WorldWideScience

Sample records for acs evidence based

  1. Composite Based EHV AC Overhead Transmission Lines

    DEFF Research Database (Denmark)

    Sørensen, Thomas Kjærsgaard

    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

    Science.gov (United States)

    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

    Directory of Open Access Journals (Sweden)

    Rakan Kh Antar

    2013-05-01

    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 Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    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...... and electronic patient records for diabetes patients, this paper reports research in progress regarding the prospects and pitfalls of evidence-based development....

  5. Evidence based practice

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2011-01-01

    Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...... is that practitioners lose their autonomy, that the understanding of theory and of underlying mechanisms is weakened, and that the concept of evidence is too narrow in the empiricist tradition. In this article, it is suggested that we should speak of “research-based practice” rather than EBP, because this term is open...... to more fruitful epistemologies and provides a broader understanding of evidence.The focus on scientific argumentation in EBP is an important contribution from EBP to LIS, which is long overdue, but parts of the underlying epistemological assumptions should be replaced: EBP is too narrow, too formalist...

  6. Evidence based pediatrics.

    OpenAIRE

    Elizabeta ZISOVSKA

    2015-01-01

    It is very difficult to define the entire phrase “Evidence based pediatrics”, covering all components of this overused sentence. The definition comes out of the common sentence and it means integration of the individual clinical expertize together with the best external clinically available evidence of the systematic reviews which are of interest and benefit of the individual patient.Development of clinically appropriate structured question follows PICO model, i.e. containing f...

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

    Directory of Open Access Journals (Sweden)

    Cuidong Xu

    2015-09-01

    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.

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

    International Nuclear Information System (INIS)

    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 (CaCO3, 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 (Ca10(PO4)6(OH)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

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

    Energy Technology Data Exchange (ETDEWEB)

    Tas, A. Cuneyt, E-mail: c_tas@hotmail.com

    2015-03-01

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

    Science.gov (United States)

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

    2010-12-01

    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.

  11. Evidence-based dentistry.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    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

  12. AC dipole based optics measurement and correction at RHIC

    CERN Document Server

    Shen, X; Bai, M; White, S; Robert-Domolaize, G; Luo, Y; Marusic, A; Tomas, R

    2013-01-01

    Independent component analysis (ICA) was applied to the AC dipole based optics measurement at RHIC to extract beta functions as well as phase advances at each BPM. Existence of excessive beta-beat was observed in both rings of RHIC at polarized proton store energy. A unique global optics correction scheme was then developed and tested successfully during the RHIC polarized proton run in 2013. The feasibility of using horizontal closed orbit bump at sextupole for arc beta-beat correction was also demonstrated.

  13. Context based computational analysis and characterization of ARS consensus sequences (ACS) of Saccharomyces cerevisiae genome.

    Science.gov (United States)

    Singh, Vinod Kumar; Krishnamachari, Annangarachari

    2016-09-01

    Genome-wide experimental studies in Saccharomyces cerevisiae reveal that autonomous replicating sequence (ARS) requires an essential consensus sequence (ACS) for replication activity. Computational studies identified thousands of ACS like patterns in the genome. However, only a few hundreds of these sites act as replicating sites and the rest are considered as dormant or evolving sites. In a bid to understand the sequence makeup of replication sites, a content and context-based analysis was performed on a set of replicating ACS sequences that binds to origin-recognition complex (ORC) denoted as ORC-ACS and non-replicating ACS sequences (nrACS), that are not bound by ORC. In this study, DNA properties such as base composition, correlation, sequence dependent thermodynamic and DNA structural profiles, and their positions have been considered for characterizing ORC-ACS and nrACS. Analysis reveals that ORC-ACS depict marked differences in nucleotide composition and context features in its vicinity compared to nrACS. Interestingly, an A-rich motif was also discovered in ORC-ACS sequences within its nucleosome-free region. Profound changes in the conformational features, such as DNA helical twist, inclination angle and stacking energy between ORC-ACS and nrACS were observed. Distribution of ACS motifs in the non-coding segments points to the locations of ORC-ACS which are found far away from the adjacent gene start position compared to nrACS thereby enabling an accessible environment for ORC-proteins. Our attempt is novel in considering the contextual view of ACS and its flanking region along with nucleosome positioning in the S. cerevisiae genome and may be useful for any computational prediction scheme. PMID:27508123

  14. Context based computational analysis and characterization of ARS consensus sequences (ACS of Saccharomyces cerevisiae genome

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Singh

    2016-09-01

    Full Text Available Genome-wide experimental studies in Saccharomyces cerevisiae reveal that autonomous replicating sequence (ARS requires an essential consensus sequence (ACS for replication activity. Computational studies identified thousands of ACS like patterns in the genome. However, only a few hundreds of these sites act as replicating sites and the rest are considered as dormant or evolving sites. In a bid to understand the sequence makeup of replication sites, a content and context-based analysis was performed on a set of replicating ACS sequences that binds to origin-recognition complex (ORC denoted as ORC-ACS and non-replicating ACS sequences (nrACS, that are not bound by ORC. In this study, DNA properties such as base composition, correlation, sequence dependent thermodynamic and DNA structural profiles, and their positions have been considered for characterizing ORC-ACS and nrACS. Analysis reveals that ORC-ACS depict marked differences in nucleotide composition and context features in its vicinity compared to nrACS. Interestingly, an A-rich motif was also discovered in ORC-ACS sequences within its nucleosome-free region. Profound changes in the conformational features, such as DNA helical twist, inclination angle and stacking energy between ORC-ACS and nrACS were observed. Distribution of ACS motifs in the non-coding segments points to the locations of ORC-ACS which are found far away from the adjacent gene start position compared to nrACS thereby enabling an accessible environment for ORC-proteins. Our attempt is novel in considering the contextual view of ACS and its flanking region along with nucleosome positioning in the S. cerevisiae genome and may be useful for any computational prediction scheme.

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

    Science.gov (United States)

    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

  16. Evidence-Based Laboratory Medicine

    Institute of Scientific and Technical Information of China (English)

    Christopher P Price

    2004-01-01

    @@ 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].

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

    Science.gov (United States)

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

    2012-09-01

    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.

  18. AC Zeeman potentials for atom chip-based ultracold atoms

    Science.gov (United States)

    Fancher, Charles; Pyle, Andrew; Ziltz, Austin; Aubin, Seth

    2015-05-01

    We present experimental and theoretical progress on using the AC Zeeman force produced by microwave magnetic near-fields from an atom chip to manipulate and eventually trap ultracold atoms. These AC Zeeman potentials are inherently spin-dependent and can be used to apply qualitatively different potentials to different spin states simultaneously. Furthermore, AC Zeeman traps are compatible with the large DC magnetic fields necessary for accessing Feshbach resonances. Applications include spin-dependent trapped atom interferometry and experiments in 1D many-body physics. Initial experiments and results are geared towards observing the bipolar detuning-dependent nature of the AC Zeeman force at 6.8 GHz with ultracold 87Rb atoms trapped in the vicinity of an atom chip. Experimental work is also underway towards working with potassium isotopes at frequencies of 1 GHz and below. Theoretical work is focused on atom chip designs for AC Zeeman traps produced by magnetic near-fields, while also incorporating the effect of the related electric near-fields. Electromagnetic simulations of atom chip circuits are used for mapping microwave propagation in on-chip transmission line structures, accounting for the skin effect, and guiding impedance matching.

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

    Directory of Open Access Journals (Sweden)

    Venkatesan Jamuna

    2009-01-01

    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. .

  20. Active Power Regulation based on Droop for AC Microgrid

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  1. AC transport in graphene-based Fabry-Perot devices

    OpenAIRE

    Rocha, Claudia G; Torres, Luis E. F. Foa; Cuniberti, Gianaurelio

    2009-01-01

    We report on a theoretical study of the effects of time-dependent fields on electronic transport through graphene nanoribbon devices. The Fabry-P\\'{e}rot interference pattern is modified by an ac gating in a way that depends strongly on the shape of the graphene edges. While for armchair edges the patterns are found to be regular and can be controlled very efficiently by tuning the ac field, samples with zigzag edges exhibit a much more complex interference pattern due to their peculiar elect...

  2. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    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...

  3. Evidence-based policy

    DEFF Research Database (Denmark)

    Vohnsen, Nina Holm

    2013-01-01

    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....

  4. Evidence-based playground design

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... opportunities for play, nature exploration and sensory stimulation. As it is increasingly expected that designers base their decisions on research evidence, there is a need to develop approaches to facilitate this, which also applies to playground design. The design of PlayLab Cph was based on relevant evidence......, best practice, and the theories of Affordances and Behaviour Settings. A post-occupancy evaluation was carried out through a questionnaire survey and observation studies, which revealed that a majority of the potential evidence-based affordances were actualised, and that the application of the theories...

  5. Insufficient Evidence: The Problems of Evidence-Based Nursing.

    Science.gov (United States)

    Rolfe, Gary

    1999-01-01

    Challenges the wisdom of basing nursing practice on the findings of statistical research and offers objections to the philosophy of evidence-based nursing. Proposes rethinking what counts as evidence, suggesting a model based on reflection after the event. (SK)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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....

  7. Non-oxidized porous silicon-based power AC switch peripheries

    OpenAIRE

    Menard, Samuel; Fèvre, Angélique; Valente, Damien; Billoué, Jérôme; Gautier, Gaël

    2012-01-01

    We present in this paper a novel application of porous silicon (PS) for low-power alternating current (AC) switches such as triode alternating current devices (TRIACs) frequently used to control small appliances (fridge, vacuum cleaner, washing machine, coffee makers, etc.). More precisely, it seems possible to benefit from the PS electrical insulation properties to ensure the OFF state of the device. Based on the technological aspects of the most commonly used AC switch peripheries physicall...

  8. Risk Based Assessment of Subsynchronous Resonance in AC/DC Systems

    OpenAIRE

    Adrees, Atia

    2014-01-01

    Risk Based Assessment of Subsynchronous Resonance in compensated AC/DC systemMrs Atia Adrees, The University of Manchester, April 2014This thesis investigates the phenomenon of subsynchronous resonance (SSR) in meshed series compensated AC/DC systems in the presence of operational uncertainties. The main contribution of this research is the novel application of risk assessment methods to SSR studies.In terms of network topology, future electric power transmission networks alongside the curren...

  9. Evidence-Based IT Development

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2005-01-01

    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...

  10. An ac quantum voltmeter based on a 10 V programmable Josephson array

    Science.gov (United States)

    Lee, Jinni; Behr, Ralf; Palafox, Luis; Katkov, Alexander; Schubert, Marco; Starkloff, Michael; Böck, Andreas Charles

    2013-12-01

    An ac quantum voltmeter based on a 10 V programmable Josephson array that is simple to use, provides dc and ac calibration up to kHz range for equipment widely used in metrology, and ensures direct traceability to a quantum-based standard, is developed. This ac quantum voltmeter is proven to match conventional Josephson standard systems at dc and extends its advantages up to 10 kHz in the low-frequency ac range. The ac quantum voltmeter is capable of performing calibrations up to 7 VRMS in the frequency range from dc to 10 kHz completely under software control. A direct comparison at dc has demonstrated an uncertainty better than 2 parts in 1010 (k = 2). The uncertainty at 1 kHz is better than 1.7 µV V-1 (k = 2) for a measurement time of 1 min. The ac quantum voltmeter is a robust and practical system that fulfils the needs of general metrology laboratories for quantum-based voltage calibrations.

  11. Non-oxidized porous silicon-based power AC switch peripheries

    Science.gov (United States)

    Menard, Samuel; Fèvre, Angélique; Valente, Damien; Billoué, Jérôme; Gautier, Gaël

    2012-10-01

    We present in this paper a novel application of porous silicon (PS) for low-power alternating current (AC) switches such as triode alternating current devices (TRIACs) frequently used to control small appliances (fridge, vacuum cleaner, washing machine, coffee makers, etc.). More precisely, it seems possible to benefit from the PS electrical insulation properties to ensure the OFF state of the device. Based on the technological aspects of the most commonly used AC switch peripheries physically responsible of the TRIAC blocking performances (leakage current and breakdown voltage), we suggest to isolate upper and lower junctions through the addition of a PS layer anodically etched from existing AC switch diffusion profiles. Then, we comment the voltage capability of practical samples emanating from the proposed architecture. Thanks to the characterization results of simple Al-PS-Si(P) structures, the experimental observations are interpreted, thus opening new outlooks in the field of AC switch peripheries.

  12. Evidence-Based Radiology (EBR

    Directory of Open Access Journals (Sweden)

    Mansoor Fatehi

    2009-01-01

    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

  13. DNA molecular wire-based nanoelectronics: New insight and high frequency AC electrical characterization

    Science.gov (United States)

    Wibowo, Denni Ari

    While recent research in electron-transport mechanism on a double strands DNA seems to converge into a consensus, experiments in direct electrical measurements on a long DNA molecules still lead to a conflicting result. This research investigates experimentally the attachment of DNA molecular wire to high aspect ratio three-dimensional (3D) metal electrode and the effect of temperature to its AC electrical conductivity. The 3-D microelectrode was built on a silicone oxide substrate using patterned thick layers of negative tone photoresist covered by sputtered gold on the top surface. Attachment of lambda-DNA to the microelectrode was demonstrated using oligonucleotide-DNA phosphate backbone ligation and thiol-gold covalent bonding. Electrical characterizations based on I-V and AC impedance analysis of several repeatable data points of attachment with varying lambda-DNA concentration (500 ng/microL to 0.0625 ng/microL) showed measurable and significant conductivity of lambda-DNA molecular wires. Further study was carried out by measuring I-V and impedance while ramping up the temperature to reach complete denaturation (~1100C) resulting in no current transduction. Subsequent re-annealing of the DNA through incubation in TM buffer at annealing temperature (~900C) resulted in recovery of electrical conduction, providing a strong proof that DNA molecular wire is the one generate the electrical conductivity. lambda-DNA molecular wires reported to have differing impedance response at two temperature regions: impedance increases (conductivity decrease) between 40C -- 400C, and then decreases from 400C until DNA completely denatured (~1100C). The increase conductivity after 400C is an experimental support the long distance electron transport mechanism referred as "thermal hopping" mechanism. We believe that this research represents a significant departure from previous studies and makes unique contributions through (i) modification of DNA attachment methods has increase

  14. Water-induced dc and ac degradations in TiO2-based ceramic capacitors

    International Nuclear Information System (INIS)

    Water-induced degradations of TiO2-based ceramic capacitors in the presence of dc and ac voltages are reported in this paper. Atomic hydrogen generated by electrolysis of water using dc voltages reduced TiO2-based ceramics at ambient temperature. The resulting degradation was characterized by an increase in capacitance, a large dielectric loss and a dramatic decrease in insulation resistance. Hydrogen and oxygen generated by the electrolysis of water using ac voltages reacted with TiO2-based ceramics. The resulting degradation was characterized by a decrease in capacitance, a large dielectric loss, but no noticeable changes in insulation resistance. Water played a vital role in both dc and ac degradations of TiO2-based capacitors and an effort should be made to prevent water-induced degradations

  15. 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

    Institute of Scientific and Technical Information of China (English)

    郑诗程; 陈玲; 曹小虎

    2011-01-01

    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.

  16. Evidence-Based Practice and School Nursing

    Science.gov (United States)

    Adams, Susan; McCarthy, Ann Marie

    2005-01-01

    School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…

  17. Evidence of me” in evidence based medicine?

    OpenAIRE

    Lockwood, Susan

    2004-01-01

    Evidence based medicine provides independent, validated advice about treatment options, but does it take sufficient account of individual patients' values to provide them with an optimal health outcome?

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

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    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.

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

    DEFF Research Database (Denmark)

    Wang, Yanbo; Chen, Zhe; Wang, Xiongfei;

    2015-01-01

    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 each...

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

    DEFF Research Database (Denmark)

    Wang, Xiongfei; Blaabjerg, Frede; Liserre, Marco;

    2014-01-01

    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...... tests on a three-converter-based setup are carried out. The results show that the active damper can become a promising way to stabilize the power-electronics-based ac power systems....

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

    Directory of Open Access Journals (Sweden)

    Janaína G. Oliveira

    2011-01-01

    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 Science Communication

    Science.gov (United States)

    Kahan, D.

    2012-12-01

    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.

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

    NARCIS (Netherlands)

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

    2007-01-01

    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

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

    Science.gov (United States)

    Soni, Gaurav; Squires, Todd; Meinhart, Carl

    2006-11-01

    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.

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

    DEFF Research Database (Denmark)

    Wang, Xiongfei; Blaabjerg, Frede; Wu, Weimin

    2014-01-01

    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 w...... power system can be easily predicted through Nyquist diagrams. Time-domain simulations and experimental tests on a three-inverter-based power system are presented. The results validate the effectiveness of the theoretical approach....

  6. Synthesizing Quantitative Evidence for Evidence-based Nursing: Systematic Review.

    Science.gov (United States)

    Oh, Eui Geum

    2016-06-01

    As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR), a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings. PMID:27349664

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

    Directory of Open Access Journals (Sweden)

    WISUTMETHEEKORN, P.

    2011-05-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Mohammed Abdeljalil DJEHAF

    2014-02-01

    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.

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

    CERN Document Server

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

    2015-01-01

    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...

  10. Evidence-based integrative dermatology

    Directory of Open Access Journals (Sweden)

    Saravu R Narahari

    2013-01-01

    Full Text Available American recognition for medical pluralism arrived in 1991. The National Center for Complementary and Alternative Medicine was established under the National Institutes of Health in 1998. Following this, patients and researchers began exploring use of integrative medicine. Terence Ryan with Gerry Bodeker in Europe, Brian Berman in America, and the Indian council of Medical Research advocated traditional medicine and integrative medicine. The Institute of Applied Dermatology (IAD, Kerala has developed integrated allopathic (biomedical and ayurvedic therapies to treat Lymphatic Filariasis, Lichen planus, and Vitiligo. Studies conducted at the IAD have created a framework for evidence-based and integrative dermatology (ID. This paper gives an overview of advances in ID with an example of Lichen Planus, which was examined jointly by dermatologists and Ayurveda doctors. The clinical presentation in these patients was listed in a vikruthi table of comparable biomedical terms. A vikruthi table was used for drug selection in ayurvedic dermatology. A total of 19 patients were treated with ayurvedic prescriptions to normalize the vatha-kapha for 3 months. All patients responded and no side effects were recorded. In spite of advancing knowledge on ID, several challenges remain for its use on difficult to treat chronic skin diseases. The formation of new integrative groups and financial support are essential for the growth of ID in India.

  11. Evidence-Based Practice: Management of Vertigo

    OpenAIRE

    Nguyen-Huynh, Anh T.

    2012-01-01

    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.

  12. Evidence-based practice voor verpleegkundigen

    NARCIS (Netherlands)

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

    2004-01-01

    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-

  13. 76 FR 4649 - ACS Energy Services, Inc.; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Science.gov (United States)

    2011-01-26

    ... 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...

  14. Defending Evidence Based Practice (Editorial

    Directory of Open Access Journals (Sweden)

    Lindsay Glynn

    2007-07-01

    contributing to the existing literature by publishing original research. One of the strengths of the EBLIP journal is the Evidence Summaries section. Not only are these critical appraisals of previously published research, but the critical appraisals themselves are peer reviewed. The knowledge base, therefore, is being populated with original research as well as rigorously evaluated research. Am I still feeling defensive? Perhaps a little. I am sure that the time and effort that I have invested in EBLIP cannot help but create some bias. On the other hand, I have seen that evidence based practice is making an impact on how numerous individuals and institutions approach decision making. I am reading, seeing and hearing about research being designed, performed and evaluated within a new framework. EBP is standard practice in the health professions and is swiftly gaining solid ground in the social sciences, education and in government. Our profession prides itself on being on the cutting edge of information access and management: if information professionals choose not to adopt the model, which has been proven time and time again to be effective, they risk being placed outside cutting edge, innovative practice. Is that where we want to be?

  15. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Garattini, Silvio; Jakobsen, Janus C; Wetterslev, Jørn;

    2016-01-01

    Using the best quality of clinical research evidence is essential for choosing the right treatment for patients. How to identify the best research evidence is, however, difficult. In this narrative review we summarise these threats and describe how to minimise them. Pertinent literature was consi...... research are carefully considered and minimised, research results will be more valid and this will benefit patients and heath care systems....

  16. Psiquiatria baseada em evidências Evidence-based psychiatry

    Directory of Open Access Journals (Sweden)

    Maurício S de Lima

    2000-09-01

    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.

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

    CERN Document Server

    Szczesniak, Pawel

    2013-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Wendy A. Abbott

    2006-03-01

    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.

  19. Implementing Evidence-Based Social Work Practice

    Science.gov (United States)

    Mullen, Edward J.; Bledsoe, Sarah E.; Bellamy, Jennifer L.

    2008-01-01

    Recently, social work has been influenced by new forms of practice that hold promise for bringing practice and research together to strengthen the scientific knowledge base supporting social work intervention. The most recent new practice framework is evidence-based practice. However, although evidence-based practice has many qualities that might…

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  1. Sicily statement on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Hopayian Kevork

    2005-01-01

    Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.

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

    Directory of Open Access Journals (Sweden)

    Farhan Beg

    2015-01-01

    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.

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

    Science.gov (United States)

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

    2014-08-01

    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.

  4. Evidence Based Practice: Science? Or Art? (Editorial)

    OpenAIRE

    Denise Koufogiannakis

    2011-01-01

    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...

  5. Making Evidence-based Practice Educational.

    Science.gov (United States)

    Elliott, John

    2001-01-01

    Examines David Hargreaves' ideas about the nature of evidence-based practice and the future direction for educational research. States that one major theme is that current discourse about evidence-based teaching is uninformed by an articulate educational theory, therefore excluding thoughtful consideration of implications of such a theory for…

  6. Evidence-Based Clearinghouses in Social Work

    Science.gov (United States)

    Soydan, Haluk; Mullen, Edward J.; Alexandra, Laine; Rehnman, Jenny; Li, You-Ping

    2010-01-01

    Objectives: The purpose of this article is to describe several evidence-based clearinghouses focused on social work and related intervention outcomes, placing them in the context of how such clearinghouses can contribute to research dissemination to foster effective, evidence-based practice. Method: The study employed an analysis of data provided…

  7. Evidence-based medicine and levels of evidence.

    Science.gov (United States)

    Wallace, David K

    2010-01-01

    Evidence-based medicine is the practice of making medical decisions based on evidence gained from applying the scientific method. Published studies are evaluated using three key questions: "Are the results valid?"; "What are the results?"; and "Can the results be applied to my patients?" The hierarchy of study methods for obtaining evidence is, in order from least to most useful: laboratory research, editorials, case reports and series, case-control studies, cohort studies, and randomized clinical trials. Retrospective case series can suffer from problems such as selection of a biased sample, mixing of treatment effects, and lack of control group. Randomized clinical trials (and meta-analyses of multiple trials) provide the highest level of evidence because randomization limits confounding and prevents bias of treatment assignment. In addition, randomized trials have standardization of interventions, prospective data collection, and masked outcome measures. Although every question cannot be addressed by a randomized clinical trial, the best available evidence should be sought and used to guide treatments. PMID:21061876

  8. From evidence-based to evidence-reflected practice

    DEFF Research Database (Denmark)

    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...... of a thing, a situation, an action, or something else, and judgments involves criteria, either explicit or implicit criteria. Thus, the Wittgensteinian approach I take suggests a more interpretative, reasoning approach, one that is sensitive to ambiguity, incoherence, multiple meanings and contradiction...... within professional practice and learning. Hence, it suggest the need to move beyond current ideas of an evidence-based practice towards a conception of an evidence-reflected practice in which professional knowledge is regarded not as a fixed base, but as a field of ambiguity and multiple meanings which...

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

    CERN Document Server

    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

    2016-01-01

    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

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

    DEFF Research Database (Denmark)

    Nielsen, Nils

    2004-01-01

    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...

  11. Single stage AC-DC converter for Galfenol-based micro-power energy harvesters

    Science.gov (United States)

    Cavaroc, Peyton; Curtis, Chandra; Naik, Suketu; Cooper, James

    2014-06-01

    Military based sensor systems are often hindered in operational deployment and/or other capabilities due to limitations in their energy storage elements. Typically operating from lithium based batteries, there is a finite amount of stored energy which the sensor can use to collect and transmit data. As a result, the sensors have reduced sensing and transmission rates. However, coupled with the latest advancements in energy harvesting, these sensors could potentially operate at standard sensing and transition rates as well as dramatically extend lifetimes. Working with the magnetostrictive material Galfenol, we demonstrate the production of enough energy to supplement and recharge a solid state battery thereby overcoming the deficiencies faced by unattended sensors. As with any vibration-based energy harvester, this solution produces an alternating current which needs to be rectified and boosted to a level conducive to recharge the storage element. This paper presents a power converter capable of efficiently converting an ultra-low AC voltage to a solid state charging voltage of 4.1VDC. While we are working with Galfenol transducers as our energy source, this converter may also be applied with any AC producing energy harvester, particularly at operating levels less than 2mW and 200mVAC.

