is applied in this step of assessment. The APN will then use clinical judgment and the knowledge gained from graduate education to assist with the formulation of a diagnosis. The APN has a unique opportunity to promote an evidence-based practice model at the grass roots level and persuade the bedside nurse to integrate this process into his or her practice. Ultimately, patients will receive better care and outcomes will be improved using evidence-based assessment.

  2. Ag incorporated Mn3O4/AC nanocomposite based supercapacitor devices with high energy density and power density.

    Nagamuthu, S; Vijayakumar, S; Muralidharan, G


    Silver incorporated Mn3O4/amorphous carbon (AC) nanocomposites are synthesized by a green chemistry method. X-ray diffraction studies revealed the structural changes in Mn3O4/AC nanocomposites attributable to the addition of silver. Cyclic voltammetry, charge-discharge and ac-impedance studies indicated that the Ag-Mn3O4/AC-5 electrode was the most suitable candidate for supercapacitor applications. From the galvanostatic charge-discharge studies, a higher specific capacitance of 981 F g(-1) at a specific current of 1 A g(-1) was obtained. An Ag-Mn3O4/AC-symmetric supercapacitor consisting of an Ag-incorporated Mn3O4/AC composite as an anode as well as a cathode, and an asymmetric supercapacitor consisting of an Ag-incorporated Mn3O4/AC composite as a cathode and an activated carbon as an anode have been fabricated. The symmetric device exhibits a specific cell capacitance of 72 F g(-1) at a specific current of 1 A g(-1) whereas the asymmetric device delivers a specific cell capacitance of 180 F g(-1) at a high current rate of 10 A g(-1). The asymmetric supercapacitor device yields a high energy density of 81 W h kg(-1). This is higher than that of lead acid batteries and comparable with that of nickel hydride batteries.

  3. Cesarean delivery technique: evidence or tradition? A review of the evidence-based cesarean delivery.

    Encarnacion, Betsy; Zlatnik, Marya G


    Cesarean delivery is the most common surgical procedure performed in the United States, yet the techniques used during this procedure often vary significantly among providers. The purpose of this review was to evaluate and outline current evidence behind the cesarean delivery technique. A search of the PubMed database was conducted using the terms cesarean section and cesarean delivery and the technique of interest, for example, cesarean section prophylactic antibiotics. Few aspects of the cesarean delivery were found to have high-quality consistent evidence to support use of a particular technique. Because many aspects of the procedure are based on limited or no data, more studies on specific cesarean delivery techniques are clearly needed. Providers should be aware of which components of the cesarean delivery are evidence-based versus not when performing this procedure.

  4. Toward Collaborative Evidence Based Information Practices: Organisation and Leadership Essentials

    Anita Mirijamdotter


    Full Text Available This commentary is based on my keynote address for the EBLIP conference held in 2009 in Stockholm, Sweden. The title was: Bridging the gap between users and systems – the potential contribution of Social Informatics to Evidence Based Library and Information Practice. In the following commentary, I focus on the application of social informatics principles to develop a collaborative evidence based approach grounded in shared workplace leadership. My remarks highlight some main contributions from the field of library and information science and social informatics and conclude with implications for practice, including further research.

  5. Building the evidence base for postoperative and postpartum advice.

    Minig, Lucas; Trimble, Edward L; Sarsotti, Carlos; Sebastiani, Mario M; Spong, Catherine Y


    Recommendations for activity after obstetric and gynecologic procedures remain based on tradition and anecdote. After reviewing the current evidence base, guidelines, and practice for postdischarge instructions related to physical activity after the most common obstetric and gynecologic surgical procedures, we conclude that the available data do not support many of the recommendations currently provided. Restrictions on lifting and climbing stairs should likely be abandoned. Guidance on driving should focus on the concern regarding cognitive function and analgesics rather than concerns of wound separation/dehiscence. Given the impact of these recommendations on daily life events, consistent, evidence-based advice on when and how women can safely resume exercise, driving, working, and sexual intercourse is critical. The evidence base informing advice for most of these issues is minimal; we need prospective, well-designed studies to help guide us and our patients.

  6. Annotating Evidence Based Clinical Guidelines: A Lightweight Ontology

    R. Hoekstra; A. de Waard; R. Vdovjak


    This paper describes a lightweight ontology for representing annotations of declarative evidence based clinical guidelines. We present the motivation and requirements for this representation, based on an analysis of several guidelines. The ontology provides the means to connect clinical questions an

  7. An evidence-based rehabilitation program for tracheoesophageal speakers

    Jongmans, P.; Rossum, M.; As-Brooks, C.; Hilgers, F.; Pols, L.; Hilgers, F.J.M.; Pols, L.C.W.; van Rossum, M.; van den Brekel, M.W.M.


    Objectives: to develop an evidence-based therapy program aimed at improving tracheoesophageal speech intelligibility. The therapy program is based on particular problems found for TE speakers in a previous study as performed by the authors. Patients/Materials and Methods: 9 male laryngectomized indi



    ... government and evidence- based regulation. If regulatory choices are based on careful analysis of the... emphasis on sound analysis and on ensuring a careful accounting of the anticipated consequences of... burdens and innovative solutions. By promoting accountability, open government policies can help to...

  9. Dicty_cDB: FCL-AC21 [Dicty_cDB

    Full Text Available FCL (Link to library) FCL-AC21 (Link to dictyBase) - - - Contig-U15479-1 FCL-AC21E ...(Link to Original site) - - - - - - FCL-AC21E 632 Show FCL-AC21 Library FCL (Link to library) Clone ID FCL-AC2... Representative seq. ID FCL-AC2...1E (Link to Original site) Representative DNA sequence >FCL-AC21 (FCL-AC21Q) /CSM/FCL/FCL-AC/FCL-AC2...M/SL/SLG7-D/SLG773Q.Seq.d/ 1205 0.0 FCL-AC21 (FCL-AC21Q) /CSM/FCL/FCL-AC/FCL-AC21

  10. Comparison of Traditional Versus Evidence-Based Journal Club Formats

    Kathleen Packard, PharmD, MS, BCPS


    Full Text Available AbstractPurpose: The objective of the study was to compare a traditionally structured journal club with an evidence based structured journal club during an advanced clinical pharmacy rotation and to determine the best utilization that aligns with recent changes to the pharmacy school accreditation standards.Methods: The study included 21 students who completed journal club utilizing the traditional journal club format and 24 students who utilized an evidence based journal club format. Background characteristics, student reported beliefs, and mean critical evaluation skills scores were evaluated and compared in each group.Results: There were no statistically significant differences between the two cohorts in mean overall percentage grade for the activity. Students in the traditional cohort received significantly higher grades for the Study Analysis and Critique section (90.97 + 12.18 versus 81.25 + 11.18, P=0.01 as well as for the Preparedness section (96.11 + 8.03 versus 85.0 + 17.13, P=0.002. Students in the evidence based cohort received statistically superior grades for the Presentation Skills section (96.43 + 6.39 versus 82.47 + 14.12, P=0.0004.Conclusion: An evidence based journal club is a reasonable and effective alternative to the traditionally structured journal club when the primary objective is to assist students in understanding evidence based concepts and to apply current literature to clinical practice.

  11. Using Evidence-Based Design to Improve Pharmacy Department Efficiency.

    Greenroyd, Fraser L; Hayward, Rebecca; Price, Andrew; Demian, Peter; Sharma, Shrikant


    Using a case study of a pharmacy department rebuild in the South West of England, this article examines the use of evidence-based design to improve the efficiency and staff well-being with a new design. This article compares three designs, the current design, an anecdotal design, and an evidence-based design, to identify how evidence-based design can improve efficiency and staff well-being by reducing walking time and distance. Data were collected from the existing building and used to measure the efficiency of the department in its current state. These data were then mapped onto an anecdotal design, produced by architects from interviews and workshops with the end users, and an evidence-based design, produced by highlighting functions with high adjacencies. This changed the view on the working processes within the department, shifting away from a focus on the existing robotic dispensing system. Using evidence-based design was found to decrease the walking time and distance for staff by 24%, as opposed to the anecdotal design, which increased these parameters by 9%, and is predicted to save the department 248 min across 2 days in staff time spent walking.

  12. Evidence-Based Practice and School Libraries: Interconnections of Evidence, Advocacy, and Actions

    Todd, Ross J.


    This author states that a professional focus on evidence based practice (EBP) for school libraries emerged from the International Association of School Librarianship conference when he presented the concept. He challenged the school library profession to actively engage in professional and reflective practices that chart, measure, document, and…

  13. Pediatric Depression: Is There Evidence to Improve Evidence-Based Treatments?

    Brent, David A.; Maalouf, Fadi T.


    Although there have been advances in our ability to treat child and adolescent depression, use of evidence-based treatments still results in many patients with residual symptoms. Advances in our understanding of cognitive, emotional, and ecological aspects of early-onset depression have the potential to lead to improvements in the assessment and…

  14. Carbon Nanotube-Based Supercapacitors with Excellent ac Line Filtering and Rate Capability via Improved Interfacial Impedance.

    Rangom, Yverick; Tang, Xiaowu Shirley; Nazar, Linda F


    We report the fabrication of high-performance, self-standing composite sp(2)-carbon supercapacitor electrodes using single-walled carbon nanotubes (CNTs) as conductive binder. The 3-D mesoporous mesh architecture of CNT-based composite electrodes grants unimpaired ionic transport throughout relatively thick films and allows superior performance compared to graphene-based devices at an ac line frequency of 120 Hz. Metrics of 601 μF/cm(2) with a -81° phase angle and a rate capability (RC) time constant of 199 μs are obtained for thin carbon films. The free-standing carbon films were obtained from a chlorosulfonic acid dispersion and interfaced to stainless steel current collectors with various surface treatments. CNT electrodes were able to cycle at 200 V/s and beyond, still showing a characteristic parallelepipedic cyclic votammetry shape at 1 kV/s. Current densities are measured in excess of 6400 A/g, and the electrodes retain more than 98% capacity after 1 million cycles. These promising results are attributed to a reduction of series resistance in the film through the CNT conductive network and especially to the surface treatment of the stainless steel current collector.

  15. [Evidence-based clinical practice. Part II--Searching evidence databases].

    Bernardo, Wanderley Marques; Nobre, Moacyr Roberto Cuce; Jatene, Fábio Biscegli


    The inadequacy of most of traditional sources for medical information, like textbook and review article, do not sustained the clinical decision based on the best evidence current available, exposing the patient to a unnecessary risk. Although not integrated around clinical problem areas in the convenient way of textbooks, current best evidence from specific studies of clinical problems can be found in an increasing number of Internet and electronic databases. The sources that have already undergone rigorous critical appraisal are classified as secondary information sources, others that provide access to original article or abstract, as primary information source, where the quality assessment of the article rely on the clinician oneself . The most useful primary information source are SciELO, the online collection of Brazilian scientific journals, and Medline, the most comprehensive database of the USA National Library of Medicine, where the search may start with use of keywords, that were obtained at the structured answer construction (P.I.C.O.), with the addition of boolean operators "AND", "OR", "NOT". Between the secondary information sources, some of them provide critically appraised articles, like ACP Journal Club, Evidence Based Medicine and InfoPOEMs, others provide evidences organized as online texts, such as "Clinical Evidence" and "UpToDate", and finally, Cochrane Library are composed by systematic reviews of randomized controlled trials. To get studies that could answer the clinical question is part of a mindful practice, that is, becoming quicker and quicker and dynamic with the use of PDAs, Palmtops and Notebooks.

  16. Evidence-based practice: reflections from five European case studies.

    Baeza, Juan I; Fraser, Alec; Boaz, Annette


    Background Evidence-based practice (EBP) is now the accepted orthodoxy in clinical practice and developed from evidence-based medicine. EBP is based on a specific type of evidence that is derived from studies based on randomised controlled trials (RCT). This type of evidence is suited to acute medical care and is more problematic for other clinicians such as nurses and therapists, particularly when they are situated within community or primary care settings. Setting Five stroke care services in England (2), Sweden (2) and Poland (1). Aims To reflect on the evidence gained from these case studies to shed light on various aspects of EBP. This paper focuses on three key issues: (1) the importance of context for evidence, (2) the nature of knowledge, and (3) professional hierarchies. Methods Five qualitative case studies into stroke care were carried out in England, Sweden and Poland. One hundred and twenty semi-structured interviews were carried out with a range of healthcare staff who provided specialised and non-specialised stroke care in acute, community and primary care between October 2010 and September 2011. Medical doctors, nurses and different therapists were included in the samples in all five case studies. For this paper, we reflect on some aspects of this work to illuminate the different interprofessional perspectives relating to EBP in stroke care. Results The lack of RCT-based evidence in the community and primary care sectors can lead to the clinicians working in these sectors being perceived as having a lower status. Clinicians use both tacit and encoded knowledge to guide their practice and there existed both intraand interprofessional tensions in these two types of knowledge. The professional hierarchy of stroke teams varies with national context and the role of the non-specialists is less valued in stroke care.

  17. Modeling and analysis of harmonic resonance in a power electronics based AC power system

    Wang, Xiongfei; Blaabjerg, Frede; Chen, Zhe


    The dynamic interactions among the interconnected power converters may bring in harmonic resonance in a power electronics based power system. This paper addresses this issue in a power system dominated by multiple current- and voltage-controlled inverters with LCL- and LC-filters. The impedance-b...

  18. An active damper for stabilizing power-electronics-based AC systems

    Wang, Xiongfei; Blaabjerg, Frede; Liserre, Marco


    The interactions among the parallel grid-connected converters coupled through the grid impedance tend to result in stability and power quality problems. To address them, this paper proposes an active damper based on a high bandwidth power electronics converter. The general idea behind this propos...

  19. An active damper for stabilizing power electronics-based AC systems

    Wang, Xiongfei; Blaabjerg, Frede; Liserre, Marco


    The mutual interactions between the parallel grid-connected converters coupled through the grid impedance tend to result in a number of stability and power quality challenges. To address them, this paper proposes an active damper concept based on a low-power, high-bandwidth power converter. The b...

  20. A clinician's perspective on evidence-based dentistry.

    Feinberg, Edward M


    Evidence-based dentistry seems to be more popular with researchers and those in policy positions than with clinicians. A private practitioner looks at the difference between the promise of evidence-based dentistry, which urges a blend of science, clinical judgment, and patient preferences, and the actuality of the rhetoric of rigorous and formulaic clinical trials. The same dichotomy exists in medicine, where the concept originated. Without subscribing to the formality of evidence-based dentistry, practitioners can place a valid scientific foundation under their practices by avoiding unproven assumptions, carefully monitoring outcomes, using measures that are clinically relevant, relating both positive and negative outcomes to possible explanations, and cautiously introducing new techniques. The standards for publishing clinical research seem to favor adherence to methodological rules over useful of outcomes.

  1. [Evidence-based orthodontics, still a long way to go].

    Kuijpers-Jagtman, A M


    Clinical performance can be kept up to date by learning how to practice evidence-based orthodontics, by seeking and appraising evidence-based summaries from the literature and by applying evidence-based strategies to change clinical behaviour. A MEDLINE search over the period 1990-2000 identified 8345 publications on clinical orthodontic subjects. Of these articles 49.5% was published in five specific orthodontic journals, while the others were published in about seventy other journals making it difficult for the clinician to stay current easily. Systematic reviews are an efficient and reliable source of information, but due to a lack of well-designed randomised clinical trials systematic reviews in orthodontics are still rare.

  2. Bridging Ayurveda with evidence-based scientific approaches in medicine.

    Patwardhan, Bhushan


    This article reviews contemporary approaches for bridging Ayurveda with evidence-based medicine. In doing so, the author presents a pragmatic assessment of quality, methodology and extent of scientific research in Ayurvedic medicine. The article discusses the meaning of evidence and indicates the need to adopt epistemologically sensitive methods and rigorous experimentation using modern science. The author critically analyzes the status of Ayurvedic medicine based on personal observations, peer interactions and published research. This review article concludes that traditional knowledge systems like Ayurveda and modern scientific evidence-based medicine should be integrated. The author advocates that Ayurvedic researchers should develop strategic collaborations with innovative initiatives like 'Horizon 2020' involving predictive, preventive and personalized medicine (PPPM).

  3. Evidence-based practice and the professionalization of dental hygiene.

    Cobban, Sandra J


    The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research-practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice.

  4. Complex state variable- and disturbance observer-based current controllers for AC drives

    Dal, Mehmet; Teodorescu, Remus; Blaabjerg, Frede


    , extracted by a disturbance observer and then injected into the current controller. In this study, a revised version of a disturbance observer-based controller and a well known complex variable model-based design with a single set of complex pole are compared in terms of design aspects and performance...... of the parameter and the cross-coupling effect. Moreover, it provides a better performance, smooth and low noisy operation with respect to the complex variable controller....... of the stator current. In order to improve the current control performance an alternative current control strategy was proposed previously aiming to avoid the undesired cross-coupling and non-linearities between the state variables. These effects are assumed as disturbances arisen in the closed-loop path...

  5. Grid impedance estimation based hybrid islanding detection method for AC microgrids

    Ghzaiel, Walid; Jebali-Ben Ghorbal, Manel; Slama-Belkhodja, Ilhem;


    This paper focuses on a hybrid islanding detection algorithm for parallel-inverters-based microgrids. The proposed algorithm is implemented on the unit ensuring the control of the intelligent bypass switch connecting or disconnecting the microgrid from the utility. This method employs a grid impe...... that the resonance excitation is canceled and the resistive and inductive grid impedance parts are estimated. Simulation results are carried out to illustrate the effectiveness of the proposed method....

  6. Proposing an Evidence-Based Strategy for Software Requirements Engineering.

    Lindoerfer, Doris; Mansmann, Ulrich


    This paper discusses an evidence-based approach to software requirements engineering. The approach is called evidence-based, since it uses publications on the specific problem as a surrogate for stakeholder interests, to formulate risks and testing experiences. This complements the idea that agile software development models are more relevant, in which requirements and solutions evolve through collaboration between self-organizing cross-functional teams. The strategy is exemplified and applied to the development of a Software Requirements list used to develop software systems for patient registries.

  7. Strategies for searching and managing evidence-based practice resources.

    Robb, Meigan; Shellenbarger, Teresa


    Evidence-based nursing practice requires the use of effective search strategies to locate relevant resources to guide practice change. Continuing education and staff development professionals can assist nurses to conduct effective literature searches. This article provides suggestions for strategies to aid in identifying search terms. Strategies also are recommended for refining searches by using controlled vocabulary, truncation, Boolean operators, PICOT (Population/Patient Problem, Intervention, Comparison, Outcome, Time) searching, and search limits. Suggestions for methods of managing resources also are identified. Using these approaches will assist in more effective literature searches and may help evidence-based practice decisions.

  8. Evidence-based practice for marriage and family therapists.

    Patterson, Jo Ellen; Miller, Richard B; Carnes, Stefanie; Wilson, Shanna


    The purpose of this article is to integrate science into clinical practice by introducing marriage and family therapists to the ideas of evidence-based practice (EBP). Evidence-based practice, which originated in the medical field, refers to the process of using research to make clinical decisions that best meet the needs of each client. Included in the description is a brief history of EBPs and ideas about learning EBPs. Suggestions are also made about the use of EBPs in MFT training programs, and resources are provided to enable clinicians to use EBPs in clinical practice.

  9. Enhanced absorption performance of carbon nanostructure based metamaterials and tuning impedance matching behavior by an external AC electric field.

    Gholipur, Reza; Khorshidi, Zahra; Bahari, Ali


    Metamaterials have surprisingly broadened the range of available practical applications in new devices such as shielding, microwave absorbing, and novel antenna. More researches are related to the tuning DNG frequency bands of ordered or disordered metamaterials, and far less research has focused on the importance of impedance matching behavior, and is not effort and attention in adjusting the magnitude of negative permittivity values. This is particularly important if devices deal with low amplitude signals such as radio or TV antenna. The carbon/hafnium nickel oxide (C/Hf0.9Ni0.1Oy) nanocomposites with simultaneously negative permittivity and negative permeability, excellent metamaterial performance and good impedance matching could become an efficient alternative for the ordered metamaterials in wave-transparent, microwave absorbing, and solar energy harvesting fields. In this study, we prepared C/Hf0.9Ni0.1Oy nanocomposites by solvothermal method, and we clarified how the impedance matching and double negative (DNG) behaviors of C/Hf0.9Ni0.1Oy can be tuned by an external AC electric field created by electric quadrupole system. External electric field allows for the alignment of the well-dispersed nanoparticles of carbon with long-range orientations order. We believe that this finding broadens our understanding of moderate conductive material-based random metamaterials (MCMRMs), and provides a novel strategy for replacing high loss ordered or disordered metamaterials with MCMRMs.

  10. [Pharmacist's requirements for evidence-based self-medication guidelines].

    Laven, Anna; Läer, Stephanie


    Due to the removal of many pharmaceuticals from the prescription requirement, self-medication implies an increasing responsibility for pharmacists towards their patients. The application of evidence-based guidelines could be a responsible basis for consulting in pharmacies. Evidence-based guidelines represent the systematically accumulated and evaluated facts (the evidence) of desired and undesired effects of pharmaceuticals in the population. We wanted to find out which interest pharmaceutical professionals have in evidence-based guidelines and which are the exact requirements on their content, deducted from public pharmacies everyday demands. With this purpose, three surveys were conducted between March and August 2012, in which 365, 350, and 486 pharmaceutical professionals participated respectively. The results show that pharmacy staff is very interested in evidence based guidelines. Furthermore, they suggest that the pharmacy staff feel safe with the self-diagnosis of the customer, with the consideration of limits of self-medication, as well as with the selection of the--according to own assessment--appropriate active substance. For the selection of the correct active substance, the following criteria are named: self-security in the counselling, first-hand experiences as well as the wish of the customer. At the same time, it is striking that the most frequent critique the pharmacy staff gets from pharmacy customers is the lack of effectiveness of the selected medication. With that in mind, it is possible that not the appropriate medication was selected, and the chosen criteria as selection method should be replaced by an evidence-based decision. Secondly, the results show that in up to 52% of the cases, depending on the indications, the participating consultants felt less certain to uncertain with regards to possible interactions or contraindications. Also in this context, it is desirable to prepare the existing data in such a practical way, that the

  11. Training Methods to Improve Evidence-Based Medicine Skills

    Filiz Ozyigit


    Full Text Available Evidence based medicine (EBM is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It is estimated that only 15% of medical interventions is evidence-based. Increasing demand, new technological developments, malpractice legislations, a very speed increase in knowledge and knowledge sources push the physicians forward for EBM, but at the same time increase load of physicians by giving them the responsibility to improve their skills. Clinical maneuvers are needed more, as the number of clinical trials and observational studies increase. However, many of the physicians, who are in front row of patient care do not use this increasing evidence. There are several examples related to different training methods in order to improve skills of physicians for evidence based practice. There are many training methods to improve EBM skills and these trainings might be given during medical school, during residency or as continuous trainings to the actual practitioners in the field. It is important to discuss these different training methods in our country as well and encourage dissemination of feasible and effective methods. [TAF Prev Med Bull 2010; 9(3.000: 245-254

  12. Analytical Solution for Model-Based Dynamic Power Factor Measurement in AC Resistance Spot Welding


    On the basis of welding transformer circuit model, a new measuring method was proposed. This method measures the peak angle of the welding current, and then calculates the dynamic power factor in each half-wave.An artificial neural network is trained and used to generate simulation data for the analytical solution, i.e. a highorder binary polynomial, which can be easily adopted to calculate the power factor online. The tailored sensing and computing system ensures that the method possesses a real-time computational capacity and satisfying accuracy. A DSP-based resistance spot welding monitoring system was developed to perform ANN computation. The experimental results suggest that this measuring method is feasible.

  13. FPGA Based Optimized Discontinuous SVPWM Algorithm for Three Phase VSI in AC Drives

    Tole Sutikno


    Full Text Available The discontinuous space vector pulse width modulation (SVPWM has well-known that can reduce switching losses. By simplifying the thermal management issues, the discontinuous SVPWM can potentially reduce the inverter size and cost. However, using the modulation due to different time interval equations for each sector can introduce glitches at the points when the sector is changed. The more main problem, it can increase unwanted harmonic content and current ripple. Consider the decrease in switching losses associated with discontinuous modulation allows the system to utilize a higher switching frequency, this paper present high frequency switching of optimized discontinuous SVPWM based on FPGA to overcome the problems above. The proposed SVPWM has been successfully implemented by using APEX20KE Altera FPGA to drive on a three phase inverter system with 1.5 kW induction machine as load. The results have proved that the method can reduce harmonic content and current ripple without glitches.

