WorldWideScience

Sample records for european evidence based

  1. Reforming European universities: Scope for an evidence-based process

    NARCIS (Netherlands)

    Veugelers, R.; van der Ploeg, F.; Dewatripont, M.; Thys-Clément, F.; Wilkin, L.

    2008-01-01

    Universities are key players in the successful transition to a knowledge-based economy and society. However, this crucial sector of society needs restructuring if Europe is not to lose out in the global competition in education, research and innovation. To allow a more evidence based process of

  2. European evidence-based recommendations for diagnosis and treatment of paediatric antiphospholipid syndrome: the SHARE initiative.

    Science.gov (United States)

    Groot, Noortje; de Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Dolezalova, Pavla; Feldman, Brian; Kenet, Gili; Koné-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza; Pilkington, Clarissa A; Ravelli, Angelo; van Royen-Kerkhof, Annet; Uziel, Yosef; Vastert, Sebastiaan J; Wulffraat, Nico M; Ozen, Seza; Brogan, Paul; Kamphuis, Sylvia; Beresford, Michael W

    2017-10-01

    Antiphospholipid syndrome (APS) is rare in children, and evidence-based guidelines are sparse. Consequently, management is mostly based on observational studies and physician's experience, and treatment regimens differ widely. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative was launched to develop diagnostic and management regimens for children and young adults with rheumatic diseases. Here, we developed evidence-based recommendations for diagnosis and treatment of paediatric APS. Evidence-based recommendations were developed using the European League Against Rheumatism standard operating procedure. Following a detailed systematic review of the literature, a committee of paediatric rheumatologists and representation of paediatric haematology with expertise in paediatric APS developed recommendations. The literature review yielded 1473 articles, of which 15 were valid and relevant. In total, four recommendations for diagnosis and eight for treatment of paediatric APS (including paediatric Catastrophic Antiphospholipid Syndrome) were accepted. Additionally, two recommendations for children born to mothers with APS were accepted. It was agreed that new classification criteria for paediatric APS are necessary, and APS in association with childhood-onset systemic lupus erythematosus should be identified by performing antiphospholipid antibody screening. Treatment recommendations included prevention of thrombotic events, and treatment recommendations for venous and/or arterial thrombotic events. Notably, due to the paucity of studies on paediatric APS, level of evidence and strength of the recommendations is relatively low. The SHARE initiative provides international, evidence-based recommendations for diagnosis and treatment for paediatric APS, facilitating improvement and uniformity of care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

  3. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium

    DEFF Research Database (Denmark)

    Aldecoa, César; Bettelli, Gabriella; Bilotta, Federico

    2017-01-01

    The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoper...

  4. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium

    NARCIS (Netherlands)

    Aldecoa, César; Bettelli, Gabriella; Bilotta, Federico; Sanders, Robert D.; Audisio, Riccardo; Borozdina, Anastasia; Cherubini, Antonio; Jones, Christina; Kehlet, Henrik; Maclullich, Alasdair; Radtke, Finn; Riese, Florian; Slooter, Arjen J C; Veyckemans, Francis; Kramer, Sylvia; Neuner, Bruno; Weiss, Bjoern; Spies, Claudia D.

    2017-01-01

    The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care,

  5. European Union research in support of environment and health: Building scientific evidence base for policy.

    Science.gov (United States)

    Karjalainen, Tuomo; Hoeveler, Arnd; Draghia-Akli, Ruxandra

    2017-06-01

    Opinion polls show that the European Union citizens are increasingly concerned about the impact of environmental factors on their health. In order to respond and provide solid scientific evidence for the numerous policies related to the protection of human health and the environment managed at the Union level, the European Union made a substantial investment in research and innovation in the past two decades through its Framework Programmes for Research and Technological Development, including the current programme, Horizon 2020, which started in 2014. This policy review paper analysed the portfolio of forty collaborative projects relevant to environment and health, which received a total amount of around 228 million euros from the EU. It gives details on their contents and general scientific trends observed, the profiles of the participating countries and institutions, and the potential policy implications of the results obtained. The increasing knowledge base is needed to make informed policy decisions in Europe and beyond, and should be useful to many stakeholders including the scientific community and regulatory authorities. Copyright © 2017. Published by Elsevier Ltd.

  6. Methods of Implementation of Evidence-Based Stroke Care in Europe: European Implementation Score Collaboration.

    Science.gov (United States)

    Di Carlo, Antonio; Pezzella, Francesca Romana; Fraser, Alec; Bovis, Francesca; Baeza, Juan; McKevitt, Chris; Boaz, Annette; Heuschmann, Peter; Wolfe, Charles D A; Inzitari, Domenico