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

    Directory of Open Access Journals (Sweden)

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

    2007-01-01

    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.

  13. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    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.

  14. Evidence-Based ACL Reconstruction.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 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-analyses focused 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. PMID:25692162

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

    Institute of Scientific and Technical Information of China (English)

    MEI Hongwei; WANG Liming; GUAN Zhicheng; MAO Yingke

    2012-01-01

    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.

  16. De Bijziendheid van evidence based practice

    NARCIS (Netherlands)

    Steyaert, Jan; Biggelaar, Tineke van den; Peels, Johan

    2010-01-01

    Evidence based practice is tegenwoordig "hot"in de sociale sector maar is dat terecht? Is er veel heil van te verwachten en draagt dit bij aan beroepsinnovatie? Kritische beschouwing over een trendy fenomeen.

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

    DEFF Research Database (Denmark)

    Dal, Mehmet; Teodorescu, Remus; Blaabjerg, Frede

    2013-01-01

    In vector-controlled AC drives, the design of current controller is usually based on a machine model defined in synchronous frame coordinate, where the drive performance may be degraded by both the variation of the machine parameters and the cross-coupling between the d- and q-axes components......, 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....

  18. [Looking for evidence-based medical informatics].

    Science.gov (United States)

    Coiera, Enrico

    2016-03-01

    e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work. PMID:27030221

  19. Evidence-based Management of Glaucoma

    Institute of Scientific and Technical Information of China (English)

    Yangfan Yang; Minbin Yu

    2005-01-01

    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.

  20. A Kalman filtering based control scheme for the improvement of dynamic performance of an AC/DC power system

    Science.gov (United States)

    Pecen, Recayi

    In this dissertation, two major accomplishments are achieved. First, the feasibility of a proposed Wyoming to California HVDC system having the ratings of 1000 MW, ±500 kV, 2 kA, 860 miles and 12-pulse bipolar lines is shown for exporting Wyoming's electrical power resources to the heavy loaded western states. The second and the main objective of this dissertation is the development of a Kalman filtering (KF) based control scheme applied to an ac/dc power system. It is shown that the use KF algorithm to estimate some of the system states and utilizing them in a proportional Integral (PI) controller which has a better performance for this specific control scheme have resulted in a better dynamic performance of the proposed system. A set of case studies has shown that the system dynamic performance is improved for most of the contingencies. Ac and dc noisy voltage and current measurements received from the simulated ac/dc power system are sent to the KF estimation algorithm. The noise-separated best estimates of measurable states are computed and sent to a PI controller-based current and firing angle control subsections in order to provide a set of optimum thyristor firing angles for both converter stations during and after contingencies until the normal operation is reached. To evaluate the dynamic performance of the system with the KF algorithm, the model is simulated by a well-known digital simulation package, Electromagnetic Transients DC Program (PSCAD/EMTDC) of Manitoba HVDC Research Center. To apply the KF algorithm, a general, linearized, state-space model of the proposed ac/dc system, appropriate for analyzing both the KF and the electromagnetics transients, is derived first. The derived model enables the representation of an ac power system with two ac sources and one HVDC line with a parallel ac line connecting the two systems. It is shown that system eigenvalues of the discretized system model for a normal operating point are inside the unit circle that

  1. Evidence-based equine dentistry: preventive medicine.

    Science.gov (United States)

    Carmalt, James L

    2007-08-01

    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. PMID:17616326

  2. Professionalism and evidence-based practice

    DEFF Research Database (Denmark)

    Rasmussen, Palle

    2015-01-01

    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...

  3. The fallacy of evidence based policy

    CERN Document Server

    Saltelli, Andrea

    2016-01-01

    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...

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

    Science.gov (United States)

    Wang, Dafang; Peterson, Thomas

    2013-01-01

    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.

  5. Crime prevention: more evidence-based analysis.

    Science.gov (United States)

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

    2008-02-01

    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. ACS: ALMA Common Software

    Science.gov (United States)

    Chiozzi, Gianluca; Šekoranja, Matej

    2013-02-01

    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.

  7. A Corpus for Evidence Based Medicine Summarisation

    Directory of Open Access Journals (Sweden)

    Diego Mollá Aliod

    2012-09-01

    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 http://sourceforge.net/projects/ebmsumcorpus.

  8. Oncology Nursing Is Evidence-Based Care.

    Science.gov (United States)

    Kennedy Sheldon, Lisa; Brown, Carlton G

    2016-06-01

    This issue of the Clinical Journal of Oncology Nursing (CJON) will be the final time that you will see the Evidence-Based Practice (EBP) feature column. Why? Because we have seen oncology nursing evolve in the past 20 years and EBP is everywhere! We use it in our clinics and hospital units, incorporate it into decisions about symptom management, and use evidence to develop survivorship guidelines. We discuss EBP in journal clubs and use applications on mobile devices to find the best interventions for our patients. We have oncology nurses sitting on committees to develop guidelines based on the best evidence and expert opinion. We have come a long way and it is our belief that EBP is included in almost every article in CJON and, therefore, a need no longer exists for an individual column about EBP. 
. PMID:27206287

  9. Evidence-Based Classroom Behaviour Management Strategies

    Science.gov (United States)

    Parsonson, Barry S.

    2012-01-01

    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. Evidence Based Education Request Desk. EBE #359

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2008

    2008-01-01

    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…

  11. Evidence Based Education Request Desk. EBE #555

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    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…

  12. Evidence Based Education Request Desk. EBE #510

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    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,…

  13. Evidence Based Education Request Desk. EBE #741

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

    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…

  14. Evidence Based Education Request Desk. EBE #798

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

    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…

  15. Evidence-Based Education in Plastic Surgery.

    Science.gov (United States)

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

    2015-08-01

    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.

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

    Institute of Scientific and Technical Information of China (English)

    TAN Guan-zheng; DOU Hong-quan

    2007-01-01

    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.

  17. The Evidence-Based Manifesto for School Librarians

    Science.gov (United States)

    Todd, Ross

    2008-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-03-01

    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

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

    Directory of Open Access Journals (Sweden)

    Chendan Li

    2016-09-01

    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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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. Observation, Sherlock Holmes, and Evidence Based Medicine.

    Science.gov (United States)

    Osborn, John

    2002-01-01

    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.

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

    Science.gov (United States)

    Osborn, John

    2002-01-01

    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. PMID:14509997

  3. [Evidence-based medicine: an epistemological approach].

    Science.gov (United States)

    Henao, Daniel Eduardo; Jaimes, Fabián Alberto

    2009-03-01

    Evidence-based medicine gathers physician's experience and the best scientific evidence to make medical decisions. This proposal has been widely promulgated by medical opinion leaders. Despite a large literature supporting this practice, a formal discussion has not been established regarding its epistemological consequences in daily medical work. The main proposal of evidence-based medicine consists of choosing the best medical decision according to the best available results from scientific studies. Herein, the goal was to highlight inappropriate application of the scientific method used by physics to clinical science. The inaccuracy resides in describing health and disease in strictly numeric equivalents that can be homogenized on a continuous scale. Finally, the authors consider each diseased human being as a complex system, unique and particular, and that this being is defined by an historical background as well as current actual context. Therefore, evidence-based medicine possesses certain limitations that must be recognized in order to to provide better health care to patients. PMID:19753837

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

    Institute of Scientific and Technical Information of China (English)

    许柏宏; 葛红娟; 张文彬; 李后春

    2013-01-01

    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.

  5. Evidence Based Education: un quadro storico

    Directory of Open Access Journals (Sweden)

    Giuliano Vivanet

    2013-08-01

    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.

  6. Evidence-based policymaking: A review

    Directory of Open Access Journals (Sweden)

    Karen Nortje

    2010-05-01

    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

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    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?

    Directory of Open Access Journals (Sweden)

    Finlay A McAlister

    2007-08-01

    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

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2010-12-01

    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 recommendation on toothpaste use

    Directory of Open Access Journals (Sweden)

    Jaime Aparecido Cury

    2014-01-01

    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.

  11. Evidence-Based Chinese Medicine for Hypertension

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    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. Creative teaching an evidence-based approach

    CERN Document Server

    Sale, Dennis

    2015-01-01

    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...

  13. Evidence based psychosocial interventions in substance use

    Directory of Open Access Journals (Sweden)

    Sonali Jhanjee

    2014-01-01

    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.

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

    Indian Academy of Sciences (India)

    E Z Karimi; J Esmaeilzadeh; E Marzbanrad

    2015-02-01

    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.

  15. [Acupressure and Evidence-Based Nursing].

    Science.gov (United States)

    Chen, Li-Li; Lin, Jun-Dai

    2015-12-01

    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. PMID:26645442

  16. Evidence-Based Interactive Management of Change

    Directory of Open Access Journals (Sweden)

    Albert Fleischmann

    2011-06-01

    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.

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

    Science.gov (United States)

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

    2008-01-01

    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.

  18. How to teach evidence-based surgery.

    Science.gov (United States)

    Fingerhut, Abe; Borie, Frédéric; Dziri, Chadli

    2005-05-01

    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.

  19. Disseminating evidence-based care into practice.

    Science.gov (United States)

    Coleman, Eric A; Rosenbek, Susan A; Roman, Sarah P

    2013-08-01

    The Centers for Medicare and Medicaid Services (CMS) has launched the Partnership for Patients initiative, promising a 20% reduction in readmissions nationally across all payers by December 31, 2013. To address this ambitious goal, CMS has awarded grants to Hospital Engagement Networks, Pioneer Accountable Care Organizations, and the Community-based Care Transitions Program, as well as instituted new penalties for excessive readmission that began in October 2012. National efforts aimed at realizing this goal are predicated, in part, on our effectiveness in disseminating evidence-based care models into practice to improve outcomes and reduce costs. The Care Transitions Intervention (CTI) has been developed, tested, and disseminated to over 750 health care organizations in 40 states nationwide. Four factors promote wide-scale CTI dissemination. The first factor focuses on model fidelity whereby adopters are given insight into which elements of the intervention can be adapted and customized. The second factor concerns the selection of Transitions Coaches and reinforcement of their role through training and participation in a national peer learning network. The third factor relates to model execution with attention to integrating the intervention into existing workflows and fostering relationships with community stakeholders. The fourth factor involves cultivating the support to sustain or expand the intervention through continually making the business case in a changing health care landscape. The lessons learned through the dissemination and implementation of the CTI may be generalizable to the spread of a variety of evidence-based care models.

  20. The religion of evidence-based practice

    DEFF Research Database (Denmark)

    Wigram, Tony; Gold, Christian

    2012-01-01

    , 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...... 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. 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

    Institute of Scientific and Technical Information of China (English)

    巫付专; 侯婷婷; 韩梁; 冯占伟

    2015-01-01

    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 .

  2. Theory- and evidence-based Intervention

    DEFF Research Database (Denmark)

    Nissen, Poul

    2011-01-01

    In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence-based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning which includes recognition...... of the influence of community, school, peers, famely and the functional and structural domains of personality at the behavioural, psenomenological, intra-psychic and biophysical level in a dialectical process. One important aspect of the theoretical basis for presentation of this model is that the child......'s personality must be understood in terms of the historical development. This assessment and intervention model focusses equally on strength and virtues as well as obstacles against development within the individual and its relations. Finally, guidelines for how to measure outcome are provided....

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  6. Evidence-Based Practice Guidelines and School Nursing

    Science.gov (United States)

    Adams, Susan; McCarthy, Ann Marie

    2007-01-01

    The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

  7. Evidence Based Practice Outside the Box (Editorial

    Directory of Open Access Journals (Sweden)

    Lindsay Glynn

    2008-09-01

    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

  8. Teaching strategies to support evidence-based practice.

    Science.gov (United States)

    Winters, Charlene A; Echeverri, Rebecca

    2012-06-01

    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.

  9. Reducing Emergency Department Crowding: Evidence Based Strategies.

    Science.gov (United States)

    Khalifa, Mohamed; Zabani, Ibrahim

    2016-01-01

    Emergency department (ED) crowding has become a major barrier to receiving timely care. King Faisal Specialist Hospital & Research Center, Saudi Arabia worked on identifying evidence based strategies for reducing the ED crowding by improving the intake. In addition to a review of literature, qualitative survey methods were used to identify strategies, which were classified into 10 suggested procedures categorized into three types of changes. Physical improvements include using physician cubicles, creating a team triage area and an internal waiting area for less acute patients instead of occupying beds. Technology improvements; include using informatics to update the electronic emergency record with information, using palmar scanning to instantly identify patients and using radio communication devices. Process improvements; include a scribe program to decrease clerical documentation tasks, switching between low flow and high flow processes, placing a physician in triage and using patient segmentation methods. PMID:27350468

  10. EVIDENCE-BASED USE OF EPLERENONE

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevski

    2014-07-01

    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.

  11. EVIDENCE-BASED USE OF EPLERENONE

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevski

    2012-01-01

    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.

  12. Evidence Base Update for Autism Spectrum Disorder.

    Science.gov (United States)

    Smith, Tristram; Iadarola, Suzannah

    2015-01-01

    This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008 ). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers. PMID:26430947

  13. Evidence-based treatment of metabolic myopathy

    Directory of Open Access Journals (Sweden)

    Yan LIN

    2014-05-01

    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

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

    Directory of Open Access Journals (Sweden)

    Gu Yungao

    2015-01-01

    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.

  15. Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example

    Science.gov (United States)

    Schoenwald, Sonja K.

    2008-01-01

    This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

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

    Science.gov (United States)

    Regehr, Cheryl; Stern, Susan; Shlonsky, Aron

    2007-01-01

    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…

  17. NEURAL NETWORK BASED OPTIMISATION OF HARMONICS ON AC - DC SIDES OF HVDC TRANSMISSION

    OpenAIRE

    Smriti Tapadar; Tikeshwar Gajpal

    2015-01-01

    This paper investigates possibility of using Neural network for optimisation of AC - DC Harmonics of HVDC Transmission. Dependableness and potency of power transmission has been at the forefront of analysis for a few time and is presently being given essential thought owing to the inflated dependence on current. With the inflated demand for e lectricity, engineers area unit considering completely different strategies of provide arrangement to enhance the ...

  18. Faculty Training in Evidence-Based Medicine: Improving Evidence Acquisition and Critical Appraisal

    Science.gov (United States)

    Nicholson, Laura J.; Warde, Carole M.; Boker, John R.

    2007-01-01

    Introduction: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are…

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

    Science.gov (United States)

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

    2006-01-01

    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.

  20. Evidence-Based Medicine in the Education of Psychiatrists

    Science.gov (United States)

    Srihari, Vinod

    2008-01-01

    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…

  1. Evidence-based medicine in general practice specialty training

    NARCIS (Netherlands)

    S.E. Zwolsman

    2012-01-01

    Aio’s huisartsgeneeskunde hebben adequate kennis ten aanzien van evidence-based medicine (geneeskunde op basis van bewijs). In de huisartspraktijk is evidence-based gedrag vaak niet direct zichtbaar, maar artsen kunnen wel aangeven op welk aspect van evidence-based medicine de voorgeschreven behande

  2. Impact of incorrect tissue classification in Dixon-based MR-AC: fat-water tissue inversion

    OpenAIRE

    Ladefoged, Claes Nøhr; Hansen, Adam Espe; Keller, Sune Høgild; Holm, Søren; Law, Ian; Beyer, Thomas; Højgaard, Liselotte; Kjær, Andreas; Andersen, Flemming Littrup

    2014-01-01

    Background The current MR-based attenuation correction (AC) used in combined PET/MR systems computes a Dixon attenuation map (MR-ACDixon) based on fat and water images derived from in- and opposed-phase MRI. We observed an occasional fat/water inversion in MR-ACDixon. The aim of our study was to estimate the prevalence of this phenomenon in a large patient cohort and assess the possible bias on PET data. Methods PET/MRI was performed on a Siemens Biograph mMR (Siemens AG, Erlangen, Germany). ...

  3. 脉冲阻塞式交交变频系统的动态性能研究%Research on dynamic performance of AC/AC converter based on principle of pulse blocking

    Institute of Scientific and Technical Information of China (English)

    陈玲; 朱虹; 纪萍

    2015-01-01

    Dynamic performance of AC/AC converter based on principle of pulse blocking is analyzed in this paper, in order to improve the stability of cycloconverter system, and to optimum the dynamic performance. The structure and principle of pulse blocking are introduced, and the main mathematical model of the type was built in SIMULINK environment in this paper. Based on the simulation experiment and results, the change of the effects of structure parameters on the dynamic performance of the system was analyzed carefully. The results of these analyses will be provided the basis for the optimization design of AC/AC converter based on principle of pulse blocking.%为了提高交交变频系统的稳定性,改善其动态性能,进行了基于脉冲阻塞斩波控制的动态性能分析。文中介绍了脉冲阻塞式交交变频系统的结构和变频原理,建立了其主要模块的数学模型,应用MATLAB环境进行了模型搭建,分析了系统中结构参数对其动态性能影响的变化规律,为脉冲阻塞式交交变频系统的性能优化设计提供了依据。

  4. How to understand and conduct evidence-based medicine

    Science.gov (United States)

    2016-01-01

    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.

  5. Teaching Evidence-Based Medicine More Effectively

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2010-10-01

    Full Text Available Evidence-based Medicine (EBM is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT were 170 members of the medical faculty who were divided into two groups of 86 (intervention and 84 (control. Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI was defined and computed. Results: The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P

  6. Portuguese version of the evidence-based practice questionnaire

    OpenAIRE

    Pereira, Rui Pedro Gomes; Guerra, Ana; Peixoto, Maria José; Martins, Teresa; Barbieri, Maria do Céu; Carneiro, António Vaz

    2014-01-01

    1. Objectives: Evidence-based practice is defined as the process by which nurses make clinical decisions using the best available scientific evidence, according with their clinical experience and patient preferences in the context of available resources. The Evidence-Based Practice Questionnaire (EBPQ) developed by Upton & Upton (2006) was designed to collect information and opinions on the use of evidence-based practices by health professionals and is validating its important so that it can ...

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

    Institute of Scientific and Technical Information of China (English)

    GAO Chao

    2008-01-01

    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.

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

    OpenAIRE

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

    2011-01-01

    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-gri...

  9. Evidence based radiation oncology: Breast cancer

    International Nuclear Information System (INIS)

    Purpose: Radiotherapy is, similar to surgery, a local treatment. In the case of breast cancer, it is generally given after conservative or after more extensive, tumour and patient adapted, surgery. The target volumes can be the breast and/or the thoracic wall and/or the regional lymph node areas. The integration and the extent of radiotherapy as part of the comprehensive treatment of the breast cancer patient, including the amount of surgery and the sequencing with the systemic treatments, has to be well discussed with all medical specialists involved in treating breast cancer on a multidisciplinary basis. Guidelines for the appropriate prescription and execution of radiotherapy are of utmost importance. However, individualisation based on the individual patients' and tumours' characteristics should always be envisaged. Materials and methods: Based on a review of the literature the level of evidence that is available for the indications for radiotherapy is summarised, as well as the main clinical questions that are unanswered today. An overview of the recent and ongoing clinical trails in breast cancer will highlight some of the current ongoing debates. Conclusions: In the case of breast cancer, radiotherapy, given after as well conservative as extensive risk-adapted surgery, significantly reduces the risk of local and regional recurrences. Especially for patients with an intermediate to high absolute risk for local recurrences, a positive influence on overall survival has been shown, notably when appropriate radiotherapy techniques are used. Most important is that the best results that we can offer to our breast cancer patients for all clinical endpoints (local and regional control; quality of life; cosmetic results; survival) can be obtained by a multidisciplinary and patient-oriented approach, involving all those involved in the treatment of breast cancer patients

  10. Fabrication of a flexible Ag-grid transparent electrode using ac based electrohydrodynamic Jet printing

    International Nuclear Information System (INIS)

    In the dc voltage-applied electrohydrodynamic (EHD) jet printing of metal nanoparticles, the residual charge of droplets deposited on a substrate changes the electrostatic field distribution and interrupts the subsequent printing behaviour, especially for insulating substrates that have slow charge decay rates. In this paper, a sinusoidal ac voltage was used in the EHD jet printing process to switch the charge polarity of droplets containing Ag nanoparticles, thereby neutralizing the charge on a polyethylene terephthalate (PET) substrate. Printed Ag lines with a width of 10 µm were invisible to the naked eye. After sintering lines with 500 µm of line pitch at 180 °C, a grid-type transparent electrode (TE) with a sheet resistance of ∼7 Ω sq−1 and a dc to optical conductivity ratio of ∼300 at ∼84.2% optical transmittance was obtained, values that were superior to previously reported results. In order to evaluate the durability of the TE under bending stresses, the sheet resistance was measured as the number of bending cycles was increased. The sheet resistance of the Ag grid electrode increased only slightly, by less than 20% from its original value, even after 500 cycles. To the best of our knowledge, this is the first time that Ag (invisible) grid TEs have been fabricated on PET substrates by ac voltage applied EHD jet printing. (paper)

  11. 'We hold these truths to be self-evident': deconstructing 'evidence-based' medical practice.

    Science.gov (United States)

    Devisch, Ignaas; Murray, Stuart J

    2009-12-01

    Rationale, aims and objectives Evidence-based medicine (EBM) claims to be based on 'evidence', rather than 'intuition'. However, EBM's fundamental distinction between quantitative 'evidence' and qualitative 'intuition' is not self-evident. The meaning of 'evidence' is unclear and no studies of quality exist to demonstrate the superiority of EBM in health care settings. This paper argues that, despite itself, EBM holds out only the illusion of conclusive scientific rigour for clinical decision making, and that EBM ultimately is unable to fulfil its own structural criteria for 'evidence'. Methods Our deconstructive analysis of EBM draws on the work of the French philosopher, Jacques Derrida. Deconstruction works in the name of justice to lay bare, to expose what has been hidden from view. In plain language, we deconstruct EBM's paradigm of 'evidence', the randomized controlled trial (RCT), to demonstrate that there cannot be incontrovertible evidence for EBM as such. We argue that EBM therefore 'auto-deconstructs' its own paradigm, and that medical practitioners, policymakers and patients alike ought to be aware of this failure within EBM itself. Results EBM's strict distinction between admissible evidence (based on RCTs) and other supposedly inadmissible evidence is not itself based on evidence, but rather, on intuition. In other words, according to EBM's own logic, there can be no 'evidentiary' basis for its distinction between admissible and inadmissible evidence. Ultimately, to uphold this fundamental distinction, EBM must seek recourse in (bio)political ideology and an epistemology akin to faith. PMID:20367689

  12. 3-V Solid-State Flexible Supercapacitors with Ionic-Liquid-Based Polymer Gel Electrolyte for AC Line Filtering.

    Science.gov (United States)

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

    2016-06-01

    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. PMID:27167760

  13. Ambulatory Medical Assistance - After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy

    OpenAIRE

    Compaci, Gisèle; Rueter, Manuela; Lamy, Sébastien; Oberic, Lucie; Recher, Christian; Lapeyre-Mestre, Maryse; LAURENT, GUY; Despas, Fabien

    2015-01-01

    Background Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy. Methods AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) ...

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

    CERN Document Server

    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.

    2004-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Gang Qin

    2015-01-01

    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.

  16. AN EFFICIENT ROBUST IMAGE WATERMARKING BASED ON AC PREDICTION TECHNIQUE USING DCT TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Gaurav Gupta

    2015-08-01

    Full Text Available The expansion of technology has made several simple ways to manipulate the original content. This has brought the concern for security of the content which is easily available in open network. Digital watermarking is the most suitable solution for the defined issue. Digital watermarking is the art of inserting the logo into multimedia object to have proof of ownership whenever it is required. The proposed algorithm is useful in authorized distribution and ownership verification. The algorithm uses the concept of AC prediction using DCT to embed the watermark in the image. The algorithm has excellent robustness against all the attacks and outperforms the similar work with admirable performance in terms of Normalized Correlation (NC, Peak Signal to Noise Ratio (PSNR and Tamper Assessment Function (TAF.