  14. Evidence-based practices in preconception period and pregnancy

    Şükran Başgöl


    Full Text Available Pregnancy is a special period which affects the women’s life aspect bio-psycho- social. In this period, pregnant reguires medical care and psychosocial support. It begins with the preconception period. Providing quality care during preconception period, will affect pregnancy and other periods. Quality of care and avoiding unnecessary applications will be with evidence-based practices. The purpose of health professionals is to take control/ prevent maternal and fetal health risks, protect and promote health in the period of pregnancy by physical, psychological and social holistic care. When they provide care, they should be guided by evidence based practices and integrate them with the clinical practices. The purpose of this review is to evaluate the degree of evidence of the interventions that are often applied preconception period and during pregnancy.     

  15. Evidence-based practices in preconception period and pregnancy

    Ümran Oskay


    Full Text Available Pregnancy is a special period which affects the women’s life aspect bio-psycho- social. In this period, pregnant reguires medical care and psychosocial support. It begins with the preconception period. Providing quality care during preconception period, will affect pregnancy and other periods. Quality of care and avoiding unnecessary applications will be with evidence-based practices. The purpose of health professionals is to take control/ prevent maternal and fetal health risks, protect and promote health in the period of pregnancy by physical, psychological and social holistic care. When they provide care, they must guide evidence based practices and integrate them with the clinical practices.The purpose of this review is to evaluate the degree of evidence of the interventions that are often applied preconception period and during pregnancy.

  16. Recommendations for Evidence-based Thinking on Migrant Worker Training

    Zheng ZHANG


    Evidence-based thinking originates from the United States. It stresses combination of actual facts and practical experience of managers to find out optimal evidence and make decisions accordingly. Migrant worker is a unique concept of China. Migrant workers are essential parts of industrial forces. However,due to limitation of their quality,they generally fail to bring into play their important function in the industry chain. At present,there are many problems in training models of migrant workers,leading to failure to raise their employment ability. This study is expected to introduce the evidence-based thinking into the building of training models for migrant workers,to provide recommendations for migrant worker training,raise efficiency of migrant worker training,and so as to bring into play important function of migrant workers in socialist construction of China.

  17. Evidence-based decision-making 1: Critical appraisal.

    Twells, Laurie K


    This chapter provides an introduction to the concept of Evidence-based Medicine (EBM) including its history, rooted in Canada and its important role in modern medicine. The chapter both defines EBM and explains the process of conducting EBM. It includes a discussion of the hierarchy of evidence that exists with reference to common methods used to assess the levels of quality inherent in study designs. The focus of the chapter is on how to critically appraise the medical literature, as one step in the EBM process. Critical appraisal requires an understanding of the strengths and weaknesses of study design and how these in turn impact the validity and applicability of research findings. Strong critical appraisal skills are critical to evidence-based decision-making.

  18. Line-to-line voltage based modulation scheme for single-phase reduced switch ac-dc-ac converters to achieve improved performance

    Qin, Zian; Loh, Poh Chiang; Blaabjerg, Frede


    . With the SVPWM or DPWM proposed in literatures, the generation of the references is phase voltage based. But the phase voltages actually cannot be controlled directly by the PWM converter, since they can be influenced by both of terminal voltages and the load network while the PWM converter can only control...

  19. AC 410 AC410 AC410 Unit 7 Homework Assignment



    AC 410 AC410 AC410 Unit 7 Homework Assignment Click Link Below To Buy:    Questions Requiring Analysis 14-30   Early in your first audit of Star Corporation, you notice that sales and year-end inventory are almost unchanged from the prior year. However, cost of goods sold is less than in the preceding year, and accounts payable also are down substantially. Gross profit has increased, but this increase has not c...

  20. Chemical reduction synthesis and ac field effect of iron based core-shell magnetic nanoparticles

    Balakrishnan, Srinivasan; Bonder, Michael J.; Hadjipanayis, George C.


    High magnetization nanoparticles coated with a biocompatible polymer have attracted considerable interest in recent times as potential materials for biomedical applications associated with targeted drug delivery, detection and the treatment of cancer. This paper considers the use of sodium borohydride reduction of metal salts to form Fe based nanoparticles coated with carboxyl terminated polyethylene glycol (cPEG). By mixing the reactants in a Y-junction, the synthesis produces uniform nanoparticles in the size range 10-20 nm with a core-shell structure. The particles are subsequently coated with a 1-3 nm thick layer of cPEG. These nanoparticles are soft ferromagnets with Hc = 400 Oe. Exciting these nanoparticles with a 4 Oe, 500 kHz alternating magnetic field leads to particle heating with a maximal increase in the saturation temperature as the particle size is decreased. For the largest particles considered here, the temperature reaches 35 °C with a 10 mg sample mass whilst for the smallest nanoparticles considered the temperature exceeds 40 °C.

  1. Critical Thinking: Knowledge and Skills for Evidence-Based Practice

    Finn, Patrick


    Purpose: I respond to Kamhi's (2011) conclusion in his article "Balancing Certainty and Uncertainty in Clinical Practice" that rational or critical thinking is an essential complement to evidence-based practice (EBP). Method: I expand on Kamhi's conclusion and briefly describe what clinicians might need to know to think critically within an EBP…

  2. Evidence-based or status-seduced opinions

    Ray Wilks


    Full Text Available ‘There are infact, two things, science and opinion;the former begets knowledge, the latter ignorance.’(HippocratesThe professional and accreditation bodies ofmost healthcare professions now require that theirpractitioners adhere to evidence-based clinical decisionmaking and that they act only within their scope ofclinical expertise.

  3. Developing evidence-based guidelines for referral for short stature

    Grote, F.K.; Dommelen, P. van; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Verkerk, P.H.; Wit, J.M.; Buuren, S. van


    Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population. Results

  4. Embedding trials in evidence-based clinical practice

    Oude Rengerink, K.


    This thesis presents a number of research projects centred on ‘evidence-based medicine’. It consists of two parts. Part 1 focuses on improving recruitment of the necessary number of patients in clinical trials, as this is the major problem while evaluating the effectiveness of interventions in healt

  5. Evidence-based diagnosis and clinical decision making

    Mileman, P.A.; van den Hout, W.B.


    The application of evidence-based dentistry to diagnosis should result in a reduction of errors in decision making. The frequency of errors is dependent not only on the accuracy of a diagnostic test for pathology, but also on the prior chance of disease being present. If this chance is low and below

  6. Reflections on the Teaching of Evidence-Based Practice

    Shlonsky, Aron; Stern, Susan B.


    As the process of evidence-based practice (EBP) gains a foothold in the curricula of schools of social work and the various helping professions, instructors have been encountering a unique set of challenges. On one hand, educators must develop new curricula to convey material that is often complex and is, even in its most advanced state, still in…

  7. Deterministic versus evidence-based attitude towards clinical diagnosis.

    Soltani, Akbar; Moayyeri, Alireza


    Generally, two basic classes have been proposed for scientific explanation of events. Deductive reasoning emphasizes on reaching conclusions about a hypothesis based on verification of universal laws pertinent to that hypothesis, while inductive or probabilistic reasoning explains an event by calculation of some probabilities for that event to be related to a given hypothesis. Although both types of reasoning are used in clinical practice, evidence-based medicine stresses on the advantages of the second approach for most instances in medical decision making. While 'probabilistic or evidence-based' reasoning seems to involve more mathematical formulas at the first look, this attitude is more dynamic and less imprisoned by the rigidity of mathematics comparing with 'deterministic or mathematical attitude'. In the field of medical diagnosis, appreciation of uncertainty in clinical encounters and utilization of likelihood ratio as measure of accuracy seem to be the most important characteristics of evidence-based doctors. Other characteristics include use of series of tests for refining probability, changing diagnostic thresholds considering external evidences and nature of the disease, and attention to confidence intervals to estimate uncertainty of research-derived parameters.

  8. Single-Subject Experimental Design for Evidence-Based Practice

    Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.


    Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…

  9. Validating evidence based decision making in health care

    Nüssler, Emil Karl; Eskildsen, Jacob Kjær; Håkonsson, Dorthe Døjbak;

    of Gynecological Surgery we examine factors related to decisions to use mesh. Our results indicate that decisions to use mesh are not evidence based, and cannot be explained neither by FDA safety communications, nor by medical conditions usually assumed to predict its usage. Instead, decisions to use mesh...

  10. Evidence-based practice guidelines for plasma transfusion

    Roback, John D.; Caldwell, Stephen; Carson, Jeff; Davenport, Robertson; Drew, Mary Jo; Eder, Anne; Fung, Mark; Hamilton, Marilyn; Hess, John R.; Luban, Naomi; Perkins, Jeremy G.; Sachais, Bruce S.; Shander, Aryeh; Silverman, Toby; Snyder, Ed; Tormey, Christopher; Waters, John; Djulbegovic, Ben


    BACKGROUND: There is little systematically derived evidence-based guidance to inform plasma transfusion decisions. To address this issue, the AABB commissioned the development of clinical practice guidelines to help direct appropriate transfusion of plasma. STUDY DESIGN AND METHODS: A systematic rev

  11. ADDIS: A decision support system for evidence-based medicine

    G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)


    textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

  12. Marketing evidence-based practice: what a CROC™!

    Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry


    Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.

  13. The integrated and evidence-based design of healthcare environments.

    van Hoof, J.; Rutten, P.G.S.; Struck, C.; Huisman, E.R.C.M.; Kort, H.S.M.


    van Hoof, J., Rutten, P.G.S., Struck, C., Huisman, E.R.C.M., Kort, H.S.M. (2014) The integrated and evidence-based design of healthcare environments. Architectural Engineering and Design Management doi:10.1080/17452007.2014.892471

  14. Evidence-based practice for information professionals a handbook

    Booth, Andrew


    Examines to what extent the skills and techniques of evidence-based practice are transferable to the areas of professional practice of librarians and information professionals? Is it desirable for information professionals to integrate research findings into their day-to-day decision making?

  15. Evidence-Based Rehabilitation Counseling Practice: A Pedagogical Imperative

    Kosciulek, John F.


    This article describes how rehabilitation educators can aid students and practitioners in learning about and engaging in evidence-based rehabilitation counseling practice (EBRCP). Information describing (a) the definition and rationale for EBRCP, (b) controversies surrounding EBRCP, (c) facilitating rehabilitation counselor enthusiasm for EBRCP,…

  16. An Evidence Based Approach to Sepsis: Educational Program

    Perez, Dolores


    Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most…

  17. Evidence-Based Practices in Outpatient Treatment for Eating Disorders

    Schaffner, Angela D.; Buchanan, Linda Paulk


    This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

  18. Evidence-Based Library Management: The Leadership Challenge

    Lakos, Amos


    This paper is an extension of the author's earlier work on developing management information services and creating a culture of assessment in libraries. The author will focus observations on the use of data in decision-making in libraries, specifically on the role of leadership in making evidence-based decision a reality, and will review new…

  19. Determining Evidence-Based Practices in Special Education

    Cook, Bryan G.; Tankersley, Melody; Landrum, Timothy J.


    Determining evidence-based practices is a complicated enterprise that requires analyzing the methodological quality and magnitude of the available research supporting specific practices. This article reviews criteria and procedures for identifying what works in the fields of clinical psychology, school psychology, and general education; and it…

  20. Evidence Based Education Request Desk. EBE #833A

    Regional Educational Laboratory Southeast, 2011


    Over the past decade, research on dropout prevention has become focused on using evidence-based practice, and data-driven decisions, to mitigate students' dropping out of high school and instead, support and prepare students for career and college. Early warning systems or on-track indicators, in which readily available student-level data are used…

  1. Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

    Huey, Stanley J., Jr.; Polo, Antonio J.


    This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no "well-established" treatments were identified, "probably efficacious" or "possibly efficacious" treatments were found for ethnic minority…

  2. Situational Analysis: A Framework for Evidence-Based Practice

    Annan, Jean


    Situational analysis is a framework for professional practice and research in educational psychology. The process is guided by a set of practice principles requiring that psychologists' work is evidence-based, ecological, collaborative and constructive. The framework is designed to provide direction for psychologists who wish to tailor their…

  3. Evidence-based postoperative pain management after laparoscopic colorectal surgery

    Joshi, G P; Bonnet, F; Kehlet, H


    undergoing laparoscopic colorectal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. The efficacy and adverse effects of the analgesic techniques was assessed. The recommendations were based on procedure-specific evidence from a systematic review and supplementary...

  4. Modeling Sensor Reliability in Fault Diagnosis Based on Evidence Theory.

    Yuan, Kaijuan; Xiao, Fuyuan; Fei, Liguo; Kang, Bingyi; Deng, Yong


    Sensor data fusion plays an important role in fault diagnosis. Dempster-Shafer (D-R) evidence theory is widely used in fault diagnosis, since it is efficient to combine evidence from different sensors. However, under the situation where the evidence highly conflicts, it may obtain a counterintuitive result. To address the issue, a new method is proposed in this paper. Not only the statistic sensor reliability, but also the dynamic sensor reliability are taken into consideration. The evidence distance function and the belief entropy are combined to obtain the dynamic reliability of each sensor report. A weighted averaging method is adopted to modify the conflict evidence by assigning different weights to evidence according to sensor reliability. The proposed method has better performance in conflict management and fault diagnosis due to the fact that the information volume of each sensor report is taken into consideration. An application in fault diagnosis based on sensor fusion is illustrated to show the efficiency of the proposed method. The results show that the proposed method improves the accuracy of fault diagnosis from 81.19% to 89.48% compared to the existing methods.

  5. Improving the evidence for ecosystem-based adaptation

    Reid, Hannah


    Ecosystem-based approaches to adaptation (EBA) integrate the use of biodiversity and ecosystem services into an overall strategy for helping people adapt to climate change. The body of scientific evidence that indicates how effective they are is in some cases lacking but in other cases is dispersed across a range of related fields, such as natural resource management, disaster risk reduction and agroecology, from which it needs to be synthesised. Without presenting and strengthening this evidence in a consolidated way, EBA cannot secure the policy traction at local, national and international levels that it merits.

  6. The personalised medicine: a paradigm of evidence-based medicine

    Dhavendra Kumar


    Full Text Available The practice of "evidence-based medicine" aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the individualised patient care. The clinical genetics evolved from translational genetics research and contributes to the clinical care of patients and families through evidence-based health care in managing inherited disorders through accurate diagnosis, molecular pathology and assessing phenotypic correlations. Translational genetics and genomics research has led to the development of powerful tools for clinical diagnosis, assessing individual's genomic profile for disease prediction/prevention, high-throughput genome-wide screening for predisposition and/or protection to complex medical conditions, and discovery and development of new drugs and vaccines. Gene mapping and deciphering pathogenic mutations have helped in unravelling the basic biological mechanisms leading to new drug discovery and development. Targeted pharmacotherapy is now possible for managing the highly penetrant multi-system dominantly inherited conditions. Notable examples include rapamycin (sirolimus in suppressing the mTOR pathway associated hamartomas in dominantly inherited cancer family syndromes and angiotensin converting enzyme receptor blockers (ACE-RB in preventing aortic dilatation in Marfan syndrome and related familial arteriopathies. The translational genomic research is the essential prerequisite for developing sound evidence-based diagnostic, therapeutic and prognostic clinical protocols for the practice of personalised clinical medicine.

  7. Perfectionism in anorexia nervosa: novel performance based evidence.

    Lloyd, Samantha; Yiend, Jenny; Schmidt, Ulrike; Tchanturia, Kate


    Existing research into perfectionism in Anorexia Nervosa (AN) is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study--81 with a diagnosis of AN and 72 healthy controls (HCs). Participants completed two performance based tasks assessing perfectionism--a text replication task and a bead sorting task--along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36) and produced significantly higher quality copies (p = perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.

  8. [Evidence-based clinical practice guidelines in oral care 2: process and content of evidence-based guideline development

    Mettes, T.G.P.H.; Loveren, C. van; Oirschot, B.A.J.A. van; Maanen-Schakel, N.W. van; Weijden, F.G. van der; Bruers, J.J.


    In 2014, an advisory report was published by a national working committee concerning how the current, applied method of evidence-based guideline development in healthcare can be used in oral care in a national guideline programme. In an independent Institute of Knowledge Translation in Oral Care, as

  9. [Computer work and De Quervain's tenosynovitis: an evidence based approach].

    Gigante, M R; Martinotti, I; Cirla, P E


    The debate around the role of the work at personal computer as cause of De Quervain's Tenosynovitis was developed partially, without considering multidisciplinary available data. A systematic review of the literature, using an evidence-based approach, was performed. In disorders associated with the use of VDU, we must distinguish those at the upper limbs and among them those related to an overload. Experimental studies on the occurrence of De Quervain's Tenosynovitis are quite limited, as well as clinically are quite difficult to prove the professional etiology, considering the interference due to other activities of daily living or to the biological susceptibility (i.e. anatomical variability, sex, age, exercise). At present there is no evidence of any connection between De Quervain syndrome and time of use of the personal computer or keyboard, limited evidence of correlation is found with time using a mouse. No data are available regarding the use exclusively or predominantly for personal laptops or mobile "smart phone".

  10. The relationship between fifth grade students' Understandings about Evidence-Based Explanations and their Abilities to Develop Evidence-Based Explanations

    Ko, Eun Kyung

    The purpose of this study was to investigate how fifth grade students' abilities to develop evidence-based explanations are related to their understandings about evidence-based explanations. A total of 97 fifth graders' understandings about evidence-based explanations and their abilities to develop evidence-based explanations were examined by two open-ended questionnaires and follow-up interviews. The Understandings about Evidence-Based Explanations (UEBE) and the Abilities to Develop Evidence-Based Explanations (ADEE) were developed by the researcher and content validity and face validity were established. Data analysis involved a systematic process consistent with analytic induction as well as a statistical analysis. The patterns from students' understandings about evidence-based explanations and abilities to develop evidence-based explanations were explored and the relationship between understandings and abilities were examined by Fisher's Exact test at the .05 level of significance. Results indicated that there was no relationship between students' understandings about evidence-based explanations and their abilities to develop evidence-based explanations (p>.05). The results of this study do not support the appealing assumption held by many science educators that students' inquiry skills reflect their understandings about scientific inquiry. Instead, the findings suggest that students' understandings about evidence-based explanations should be assessed separately and students' abilities to develop evidence-based explanations should not be inferred by their understandings about evidence-based explanations. Overall, students' understandings about evidence-based explanations were not well developed compared to their abilities to develop evidence-based explanations. Therefore, it is necessary for science educators to teach both understandings about evidence-based explanations and abilities to develop evidence-based explanations.

  11. Modeling of cross-coupling magnetic saturation in signal-injection-based sensorless control of permanent-magnet brushless AC motors

    Li, Y.; Zhu, Z.Q.; Howe, D.; Bingham, Chris


    An improved brushless AC motor model is proposed for use in signal-injection-based sensorless control schemes by accounting for cross-coupling magnetic saturation between the - and -axes. The incremental self- and mutual-inductance characteristics are obtained by both finite-element analysis and measurements, and have been successfully used to significantly reduce the error in the rotor position estimation of sensorless control.

  12. Investigations on the Sensing Mechanism of Humidity Sensors Based on Poly(4-vinylpyridine)/carbon Black Composite by AC Impedance Spectra


    1 Results Investigations on the sensing mechanism is important for understanding the electrical responses of humidity sensors to humidity change,and could provide guidelines for the design and synthesis of humidity sensitive materials with desirable properties.In this work,the sensing mechanism of humidity sensors based on quaternized poly(4-vinylpyridine) (PVP)/carbon black (CB) composite[1] was studied by measuring their AC impedance spectra at various humidities at room temperature.Under low humidity...

  13. Evidence-based therapy for sleep disorders in neurodegenerative diseases

    LIU Ling


    Full Text Available Objective To evaluate the effectiveness of the treatments for sleep disorders in neurodegenerative diseases so as to provide the best therapeutic regimens for the evidence-based treatment. Methods Search PubMed, MEDLINE, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases with "sleep disorder or sleep disturbance", "neurodegenerative diseases", "Parkinson's disease or PD", "Alzheimer's disease or AD", "multiple system atrophy or MSA" as retrieval words. The quality of the articles were evaluated with Jadad Scale. Results A total of 35 articles, including 2 systematic reviews, 5 randomized controlled trials, 13 clinical controlled trials, 13 case series and 2 epidemiological investigation studies were included for evaluation, 13 of which were high grade and 22 were low grade articles. Clinical evidences showed that: 1 advice on sleep hygiene, careful use of dopaminergic drugs and hypnotic sedative agents should be considered for PD. Bright light therapy (BLT may improve circadian rhythm sleep disorders and clonazepam may be effective for rapid eye movement sleep behavior disorder (RBD. However, to date, very few controlled studies are available to make a recommendation for the management of sleep disorders in PD; 2 treatments for sleep disorders in AD include drug therapy (e.g. melatonin, acetylcholinesterase inhibitors, antipsychotic drugs, antidepressants and non-drug therapy (e.g. BLT, behavior therapy, but very limited evidence shows the effectiveness of these treatments; 3 the first line treatment for sleep-related breathing disorder in MSA is nasal continuous positive airway pressure (nCPAP, and clonazepam is effective for RBD in MSA; 4 there is rare evidence related to the treatment of sleep disorders in dementia with Lewy body (DLB and amyotrophic lateral sclerosis (ALS. Conclusion Evidence-based medicine can provide the best clinical evidence on sleep disorders' treatment in neurodegenerative

  14. Evidence based medicine in physical medicine and rehabilitation (German version

    Helmut Kern


    Full Text Available In the last twenty years the term “Evidence Based Medicine (EBM” has been increasingly applied in all areas of medicine and is often used for decision-making in the medical and public health sector. It is also used to verify the significance and/or the effectiveness of different therapies. The original definition of EBM rests on the following three pillars: the physician’s individual expertise, the patient’s needs and the best external evidence. Today, however, the term EBM is often wrongly used as a synonym for best external evidence, without taking into consideration the other two pillars of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions and politicians use external evidence alone as the main guideline for financing therapies and therapy guidelines in physical medicine and general rehabilitation without taking into account the physician’s expertise and the patient’s needs.The wrong interpretation of EBM can lead to the following problems: well established clinical therapies are either questioned or not granted and are therefore withheld from patients (for example physical pain management. An absence of evidence for individual therapy methods does not prove their ineffectiveness! In this short statement the significance of EBM in Physical Medicine and general rehabilitation will be analysed and discussed.

  15. The development of evidence-based guidelines in dentistry.

    Faggion, C M


    Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

  16. How do innovative students fit into evidence-based education?

    Lund, Birthe

    This paper discusses pedagogical contradictions introduced on account of a conflict between the ‘global innovation discourse’ and the development of an ‘evidence discourse’ within the education policy that frames our understanding of “innovative students” in the Nordic countries. Two dominating......, competences and learning outcomes, all based on the assumption that assessing and testing student learning will improve learning, and furthermore, this is done without questioning whether the subject knowledge or competence to be developed are in fact possible to test or evaluate. This discourse is linked...... to evidence-based policy and practice, which is regarded as the new epistemological basis for educational policy. Both educational discourses imply a growing political interest in pedagogy. In order to teach students from kindergarten through to PhD level how to innovate, new collaborations and partnerships...

  17. Establishing CASA as an evidence-based practice.

    Lawson, Jennifer; Berrick, Jill Duerr


    In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.

  18. Standardized Nursing Documentation Supports Evidence-Based Nursing Management.

    Mykkänen, Minna; Miettinen, Merja; Saranto, Kaija


    Nursing documentation is crucial to high quality, effective and safe nursing care. According to earlier studies nursing documentation practices vary and nursing classifications used in electronic patient records (EPR) are not yet standardized internationally nor nationally. A unified national model for documenting patient care improves information flow in nursing practice, management, research and development toward evidence-based nursing care. Nursing documentation quality, accuracy and development requires follow-up and evaluation. An audit instrument is used in the Kuopio University Hospital (KUH) when evaluating nursing documentation. The results of the auditing process suggest that the national nursing documentation model fulfills nurses' expectations of electronic tools, facilitating their important documentation duty. This paper discusses the importance of using information about nursing documentation and how we can take advantage of structural information in evidence-based nursing management.

  19. Multicultural competence and evidence-based practice in group therapy.

    Chen, Eric C; Kakkad, Dhruvi; Balzano, Julie


    The multicultural competence (MC) and evidence-based practice (EBP) initiatives have each generated healthy debates in the mental health field, with ample implications for clinical training and practice. Using two case illustrations, we highlight practical challenges and prospects in the intersection of MC and EBP. To facilitate complementary practice of MC and EBP, we offer strategies for the group therapist as a "local clinical scientist" to deliver culturally responsive treatments. We stress the importance of cultural adaptation of EBP models, namely, modifying evidence-based interventions that involve changes in service delivery, in the nature of the therapeutic relationship, or in components of the treatment itself to accommodate the cultural beliefs and behaviors of racial-cultural minority clients. Cultural adaptation of EBP in group therapy needs to be grounded in developmental contextualism and social justice. We discuss the two cases with an eye toward advancing multicultural competence in group therapy.

  20. Evidence-based medicine in rapidly changing technologies

    Schroeder, T V


    Evidence-based medicine (EBM) is not a randomised controlled trial (RCT), but EBM seeks to apply evidence gained from scientific methods - which could be RCT - to daily medical practice. Any surgical treatment reflects a certain development technically as well as skills based. The procedure may...... be modified and refined and the device may be developed and inherent technical weaknesses may need to be corrected. Therefore the best time to conduct a trial may be discussed. The appropriate time to initiate a RCT is when all the participating surgeons or therapists have gone through their learning curve....... Special considerations should be given in rapidly developing fields. If started too early the resulting comparison will likely turn out to be irrelevant because the new technology is not fully developed, not mastered or the device may have undergone major modifications rendering the results obsolete...

  1. 基于AC/DC数字电源控制器IW1810的LED驱动电路设计%Based on the AC/DC Digital Power Supply Controller IW1810 LED Driver Design

    徐晶; 付贤松; 牛萍娟


    The IW1810 incorporates a 64 kHz controller and a 800 V BJT. The device uses the numerical control technology and operates in quasi-resonant mode to provide current and output overvoltage protection, while minimizing the external component count and ensuring the high efficiency, no load power is less than 100 mW. Based on IW1810 designed a highly integrated,high efficient and constant current AC/DC LED driver circuit was designed. The circuit operates at 90 V to 264 V wide voltage range,output current is 340 mA,output power is 4 W, efficiency up to 80%,the area of the designed source is only 18 mm×38 mm.%IW1810集成了一个64 kHz的PWM控制器和一个800 V的BJT,该芯片采用数控技术,工作在准谐振模式,提供过流和输出过压保护,简化外围元件确保电路的高效性,无载功率小于100 mW。设计一款基于IW1810高度集成、高效恒流的AC/DC LED驱动电路,电路工作在90 V到264 V的宽电压范围内,输出恒流340 mA,输出功率为4 W,效率高达80%以上,电路板面积仅为18 mm×38 mm。

  2. Cochrane Lecture 1997. What evidence do we need for evidence based medicine?

    Hart, J T


    As presently understood, evidence based medicine aims to advance practice from its traditional unverifiable mix of art and science to rational use of measurable inputs and outputs. In practice, however, its advocates accept uncritically a desocialised definition of science, assume that major clinical decisions are taken at the level of secondary specialist rather than primary generalist care, and ignore the multiple nature of most clinical problems, as well as the complexity of social problems within which clinical problems arise and have to be solved. These reductionist assumptions derive from the use of evidence based medicine as a tool for managed care in a transactional model for consultations. If these assumptions persist, they will strengthen reification of disease and promote the episodic output of process regardless of health outcome. We need to work within a different paradigm based on development of patients as co-producers rather than consumers, promoting continuing output of health gain through shared decisions using all relevant evidence, within a broader, socialised definition of science. Adoption of this model would require a major social and cultural shift for health professionals. This shift has already begun, promoted by changes in public attitudes to professional authority, changes in the relation of professionals to managers, and pressures for improved effectiveness and efficiency which, contrary to received wisdom, seem more likely to endorse cooperative than transactional clinical production. Progress on these lines is resisted by rapidly growing and extremely powerful economic and political interests. Health professionals and strategists have yet to recognise and admit the existence of this choice.

  3. Evidence-based practice: management of adult sensorineural hearing loss.

    Chau, Justin K; Cho, John J W; Fritz, Dieter K


    Sensorineural hearing loss is a complex disease state influenced by genetics, age, noise, and many other factors. This article reviews our current knowledge regarding the causes of sensorineural hearing loss and reviews the more challenging clinical presentations of sensorineural hearing loss. We have reviewed the latest medical literature in an attempt to provide an evidence-based strategy for the assessment and management of sudden sensorineural hearing loss, rapidly progressive sensorineural hearing loss, and asymmetric/unilateral sensorineural hearing loss.

  4. Social media, evidence-based tweeting, and JCEHP.

    Djuricich, Alexander M


    Medical practice and medical journals must adapt to a constantly changing environment, in which social media plays an ever-increasing role. Social media platforms such as Twitter can provide an opportunity to disseminate information in innovative ways. The concept of evidence-based tweeting is introduced, especially as "tweeting the meeting" continues to expand within medical conferences and other venues important for continuing education for health care providers. Future social media strategies for the journal are outlined.

  5. Clinical Evidence: a useful tool for promoting evidence-based practice?

    Addis Antonio


    Full Text Available Abstract Background Research has shown that many healthcare professionals have problems with guidelines as they would prefer to be given all relevent information relevent to decision-making rather than being told what they should do. This study assesses doctors' judgement of the validity, relevance, clarity and usability of the Italian translation of Clinical Evidence (CE after its free distribution launched by the Italian Ministry of Health Methods Opinions elicited using a standardised questionnaire delivered either by mail or during educational or professional meetings Results Twenty percent (n = 1350 doctors participated the study. Most of them found CE's content valid, useful and relevant for their clinical practice, and said CE can foster communications among clinicians, particularly among GPs and specialists. Hospital doctors (63% more often than GPs (48% read the detailed presentation of individual chapters. Twenty-nine percent said CE brought changes in their clinical practice. Doctors appreciated CE's nature of an evidence-based information compendium and would have not preferred a collection of practice guidelines. Conclusions Overall, the pilot initiative launched by the Italian Ministry of Health seems to have been well received and to support the subsequent decision to make the Italian edition of Clinical Evidence concise available to all doctors practising in the country. Local implementation initiatives should be warranted to favour doctor's use of CE.

  6. Invasive candidiasis in the ICU: evidence based and on the edge of evidence.

    Hollenbach, Eike


    Invasive candidiasis is a common nosocomial infection among critically ill patients, constitutes an important cause of sepsis, and is associated with significant morbidity and mortality. The Infectious Diseases Society of America (IDSA) has created evidence-based guidelines for the management of invasive candidiasis. However, several new antifungal agents with excellent activity against Candida spp. and favourable safety profiles have been introduced successfully in the clinical setting since the IDSA guidelines were published in late 2003. Further, the role of antifungals is not entirely clear in the intensive care unit (ICU) setting. Therefore, this article discusses daily problems in the prophylaxis and treatment of invasive candidasis in interdisciplinary ICUs.

  7. AC bias characterization of low noise bolometers for SAFARI using an Open-Loop Frequency Domain SQUID-based multiplexer operating between 1 and 5 MHz

    Gottardi, Luciano; Gao, Jan-R; Hartog, Roland den; Hijmering, Richard; Hoevers, Henk; Khosropanah, Pourya; de Korte, Piet; van der Kuur, Jan; Lindeman, Mark; Ridder, Marcel


    SRON is developing the Frequency Domain Multiplexing (FDM) readout and the ultra low NEP TES bolometers array for the infrared spectrometer SAFARI on board of the Japanese space mission SPICA. The FDM prototype of the instrument requires critical and complex optimizations. For single pixel characterization under AC bias we are developing a simple FDM system working in the frequency range from 1 to 5 MHz, based on the open loop read-out of a linearized two-stage SQUID amplifier and high Q lithographic LC resonators. We describe the details of the experimental set-up required to achieve low power loading (< 1 fW) and low noise (NEP $\\sim 10^{-19} W/Hz^{1/2}$) in the TES bolometers. We conclude the paper by comparing the performance of a $4 \\cdot 10^{-19} W/Hz^{1/2}$ TES bolometer measured under DC and AC bias.

  8. Conventional P-ω/Q-V Droop Control in Highly Resistive Line of Low-Voltage Converter-Based AC Microgrid

    Hou, Xiaochao; Sun, Yao; Yuan, Wenbin


    In low-voltage converter-based alternating current (AC) microgrids with resistive distribution lines, the P-V droop with Q-f boost (VPD/FQB) is the most common method for load sharing. However, it cannot achieve the active power sharing proportionally. To overcome this drawback, the conventional P......-ω/Q-V droop control is adopted in the low-voltage AC microgrid. As a result, the active power sharing among the distributed generators (DGs) is easily obtained without communication. More importantly, this study clears up the previous misunderstanding that conventional P-ω/Q-V droop control is only applicable...... to microgrids with highly inductive lines, and lays a foundation for the application of conventional droop control under different line impedances. Moreover, in order to guarantee the accurate reactive power sharing, a guide for designing Q-V droop gains is given, and virtual resistance is adopted to shape...

  9. 基于DDS技术的交流恒流源设计%Design of AC constant current source based on DDS

    黄怡然; 李娜


    The design and the implement method of AC constant current source with the ML2035 sine signal generator based on DOS was introduced in this paper, the AC constant current source was a closed-loop control system, and current negative feedback loop circuit. The testing results show the output current is between 100-200 mA.%介绍了运用直接数字合成技术( DDS )研制的ML2035正弦信号发生器来实现交流恒流源的设计思想和实现方法.该恒流源是一闭环控制系统、电流负反馈电路,测试结果表明,输出电流在100~ 200 mA范围内.

  10. Community Education and Evidence-based Knowledge Use

    N mohaghegh


    Full Text Available Introduction: Utilizing as well as transferring knowledge can be provided via motivating teachers, educating researchers, better utilizing of evidence and creating communication between members of the scientific communities based on the needs of the community and community education. Therefore, the present study mainly aimed at evaluating the process of knowledge production and use of evidence in the research centres of Tehran and Iran University of Medical Sciences. Moreover, this study intended to investigate its application in improving the health system and community education of students.   Methods: In this descriptive cross-sectional study, the study population finally consisted of 68 research centres affiliated to Tehran and Iran University of Medical Sciences. In order to glean the study data, a questionnaire was utilized by Nejat et al. in two fields of “knowledge production” and “promote using of evidence”, and the study data were analyzed using SPSS (version 18.   Results: The production and use of knowledge status in Tehran and Iran medical universities in regard with “knowledge and evidence production” used in decision-making was reported in a favourable condition. Moreover, an unfavourable condition was revealed regarding “promoting use of evidence” which needs proper intervention.   Conclusion: The study finding revealed that at the beginning of the formulation of each research, identifying the specific audience of the study results causes the produced evidence and knowledge to be applicable. This leads to conducting research in accordance with the needs of community. As a result, status of medical universities in Iran necessitates to be reviewed. Ameliorating production status and promoting evidence-based knowledge can lead to a significant qualitative development in community education.

  11. Conventional P-ω/Q-V Droop Control in Highly Resistive Line of Low-Voltage Converter-Based AC Microgrid

    Xiaochao Hou


    Full Text Available In low-voltage converter-based alternating current (AC microgrids with resistive distribution lines, the P-V droop with Q-f boost (VPD/FQB is the most common method for load sharing. However, it cannot achieve the active power sharing proportionally. To overcome this drawback, the conventional P-ω/Q-V droop control is adopted in the low-voltage AC microgrid. As a result, the active power sharing among the distributed generators (DGs is easily obtained without communication. More importantly, this study clears up the previous misunderstanding that conventional P-ω/Q-V droop control is only applicable to microgrids with highly inductive lines, and lays a foundation for the application of conventional droop control under different line impedances. Moreover, in order to guarantee the accurate reactive power sharing, a guide for designing Q-V droop gains is given, and virtual resistance is adopted to shape the desired output impedance. Finally, the effects of power sharing and transient response are verified through simulations and experiments in converter-based AC Microgrid.

  12. AC Electrokinetics of Physiological Fluids for Biomedical Applications.

    Lu, Yi; Liu, Tingting; Lamanda, Ariana C; Sin, Mandy L Y; Gau, Vincent; Liao, Joseph C; Wong, Pak Kin


    Alternating current (AC) electrokinetics is a collection of processes for manipulating bulk fluid mass and embedded objects with AC electric fields. The ability of AC electrokinetics to implement the major microfluidic operations, such as pumping, mixing, concentration, and separation, makes it possible to develop integrated systems for clinical diagnostics in nontraditional health care settings. The high conductivity of physiological fluids presents new challenges and opportunities for AC electrokinetics-based diagnostic systems. In this review, AC electrokinetic phenomena in conductive physiological fluids are described followed by a review of the basic microfluidic operations and the recent biomedical applications of AC electrokinetics. The future prospects of AC electrokinetics for clinical diagnostics are presented.

  13. Evidence-based practice in times of drug shortage.

    de Lemos, Mário L; Waignein, Sally; de Haan, Marie


    Shortage of oncology drugs is a particularly complicated issue because there are usually limited therapeutic options. Moreover, oncology practice may employ medications for supportive indications which differ from their main usage. This means shortage of oncology drugs is not usually addressed by the major drug shortage guidelines. We have previously shown that, during a shortage crisis, it is possible to make a recommendation on the use of an expired drug supply based on a reasonable estimate of its safety and efficacy. Here, we would like to share further examples on how to deduce potential therapeutic alternatives based on pharmacokinetic and pharmacodynamic principles in the absence of direct clinical evidence in the literature.

  14. An Evidence-Based Videotaped Running Biomechanics Analysis.

    Souza, Richard B


    Running biomechanics play an important role in the development of injuries. Performing a running biomechanics analysis on injured runners can help to develop treatment strategies. This article provides a framework for a systematic video-based running biomechanics analysis plan based on the current evidence on running injuries, using 2-dimensional (2D) video and readily available tools. Fourteen measurements are proposed in this analysis plan from lateral and posterior video. Identifying simple 2D surrogates for 3D biomechanic variables of interest allows for widespread translation of best practices, and have the best opportunity to impact the highly prevalent problem of the injured runner.

  15. Implementation of evidence-based practice and organizational performance.

    Hovmand, Peter S; Gillespie, David F


    Administrators of mental health services may expect evidence-based practice (EBP) to offer strategic benefits. Existing theory suggests that the benefits of implementing EBP vary by organizational characteristics. This paper presents a conceptual framework for considering how implementation impacts organizational performance. The framework is developed as a system dynamics simulation model based on existing literature, organizational theory, and key informant interviews with mental health services administrators and clinical directors. Results from the simulations show how gains in performance depended on organizations' initial inertia and initial efficiency and that only the most efficient organizations may see benefits in organizational performance from implementing EBP. Implications for administrators, policy makers, and services researchers are discussed.

  16. Neuropsychology 3.0: evidence-based science and practice.

    Bilder, Robert M


    Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift toward evidence-based science and practice can be enabled by innovations, including (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of Web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress toward these goals.

  17. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

    Meredith Harrell


    Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

  18. Evidence-based practice recommendations for memory rehabilitation.

    Piras, F; Borella, E; Incoccia, C; Carlesimo, G A


    Memory impairment is a common consequence of neurological injury or disease, causing significant disability in everyday life, and is therefore a critical target for rehabilitation intervention. Here we report a review of the available evidence on the efficacy of restitution-oriented therapies and compensatory approaches for memory rehabilitation. A total of 110 studies was systematically classified and analyzed in order to generate evidence-based clinical recommendations for treatment providers. Different key aspects, such as types of brain damage, treatments characteristics and outcome measurements guided the evaluation of the literature as to appraise the potential interaction between patients characteristics, interventions and outcomes. The general conclusion is that memory re-training programs and compensatory approaches are probably effective in ameliorating memory disorders in patients with focal brain lesions, with some evidences of changes in memory functioning extending beyond the trained skills. Externally directed assistive devices and specific learning strategies are effective (with a level D and B of evidence, respectively) in retaining information relevant for daily needs also in patients with degenerative diseases. Some methodological concerns, such as the heterogeneity of subjects, interventions and outcomes studied, may limit the generalization of the present recommendations.

  19. Integration of Evidence Base into a Probabilistic Risk Assessment

    Saile, Lyn; Lopez, Vilma; Bickham, Grandin; Kerstman, Eric; FreiredeCarvalho, Mary; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei


    INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list

  20. Is evidence-based medicine so evident in veterinary research and practice? History, obstacles and perspectives.

    Vandeweerd, Jean-Michel; Kirschvink, Nathalie; Clegg, Peter; Vandenput, Sandrine; Gustin, Pascal; Saegerman, Claude


    Evidence-based medicine (EBM) refers to the conscientious, explicit and judicious use of current best evidence from research for the care of an individual patient. The concept of EBM was first described in human medicine in the early 1990s and was introduced to veterinary medicine 10 years later. However, it is not clear that the EBM approach promulgated in human medicine can be applied to the same extent to veterinary medicine. EBM has the potential to help veterinarians to make more informed decisions, but obstacles to the implementation of EBM include a lack of high quality patient-centred research, the need for basic understanding of clinical epidemiology by veterinarians, the absence of adequate searching techniques and accessibility to scientific data bases and the inadequacy of EBM tools that can be applied to the busy daily practise of veterinarians. This review describes the development of EBM in the veterinary profession, identifies its advantages and disadvantages and discusses whether and how veterinary surgeons should further adopt the EBM approach of human medicine.

  1. Psicanálise baseada em evidências? Evidence-based psychoanalysis?

    Liana Albernaz de Melo Bastos


    Full Text Available A partir da discussão sobre a eficácia da psicanálise, a autora considera necessário o diálogo com as neurociências e a psicofarmacologia. Aponta como o critério de eficácia, entendido pela medicina baseada em evidências, apaga a dimensão da narratividade e, conseqüentemente, da subjetividade. Apresenta uma vinheta de um atendimento emergencial no Hospital Universitário Clementino Fraga Filho como possibilidade de se manter a escuta psicanalítica no atendimento psiquiátrico.Based on the discussion concerning the efficacy of psychoanalysis, the author considers the need to engage in dialogue with the neurosciences and psychopharmacology. She indicates how the criterion of efficacy, as defined by evidence-based medicine, erases the dimension of the narrative and consequently that of subjectivity. She presents as a vignette an emergency case at the Clementino Fraga Filho University Hospital in Rio de Janeiro, illustrating the possibility of maintaining psychoanalytic listening in psychiatric treatment.

  2. Integration of evidence based medicine into a medical curriculum.

    Tamim, H M; Ferwana, M; Al Banyan, E; Al Alwan, I; Hajeer, A H


    The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was established in January 2004. The four-year curriculum was based on the Problem Based Learning (PBL) format and involved the web-based graduate medical program adopted from the University of Sydney, Australia. At KSAU-HS, one additional semester was added to the beginning of this curriculum to prepare the students in English language skills, PBL, Information Technology and Evidence Based Medicine (EBM). EBM is part of the Personal and Professional Development (PPD) theme of the medical curriculum and is integrated into each stage of the medical curriculum. These modifications of the University of Sydney curriculum are presented here as a model of EBM integration into a college of medicine curriculum.

  3. Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50.

    Aarons, Gregory A; Cafri, Guy; Lugo, Lindsay; Sawitzky, Angelina


    Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61-74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.

  4. Definition of drug-resistant epilepsy: is it evidence based?

    Wiebe, Samuel


    Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition.

  5. Evidence-based reform of teaching and learning.

    Cooper, Melanie M


    Over the years a great deal of time and attention has been devoted to reform of teaching and learning in chemistry. However, many of these efforts have focused on individual faculty's experiences and intuition, rather than our understanding of how people learn or evidence about the effects of such reforms. For example, while it is widely known that students emerge from our courses with non-scientific ideas about core concepts, the reasons why this happens are often ascribed to the students' lack of ability or work ethic. However, there is emerging evidence that both the traditional pedagogical approach and the structure of the curriculum contribute to this problem. Students must be provided both with a strong foundation on which to build and link new knowledge, and an understanding of what that knowledge will be used for. In order to achieve this we need to rely on the research base and evidence emerging from discipline-based education research (DBER)-a field that combines deep disciplinary expertise with knowledge and understanding of the science of teaching and learning. This paper presents a short overview of these ideas.

  6. Evidence-based medicine: what it can and cannot do

    Goffredo Freddi


    Full Text Available Evidence-based medicine (EBM is not a old hat, a "cookbook" medicine perpetrated by arrogant to serve cost cutters to suppress clinical freedom, a mandatory, deterministic, totalitarian practice of medicine, a way to control cost and to ignore patient preferences, a limit to personal/humanistic/individual medicine. EBM is a reference of excellence to guide clinical decisions, the integration of own expertise with others' expertise and patient preferences, a way to improve medical practice and limit the variability and errors created when there is not evidence to identify the gold standard and differentiate among alternatives available. But evidences need to be integrated with a new thinking based on Complexity Science. Health care systems operates as complex adaptative systems rather than rigid, linear or mechanical organizations and innovation is a critical outcome of Complexity Science. How does EBM impact drug innovation? New drug approvals are not keeping pace with rising Research and Development spending, clinical approval success rate for new chemical entities (NCEs is progressively dropping and maybe, through these indicators, we are seeing the worst face of EBM: its limiting, blocking, and controlling side. If that is the case, EBM is the main ally to keep the economy of health systems under control and the great excuse to block the access of the innovation to patients. Certainly not the best way to maximize the benefits of EBM.

  7. Managing evidence-based health care: a diagnostic framework.

    Newman, K; Pyne, T; Cowling, A


    This paper proposes a diagnostic framework useful to Trust managers who are faced with the task of devising and implementing strategies for improvements in clinical effectiveness, and is based on a recent study incorporating clinicians, managers, and professional staff in four NHS Trusts in the North Thames Region. The gap framework is inspired by the gap model developed by Zeithaml, Parasuraman and Berry from their research into service quality and incorporates Dave Sackett's schema as well as a personal competency profile needed for the practice of evidence based health-care (EBHC). The paper highlights the four organisational and personal failures (gaps) which contribute to the fifth gap, namely the discrepancy between clinically relevant research evidence and its implementation in health care. To close the gaps, Trusts need to set the goal and tackle the cultural, organisational, attitudinal and more material aspects such as investment in the information infrastructure, education and training of doctors. Doctors need to go through a process from awareness to action facilitated through a combination of personal and organisational incentives and rewards as well as training in the requisite skills. Researchers should take steps to improve the quality of the evidence and its accessibility and purchasers should reinforce the use of EBHC by withdrawing funding for care which has proved to be ineffective, inappropriate or inferior.

  8. Evidence-Based Redesign of the COMLEX-USA Series.

    Gimpel, John R; Horber, Dorothy; Sandella, Jeanne M; Knebl, Janice A; Thornburg, John E


    To ensure that the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) reflects the evolving practice of osteopathic medicine, the National Board of Osteopathic Medical Examiners has developed new content and format specifications for an enhanced, competency-based examination program to be implemented with COMLEX-USA Level 3 in 2018. This article summarizes the evidence-based design processes that served as the foundation for blueprint development and the evidence supporting its validity. An overview is provided of the blueprint's 2 dimensions: Competency Domains and Clinical Presentations. The authors focus on the evidence that supports interpretation of test scores for the primary and intended purpose of COMLEX-USA, which is osteopathic physician licensure. Important secondary uses and the educational and catalytic effect of assessments are also described. This article concludes with the National Board of Osteopathic Medical Examiners' plans to ensure that the COMLEX-USA series remains current and meets the needs of its stakeholders-the patients who seek care from osteopathic physicians.

  9. Management of the infertile couple: an evidence-based protocol

    Kamel Remah M


    Full Text Available Abstract Background Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female factor such as ovulation dysfunction and tubal pathology, combined male and female factors and unexplained infertility. Objectives The aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload. Methods A comprehensive review where the literature was searched for "Management of infertility and/or infertile couples" at library website of University of Bristol (MetaLib by using a cross-search of different medical databases besides the relevant printed medical journals and periodicals. Guidelines and recommendations were retrieved from the best evidence reviews such as that from the American College of Obstetricians and Gynaecologists (ACOG, American Society for Reproductive Medicine (ASRM, Canadian Fertility and Andrology Society (CFAS, and Royal College of Obstetricians and Gynaecologists (RCOG. Results A simple guide for the clinicians to manage the infertile couples. Conclusions The study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. It is an approach to disseminate the recommended medical care for infertile couple to the practicing clinicians.

  10. Rural hospital web-based, evidence-based practice professional development: challenges and opportunities.

    Oman, Kathleen S; Fink, Regina M; Krugman, Mary; Goode, Colleen J; Traditi, Lisa K


    To provide quality patient care and achieve positive patient outcomes, it is widely recognized that organizations must develop a supportive environment that encourages individuals to practice from a research- and evidence-based framework. This article describes a Web-based professional educational program designed to teach principles of evidence-based practice to nurses in rural hospitals. Nurses working in staff development will find this useful for designing educational programs for staff in rural hospitals.