  17. Evaluation of reliability of on-site A.C. power systems based on maintenance records

    International Nuclear Information System (INIS)

    To the end of ascertain in what extent the evaluation of reliability of emergency diesel generators (D.G.) can be improved by means of a deeper knowledge of their operating history a study has been carried-out on 21 D.G. sets: 4 D.G. of the Caorso nuclear plant (BWR, 870 MWe) and 17 D.G. in service at 6 steam-electric fossil-fuelled plants. The major points of interest resulting from this study are: 1) reliability assessments of A.C. on-site power Systems, made on the basis of outcomes of surveillance tests, may lead to results which overestimate the real performance. 2) the unreliability of a redundant System of stand-by components is determined in large extent by unavailabilities due to scheduled and unscheduled maintenance, latent failures, tests. (authors)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......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...

  19. Evidence-based medicine – an appropriate tool for evidence-based health policy? A case study from Norway

    OpenAIRE

    Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

    2016-01-01

    Abstract Background Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evi...

  20. Evidence-Based Practice: On the Function of Evidence in Practical Reasoning

    Directory of Open Access Journals (Sweden)

    Tone Kvernbekk

    2014-01-01

    Full Text Available There is a vast literature on evidence-based practice (EBP in education. What function does evidence have in practical deliberations toward decisions about what to do? Most writers on EBP seem to think of evidence largely as quantitative data, serving as a foundation from which practice could and should be directly derived. In this paper I argue that we are better served by according a different and more indirect function to evidence in practical reasoning. To establish this claim I employ Toulmin’s model of argumentation. On this model the evidence-as-foundation view amounts to evidence as data/grounds. The model also offers a different function for evidence, as backing of the warrant, and I argue in this paper that this is a more adequate understanding of the function of evidence in practical reasoning

  1. Application of Evidence-based Prosthodontics in Practice

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    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.

  2. Evidence-based practice: developing mentors to support students.

    Science.gov (United States)

    Barry, Debbie; Houghton, Trish; Warburton, Tyler

    2016-08-17

    This article, the ninth in a series of 11, provides guidance for new and established mentors and practice teachers on evidence-based practice, the seventh domain of the Nursing and Midwifery Council's Standards to Support Learning and Assessment in Practice (SSLAP). Evidence-based practice is an important aspect of contemporary healthcare and is central to student preparation programmes for nursing, midwifery and specialist community public health nursing (SCPHN). The article describes evidence-based practice, discussing the importance and implementation of an evidence-based approach in the context of role development for mentors and practice teachers in the preparation of nursing, midwifery and SCPHN students. PMID:27533414

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

    Science.gov (United States)

    Likosky, Donald S

    2006-12-01

    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.

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

    Science.gov (United States)

    Likosky, Donald S

    2006-12-01

    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. PMID:17312899

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

    Institute of Scientific and Technical Information of China (English)

    Chen Liangzhou; Shi Wenkang; Du Feng

    2005-01-01

    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.

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

    Science.gov (United States)

    Yang, Hai

    2009-03-01

    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. PMID:19565800

  7. Justifying Physical Education Based on Neuroscience Evidence

    Science.gov (United States)

    Berg, Kris

    2010-01-01

    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…

  8. An evidence-based view on hyperbilirubinaemia

    NARCIS (Netherlands)

    Dijk, Peter H.; Hulzebos, Christian V.

    2012-01-01

    Introduction: We conducted a review of the evidence which contributes to the current care of jaundiced newborn infants. Methods: Literature was searched for reviews and randomized controlled trials (RCTs). Results: Six Cochrane reviews and eight other reviews and eighteen recent RCTs are discussed.

  9. Evidence Based Complementary Intervention for Insomnia

    OpenAIRE

    Lopez, Dr. Hassen H.; Bracha, Adam S.; Bracha, Dr. Stefan

    2002-01-01

    Increasing scientific evidence point to a non-pharmacological complementary treatment for insomnia: white noise. Its presentation has been shown to induce sleep in human neonates and adults, probably by reducing the signal-to-noise ratio of ambient sound. White noise may be a simple, safe, cost-effective alternative to hypnotic medication in many psychiatric disorders, especially acute stress disorder and PTSD.

  10. Evidence-Based Treatment of Maisonneuve Fractures

    NARCIS (Netherlands)

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

    2011-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Christina Ouzouni

    2008-07-01

    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.

  12. TES-Based X-ray Microcalorimeter Performances Under AC Bias and FDM for Athena

    Science.gov (United States)

    Akamatsu, H.; Gottardi, L.; de Vries, C. P.; Adams, J. S.; Bandler, S. R.; Bruijn, M. P.; Chervenak, J. A.; Eckart, M. E.; Finkbeiner, F. M.; Gao, J. R.; den Herder, J.-W.; den Hartog, R.; Hoevers, H.; Kelley, R. E.; Khosropanah, P.; Kilbourne, C. A.; van der Kuur, J.; Lee, S.-J.; van den Linden, A. J.; Porter, F. S.; Ravensberg, K.; Sadleir, J. E.; Smith, S. J.; Suzuki, T.; Wassell, E. J.; Kiviranta, M.

    2016-07-01

    Athena is a European X-ray observatory, scheduled for launch in ˜ 2028. Athena will employ a high-resolution imaging spectrometer called X-ray integral field unit (X-IFU), consisting of an array of ˜ 4000 transition edge sensor (TES) microcalorimeter pixels. For the readout of X-IFU, we are developing frequency domain multiplexing, which is the baseline readout system. In this paper, we report on the performance of a TES X-ray calorimeter array fabricated at Goddard Space Flight Center (GSFC) at MHz frequencies for the baseline of X-IFU detector. During single-pixel AC bias characterization, we measured X-ray energy resolutions (at 6 keV) of about 2.9 eV at both 2.3 and 3.7 MHz. Furthermore, in the multiplexing mode, we measured X-ray energy resolutions of about 2.9 eV at 1.3 and 1.7 MHz.

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

    Science.gov (United States)

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

    2011-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Eva González-Romera

    2011-09-01

    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.

  15. Structured analysis of iron-based amorphous alloy coating dep osited by AC-HVAF spray%通过AC-HVAF方法制备铁基非晶合金涂层的结构分析

    Institute of Scientific and Technical Information of China (English)

    叶凤霞; 陈燕; 余鹏; 罗强; 曲寿江; 沈军

    2014-01-01

    本研究通过活性燃烧高速燃气喷涂(AC-HVAF)方法制备出了均匀致密的铁基非晶化合金涂层。通过调制AC-HVAF喷涂过程的工艺参数,研究了喷涂枪长、喷涂距离和送粉率对涂层非晶化程度的影响,得出控制枪长是形成高质量非晶化涂层的关键,而喷涂距离和送粉率决定了涂层的厚度和形成速率。制备出的铁基非晶合金与基体结合致密,孔隙率较低,完全的非晶化结构有效的保持了铁基非晶合金优异的力学性能,可以对基体材料进行很好的防护。%The uniform and compact Fe-based amorphous alloy coating was prepared by active combustion high velocity air fuel (AC-HVAF) spray method. By tuning the parameters of AC-HVAF spray process, the influence of the spraying gun length, spraying distance, and powder feed rate on non-crystallization has been studied carefully. Results indicate that spraying gun length is the key factor in forming perfect amorphous coating. Spraying distance and powder feed rate may determine the thickness and formation rate of the coating. The prepared coatings have a tight adhesion with the substrate, low porosity, and good non-crystallization, which would effectively maintain the excellent mechanical properties of the Fe-based amorphous alloy. The coating can provide a good protection for the substrate material.

  16. CAN AYURVEDA BE AN EVIDENCE BASED MEDICINE?

    OpenAIRE

    Bali Yogitha

    2012-01-01

    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 t...

  17. Curriculum for Evidence Based Medicine for MBBS II phase Graduates

    OpenAIRE

    Saxena R; Kulkarni N; Shekhar S; Shivyogi; Prasad S; Goudar SP

    2014-01-01

    Evidence based medicine is the training of health care professionals to access, assess and apply the best scientific evidence to clinical practice. EBM is the conscientious, explicit and judicious use of current best evidence along with clinical expertise and patient values in making decisions about the case of individual patients. The current undergraduate curriculum of health profession is based on past knowledge accumulated for years. The scientific relevance of the mostly outdated infor...

  18. Personalizing Research: Special Educators' Awareness of Evidence-Based Practice

    Science.gov (United States)

    Guckert, Mary; Mastropieri, Margo A.; Scruggs, Thomas E.

    2016-01-01

    Although evidence-based practices are considered critical to student success, a research-to-practice gap exists. This qualitative study examined practicing special education teachers' perceptions of their use of evidence-based practices. Special education teachers were interviewed and their classroom practices examined. Major themes emerged and…

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

    Science.gov (United States)

    Sturmey, Peter

    2009-01-01

    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…

  20. Evidence-based gene predictions in plant genomes

    Science.gov (United States)

    Automated evidence-based gene building is a rapid and cost-effective way to provide reliable gene annotations on newly sequenced genomes. One of the limitations of evidence-based gene builders, however, is their requirement for gene expression evidence—known proteins, full-length cDNAs, or expressed...

  1. Evidence-based Nursing Practice: To Infinity and Beyond.

    Science.gov (United States)

    Pape, Tess M.

    2003-01-01

    Provides an historical background for evidence-based practice and methods for assimilating research into practice. Information searching, systematic reviews, and other decision-making models are discussed using specific questions for establishing policy guidelines. Stresses the need for evidence-based practice implementing the best-known practices…

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

    Science.gov (United States)

    Brancato, Vera C

    2006-01-01

    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.

  3. Evidence-Based Assessment of Anxiety Disorders in Adults

    Science.gov (United States)

    Antony, Martin M.; Rowa, Karen

    2005-01-01

    This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability,…

  4. Evidence-based medicine in rapidly changing technologies

    DEFF Research Database (Denmark)

    Schroeder, Torben Veith

    2008-01-01

    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...

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

    DEFF Research Database (Denmark)

    Johannsen, Carl Gustav

    2012-01-01

    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...

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

    Science.gov (United States)

    Qiu, Yun-Liang; Peng, Ming-Qi

    2013-12-01

    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.

  7. Multi-Agent-Based Distributed State of Charge Balancing Control for Distributed Energy Storage Units in AC Microgrids

    DEFF Research Database (Denmark)

    Li, Chendan; Dragicevic, Tomislav; Vasquez, Juan Carlos;

    2015-01-01

    and they schedule their own frequency reference given of the real power droop controller according to the SoC values of the other DES units. Further, to obtain the average SoC value of DES, dynamic average consensus algorithm is adapted by each agent. A smallsignal model of the system is developed in order......In this paper, a multiagent based distributed control algorithm has been proposed to achieve state of charge (SoC) balance of distributed energy storage (DES) units in an AC microgrid. The proposal uses frequency scheduling instead of adaptive droop gain. Each DES unit is taken as an agent...... to verify the stability of the control system and control parameters design. Simulation results demonstrate the effectiveness of the control strategy and also show the robustness against communication topology changes....

  8. SoC-Based Dynamic Power Sharing Method with AC-Bus Voltage Restoration for Microgrid Applications

    DEFF Research Database (Denmark)

    Lu, Xiaonan; Sun, Kai; Guerrero, Josep M.;

    2012-01-01

    shared in the energy storage system. The relationship between the droop coefficient and SoC are studied deeply and the small signal model is developed to verify the stability of the control system. It is found that the active power sharing speed becomes faster with higher exponent of SoC. At the same...... time, in order to restore the AC-bus voltage, secondary control is employed to eliminate the deviations of the voltage frequency and amplitude caused by the droop control, with the droop coefficients adjusting according to the SoCs. The model of the secondary control scheme for SoC-based droop method...... is developed and its stability is discussed. The theoretical analysis is demonstrated by both simulation and experimental results....

  9. Interverntion, evidence-based research and everyday life

    DEFF Research Database (Denmark)

    Dreier, Ole

    2011-01-01

    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...... evidence-based research and practice, I argue that, while psychological interventions are primarily meant to work in people’s everyday lives, how interventions do so is barely addressed and poorly captured. Evidence-based research, as currently conceived, is an obstacle to overcome this shortcoming...

  10. Evidence-based medicine in health care reform.

    Science.gov (United States)

    Hughes, Gordon B

    2011-10-01

    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.

  11. Course Redesign: An Evidence-Based Approach

    Directory of Open Access Journals (Sweden)

    Kathy Nomme

    2014-11-01

    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.

  12. Modification of evidence theory based on feature extraction

    Institute of Scientific and Technical Information of China (English)

    DU Feng; SHI Wen-kang; DENG Yong

    2005-01-01

    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.

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

    OpenAIRE

    Christina Ouzouni; Konstantinos Nakakis

    2008-01-01

    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 litera...

  14. Evidence-based practice: a trainee clinical psychologist perspective

    OpenAIRE

    Chapman, Lynn

    2010-01-01

    Evidence-based practice (EBP) is now the dominant model in health care; its aim is to increase the use of research evidence to inform clinical decision making. Clinical practice guidelines are the predominant method by which research is distilled into practice recommendations. Clinical psychology has its own model which promotes the integration of research evidence with clinical expertise, the scientist practitioner model (SPM). Recent developments within the United Kingdom health service, su...

  15. Evidence base for pre-employment medical screening

    OpenAIRE

    Pachman, Joseph

    2009-01-01

    This paper examines the evidence base for the use of pre-employment/pre-placement medical examinations. The use of pre‑employment examinations is often driven more by cultural practices than evidence. There is a lack of evidence on their effectiveness in preventing health-related occupational risks. Hypertension screening is highlighted as a common pre-employment practice for which there is no standardized criteria to use to determine fitness for work. There are inherent problems in screening...

  16. A Third-Generation Evidence Base for Human Spaceflight Risks

    Science.gov (United States)

    Kundrot, Craig E.; Lumpkins, Sarah; Steil, Jennifer; Pellis, Neal; Charles, John

    2014-01-01

    NASA's Human Research Program seeks to understand and mitigate risks to crew health and performance in exploration missions center dot HRP's evidence base consists of an Evidence Report for each HRP risk center dot Three generations of Evidence Reports 1) Review articles + Good content - Limited authorship, infrequent updates 2) Wikipedia articles + Viewed often, very open to contributions - Summary of reviews, very few contributions 3) HRP-controlled wiki articles + Incremental additions to review articles with editorial control

  17. Treating bipolar disorder. Evidence-based guidelines for family medicine.

    OpenAIRE

    McIntyre, Roger S; Mancini, Deborah A.; Lin, Peter; Jordan, John

    2004-01-01

    OBJECTIVE: To provide an evidence-based summary of medications commonly used for bipolar disorders and a practical approach to managing bipolar disorders in the office. QUALITY OF EVIDENCE: Articles from 1990 to 2003 were selected from MEDLINE using the key words "bipolar disorder," "antiepileptics," "antipsychotics," "antidepressants," and "mood stabilizers." Good-quality evidence for many of these treatments comes from randomized trials. Lithium, divalproex, carbamazepine, lamotrigine, oxca...

  18. CAN AYURVEDA BE AN EVIDENCE BASED MEDICINE?

    Directory of Open Access Journals (Sweden)

    Bali Yogitha

    2012-04-01

    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.

  19. Applying Evidence-based Medicine Principles to Fracture Management

    Directory of Open Access Journals (Sweden)

    Joseph eBernstein

    2014-10-01

    Full Text Available Bone has the capacity to regenerate and not scar after injury—-sometimes leaving behind no evidence at all of a prior fracture. As surgeons capable of facilitating such healing, it becomes our responsibility to help choose a treatment that minimizes functional deficits and residual symptoms. And in the case of the geriatric hip fracture, we have seen the accumulation of a vast amount of evidence to help guide us.The best method we currently have for selecting treatment plans is by the practice of evidence-based medicine. According to the now accepted hierarchy, the best is called Level I evidence (eg, well performed randomized controlled trials—but this evidence is best only if it is available and appropriate. Lower forms of accepted evidence include cohort studies, case control studies, case series and case reports, and last, expert opinion--all of which can be potentially instructive. The hallmark of evidence-based treatment is not so much the reliance on evidence in general, but to use the best available evidence relative to the particular patient, the clinical setting and surgeon experience. Correctly applied, varying forms of evidence each have a role in aiding surgeons offer appropriate care for their patients--to help them best fix the fracture.

  20. Evidence Based Education Request Desk. EBE #652

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

    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…

  1. Evidence Based Education Request Desk. EBE #492

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    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…

  2. Evidence Based Education Request Desk. EBE #791

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

    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…

  3. Evidence-Based Marketing for Academic Librarians

    Directory of Open Access Journals (Sweden)

    Yoo-Seong Song

    2006-03-01

    Full Text Available Objective - In developing marketing strategies for the Business & Economics Library (BEL at the University of Illinois at Urbana-Champaign (UIUC, a survey was designed to answer the following questions: - Should BEL develop marketing strategies differently for East Asian business students? - What services do graduate business students want to receive from BEL? - With whom should BEL partner to increase visibility at the College of Business? Marketing research techniques were used to gather evidence upon which BEL could construct appropriate marketing strategies. Methods - A questionnaire was used with graduate business students enrolled at UIUC. The survey consisted of four categories of questions: 1 demographics, 2 assessment of current library services, 3 desired library services, and 4 research behavior. The data were analyzed using desriptive statistics and hypothesis testing to answer the three research questions. Results - East Asian business students showed similar assessment of current services as non-East Asian international business students. Survey results also showed the graduate business students had low awareness of current library services. The Business Career Services Office was identified as a co-branding partner for BEL to increase its visibility. Conclusion - A marketing research approach was used to help BEL make important strategic decisions before launching marketing campaigns to increase visibility to graduate business students at UIUC. As a result of the survey, a deeper understanding of graduate business students' expectations and assessment of library services was gained. Students' perceptions became a foundation that helped shape marketing strategies for BEL to increase its visibility at the College of Business. Creating marketing strategies without concrete data and analysis is a risky endeavor that librarians, not just corporate marketers, should avoid.

  4. What Is "Evidence-Based Practice" in Geography Education?

    Science.gov (United States)

    Roberts, Margaret

    2010-01-01

    Educationalists developed the concept of "evidence-based practice" during the 1990s because of concern about the relevance of educational research to practitioners and about its impact on their practice. This article outlines the different kinds of research evidence related to geographical education, which might inform practice. It then discusses…

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

    Science.gov (United States)

    Kowalski, Theodore

    2009-01-01

    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…

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

    DEFF Research Database (Denmark)

    Wang, Xiongfei; Blaabjerg, Frede; Chen, Zhe;

    2013-01-01

    -based analysis approach is adopted and expanded to a meshed and balanced three-phase power network. An impedance ratio derivation method is proposed based on the nodal admittance matrix. By this means, the contribution of each inverter to the system resonance modes can be easily predicted by the Nyquist...

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

    Science.gov (United States)

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

    2012-09-01

    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.

  8. Implementing evidence-based practices in an emergency department

    DEFF Research Database (Denmark)

    Wassar Kirk, Jeanette; Nilsen, Per

    2016-01-01

    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...

  9. Evidence-based care in Iran: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Morteza Ghojazadeh

    2014-08-01

    Conclusion: Weak knowledge, weak attitude, and time shortage .are among the most significant barriers of evidence-based care in Iran. These problems require more accurate planning and more favorable policies on the part of medical science authorities.

  10. CDMBE: A Case Description Model Based on Evidence

    Directory of Open Access Journals (Sweden)

    Jianlin Zhu

    2015-01-01

    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.

  11. Evidence-based Assessment of Cognitive Functioning in Pediatric Psychology

    OpenAIRE

    Campbell, Jonathan M.; Brown, Ronald T.; Cavanagh, Sarah E.; Vess, Sarah F.; Segall, Mathew J.

    2008-01-01

    Objective To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology. Methods From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g., attention/executive functioning, memory). Results Twenty-two of 27 measures...

  12. The place of research and Evidence Based Practice in nursing.

    OpenAIRE

    HRSTKOVÁ, Pavla

    2011-01-01

    Nursing is a permanently developing field of activity. Research plays an irreplaceable role in this field. We moreover more and more often see the term Evidence Based Practice nowadays. However a lot of general nurses do not know that this term also relates to the field of nursing, where it is called Evidence Based Nursing. Quantitative research was chosen for this thesis. The research was performed in South Bohemian and Central Bohemian regions among general nurses with bachelor degree. The ...

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

    OpenAIRE

    Kathleen Packard, PharmD, MS, BCPS; Megan Herink, PharmD, BCPS; Thomas L. Lenz, PharmD, MA

    2011-01-01

    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. Backgro...

  14. From Opinion-Based to Evidence-Based Social Work: The Swedish Case

    Science.gov (United States)

    Sundell, Knut; Soydan, Haluk; Tengvald, Karin; Anttila, Sten

    2010-01-01

    This article presents an account of Sweden's Institute for Evidence-Based Social Work Practice (IMS), located in Stockholm, Sweden. The article places IMS in the context of making Swedish social care services less opinion-based and more evidence-based. The institute is an example of how policy-driven processes promote the use of evidence-based…

  15. A new fusion approach based on distance of evidences

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

    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.

  16. Evidence-based intervention in physical activity

    DEFF Research Database (Denmark)

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

    2012-01-01

    Promotion of physical activity is a priority for health agencies. We searched for reviews of physical activity interventions, published between 2000 and 2011, and identified effective, promising, or emerging interventions from around the world. The informational approaches of community......-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...

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

    Science.gov (United States)

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

    2015-07-28

    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.

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

    DEFF Research Database (Denmark)

    Wang, Xiongfei; Blaabjerg, Frede; Liserre, Marco;

    2013-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    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

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

    Science.gov (United States)

    Rousseau, Denise M; Gunia, Brian C

    2016-01-01

    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. EVIDENCEBASED MEDICINE/PRACTICE IN SPORTS PHYSICAL THERAPY

    OpenAIRE

    Manske, Robert C.; Lehecka, B.J.

    2012-01-01

    A push for the use of evidence‐based medicine and evidence‐based practice patterns has permeated most health care disciplines. The use of evidence‐based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision‐making. In this era of health care utilization sports physical therapists are expected to integrate cl...

  2. Hilbert spectroscopy based on the ac Josephson effect for liquid identification

    International Nuclear Information System (INIS)

    Fast and reliable identification of liquids is of great importance in developing new security measures at public places. A concept of liquid identification is presented, based on our Hilbert spectroscopy and high-Tc Josephson junctions, that can operate at the frequency range of main dispersions of liquids under concern, i.e. at the intermediate range from microwaves to terahertz frequencies. Several demonstration setups, consisting of synthesized polychromatic radiation sources and compact Hilbert spectrometers integrated in Stirling coolers, have been developed and characterized. Reflection polychromatic spectra of various bottled liquids have been measured at the spectral range of 15 - 400 GHz with total scanning time down to 0.5 second and the possibility of reliable identification of liquids has been demonstrated.

  3. Hilbert spectroscopy based on the ac Josephson effect for liquid identification

    Science.gov (United States)

    Divin, Y.; Lyatti, M.; Poppe, U.; Urban, K.

    2010-06-01

    Fast and reliable identification of liquids is of great importance in developing new security measures at public places. A concept of liquid identification is presented, based on our Hilbert spectroscopy and high-Tc Josephson junctions, that can operate at the frequency range of main dispersions of liquids under concern, i.e. at the intermediate range from microwaves to terahertz frequencies. Several demonstration setups, consisting of synthesized polychromatic radiation sources and compact Hilbert spectrometers integrated in Stirling coolers, have been developed and characterized. Reflection polychromatic spectra of various bottled liquids have been measured at the spectral range of 15 - 400 GHz with total scanning time down to 0.5 second and the possibility of reliable identification of liquids has been demonstrated.

  4. Hilbert spectroscopy based on the ac Josephson effect for liquid identification

    Energy Technology Data Exchange (ETDEWEB)

    Divin, Y; Lyatti, M; Poppe, U; Urban, K, E-mail: Y.Divin@fz-juelich.d [IFF-8, Forschungszentrum Juelich, 52425 Juelich (Germany)

    2010-06-01

    Fast and reliable identification of liquids is of great importance in developing new security measures at public places. A concept of liquid identification is presented, based on our Hilbert spectroscopy and high-T{sub c} Josephson junctions, that can operate at the frequency range of main dispersions of liquids under concern, i.e. at the intermediate range from microwaves to terahertz frequencies. Several demonstration setups, consisting of synthesized polychromatic radiation sources and compact Hilbert spectrometers integrated in Stirling coolers, have been developed and characterized. Reflection polychromatic spectra of various bottled liquids have been measured at the spectral range of 15 - 400 GHz with total scanning time down to 0.5 second and the possibility of reliable identification of liquids has been demonstrated.