  11. Original research in pathology: judgment, or evidence-based medicine?

    Crawford, James M


    Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has been given to testing accuracy and precision. Critical examination of the evidence base supporting the clinical use of specific laboratory tests or technologies is a separate endeavor, to which specific attention must be given. In the case of anatomic pathology and more specifically surgical pathology, the expertise required to render a diagnosis is derived foremost from experience, both personal and literature-based. In the first instance, knowledge of the linkage between one's own diagnoses and individual patient outcomes is required, to validate the role of one's own interpretations in the clinical course of patients. Experience comes from seeing this linkage first hand, from which hopefully comes wisdom and, ultimately, good clinical judgment. In the second instance, reading the literature and learning from experts is required. Only a minority of the relevant literature is published in pathology journals to which one may subscribe. A substantial portion of major papers relevant to the practice of anatomic pathology are published in collateral clinical specialty journals devoted to specific disease areas or organs. Active effort is therefore required to seek out the literature beyond the domain of pathology journals. In examining the published literature, the essential question then becomes: Does the practice of anatomic pathology fulfill the tenets of 'evidence-based medicine' (EBM)? If the pinnacle of EBM is 'systematic review of randomized clinical trials, with or without meta-analysis', then anatomic pathology falls far short. Our published

  12. Cognitive maturity and readiness for evidence-based nursing practice.

    Nickerson, Carolyn J; Thurkettle, Mary Ann


    Individual factors are known to influence engagement in research utilization and evidence-based practice (EBP). Cognitive maturity is one factor that may enhance interest in and willingness to engage in clinical inquiry, research utilization, and EBP. Adult cognitive development theory explains why research training alone may not suffice to prepare nurses for EBP. Epistemic assumptions held by pre-reflective and quasireflective thinkers interfere with openness to uncertainty and ambiguity in practice and accurate understanding of the value of research for practice. Nurses may use good formal logic, but they also believe in authority, or revealed truth, as the criterion for knowledge and sometimes fail to perceive the need to evaluate evidence. Developmentally oriented educational efforts informed by the reflective judgment model have the potential to foster the cognitive development required in students of EBP. Further inquiry into the relationship between cognitive maturity and EBP will enhance these educational efforts.

  13. Evidence-Based Parenting Interventions to Promote Secure Attachment

    Wright, Barry; Edginton, Elizabeth


    Various interventions are used in clinical practice to address insecure or disorganized attachment patterns and attachment disorders. The most common of these are parenting interventions, but not all have a robust empirical evidence base. We undertook a systematic review of randomized trials comparing a parenting intervention with a control, where these used a validated attachment instrument, in order to evaluate the clinical and cost-effectiveness of interventions aiming to improve attachment in children with severe attachment problems (mean age <13 years). This article aims to inform clinicians about the parenting interventions included in our systematic review that were clinically effective in promoting secure attachment. For completeness, we also briefly discuss other interventions without randomized controlled trial evidence, identified in Patient Public Involvement workshops and expert groups at the point our review was completed as being used or recommended. We outline the key implications of our findings for clinical practice and future research. PMID:27583298

  14. [Evidence-based therapy of polycystic ovarian syndrome].

    Gődény, Sándor; Csenteri, Orsolya Karola


    Polycystic ovary syndrome is recognized as the most common hormonal and metabolic disorder likely to affect women. The heterogeneous endocrinopathy is characterized by clinical and/or biochemical hyperandrogenism, oligo- or amenorrhoea, anovulatory infertility, and polycystic ovarian morphology. The syndrome is often associated with obesity, hyperinsulinemia and adversely affects endocrine, metabolic, and cardiovascular health. The symptoms and complaint of the patients vary with age. To maximise health gain of the syndrome, adequate, evidence based effective, efficient and safe treatment is necessary. This article summarises the highest available evidence provided by studies, meta-analysis and systematic reviews about the therapeutical possibilities for treating obesity, hyperandrogenism, menstrual abnormalities, infertility and psychological problems related to polycystic ovary syndrome.

  15. Structural and frequency dependencies of a.c. and dielectric characterizations of epitaxial InSb-based heterojunctions



    In this work, heterojunction of InSb/InP was grown by liquid phase epitaxy (LPE). Surface morphology and crystalline structure of the heterojunction were characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD). The frequency and temperature dependences of a.c. conductivity and dielectric properties of the heterojunctions were investigated in the ranges of 100 kHz–5 MHz and 298–628 K, respectively. The a.c. conductivity and its frequency exponents were interpreted in terms of correlated barrier hopping model (CBH), as the dominant conduction mechanism for charge carrier transport. The calculated activation energy, from the Arrhenius plot, was found to decrease with increasing frequency. Experimental results of both dielectric constant $\\epsilon_1$ and dielectric loss $\\epsilon_2$ showed a remarkable dependence of both frequency and temperature.

  16. Research on Suction Properties of AC Electromagnet Based on Ansoft%基于Ansoft的交流电磁铁吸力特性研究

    徐承韬; 焦禹; 蔡胜年; 秦然; 梁禹; 庞宝麟


    以吸入式交流电磁铁为研究对象,使用有限元分析软件Ansoft对交流电磁铁的电磁吸力特性进行仿真研究,深入分析分磁环对电磁吸力的影响、电磁铁平均吸力的变化趋势及影响因素以及电磁铁工作过程中各部分产生的涡流对电磁力的影响,并针对仿真计算结果与实验结果进行对比分析.%Finite element analysis can be used as an effective tool for study of AC electromagnet.Suction properties of AC electromagnet were investigated based on Ansoft software.The instantaneous armature force and time average armature forces at different conditions were simulated.The effect of eddy currents in the shading ring and other part of AC electromagnet was discussed.The simulation results of armature force were compared with experimental values.

  17. Developing research competence to support evidence-based practice.

    Burke, Lora E; Schlenk, Elizabeth A; Sereika, Susan M; Cohen, Susan M; Happ, Mary Beth; Dorman, Janice S


    This article describes one step in the process that was undertaken to prepare for the introduction of evidence-based practice (EBP) into the curriculum across the Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Philosophy programs, as well as the programs that were under development, Clinical Nurse Leader and Doctor of Nursing Practice, at the University of Pittsburgh School of Nursing. Expected research competencies were identified for each level or academic year within each program. Based on these competencies, recommendations on how to modify the curriculum into one that would support students' acquisition and development of the skills necessary to be successful in matriculating through an EBP curriculum were developed. Evaluation mechanisms for the achievement of these competencies vary across the academic programs and will include performance on capstone projects, comprehensive examinations, and program milestones for doctoral students. The establishment of evidence-based competencies provided a foundation for the development of new teaching approaches and the curricular revisions across the three academic programs. Thus, the University of Pittsburgh model of educating for EBP is based on a sequential layering of research competencies throughout the curriculum.

  18. Magnetic nanobeads present during enzymatic amplification and labeling for a simplified DNA detection protocol based on AC susceptometry

    Rebecca S. Bejhed


    Full Text Available Magnetic biosensors are promising candidates for low-cost point-of-care biodiagnostic devices. For optimal efficiency it is crucial to minimize the time and complexity of the assay protocol including target recognition, amplification, labeling and read-out. In this work, possibilities for protocol simplifications for a DNA biodetection principle relying on hybridization of magnetic nanobeads to rolling circle amplification (RCA products are investigated. The target DNA is recognized through a padlock ligation assay resulting in DNA circles serving as templates for the RCA process. It is found that beads can be present during amplification without noticeably interfering with the enzyme used for RCA (phi29 polymerase. As a result, the bead-coil hybridization can be performed immediately after amplification in a one-step manner at elevated temperature within a few minutes prior to read-out in an AC susceptometer setup, i.e. a combined protocol approach. Moreover, by recording the phase angle ξ = arctan(χ″/χ′, where χ and χ″ are the in-phase and out-of-phase components of the AC susceptibility, respectively, at one single frequency the total assay time for the optimized combined protocol would be no more than 1.5 hours, often a relevant time frame for diagnosis of cancer and infectious disease. Also, applying the phase angle method normalization of AC susceptibility data is not needed. These findings are useful for the development of point-of-care biodiagnostic devices relying on bead-coil binding and magnetic AC susceptometry.

  19. Magnetic nanobeads present during enzymatic amplification and labeling for a simplified DNA detection protocol based on AC susceptometry

    Bejhed, Rebecca S.; Strømme, Maria; Svedlindh, Peter; Ahlford, Annika; Strömberg, Mattias


    Magnetic biosensors are promising candidates for low-cost point-of-care biodiagnostic devices. For optimal efficiency it is crucial to minimize the time and complexity of the assay protocol including target recognition, amplification, labeling and read-out. In this work, possibilities for protocol simplifications for a DNA biodetection principle relying on hybridization of magnetic nanobeads to rolling circle amplification (RCA) products are investigated. The target DNA is recognized through a padlock ligation assay resulting in DNA circles serving as templates for the RCA process. It is found that beads can be present during amplification without noticeably interfering with the enzyme used for RCA (phi29 polymerase). As a result, the bead-coil hybridization can be performed immediately after amplification in a one-step manner at elevated temperature within a few minutes prior to read-out in an AC susceptometer setup, i.e. a combined protocol approach. Moreover, by recording the phase angle ξ = arctan(χ″/χ'), where χ and χ″ are the in-phase and out-of-phase components of the AC susceptibility, respectively, at one single frequency the total assay time for the optimized combined protocol would be no more than 1.5 hours, often a relevant time frame for diagnosis of cancer and infectious disease. Also, applying the phase angle method normalization of AC susceptibility data is not needed. These findings are useful for the development of point-of-care biodiagnostic devices relying on bead-coil binding and magnetic AC susceptometry.

  20. Surgical treatment of hepatocellular carcinoma:Evidence-based outcomes

    Shintaro Yamazaki; Tadatoshi Takayama


    Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing.In the top nine surgical journals in 1996,half of the 175publications refer to pilot studies lacking a control group,18% to animal experiments,and only 5% to randomized controlled trials (RCT).There are five levels of clinical evidence:level 1 (randomized controlled trial),level 2 (prospective concurrent cohort study),level 3 (retrospective historical cohort study),level 4(pre-post study),and level 5 (case report).Recently,a Japanese evidence-based guideline for the surgical treatment of hepatocellular carcinoma (HCC) was made by a committee (Chairman,Professor Makuuchi and five members).We searched the literature using the Medline Dialog System with four keywords:HCC,surgery,English papers,in the last 20 years.A total of 915 publications were identified systematically reviewed.At the first selection (in which surgery-dominant papers were Selected),478 papers survived.In the second selection (clearly concluded papers),181 papers survived.In the final selection (clinically significant papers),100 papers survived.The evidence level of the 100 surviving papers is shown here:level-1 papers (13%),level-2 papers (11%),level-3 papers (52%),and level-4 papers (24%);therefore,there were 24% prospective papers and 76%retrospective papers.Here,we present a part of the guideline on the five main surgical issues:indication to operation,operative procedure,peri-operative care,prognostic factor,and post-operative adjuvant therapy.


    Hong-Zhong Huang


    . Possibility and evidence theory-based reliability methods have many advantages for practical engineering when compared with traditional probability-based reliability methods. They can work well under limited data while the latter need large amounts of information, more than possible in engineering practice due to aleatory and epistemic uncertainties. The possible directions for future work are summarized.

  2. Pulse doubling in zigzag-connected autotransformer-based 12-pulse ac-dc converter for power quality improvement

    Abdollahi, Rohollah


    This paper presents a pulse doubling technique in a 12-pulse ac-dc converter which supplies direct torque controlled motor drives (DTCIMDs) in order to have better power quality conditions at the point of common coupling. The proposed technique increases the number of rectification pulses without significant changes in the installations and yields in harmonic reduction in both ac and dc sides. The 12-pulse rectified output voltage is accomplished via two paralleled six-pulse acdc converters each of them consisting of three-phase diode bridge rectifiers. An autotransformer is designed to supply the rectifiers. The design procedure of magnetics is in a way such that makes it suitable for retrofit applications where a six-pulse diode bridge rectifier is being utilized. Independent operation of paralleled diode-bridge rectifiers, i.e. dc-ripple re-injection methodology, requires a Zero Sequence Blocking Transformer (ZSBT). Finally, a tapped interphase reactor is connected at the output of ZSBT to double the pulse numbers of output voltage up to 24 pulses. The aforementioned structure improves power quality criteria at ac mains and makes them consistent with the IEEE-519 standard requirements for varying loads. Furthermore, near unity power factor is obtained for a wide range of DTCIMD operation. A comparison is made between 6-pulse, 12-pulse, and proposed converters from view point of power quality indices. Results show that input current total harmonic distortion (THD) is less than 5% for the proposed topology at various loads.

  3. Direct Power Control Based Single-Phase AC-DC Converter Controller Design%基于直接功率控制的单相AC-DC变流器控制器设计

    马庆安; 李群湛; 邱大强; 徐英雷; 张丽艳


    Single-phase AC-DC full-bridge converter is popular in industry. The aβ-coordinate model was setup for the single-phase system via delaying variables by 90°. Controller was designed based on direct power control. The two-degree-of-freedom PI controller was utilized in this paper to increase the robustness of the system and decrease the overshoot, and sampled voltages were modified to improve the performance. Simulation was conducted based on PSCAD/EMTDC, the results verify the feasibility.%将单相系统延迟90°得到αβ坐标系二相系统,并由此建立了单相变流器的数学模型。基于直接功率控制设计了单相变流器控制系统。提出电压外环使用二自由度PI控制器以提高控制系统的鲁棒性并降低系统启动过程中的超调量,对可能影响系统性能的采样电压进行了修正。最后基于PSCAD/EMTDC的仿真分析验证了方案的可行性。

  4. Impact of an acute coronary syndrome pathway in achieving target heart rate and utilization of evidence-based doses of beta-blockers.

    Irani, Farzan; Herial, Nabeel; Colyer, William R


    Beta-blockers remain a cornerstone of therapy in the management of acute coronary syndrome (ACS). The 2007 American College of Cardiology/American Heart Association unstable angina/non-ST elevation myocardial infarction guideline revisions recommend a target heart rate (HR) of 50-60 beats per minute (bpm). Despite improved trends toward utilization of beta-blockers therapy, beta-blockers continue to be underdosed. Guideline-based tools have been shown to improve adherence to evidence-based therapy in patients with ACS. Implementation of a standardized ACS pathway would lead to titration of beta-blockers to recommended dosages with improved HRs in eligible patients. The ACS clinical protocol was implemented at the University of Toledo Medical Center in May 2007. A retrospective study of 516 patients admitted during a comparable 6-month period, before and after the institution of the protocol, was conducted. The preprotocol and protocol group included 237 and 279 patients, respectively. Patient information extracted from the medical records included age, gender, HR on admission, blood pressure on admission, duration of hospital stay, preadmission use of beta-blocker, type of beta-blocker and dosage, discharge beta-blocker and dosage, peak troponin levels, and therapeutic intervention. A target HR of less than 60 bpm was achieved in 19% of the protocol group, as compared with 6% in the preprotocol group (P metoprolol in the protocol group was noted to be significantly higher (118 vs. 80 mg/d; P < 0.001). The institution of an ACS clinical pathway led to utilization of beta-blockers in significantly higher dosages, resulting in improved HR control and increased attainment of target HR.

  5. A Learning Object Approach To Evidence based learning

    Zabin Visram


    Full Text Available This paper describes the philosophy, development and framework of the body of elements formulated to provide an approach to evidence-based learning sustained by Learning Objects and web based technology Due to the demands for continuous improvement in the delivery of healthcare and in the continuous endeavour to improve the quality of life, there is a continuous need for practitioner's to update their knowledge by accomplishing accredited courses. The rapid advances in medical science has meant increasingly, there is a desperate need to adopt wireless schemes, whereby bespoke courses can be developed to help practitioners keep up with expanding knowledge base. Evidently, without current best evidence, practice risks becoming rapidly out of date, to the detriment of the patient. There is a need to provide a tactical, operational and effective environment, which allows professional to update their education, and complete specialised training, just-in-time, in their own time and location. Following this demand in the marketplace the information engineering group, in combination with several medical and dental schools, set out to develop and design a conceptual framework which form the basis of pioneering research, which at last, enables practitioner's to adopt a philosophy of life long learning. The body and structure of this framework is subsumed under the term Object oriented approach to Evidence Based learning, Just-in-time, via Internet sustained by Reusable Learning Objects (The OEBJIRLO Progression. The technical pillars which permit this concept of life long learning are pivoted by the foundations of object oriented technology, Learning objects, Just-in-time education, Data Mining, intelligent Agent technology, Flash interconnectivity and remote wireless technology, which allow practitioners to update their professional skills, complete specialised training which leads to accredited qualifications. This paper sets out to develop and

  6. Evidence-based toxicology: a comprehensive framework for causation.

    Guzelian, Philip S; Victoroff, Michael S; Halmes, N Christine; James, Robert C; Guzelian, Christopher P


    This paper identifies deficiencies in some current practices of causation and risk evaluation by toxicologists and formulates an evidence-based solution. The practice of toxicology focuses on adverse health events caused by physical or chemical agents. Some relations between agents and events are identified risks, meaning unwanted events known to occur at some frequency. However, other relations that are only possibilities--not known to occur (and may never be realized)--also are sometimes called risks and are even expressed quantitatively. The seemingly slight differences in connotation among various uses of the word 'risk' conceal deeply philosophic differences in the epistemology of harm. We label as 'nomological possibilities' (not as risks) all predictions of harm that are known not to be physically or logically impossible. Some of these nomological possibilities are known to be causal. We term them 'epistemic'. Epistemic possibilities are risks. The remaining nomological possibilities are called 'uncertainties'. Distinguishing risks (epistemic relationships) from among all nomological possibilities requires knowledge of causation. Causality becomes knowable when scientific experiments demonstrate, in a strong, consistent (repeatable), specific, dose-dependent, coherent, temporal and predictive manner that a change in a stimulus determines an asymmetric, directional change in the effect. Many believe that a similar set of characteristics, popularly called the 'Hill Criteria', make it possible, if knowledge is robust, to infer causation from only observational (nonexperimental) studies, where allocation of test subjects or items is not under the control of the investigator. Until the 1980s, medical decisions about diagnosis, prevention, treatment or harm were often made authoritatively. Rather than employing a rigorous evaluation of causal relationships and applying these criteria to the published knowledge, the field of medicine was dominated by authority-based

  7. Peltier ac calorimeter

    Jung, D. H.; Moon, I. K.; Jeong, Y. H.


    A new ac calorimeter, utilizing the Peltier effect of a thermocouple junction as an ac power source, is described. This Peltier ac calorimeter allows to measure the absolute value of heat capacity of small solid samples with sub-milligrams of mass. The calorimeter can also be used as a dynamic one with a dynamic range of several decades at low frequencies.

  8. Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

    Snyder, Patricia A.; Hemmeter, Mary Louise; Fox, Lise


    In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

  9. Opening up a Way of Evaluating Evidence-based Medicine in Traditional Chinese Medicine


    Evidence-based medicine is an authoritative way of evaluating the clinical efficacy of drugs, which provides the direct evidence for clinical medication. The rise of evidence-based medical research brought about the changes in Chinese medicine from the empirical medical era into the era of evidence-based medicine. Chinese medicine, as the experience

  10. [Alternative medicines and "Evidence-Based Medicine" a possible reconciliation?].

    Vanherweghem, J-L


    The contrast between the efficiency of Evidence-Based Medicine (EBM), a scientific fact, and the popularity of Complementary and Alternative Medicines (CAM) is a paradox of the art of healing. EBM is based on the paradigm of positivism and materialism while CAM are based on those of relativism and vitalism. These paradigms are diametrically opposed and the aim of an integrative medicine is aporetic. However, EBM is today in a dead end. The objective proof of a disease according to the rules of EBM is often lacking face to the expectations of patients demanding their illness to be taken into account. EBM and CAM have thus to coexist. Lessons can be drawn from CAM : patient expectations should be given a meaning and be integrated in his or her psychosocial context.

  11. Informed Systems: Enabling Collaborative Evidence Based Organizational Learning

    Mary M. Somerville


    Full Text Available Objective – In response to unrelenting disruptions in academic publishing and higher education ecosystems, the Informed Systems approach supports evidence based professional activities to make decisions and take actions. This conceptual paper presents two core models, Informed Systems Leadership Model and Collaborative Evidence-Based Information Process Model, whereby co-workers learn to make informed decisions by identifying the decisions to be made and the information required for those decisions. This is accomplished through collaborative design and iterative evaluation of workplace systems, relationships, and practices. Over time, increasingly effective and efficient structures and processes for using information to learn further organizational renewal and advance nimble responsiveness amidst dynamically changing circumstances. Methods – The integrated Informed Systems approach to fostering persistent workplace inquiry has its genesis in three theories that together activate and enable robust information usage and organizational learning. The information- and learning-intensive theories of Peter Checkland in England, which advance systems design, stimulate participants’ appreciation during the design process of the potential for using information to learn. Within a co-designed environment, intentional social practices continue workplace learning, described by Christine Bruce in Australia as informed learning enacted through information experiences. In addition, in Japan, Ikujiro Nonaka’s theories foster information exchange processes and knowledge creation activities within and across organizational units. In combination, these theories promote the kind of learning made possible through evolving and transferable capacity to use information to learn through design and usage of collaborative communication systems with associated professional practices. Informed Systems therein draws from three antecedent theories to create an original

  12. Evidence-based evaluation of treatment strategy for multiple sclerosis

    LI Meng-qiu


    Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

  13. Perfectionism in anorexia nervosa: novel performance based evidence.

    Samantha Lloyd

    Full Text Available Existing research into perfectionism in Anorexia Nervosa (AN is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study--81 with a diagnosis of AN and 72 healthy controls (HCs. Participants completed two performance based tasks assessing perfectionism--a text replication task and a bead sorting task--along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36 and produced significantly higher quality copies (p = <0.01, d = 0.45. In the bead sorting task, there was a trend towards more participants in the AN group choosing to check their work compared with the HC group (p = 0.07, d = 0.30 and the AN group took significantly longer checking than those in the HC group (p = <0.01, d = 0.45. Only copy quality uniquely predicted scores on self report measures of perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.

  14. A systematic review of the evidence base for Schema Therapy.

    Masley, Samantha A; Gillanders, David T; Simpson, Susan G; Taylor, Morag A


    Schema Therapy is becoming an increasingly popular psychological model for working with individuals who have a variety of mental health and personality difficulties. The aim of this review is to look at the current evidence base for Schema Therapy and highlight directions for further research. A systematic search of the literature was conducted up until January 2011. All studies that had clinically tested the efficacy of Schema Therapy as described by Jeffrey Young (1994 and 2003) were considered. These studies underwent detailed quality assessments based on Scottish Intercollegiate Guidelines Network (SIGN-50) culminating in 12 studies being included in the review. The culminative message (both from the popularity of this model and the medium-to-large effect sizes) is of a theory that has already demonstrated clinically effective outcomes in a small number of studies and that would benefit from ongoing research and development with complex client groups. It is imperative that psychological practice be guided by high-quality research that demonstrates efficacious, evidence-based interventions. It is therefore recommended that researchers and clinicians working with Schema Therapy seek to build on these positive outcomes and further demonstrate the clinical effectiveness of this model through ongoing research.

  15. Evidence-based ergonomics: a model and conceptual structure proposal.

    Silveira, Dierci Marcio


    In Human Factors and Ergonomics Science (HFES), it is difficult to identify what is the best approach to tackle the workplace and systems design problems which needs to be solved, and it has been also advocated as transdisciplinary and multidisciplinary the issue of "How to solve the human factors and ergonomics problems that are identified?". The proposition on this study is to combine the theoretical approach for Sustainability Science, the Taxonomy of the Human Factors and Ergonomics (HFE) discipline and the framework for Evidence-Based Medicine in an attempt to be applied in Human Factors and Ergonomics. Applications of ontologies are known in the field of medical research and computer science. By scrutinizing the key requirements for the HFES structuring of knowledge, it was designed a reference model, First, it was identified the important requirements for HFES Concept structuring, as regarded by Meister. Second, it was developed an evidence-based ergonomics framework as a reference model composed of six levels based on these requirements. Third, it was devised a mapping tool using linguistic resources to translate human work, systems environment and the complexities inherent to their hierarchical relationships to support future development at Level 2 of the reference model and for meeting the two major challenges for HFES, namely, identifying what problems should be addressed in HFE as an Autonomous Science itself and proposing solutions by integrating concepts and methods applied in HFES for those problems.

  16. Obstacle and solution of Chinese evidence-based orthopedics

    WANG Yan; LIU Hui


    Over the past decade,evidence-based medicine (EBM)is increasingly advocated as the “gold standard” of clinical practice.In 2001,the New York Times identified it as one of the ideas that made a difference,1 although EBM was still an academic concept in 1990.In 1996,Sackett et al2 first defined EBM as the conscientious,explicit,and judicious use of current best evidence in making decisions about the care of individual patients.It means integrating the best research evidence with clinical expertise and patient values.In China,EBM related studies seem to still be a “step behind”.For example,a PubMed search of “spine and China,limited to randomized controlled trial (RCT)” revealed two citations before 2000,but by 2012,the number was 183;compared with total published papers on spine limited to RCT found 842 citations before 2000 and by 2012,3895citations.

  17. Developing evidence-based librarianship: practical steps for implementation.

    Crumley, Ellen; Koufogiannakis, Denise


    Evidence-based librarianship (EBL) is a relatively new concept for librarians. This paper lays out a practical framework for the implementation of EBL. A new way of thinking about research in librarianship is introduced using the well-built question process and the assignment of librarian research questions to one of six domains specific to librarianship. As a profession, librarianship tends to reflect more qualitative, social sciences/humanities in its research methods and study types which tend to be less rigorous and more prone to bias. Randomised controlled trials (RCT) do not have to be placed at the top of an evidence 'hierarchy' for librarianship. Instead, a more encompassing model reflecting librarianship as a whole and the kind of research likely to be done by librarians is proposed. 'Evidence' from a number of disciplines including health sciences, business and education can be utilized by librarians and applied to their practice. However, access to and availability of librarianship literature needs to be further studied. While using other disciplines (e.g. EBHC) as a model for EBL has been explored in the literature, the authors develop models unique to librarianship. While research has always been a minor focus in the profession, moving research into practice is becoming more important and librarians need to consider the issues surrounding research in order to move EBL forward.

  18. Proton pump inhibitors in cirrhosis: Tradition or evidence based practice?

    Francesca Lodato; Francesco Azzaroli; Maria Di Girolamo; Valentina Feletti; Paolo Cecinato; Andrea Lisotti; Davide Festi; Enrico Roda; Giuseppe Mazzella


    Proton Pump Inhibitors (PPI) are very effective in inhibiting acid secretion and are extensively used in many acid related diseases. They are also often used in patients with cirrhosis sometimes in the absence of a specific acid related disease, with the aim of preventing peptic complications in patients with variceal or hypertensive gastropathic bleeding receiving multidrug treatment. Contradicting reports support their use in cirrhosis and evidence of their efficacy in this condition is poor. Moreover there are convincing papers suggesting that acid secretion is reduced in patients with liver cirrhosis. With regard to H pylori infection, its prevalence in patients with cirrhosis is largely variable among different studies, and it seems that H pylori eradication does not prevent gastro-duodenal ulcer formation and bleeding. With regard to the prevention and treatment of oesophageal complications after banding or sclerotherapy of oesophageal varices, there is little evidence for a protective role of PPI. Moreover, due to liver metabolism of PPI, the dose of most available PPIs should be reduced in cirrhotics. In conclusion, the use of this class of drugs seems more habit related than evidence-based eventually leading to an increase in health costs.

  19. Qigong in Cancer Care: Theory, Evidence-Base, and Practice

    Penelope Klein


    Full Text Available Background: The purpose of this discussion is to explore the theory, evidence base, and practice of Qigong for individuals with cancer. Questions addressed are: What is qigong? How does it work? What evidence exists supporting its practice in integrative oncology? What barriers to wide-spread programming access exist? Methods: Sources for this discussion include a review of scholarly texts, the Internet, PubMed, field observations, and expert opinion. Results: Qigong is a gentle, mind/body exercise integral within Chinese medicine. Theoretical foundations include Chinese medicine energy theory, psychoneuroimmunology, the relaxation response, the meditation effect, and epigenetics. Research supports positive effects on quality of life (QOL, fatigue, immune function and cortisol levels, and cognition for individuals with cancer. There is indirect, scientific evidence suggesting that qigong practice may positively influence cancer prevention and survival. No one Qigong exercise regimen has been established as superior. Effective protocols do have common elements: slow mindful exercise, easy to learn, breath regulation, meditation, emphasis on relaxation, and energy cultivation including mental intent and self-massage. Conclusions: Regular practice of Qigong exercise therapy has the potential to improve cancer-related QOL and is indirectly linked to cancer prevention and survival. Wide-spread access to quality Qigong in cancer care programming may be challenged by the availability of existing programming and work force capacity.

  20. NLM Evidence-based Information at Your Fingertips - NBNA

    Womble, R.


    The workshop titled, National Library of Medicine: Evidence-based Information At Your Fingertips, is a computer training class designed to meet the needs of nurses who require access to information on specific medical topics and on the adverse health effects of exposure to hazardous substances. The Specialized Information Services Division of the National Library of Medicine (NLM) is sponsoring this workshop for the National Black Nurses Association to increase the awareness of health professionals of the availability and value of the free NLM medical, environmental health, and toxicology databases.

  1. Evidence based abreactive ego state therapy for PTSD.

    Barabasz, Arreed


    A single 5-6 hours manualized abreactive ego state therapy session has recently been subjected to two placebo-controlled investigations meeting evidence-based criteria. Ego state therapy was found to be a highly effective and durable treatment for posttraumatic stress disorder. Apparently, ego state therapy works because it is emotion focused, activates sub-cortical structures, and because the supportive, interpretive therapist reconstructs the patient's personality to be resilient and adaptive. In this article the author reviews the treatment procedures and presents the findings of both studies.

  2. Do evidence-based guidelines change clinical practice patterns?

    Kessel, Line; Erngaard, Ditte; Flesner, Per;


    In 2013, the Danish Health and Medicines Authorities published a National Clinical Guideline on the treatment of age-related cataracts. The guideline provided evidence-based recommendations on the indication for cataract surgery, cataract surgery in patients with age-related macular degeneration...... sequential bilateral cataract surgery and on the postoperative check-up of patients. A questionnaire was sent to all members of the Danish Ophthalmological Society before and after publication of the guideline. The responses showed that the guideline had changed practice patterns so that surgeons were more...

  3. Evidence-based practice: triumph of style over substance?

    Booth, Andrew


    This feature examines the success of evidence-based practice (EBP) and the associated Cochrane Collaboration. It seeks to identify critical success factors associated with the way that both initiatives have been marketed. The simplicity of the original message used by each initiative allowed for subsequent assimilation of nuances and variants. Two implications for health librarians are highlighted; recognition that EBP is simply the embodiment of one world view and that many others may make a useful contribution and the need to craft a simple message capturing the unique selling points of the profession. To create a unique contribution health librarians require a detailed picture from market research of user information needs.

  4. Evidence-based Complementary and Alternative Medicine简介

    李霄茜; 周庆辉


    Evidence-based Complementary and Alternative Medicine(eCAM,《循证补充替代医学》)于2004年创刊。ISSN:1741—427X;e—ISSN:1741—4288。此杂志为牛津大学出版社旗下的一本国际性同行评议杂志,现任主编为其创立者Edwin L.Cooper教授,杂志当前的SCI影响因子为2.535。

  5. Interdisciplinary evidence-based practice: moving from silos to synergy.

    Newhouse, Robin P; Spring, Bonnie


    Despite the assumption that health care providers work synergistically in practice, professions have tended to be more exclusive than inclusive when it comes to educating students in a collaborative approach to interdisciplinary evidence-based practice (EBP). This article explores the state of academic and clinical training regarding interdisciplinary EBP, describes efforts to foster interdisciplinary EBP, and suggests strategies to accelerate the translation of EBP across disciplines. Moving from silos to synergy in interdisciplinary EBP will require a paradigm shift. Changes can be leveraged professionally and politically using national initiatives currently in place on improving quality and health care reform.

  6. Developing an evidence-based list of journals for nursing.

    Sherwill-Navarro, Pamela; Kennedy, Joy C; Allen, Margaret Peg


    The Nursing and Allied Health Resources Section (NAHRS) of the Medical Library Association created the 2012 NAHRS Selected List of Nursing Journals to assist librarians with collection development and to provide nurses and librarians with data on nursing and interdisciplinary journals to assist their decisions about where to submit articles for publication. This list is a continuation and expansion of a list initially known as the Key Nursing Journals list. It compares database coverage and full-text options for each title and includes an analysis of the number of evidence-based, research, and continuing education articles.

  7. International Workshop on Evidence-Based Technology Enhanced Learning

    Gennari, Rosella; Marenzi, Ivana; Prieta, Fernando; Rodríguez, Juan


    Research on Technology Enhanced Learning (TEL) investigates how information and communication technologies can be designed in order to support pedagogical activities. The workshop proceedings collects contributions concerning evidence based TEL systems, like their design following EBD principles as well as studies or best practices that educators, education stakeholders or psychologists used to diagnose or improve their students' learning skills, including students with specific difficulties. The international ebTEL’12 workshop wants to be a forum in which TEL researchers and practitioners alike can discuss ideas, projects, and lessons related to ebTEL. The workshop takes place in Salamanca, Spain, on March 28th-30th 2012.  

  8. Creating a nursing strategic planning framework based on evidence.

    Shoemaker, Lorie K; Fischer, Brenda


    This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article.

  9. Evidence-based rationale for offloading treatment modalities.

    Bell, Desmond


    Diabetic foot ulcers (DFU) are a common co-morbidity affecting patients with diabetes. A variety of factors, including diabetic peripheral neuropathy, altered gait, and increased pressure on certain regions of the foot, can over time result in a diabetic foot wound. Reducing pressure at the site of the ulcer can promote healing and prevent further ulceration. Offloading is an evidence-based treatment modality for patients with DFUs and is part of the standard protocol for treatment. We discuss here the most common offloading modalities, placing them in the context of relevant medical and compliance issues that affect their use and success.

  10. The Evidence-Based Evaluation of Iron Deficiency Anemia.

    Hempel, Eliana V; Bollard, Edward R


    Anemia is a prevalent disease with multiple possible etiologies and resultant complications. Iron deficiency anemia is a common cause of anemia and is typically due to insufficient intake, poor absorption, or overt or occult blood loss. Distinguishing iron deficiency from other causes of anemia is integral to initiating the appropriate treatment. In addition, identifying the underlying cause of iron deficiency is also necessary to help guide management of these patients. We review the key components to an evidence-based, cost-conscious evaluation of suspected iron deficiency anemia.

  11. Evidence-based integrative medicine in clinical veterinary oncology.

    Raditic, Donna M; Bartges, Joseph W


    Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology.

  12. Evidence-based investigations and treatments of recurrent pregnancy loss

    Christiansen, Ole B; Nybo Andersen, Anne-Marie; Bosch, Ernesto


    OBJECTIVE: To give an overview of currently used investigations and treatments offered to women with recurrent pregnancy loss (RPL) and, from an evidence-based point of view, to evaluate the usefulness of these interventions. DESIGN: Ten experts on epidemiologic, genetic, anatomic, endocrinologic......, and an extensive investigation for all major factors should always be undertaken. There is an urgent need for agreement concerning the thresholds for detecting what is normal and abnormal, irrespective of whether laboratory tests or uterine abnormalities are concerned. A series of lifestyle factors should...

  13. Evidence-Based Medicine in the Treatment of Infantile Hemangiomas.

    Keller, Robert G; Patel, Krishna G


    Over the past decade, the treatment of infantile hemangiomas has undergone dramatic breakthroughs. This review critically evaluates the latest literature that supports the myriad treatment options for infantile hemangiomas. It chronicles the fading role of steroid therapy and evolution of propranolol use as the major treatment modality. Although propranolol is helping this disease become more of a medical disease and less of a surgical dilemma, the report also reveals a continued search to find nonsystemic treatment options. In summary, this is an evidence-based medicine review for the treatment of infantile hemangiomas.

  14. Educational evidence based interventions for adults with autism spectrum disorders: experimental evidence

    Saverio Fontani


    Full Text Available The educational interventions for adults with autism spectrum disorders are a relatively unexplored topic, in the face of numerous studies on the educational intervention models for the child population. In this paper the results of major studies and meta-analysis on the topic are presented and their implications for educational intervention are discussed.Interventi educativi evidence based per adulti con disturbi dello spettro autistico: evidenze sperimentaliGli interventi educativi per adulti con Disturbi dello Spettro Autistico rappresentano un’area relativamente poco esplorata, a fronte di numerosi studi dedicati ai modelli di intervento educativo rivolti alla popolazione infantile. In questo articolo sono presentati i risultati dei principali studi e delle meta-analisi sul tema e vengono discusse le loro implicazioni per l’intervento educativo.

  15. From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

    Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera


    Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

  16. From evidence based medicine to mechanism based medicine : Reviewing the role of pharmacogenetics

    Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van Der Zee, Anke-Hilse; Deneer, Vera


    Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its

  17. 基于APA车辙深度的AC-5沥青混合料体积参数的标准%Volumetric Parameter Standard of AC-5 Asphalt Mixture Based on APA Rutting Depth

    李闯民; 王涛



  18. Evidence-based evaluation of therapeutic measures for sleep disorders

    LI Juan


    Full Text Available Objective To evaluate the therapeutic efficacy and side effects of various treatment for sleep disorders in order to provide the best therapeutic regimen for the evidence-based treatment of sleep disorders. Methods Sleep disorder, insomnia, restless legs syndrome or RLS, obstructive sleep apnea or OSA, narcolepsy, REM behaviour disorder or RBD, treatment or therapy were used as retrieval words. Cochrane Library, MEDLINE, ScienceDirect were used for retrieval, and manual searching was also used. Related clinical guidelines, systematic reviews, randomized controlled clinical trials, retrospective case analysis, case-observation studies and reviews were collected and evaluated by Jadad Scale. Results Forty related articles were selected as following: 6 clinical guidelines, 12 systematic reviews, 5 randomized controlled trials, 2 retrospective case analysis, 1 case-observation study and 14 reviews. Thirty-three were of high quality, while 7 were of low quality with score. According to the evaluation of therapeutic efficacy and side effects of various therapies, it is suggested as following: 1 insomnia is the most common in sleep disorders; the treatment methods of insomnia mainly include drug therapy and cognitive behavioral treatment (CBT; the two kinds of therapy have their own advantages and disadvantages, and the combination therapy of drugs and CBT is the best treatment plan. 2 The first-line treatment of primary RLS is dopamine agonists and anti-seizure drugs; however, the treatment of secondary RLS is mainly etiologic treatment. 3 The main treatments of OSAS are nasal continuous positive airway pressure (nCPAP, oral orthotics and surgery, and nCPAP is the first-line treatments. 4 The medication of narcolepsy is mainly modafinil, hydroxy butyric acid sodium and antidepressants, and the specific choosingshould accord to clinical classifications. 5 The main treatments of RBD include general treatments such as avoiding triggers, insuring the

  19. Evidence Based Conservative Management of Patello-femoral Syndrome

    E. Carlos Rodriguez-Merchan


    Full Text Available Background:   Patellofemoral pain syndrome (PFPS is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or   athletic activities. Patella dislocation is not included in PFPS.     Purpose:   This review analyzes the evidence based conservative management of PFPS.   Methods:   A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused   on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative   management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because   they were focused on the topic of the article. Overall ten articles were analyzed.     Results:   Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces.     Conclusions:   Non-steroidal anti-inflammatory drugs (NSAIDs may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for   patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited   with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has   been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed.    

  20. Evidence Based Conservative Management of Patello-femoral Syndrome

    E. Carlos Rodriguez-Merchan


    Full Text Available Background:   Patellofemoral pain syndrome (PFPS is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or   athletic activities. Patella dislocation is not included in PFPS.     Purpose:   This review analyzes the evidence based conservative management of PFPS.   Methods:   A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused   on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative   management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because   they were focused on the topic of the article. Overall ten articles were analyzed.     Results:   Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces.     Conclusions:   Non-steroidal anti-inflammatory drugs (NSAIDs may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for   patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited   with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has   been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed.

  1. Online tools for teaching evidence-based veterinary medicine.

    Steele, Michael; Crabb, Nicholas P; Moore, Lynda J; Reyher, Kristen K; Baillie, Sarah; Eisler, Mark C


    Evidence-based veterinary medicine (EBVM) is of interest and relevance to veterinary practitioners. Consequently, veterinary schools take responsibility for teaching students how to appraise scientific articles and for equipping them with the skills needed to obtain and evaluate the best evidence and to apply this approach to their own cases. As part of our farm animal clinical rotation, we train students in qualitative and quantitative EBVM methods using an e-learning environment, online teaching materials, a wiki (a Web site that allows its users to edit its content via a Web browser), and face-to-face tutorials that support learning. Students working in small groups use a wiki to record details of the history, clinical presentation, diagnostic tests, herd data, and management plans for their chosen farm animal clinical cases. Using a standardized patient, intervention, comparison, and outcome (PICO) format, each group formulates a patient question based on either a proposed intervention or diagnostic procedure for the case and conducts an online scientific literature database search. The students appraise the articles retrieved using EBVM approaches and record the information in the wiki. The summation of this body of work, the group's critically appraised topic (CAT), includes the original PICO, a standardized table of the scientific evidence for the effectiveness of the intervention or diagnostic procedure, a summary statement in the form of a clinical bottom line, and their reflections upon the CAT. At the end of the rotation, students take part in a structured "CAT Club" where they present and discuss their findings with fellow students and clinicians.

  2. Practice-Based Evidence of Evidence-Based Practice: Professional Practice Portfolios for the Assessment of Work-Based Learning

    Jones, Elizabeth


    This article proposes that professional education programmes can help promote the development of professional judgment by the use of a well-designed professional practice portfolio as an assessment tool. An explanation of the portfolio process is followed by evidence from a four-year action research study, demonstrating how compiling a…

  3. Evaluating competency to stand trial with evidence-based practice.

    Rogers, Richard; Johansson-Love, Jill


    Evaluations for competency to stand trial are distinguished from other areas of forensic consultation by their long history of standardized assessment beginning in the 1970s. As part of a special issue of the Journal on evidence-based forensic practice, this article examines three published competency measures: the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), the Evaluation of Competency to Stand Trial-Revised (ECST-R), and the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST-MR). Using the Daubert guidelines as a framework, we examined each competency measure regarding its relevance to the Dusky standard and its error and classification rates. The article acknowledges the past polarization of forensic practitioners on acceptance versus rejection of competency measures. It argues that no valuable information, be it clinical acumen or standardized data, should be systematically ignored. Consistent with the American Academy of Psychiatry and the Law Practice Guideline, it recommends the integration of competency interview findings with other sources of data in rendering evidence-based competency determinations.

  4. Evidence-based prevention, management, and monitoring of dental caries.

    Barber, Lois Rigmont; Wilkins, Esther M


    Dental caries, not unlike periodontal diseases, is now recognized as an infectious, transmissible, multifactorial disease of bacterial origin. Current evidence-based emphasis is on the need to recognize a carious lesion in its earliest stage before demineralization has produced a cavitated lesion that requires restoration by a dentist. As a result of current understanding of caries control, the dental hygienist's role as a prevention specialist is to determine the dental caries risk factors for patients of all ages and to introduce remineralization strategies into the patient's dental hygiene care plan. Conservative strategies of a concentrated program include initial infection control with a chlorhexidine rinse; extra daily fluoride exposures; placement of pit and fissure sealants where indicated; control of sucrose exposures; use of sugar substitutes, particularly xylitol-containing sugar-free chewing gum; and an emphasis on a daily bacterial plaque removal routine. Evidence supports the management and monitoring of dental caries. Caries risk level must be reevaluated at each maintenance appointment. Appropriate in-office strategies to preserve tooth structure should be carried out and followed by applicable home regimens that are based on need, not age.

  5. Evidence-based surgical wound care on surgical wound infection.

    Reilly, Jaqueline


    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  6. Reality of evidence-based practice in palliative care

    Claire Visser; Gina Hadley; Bee Wee


    hTere has been a paradigm shitf in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically signiifcant beneifts may be marginal and may not be related to clinical meaningfulness. hTe typical treatmentvs. placebo comparison necessitated by ‘gold standard’ randomised controlled trials (RCTs) is not necessarily applicable. hTe complex multimorbidity of end of life care involves considerations of the patient’s physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be diffcult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. hTis review uses examples of the management of cancer-related fatigue and death rattle (noisy breathing) to demonstrate the current state of EBM in palliative care. hTe future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach’ are likely to pose the correct clinical questions and derive evidence-based yet clinically relevant outcomes.

  7. Evidence-based practice in group work with incarcerated youth.

    Quinn, Ashley; Shera, Wes


    As a result of the Youth Criminal Justice Act's increased focus on restorative justice, treatment, rehabilitation, and reintegration of youth, many more juvenile offenders require mental health services while resident in youth detention facilities [Youth Criminal Justice Act (2002, c.1). Ottawa: Department of Justice Canada. Retrieved September 19, 2008 from]. Several common characteristics such as violence, aggression, and other antisocial behaviors, associated with criminal behavior, have been identified among male and female offenders. Dialectical behavior therapy, originally developed by Linehan [Linehan, M. M., 1993a. Cognitive-behavioural treatment of borderline personality disorder. New York: Guildford Press] for chronically parasuicidal women diagnosed with borderline personality disorder, has been successfully modified for use with other populations, including violent and impulse-oriented male and female adolescents residing in correctional facilities. The intent of this article is to encourage the wider use of dialectical behavior therapy (DBT) with young offenders. It includes an extensive review of the evidence-base to date and describes some of the creative modifications that have been made to standard DBT program format to meet the particular needs of various groups in both Canada and the United States. In keeping with the movement toward more evidence-based practice, the authors argue that DBT is a promising approach in group work with incarcerated adolescents and should be more widely used.

  8. Evidence-based insulin treatment in type 1 diabetes mellitus

    Jacobsen, Iben Brock; Henriksen, J E; Hother-Nielsen, O


    AIM: Evaluation of the evidence base for recommending different insulin treatment regimens in type 1 diabetes. METHODS: A computerised literature survey was conducted using The Cochrane Controlled Trials Register and the Pub Med database for the period of 1982-2007. RESULTS: A meta-analysis on only...... 49 out of 1295 references showed that CSII compared with conventional or multiple insulin injections therapy demonstrated a significant reduction in mean HbA1c (primary outcome) of 1.2% CI [0.73; 1.59] (P... daily insulin injections was based on only one publication demonstrating an improved quality of life but no significant reduction in HbA1c or hypoglycaemia. A comparison of rapid-acting insulin analogues and human soluble insulin demonstrated a statistically significant reduction in HbA1c of 0.1% CI: [0...

  9. ACAC Converters for UPS

    Rusalin Lucian R. Păun


    Full Text Available This paper propose a new control technique forsingle – phase ACAC converters used for a on-line UPSwith a good dynamic response, a reduced-partscomponents, a good output characteristic, a good powerfactorcorrection(PFC. This converter no needs anisolation transformer. A power factor correction rectifierand an inverter with the proposed control scheme has beendesigned and simulated using Caspoc2007, validating theconcept.

  10. Revitalising the evidence base for public health: an assets model.

    Morgan, Antony; Ziglio, Erio


    Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective

  11. An evidence-based approach to treating otitis media.

    Rosenfeld, R M


    More than 20 years ago, a shrewd clinician remarked, "There is little evidence that those antimicrobial agents which hypothetically or in vitro are more effective ... are superior in the treatment of otitis when compared to penicillin alone." Several hundred clinical trials later, the advantages of broad spectrum drugs remain unproved, and questions remains as to whether antibiotics are required for most episodes of AOM. Further, antibiotics have been demoted to the status of optional therapy for OME. This situation is unlikely to change as new studies with new antibiotics proliferate. What is clear, however, is that accelerated patterns of bacterial resistance mandate an evidence-based approach to managing otitis media. Bacteria have an uncanny ability to learn new mechanisms of antibiotic resistance. A large part of bacterial "education" has undoubtedly been fueled by antibiotic prescriptions from well-intentioned physicians, with unrealistic expectations of drug efficacy. A judicious approach to antibiotic treatment of otitis media can result only from knowing the spontaneous course of the disorder and incremental effect of antibiotics on clinical outcomes. In this article, a series of unifying concepts are developed to help practicing clinicians with an evidence-based approach to managing otitis media. Critical review of the published evidence suggests that the most favorable outcomes from medical treatment will occur if practitioners: appreciate the favorable natural history of untreated otitis media realize that OME may take months to resolve following a single AOM episode modify risk factors to improve the odds of spontaneous resolution use pneumatic otoscopy and confirmatory tympanometry to diagnose OME recognize the limited impact of antibiotic therapy on treatment and prevention balance the benefits of antibiotics against the risk of accelerated bacterial resistance avoid repetitive, prolonged, or prophylactic antibiotic treatment of chronic OME avoid

  12. Transitioning toward Evidence-Based Research in the Health Sciences for the XXI Century


    This article discusses some of the misconceptions of evidence-based research in the health sciences. It proposes that since not all treatments in medicine and dentistry can be evidence-based, clinical applications of the evidence-based process should become a specialty. The case is particularly evident in dentistry. Therefore dentistry is taken in this article as a model for discussion. We propose that to approach dentistry from the viewpoint of the patient-oriented evidence that matters (POE...