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

    Directory of Open Access Journals (Sweden)

    Tole Sutikno

    2013-02-01

    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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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 bas...... 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.......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...

  7. AC Power Routing System in Home Based on Demand and Supply Utilizing Distributed Power Sources

    Directory of Open Access Journals (Sweden)

    Takashi Hikihara

    2011-04-01

    Full Text Available To help reduce consumption of fossil fuels, renewable, natural and distributed power sources are being adopted. These alternative energy sources inevitably show fluctuations in the amount of output power, frequency, and voltage. The suppression of such fluctuations is a key issue to avoid disturbances in power grids. A similar situation arises as far as the regulation of in-home power flow is concerned. We focus on the quality of supplied and demanded power in particular. In this paper, an in-home power distribution system based on information of power is proposed. The system is developed in order to integrate power dispatch and communication. The experimental results show the feasibility of new flexible and efficient power management approaches.

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

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    . 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...

  10. Annotating Evidence Based Clinical Guidelines: A Lightweight Ontology

    NARCIS (Netherlands)

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

    2012-01-01

    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

  11. Evidence-Based Psychosocial Treatments for Child and Adolescent Depression

    Science.gov (United States)

    David-Ferdon, Corinne; Kaslow, Nadine J.

    2008-01-01

    The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and…

  12. Management of REM sleep behavior disorder: An evidence based review

    OpenAIRE

    Preeti Devnani; Racheal Fernandes

    2015-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, ...

  13. Proteomics-based identification of midgut proteins correlated with Cry1Ac resistance in Plutella xylostella (L.).

    Science.gov (United States)

    Xia, Jixing; Guo, Zhaojiang; Yang, Zezhong; Zhu, Xun; Kang, Shi; Yang, Xin; Yang, Fengshan; Wu, Qingjun; Wang, Shaoli; Xie, Wen; Xu, Weijun; Zhang, Youjun

    2016-09-01

    The diamondback moth, Plutella xylostella (L.), is a worldwide pest of cruciferous crops and can rapidly develop resistance to many chemical insecticides. Although insecticidal crystal proteins (i.e., Cry and Cyt toxins) derived from Bacillus thuringiensis (Bt) have been useful alternatives to chemical insecticides for the control of P. xylostella, resistance to Bt in field populations of P. xylostella has already been reported. A better understanding of the resistance mechanisms to Bt should be valuable in delaying resistance development. In this study, the mechanisms underlying P. xylostella resistance to Bt Cry1Ac toxin were investigated using two-dimensional differential in-gel electrophoresis (2D-DIGE) and ligand blotting for the first time. Comparative analyses of the constitutive expression of midgut proteins in Cry1Ac-susceptible and -resistant P. xylostella larvae revealed 31 differentially expressed proteins, 21 of which were identified by mass spectrometry. Of these identified proteins, the following fell into diverse eukaryotic orthologous group (KOG) subcategories may be involved in Cry1Ac resistance in P. xylostella: ATP-binding cassette (ABC) transporter subfamily G member 4 (ABCG4), trypsin, heat shock protein 70 (HSP70), vacuolar H(+)-ATPase, actin, glycosylphosphatidylinositol anchor attachment 1 protein (GAA1) and solute carrier family 30 member 1 (SLC30A1). Additionally, ligand blotting identified the following midgut proteins as Cry1Ac-binding proteins in Cry1Ac-susceptible P. xylostella larvae: ABC transporter subfamily C member 1 (ABCC1), solute carrier family 36 member 1 (SLC36A1), NADH dehydrogenase iron-sulfur protein 3 (NDUFS3), prohibitin and Rap1 GTPase-activating protein 1. Collectively, these proteomic results increase our understanding of the molecular resistance mechanisms to Bt Cry1Ac toxin in P. xylostella and also demonstrate that resistance to Bt Cry1Ac toxin is complex and multifaceted. PMID:27521921

  14. Evaluation of Evidence-based Nursing Pain Management Practice.

    Science.gov (United States)

    Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

    2015-08-01

    It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

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

    Science.gov (United States)

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

    2016-10-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Kathleen Packard, PharmD, MS, BCPS

    2011-01-01

    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.

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

    Science.gov (United States)

    Todd, Ross J.

    2015-01-01

    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…

  18. MOEA based design of decentralized controllers for LFC of interconnected power systems with nonlinearities, AC-DC parallel tie-lines and SMES units

    Energy Technology Data Exchange (ETDEWEB)

    Ganapathy, S., E-mail: ganapathy1967@gmail.co [Department of Electrical Engineering, Annamalai University, Annamalainagar, Tamilnadu 608 002 (India); Velusami, S. [Department of Electrical Engineering, Annamalai University, Annamalainagar, Tamilnadu 608 002 (India)

    2010-05-15

    A new design of Multi-Objective Evolutionary Algorithm based decentralized controllers for load-frequency control of interconnected power systems with Governor Dead Band and Generation Rate Constraint nonlinearities, AC-DC parallel tie-lines and Superconducting Magnetic Energy Storage (SMES) units, is proposed in this paper. The HVDC link is used as system interconnection in parallel with AC tie-line to effectively damp the frequency oscillations of AC system while the SMES unit provides bulk energy storage and release, thereby achieving combined benefits. The proposed controller satisfies two main objectives, namely, minimum Integral Squared Error of the system output and maximum closed-loop stability of the system. Simulation studies are conducted on a two area interconnected power system with nonlinearities, AC-DC tie-lines and SMES units. Results indicate that the proposed controller improves the transient responses and guarantees the closed-loop stability of the overall system even in the presence of system nonlinearities and with parameter changes.

  19. MOEA based design of decentralized controllers for LFC of interconnected power systems with nonlinearities, AC-DC parallel tie-lines and SMES units

    International Nuclear Information System (INIS)

    A new design of Multi-Objective Evolutionary Algorithm based decentralized controllers for load-frequency control of interconnected power systems with Governor Dead Band and Generation Rate Constraint nonlinearities, AC-DC parallel tie-lines and Superconducting Magnetic Energy Storage (SMES) units, is proposed in this paper. The HVDC link is used as system interconnection in parallel with AC tie-line to effectively damp the frequency oscillations of AC system while the SMES unit provides bulk energy storage and release, thereby achieving combined benefits. The proposed controller satisfies two main objectives, namely, minimum Integral Squared Error of the system output and maximum closed-loop stability of the system. Simulation studies are conducted on a two area interconnected power system with nonlinearities, AC-DC tie-lines and SMES units. Results indicate that the proposed controller improves the transient responses and guarantees the closed-loop stability of the overall system even in the presence of system nonlinearities and with parameter changes.

  20. Nursing implementation science: how evidence-based nursing requires evidence-based implementation.

    NARCIS (Netherlands)

    Achterberg, T. van; Schoonhoven, L.J.; Grol, R.P.T.M.

    2008-01-01

    PURPOSE: Evidence is not always used in practice, and many examples of problematic implementation of research into practice exist. The aim of this paper is to provide an introduction and overview of current developments in implementation science and to apply these to nursing. METHODS: We discuss a f

  1. Using evidence-based management in a medical practice.

    Science.gov (United States)

    Solomon, Robert J

    2010-01-01

    Evidence-based management (EBMa) is the application of the evidence-based medicine process to making management decisions. EBMa has been described in a number of publications, which note the advantages of utilizing EBMa and offer generic guidance on the nature of EBMa evidence. This paper provides a specific EBMa pathway for physician practice and health system mangers to use to conduct EBMa database searches. It provides an example of conducting an EBMa search for a practice-based management problem. It describes how to do database searches using Advance Google Scholar, PubMed, and other data sources. It discusses challenges to conducting quality searches, including access to paid subscription databases, and offers suggestions to improve searches. Finally, the paper discusses the importance of establishing a culture of inquiry and using rapid cycle improvement methods to develop organizational EBMa support so health systems will devote adequate resources to information acquisition. PMID:20222263

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

    Science.gov (United States)

    Robb, Meigan; Shellenbarger, Teresa

    2014-10-01

    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. PMID:25221988

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

    Science.gov (United States)

    Lindoerfer, Doris; Mansmann, Ulrich

    2016-01-01

    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.

  4. Evidence-Based Practice and Quality Improvement in Nursing Education.

    Science.gov (United States)

    Balakas, Karen; Smith, Joan R

    2016-01-01

    For more than a decade, nursing education has experienced several significant changes in response to challenges faced by healthcare organizations. Accrediting organizations have called for improved quality and safety in care, and the Institute of Medicine has identified evidence-based practice and quality improvement as 2 core competencies to include in the curricula for all healthcare professionals. However, the application of these competencies reaches far beyond the classroom setting. For nurses to possess the knowledge, skills, and attitudes to apply evidence-based practice and quality improvement to the real-world setting, academic-clinical institution partnerships are vital. PMID:27465447

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

    Science.gov (United States)

    Lindoerfer, Doris; Mansmann, Ulrich

    2016-01-01

    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. PMID:27577464

  6. Dicty_cDB: FCL-AC08 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC08 (Link to dictyBase) - - - Contig-U15080-1 FCL-AC08P ...(Link to Original site) FCL-AC08F 616 FCL-AC08Z 291 FCL-AC08P 907 - - Show FCL-AC08 Library FCL (Link to library) Clone ID FCL-...-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-AC08Q....Seq.d/ Representative seq. ID FCL-AC08P (Link to Original site) Representative DNA sequence >FCL-AC08 (FCL-AC08Q) /CSM/FCL/FCL-...ignificant alignments: (bits) Value FCL-AC08 (FCL-AC08Q) /CSM/FCL/FCL-AC/FCL-AC08Q.Seq.d/ 1322 0.0 SFA226 (S

  7. Achievements and Limitations of Evidence-Based Medicine.

    Science.gov (United States)

    Sheridan, Desmond J; Julian, Desmond G

    2016-07-12

    Evidence-based medicine (EBM) has a long history, but was revived in the early 1990s by a campaign mounted by a movement that took its name. The EBM movement focused attention on the need for greater objectivity in medical decision-making and led to the Cochrane Collaboration, which provides reviews of evidence on the basis of comparative research. Important limitations of EBM's effect on medicine have also emerged. Failure to acknowledge the limitations of clinical trials and systematic reviews has limited their applicability to individual patients' circumstances. An almost exclusive focus on drugs and devices has left vast areas of health care in an evidence vacuum. An overdependence on commissions for its research may have limited its independence in selecting what it investigates. EBM needs to widen its scope beyond drugs and devices to address many areas that often lack evidence at present, notably, health policy, management, and reforms. PMID:27386775

  8. Evidence fusion procedure based on hybrid DSm model

    Institute of Scientific and Technical Information of China (English)

    Hongfei Li; Hongbin Jin; Kangsheng Tian

    2014-01-01

    Dezert-Smarandache (DSm) theory, a new informa-tion fusion theory, is widely applied in image processing, multiple targets tracking identification, and other areas for its excel ent pro-cessing ability of imperfect information. However, earlier research on DSm theory mainly focused on one sort of questions. An ev-idence fusion procedure is proposed based on the hybrid DSm model to compensate for a lack of research on the entire informa-tion procedure of DSm theory. This paper analyzes the evidence fusion procedure, as wel as correlative node input and output in-formation. Key steps and detailed procedures of evidence fusion are also discussed. Final y, an experiment il ustrates the efficiency of the proposed evidence fusion procedure.

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

    Science.gov (United States)

    Laven, Anna; Läer, Stephanie

    2013-03-01

    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

  10. Training Methods to Improve Evidence-Based Medicine Skills

    Directory of Open Access Journals (Sweden)

    Filiz Ozyigit

    2010-06-01

    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

  11. Evidence, discovery and justification: the case of evidence-based medicine.

    Science.gov (United States)

    Gaeta, Rodolfo; Gentile, Nelida

    2016-08-01

    The purpose of this paper is to develop some thoughts on philosophical issues surrounding evidence-based medicine (EBM), especially related to its epistemological dimensions. After considering the scope of several philosophical concepts that are relevant to the discussion, and drawing some distinctions among different aspects of EBM, we evaluate the status of EBM and suggest that EBM is mainly a meta-methodology. Then, we outline an evaluation of the thesis that EBM is a 'new paradigm' in the practice of medicine. We argue that EBM does not seem to have arisen in the way Kuhn imagined paradigms to arise but as a conscious, deliberate proposal, more as programme than as a reality. Furthermore, there is something paradoxical about appealing to evidence or to the best evidence as a way of promoting a new paradigm. For the proposal seems to assume that there is something that by its own virtue is the best evidence for a given time. But this idea would have been rejected by Kuhn. If EBM involves a genuine new alternative in the field of medicine and shows a way in which the discipline will endure henceforth, this indicates that it is not what Kuhn once called a 'paradigm' and even, paradoxically, it is good evidence that scientific paradigms do not exist, at least in medicine. PMID:26200433

  12. New aspects in the Bragg Glass-Disordered phase transition: an analysis based on the 3rd harmonics of the AC magnetic susceptibility

    OpenAIRE

    Adesso*, M. G.; Flukiger, R.; Giamarchi, T.; Goldacker, W.; H.; Kupfer; Pace, S.; Polichetti, M.; Uglietti, D.

    2007-01-01

    We analyse the phase transition between the Bragg Glass and the Disordered phase in the vortex lattice in type-II superconductors, both by analytical computations and experimental investigations. It is known that if the Peak Effect can be detected, a Bragg Glass/Disordered phase transition takes place. We show that, in some conditions, this transition can occur without the observation of the Peak Effect Phenomenon. We introduce a method based on the 3rd harmonics of the AC magnetic susceptibi...

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

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    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...

  14. Evidence-based practices in preconception period and pregnancy

    Directory of Open Access Journals (Sweden)

    Şükran Başgöl

    2012-11-01

    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. A framework for disseminating evidence-based health promotion practices.

    Science.gov (United States)

    Harris, Jeffrey R; Cheadle, Allen; Hannon, Peggy A; Forehand, Mark; Lichiello, Patricia; Mahoney, Eustacia; Snyder, Susan; Yarrow, Judith

    2012-01-01

    Wider adoption of evidence-based, health promotion practices depends on developing and testing effective dissemination approaches. To assist in developing these approaches, we created a practical framework drawn from the literature on dissemination and our experiences disseminating evidence-based practices. The main elements of our framework are 1) a close partnership between researchers and a disseminating organization that takes ownership of the dissemination process and 2) use of social marketing principles to work closely with potential user organizations. We present 2 examples illustrating the framework: EnhanceFitness, for physical activity among older adults, and American Cancer Society Workplace Solutions, for chronic disease prevention among workers. We also discuss 7 practical roles that researchers play in dissemination and related research: sorting through the evidence, conducting formative research, assessing readiness of user organizations, balancing fidelity and reinvention, monitoring and evaluating, influencing the outer context, and testing dissemination approaches. PMID:22172189

  16. Evidence-based practices in preconception period and pregnancy

    Directory of Open Access Journals (Sweden)

    Ümran Oskay

    2012-11-01

    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.

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

    Science.gov (United States)

    Twells, Laurie K

    2015-01-01

    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. Evidence-based investigations and treatments of recurrent pregnancy loss

    DEFF Research Database (Denmark)

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

    2005-01-01

    , thrombophilic, immunologic, and immunogenetic aspects of RPL discussed methodologic problems threatening the validity of research in RPL during and after an international workshop on the evidence-based management of RPL. CONCLUSION(S): Most RPL patients have several risk factors for miscarriage...

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

    Science.gov (United States)

    Annan, Jean

    2005-01-01

    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…

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

    NARCIS (Netherlands)

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

    2014-01-01

    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

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

    Science.gov (United States)

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

    2010-10-01

    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. PMID:20880823

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    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 on...

  3. Reflections on the Teaching of Evidence-Based Practice

    Science.gov (United States)

    Shlonsky, Aron; Stern, Susan B.

    2007-01-01

    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…

  4. Evidence-based or status-seduced opinions

    OpenAIRE

    Ray Wilks

    2012-01-01

    ‘There are infact, two things, science and opinion;the former begets knowledge, the latter ignorance.’(Hippocrates)The 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.

  5. Evidence-based or status-seduced opinions

    Directory of Open Access Journals (Sweden)

    Ray Wilks

    2012-12-01

    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.

  6. Evidence-Based Library Management: The Leadership Challenge

    Science.gov (United States)

    Lakos, Amos

    2007-01-01

    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…

  7. Determining Evidence-Based Practices in Special Education

    Science.gov (United States)

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

    2009-01-01

    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…

  8. Evidence-based practice for information professionals a handbook

    CERN Document Server

    Booth, Andrew

    2004-01-01

    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?

  9. An Evidence Based Approach to Sepsis: Educational Program

    Science.gov (United States)

    Perez, Dolores

    2015-01-01

    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…

  10. Evidence Based Order Sets as a Nursing Care Planning System

    OpenAIRE

    LaCrosse, Lisa M.; Heermann, Judith; Azevedo, Karen; Sorrentino, Catherine; Straub, Dawn; O'Dowd, Gloria

    2002-01-01

    The process for developing the nursing care planning (NCP) function for integration into a clinical information system (CIS) will be described. This NCP system uses evidence based order sets or interventions that are specific to a problem with associated patient focused goals or outcomes. The problem, order set, goal framework will eventually be used by all disciplines in the patient focused record.

  11. Fostering Evidence-Based Practice in Nursing Education.

    Science.gov (United States)

    Rambur, Betty

    1999-01-01

    Evidence-based nursing practice is impeded by low numbers of baccalaureate nurses, lack of critical perspectives toward research, the volume of information, and conflicting worldviews. Teaching strategies to address the challenge include fostering the ability to question and initiating teacher/student dialog. (SK)

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

    Science.gov (United States)

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

    2010-10-01

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

    Science.gov (United States)

    Finn, Patrick

    2011-01-01

    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…

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

    NARCIS (Netherlands)

    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

    2008-01-01

    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

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

    Science.gov (United States)

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

    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…

  16. Evidence-based practice guidelines for plasma transfusion

    NARCIS (Netherlands)

    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

    2010-01-01

    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

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

    Science.gov (United States)

    Kosciulek, John F.

    2010-01-01

    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,…

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

    Science.gov (United States)

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

    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…

  19. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

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

    Science.gov (United States)

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

    2016-01-18

    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.

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

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26797611

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

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26797611

  3. A Learning Object Approach To Evidence based learning

    OpenAIRE

    Zabin Visram; Bruce Elson; Patricia Reynolds

    2005-01-01

    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 mea...

  4. An Evidence Base for Human Spaceflight Risks in Wikipedia

    Science.gov (United States)

    Kundrot, Craig; Steil, Jennifer; Lumpkins, Sarah; Pellis, Neal

    2013-01-01

    NASA's Human Research Program (HRP) is focused on understanding and mitigating thirty two risks to crew health and performance in exploration missions beyond low Earth orbit. The HRP has developed an evidence report for each of the risks. Most evidence reports are a brief review article describing the evidence related to a specified risk, written at a level appropriate for the scientifically educated, non-specialist reader. Each evidence report captured the current state of knowledge from both research and operations. Two limitations of the evidence reports have become apparent: 1) they are updated infrequently and 2) they do not take full advantage of the expertise available in other space agencies and in related fields of terrestrial research. Therefore, the HRP is experimenting with the use of Wikipedia articles as a repository for evidence. Wikipedia's accessibility to the international space flight community and researchers in related terrestrial fields creates the opportunity to generate a more timely and comprehensive evidence base. Initial Wikipedia articles were populated for seven risks using a subset of the information in the HRP-approved evidence reports: Fatigue and Sleep Loss, Treating An Ill or Injured Crew Member, Radiation Carcinogenesis, Visual Impairment and Intracranial Pressure, Renal Stone Formation, Team Cohesion, and Intervertebral Disc Damage. Since the initial articles were created, there have been additions to these Wikipedia articles, including content from sources outside the HRP, and editorial changes to the pages. We will report on the nature of the contributions made after the initial articles were created, the comprehensiveness of the resulting Wikipedia articles, and the effort required to maintain quality control of the content. The Wikipedia approach will also be compared to wiki efforts that exert more traditional editorial control of content prior to posting.

  5. Evaluation of Evidence-Based Nursing Pain Management Practice

    Science.gov (United States)

    Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

    2014-01-01

    Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

  6. The Notion of Evidence in Evidence-Based Practice by the Nursing Philosophy Working Group.

    Science.gov (United States)

    Romyn, Donna M.; Allen, Marion N.; Boschma, Geertje; Duncan, Susan M.; Edgecombe, Nancy; Jensen, Louise A.; Ross-Kerr, Janet C.; Marck, Patricia; Salsali, Mahvash; Tourangeau, Ann E.; Warnock, Fay

    2003-01-01

    Addresses these questions: To what end is evidence sought? What is the nature of evidence? What kinds of evidence are valued by the nursing profession? and What kinds of evidence should underlie clinical decision making? (Contains 28 references.) (SK)

  7. The evidence base for professional and self-care prevention

    DEFF Research Database (Denmark)

    Twetman, Svante

    2015-01-01

    BACKGROUND: The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. METHODS: A mapping of systematic reviews (SR) of literature was carried out in Pub....... Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low. CONCLUSIONS: There are knowledge gaps in many domains of cariology...

  8. Improving the evidence for ecosystem-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Hannah

    2011-11-15

    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.

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

    CERN Document Server

    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

    2016-01-01

    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.

  10. Implementation of evidence-based practice: A naturopath perspective.

    Science.gov (United States)

    Ooi, Soo Liang; Rae, John; Pak, Sok Cheon

    2016-02-01

    Evidence-based practice (EBP), an approach to clinical practice that places emphasis on the use of best available research evidence for decision-making, has been adopted broadly in clinical practice. As a patient-focused approach, EBP promotes the spirit of inquiry. It can also facilitate consistency of care across professional boundaries, and clarify the directions of research. However, over-emphasis on systematic reviews and randomised control trials as the "gold standard" for evidence is a major limitation of EBP as it is being practised today. There are also objections to EBP based on epistemological grounds. Complementary and alternative medicine (CAM) therapies often fare unfavourably under the scrutiny of EBP due to the lack of research and inherent differences in healing ideology. Naturopathy is a unique form of CAM, based on both traditional and scientific knowledge. We argue that there is no conflict between naturopathy and EBP. EBP can be adopted as a useful approach to assimilate scientific evidence in naturopathic practices. However, naturopaths need to reconcile tensions between traditional and scientific knowledge in their choice of treatment remedies, while adhering to the naturopathic principles of healing, to benefit the patients. They must also maintain their emphasis on clinical expertise, and also patient preferences and values, in clinical decision-making. PMID:26850801

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

    Directory of Open Access Journals (Sweden)

    Dhavendra Kumar

    2011-01-01

    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.

  12. Evidence-Based Assessment of Obsessive–Compulsive Disorder

    Science.gov (United States)

    Rapp, Amy M.; Bergman, R. Lindsay; Piacentini, John; McGuire, Joseph F.

    2016-01-01

    Obsessive–compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793

  13. Evidence-based orthopedic surgery: is it possible?

    Science.gov (United States)

    Suk, Michael; Hanson, Beate; Helfet, David L

    2010-04-01

    The promise of evidence-based medicine is to integrate the highest levels of clinical data with patient outcomes. After framing the question and identifying appropriate studies, evaluating their relevance to clinical practice is highly dependent on the instruments and measures selected to demonstrate outcomes. Currently, there are hundreds of outcomes measures available in the orthopedic literature evaluating these treatments, and it is not uncommon for different measures to produce conflicting results. Consequently, the ability to evaluate an outcomes measure is critical in determining the value of a specific treatment intervention. Similarly, selecting the appropriate outcomes measure for research or clinical purposes is an important decision that may have far reaching implications on reimbursement, surgeon reputation, and patient treatment success. Evidence-based orthopedic surgery is indeed possible, but demands a detailed understanding of why appropriate outcomes selection is important, the difference between clinician-based and patient-reported outcomes (PROs), and potential future directions in orthopedics outcomes research. PMID:20399353

  14. Evidence-Based Assessment of Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Rapp, Amy M; Bergman, R Lindsay; Piacentini, John; McGuire, Joseph F

    2016-01-01

    Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%-2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793

  15. An evidence-based review of dental matrix systems.

    Science.gov (United States)

    Owens, Barry M; Phebus, Jeffrey G

    2016-01-01

    The restoration of proximal surface cavities, originating from Class II carious lesions, to "normal" anatomical specifications is a fundamental objective for the dental practitioner. Cognitive interpretation of tooth morphology attained from evidence-based resources, together with the necessary psychomotor skills for correct design and completion, are considered essential strategies for restoration success. Also, the visualization of the original tooth structure, if present, should substantially benefit the dentist in the creation of a clinically satisfactory restoration. The purpose of this evidence-based review is to define the cause and effect of decisions based on optimum treatment standards of care for the patient. The concepts of form and function, as related to the oral environment, and the consequences of unsatisfactory dental restorative care will be scrutinized. This article will identify and explain the different challenges and solutions for restoration of dental proximal lesions and provide an overview of past, present, and future procedures. PMID:27599285

  16. Validating evidence based decision making in health care

    DEFF Research Database (Denmark)

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

    Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register o...... are highly influenced by the geographical placement of surgeons. Therfore, decisions to use mesh are boundedly rationality, rather than rational.......Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register...... 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...