  13. Importance of Attenuation Correction (AC) for Small Animal PET Imaging

    El Ali, Henrik H.; Bodholdt, Rasmus Poul; Jørgensen, Jesper Tranekjær;


    was performed. Methods: Ten NMRI nude mice with subcutaneous implantation of human breast cancer cells (MCF-7) were scanned consecutively in small animal PET and CT scanners (MicroPETTM Focus 120 and ImTek’s MicroCATTM II). CT-based AC, PET-based AC and uniform AC methods were compared. Results: The activity...

  14. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

    Fry Margaret


    Full Text Available Abstract Background Venous Thromboembolism (VTE is a cause of hospital mortality and managing its morbidity is associated with significant expenditure. Uptake of evidenced based guideline recommendations intended to prevent VTE in hospital settings is sub-optimal. This study was conducted to explore clinicians' attitudes and the clinical environment in which they work to understand their reluctance to adopt VTE prophylaxis guidelines. Methods Between February and November 2009, 40 hospital employed doctors from 2 Australian metropolitan hospitals were interviewed in depth. Qualitative data were analysed according to thematic methodology. Results Analysis of interviews revealed that barriers to evidence based practice include i the fragmented system of care delivery where multiple members of teams and multiple teams are responsible for each patient's care, and in the case of VTE, where everyone shares responsibility and no-one in particular is responsible; ii the culture of practice where team practice is tailored to that of the team head, and where medicine is considered an 'art' in which guidelines should be adapted to each patient rather than applied universally. Interviewees recommend clear allocation of responsibility and reminders to counteract VTE risk assessment being overlooked. Conclusions Senior clinicians are the key enablers for practice change. They will need to be convinced that guideline compliance adds value to their patient care. Then with the support of systems in the organisation designed to minimize the effects of care fragmentation, they will drive practice changes in their teams. We believe that evidence based practice is only possible with a coordinated program that addresses individual, cultural and organisational constraints.

  15. RHIC spin flipper AC dipole controller

    Oddo, P.; Bai, M.; Dawson, C.; Gassner, D.; Harvey, M.; Hayes, T.; Mernick, K.; Minty, M.; Roser, T.; Severino, F.; Smith, K.


    The RHIC Spin Flipper's five high-Q AC dipoles which are driven by a swept frequency waveform require precise control of phase and amplitude during the sweep. This control is achieved using FPGA based feedback controllers. Multiple feedback loops are used to and dynamically tune the magnets. The current implementation and results will be presented. Work on a new spin flipper for RHIC (Relativistic Heavy Ion Collider) incorporating multiple dynamically tuned high-Q AC-dipoles has been developed for RHIC spin-physics experiments. A spin flipper is needed to cancel systematic errors by reversing the spin direction of the two colliding beams multiple times during a store. The spin flipper system consists of four DC-dipole magnets (spin rotators) and five AC-dipole magnets. Multiple AC-dipoles are needed to localize the driven coherent betatron oscillation inside the spin flipper. Operationally the AC-dipoles form two swept frequency bumps that minimize the effect of the AC-dipole dipoles outside of the spin flipper. Both AC bumps operate at the same frequency, but are phase shifted from each other. The AC-dipoles therefore require precise control over amplitude and phase making the implementation of the AC-dipole controller the central challenge.

  16. Sentiment Prediction Based on Dempster-Shafer Theory of Evidence

    Mohammad Ehsan Basiri


    Full Text Available Sentiment prediction techniques are often used to assign numerical scores to free-text format reviews written by people in online review websites. In order to exploit the fine-grained structural information of textual content, a review may be considered as a collection of sentences, each with its own sentiment orientation and score. In this manner, a score aggregation method is needed to combine sentence-level scores into an overall review rating. While recent work has concentrated on designing effective sentence-level prediction methods, there remains the problem of finding efficient algorithms for score aggregation. In this study, we investigate different aggregation methods, as well as the cases in which they perform poorly. According to the analysis of existing methods, we propose a new score aggregation method based on the Dempster-Shafer theory of evidence. In the proposed method, we first detect the polarity of reviews using a machine learning approach and then, consider sentence scores as evidence for the overall review rating. The results from two public social web datasets show the higher performance of our method in comparison with existing score aggregation methods and state-of-the-art machine learning approaches.

  17. Changing behavior: evidence based practice supporting hair removal with clippers.

    Waddington, Carolyn


    Evidence based practice demonstrates using clippers immediately before surgery, when perioperative hair removal is necessary, results in the fewest surgical site infections (Kjonniksen, Andersen, Sondenaa, & Segadal, 2002). In addition, one of The Joint Commission's national patient safety goals for 2008 is "to reduce the risk of healthcare associated infections" (The Joint Commission, 2008, Goal 7). Therefore, a project was undertaken to change perioperative nursing care in a large teaching hospital from using razors for hair removal in the perioperative setting to using clippers. Change is difficult and encompasses many interdisciplinary areas. A description of the process of utilizing evidence to change behavior in the perioperative setting and its outcomes will be provided in this paper. Klevens, et al., (2007) reported that 22% of healthcare associated infections were the result of surgical site infections (SSIs). Changing practice to utilizing clippers for hair removal is an extrinsic factor of SSIs that can be easily modified. Otorhinolaryngology (ORL) patients that require hair removal before surgery (i.e., acoustic neuroma, cranial-facial resections, and head and neck reconstruction) may benefit from this change in practice. Perioperative nurses are in a prime position to reduce the incidence of SSIs in ORL patients.

  18. Evidence-based post-exercise recovery strategies in basketball.

    Calleja-González, Julio; Terrados, Nicolás; Mielgo-Ayuso, Juan; Delextrat, Anne; Jukic, Igor; Vaquera, Alejandro; Torres, Lorena; Schelling, Xavier; Stojanovic, Marko; Ostojic, Sergej M


    Basketball can be described as a moderate-to-long duration exercise including repeated bouts of high-intensity activity interspersed with periods of low to moderate active recovery or passive rest. A match is characterized by repeated explosive activities, such as sprints, jumps, shuffles and rapid changes in direction. In top-level modern basketball, players are frequently required to play consecutive matches with limited time to recover. To ensure adequate recovery after any basketball activity (i.e., match or training), it is necessary to know the type of fatigue induced and, if possible, its underlying mechanisms. Despite limited scientific evidence to support their effectiveness in facilitating optimal recovery, certain recovery strategies are commonly utilized in basketball. It is particularly important to optimize recovery because players spend a much greater proportion of their time recovering than they do in training. Therefore, the main aim of this report is to facilitate useful information that may lead to practical application, based on the scientific evidence and applied knowledge specifically in basketball.

  19. An evidence-based approach to earlier initiation of dialysis.

    Churchill, D N


    The objective was to review evidence addressing the optimal time to initiate dialysis treatment. The database was derived from an evidence-based review of the medical literature and from the Canada-United States peritoneal dialysis study. The publications were divided into (1) those addressing the clinical impact of early versus late referral to a dialysis program; (2) those evaluating the association between residual renal function at initiation of dialysis and the concurrent nutritional status; (3) those evaluating the association between residual renal function at initiation of dialysis and subsequent clinical outcomes, including patient survival. There were five studies evaluating early versus late referral, three cohort design and two case-control design. Late referrals had worse outcomes than early referrals. The former had more serious comorbidity and many had been noncompliant with follow-up. The latter were more likely to have hereditary renal disease. Renal function was slightly worse at initiation among those referred late. Three studies addressed the association between renal function at initiation of dialysis and concurrent nutritional status. Two showed decreased protein intake with diminished glomerular filtration rate (GFR). Poor nutritional status is associated with decreased patient survival among both incident and prevalent dialysis patients. The third study reported excellent patient survival among patients with late initiation of dialysis. These patients had received a supplemented low-protein diet and were not malnourished at initiation of dialysis. Three groups have studied the association between GFR at initiation of dialysis and clinical outcomes. Decreased GFR at initiation of dialysis is associated with a increased probability of hospitalization and death. None of these studies has used the rigorous randomized clinical trial design, and they are therefore subject to bias. Referral time bias, comorbidity, patient compliance, and starting

  20. Palliative radiotherapy in head and neck cancers: Evidence based review

    Talapatra Kaustav


    Full Text Available Squamous cell carcinoma of head and neck (SCCHN is one of the commonest cancers seen in India, constituting up to 25% of their overall cancer burden. Advanced SCCHN is a bad disease with a poor prognosis and patients usually die of uncontrolled loco-regional disease. Curative intent management of loco-regionally advanced SCCHN has become more evidence-based with active clinical research in the form of large prospective randomized controlled trials and meta-analyses. However, little has been written about palliative radiotherapy (PRT in head and neck cancers. It is widely recognized that PRT provides effective palliation and improved quality-of-life in advanced incurable malignancies. It is in this context that this study proposes to review the existing literature on palliative radiotherapy in advanced incurable SCCHN to help formulate consensus guidelines and recommendations.

  1. Social Workers’ Orientation Toward the Evidence-Based Practice Process

    Kolmer, Deirdre M. Beneken genaamd; Schalk, René


    Objectives: This study assesses social workers’ orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions. Results: The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29. Conclusions: We recommend educators to take a more active role in teaching the EBP process to students and social workers. PMID:27630517

  2. The oil crisis, risk and evidence-based practice.

    Traynor, Michael


    Evidence-based practice has risen to prominence over the last 20 years. Different professions have taken it up in different ways and for different purposes. It has been seen as holding both threats and advantages to professionalising endeavours and professional identity. It has engendered controversy but some criticisms of it have been unconvincing. It is possible to account for its rise as a response to tightening financial constraints on state spending in the west, as a sign of a culture increasingly concerned with risk, distrust of professionals and experts, as well as a way for professionals themselves to maintain control over their activity in the face of growing managerialism. This paper reviews the literature of some of the movement's proponents as well as criticism from various professional groups. It concludes that more useful than either arguing for or against it, is to understand the policy background and sociological reasons for its emergence and spread.

  3. The professional portfolio: an evidence-based assessment method.

    Byrne, Michelle; Schroeter, Kathryn; Carter, Shannon; Mower, Julie


    Competency assessment is critical for a myriad of disciplines, including medicine, law, education, and nursing. Many nurse managers and educators are responsible for nursing competency assessment, and assessment results are often used for annual reviews, promotions, and satisfying accrediting agencies' requirements. Credentialing bodies continually seek methods to measure and document the continuing competence of licensees or certificants. Many methods and frameworks for continued competency assessment exist. The portfolio process is one method to validate personal and professional accomplishments in an interactive, multidimensional manner. This article illustrates how portfolios can be used to assess competence. One specialty nursing certification board's process of creating an evidence-based portfolio for recertification or reactivation of a credential is used as an example. The theoretical background, development process, implementation, and future implications may serve as a template for other organizations in developing their own portfolio models.

  4. Legacy of Avicenna and evidence-based medicine.

    Shoja, Mohammadali M; Rashidi, Mohammad Reza; Tubbs, R Shane; Etemadi, Jalal; Abbasnejad, Feridoon; Agutter, Paul S


    Although the term 'evidence-based medicine' (EBM) is of recent origin, its roots are generally agreed to lie in earlier times. Several writers have suggested that the 11th century CE physician and philosopher Avicenna (Ibn Sina) formulated an approach to EBM that broadly resembles modern-day principles and practice. The aim of this paper is to explore the origins and influence of Avicenna's version of EBM. A survey of the literature suggests that two influences on Avicenna's thought were crucial: the doctrine of Ijma; and Stoic logic, perhaps transmitted via the writings of Galen. In turn, Avicenna is known to have been a major influence on both medical practice and the development of logic in medieval Europe. Through this route, Avicennian logic (notably its inductive aspect) inspired the new style of thought associated with the scientific revolution, which later came to be reflected in 'scientific medicine', and may therefore have been an indirect source of EBM today.

  5. Surgery for gastric cancer: An evidence-based perspective

    D'souza Melroy


    Full Text Available Despite a decreasing incidence, stomach cancer is the second leading cause of cancer mortality worldwide. Surgical resection offers the only chance for cure in this aggressive cancer. The surgical management of gastric cancer has witnessed numerous debates in the past decades. These include the extent of lymphadenectomy, extent of surgery, role of laparoscopic gastrectomy, and the impact of high volume of centers, on the outcome of surgery. This review attempts to address these controversies with an evidence-based perspective. A literature search in MEDLINE ( has been performed with the relevant key words and corresponding MeSH terms. The search has been limited to English publications on human subjects. A manual search of the bibliographies has also been carried out, to identify the relevant publications for possible inclusion.

  6. Plantar fasciitis: evidence-based review of diagnosis and therapy.

    Cole, Charles; Seto, Craig; Gazewood, John


    Plantar fasciitis causes heel pain in active as well as sedentary adults of all ages. The condition is more likely to occur in persons who are obese or in those who are on their feet most of the day. A diagnosis of plantar fasciitis is based on the patient's history and physical findings. The accuracy of radiologic studies in diagnosing plantar heel pain is unknown. Most interventions used to manage plantar fasciitis have not been studied adequately; however, shoe inserts, stretching exercises, steroid injection, and custom-made night splints may be beneficial. Extracorporeal shock wave therapy may effectively treat runners with chronic heel pain but is ineffective in other patients. Limited evidence suggests that casting or surgery may be beneficial when conservative measures fail.

  7. Evidence-based medicine and quality of care.

    Dickenson, Donna; Vineis, Paolo


    In this paper we set out to examine the arguments for and against the claim that Evidence-Based Medicine (EBM) will improve the quality of care. In particular, we examine the following issues: 1. Are there hidden ethical assumptions in the methodology of EBM? 2. Is there a tension between the duty of care and EBM? 3. How can patient preferences be incorporated into quality guidelines and effectiveness studies? 4. Is there a tension between the quality of a particular intervention and overall quality of care? 5. Are certain branches of medicine and patient groups innately or prima facie disadvantaged by a shift to EBM? In addition we consider a case study in the ethics of EBM, on a clinical trial concerning the collection of umbilical cord blood in utero and ex utero, during or after labour in childbirth.

  8. Treatment-resistant schizophrenia: Evidence-based strategies

    Susanne Englisch


    Full Text Available Treatment-resistant symptoms complicate the clinical course of schizophrenia, and a large proportion of patients do not reach functional recovery. In consequence, polypharmacy is frequently used in treatment-refractory cases, addressing psychotic positive, negative and cognitive symptoms, treatment-emergent side effects caused by antipsychotics and comorbid depressive or obsessive-compulsive symptoms. To a large extent, such strategies are not covered by pharmacological guidelines which strongly suggest antipsychotic monotherapy. Add-on strategies comprise combinations of several antipsychotic agents and augmentations with mood stabilizers; moreover, antidepressants and experimental substances are applied. Based on the accumulated evidence of clinical trials and meta-analyses, combinations of clozapine with certain second-generation antipsychotic agents and the augmentation of antipsychotics with antidepressants seem recommendable, while the augmentation with mood stabilizers cannot be considered superior to placebo. Forthcoming investigations will have to focus on innovative pharmacological agents, the clinical spectrum of cognitive deficits and the implementation of cognitive behavioral therapy.

  9. Evidence-based guidelines for teaching patient-centered interviewing.

    Smith, R C; Marshall-Dorsey, A A; Osborn, G G; Shebroe, V; Lyles, J S; Stoffelmayr, B E; Van Egeren, L F; Mettler, J; Maduschke, K; Stanley, J M; Gardiner, J C


    In a rare study of effectiveness of an interviewing method, we previously reported a randomized controlled trial demonstrating that training in a step-by-step patient-centered interviewing method improved residents' knowledge, attitudes, and skills and had a consistently positive effect on trained residents' patients. For those who wish to use this evidence-based patient-centered method as a template for their own teaching, we describe here for the first time our training program--and propose that the training can be adapted for students, physicians, nurse practitioners, physician assistants, and other new learners as well. Training was skills-oriented and experiential, fostered positive attitudes towards patient-centered interviewing, and used a learner-centered approach which paid special attention to the teacher-resident relationship and to the resident's self-awareness. Skills training was guided by a newly identified patient-centered interviewing method that described the step-by-step use of specific behaviors.

  10. How evidence-based practices contribute to community integration.

    Bond, Gary R; Salyers, Michelle P; Rollins, Angela L; Rapp, Charles A; Zipple, Anthony M


    Since the groundbreaking work of the Robert Wood Johnson Conference in 1998 identifying six evidence-based practices (EBPs) for people with severe mental illness (SMI), the mental health field has moved in the direction of re-examination and redesign of service systems. Surprisingly, one area that has not been fully explicated is the role that EBPs play in promoting community integration. In this paper, we explain how community integration is a unifying concept providing direction and vision for community mental health for people with SMI. As one crucial aspect of the recovery process, community integration clarifies the link between EBPs and recovery. We propose an alternate view, grounded in the empirical literature, to the assertion by Anthony, Rogers, and Farkas [2003, Community Mental Health Journal, 39, 101-114] that "EBP research has rarely demonstrated a positive impact on recovery related outcomes."

  11. Evidence-based Health Care via Multi-Criteria Decision Analytic decision

    Kjer Kaltoft, Mette; Dowie, Jack

    Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study......’Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study...

  12. Scientifically Based Research and Evidence-Based Education: A Federal Policy Context.

    Smith, Anne


    This article provides a look at the federal policy context for the scientifically based research (SBR) and evidence-based education (EBE) initiatives by sharing U.S. Department of Education presentations and related publications about SBR and EBE. It discusses the impact of these policy initiatives on special education research activities.…

  13. Periodontal self-care: evidence-based support.

    Drisko, Connie L


    The focus of this review on periodontal self-care will be based primarily on the results of systematic reviews and meta-analyses. Based on the evidence gleaned from systematic reviews, it is notable that most authors of these reviews commented on the relatively small number of trials that could pass the quality-assessment inclusion in the systematic review. Interproximal devices, namely interproximal brushes, are more effective for reducing interproximal plaque and gingivitis than are flossing or brushing alone. Some added benefit may be attributed to the use of rotational oscillation powered toothbrushes over manual toothbrushes. Recommendations by the dentist and dental hygienist to add one or more chemotherapeutic agents to the typical oral hygiene regimen has been shown, in systematic reviews and meta-analyses, to reduce the level of plaque and gingival inflammation in patients. Oral irrigation does not seem to reduce visible plaque but does tend to reduce inflammation, determined by the presence of bleeding on probing, the gingival index score and probing depth measurements. To date, high-quality evidence is either lacking or weak in some areas regarding the efficacy of self-care and periodontal disease. Low educational attainment, smoking and socio-economic status are related to adverse periodontal health outcomes. Variation in self-esteem, self-confidence and perfectionism are associated with oral health status and oral health behaviors. Better understanding of the psychological factors associated with oral hygiene would be of benefit in further developing strategies to help patients improve their oral hygiene in addition to helping professionals design better programs on prevention and education.


    J. O. Macaulay


    Full Text Available Introduction and objectivesIt is has been widely accepted that assessment of learning is a critical component of education and that assessment drives/guides student learning through shaping study habits and student approaches to learning. However, although most academics would agree that assessment is a critical aspect of their roles as teachers it is often an aspect of teaching that is regarded more as an additional task rather than an integral component of the teaching/learning continuum. An additional impediment to high quality assessment is the non-evidence based-approach to the decision making process. The overall aim of this project was to improve the quality of assessment in Biochemistry and Molecular Biology undergraduate education by promoting high quality assessment.Materials and methodsTo do this we developed and trialled an audit tool for mapping assessment practices. The audit tool was designed to gather data on current assessment practices and identify areas of good practice in which assessment aligned with the learning objectives and areas in need of improvement. This evidence base will then be used to drive change in assessment.Results and conclusionsUsing the assessment mapping tool we have mapped the assessment regime in a Biochemistry and Molecular Biology major at Monash University. Criteria used included: assessment type, format, timing, assessors, provision of feedback, level of learning (Bloom’s, approaches taken to planning assessment. We have mapped assessment of content and the systematic development of higher order learning and skills progression throughout the program of study. The data has enabled us to examine the assessment at unit (course level as well as the vertical development across the major. This information is now being used to inform a review of the units and the major.

  15. Evidence-based and data-driven road safety management

    Fred Wegman


    Full Text Available Over the past decades, road safety in highly-motorised countries has made significant progress. Although we have a fair understanding of the reasons for this progress, we don't have conclusive evidence for this. A new generation of road safety management approaches has entered road safety, starting when countries decided to guide themselves by setting quantitative targets (e.g. 50% less casualties in ten years' time. Setting realistic targets, designing strategies and action plans to achieve these targets and monitoring progress have resulted in more scientific research to support decision-making on these topics. Three subjects are key in this new approach of evidence-based and data-driven road safety management: ex-post and ex-ante evaluation of both individual interventions and intervention packages in road safety strategies, and transferability (external validity of the research results. In this article, we explore these subjects based on recent experiences in four jurisdictions (Western Australia, the Netherlands, Sweden and Switzerland. All four apply similar approaches and tools; differences are considered marginal. It is concluded that policy-making and political decisions were influenced to a great extent by the results of analysis and research. Nevertheless, to compensate for a relatively weak theoretical basis and to improve the power of this new approach, a number of issues will need further research. This includes ex-post and ex-ante evaluation, a better understanding of extrapolation of historical trends and the transferability of research results. This new approach cannot be realized without high-quality road safety data. Good data and knowledge are indispensable for this new and very promising approach.

  16. Current distribution mapping in insulated (Gd,Y)BCO based stabilizer-free coated conductor after AC over-current test for R-SFCL application

    Kar, Soumen; Li, Xiao-Fen; Selvamanickam, Venkat; Rao, V. V.


    Uniformity of critical current (Ic ) over long lengths of (GdY)-Ba-Cu-O ((Gd,Y)BCO)-based high temperature superconducting (HTS) tapes after long periods of AC current excitation is an important criterion in their selection for resistive type superconducting fault current limiter (R-SFCL). The present work describes such critical current (Ic ) uniformity measurements performed over 1m long, stabilizer-free (SF), 12 mm wide, 2nd generation (2G) (Gd,Y)BCO based HTS tape. A non-destructive method using a static hall probe (Tapestar®) with moving HTS tape configuration was employed for estimation of Ic uniformity. Scanning Hall probe microscopy (SHPM) was then used to examine the weak superconducting regions (i.e. less Ic ) with a static HTS tape. Remanent field distribution on the HTS tape was measured to yield the critical current density distribution. Except for small degradation of Ic at some locations, these studies confirmed near-uniform critical current distribution over meter-long (Gd,Y)BCO tapes, both in virgin state and after exposure to AC over current.

  17. Evidence-based Comprehensive Approach to Forearm Arterial Laceration

    Janice N. Thai


    Full Text Available Introduction: Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and nerves. The management of forearm laceration with arterial injury involves both operative and nonoperative strategies. An evolution in management has emerged especially at urban trauma centers, where the multidisciplinary resource of trauma and hand subspecialties may invoke controversy pertaining to the optimal management of such injuries. The objective of this review was to provide an evidence-based, systematic, operative and nonoperative approach to the management of isolated and complex forearm lacerations. A comprehensive search of MedLine, Cochrane Library, Embase and the National Guideline Clearinghouse did not yield evidence-based management guidelines for forearm arterial laceration injury. No professional or societal consensus guidelines or best practice guidelines exist to our knowledge. Discussion: The optimal methods for achieving hemostasis are by a combination approach utilizing direct digital pressure, temporary tourniquet pressure, compressive dressings followed by wound closure. While surgical hemostasis may provide an expedited route for control of hemorrhage, this aggressive approach is often not needed (with a few exceptions to achieve hemostasis for most forearm lacerations. Conservative methods mentioned above will attain the same result. Further, routine emergent or urgent operative exploration of forearm laceration injuries are not warranted and not cost-beneficial. It has been widely accepted with ample evidence in the literature that neither injury to forearm artery, nerve or tendon requires immediate surgical repair. Attention should be directed instead to control of bleeding, and perform a complete physical examination of the hand to document the presence or absence of other associated injuries. Critical ischemia will require expeditious

  18. Heat generation ability in AC magnetic field of nano MgFe2O4-based ferrite powder prepared by bead milling

    Hirazawa, Hideyuki; Aono, Hiromichi; Naohara, Takashi; Maehara, Tsunehiro; Sato, Mitsunori; Watanabe, Yuji


    Nanosized MgFe2O4-based ferrite powder having heat generation ability in an AC magnetic field was prepared by bead milling and studied for thermal coagulation therapy applications. The crystal size and the particle size significantly decreased by bead milling. The heat generation ability in an AC magnetic field improved with the milling time, i.e. a decrease in crystal size. However, the heat generation ability decreased for excessively milled samples with crystal sizes of less than 5.5 nm. The highest heat ability (ΔT=34 °C) in the AC magnetic field (370 kHz, 1.77 kA/m) was obtained for fine MgFe2O4 powder having a ca. 6 nm crystal size (the samples were milled for 6-8 h using 0.1 mm ϕ beads). The heat generation of the samples was closely related to hysteresis loss, a B-H magnetic property. The reason for the high heat generation properties of the samples milled for 6-8 h using 0.1 mm ϕ beads was ascribed to the increase in hysteresis loss by the formation of a single domain. Moreover, the improvement in heating ability was obtained by calcination of the bead-milled sample at low temperature. In this case, the maximum heat generation (ΔT=41 °C) ability was obtained for a ca. 11 nm crystal size sample was prepared by crystal growth during the sample calcination. On the other hand, the ΔT value for Mg0.5Ca0.5Fe2O4 was synthesized using a reverse precipitation method decreased by bead milling.

  19. Multi-Agent-Based Controller for Voltage Enhancement in AC/DC Hybrid Microgrid Using Energy Storages

    Ahmadali Khatibzadeh


    Full Text Available Development of renewable energies and DC loads have led microgrids toward the creation of DC networks. The predictions show that the hybrid microgrids will be used widely in the future. This article has studied the voltage stability in the presence of sources of energy storage in AC/DC hybrid networks. However, because the different dynamics of hybrid networks applying centralized and distributed controllers will be faced with different problems, in this study, a multi-agent control for the microgrid has been used. A new structure referred to here as an event-driven microgrid control management (EDMCM has been developed to control the microgrid. This method increases response speed and accuracy of decision making. Hybrid Network Simulation results confirm the validity of the developed model.

  20. The Effect of the Feedback Controller on Superconducting Tokamak AC Losses + AC-CRPP user manual

    Schaerz, B.; Bruzzone, P.; Favez, J.Y.; Lister, J.B.; Zapretilina, E


    Superconducting coils in a Tokamak are subject to AC losses when the field transverse to the coil current varies. A simple model to evaluate the AC losses has been derived and benchmarked against a complete model used in the ITER design procedure. The influence of the feedback control strategy on the AC losses is examined using this model. An improved controller is proposed, based on this study. (author)

  1. Incorporating Mobile Phone Technologies to Expand Evidence-Based Care.

    Jones, Deborah J; Anton, Margaret; Gonzalez, Michelle; Honeycutt, Amanda; Khavjou, Olga; Forehand, Rex; Parent, Justin


    Ownership of mobile phones is on the rise, a trend in uptake that transcends age, region, race, and ethnicity, as well as income. It is precisely the emerging ubiquity of mobile phones that has sparked enthusiasm regarding their capacity to increase the reach and impact of health care, including mental health care. Community-based clinicians charged with transporting evidence-based interventions beyond research and training clinics are in turn, ideally and uniquely situated to capitalize on mobile phone uptake and functionality to bridge the efficacy to effectiveness gap. As such, this article delineates key considerations to guide these frontline clinicians in mobile phone-enhanced clinical practice, including an overview of industry data on the uptake of and evolution in the functionality of mobile phone platforms, conceptual considerations relevant to the integration of mobile phones into practice, representative empirical illustrations of mobile-phone enhanced assessment and treatment, and practical considerations relevant to ensuring the feasibility and sustainability of such an approach.

  2. Pros and cons of circumcision: an evidence-based overview.

    Friedman, B; Khoury, J; Petersiel, N; Yahalomi, T; Paul, M; Neuberger, A


    Based on three large randomized controlled trials (RCTs) conducted in Africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus (HIV) and some sexually transmitted infections (STIs) among males in settings of high HIV and STI endemicity. Similar effects on STI risk may exist for females, although this may result from an indirect effect of decreasing risk of infection among male partners. It is unknown whether circumcision prevents HIV acquisition in men who have sex with men (MSM), although there might be a protective effect for men who engage mainly in insertive anal intercourse. When the effects of adult circumcision on sexual function and satisfaction of men are examined, high-quality evidence strongly supports lack of harm. Whether circumcision alters sexual satisfaction of female partners is not known as fewer and smaller studies reported conflicting results. Circumcision rarely causes serious complications if practiced by trained practitioners, in a sterile setting, and with a proper follow-up. These conclusions are limited by the lack of high-quality data from areas outside of Africa. RCTs have not been conducted to assess the effects of circumcising infants or MSM. Circumcision has well-proven benefits for people residing in areas with high prevalence of STIs, including HIV, and is not unethical for those who choose to be circumcised or have their children circumcised on religious, social, or cultural grounds. For many others, a definite pro or con recommendation, based on a risk-benefit ratio, cannot be made.

  3. Disruptive innovations for designing and diffusing evidence-based interventions.

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F


    Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles.

  4. Health care-associated pneumonia: an evidence-based review.

    Attridge, Russell T; Frei, Christopher R


    Health care-associated pneumonia is a relatively new classification of pneumonia that includes community-dwelling pneumonia patients having contact with the health care system. Current data indicate that health care-associated pneumonia patients present with more severe disease, are more likely to be infected with drug-resistant pathogens, and suffer increased mortality compared with community-acquired pneumonia patients. Guidelines recommend that these patients receive empiric antibiotics similar to those recommended for nosocomial pneumonia; however, it is not currently known if outcomes are improved when health care-associated pneumonia patients are treated with these therapies. In addition, the individual health care-associated pneumonia risk factors are based on limited data and are a poor predictor of patients likely to be infected with drug-resistant pathogens. Many questions remain on how to most appropriately care for this growing group of pneumonia patients. This review is an evidence-based discussion of current health care-associated pneumonia data, the individual health care-associated pneumonia risk factors, and limitations and additional considerations for the health care-associated pneumonia classification system.

  5. An evidence-based conceptual framework of healthy cooking.

    Raber, Margaret; Chandra, Joya; Upadhyaya, Mudita; Schick, Vanessa; Strong, Larkin L; Durand, Casey; Sharma, Shreela


    Eating out of the home has been positively associated with body weight, obesity, and poor diet quality. While cooking at home has declined steadily over the last several decades, the benefits of home cooking have gained attention in recent years and many healthy cooking projects have emerged around the United States. The purpose of this study was to develop an evidence-based conceptual framework of healthy cooking behavior in relation to chronic disease prevention. A systematic review of the literature was undertaken using broad search terms. Studies analyzing the impact of cooking behaviors across a range of disciplines were included. Experts in the field reviewed the resulting constructs in a small focus group. The model was developed from the extant literature on the subject with 59 studies informing 5 individual constructs (frequency, techniques and methods, minimal usage, flavoring, and ingredient additions/replacements), further defined by a series of individual behaviors. Face validity of these constructs was supported by the focus group. A validated conceptual model is a significant step toward better understanding the relationship between cooking, disease and disease prevention and may serve as a base for future assessment tools and curricula.

  6. A systematic appraisal of the Evidence-Based Dentistry Journal.

    Mehta, Nikisha; Marshman, Zoe


    BackgroundThis systematic appraisal was conducted to determine if the Evidence-Based Dentistry Journal (EBDJ) acts as a reliable and contemporary source of knowledge for practitioners across all disciplines within dentistry.ObjectivesThe main objectives were to determine i) the year the articles were published and included in the EBDJ; ii) if the articles published covered all fields equally within dentistry; iii) the type of study design of the articles reported in the journal and; iv) the level of expertise of the writers of the commentaries.MethodsThis study used a systematic approach to assess the articles included in the journal. Data were extracted on the difference in the year the article was originally published and the year the article was included in the EBDJ, the number of articles in each dental discipline, the type of study designs included in the journal and the expertise of the commentators of each article. The information provided by the journal was validated by accessing the original articles through electronic databases.ResultsThe appraisal considered the 582 articles that met the inclusion criteria. Overall, 45.3% of the articles were included in the EBDJ in the same year and 44.8% of the articles were included a year after they were originally published. The number of articles varied across disciplines within dentistry: 23.7% from dental public health, 18.4% from periodontology and 11.8% from orthodontics, with only 4.6% from prosthodontics, 1% from oral pathology and 0.5% from dental materials. Most of the articles were systematic reviews and randomised controlled trials at 72% and 22.3% respectively. The writers of the commentaries were mostly academics and hospital consultants (71.2% and 13.6% commentators).ConclusionsOn the whole, it can be concluded that the journal acts as a reliable and contemporary source of knowledge/evidence for dentists, however, not all specialities within dentistry had equal coverage.

  7. A web-based library consult service for evidence-based medicine: Technical development

    Schwartz Alan


    Full Text Available Abstract Background Incorporating evidence based medicine (EBM into clinical practice requires clinicians to learn to efficiently gain access to clinical evidence and effectively appraise its validity. Even using current electronic systems, selecting literature-based data to solve a single patient-related problem can require more time than practicing physicians or residents can spare. Clinical librarians, as informationists, are uniquely suited to assist physicians in this endeavor. Results To improve support for evidence-based practice, we have developed a web-based EBM library consult service application (LCS. Librarians use the LCS system to provide full text evidence-based literature with critical appraisal in response to a clinical question asked by a remote physician. LCS uses an entirely Free/Open Source Software platform and will be released under a Free Software license. In the first year of the LCS project, the software was successfully developed and a reference implementation put into active use. Two years of evaluation of the clinical, educational, and attitudinal impact on physician-users and librarian staff are underway, and expected to lead to refinement and wide dissemination of the system. Conclusion A web-based EBM library consult model may provide a useful way for informationists to assist clinicians, and is feasible to implement.

  8. 基于AC+FIT AP的WLAN跨越三层网络注册问题研究%Research on WLAN Across Three-layer Network Registration Based on AC+FIT AP

    杨晓英; 薛文静


    本文首先给出学院WLAN覆盖需求,其次给出两种方案可供选择,最佳方案是AC+FIT AP方案,这也是大中型网络以后发展的方向,其中在此方案中最重要的是AC+FIT AP的option43注册, AP能否注册成功直接关系到WLAN的覆盖,最后给出FIT AP在AC上注册不成功故障排查方法。%This paper gives the college WLAN coverage requirements, and then gives two options. The best choice is AC+FIT AP scheme, which is the development trend of large and medium-sized network in future, the most important thing of which is the registration of AC+FIT AP option43. The success of AP registration is directly related to the WLAN coverage, and this paper finally proposes the method of solving the unsuccessful FIT AP registration.

  9. 基于谐振电抗器和磁能恢复开关的单相AC-DC变换器%Single-phase AC-DC converters based on resonance reactors and magnetic energy recovery switches

    王建全; 杨兴华; 张峦国; 杨喜军


    将谐振电抗器和磁能恢复开关引入到单相AC-DC变换器中,设计了一种新颖的混合单相AC-DC变换器.在理论分析谐振电抗器和磁能恢复开关单独在单相功率因数校正器(PFC)应用中的优点和不足的基础上,提出了一种结合两者长处的功率因数校正方法,能够获得更高输入功率因数(PF)和更高输出直流电压.并利用仿真软件ORCAD 10.5建立了完整的单相AC-DC变换器-逆变器仿真电路,对上述3种情况进行了FFT和参数扫描等仿真分析.结果说明了所提出的方案是可行的和低成本的,能够支持较大的输出功率,可以作为变频家用电器等的前级单相AC-DC变换器.

  10. Surveillance and Protection-Based Approach for Link Failures over Fiber-to the-Home (FTTH with Combination of ACS and SANTAD

    Aswir Premadi


    Full Text Available This paper introduces an in-service transmission surveillance and protection-based approach for fiber failures/faults over fiber-to-the-home passive optical network (FTTH-PON with an excellent combination of Access Control System (ACS and Smart Access Network Testing, Analyzing and Database (SANTAD. Our hardware design works on a standard local area network (LAN using a specially designed hardware interfaced with a microcontroller integrated Ethernet to monitor the status of optical signals flow and provide the restoration against fiber failures/faults in FTTH-PON. We also introduce the centralized management and access control program by means of SANTAD. ACS is used to control the troubleshooting mechanism carried out by SANTAD. This design will be implemented at central office (CO for distant monitoring and remote controlling each optical fiber line’s status as well as for detecting any failures/faults that occurs in the network system downwardly from CO towards multiple optical network units (ONUs. The scope of this discussion only highlighted on the monitoring and controlling instead of the restoration scheme.

  11. DC and AC voltammetry of a free-base porphyrin adsorbed onto basal-plane graphite under acidic conditions: An example of a close to ideal reversible two-electron surface-confined redox process at sub-monolayer coverages

    Fleming, Barry D. [School of Chemistry, Monash University, Wellington Rd, Clayton, Victoria 3800 (Australia)], E-mail:; Bond, Alan M. [School of Chemistry, Monash University, Wellington Rd, Clayton, Victoria 3800 (Australia)], E-mail:


    The free-base porphyrin, 5,10,15,20-tetrakis(1-methyl-4-pyridyl)-21H,23H-porphine (H{sub 2}TMPyP), adsorbs onto a basal-plane graphite electrode. Under DC cyclic voltammetric conditions, the fully protonated dication, [H{sub 4}TMPyP(0)]{sup 2+}, undergoes an apparently close to ideal surface-confined two-electron reduction to the neutral [H{sub 4}TMPyP(-II)] species when the supporting electrolyte consists of aqueous 1 M HCl and 1 M NaCl and coverages are sub-monolayer. The reversible potential calculated from the average of the oxidation and reduction peak potentials is 0.138 {+-} 0.002 V (vs Ag/AgCl, 3 M NaCl) whilst their separation {delta}E{sub p}, approaches 0 mV at slow scan rates, as expected theoretically for an ideal surface-confined electron transfer process. Comparisons of simulated and experimental data imply that the increase in {delta}E{sub p} observed at scan rates above 10 V s{sup -1} is consistent with uncompensated Ohmic IR{sub u} drop effects, and not limitations imposed by electron transfer kinetics. Analysis of fundamental and higher harmonic components derived from large-amplitude sine-wave AC voltammetry is consistent with a very fast electron transfer rate constant, k{sup 0}, in excess of 10{sup 6} s{sup -1} for the overall two-electron process. However, careful comparison with AC theory highlights minor levels of non-ideality not attributable to purely capacitative background or uncompensated resistance effects. These are particularly evident when greater than monolayer surface coverages are employed. It is likely that subtle contributions from heterogeneity in the adsorbed layer and complexities in the reaction mechanism are present in this close to ideal surface-confined process, but they are more readily detected under conditions of large-amplitude Fourier transformed AC cyclic voltammetry than with the conventionally used DC cyclic format.

  12. The Perception and Practice of Evidence Based Library and Information Practice

    Vahideh Zarea Gavgani


    Full Text Available Objective – Evidence based library and information services help to link best evidence with decision making in library practice. Current library and information science practice operates in both a knowledge and evidence‐based environment. Health service librarians provide information services in an evidence based health care context to improve patient care. But the evidence based practice movement has influenced many fields of human knowledge, including librarianship. Therefore, this study seeks to answer the following questions: 1 What are the perceptions of Iranian medical librarians regarding the use of an evidence based approach in their decision making processes? 2 Do Iranian medical librarians apply an evidence based approach in their professional work? 3 How do Iranian medical librarians practice an evidence based approach? 4 What are the barriers and limitations for Iranian medical librarians who engage in evidence based library and information practice (EBLIP?Methods – This study utilized a survey to discover medical librarians’ attitudes and perceptions towards the use of an evidence based approach to library practice in Iran. Data was collected using a structured questionnaire to identify medical librarians’ attitudes toward EBLIP.Results – The findings of the study indicate that Iranian medical librarians are aware of EBLIP and that they utilize an evidence based approach towards their LIS work. They practice the five steps of an evidence based answering cycle in formulating, locating, assessing, applying, and redefining questions. However, they have less knowledge about levels of evidence, research methodologies, and critical appraisal. Conclusions – Medical librarians in Iran are familiar with the concept of an evidence based approach. More training is needed in some elements of evidence based practice to improve their approach to evidence based library and information practice.

  13. ACS from development to operations

    Caproni, Alessandro; Colomer, Pau; Jeram, Bogdan; Sommer, Heiko; Chiozzi, Gianluca; Mañas, Miguel M.


    The ALMA Common Software (ACS), provides the infrastructure of the distributed software system of ALMA and other projects. ACS, built on top of CORBA and Data Distribution Service (DDS) middleware, is based on a Component- Container paradigm and hides the complexity of the middleware allowing the developer to focus on domain specific issues. The transition of the ALMA observatory from construction to operations brings with it that ACS effort focuses primarily on scalability, stability and robustness rather than on new features. The transition came together with a shorter release cycle and a more extensive testing. For scalability, the most problematic area has been the CORBA notification service, used to implement the publisher subscriber pattern because of the asynchronous nature of the paradigm: a lot of effort has been spent to improve its stability and recovery from run time errors. The original bulk data mechanism, implemented using the CORBA Audio/Video Streaming Service, showed its limitations and has been replaced with a more performant and scalable DDS implementation. Operational needs showed soon the difference between releases cycles for Online software (i.e. used during observations) and Offline software, which requires much more frequent releases. This paper attempts to describe the impact the transition from construction to operations had on ACS, the solution adopted so far and a look into future evolution.

  14. A philosophical analysis of the evidence-based medicine debate

    Stanley Donald E


    Full Text Available Abstract Background The term "evidence-based medicine" (or EBM was introduced about ten years ago, and there has been considerable debate about the value of EBM. However, this debate has sometimes been obscured by a lack of conceptual clarity concerning the nature and status of EBM. Discussion First, we note that EBM proponents have obscured the current debate by defining EBM in an overly broad, indeed almost vacuous, manner; we offer a clearer account of EBM and its relation to the alternative approaches to medicine. Second, while EBM proponents commonly cite the philosophical work of Thomas Kuhn and claim that EBM is a Kuhnian 'paradigm shift,' we argue that such claims are seriously mistaken and unduly polarize the EBM debate. Third, we suggest that it is much more fruitful to understand the relationship between EBM and its alternatives in light of a different philosophical metaphor: W.V. Quine's metaphor of the web of belief. Seen in this way, we argue that EBM is an approach to medical practice that is indeed importantly different from the alternatives. Summary We can have a more productive debate about the value of EBM by being clearer about the nature of EBM and its relationship to alternative approaches to medicine.

  15. Treatment of neuromyelitis optica: an evidence based review

    Douglas Sato


    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS, and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

  16. Introducing evidence-based dentistry to dental students using histology.

    Lallier, Thomas E


    The expansion of evidence-based dentistry (EBD) is essential to the continued growth and development of the dental profession. Expanding EBD requires increased emphasis on critical thinking skills during dental education, as noted in the American Dental Education Association's Competencies for the New General Dentist. In order to achieve this goal, educational exercises must be introduced to increase the use of critical thinking skills early in the dental curriculum, with continued reinforcement as students progress through subsequent years. Described in this article is one approach to increasing student exposure to critical thinking during the early basic science curriculum-specifically, within the confines of a traditional histology course. A method of utilizing the medical and dental research literature to reinforce and enliven the concepts taught in histology is described, along with an approach for using peer-to-peer presentations to demonstrate the tools needed to critically evaluate research studies and their presentation in published articles. This approach, which could be applied to any basic science course, will result in a stronger foundation on which students can build their EBD and critical thinking skills.

  17. Evidence Based Validation of Indian Traditional Medicine – Way Forward

    Pulok K Mukherjee


    Full Text Available Evidence based validation of the ethno-pharmacological claims on traditional medicine (TM is the need of the day for its globalization and reinforcement. Combining the unique features of identifying biomarkers that are highly conserved across species, this can offer an innovative approach to biomarker-driven drug discovery and development. TMs are an integral component of alternative health care systems. India has a rich wealth of TMs and the potential to accept the challenge to meet the global demand for them. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH medicine are the major healthcare systems in Indian Traditional Medicine. The plant species mentioned in the ancient texts of these systems may be explored with the modern scientific approaches for better leads in the healthcare. TM is the best sources of chemical diversity for finding new drugs and leads. Authentication and scientific validation of medicinal plant is a fundamental requirement of industry and other organizations dealing with herbal drugs. Quality control (QC of botanicals, validated processes of manufacturing, customer awareness and post marketing surveillance are the key points, which could ensure the quality, safety and efficacy of TM. For globalization of TM, there is a need for harmonization with respect to its chemical and metabolite profiling, standardization, QC, scientific validation, documentation and regulatory aspects of TM. Therefore, the utmost attention is necessary for the promotion and development of TM through global collaboration and co-ordination by national and international programme.

  18. Evidence Based Validation of Indian Traditional Medicine-Way Forward

    Pulok K Mukherjee; Ranjit K Harwansh; Shiv Bahadur; Subhadip Banerjee; Amit Kar


    Evidence based validation of the ethno-pharmacological claims on traditional medicine (TM) is the need of the day for its globalization and reinforcement. Combining the unique features of identifying biomarkers that are highly conserved across species, this can offer an innovative approach to biomarker-driven drug discovery and development. TMs are an integral component of alternative health care systems. India has a rich wealth of TMs and the potential to accept the challenge to meet the global demand for them. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicine are the major healthcare systems in Indian Traditional Medicine. The plant species mentioned in the ancient texts of these systems may be explored with the modern scientific approaches for better leads in the healthcare. TM is the best sources of chemical diversity for finding new drugs and leads. Authentication and scientific validation of medicinal plant is a fundamental requirement of industry and other organizations dealing with herbal drugs. Quality control (QC) of botanicals, validated processes of manufacturing, customer awareness and post marketing surveillance are the key points, which could ensure the quality, safety and efficacy of TM. For globalization of TM, there is a need for harmonization with respect to its chemical and metabolite profiling, standardization, QC, scientific validation, documentation and regulatory aspects of TM. Therefore, the utmost attention is necessary for the promotion and development of TM through global collaboration and co-ordination by national and international programme.

  19. Preventing child maltreatment: An evidence-based update

    Gonzalez A


    Full Text Available Child maltreatment is a significant public health problem associated with a broad range of negative outcomes in children and adolescents that can extend into adulthood. This review summarizes information about programs aimed at the prevention of child maltreatment evaluated by controlled trials, with a focus on home visitation programs. It does not include programs aimed at prevention of child sexual abuse, the subject of a separate review in this series. We discuss those programs that include one or more measures of child maltreatment and related outcomes (reports of abuse and neglect, injuries, hospitalizations and emergency room visits. Most programs targeting at-risk families have not shown evidence of effectiveness in preventing abuse or neglect. An important exception is the Nurse Family Partnership (NFP, a program provided by nurses to first-time socially disadvantaged mothers beginning prenatally that has undergone rigorous evaluation in three randomized controlled trials. It has shown consistent effects in reducing reports of maltreatment and associated outcomes as well as additional benefits in maternal and child health in high-risk families. A second exception is the promising Early Start program provided by nurses and social workers to at-risk families beginning postnatally. One randomized controlled trial of the program has shown reduced rates of parental reports of severe abuse and hospital attendance for injuries and poisonings, based on records. The characteristics of the NFP and Early Start programs are discussed with special emphasis on ways in which they differ from other home visitation programs.

  20. Evidence-based approach to cutaneous hyperandrogenism in women.

    Schmidt, Timothy H; Shinkai, Kanade


    Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA.

  1. Single stage single phase active power factor corrected Ĉuk Topology Based AC-DC Converter

    Md. Ismail Hossain


    Full Text Available This paper focuses on the analysis of a power factor correction (PFC converter using close loop Ĉuk topology. Regardless of the input line voltage and output load variations, input current drawn by the buck or buck-boost converter is always discontinuous. The Boost converter suffers from high voltage stresses across the power electronic devices. The input current in Ĉuk converter is comparable to boost converter’s input current. In this paper output voltage is controlled by inner current and outer voltage control loop along with power factor correction (PFC. It shows less input current THD, nearly unity power factor and better output voltage regulation of AC-DC converter under variable input voltage and output load. In this paper the relative performance between normal diode rectifier, open loop Ĉuk rectifier and close loop Ĉuk rectifier is presented. An algorithm for implementing close loop Ĉuk rectifier in digital domain is developed and simulated.