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

    Science.gov (United States)

    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.

  18. Strengths and limitations of evidence-based dermatology

    Directory of Open Access Journals (Sweden)

    Hywel C Williams

    2014-01-01

    Full Text Available The need for understanding and reflecting on evidence-based dermatology (EBD has never been greater given the exponential growth of new external evidence to inform clinical practice. Like any other branch of medicine, dermatologists need to acquire new skills in constructing answerable questions, efficiently searching electronic bibliographic databases, and critically appraising different types of studies. Secondary summaries of evidence in the form of systematic reviews (SR, that is, reviews that are conducted in a systematic, unbiased and explicit manner, reside at the top of the evidence hierarchy, because they are less prone to bias than traditional expert reviews. In addition to providing summaries of the best external evidence, systematic reviews and randomized controlled trials (RCTs are also powerful ways of identifying research gaps and ultimately setting the agenda of future clinical research in dermatology. But like any paradigm, EBD can have its limitations. Wrong application, misuse and overuse of EBD can have serious consequences. For example, mindless pooling together of data from dissimilar studies in a meta-analysis may render it a form of reductionism that does not make any sense. Similarly, even highly protocolised study designs such as SRs and RCTs are still susceptible to some degree of dishonesty and bias. Over-reliance on randomized controlled trials (RCT may be inappropriate, as RCTs are not a good source for picking up rare but important adverse effects such as lupus syndrome with minocycline. A common criticism leveled against SRs is that these frequently conclude that there is lack of sufficient evidence to inform current clinical practice, but arguably, such a perception is grounded more on the interpretation of the SRs than anything else. The apparent absence of evidence should not paralyze the dermatologist to adopt a state of therapeutic nihilism. Poor primary data and an SR based on evidence that is not up

  19. Strengths and limitations of evidence-based dermatology.

    Science.gov (United States)

    Williams, Hywel C

    2014-03-01

    The need for understanding and reflecting on evidence-based dermatology (EBD) has never been greater given the exponential growth of new external evidence to inform clinical practice. Like any other branch of medicine, dermatologists need to acquire new skills in constructing answerable questions, efficiently searching electronic bibliographic databases, and critically appraising different types of studies. Secondary summaries of evidence in the form of systematic reviews (SR), that is, reviews that are conducted in a systematic, unbiased and explicit manner, reside at the top of the evidence hierarchy, because they are less prone to bias than traditional expert reviews. In addition to providing summaries of the best external evidence, systematic reviews and randomized controlled trials (RCTs) are also powerful ways of identifying research gaps and ultimately setting the agenda of future clinical research in dermatology. But like any paradigm, EBD can have its limitations. Wrong application, misuse and overuse of EBD can have serious consequences. For example, mindless pooling together of data from dissimilar studies in a meta-analysis may render it a form of reductionism that does not make any sense. Similarly, even highly protocolised study designs such as SRs and RCTs are still susceptible to some degree of dishonesty and bias. Over-reliance on randomized controlled trials (RCT) may be inappropriate, as RCTs are not a good source for picking up rare but important adverse effects such as lupus syndrome with minocycline. A common criticism leveled against SRs is that these frequently conclude that there is lack of sufficient evidence to inform current clinical practice, but arguably, such a perception is grounded more on the interpretation of the SRs than anything else. The apparent absence of evidence should not paralyze the dermatologist to adopt a state of therapeutic nihilism. Poor primary data and an SR based on evidence that is not up-to-date are also

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

    Directory of Open Access Journals (Sweden)

    LIU Ling

    2013-08-01

    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

  1. AC Electrokinetics of Physiological Fluids for Biomedical Applications.

    Science.gov (United States)

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

    2015-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Helmut Kern

    2013-12-01

    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.

  3. Evidence-based treatment for acute spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Zhouming Deng; Jiajia Su; Lin Cai; Ansong Ping; Wei Jin; Renxiong Wei; Yan Zhan

    2011-01-01

    OBJECTIVE: To formulate an evidence-based treatment for one patient with acute spinal cord injury and summarize evidence for evaluating acute spinal cord injury treatment. METHODS: Studies related to the treatment for acute spinal cord injury were identified via a search of National Guideline Clearinghouse (NGC, 2000-11), the Cochrane Library (Issue 1, 2011), TRIP Database (2000-11), and PubMed (1966-2011). Treatment strategies were formulated according to three basic principles: best evidence, doctor's professional experience, and wishes of the patient. RESULTS: A total of 34 articles were selected, including 1 NGC guideline, 22 systematic reviews, and 11 randomized controlled trials. Based on our review, we arrived at the following recommendations: no clinical evidence exists definitively to recommend the use of any of neuroprotective pharmaceuticals; surgery should be undertaken early; mechanical compression devices and low-molecular weight heparin should be employed to prevent thrombosis; respiratory muscle training is beneficial for pulmonary function and quality of life; and functional electrical stimulation and acupuncture can promote functional recovery. The patient accordingly underwent surgery 6 hours after trauma without receiving any neuroprotective pharmaceuticals; low-molecular weight heparin and intermittent pneumatic compression were applied to prevent thrombosis. He also underwent respiratory muscle training daily for 8 weeks and received functional electrical stimulation for 15 minutes and acupuncture for 30 minutes every day. After follow-up for 3 months, the above therapeutic regimen was confirmed efficacious for acute spinal cord injury.CONCLUSION: Evidence-based medicine provides an individualized treatment protocol for acute spinal cord injury, which can significantly improve the therapeutic effect and prognosis.

  4. Paving the way for evidence-based medicine in Pakistan.

    Science.gov (United States)

    Zaidi, Zareen; Hashim, Jawad; Iqbal, Mobeen; Quadri, K Mujtaba

    2007-11-01

    Evidence-based Medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimal clinical care to patients. EBM has become popular due to: the need for valid information about diagnosis, prognosis, therapy and prevention during patient care; traditional sources such as textbooks and expert opinion being frequently out-of-date; and knowledge of current best evidence declining with time from graduation from medical college. EBM has become feasible for practicing clinicians due to: new strategies for appraising studies; availability of systematic reviews (summaries) of current best evidence; and information technology (computers with Internet access). In a resource-limited country such as Pakistan, an evidence-based approach can be cost-effective by reducing clinical practices that have no proven benefit. Commonly perceived obstacles to EBM include limited access to computers, the Internet and online resources. Reliable resources of EBM are available (such as The Cochrane Database of Systematic Reviews http://www.cochrane.org) although many of these require paid subscriptions. Another difficulty is the issue of applicability of data from other countries to patients in our setting with different socio-economic factors. Other barriers to EBM in developing countries include: inexperience in small-group learning, limited time to attend workshops, and the lack of role models for practicing EBM. We have also tried to address the common fallacies related to EBM in the hope of greater use of these skills by busy clinicians as well as academic researchers. PMID:18062522

  5. Management of REM sleep behavior disorder: An evidence based review

    Directory of Open Access Journals (Sweden)

    Preeti Devnani

    2015-01-01

    Full Text Available Rapid eye movement (REM sleep behavior disorder (RBD is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.

  6. Teaching of evidence-based medicine to medical undergraduates.

    Science.gov (United States)

    Atiya, A S

    2002-12-01

    Medical practice is changing, and the foundations of the paradigm shift lie in the development in research over the last four decades. Today, it is no longer adequate to treat a patient purely on clinical experience alone without a clear demonstration of evidence based on research, particularly the use of randomised controlled clinical trials. What is thought to be an effective mode of treatment currently may not necessarily hold true by the time medical students begin his/her medical practice. As a consequence, many medical schools worldwide are increasingly promoting evidence-based medicine (EBM) teaching in their medical curriculum along with problem-based learning (PBL). Teaching of EBM requires a paradigm shift in itself, as students must possess additional skills that are not traditionally part of medical training. These include the ability to acquire the skills in 'means of answering questions' than just 'knowing the answer to questions'. This paper aims to describe what EBM is and to highlight the formative experience of the teaching of EBM at the medical undergraduate level in the University of Malaya. Challenges and opportunities towards successful adoption of evidence-based practice are discussed. PMID:12733204

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

    Indian Academy of Sciences (India)

    A ASHERY; A H ZAKI; M HUSSIEN MOURAD; A M AZAB; A A M FARAG

    2016-08-01

    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.

  8. Reliability evaluation of emergency AC power systems based on operating experience at U.S. nuclear power plants

    International Nuclear Information System (INIS)

    The reliability of emergency AC power Systems has been under study at the U.S. Nuclear Regulatory Commission and by its contractors for several years. This paper provides the results of work recently performed to evaluate past U.S. nuclear power plant emergency AC power System reliability performance using system level data. Operating experience involving multiple diesel generator failures, unavailabilities, and simultaneous occurrences of failures and out of service diesel generators were used to evaluate reliability performance at individual nuclear power plants covering a 9 year period from 1976 through 1984. The number and nature of failures and distributions of reliability evaluation results are provided. The results show that plant specific performance varied considerably during the period with a large number achieving high reliability performance and a smaller number accounting for lower levels of reliability performance. (author)

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

    Directory of Open Access Journals (Sweden)

    Rebecca S. Bejhed

    2015-12-01

    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.

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

    Science.gov (United States)

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

    2015-12-01

    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.

  11. Stability Analysis of Three-Phase AC Power Systems Based on Measured D-Q Frame Impedances

    OpenAIRE

    Wen, Bo

    2015-01-01

    Small-signal stability is of great concern for distributed power systems with a large number of regulated power converters. These converters are constant-power loads (CPLs) exhibit a negative incremental input resistance within the output voltage regulation bandwidth. In the case of dc systems, design requirements for impedances that guarantee stability have been previously developed and are used in the design and specification of these systems. In terms of three-phase ac systems, a mathemati...

  12. 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

    Institute of Scientific and Technical Information of China (English)

    徐承韬; 焦禹; 蔡胜年; 秦然; 梁禹; 庞宝麟

    2013-01-01

    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.

  13. Reconciling evidence-based medicine and patient-centred care: defining evidence-based inputs to patient-centred decisions.

    Science.gov (United States)

    Weaver, Robert R

    2015-12-01

    Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. PMID:26456314

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

    Science.gov (United States)

    Mykkänen, Minna; Miettinen, Merja; Saranto, Kaija

    2016-01-01

    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. PMID:27332244

  15. Pragmatic prevention of preterm birth and evidence based medicine.

    Science.gov (United States)

    Hoyme, Udo B

    2016-07-01

    Effective prevention of preterm birth is one of the unsolved problems in modern medicine. In the Thuringia campaign 2000 based on a simple screening with intravaginal pH self-measurements, adequate medical diagnosis and immediate antimicrobial therapy of genital infection, the rate of newborns methods, do we really have to wait even more decades to come for a prospectively randomized double-blinded almost impracticable study to convince the latest skeptical scientist that we have plenty of evidence-based means to reduce the incidence of premature birth, now, by decreasing infectious morbidity in pregnancy and by the same action childbed fever as well? Insisting scholastically on nothing but the 100 % pure evidence sometimes can hamper innovations and potential benefit. Would a similar caution ever had allowed us for instance to introduce handwashing according to Semmelweis? Good news, the Government of the State of Thuringia has decided this year to reestablish a pH selfcare screening programme. PMID:27146862

  16. Establishing CASA as an evidence-based practice.

    Science.gov (United States)

    Lawson, Jennifer; Berrick, Jill Duerr

    2013-01-01

    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.

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

    Science.gov (United States)

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

    2008-11-01

    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. PMID:18802951

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

    Science.gov (United States)

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

    2008-11-01

    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.

  19. 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

    Institute of Scientific and Technical Information of China (English)

    马庆安; 李群湛; 邱大强; 徐英雷; 张丽艳

    2012-01-01

    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。

  20. Common Processes in Evidence-Based Adolescent HIV Prevention Programs

    OpenAIRE

    Ingram, Barbara L.; Flannery, Diane; Elkavich, Amy; Rotheram-Borus, Mary Jane

    2008-01-01

    Dissemination of evidence-based HIV prevention programs for adolescents will be increased if community interventionists are able to distinguish core, essential program elements from optional, discretionary ones. We selected five successful adolescent HIV prevention programs, used a qualitative coding method to identify common processes described in the procedural manuals, and then compared the programs. Nineteen common processes were categorized as structural features, group management strate...

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

    OpenAIRE

    Li, Juan; Liu, Ling; Li, Meng-qiu; ZHANG Wen-wu; SI Yang

    2013-01-01

    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 use...

  2. An evidence and consensus based guideline for acute diarrhoea management

    OpenAIRE

    Armon, K; Stephenson, T; MacFaul, R; Eccleston, P; Werneke, U; Baumer, H

    2001-01-01

    OBJECTIVE—To develop an evidence and consensus based guideline for the management of the child who presents to hospital with diarrhoea (with or without vomiting), a common problem representing 16% of all paediatric medical attenders at an accident and emergency department. Clinical assessment, investigations (biochemistry and stool culture in particular), admission, and treatment are addressed. The guideline aims to aid junior doctors in recognising children who need admi...

  3. Nursing faculties’ knowledge and attitude on evidence-based practice

    OpenAIRE

    Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser

    2012-01-01

    Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descr...

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

    Science.gov (United States)

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

    2012-10-01

    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.

  5. AMNIOTIC FLUID EMBOLISM: AN EVIDENCE-BASED REVIEW

    OpenAIRE

    Conde-Agudelo, Agustin; Romero, Roberto

    2009-01-01

    We conducted an evidence-based review of information bout amniotic fluid embolism (AFE). The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 13–30% and 9–44%, respectively. Risk factors associated with an increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical lacerations, and uterine ru...

  6. Peltier ac calorimeter

    OpenAIRE

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

    2001-01-01

    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.

  7. Community Education and Evidence-based Knowledge Use

    Directory of Open Access Journals (Sweden)

    N mohaghegh

    2015-09-01

    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.

  8. Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016.

    Science.gov (United States)

    Bikson, Marom; Grossman, Pnina; Thomas, Chris; Zannou, Adantchede Louis; Jiang, Jimmy; Adnan, Tatheer; Mourdoukoutas, Antonios P; Kronberg, Greg; Truong, Dennis; Boggio, Paulo; Brunoni, André R; Charvet, Leigh; Fregni, Felipe; Fritsch, Brita; Gillick, Bernadette; Hamilton, Roy H; Hampstead, Benjamin M; Jankord, Ryan; Kirton, Adam; Knotkova, Helena; Liebetanz, David; Liu, Anli; Loo, Colleen; Nitsche, Michael A; Reis, Janine; Richardson, Jessica D; Rotenberg, Alexander; Turkeltaub, Peter E; Woods, Adam J

    2016-01-01

    This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3-13 A/m(2)) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 milliamperes, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations. PMID:27372845

  9. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence.

    Science.gov (United States)

    Graham, David Y; Lee, Yi-Chia; Wu, Ming-Shiang

    2014-02-01

    Data are available such that choice of Helicobacter pylori therapy for an individual patient can be reliably predicted. Here, treatment success is defined as a cure rate of 90% or greater. Treatment outcome in a population or a patient can be calculated based on the effectiveness of a regimen for infections with susceptible and with resistant strains coupled with the knowledge of the prevalence of resistance (ie, based on formal measurement, clinical experience, or both). We provide the formula for predicting outcome and we illustrate the calculations. Because clarithromycin-containing triple therapy and 10-day sequential therapy are now only effective in special populations, they are considered obsolete; neither should continue to be used as empiric therapies (ie, 7- and 14-day triple therapies fail when clarithromycin resistance exceeds 5% and 15%, respectively, and 10-day sequential therapy fails when metronidazole resistance exceeds 20%). Therapy should be individualized based on prior history and whether the patient is in a high-risk group for resistance. The preferred choices for Western countries are 14-day concomitant therapy, 14-day bismuth quadruple therapy, and 14-day hybrid sequential-concomitant therapy. We also provide details regarding the successful use of fluoroquinolone-, rifabutin-, and furazolidone-containing therapies. Finally, we provide recommendations for the efficient development (ie, identification and optimization) of new regimens, as well as how to prevent or minimize failures. The trial-and-error approach for identifying and testing regimens frequently resulted in poor treatment success. The described approach allows outcome to be predicted and should simplify treatment and drug development. PMID:23751282

  10. Development and evaluation of evidence-based nursing (EBN) filters and related databases*

    OpenAIRE

    Lavin, Mary A.; Krieger, Mary M.; Meyer, Geralyn A.; Spasser, Mark A.; Cvitan, Tome; Reese, Cordie G.; Carlson, Judith H.; Perry, Anne G.; McNary, Patricia

    2005-01-01

    Objectives: Difficulties encountered in the retrieval of evidence-based nursing (EBN) literature and recognition of terminology, research focus, and design differences between evidence-based medicine and nursing led to the realization that nursing needs its own filter strategies for evidence-based practice. This article describes the development and evaluation of filters that facilitate evidence-based nursing searches.

  11. Evidence-Based Chiropractic Education: Are We Equipping Graduates for Clinical Practice with Improved Patient Outcomes?

    OpenAIRE

    Shreeve, Michael W.

    2012-01-01

    Evidence-based practice has emerged as a driving factor in current curriculum development in chiropractic education. This commentary discusses educational strategies incorporating evidence-based practices in the doctor of chiropractic curriculum and explores whether all five steps of the evidence-based process and patient outcomes from evidence-based practice are being assessed.

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

    Science.gov (United States)

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

    2016-06-01

    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.

  13. Evidence-based practice recommendations for memory rehabilitation.

    Science.gov (United States)

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

    2011-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

    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.

  15. Integration of Evidence Base into a Probabilistic Risk Assessment

    Science.gov (United States)

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

    2011-01-01

    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

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

    Science.gov (United States)

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

    2009-09-20

    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.

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

    Directory of Open Access Journals (Sweden)

    Goffredo Freddi

    2011-01-01

    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.

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

    Science.gov (United States)

    Wiebe, Samuel

    2013-05-01

    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.

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

    Science.gov (United States)

    Newman, K; Pyne, T; Cowling, A

    1998-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Kamel Remah M

    2010-03-01

    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.

  1. Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

    Science.gov (United States)

    Besag, Frank; Ettinger, Alan B.; Mula, Marco; Gobbi, Gabriella; Comai, Stefano; Aldenkamp, Albert P.; Steinhoff, Bernhard J.

    2016-01-01

    Antiepileptic drugs (AEDs) have many benefits but also many side effects, including aggression, agitation, and irritability, in some patients with epilepsy. This article offers a comprehensive summary of current understanding of aggressive behaviors in patients with epilepsy, including an evidence-based review of aggression during AED treatment. Aggression is seen in a minority of people with epilepsy. It is rarely seizure related but is interictal, sometimes occurring as part of complex psychiatric and behavioral comorbidities, and it is sometimes associated with AED treatment. We review the common neurotransmitter systems and brain regions implicated in both epilepsy and aggression, including the GABA, glutamate, serotonin, dopamine, and noradrenaline systems and the hippocampus, amygdala, prefrontal cortex, anterior cingulate cortex, and temporal lobes. Few controlled clinical studies have used behavioral measures to specifically examine aggression with AEDs, and most evidence comes from adverse event reporting from clinical and observational studies. A systematic approach was used to identify relevant publications, and we present a comprehensive, evidence-based summary of available data surrounding aggression-related behaviors with each of the currently available AEDs in both adults and in children/adolescents with epilepsy. A psychiatric history and history of a propensity toward aggression/anger should routinely be sought from patients, family members, and carers; its presence does not preclude the use of any specific AEDs, but those most likely to be implicated in these behaviors should be used with caution in such cases. PMID:27255267

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

    Directory of Open Access Journals (Sweden)

    Liana Albernaz de Melo Bastos

    2002-12-01

    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.

  3. The philosophical limits of evidence-based medicine.

    Science.gov (United States)

    Tonelli, M R

    1998-12-01

    Evidence-based medicine (EBM) has already had a profound effect on both medical education and clinical practice. The benefits of EBM, which defines the value of medical interventions in terms of empirical evidence from clinical trials, are enormous and well described. Not clearly acknowledged, however, are the limits of EBM. An intrinsic gap exists between clinical research and clinical practice. Failure to recognize and account for this gap may lead to unintended and untoward consequences. Under the current understanding of EBM, the individuality of patients tends to be devalued, the focus of clinical practice is subtly shifted away from the care of individuals toward the care of populations, and the complex nature of sound clinical judgment is not fully appreciated. Despite its promise, EBM currently fails to provide an adequate account of optimal medical practice. A broader understanding of medical knowledge and reasoning is necessary.

  4. Evidence-Based Parenting Interventions to Promote Secure Attachment

    Science.gov (United States)

    Wright, Barry; Edginton, Elizabeth

    2016-01-01

    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

  5. Knowledge sources for evidence-based practice in rheumatology nursing.

    Science.gov (United States)

    Neher, Margit; Ståhl, Christian; Ellström, Per-Erik; Nilsen, Per

    2015-12-01

    As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles. PMID:25059719

  6. Evidence-Based Parenting Interventions to Promote Secure Attachment

    Science.gov (United States)

    Wright, Barry; Edginton, Elizabeth

    2016-01-01

    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 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

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

    Science.gov (United States)

    Gődény, Sándor; Csenteri, Orsolya Karola

    2015-11-01

    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.

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

    Science.gov (United States)

    Crawford, James M

    2007-02-01

    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

  9. Reliable, Efficient and Cost-Effective Electric Power Converter for Small Wind Turbines Based on AC-link Technology

    Energy Technology Data Exchange (ETDEWEB)

    Darren Hammell; Mark Holveck; DOE Project Officer - Keith Bennett

    2006-08-01

    Grid-tied inverter power electronics have been an Achilles heel of the small wind industry, providing opportunity for new technologies to provide lower costs, greater efficiency, and improved reliability. The small wind turbine market is also moving towards the 50-100kW size range. The unique AC-link power conversion technology provides efficiency, reliability, and power quality advantages over existing technologies, and Princeton Power will adapt prototype designs used for industrial asynchronous motor control to a 50kW small wind turbine design.

  10. Dicty_cDB: FCL-AC03 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC03 (Link to dictyBase) - - - Contig-U16477-1 FCL-AC03P ...(Link to Original site) FCL-AC03F 538 FCL-AC03Z 570 FCL-AC03P 1108 - - Show FCL-AC03 Library FCL (Link to library) Clone ID FCL-...7-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-AC03Q....Seq.d/ Representative seq. ID FCL-AC03P (Link to Original site) Representative DNA sequence >FCL-AC03 (FCL-AC03Q) /CSM/FCL/FCL-...AC/FCL-AC03Q.Seq.d/ AATTTTTAAAAAAAAAAGAAAATAAAAAAAAAAATAATATTTTATTAGTCATTATAAAAT TGTGAAT

  11. Dicty_cDB: FCL-AC20 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC20 (Link to dictyBase) - - - Contig-U15117-1 FCL-AC20Z ...(Link to Original site) - - FCL-AC20Z 600 - - - - Show FCL-AC20 Library FCL (Link to library) Clone ID FCL-A... http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-AC20Q.Seq.d/ Representative seq. ID FCL-...AC20Z (Link to Original site) Representative DNA sequence >FCL-AC20 (FCL-AC20Q) /CSM/FCL/FCL-AC/FCL-...Homology vs CSM-cDNA Score E Sequences producing significant alignments: (bits) Value FCL-AC20 (FCL-AC20Q) /CSM/FCL/FCL-AC/FCL-

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

    Institute of Scientific and Technical Information of China (English)

    Shintaro Yamazaki; Tadatoshi Takayama

    2008-01-01

    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.

  13. ACAC Converters for UPS

    Directory of Open Access Journals (Sweden)

    Rusalin Lucian R. Păun

    2008-05-01

    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.

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

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    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

  15. A Learning Object Approach To Evidence based learning

    Directory of Open Access Journals (Sweden)

    Zabin Visram

    2005-06-01

    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

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

    Science.gov (United States)

    Vanherweghem, J-L

    2015-09-01

    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. PMID:26591330

  17. High-Speed Visualization of Evaporation Phenomena from Tungsten Based Electrode in Multi-Phase AC Arc

    Science.gov (United States)

    Tanaka, Manabu; Hashizume, Taro; Imatsuji, Tomoyuki; Nawata, Yushi; Watanabe, Takayuki

    2015-09-01

    A multi-phase AC arc has been developed for applications in various fields of engineering because it possesses unique advantages such as high energy efficiency. However, understanding of fundamental phenomena in the multi-phase AC arc is still insufficient for practical use. Purpose of this study is to investigate electrode erosion mechanism by high-speed visualization of the electrode metal vapor in the arc. Results indicated that the electrode mainly evaporated at anodic period, leading to the arc constriction. Moreover, evaporation of W electrode with 2wt% La2O3 at the anodic period was much higher than that with 2wt% ThO2. This can be explained by different properties of these oxide additives. Evaporation of the oxide additive resulted in the arc constriction, which accelerated the evaporation of W electrode. Therefore, addition of La2O3 with lower melting and boiling point than ThO2 lead to stronger arc constriction, resulting in severer evaporation of W electrode.

  18. Informed Systems: Enabling Collaborative Evidence Based Organizational Learning

    Directory of Open Access Journals (Sweden)

    Mary M. Somerville

    2015-12-01

    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

  19. Curriculum for Evidence Based Medicine for MBBS II phase Graduates

    Directory of Open Access Journals (Sweden)

    Saxena R

    2014-12-01

    Full Text Available Evidence based medicine is the training of health care professionals to access, assess and apply the best scientific evidence to clinical practice. EBM is the conscientious, explicit and judicious use of current best evidence along with clinical expertise and patient values in making decisions about the case of individual patients. The current undergraduate curriculum of health profession is based on past knowledge accumulated for years. The scientific relevance of the mostly outdated information has never been questioned. The students passively absorb this available knowledge and apply it in their future professional life. There is no active learning on their part, by way of positive enquiry and critical analysis of the curriculum imposed on them. This has an undesirable impact on their competency as health professionals and the quality of the health care imparted by them. Hence there is need for emphasis on the teaching of EBM skills in undergraduate, postgraduate, and continuing medical education programs. Early introduction of EBM in the undergraduate medical curriculum, in the form of a short course, using various modes of instruction, enhances the competence of critical thinking and also influences change in attitude towards EBM positively in medical students. The EBM course is planned to introduce in the curriculum of medical undergraduates at the beginning of second phase when they enter clinical posting. Total number of student would be 100 per batch and the course duration will be of 1 year. Educational methods program incorporates multiple teaching methods like lectures, discussion sessions, demonstration, case based learning, timely feedback, real life exposure, role modeling and peer evaluation.

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

    Directory of Open Access Journals (Sweden)

    LI Meng-qiu

    2012-04-01

    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.

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

    Science.gov (United States)

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

    2012-01-01

    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.

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

    Science.gov (United States)

    Silveira, Dierci Marcio

    2012-01-01

    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.

  3. Evidence based prevention of hamstring injuries in sport.

    Science.gov (United States)

    Petersen, J; Hölmich, P

    2005-06-01

    A common soft tissue injury in sports involving sprinting and jumping is the hamstring strain. A major problem with hamstring strains is the high incidence of reinjury. Muscle injuries can be classified as direct or indirect and are typically grouped into three categories according to severity. A number of potential risk factors have been proposed for hamstring strains. Only a few are evidence based and some are mainly based on theoretical assumptions. There is a lack of clinical research on the effectiveness of rehabilitation programmes for hamstring strains. Although the initial treatment of rest, ice, compression, and elevation is accepted for muscle strains, no consensus exists for their rehabilitation. Not much evidence based research has been carried out on prevention of hamstring strain. To our knowledge only two prospective studies have so far been published. As the injuries are common in football and other sports involving sprinting and jumping, there is a need for further research preferably in the form of randomised controlled trials.

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

    NARCIS (Netherlands)

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

    2011-01-01

    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

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

    NARCIS (Netherlands)

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

    2013-01-01

    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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

    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.

  7. Evidence base for pre-employment medical screening.

    Science.gov (United States)

    Pachman, Joseph

    2009-07-01

    This paper examines the evidence base for the use of pre-employment/pre-placement medical examinations. The use of pre-employment examinations is often driven more by cultural practices than evidence. There is a lack of evidence on their effectiveness in preventing health-related occupational risks. Hypertension screening is highlighted as a common pre-employment practice for which there is no standardized criteria to use to determine fitness for work. There are inherent problems in screening for psychiatric disorders and substance abuse as well as potential for racial bias and other unintended negative effects. This paper questions the economic case for this practice and also expresses concerns about paternalism related to identified risk factors. Health assessments should only be included when appropriate to the task environment and the general use of pre-employment exams and drug screening should be eliminated. Generally, a health assessment by questionnaire should suffice. Occupational health providers should advise against the application of physical or mental standards that are not relevant to fulfilment of the essential job functions. Consensus development regarding best practice, as well as consideration for acquiring outcome data related to pre-employment practice, is recommended. PMID:19649367

  8. Drugs and blood transfusions: dogma- or evidence-based practice?

    Science.gov (United States)

    Murdock, J; Watson, D; Dorée, C J; Blest, A; Roberts, M M; Brunskill, S J

    2009-02-01

    There is a lack of consensus on the safety of the coadministration of drugs and red blood cells (RBCs). A systematic review was undertaken to establish the evidence base for this question and assess how the evidence may be translated into present clinical day practice. Comprehensive searches of MEDLINE, EMBASE, CINAHL, the Cochrane Library and hand searching of transfusion journals, guidelines and websites identified 12 relevant papers: 11 in-vitro experiments and 1 case report. Data on incidences of haemolysis and agglutination following coadministration were extracted and analysed. Overall findings suggest that iron chelators (two papers), antimicrobials (three papers) and lower doses of opioids (three papers) are safe to coadminister with RBCs. Haemolysis was observed with higher doses of opioids (three papers). Transposition of these findings to clinical practice is limited because of the lack of clinical applicability of in-vitro experiments and diversity in how, and what, clinical outcome measures were used. Further evidence from true clinical settings would be required to inform clinical practice on the efficacy and safety of the coadministration of drugs and RBCs. PMID:19302450

  9. Obstacle and solution of Chinese evidence-based orthopedics

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; LIU Hui

    2011-01-01

    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.

  10. Evidence-based rationale for offloading treatment modalities.

    Science.gov (United States)

    Bell, Desmond

    2008-01-01

    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.

  11. Sustainability and evidence-based design in the healthcare estate

    CERN Document Server

    Phiri, Michael

    2014-01-01

    This work aims to deepen our understanding of the role played by technical guidelines and tools for the design, construction and operation of healthcare facilities, ultimately establishing the impact of the physical environment on staff and patient outcomes. Using case studies largely drawn from the UK, Europe, China and Australasia, design approaches such as sustainability (e.g. targets for energy efficiency, carbon neutrality, reduction of waste), evidence-based design (EBD), and Post-Project Evaluation (PPE) are examined in order to identify policies, mechanisms and strategies that can promote an integrated learning environment that in turn supports innovation in healthcare.

  12. International Workshop on Evidence-Based Technology Enhanced Learning

    CERN Document Server

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

    2012-01-01

    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.  

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

    Science.gov (United States)

    Raditic, Donna M; Bartges, Joseph W

    2014-09-01

    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. PMID:25174902

  14. Theoretical Foundations for Evidence-Based Health Informatics: Why? How?

    Science.gov (United States)

    Scott, Philip J; Georgiou, Andrew; Hyppönen, Hannele; Craven, Catherine K; Rigby, Michael; Brender McNair, Jytte

    2016-01-01

    A scientific approach to health informatics requires sound theoretical foundations. Health informatics implementation would be more effective if evidence-based and guided by theories about what is likely to work in what circumstances. We report on a Medinfo 2015 workshop on this topic jointly organized by the EFMI Working Group on Assessment of Health Information Systems and the IMIA Working Group on Technology Assessment and Quality Development. We discuss the findings of the workshop and propose an approach to consolidate empirical knowledge into testable middle-range theories. PMID:27577457

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

    Science.gov (United States)

    Shoemaker, Lorie K; Fischer, Brenda

    2011-03-01

    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. PMID:21320657

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

    Science.gov (United States)

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

    2014-01-01

    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. PMID:24860267

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

    Science.gov (United States)

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

    2014-04-01

    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.

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

    Science.gov (United States)

    Shoemaker, Lorie K; Fischer, Brenda

    2011-03-01

    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.

  19. Evidence-based Complementary and Alternative Medicine简介

    Institute of Scientific and Technical Information of China (English)

    李霄茜; 周庆辉

    2009-01-01

    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。

  20. Score-based likelihood ratios for handwriting evidence.

    Science.gov (United States)

    Hepler, Amanda B; Saunders, Christopher P; Davis, Linda J; Buscaglia, JoAnn

    2012-06-10

    Score-based approaches for computing forensic likelihood ratios are becoming more prevalent in the forensic literature. When two items of evidential value are entangled via a scorefunction, several nuances arise when attempting to model the score behavior under the competing source-level propositions. Specific assumptions must be made in order to appropriately model the numerator and denominator probability distributions. This process is fairly straightforward for the numerator of the score-based likelihood ratio, entailing the generation of a database of scores obtained by pairing items of evidence from the same source. However, this process presents ambiguities for the denominator database generation - in particular, how best to generate a database of scores between two items of different sources. Many alternatives have appeared in the literature, three of which we will consider in detail. They differ in their approach to generating denominator databases, by pairing (1) the item of known source with randomly selected items from a relevant database; (2) the item of unknown source with randomly generated items from a relevant database; or (3) two randomly generated items. When the two items differ in type, perhaps one having higher information content, these three alternatives can produce very different denominator databases. While each of these alternatives has appeared in the literature, the decision of how to generate the denominator database is often made without calling attention to the subjective nature of this process. In this paper, we compare each of the three methods (and the resulting score-based likelihood ratios), which can be thought of as three distinct interpretations of the denominator proposition. Our goal in performing these comparisons is to illustrate the effect that subtle modifications of these propositions can have on inferences drawn from the evidence evaluation procedure. The study was performed using a data set composed of cursive writing

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

    Energy Technology Data Exchange (ETDEWEB)

    Womble, R.

    2010-08-06

    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.

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

    Science.gov (United States)

    Hempel, Eliana V; Bollard, Edward R

    2016-09-01

    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. PMID:27542426

  3. Evidence-based medicine: a new tool for resource allocation?

    Science.gov (United States)

    Nunes, Rui

    2003-01-01

    Evidence-Based Medicine (EBM) is defined as the conscious, and judicious use of current best evidence in making decisions about the care of individual patients. The greater the level of evidence the greater the grade of recommendation. This pioneering explicit concept of EBM is embedded in a particular view of medical practice namely the singular nature of the patient-physician relation and the commitment of the latter towards a specific goal: the treatment and the well being of his or her client. Nevertheless, in many European countries as well as in the United States, this "integration of the best evidence from systematic research with clinical expertise and patient values" appears to be re-interpreted in light of the scarcity of healthcare resources. The purpose of this paper is double. First, to claim that from an ethical perspective EBM should be a guideline to clinical practice; and second, that in specific circumstances EBM might be a useful tool in macro-allocation of healthcare resources. Methodologically the author follows Norman Daniels' theory of "democratic accountability" to justify this assumption. That is, choices in healthcare must be accountable by democratic procedures. This perspective of distributive justice is responsible for the scope and limits of healthcare services. It follows that particular entitlements to healthcare--namely expensive innovative treatments and medicines--may be fairly restricted as long as this decision is socially and democratically accountable and imposed by financial restrictions of the system. In conclusion, the implementation of EBM, as long as it limits the access to drugs and treatments of unproven scientific results is in accordance with this perspective. The use of EBM is regarded as an instrument to facilitate the access of all citizens to a reasonable level of healthcare and to promote the efficiency of the system.

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

    Science.gov (United States)

    Jones, Elizabeth

    2013-01-01

    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…

  5. Knowledge-Based Query Construction Using the CDSS Knowledge Base for Efficient Evidence Retrieval

    Directory of Open Access Journals (Sweden)

    Muhammad Afzal

    2015-08-01

    Full Text Available Finding appropriate evidence to support clinical practices is always challenging, and the construction of a query to retrieve such evidence is a fundamental step. Typically, evidence is found using manual or semi-automatic methods, which are time-consuming and sometimes make it difficult to construct knowledge-based complex queries. To overcome the difficulty in constructing knowledge-based complex queries, we utilized the knowledge base (KB of the clinical decision support system (CDSS, which has the potential to provide sufficient contextual information. To automatically construct knowledge-based complex queries, we designed methods to parse rule structure in KB of CDSS in order to determine an executable path and extract the terms by parsing the control structures and logic connectives used in the logic. The automatically constructed knowledge-based complex queries were executed on the PubMed search service to evaluate the results on the reduction of retrieved citations with high relevance. The average number of citations was reduced from 56,249 citations to 330 citations with the knowledge-based query construction approach, and relevance increased from 1 term to 6 terms on average. The ability to automatically retrieve relevant evidence maximizes efficiency for clinicians in terms of time, based on feedback collected from clinicians. This approach is generally useful in evidence-based medicine, especially in ambient assisted living environments where automation is highly important.

  6. Evidence Based Conservative Management of Patello-femoral Syndrome

    Directory of Open Access Journals (Sweden)

    E. Carlos Rodriguez-Merchan

    2014-03-01

    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.    

  7. Evidence Based Conservative Management of Patello-femoral Syndrome

    Directory of Open Access Journals (Sweden)

    E. Carlos Rodriguez-Merchan

    2014-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    LI Juan

    2013-05-01

    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

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

    Science.gov (United States)

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

    2013-01-01

    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.

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

    Science.gov (United States)

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

    2013-01-01

    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. PMID:23975071

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

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    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.

  12. Updated Evidence-Based Treatment Algorithm in Pulmonary Arterial Hypertension

    Science.gov (United States)

    Barst, Robyn J.; Gibbs, J. Simon; Ghofrani, Hossein A.; Hoeper, Marius M.; McLaughlin, Vallerie V.; Rubin, Lewis J.; Sitbon, Olivier; Tapson, Victor; Galiè, Nazzareno

    2009-01-01

    Uncontrolled and controlled clinical trials with different compounds and procedures are reviewed to define the risk-benefit profiles for therapeutic options in pulmonary arterial hypertension (PAH). A grading system for the level of evidence of treatments based on the controlled clinical trials performed with each compound is used to propose an evidence-based treatment algorithm. The algorithm includes drugs approved by regulatory agencies for the treatment of PAH and/or drugs available for other indications. The different treatments have been evaluated mainly in idiopathic PAH, heritable PAH, and in PAH associated with the scleroderma spectrum of diseases or with anorexigen use. Extrapolation of these recommendations to other PAH subgroups should be done with caution. Oral anticoagulation is proposed for most patients; diuretic treatment and supplemental oxygen are indicated in cases of fluid retention and hypoxemia, respectively. High doses of calcium channel blockers are indicated only in the minority of patients who respond to acute vasoreactivity testing. Nonresponders to acute vasoreactivity testing, or responders who remain in World Health Organization (WHO) functional class III, should be considered candidates for treatment with either an oral phosphodiesterase-5 inhibitor or an oral endothelin-receptor antagonist. Continuous intravenous administration of epoprostenol remains the treatment of choice in WHO functional class IV patients. Combination therapy is recommended for patients treated with PAH monotherapy who remain in New York Heart Association functional class III. Atrial septostomy and lung transplantation are indicated for refractory patients or where medical treatment is unavailable. PMID:19555861

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

    Science.gov (United States)

    Barber, Lois Rigmont; Wilkins, Esther M

    2002-01-01

    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.

  14. Reality of evidence-based practice in palliative care

    Institute of Scientific and Technical Information of China (English)

    Claire Visser; Gina Hadley; Bee Wee

    2015-01-01

    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.

  15. Antiplatelet therapy: focus on evidence-based therapy with clopidogrel

    Directory of Open Access Journals (Sweden)

    Ljevar Veronika

    2013-02-01

    Full Text Available Acute coronary syndromes are the leading cause of mortality and one of the main reasons for hospital admissions in the developed nations. Due to high rates of mortality and reinfarction, acute coronary syndromes represent a major public health concern. Clopidogrel has a strong evidence base supporting its use as an effective and well-tolerated antiplatelet agent for the secondary prevention of ischemic events in patients with various cardiovascular conditions, including acute coronary syndrome, and is ubiquitous in cardiology practice. Landmark studies have established the importance of clopidogrel in the treatment of non-ST and ST-segment elevation myocardial infarction and in percutaneous coronary interventions, where it was shown to reduce death, reinfarction, and adverse cardiac events. Zyllt® (Krka’s clopidogrel also has an esta- blished evidence base from many post-authorisation clinical studies demonstrating its efficacy and safety. These studies yielded important results and an extensive database, which is not available for any other generic clopidogrel.

  16. Towards Evidence-Based Understanding of Electronic Data Sources

    DEFF Research Database (Denmark)

    Chen, Lianping; Ali Babar, Muhammad; Zhang, He

    2010-01-01

    Identifying relevant papers from various Electronic Data Sources (EDS) is one of the key activities of conducting these kinds of studies. Hence, the selection of EDS for searching the potentially relevant papers is an important decision, which can affect a study’s coverage of relevant papers....... Researchers usually select EDS mainly based on personal knowledge, experience, and preferences and/or recommendations by other researchers. We believe that building an evidence-based understanding of EDS can enable researchers to make more informed decisions about the selection of EDS. This paper reports our...... initial effort towards this end. We propose an initial set of metrics for characterizing the EDS from the perspective of the needs of secondary studies. We explain the usage and benefits of the proposed metrics using the data gathered from two secondary studies. We also tried to synthesize the data from...

  17. Application of independent component analysis to ac dipole based optics measurement and correction at the Relativistic Heavy Ion Collider

    Science.gov (United States)

    Shen, X.; Lee, S. Y.; Bai, M.; White, S.; Robert-Demolaize, G.; Luo, Y.; Marusic, A.; Tomás, R.

    2013-11-01

    Correction of beta-beat is of great importance for performance improvement of high energy accelerators, like the Relativistic Hadron Ion Collider (RHIC). At RHIC, using the independent component analysis method, linear optical functions are extracted from the turn by turn beam position data of the ac dipole driven betatron oscillation. Despite the constraint of a limited number of available quadrupole correctors at RHIC, a global beta-beat correction scheme using a beta-beat response matrix method was developed and experimentally demonstrated. In both rings, a factor of 2 or better reduction of beta-beat was achieved within available beam time. At the same time, a new scheme of using horizontal closed orbit bump at sextupoles to correct beta-beat in the arcs was demonstrated in the Yellow ring of RHIC at beam energy of 255 GeV, and a peak beta-beat of approximately 7% was achieved.

  18. A Simple Load Power Estimator For Quasi-Direct AC-AC Converter System

    OpenAIRE

    Marian GAICEANU; Emil ROSU

    2003-01-01

    In this paper a simple load power estimator for the three-phase quasi-direct acac converter system is reported. Since the ac-ac converter control by means of pulsewidth modulation (PWM) is based on the power balance concept, its load power should be known. Two control boards, based on the dSMC (digital Smart Motion Controller) 30 MIPS 32-bit fixed-point digital signal processor (DSP), were involved in the ac-ac system driving. By using the power balance control, the DC link voltage variation ...

  19. Pregnancy after kidney transplantation: an evidence-based approach.

    Science.gov (United States)

    Mezza, E; Oggé, G; Attini, R; Rossetti, M; Soragna, G; Consiglio, V; Burdese, M; Vespertino, E; Tattoli, F; Gai, M; Motta, D; Segoloni, G P; Todros, T; Piccoli, G B

    2004-12-01

    Despite the relatively little space for transplantation in most medical schools, this issue is considered interesting by the students both for its clinical and ethical implications. The students were asked to choose a particular aspect of nephrology for a 2-hour case discussion. They chose the case of a 35-year-old female, kidney transplant recipient now 1.5 years postoperatively, who was coming to seek advice about pregnancy. The aim of the present work is to report an integration between narrative and evidence-based medicine (EBM) approaches. The search strategy was developed within a multidisciplinary working group, two of whose members were also masters in the methodology of systematic revisions. The first step in the discussion was the identification of ethical and methodological problem. In a rapidly developing field, books are unlikely to be able to give updated information. One needs to interact with electronic databases. In this context, no randomized controlled trial on pregnancy is expected. The evidence is likely to be heterogeneous. Prenatal care delivery differs around the world in part related to attitudes toward pregnancy, which depend upon religion and traditions. The second step was the definition of the search strategy. The third step, was selecting and cataloging the evidence. The titles and abstracts retrieved by the search strategy (272 items) were examined to identify full papers to be retrieved. The evidence retrieved was screened for the type of paper (reviews, primary studies, case reports, case series) and for the authors to give an indirect idea of duplicate publication bias. Teaching a complex and ever-changing subject, such as kidney transplantation, is a difficult task. The case of a young woman seeking information on the probability to undergo a successful pregnancy was particularly likely to exemplify the importance of being aware of the biases of the book-based information and on the need to interact with the internet. The search

  20. An evidence-based approach to treating otitis media.

    Science.gov (United States)

    Rosenfeld, R M

    1996-12-01

    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

  1. Shared decision making in chronic care in the context of evidence based practice in nursing

    NARCIS (Netherlands)

    Friesen-Storms, J.H.; Bours, G.J.; Weijden, T.T. van der; Beurskens, A.J.

    2015-01-01

    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be tr

  2. Shared decision making in chronic care in the context of evidence based practice in nursing

    NARCIS (Netherlands)

    Friesen-Storms, JH; Bours, GJ; Weijden, T van der; Beurskens, AJ

    2015-01-01

    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be tr

  3. Building an Evidence Base for Speech-Language Services in the Schools: Challenges and Recommendations

    Science.gov (United States)

    Whitmire, Kathleen A.; Rivers, Kenyatta O.; Mele-McCarthy, Joan A.; Staskowski, Maureen

    2014-01-01

    Speech-language pathologists are faced with demands for evidence to support practice. Federal legislation requires high-quality evidence for decisions regarding school-based services as part of evidence-based practice. The purpose of this article is to discuss the limited scientific evidence for making appropriate decisions about speech-language…

  4. Dicty_cDB: FCL-AC29 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC29 (Link to dictyBase) - - - Contig-U15392-1 FCL-AC29P ...(Link to Original site) FCL-AC29F 104 FCL-AC29Z 591 FCL-AC29P 695 - - Show FCL-AC29 Library FCL (Link to library) Clone ID FCL-...-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-AC29Q....Seq.d/ Representative seq. ID FCL-AC29P (Link to Original site) Representative DNA sequence >FCL-AC29 (FCL-AC29Q) /CSM/FCL/FCL-...roducing significant alignments: (bits) Value VSC293 (VSC293Q) /CSM/VS/VSC2-D/VSC293Q.Seq.d/ 1063 0.0 FCL-AC29 (FCL-

  5. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

    Directory of Open Access Journals (Sweden)

    Fry Margaret

    2011-09-01

    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.

  6. 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

    Institute of Scientific and Technical Information of China (English)

    王建全; 杨兴华; 张峦国; 杨喜军

    2006-01-01

    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.

  7. Evidence-based post-exercise recovery strategies in basketball.

    Science.gov (United States)

    Calleja-González, Julio; Terrados, Nicolás; Mielgo-Ayuso, Juan; Delextrat, Anne; Jukic, Igor; Vaquera, Alejandro; Torres, Lorena; Schelling, Xavier; Stojanovic, Marko; Ostojic, Sergej M

    2016-01-01

    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.

  8. Sentiment Prediction Based on Dempster-Shafer Theory of Evidence

    Directory of Open Access Journals (Sweden)

    Mohammad Ehsan Basiri

    2014-01-01

    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.

  9. Surveillance and Protection-Based Approach for Link Failures over Fiber-to the-Home (FTTH with Combination of ACS and SANTAD

    Directory of Open Access Journals (Sweden)

    Aswir Premadi

    2009-05-01

    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.

  10. Autopsy practice in forensic pathology - Evidence-based or experience-based?

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte;

    2014-01-01

    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case......-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...

  11. Scientifically Based Research and Evidence-Based Education: A Federal Policy Context.

    Science.gov (United States)

    Smith, Anne

    2003-01-01

    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.…

  12. An evidence-based approach to earlier initiation of dialysis.

    Science.gov (United States)

    Churchill, D N

    1997-12-01

    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

  13. Evidence-based Health Care via Multi-Criteria Decision Analytic decision

    DEFF Research Database (Denmark)

    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...