  2. Autopsy practice in forensic pathology - Evidence-based or experience-based?

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte


    -gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy...

  3. Evidence based educational policy and practice: the case of applying the educational effectiveness knowledge base

    Scheerens, J.


    Evidence based educational policy and practice means, first of all, that new programs use relevant scientific knowledge for design purposes, or for critical review of initial program ideas (ex ante evaluation). Secondly, before programs are implemented on a large scale it is considered desirable to

  4. Strategies for Teaching Evidence-Based Management: What Management Educators Can Learn from Medicine

    Wright, April L.; Middleton, Stuart; Greenfield, Geoffrey; Williams, Julian; Brazil, Victoria


    Evidence-based management (EBMgt) is a growing literature stream in management education which contends that management decision making should be informed by the best available scientific evidence (Rousseau, 2006). Encouraged by the success of evidence-based practice in the field of medicine, advocates of EBMgt have increasingly called for…

  5. Effect of an evidence-based answering service on GPs and their patients : a pilot study

    Verhoeven, A.A.; Schuling, J.


    OBJECTIVES: For general practitioners (GPs), an important obstacle to practising evidence-based medicine is lack of time. An evidence-based answering service was developed that took over searching and appraisal of medical evidence from the GPs. GPs sent in questions, and the informationist formulate

  6. Student Knowledge, Attitudes, and Use of Evidence-Based Concepts Following an Educational Intervention

    Manspeaker, Sarah A.; Van Lunen, Bonnie L.; Turocy, Paula S.; Pribesh, Shana; Hankemeier, Dorice


    Context: While evidence-based practice (EBP) concepts are being taught in health profession education programs, models of instruction and effectiveness of these models are not evident in athletic training. Objective: To evaluate the effectiveness of the Evidence-Based Teaching Model (EBTM) in increasing student knowledge, attitudes, and use of…

  7. New Labour and Education: An Evidence-Based Analysis

    Galton, Maurice


    This article looks at the evidence concerning performance and progress in the primary school over the lifetime of New Labour's tenure in government since 1997. It examines the claims made by New Labour that the Literacy and Numeracy Strategies have been an outstanding success and have changed the ways that teachers teach. On the evidence of the…

  8. The evidence base for professional and self-care prevention

    Twetman, Svante


    and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low...

  9. Evidence-based decision-making: when it is worthwhile

    Ignacio Neuman


    Full Text Available Every day health professionals have to make dozens of decisions regarding patient care and management. It is not easy to integrate scientific evidence in this process. The primary ability we need in order to achieve successful results is learning how to recognize the circumstances in which evidence arising from results of scientific trials may help.

  10. Evidence-based approaches to other symptoms in advanced cancer.

    Dy, Sydney Morss; Apostol, Colleen C


    Dyspnea, nausea and vomiting, anorexia, fatigue, and sleep disturbances are common and distressing in advanced cancer. We updated previous systematic reviews of how these symptoms can be alleviated with targeted literature searches. The approach to these symptoms requires comprehensive symptom assessment; treating underlying causes when benefits exceed risks; prioritizing treatment, as patients usually have many symptoms; and addressing psychosocial and spiritual distress. For dyspnea, evidence supports systemic opioids and nonpharmacological treatments such as a fan. The strongest evidence supports metoclopramide for cancer-related nausea and octreotide for bowel obstruction. For anorexia, enteral or parenteral nutrition is indicated with obstruction and expected prognosis of at least 6 weeks. Evidence supports several drugs for appetite affecting quality of life. For fatigue, evidence supports psychosocial interventions and methylphenidate. For insomnia, evidence supports cognitive-behavioral therapy in cancer; no sleep agents have superior effectiveness.

  11. Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews.

    Kiriakou, Juliana; Pandis, Nikolaos; Madianos, Phoebus; Polychronopoulou, Argy


    Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

  12. Heat generation ability in AC magnetic field of nano MgFe{sub 2}O{sub 4}-based ferrite powder prepared by bead milling

    Hirazawa, Hideyuki, E-mail: [Department of Environmental Materials Engineering, Niihama National College of Technology, Niihama 792-8580 (Japan); Aono, Hiromichi; Naohara, Takashi; Maehara, Tsunehiro [Graduate School of Science and Engineering, Ehime University, Matsuyama 790-8577 (Japan); Sato, Mitsunori [AdMeTech Co. Ltd., 2821-4, Minami-yoshida-cyo, Matsuyama 791-8042 (Japan); Watanabe, Yuji [Department of Surgery, Graduate School of Medicine, Ehime University, Toon 791-0295 (Japan)


    Nanosized MgFe{sub 2}O{sub 4}-based ferrite powder having heat generation ability in an AC magnetic field was prepared by bead milling and studied for thermal coagulation therapy applications. The crystal size and the particle size significantly decreased by bead milling. The heat generation ability in an AC magnetic field improved with the milling time, i.e. a decrease in crystal size. However, the heat generation ability decreased for excessively milled samples with crystal sizes of less than 5.5 nm. The highest heat ability ({Delta}T=34 {sup o}C) in the AC magnetic field (370 kHz, 1.77 kA/m) was obtained for fine MgFe{sub 2}O{sub 4} powder having a ca. 6 nm crystal size (the samples were milled for 6-8 h using 0.1 mm {phi} beads). The heat generation of the samples was closely related to hysteresis loss, a B-H magnetic property. The reason for the high heat generation properties of the samples milled for 6-8 h using 0.1 mm {phi} beads was ascribed to the increase in hysteresis loss by the formation of a single domain. Moreover, the improvement in heating ability was obtained by calcination of the bead-milled sample at low temperature. In this case, the maximum heat generation ({Delta}T=41 {sup o}C) ability was obtained for a ca. 11 nm crystal size sample was prepared by crystal growth during the sample calcination. On the other hand, the {Delta}T value for Mg{sub 0.5}Ca{sub 0.5}Fe{sub 2}O{sub 4} was synthesized using a reverse precipitation method decreased by bead milling. - Research highlights: > The crystal and particle size for MgFe{sub 2}O{sub 4} based ferrite were decreased by bead milling. > The highest heat ability was obtained for MgFe{sub 2}O{sub 4} having a ca. 6 nm crystal size. > This high heat generation ability was ascribed to the increase in hysteresis loss. > Hysteresis loss was increased by the formation of a single domain.

  13. Comparative Study of Breakdown Voltage of Mineral, Synthetic and Natural Oils and Based Mineral Oil Mixtures under AC and DC Voltages

    Abderrahmane Beroual


    Full Text Available This paper deals with a comparative study of AC and DC breakdown voltages of based mineral oil mixtures with natural and synthetic esters mainly used in high voltage power transformers. The goal was to analyze the performances of oil mixtures from the dielectric withstand point of view and to predict the behavior of transformers originally filled with mineral oil and re-filled with synthetic or natural ester oils when emptied for maintenance. The study concerns mixtures based on 20%, 50%, and 80% of natural and synthetic ester oils. AC breakdown voltages were measured using a sphere-sphere electrode system according to IEC 60156 specifications; the same specification was adopted for DC measurements since there is no standard specifications for this voltage waveform. A statistical analysis of the mean values, standard deviations, and histograms of breakdown voltage data was carried out. The Normal and Weibull distribution functions were used to analyze the experimental data and the best function that the data followed was used to estimate the breakdown voltage with risk of 1%, 10%, and 50% probability. It was shown that whatever the applied voltage waveforms, ester oils always have a significantly higher breakdown voltage than mineral oil. The addition of only 20% of natural or synthetic ester oil was sufficient to considerably increase the breakdown voltage of mineral oil. The dielectric strength of such a mixture is much higher than that of mineral oil alone and can reach that of ester oils. From the point of view of dielectric strength, the mixtures constitute an option for improving the performance of mineral oil. Thus, re-filling of transformers containing up to 20% mineral oil residues with ester oils, does not present any problem; it is even advantageous when considering only the breakdown voltage. Under AC, the mixtures with natural ester always follow the behavior of vegetable oil alone. With the exception of the 20% mixture of natural

  14. Embedded Artificial Neuval Network-Based Real-Time Half-Wave Dynamic Resistance Estimation during the A.C. Resistance Spot Welding Process

    Liang Gong


    Full Text Available Online monitoring of the instantaneous resistance variation during the A.C. resistance spot welding is of paramount importance for the weld quality control. On the basis of the welding transformer circuit model, a new method is proposed to measure the transformer primary-side signal for estimating the secondary-side resistance in each 1/4 cycle. The tailored computing system ensures that the measuring method possesses a real-time computational capacity with satisfying accuracy. Since the dynamic resistance cannot be represented via an explicit function with respect to measurable parameters from the primary side of the welding transformer, an offline trained embedded artificial neural network (ANN successfully realizes the real-time implicit function calculation or estimation. A DSP-based resistance spot welding monitoring system is developed to perform ANN computation. Experimental results indicate that the proposed method is applicable for measuring the dynamic resistance in single-phase, half-wave controlled rectifier circuits.

  15. Morphological studies of the galaxy populations in distant "Butcher-Oemler" clusters with HST. II. AC103, AC118 and AC114 at z=0.31

    Couch, W J; Smail, I; Ellis, Richard S; Sharples, R M


    We present new results of a program to study the detailed morphologies of galaxies in intermediate redshift clusters and hence understand the physical origin of the enhanced star formation in these environments at earlier epochs. Deep, high resolution imagery has been obtained of 3 rich clusters, AC103,AC118 & AC114 at z=0.31, using the WFPC2 on HST. For AC103 & AC118, single pointings covering a central 0.5x0.5Mpc have been obtained; for AC114, 4 pointings covering a 1.2x0.7Mpc area have been obtained, allowing the more outer regions of a distant cluster to be studied. Hubble types plus evidence for dynamical interactions and/or structural abnormalities have been determined visually for all galaxies down to R=22.25 in AC103 & AC118 and R=23.0 in AC114.We find the numbers of spirals (Sa-Sdm) in our clusters to be up to 4x higher than that seen in present-day clusters; only in the virialised core of our most massive regular cluster, AC114, do we see morphological fractions approaching those of the ...

  16. Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach

    Houe, T; Thorböll, J E; Sigild, U;


    to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine....

  17. Alienating evidence based medicine vs. innovative medical device marketing: a report on the evidence debate at a Wounds conference.

    Madden, Mary


    Wound care management is one of the largest segments of the UK medical technology sector with a turnover exceeding £1bn in 2009 (BIS, 2010). Using data derived from participant observation, this article examines the antagonistic relationship expressed by wound care clinicians towards evidence based medicine in the context of the 2010 United Kingdom (UK) Wounds UK conference/trade show, where evidence based medicine is positioned in opposition to clinical knowledge, as an obstacle to innovation and as a remover of solutions rather than a provider of them. The article is written in the context of the trend towards increasing marketization and privatization in the UK National Health Service (NHS).

  18. Introduction to the basics of evidence-based dentistry: concepts and skills.

    Forrest, Jane L


    The purpose of this section of the ADA Champions Pre-Conference is to review the basics of Evidence-based dentistry (EBD), research designs and levels of evidence, and identify the skills necessary for clinicians to efficiently use an evidence-based approach in practice. This session of the pre-conference preceded the session on the skills needed to define a clinical question and search for the evidence to answer that question.

  19. Social skills interventions for individuals with autism: evaluation for evidence-based practices within a best evidence synthesis framework.

    Reichow, Brian; Volkmar, Fred R


    This paper presents a best evidence synthesis of interventions to increase social behavior for individuals with autism. Sixty-six studies published in peer-reviewed journals between 2001 and July 2008 with 513 participants were included. The results are presented by the age of the individual receiving intervention and by delivery agent of intervention. The findings suggest there is much empirical evidence supporting many different treatments for the social deficits of individuals with autism. Using the criteria of evidence-based practice proposed by Reichow et al. (Journal of Autism and Developmental Disorders, 38:1311-1318, 2008), social skills groups and video modeling have accumulated the evidence necessary for the classifications of established EBP and promising EBP, respectively. Recommendations for practice and areas of future research are provided.

  20. Coblation for tonsillectomy: an evidence-based review.

    Shah, Udayan K; Dunham, Brian


    Coblation technology (Arthrocare Corp., Sunnyvale, Calif., USA) allows for tonsillectomy using plasma-mediated ablation. This review presents the evidence to date with respect to surgical and recovery measures, in order to promote an objective discussion of this surgical technology.

  1. Air pollution and stroke - an overview of the evidence base.

    Maheswaran, Ravi


    Air pollution is being increasingly recognized as a significant risk factor for stroke. There are numerous sources of air pollution including industry, road transport and domestic use of biomass and solid fuels. Early reports of the association between air pollution and stroke come from studies investigating health effects of severe pollution episodes. Several daily time series and case-crossover studies have reported associations with stroke. There is also evidence linking chronic air pollution exposure with stroke and with reduced survival after stroke. A conceptual framework linking air pollution exposure and stroke is proposed. It links acute and chronic exposure to air pollution with pathways to acute and chronic effects on stroke risk. Current evidence regarding potential mechanisms mainly relate to particulate air pollution. Whilst further evidence would be useful, there is already sufficient evidence to support consideration of reduction in air pollution as a preventative measure to reduce the stroke burden globally.

  2. Evidence-based Sensor Tasking for Space Domain Awareness

    Jaunzemis, A.; Holzinger, M.; Jah, M.


    Space Domain Awareness (SDA) is the actionable knowledge required to predict, avoid, deter, operate through, recover from, and/or attribute cause to the loss and/or degradation of space capabilities and services. A main purpose for SDA is to provide decision-making processes with a quantifiable and timely body of evidence of behavior(s) attributable to specific space threats and/or hazards. To fulfill the promise of SDA, it is necessary for decision makers and analysts to pose specific hypotheses that may be supported or refuted by evidence, some of which may only be collected using sensor networks. While Bayesian inference may support some of these decision making needs, it does not adequately capture ambiguity in supporting evidence; i.e., it struggles to rigorously quantify 'known unknowns' for decision makers. Over the past 40 years, evidential reasoning approaches such as Dempster Shafer theory have been developed to address problems with ambiguous bodies of evidence. This paper applies mathematical theories of evidence using Dempster Shafer expert systems to address the following critical issues: 1) How decision makers can pose critical decision criteria as rigorous, testable hypotheses, 2) How to interrogate these hypotheses to reduce ambiguity, and 3) How to task a network of sensors to gather evidence for multiple competing hypotheses. This theory is tested using a simulated sensor tasking scenario balancing search versus track responsibilities.

  3. The "evidence-based practice inventory" : reliability and validity was demonstrated for a novel instrument to identify barriers and facilitators for Evidence Based Practice in health care

    Kaper, Nina M; Swennen, Maartje H J; van Wijk, Arjen J; Kalkman, Cor J; van Rheenen, Nanda; van der Graaf, Yolanda; van der Heijden, Geert J M G


    OBJECTIVES: To design and validate a practical questionnaire for clinicians, to identify barriers and facilitators for evidence-based practice (EBP), that is, the use of research evidence in patient care. The inventory is ultimately intended for departments to assess local conditions for EBP, to aim

  4. The "evidence-based practice inventory": reliability and validity was demonstrated for a novel instrument to identify barriers and facilitators for Evidence Based Practice in health care

    Kaper, N.M.; Swennen, M.H.J.; van Wijk, A.J.; Kalkman, C.J.; van Rheenen, N.; van der Graaf, Y.; van der Heijden, G.J.M.G.


    Objectives To design and validate a practical questionnaire for clinicians, to identify barriers and facilitators for evidence-based practice (EBP), that is, the use of research evidence in patient care. The inventory is ultimately intended for departments to assess local conditions for EBP, to aim


    Miguel Villablanca


    Full Text Available En este artículo un método y un aparato son aplicados a distintas configuraciones de rectificadores ca/cc tiristorizados para reducir la distorsión de las corrientes en el lado de C.A. La carga puede ser inductiva o capacitiva. La tecnología consiste en darle una adecuada forma de onda a la corriente en el lado de C.C. a través de dos interruptores de conmutación forzada. Esta forma de onda lograda en la corriente en el lado de C.C. se refleja en la forma de onda de las corrientes en el lado de C.A., las cuales se transforman en perfectas ondas senoidales. El circuito de control es simple y es también capaz de manejar variaciones rápidas de corriente de carga y fallas en los interruptores de conmutación forzada. La conducción simultánea de los tiristores del puente rectificador es eliminada completamente. La validación experimental de la tecnología es mostrada a través de un prototipo de laboratorio de 400 V, 50 Hz y 30 KVA.In this paper both a method and apparatus are applied to different configurations of thyristor-based ac/dc rectifiers to reduce the distortion of currents flowing from the ac supply. The load may be either inductive or capacitive. The technology involves an accurate shaping of the dc current by using two self-commutated switches. This dc-current shaping is reflected back into the shaping of the ac input currents, which become pure sine waves. The control circuit is simple, and also able to deal with both rapid load variations and failures in the self-commutated switches. Furthermore, the overlap conduction of bridge thyristors is eliminated completely. Experimental verification is provided from a 400-V 50-Hz 30-kVA laboratory prototype.

  6. Finding, retrieving and evaluating journal and web-based information for evidence-based optometry.

    Graham, Ann-Maree


    How can optometrists ensure they are basing their advice to patients on the most reliable information available? This paper discusses search tools, databases, websites and journals, which provide free, full-text, web-based access to evidence-based literature. Brief tips on searching these resources are provided for the time-poor practitioner or researcher. Criteria, such as credibility, currency and bias are used to evaluate written material and will be discussed with particular reference to the problems inherent in evaluating web pages.

  7. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    Yadav, B L


    Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

  8. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    Yadav, B L; Fealy, G M


    Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient's clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

  9. 基于FPGA的交流伺服高精度反馈系统%AC Servo High-Precision Feed-Back System Based on FPGA

    谢强强; 周虎; 黄琦


    By using FPGA high speed parallel processing features, design the AC servo high-precision feed-back system based on FPGA. The system total design concept is given, design and realize the high-speed high-precision data acquisition system for position loop, speed loop and current loop. The designed system is tested on a lkW permanent magnet synchronous motor (PMSM) AC servo platform. The test result shows that the designed system can overcoming the defect of single DSP that can not perform the functions of algorithm control and acquisition of feed-back information simultaneously, improves real-time performance and accuracy of data acquisition of feed-back system, hence enhances the bandwidth and overall performance of the servo control system.%利用FPGA高速并行处理的特点,设计了一种基于FPGA的交流伺服高精度反馈系统.给出了系统设计的总体思路,并设计实现了位置环、速度环和电流环反馈信息的高速高精度采集,将设计的系统应用于1 kW永磁同步电机交流伺服平台上进行试验.试验结果表明:该系统能克服DSP无法完成算法控制和反馈信息采集同时进行的缺陷,改善了反馈信息采集的实时性和精确度,有效地提高了交流伺服的带宽和总体性能.

  10. The benefits of evidence-based dentistry for the private dental office.

    Gillette, Jane; Matthews, Joseph D; Frantsve-Hawley, Julie; Weyant, Robert J


    Dentistry over the last 100 years has been characterized by improved approaches to education and practice. Parallel to trends in the field of medicine as a whole, dentistry is moving toward evidence-based practices. The goal of evidence-based dentistry is the assurance, through reference to high-quality evidence, that care provided is optimal for the patient and that treatment options are presented in a manner that allows for fully informed consent. As we transition toward broad-based use of evidence-based dentistry approaches in clinical practice, many dental offices will benefit from a better understanding of how evidence-based dentistry can improve patient outcomes. This article lists the likely benefits evidence-based dentistry can provide to patients, staff, and dentists when routinely adopted in daily practice.

  11. Infusion Nursing: An Evidence-Based Approach - Third edition Alexander Mary Infusion Nursing: An Evidence-Based Approach - Third edition 625pp Elsevier 9781416064107 1416064109 [Formula: see text].


    This book considers all aspects of infusion therapy and provides a solid evidence base. Its 30 chapters are well organised into six sections covering physiological considerations, infusion therapies and nursing practice.

  12. Network Forensics Method Based on Evidence Graph and Vulnerability Reasoning

    Jingsha He


    Full Text Available As the Internet becomes larger in scale, more complex in structure and more diversified in traffic, the number of crimes that utilize computer technologies is also increasing at a phenomenal rate. To react to the increasing number of computer crimes, the field of computer and network forensics has emerged. The general purpose of network forensics is to find malicious users or activities by gathering and dissecting firm evidences about computer crimes, e.g., hacking. However, due to the large volume of Internet traffic, not all the traffic captured and analyzed is valuable for investigation or confirmation. After analyzing some existing network forensics methods to identify common shortcomings, we propose in this paper a new network forensics method that uses a combination of network vulnerability and network evidence graph. In our proposed method, we use vulnerability evidence and reasoning algorithm to reconstruct attack scenarios and then backtrack the network packets to find the original evidences. Our proposed method can reconstruct attack scenarios effectively and then identify multi-staged attacks through evidential reasoning. Results of experiments show that the evidence graph constructed using our method is more complete and credible while possessing the reasoning capability.

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  14. Implications of Evidence-Based Practices for Personnel Preparation Development in Early Childhood Intervention

    Dunst, Carl J.


    The article includes a practical definition of evidence-based practices, examples of different types of practice-based research syntheses, 3 models for conceptualizing evidence-based early childhood intervention, and a description of the implications of the definition, syntheses, and models of early childhood intervention for personnel…

  15. Factors influencing the development of evidence-based practice among nurses: a self-report survey

    Dalheim Anne


    Full Text Available Abstract Background Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP. The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice.


    E.R. Soriano


    Full Text Available Psoriatic arthritis is a heterogeneous condition, the pattern of which is determined by any combination of pathology affecting peripheral joints, the enthesis and the spine. There is a paucity of evidence for most of the conventional agents used to treat psoriatic arthritis, with many of them being used on the basis of experience in rheumatoid arthritis. Herein, we summarise the evidence compiled relating to effectiveness of treatment for various manifestation of PsA. For those patients with progressive forms of arthritis who may benefit from intervention of newer biological therapies, the continued use of conventional therapy needs ever increasing scrutiny. Key words: Psoriatic arthritis, psoriasis, therapy

  17. Cooperative Frequency Control for Autonomous AC Microgrids

    Shafiee, Qobad; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.;


    Distributed secondary control strategies have been recently studied for frequency regulation in droop-based AC Microgrids. Unlike centralized secondary control, the distributed one might fail to provide frequency synchronization and proportional active power sharing simultaneously, due to having...... not require measuring the system frequency as compared to the other presented methods. An ac Microgrid with four sources is used to verify the performance of the proposed control methodology....

  18. Strength-based leadership coaching in organizations an evidence-based guide to positive leadership development

    MacKie, Doug


    Positive organizational psychology, with its focus on the identification and development of strengths, is a natural ally to executive development and leadership coaching. However, this approach is only just beginning to come to the attention of organizations and consequently, the research base for strength-based coaching is in its early stages of development. Strength-based Leadership Coaching in Organizations reviews strength-based approaches to positive leadership development and evaluates the evidence for their effectiveness, critically assesses their apparent distinctiveness and considers how strengths can be reliably assessed and developed in their organizational context. This book reviews key areas of leader and team development are reviewed and outlines and describes a model of strengths development in organizations. The application of strength-based leadership coaching will be discussed from the managerial and external perspective within the context of career stage, seniority, role challenges and orga...

  19. Understanding Evidence-Based Information for the Early Childhood Field: Tips from RAND's Promising Practices Network

    Mattox, Teryn; Kilburn, M. Rebecca


    With the growing and diverse use of the term "evidence-based practice" it can be difficult for policymakers, funders, program officers, and other professionals to separate the good evidence from the flawed. Furthermore, once good evidence has been identified, it can be difficult to know how to use it. This article discusses key issues to consider…

  20. Evidence-based practice as mental health policy: three controversies and a caveat.

    Tanenbaum, Sandra J


    Evidence-based practice (EBP) is the subject of vigorous controversy in the field of mental health. In this paper I discuss three distinct but interrelated controversies: how inclusive the mental health evidence base should be; whether mental health practice is a variety of applied science; and when and how the effectiveness goal in mental health is defined. I provide examples of evidence-based policy in mental health. These controversies pertain as well to general medicine. To the extent that they remain unresolved, evidence-based policy making may lead to ineffective and limited care.