  14. Limitations of Observational Evidence: Implications for Evidence-Based Dietary Recommendations12

    OpenAIRE

    Maki, Kevin C; Slavin, Joanne L; Rains, Tia M.; Kris-Etherton, Penny M

    2014-01-01

    Data from randomized controlled trials (RCTs) provide the strongest evidence for establishing relations between exposures, including dietary exposures, and health outcomes. However, not all diet and health outcome relations can be practically or ethically evaluated by using RCTs; therefore, many dietary recommendations are supported by evidence primarily from observational data, particularly those from prospective cohort studies. Although such evidence is of critical importance, limitations a...

  15. Treatment-resistant schizophrenia: Evidence-based strategies

    Directory of Open Access Journals (Sweden)

    Susanne Englisch

    2012-01-01

    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.

  16. The challenges of evidence-based medicine: a philosophical perspective.

    Science.gov (United States)

    Kulkarni, Abhaya V

    2005-01-01

    Although evidence-based medicine (EBM) has gained prominence in current medical practice and research, it has also had to deal with a number of problems and inconsistencies. For example, how do clinicians reconcile discordant results of randomized trials or how do they apply results of randomized trials to individual patients? In an attempt to examine such problems in a structured way, this essay describes EBM within a philosophical framework of science. Using this approach, some of the problems and challenges faced by EBM can be explained at a more fundamental level. As well, by employing a similar description of the competing alternative research tradition of clinical medicine, this essay not only highlights the philosophical differences between these two modes of medical practice, but suggests that they, in fact, play a de facto complementary role in current clinical medicine.

  17. Legacy of Avicenna and evidence-based medicine.

    Science.gov (United States)

    Shoja, Mohammadali M; Rashidi, Mohammad Reza; Tubbs, R Shane; Etemadi, Jalal; Abbasnejad, Feridoon; Agutter, Paul S

    2011-08-01

    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.

  18. Complete denture impression techniques: Evidence-based or philosophical

    Directory of Open Access Journals (Sweden)

    Singla Shefali

    2007-01-01

    Full Text Available Code of practice is dangerous and ever-changing in today′s world. Relating this to complete denture impression technique, we have been provided with a set of philosophies - "no pressure, minimal pressure, definite pressure and selective pressure". The objectives and principles of impression-making have been clearly defined. Do you think any philosophy can satisfy any operator to work on these principles and achieve these objectives? These philosophies take into consideration only the tissue part and not the complete basal seat, which comprises the periphery, the tissues and the bone structure. Under such circumstances, should we consider a code of practice dangerous or should we develop an evidence-based approach having a scientific background following certain principles, providing the flexibility to adapt to clinical procedures and to normal biological variations in patients rather than the rigidity imposed by strict laws?

  19. Evidence-based medicine and quality of care.

    Science.gov (United States)

    Dickenson, Donna; Vineis, Paolo

    2002-01-01

    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.

  20. Surgery for gastric cancer: An evidence-based perspective

    Directory of Open Access Journals (Sweden)

    D'souza Melroy

    2009-01-01

    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 (www.pubmed.org 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.

  1. Palliative radiotherapy in head and neck cancers: Evidence based review

    Directory of Open Access Journals (Sweden)

    Talapatra Kaustav

    2006-01-01

    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.

  2. Social Workers’ Orientation Toward the Evidence-Based Practice Process

    Science.gov (United States)

    Kolmer, Deirdre M. Beneken genaamd; Schalk, René

    2014-01-01

    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

  3. Decision support for health care: the PROforma evidence base

    Directory of Open Access Journals (Sweden)

    John Fox

    2006-03-01

    Full Text Available Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been evaluated in a variety of settings: in primary health care (prescribing, referral of suspected cancer patients, genetic risk assessment and in specialist care of patients with breast cancer, leukaemia, HIV infection and other conditions. About nine years of experience have been gained with PROforma technologies. Seven trials of decision support applications have been published or are in preparation. Each of these has shown significant positive effects on a variety of measures of quality and/or outcomes of care. This paper reviews the evidence base for the clinical effectiveness of these PROforma applications, and previews the CREDO project _a multi-centre trial of a complex PROforma application for supporting integrated breast cancer care across primary and secondary care settings.

  4. Comprehensive evidence-based review on European antitussives.

    Science.gov (United States)

    Morice, Alyn; Kardos, Peter

    2016-01-01

    Acute cough caused by viral respiratory tract infections is probably the most common illness to afflict mankind. Despite the widespread but ineffective prescribing of antibiotics, there is no specific therapy. Home remedies and over-the-counter medicines are the mainstay for treatment of this short-lived but debilitating condition where cough is a major troublesome symptom. Across Europe, there are large variations in the recommendations made by healthcare professionals for the treatment of acute cough. This has arisen through custom and practice based on the evidence of historical studies performed to standards well short of what would be considered legitimate today. Acute cough is particularly difficult to study in a controlled setting because of the high rate of spontaneous remission and a large placebo effect. Here we detail the validated modern methodology used to assess the efficacy of antitussives and review the drugs commonly used in Europe against these standards. PMID:27547407

  5. Evidence-based guidelines for teaching patient-centered interviewing.

    Science.gov (United States)

    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

    2000-01-01

    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.

  6. Immersive Interprofessional Education Using an Evidence-Based Practice Course.

    Science.gov (United States)

    Hale, LaDonna S; DiLollo, Anthony

    2016-09-01

    Beyond medical knowledge and clinical skills, physician assistant curricula must include instruction in collaborative, interprofessional, patient-centered, evidence-based practice (EBP). Development and implementation of interprofessional education (IPE) are challenging. This article describes a replicable model for an interprofessional graduate-level course that incorporates both exposure and immersion, allowing students to develop and demonstrate the Interprofessional Education Collaborative's 38 core competencies for interprofessional, collaborative decision making and problem solving while also acquiring functional skills in EBP. Pre- and postcourse surveys demonstrated both improved student self-confidence with EBP skills and appreciation for an interprofessional approach to patient care. Barriers to, and facilitators of, development and implementation of IPE courses, as well as effective IPE strategies and tools, are discussed. PMID:27548762

  7. LEADING CHANGES IN ASSESSMENT USING AN EVIDENCE BASED APPROACH

    Directory of Open Access Journals (Sweden)

    J. O. Macaulay

    2015-08-01

    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.

  8. Discretionary-Based Disclosure: Evidence from the Brazilian Market

    Directory of Open Access Journals (Sweden)

    Fernando Dal-Ri Murcia

    2012-01-01

    Full Text Available The primary objective of this paper is to identify the factors that explain Brazilian companies’ level of voluntary disclosure. Underpinning this work is the Discretionary-based Disclosure theory. The sample is composed of the top 100 largest non-financial companies listed in the Bolsa de Valores de São Paulo (Brazilian Securities, Commodities, and Futures exchange - BOVESPA. Information was gathered from Financial Statements for the years ending in 2006, 2007, and 2008, with the use of content analysis. A disclosure framework based on 27 studies from these years was created, with a total of 92 voluntary items divided into two dimensions: economic (43 and socio-environmental (49. Based on the existing literature, a total of 12 hypotheses were elaborated and tested using a panel data approach. Results evidence that: (a Sector and Origin of Control are statistically significant in all three models tested: economic, socio-environmental, and total; (b ‘Profitability’ is relevant in the economic model and in the total model; (c Tobin’s Q is relevant in the socio-environmental model and in the total disclosure model; (d Leverage and Auditing Firm are only relevant in the economic disclosure model; (e Size, Governance, Stock Issuing, Growth Opportunities and Concentration of Control are not statistically significant in any of the three models.

  9. Evidence-based Comprehensive Approach to Forearm Arterial Laceration

    Directory of Open Access Journals (Sweden)

    Janice N. Thai

    2015-12-01

    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

  10. [Diverticular disease: towards 2020. An evidence-based approach].

    Science.gov (United States)

    Koch, Maurizio; Festa, Virginia; Chiesara, Francesca; Moretti, Alessandra; Bianchi, Marco; Dezi, Angelo

    2016-06-01

    Diverticular disease (DD) of the colon has an increasing burden on health service resources, in terms of hospital admissions, mortality and surgery rate. We present an overview of the clinical history of DD, and of the ways that gastroenterologists have to modify it. Prevalence of the disease increases with aging. Most of diverticulosis are occasionally identified on colonscopy, and most of them remain asymptomatic for all life. Only 4% of these subjects develop diverticulitis. However, 4-25% of these patients are expected to present a second episode of diverticulitis, and 15% of them develop complications. Hospitalizations for diverticulitis and relapses of diverticulitis show strong growth (+21% 2013 vs 2003 in USA). The total annual costs for hospitalization for DD in USA are over 2,2 billion of dollars, and in Italy exceed 63 million of euros. In-hospital mortality can reach 0,5%. Diagnosis of diverticulitis is based on clinical history, lab tests and imaging (ultrasonography, CAT). Clinical diagnosis has a sensitivity of 68% and specificity around 98%. According to a meta-analysis, the performance of ultrasonograhy and CAT results very high ("pooled" sensitivity 92-94%, and specificity 90-99%; "pooled" Likelihood Ratio positive 9.6 for ultrasonography and 78.4 for CAT. Likelihood Rato negative 0.09 and 0.06 respectively). Evidences for preventing relapse are poor. Anyway, a very recent meta-analysis on 6 RCTs suggests no role for mesalazine (GRADE SCALE for evidence 3). Non absorbable antibiotics (rifaximin) have been used in two studies (one RCT, one retrospective observational). Data from the two studies suggest some evidence in favour of its use (GRADE SCALE 1). The number of admitted patients is 291. Considering a base-line risk of 19 relapses every 100 patients (5-year observation period), the absolute risk difference is minus 9 patients with relapse (CI 95% -14 a + 3) in the RCT and minus 14 patients (CI 95% -17 a -5) in the observational study. A 2020

  11. Comparing applets and oranges: barriers to evidence-based practice for app-based psychological interventions.

    Science.gov (United States)

    Leigh, Simon

    2016-08-01

    Poor-quality pharmaceuticals and medical devices rarely make it to market; however, the same cannot be said for app-based interventions. With a high availability but low evidence base for mHealth, apps are an increasingly uncertain prospect to users and healthcare professionals alike. Although in a first-best situation, the burden of proof concerning app safety, clinical and cost-effectiveness 'should' ultimately lie with app developers; a number of barriers to evidence generation, including the fact that 'acceptable evidence' itself is largely open to interpretation, mean that it may be folly to expect this paucity of real-world effectiveness research to improve. While the health technology assessment of established therapeutic modalities including pharmaceuticals and talking therapies benefits from the existence of approved evaluative guidelines, unfortunately the same cannot be said for app-based interventions, specifically with regard to outcomes measurement. As such, it would seem that in order to prevent the comparative assessment of apps simply becoming an exercise comparing apples and oranges, there is a clear need for consensus and guidance for app developers, as to which patient-reported outcome measures, among the hundreds available, are of clinical use to those making decisions, and should therefore be used when developing app-based interventions. By negating the fear that any evidence collected may be of poor quality, we can reincentivise developers to engage in evidence generation, and in doing so, maximise the likelihood of evidence-based decision-making taking a firm hold. However, only by dispelling the ambiguity around what acceptable evidence can and should look like, can we begin to do so. PMID:27431656

  12. AC power supply systems

    International Nuclear Information System (INIS)

    An ac power supply system includes a rectifier fed by a normal ac supply, and an inverter connected to the rectifier by a dc link, the inverter being effective to invert the dc output of the receiver at a required frequency to provide an ac output. A dc backup power supply of lower voltage than the normal dc output of the rectifier is connected across the dc link such that the ac output of the rectifier is derived from the backup supply if the voltage of the output of the inverter falls below that of the backup supply. The dc backup power may be derived from a backup ac supply. Use in pumping coolant in nuclear reactor is envisaged. (author)

  13. Single stage single phase active power factor corrected Ĉuk Topology Based AC-DC Converter

    Directory of Open Access Journals (Sweden)

    Md. Ismail Hossain

    2014-03-01

    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.

  14. Epidemiological characteristics of fatal pedestrian ac-cidents in Fars Province of Iran: a community-based

    Directory of Open Access Journals (Sweden)

    Peymani Payam

    2012-11-01

    Full Text Available 【Abstract】Objective: To determine the epidemio-logical characteristics of fatal pedestrian accidents in Fars Province of Iran. Methods: This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medi-cine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS ver-sion 11.5. P value less than 0.05 was considered significant. Results: The mean age of decedents was (47.2±26.2 years, ranging from 6 months to 103 years old. Males ac-counted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality. Conclusion: Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs co-ordination among trauma system organizations. Key words: Accidents, traffic; Epidemiologic studies; Mortality; Iran

  15. Decision fusion recognition based on modified evidence rule

    Institute of Scientific and Technical Information of China (English)

    黎湘; 刘永祥; 付耀文; 庄钊文

    2001-01-01

    A modified evidence combination rule with a combination parameter λ is proposed to solve some problems in D-S theory by considering the correlation and complement among the evidences as well as the size and intersection of subsets in evidence. It can get reasonable results even the evidences are conflicting. Applying this rule to the real infrared/millimetre wave fusion system, a satisfactory result has been obtained.

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

    Institute of Scientific and Technical Information of China (English)

    JIA Zhen-hua

    2009-01-01

    @@ dence-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.

  17. A web-based library consult service for evidence-based medicine: Technical development

    Directory of Open Access Journals (Sweden)

    Schwartz Alan

    2006-03-01

    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.

  18. The limits of evidence: evidence based policy and the removal of gamete donor anonymity in the UK.

    Science.gov (United States)

    Frith, Lucy

    2015-03-01

    This paper will critically examine the use of evidence in creating policy in the area of reproductive technologies. The use of evidence in health care and policy is not a new phenomenon. However, codified strategies for evidence appraisal in health care technology assessments and attempts to create evidence based policy initiatives suggest that the way evidence is used in practice and policy has changed. This paper will examine this trend by considering what is counted as 'good' evidence, difficulties in translating evidence into policy and practice and how evidence interacts with principles. To illustrate these points the removal of gamete donor anonymity in the UK in 2005 and the debates that preceded this change in the law will be examined. It will be argued that evidence will only ever take us so far and attention should also be paid to the underlying principles that guide policy. The paper will conclude with suggestions for how underlying principles can be more rigorously used in policy formation. PMID:25743050

  19. An evidence-based conceptual framework of healthy cooking.

    Science.gov (United States)

    Raber, Margaret; Chandra, Joya; Upadhyaya, Mudita; Schick, Vanessa; Strong, Larkin L; Durand, Casey; Sharma, Shreela

    2016-12-01

    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. PMID:27413657

  20. Evidence-based management of sport-related concussion.

    Science.gov (United States)

    McCrea, Michael; Guskiewicz, Kevin

    2014-01-01

    Concussion is not only one of the most common injuries encountered by athletes participating in contact and collision sports, but also among the most complex injuries to manage in a sports medicine setting. Over the past two decades, we have made great progress in advancing the basic and clinical science of concussion. These advances have had enormous clinical translational value for developing evidence-based guidelines for management of concussion in sports. Applied clinical research has clarified the defining characteristics of sport-related concussion (SRC) that support new diagnostic criteria. At the same time, major advancements have been realized in the development and validation of clinical tools that allow a more objective and accurate assessment of concussion and performance-based measures of recovery. These tools provide clinicians with a more informed basis for determining an athlete's cognitive and physical fitness to return to competition after concussion. Standardized injury management protocols that systematically prescribe rest, graded activity, and return to play have been adopted in nearly all clinical settings. Herein, we briefly summarize the findings and recommendations from several national and international consensus guidelines and position statements on best practice in the evaluation and management of SRC. PMID:24923397

  1. Are the health messages in schoolbooks based on scientific evidence? A descriptive study

    Directory of Open Access Journals (Sweden)

    Simón-Lorda Pablo

    2011-01-01

    Full Text Available Abstract Background Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. Methods The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. Results 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%, followed by "Pregnancy and newly born infants" (35%. Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. Conclusion Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.

  2. Encouraging appropriate, evidence-based use of oral nutritional supplements.

    Science.gov (United States)

    Stratton, Rebecca J; Elia, Marinos

    2010-11-01

    With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken. PMID:20696091

  3. Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

    Science.gov (United States)

    Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

    2007-01-01

    Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

  4. Embedded Artificial Neuval Network-Based Real-Time Half-Wave Dynamic Resistance Estimation during the A.C. Resistance Spot Welding Process

    Directory of Open Access Journals (Sweden)

    Liang Gong

    2013-01-01

    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.

  5. The Perception and Practice of Evidence Based Library and Information Practice

    Directory of Open Access Journals (Sweden)

    Vahideh Zarea Gavgani

    2009-12-01

    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.

  6. Morphological studies of the galaxy populations in distant "Butcher-Oemler" clusters with HST. II. AC103, AC118 and AC114 at z=0.31

    CERN Document Server

    Couch, W J; Smail, I; Ellis, Richard S; Sharples, R M

    1997-01-01

    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 ...

  7. Dicty_cDB: FCL-AC22 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC22 (Link to dictyBase) - G03266 DDB0186811 Contig-U14995-1 FCL-...AC22P (Link to Original site) FCL-AC22F 430 FCL-AC22Z 521 FCL-AC22P 951 - - Show FCL-AC22 Library FC...L (Link to library) Clone ID FCL-AC22 (Link to dictyBase) Atlas ID - NBRP ID G03266 dictyBase ID DDB0186811 ...Link to Contig Contig-U14995-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-...AC22Q.Seq.d/ Representative seq. ID FCL-AC22P (Link to Original site) Representative DNA sequence >FCL-

  8. Dicty_cDB: FCL-AC23 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FCL (Link to library) FCL-AC23 (Link to dictyBase) - G01760 DDB0186002 Contig-U16043-1 FCL-...AC23P (Link to Original site) FCL-AC23F 132 FCL-AC23Z 582 FCL-AC23P 714 - - Show FCL-AC23 Library FC...L (Link to library) Clone ID FCL-AC23 (Link to dictyBase) Atlas ID - NBRP ID G01760 dictyBase ID DDB0186002 ...Link to Contig Contig-U16043-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FCL/FCL-AC/FCL-...AC23Q.Seq.d/ Representative seq. ID FCL-AC23P (Link to Original site) Representative DNA sequence >FCL-

  9. Evidence for rule-based processes in the inverse base-rate effect.

    Science.gov (United States)

    Winman, Anders; Wennerholm, Pia; Juslin, Peter; Shanks, David R

    2005-07-01

    Three studies provide convergent evidence that the inverse base-rate effect (Medin & Edelson, 1988) is mediated by rule-based cognitive processes. Experiment 1 shows that, in contrast to adults, prior to the formal operational stage most children do not exhibit the inverse base-rate effect. Experiments 2 and 3 demonstrate that an adult sample is a mix of participants relying on associative processes who categorize according to the base-rate and participants relying on rule-based processes who exhibit a strong inverse base-rate effect. The distribution of the effect is bimodal, and removing participants independently classified as prone to rule-based processing effectively eliminates the inverse base-rate effect. The implications for current explanations of the inverse base-rate effect are discussed. PMID:16194936

  10. Evidence-based treatment for ankle injuries: a clinical perspective

    OpenAIRE

    Lin, Chung-Wei Christine; Hiller, Claire E; de Bie, Rob A.

    2010-01-01

    The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs. There is weak evidence suggesting that the use of manual therapy may lead to positive short-t...

  11. RECTIFICADORES CA/CC TIRISTORIZADOS CON FORMAS DE ONDA DE ALTA CALIDAD THYRISTOR-BASED AC/DC RECTIFIERS WITH HIGH-QUALITY WAVEFORMS

    Directory of Open Access Journals (Sweden)

    Miguel Villablanca

    2010-04-01

    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.

  12. Simulation-Based Learning as a Tactic for Teaching Evidence-Based Practice.

    Science.gov (United States)

    Raurell-Torredà, Marta; Romero-Collado, Àngel

    2015-12-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787. PMID:26264827

  13. Evidence based educational policy and practice: the case of applying the educational effectiveness knowledge base

    NARCIS (Netherlands)

    Scheerens, J.

    2014-01-01

    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

  14. Right at Your Fingertips: Important Web-Based Resources for Understanding Evidence-Based Practices

    Science.gov (United States)

    Purper, Cammy J.

    2016-01-01

    The era of educational accountability has drawn attention to a need for the use of evidence-based practices (EBPs) in today's classrooms. The existence of a research-to-practice gap is well established in the field of early childhood education (ECE), and significant barriers to the use of EBPs by practitioners have been documented through…

  15. Why evidence-based practice now?: a polemic.

    Science.gov (United States)

    Walker, Kim

    2003-09-01

    Evidence-based practice (EBP) first appeared on the healthcare horizon just over a decade ago. In 2003 its presence has intensified and extended beyond its initial relation to medicine embracing as it does now, nursing and the allied health disciplines. In this paper, I contend that its appearance and subsequent growth and development are the effects of potent "regimes of truth", four of which bear the names: positivism, empiricism, pragmatism and economic rationalism. My aim is to show how EBP generates the controversy it does because its nature and methods are inextricably interwoven with the way it has become politicised and professionalised. This exegesis is an attempt to outline how the combined effects of the four forms of rationality mentioned above allow for both the methods and objectives of EBP to be constructed as they are, while at the same moment producing the particular effects of knowledge and power in terms of who sells and who buys the idea of EBP in the culture of contemporary healthcare. PMID:12940967

  16. Evidence-based approach to cutaneous hyperandrogenism in women.

    Science.gov (United States)

    Schmidt, Timothy H; Shinkai, Kanade

    2015-10-01

    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. PMID:26138647

  17. A philosophical analysis of the evidence-based medicine debate

    Directory of Open Access Journals (Sweden)

    Stanley Donald E

    2003-07-01

    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.

  18. The first investigative science-based evidence of Morgellons psychogenesis.

    Science.gov (United States)

    Roncati, Luca; Gatti, Antonietta Morena; Pusiol, Teresa; Piscioli, Francesco; Barbolini, Giuseppe; Maiorana, Antonio

    2016-01-01

    Morgellons disease is an infrequent syndromic condition, that typically affects middle-aged white women, characterized by crawling sensations on and under the skin, associated with itchy rashes, stinging sores, fiber-like filaments emerging from the sores, severe fatigue, concentrating difficulty, and memory loss. The scientific community is prone to believe that Morgellons is the manifestation of various psychiatric syndromes (Munchausen, Munchausen by proxy, Ekbom, Wittmaack-Ekbom). Up until now, no investigative science-based evidence about its psychogenesis has ever been provided. In order to close this gap, we have analyzed the filaments extracted from the skin lesions of a 49-year-old Caucasian female patient, by using a Field Emission Gun-Environmental Electron Scanning Microscope equipped with an X-ray microprobe, for the chemico-elemental characterization of the filaments, comparing them with those collected during a detailed indoor investigation, with careful air monitoring, in her apartment. Our results prove the self-introduction under the epidermis of environmental filaments. For the first time in the literature, we have scientifically demonstrated the self-induced nature of Morgellons disease, thereby wiping out fanciful theories about its etiopathogenesis. PMID:27269255

  19. Evidence Based Validation of Indian Traditional Medicine-Way Forward

    Institute of Scientific and Technical Information of China (English)

    Pulok K Mukherjee; Ranjit K Harwansh; Shiv Bahadur; Subhadip Banerjee; Amit Kar

    2016-01-01

    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.

  20. Treatment of neuromyelitis optica: an evidence based review

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2012-01-01

    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.

  1. Evidence-based surgical treatment of carotid stenosis. Literature review.

    Science.gov (United States)

    Andaluz, N; Zuccarello, M

    2004-03-01

    Carotid stenosis is an important cause of transient ischemic attacks and stroke. The cause of carotid stenosis is most often atherosclerosis, which accounts for 10% to 20% of brain infarction cases. Despite the introduction of tissue-plasminogen activator and other promising experimental therapies for select patients with acute ischemic stroke prevention remains the best approach to reduce its impact. Stroke-prone patients can be identified and targeted for specific interventions. At this juncture, treatment of carotid stenosis is a well-established therapeutic target and a pillar of stroke prevention. Two main strategies exist for the treatment of carotid stenosis. The 1st is stabilization or halting the progression of the carotid plaque formation with medications and modifications of risk factors (e.g., hypertension, diabetes, smoking, obesity, high cholesterol). The 2nd approach is the elimination or reduction of carotid stenosis by carotid endarterectomy or angioplasty and stenting. Carotid endarterectomy is the mainstay of therapy for symptomatic, severe carotid stenosis. Although its role for asymptomatic patients appears more limited, it is distinct for severe stenosis. Carotid angioplasty and stenting are techniques in maturation with the attractiveness of being less invasive that face the challenge of at least replicating the results of surgery. In this article, we will discuss the surgical management of symptomatic and asymptomatic carotid stenosis based on the evidence provided by the literature. PMID:15257259

  2. Nursing faculties’ knowledge and attitude on evidence-based practice

    Science.gov (United States)

    Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser

    2012-01-01

    Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. Results: According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Conclusion: Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP. PMID:23922597

  3. Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?

    Science.gov (United States)

    Valkenburg, Abraham J; de Leeuw, Tom G; van Dijk, Monique; Tibboel, Dick

    2015-10-01

    This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. These antiepileptic drugs can potentially cause drug-drug interactions with analgesic drugs. It is unfortunate that children with intellectual disabilities often cannot communicate pain to caregivers. Although these children are at high risk of experiencing pain, researchers nevertheless often have to exclude them from trials on pain management because of ethical considerations. We therefore make a plea for prescribers, researchers, patient organizations, pharmaceutical companies, and policy makers to study evidence-based, safe and effective pharmacotherapy in these children through properly designed studies. In the meantime, parents and clinicians must resort to validated pain assessment tools such as the revised FLACC scale. PMID:26076801

  4. [Evidence-Based Review of Laryngeal Cancer Surgery].

    Science.gov (United States)

    Wiegand, S

    2016-04-01

    Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number of organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery and transoral robotic surgery, have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the U.S.. Improving the evidence base in laryngeal cancer surgery by successful establishment of surgical trials should be the future goal. PMID:27128401

  5. Evidence Based Validation of Indian Traditional Medicine – Way Forward

    Directory of Open Access Journals (Sweden)

    Pulok K Mukherjee

    2016-01-01

    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.

  6. Preventing child maltreatment: An evidence-based update

    Directory of Open Access Journals (Sweden)

    Gonzalez A

    2008-01-01

    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.

  7. 20 CFR 416.806 - Expedited adjudication based on documentary evidence of age.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Expedited adjudication based on documentary evidence of age. 416.806 Section 416.806 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... based on documentary evidence of age. Where documentary evidence of age recorded at least 3 years...

  8. Strategies for Teaching Evidence-Based Management: What Management Educators Can Learn from Medicine

    Science.gov (United States)

    Wright, April L.; Middleton, Stuart; Greenfield, Geoffrey; Williams, Julian; Brazil, Victoria

    2016-01-01

    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…

  9. A community of learners in the evidence-based dental clinic

    NARCIS (Netherlands)

    M. Schoonheim-Klein; P.R. Wesselink; J.M. Vervoorn

    2012-01-01

    An increasing emphasis has been placed on the need for an evidence-based approach in dentistry. This calls for effort in dental education to develop and implement tools for the application of evidence in clinical decision-making (evidence-based decision-making, EBDM). Aim:  To evaluate whether the i

  10. Effect of an evidence-based answering service on GPs and their patients : a pilot study

    NARCIS (Netherlands)

    Verhoeven, A.A.; Schuling, J.

    2004-01-01

    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

  11. Measuring energy efficiency: Is energy intensity a good evidence base?

    International Nuclear Information System (INIS)

    Highlights: • Energy intensity measure reflects consumption, not energy efficiency. • Thermodynamic indicators should describe energy efficiency at all levels. • These indicators should have no reference to economic or financial parameters. • A set of energy efficiency indicators should satisfy several basic principles. • There are trade-offs between energy efficiency, power and costs. - Abstract: There is a widespread assumption in energy statistics and econometrics that energy intensity and energy efficiency are equivalent measures of energy performance of economies. The paper points to the discrepancy between the engineering concept of energy efficiency and the energy intensity as it is understood in macroeconomic statistics. This double discrepancy concerns definitions (while engineering concept of energy efficiency is based on the thermodynamic definition, energy intensity includes economic measures) and use. With regard to the latter, the authors conclude that energy intensity can only provide indirect and delayed evidence of technological and engineering energy efficiency of energy conversion processes, which entails shortcomings for management and policymaking. Therefore, we suggest to stop considering subsectoral, sectoral and other levels of energy intensities as aggregates of lower-level energy efficiency. It is suggested that the insufficiency of energy intensity indicators can be compensated with the introduction of thermodynamic indicators describing energy efficiency at the physical, technological, enterprise, sub-sector, sectoral and national levels without references to any economic or financial parameters. Structured statistical data on thermodynamic efficiency is offered as a better option for identifying break-through technologies and technological bottle-necks that constrain efficiency advancements. It is also suggested that macro-level thermodynamic indicators should be based on the thermodynamic first law efficiency and the energy

  12. Evidence-Based Therapies, Evidence-Based Practice, and the Intersection of Nomothetic and Idiographic Foundations of Psychotherapy Research and Application: A Reply to Shean.

    Science.gov (United States)

    Pilecki, Brian; McKay, Dean

    2016-03-01

    This article is a commentary on "Psychotherapy Outcome Research: Issues and Questions" by Glenn Shean (this issue). While we agree with a couple of Shean's points, such as over-reliance on diagnoses and lack of attention to global measures of quality of life and functioning, there are several very substantive points of disagreement. We argue that evidence-based therapies and evidence-based practice occupy a central role in developing effective and non-harmful therapies. Shean conflates evidence-based therapies and evidence-based practice in a way that is not representative of how science is intended to advance everyday treatment delivery. We further contest Shean's notion that reliance on empirically based research is limiting to clinicians and instead argue that it offers a helpful and pragmatic starting point for clinical decision making with each unique patient. Further, evidence-based practice, in contrast to evidence-based therapies, represents the model ideal for service delivery, rather than a slavish adherence to protocols employed in randomized clinical trials. Finally, we argue that both nomothetic and idiographic approaches are valid and important in the ongoing advancement of modern psychotherapy, a position wholly consistent with the evidence-based practice movement. PMID:26938798

  13. New Labour and Education: An Evidence-Based Analysis

    Science.gov (United States)

    Galton, Maurice

    2007-01-01

    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…

  14. Application of evidence-based urology in improving quality of care

    OpenAIRE

    Panda, Arabind; Dorairajan, L. N.; Kumar, Santosh

    2007-01-01

    Evidence-based medicine requires use of the best available evidence for optimal patient care. Increasingly scarce resources and escalating demands on time have led to emphasis on effective treatment. Opinion is slowly yielding to high-quality existent evidence. It is important that urologists adapt to these changes for them to deliver optimum care to the patients. This article discusses the levels of evidence, the nature of desirable evidence, means of assessing quality of clinical trials and...

  15. AC1 Wing

    Directory of Open Access Journals (Sweden)

    Adrian DOBRE

    2010-03-01

    Full Text Available The AC1 wing replaces the old wing of the wind tunnel model AEROTAXI, which has been made at scale 1:9. The new wing is part of CESAR program and improves the aerodynamic characteristics of the old one. The geometry of the whole wing was given by FOI Sweden and position of AC1 wing must coincide with the structure of the AEROTAXI model.

  16. AC1 Wing

    OpenAIRE

    Adrian DOBRE

    2010-01-01

    The AC1 wing replaces the old wing of the wind tunnel model AEROTAXI, which has been made at scale 1:9. The new wing is part of CESAR program and improves the aerodynamic characteristics of the old one. The geometry of the whole wing was given by FOI Sweden and position of AC1 wing must coincide with the structure of the AEROTAXI model.

  17. Establishment of A Monoclonal Antibody-based AC-ELISA to Detect M.gallisepticum in Egg Yolk%应用单克隆抗体AC-ELISA检测鸡蛋卵黄中鸡毒支原体

    Institute of Scientific and Technical Information of China (English)

    杨百亮; 赵翠萍; 刘田生; 李天俊

    2001-01-01

    An antigen-capture ELISA(AC-ELISA) was developed for titration of M.gallisepticum in egg yolk.The plates were coated with polyclonal anti-M.gallisepticum serum and reacted with M.gallisepticum antigens,which were detected with species-specific monoclonal antibodies to M.gallisepticum,followed by anti-rat enzyme-labelled conjugate antiserum(IgG).The procedure in detecting the bacteria in egg yolk was accomplished in 6 hours,and showed to be more sensitive than the conventional culture method.Egg yolk samples collected from eggs were tested for M.gallisepticum by the method and showed a positive rate of 62%.The results demonstrated that the AC-ELISA has rapid,sensitive and simple advantages for monitoring chicken flocks and detecting M.gallisepticum in eggs.%采用抗鸡毒支原体阳性血清包被酶标板作为捕捉抗体,以4株鸡毒支原体特异单克隆抗体作为第二抗体和酶标羊抗鼠IgG作指示抗体建立了一种检测鸡蛋卵黄中鸡毒支原体的双夹心AC-ELISA。该法具有简便、灵敏、快速等优点,从采样到获得结果6小时内完成。检出率高于分离培养法,且重复性良好。该方法的建立为鸡群鸡毒支原体感染的检测和净化提供了一种新的可靠方法。

  18. Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach

    DEFF Research Database (Denmark)

    Houe, T; Thorböll, J E; Sigild, U;

    2000-01-01

    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 medicine.......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 medicine....

  19. Shared decision making in chronic care in the context of evidence based practice in nursing

    OpenAIRE

    Friesen-Storms, JH; Bours, GJ; van der Weijden, T; Beurskens, AJ

    2015-01-01

    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of th...

  20. Outcome of non-invasive treatment modalities on back pain: an evidence-based review

    OpenAIRE

    van Tulder, Maurits W.; Koes, Bart; Malmivaara, Antti

    2005-01-01

    At present, there is an increasing international trend towards evidence-based health care. The field of low back pain (LBP) research in primary care is an excellent example of evidence-based health care because there is a huge body of evidence from randomized trials. These trials have been summarized in a large number of systematic reviews. This paper summarizes the best available evidence from systematic reviews conducted within the framework of the Cochrane Back Review Group on non-invasive...

  1. Optimal perfusion during cardiopulmonary bypass: an evidence-based approach.

    Science.gov (United States)

    Murphy, Glenn S; Hessel, Eugene A; Groom, Robert C

    2009-05-01

    In this review, we summarize the best available evidence to guide the conduct of adult cardiopulmonary bypass (CPB) to achieve "optimal" perfusion. At the present time, there is considerable controversy relating to appropriate management of physiologic variables during CPB. Low-risk patients tolerate mean arterial blood pressures of 50-60 mm Hg without apparent complications, although limited data suggest that higher-risk patients may benefit from mean arterial blood pressures >70 mm Hg. The optimal hematocrit on CPB has not been defined, with large data-based investigations demonstrating that both severe hemodilution and transfusion of packed red blood cells increase the risk of adverse postoperative outcomes. Oxygen delivery is determined by the pump flow rate and the arterial oxygen content and organ injury may be prevented during more severe hemodilutional anemia by increasing pump flow rates. Furthermore, the optimal temperature during CPB likely varies with physiologic goals, and recent data suggest that aggressive rewarming practices may contribute to neurologic injury. The design of components of the CPB circuit may also influence tissue perfusion and outcomes. Although there are theoretical advantages to centrifugal blood pumps over roller pumps, it has been difficult to demonstrate that the use of centrifugal pumps improves clinical outcomes. Heparin coating of the CPB circuit may attenuate inflammatory and coagulation pathways, but has not been clearly demonstrated to reduce major morbidity and mortality. Similarly, no distinct clinical benefits have been observed when open venous reservoirs have been compared to closed systems. In conclusion, there are currently limited data upon which to confidently make strong recommendations regarding how to conduct optimal CPB. There is a critical need for randomized trials assessing clinically significant outcomes, particularly in high-risk patients. PMID:19372313

  2. Evidence-based clinical practice guidelines for liver cirrhosis 2015.

    Science.gov (United States)

    Fukui, Hiroshi; Saito, Hidetsugu; Ueno, Yoshiyuki; Uto, Hirofumi; Obara, Katsutoshi; Sakaida, Isao; Shibuya, Akitaka; Seike, Masataka; Nagoshi, Sumiko; Segawa, Makoto; Tsubouchi, Hirohito; Moriwaki, Hisataka; Kato, Akinobu; Hashimoto, Etsuko; Michitaka, Kojiro; Murawaki, Toshikazu; Sugano, Kentaro; Watanabe, Mamoru; Shimosegawa, Tooru

    2016-07-01

    The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This digest version in English introduces selected clinical questions and statements related to the management of liver cirrhosis and its complications. Branched-chain amino acids relieve hypoalbuminemia and hepatic encephalopathy and improve quality of life. Nucleoside analogues and peginterferon plus ribavirin combination therapy improve the prognosis of patients with hepatitis B virus related liver cirrhosis and hepatitis C related compensated liver cirrhosis, respectively, although the latter therapy may be replaced by direct-acting antivirals. For liver cirrhosis caused by primary biliary cirrhosis and active autoimmune hepatitis, urosodeoxycholic acid and steroid are recommended, respectively. The most adequate modalities for the management of variceal bleeding are the endoscopic injection sclerotherapy for esophageal varices and the balloon-occluded retrograde transvenous obliteration following endoscopic obturation with cyanoacrylate for gastric varices. Beta-blockers are useful for primary prophylaxis of esophageal variceal bleeding. The V2 receptor antagonist tolvaptan is a useful add-on therapy in careful diuretic therapy for ascites. Albumin infusion is useful for the prevention of paracentesis-induced circulatory disturbance and renal failure. In addition to disaccharides, the nonabsorbable antibiotic rifaximin is useful for the management of encephalopathy. Anticoagulation therapy is proposed for

  3. Cooperative Frequency Control for Autonomous AC Microgrids

    DEFF Research Database (Denmark)

    Shafiee, Qobad; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.;

    2015-01-01

    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....

  4. Air pollution and stroke - an overview of the evidence base.

    Science.gov (United States)

    Maheswaran, Ravi

    2016-08-01

    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.

  5. Coblation for tonsillectomy: an evidence-based review.

    Science.gov (United States)

    Shah, Udayan K; Dunham, Brian

    2007-01-01

    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.

  6. 一种基于MC9S08AC16的正弦波逆变器设计%A Design of Sinusoidal Inverter Based on MCgs08AC16

    Institute of Scientific and Technical Information of China (English)

    李永鹤; 殳国华; 张士文

    2013-01-01

    给出了一种将低压直流电转换为220V/50Hz交流电的方案,阐述了电路的基本结构及控制策略.逆变控制芯片采用Freescale单片机MC9S08AC16,利用其中心对齐PWM模式产生SPWM,在不同类型负载下实现了低谐波系数、低负载调整率的纯正弦波输出.制作了实验样机并对方案进行了验证.%This paper gives a solution about converting low DC voltage to 220VAC of 50Hz,and describes the basic structure and control strategy of this circuit.The chip MC9S08AC16 of Freescale company is adopted on inverter control,using it's center-aligned PWM mode to generate SPWM,and pure sine wave output of low harmonics and low load regulation is realized at different types of load.A experimental prototype has been designed' and the scheme is validated.

  7. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    LENUS (Irish Health Repository)

    Yadav, B L

    2012-03-01

    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. A Comparison Between Two Average Modelling Techniques of AC-AC Power Converters

    OpenAIRE

    Pawel Szczesniak

    2015-01-01

    In this paper, a comparative evaluation of two modelling tools for switching AC-AC power converters is presented. Both of them are based on average modelling techniques. The first approach is based on the circuit averaging technique and consists in the topological manipulations, applied to a converters states. The second approach makes use of state-space averaged model of the converter and is based on analytical manipulations using the different state representations of a converter. The two m...

  9. Pinnacle Health / Zynx Health / Siemens Medical Solutions A Study of Integration of Evidence Based Nursing Content

    OpenAIRE

    Matter, Sheri; Brown, Cindy; Button, Patricia S.; Kennedy, Rosemary

    2006-01-01

    In 2005, Pinnacle Health System, Zynx Health, and Siemens Medical Solutions developed a partnership to conduct a study to explore the opportunities and challenges associated with the integration of evidence-based knowledge within the EHR with the goal of creating repeatable methodologies for integrating nursing knowledge within the EHR. The two-phase study involved access to referential evidence-based content, as well as integration of customized evidence-based plans of care within the docume...

  10. Evidence based nursing practice : one exploratory study between different care settings

    OpenAIRE

    Pereira, Rui Pedro Gomes; Martins, Alice; Peixoto, Maria José; Martins, Teresa; Barbieri, Maria do Céu; Carneiro, António Vaz

    2014-01-01

    Introduction: Currently, the importance of a clinical practice based on the best available evidence justifies the development of investigation to construct a situational diagnosis that allows to identify in different contexts of care, barriers, attitudes and practices towards an evidence-based nursing. Objective: In this investigation we aim to identify barriers regarding the adoption of an Evidence Based Practice (EBP) in different care settings and describe the main nurse’s attitudes and pr...

  11. The Role of the Medical Library in the Development of Evidence-Based Medicine

    OpenAIRE

    Sherry Shiuan Su

    2004-01-01

    Evidence-based medicine is spreading in popularity in many health care areas. Evidence-based medicine extends the librarians’ role beyond identification of the literature to involvement in practicing and teaching quality filtering and critical appraisal of the literature. This trend requires librarians to pursue new knowledge and develop new skills. However, little discussion of the role of the librarian in the evidence-based medicine appears in library and information science literature. The...

  12. The Importance of an Evidence-based Workup for Recurrent Pregnancy Loss.

    Science.gov (United States)

    Gibbins, Karen J; Porter, T Flint

    2016-09-01

    Choosing an evidence-based workup and treatment for recurrent pregnancy loss is imperative to provide best patient care and create a culture that permits rigorous research into potential (not yet evidence-based) tests and therapeutics. As health sciences technologies become more sophisticated, more precise, and less expensive, new tools may be developed that allow better evaluation and treatment of couples with recurrent pregnancy loss. The goal must remain optimizing value and adhering to evidence-based care. PMID:27455202

  13. An adaptive neuro fuzzy inference system controlled space cector pulse width modulation based HVDC light transmission system under AC fault conditions

    Science.gov (United States)

    Ajay Kumar, M.; Srikanth, N.

    2014-03-01

    In HVDC Light transmission systems, converter control is one of the major fields of present day research works. In this paper, fuzzy logic controller is utilized for controlling both the converters of the space vector pulse width modulation (SVPWM) based HVDC Light transmission systems. Due to its complexity in the rule base formation, an intelligent controller known as adaptive neuro fuzzy inference system (ANFIS) controller is also introduced in this paper. The proposed ANFIS controller changes the PI gains automatically for different operating conditions. A hybrid learning method which combines and exploits the best features of both the back propagation algorithm and least square estimation method is used to train the 5-layer ANFIS controller. The performance of the proposed ANFIS controller is compared and validated with the fuzzy logic controller and also with the fixed gain conventional PI controller. The simulations are carried out in the MATLAB/SIMULINK environment. The results reveal that the proposed ANFIS controller is reducing power fluctuations at both the converters. It also improves the dynamic performance of the test power system effectively when tested for various ac fault conditions.

  14. Developing a Comprehensive Search Strategy for Evidence Based Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Sekhar Thadiparthi

    2008-03-01

    % MEDLINE, 18% PsycINFO, 8% EMBASE, 2% Sociological Abstracts.Conclusions ‐ Development of a comprehensive review of the literature requires searching multiple databases and methods of manual searching in order to locate all relevant citations. Understanding the project needs, recognizing the limitations and strengths of specific electronic databases, and being aware of other methods for developing and refining a search are vital in planning an effective and comprehensive search strategy. Reporting standards for literature searches as part of the broader push for procedurally transparent and reproducible systematic reviews is not only advisable, but good evidence based practice.

  15. Strength-based leadership coaching in organizations an evidence-based guide to positive leadership development

    CERN Document Server

    MacKie, Doug

    2016-01-01

    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...

  16. Understanding Evidence-Based Information for the Early Childhood Field: Tips from RAND's Promising Practices Network

    Science.gov (United States)

    Mattox, Teryn; Kilburn, M. Rebecca

    2012-01-01

    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…

  17. AC-3 audio coder

    Science.gov (United States)

    Todd, Craig

    1995-12-01

    AC-3 is a system for coding up to 5.1 channels of audio into a low bit-rate data stream. High quality may be obtained with compression ratios approaching 12-1 for multichannel audio programs. The high compression ratio is achieved by methods which do not increase decoder memory, and thus cost. The methods employed include: the transmission of a high frequency resolution spectral envelope; and a novel forward/backward adaptive bit allocation algorithm. In order to satisfy practical requirements of an emissions coder, the AC-3 syntax includes a number of features useful to broadcasters and consumers. These features include: loudness uniformity between programs; dynamic range control; and broadcaster control of downmix coefficients. The AC-3 coder has been formally selected for inclusion of the U.S. HDTV broadcast standard, and has been informally selected for several additional applications.

  18. A Comparison Between Two Average Modelling Techniques of AC-AC Power Converters

    Directory of Open Access Journals (Sweden)

    Pawel Szczesniak

    2015-03-01

    Full Text Available In this paper, a comparative evaluation of two modelling tools for switching AC-AC power converters is presented. Both of them are based on average modelling techniques. The first approach is based on the circuit averaging technique and consists in the topological manipulations, applied to a converters states. The second approach makes use of state-space averaged model of the converter and is based on analytical manipulations using the different state representations of a converter. The two modelling techniques are applied to a same AC-AC converter called matrix-reactance frequency converter based on buck-boost topology. These techniques are compared on the basis of their rapidity, quantity of calculations and transformations and its limitations.

  19. Uma visão evidente da prática baseada em evidências na medicina perinatal: ausência de evidência não é evidência de ausência An evident view of evidence-based pratice in perinatal medicine: absence of evidence is not evidence of absence

    Directory of Open Access Journals (Sweden)

    Augusto Sola

    2007-10-01

    Full Text Available OBJETIVO: Proporcionar elementos valiosos e um pouco de humor nesta chamada era da "prática baseada em evidências" com o objetivo de ajudar os clínicos a fazer escolhas melhores no cuidado que eles provêem com base em evidências, e não simples ou exclusivamente com base em um ensaio clínico randomizado (ECR ou meta-análise (o que pode não ser evidência. FONTE DOS DADOS: Livros e artigos com revisão por pares são citados e listados na bibliografia. Evidências de vida, aprendizado através de nossos próprios erros e muitos outros fatos evidentes que sustentam esta revisão não são citados. SÍNTESE DOS DADOS: 1 "Ausência de evidência não é evidência de ausência" e "falta de evidência de efeito não significa evidência de nenhum efeito". 2 Os ECR com resultado "negativo" e aqueles com resultado "positivo", mas sem os resultados importantes, muitas vezes não podem concluir o que concluem. 3 Os ensaios clínicos não-randomizados e os estudos práticos podem ser importantes. 4 A pesquisa em busca de provas é diferente da pesquisa em busca de aperfeiçoamento. 5 A escolha clínica deve avaliar os efeitos nos desfechos importantes para os pacientes e seus pais. 6 A quantificação de desfechos adversos, do número necessário para causar dano e do número necessário para tratamento não é assim tão simples. CONCLUSÕES: Desafios importantes inerentes à pesquisa em serviços de saúde devem ser correlacionados a possíveis aplicações clínicas usando ferramentas que permitam uma "visão mais clara da prática baseada em evidências" na medicina perinatal, lembrando que a ausência de evidência não é evidência de ausência.OBJECTIVE: To provide valuable elements and some humor in this so-called era of "evidence-based practice" with the aim of helping clinicians make better choices in the care they deliver based on evidence, not simply or exclusively based on a randomized clinical trial (RCT or meta-analysis (which may

  20. Storage Free Smart Energy Management for Frequency Control in a Diesel-PV-Fuel Cell-Based Hybrid AC Microgrid.

    Science.gov (United States)

    Sekhar, P C; Mishra, S

    2016-08-01

    This paper proposes a novel, smart energy management scheme for a microgrid, consisting of a diesel generator and power electronic converter interfaced renewable energy-based generators, such as photovoltaic (PV) and fuel cell, for frequency regulation without any storage. In the proposed strategy, output of the PV is controlled in coordination with other generators using neurofuzzy controller, either only for transient frequency regulation or for both transient and steady-state frequency regulation, depending on the load demand, thereby eliminating the huge storage requirements. The option of demand response control is also explored along with the generation control. For accurate and quick tracking of maximum power point and its associated reserve power from the PV generator, this paper also proposes a novel adaptive-predictor-corrector-based tracking mechanism. PMID:26011895