    2015-08-01

    Differences in stroke care and outcomes reported in Europe may reflect different degrees of implementation of evidence-based interventions. We evaluated strategies for implementing research evidence into stroke care in 10 European countries. A questionnaire was developed and administered through face-to-face interviews with key informants. Implementation strategies were investigated considering 3 levels (macro, meso, and micro, eg, policy, organization, patients/professionals) identified by the framing analysis, and different settings (primary, hospital, and specialist) of stroke care. Similarities and differences among countries were evaluated using the categorical principal components analysis. Implementation methods reported by ≥7 countries included nonmandatory policies, public financial incentives, continuing professional education, distribution of educational material, educational meetings and campaigns, guidelines, opinion leaders', and stroke patients associations' activities. Audits were present in 6 countries at national level; national and regional regulations in 4 countries. Private financial incentives, reminders, and educational outreach visits were reported only in 2 countries. At national level, the first principal component of categorical principal components analysis separated England, France, Scotland, and Sweden, all with positive object scores, from the other countries. Belgium and Lithuania obtained the lowest scores. At regional level, England, France, Germany, Italy, and Sweden had positive scores in the first principal component, whereas Belgium, Lithuania, Poland, and Scotland showed negative scores. Spain was in an intermediate position. We developed a novel method to assess different domains of implementation in stroke care. Clear variations were observed among European countries. The new tool may be used elsewhere for future contributions. © 2015 American Heart Association, Inc.

  7. Evidence based policy making in the European Union. The role of the scientific community

    Energy Technology Data Exchange (ETDEWEB)

    Majcen, Spela [Euro-Mediterranean Univ. (EMUNI), Portoroz (Slovenia)

    2017-03-15

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  8. Evidence based policy making in the European Union: the role of the scientific community.

    Science.gov (United States)

    Majcen, Špela

    2017-03-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  9. Evidence based policy making in the European Union. The role of the scientific community

    International Nuclear Information System (INIS)

    Majcen, Spela

    2017-01-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  10. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU).

    Science.gov (United States)

    Löhr, J Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-03-01

    There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as 'strong' and plenary voting revealed 'strong agreement' for 99 (98%) recommendations. The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects

  11. Choice of antipsychotic treatment by European psychiatry trainees: are decisions based on evidence?

    Directory of Open Access Journals (Sweden)

    Jauhar Sameer

    2012-03-01

    Full Text Available Abstract Background Little is known about the factors influencing treatment choice in psychosis, the majority of this work being conducted with specialists (consultant in psychiatry. We sought to examine trainees' choices of treatment for psychosis if they had to prescribe it for themselves, their patients, and factors influencing decision-making. Methods Cross-sectional, semi-structured questionnaire-based study. Results Of the 726 respondents (response rate = 66%, the majority chose second-generation antipsychotics (SGAs if they had to prescribe it for themselves (n = 530, 93% or for their patients (n = 546, 94%. The main factor influencing choice was perceived efficacy, 84.8% (n = 475 of trainees stating this was the most important factor for the patient, and 77.8% (n = 404 stating this was the most important factor for their own treatment. Trainees with knowledge of trials questioning use of SGAs (CATIE, CUtLASS, TEOSS were more likely to choose second-generation antipsychotics than those without knowledge of these trials (χ2 = 3.943; p = 0.047; O.R. = 2.11; 95% C.I. = 1.0-4.48. Regarding psychotherapy, cognitive behavioural therapy (CBT was the most popular choice for self (33.1%; n = 240 and patient (30.9%; n = 224. Trainees were significantly more likely to prefer some form of psychotherapy for themselves rather than patients (χ2 = 9.98; p Conclusions Trainees are more likely to choose second-generation antipsychotic medication for patients and themselves. Despite being aware of evidence that suggests otherwise, they predominantly base these choices on perceived efficacy.

  12. European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders.

    Science.gov (United States)

    Völlm, Birgit A; Clarke, Martin; Herrando, Vicenç Tort; Seppänen, Allan O; Gosek, Paweł; Heitzman, Janusz; Bulten, Erik

    2018-03-20

    Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders (MDOs) are often cared for in secure psychiatric environments or prisons. In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective. We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings: The forensic psychiatrist as expert witness, risk, treatment settings for mentally disordered offenders, and what works for MDOs. We undertook a rapid review of the literature with search terms related to: forensic psychiatry, review articles, randomised controlled trials and best practice. We searched the Medline, Embase, PsycINFO, and Cochrane library databases from 2000 onwards for adult groups only. We scrutinised publications for additional relevant literature, and searched the websites of relevant professional organisations for policies, statements or guidance of interest. We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified. We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only. Practitioners need to follow general psychiatric guidance as well as that for offenders, adapted for the complex needs of this patient group, paying particular attention to long-term detention and ethical issues. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Vaccination in paediatric patients with auto-immune rheumatic diseases : A systemic literature review for the European League against Rheumatism evidence-based recommendations

    NARCIS (Netherlands)

    Heijstek, M. W.; de Bruin, L. M. Ott; Borrow, R.; van der Klis, F.; Kone-Paut, I.; Fasth, A.; Minden, K.; Ravelli, A.; Abinun, M.; Pileggi, G.; Borte, M.; Bijl, M.; Wulffraat, N. M.

    2011-01-01

    Objectives: To analyze available evidence on vaccinations in paediatric patients with rheumatic and auto-inflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients. Methods: A

  14. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

    NARCIS (Netherlands)

    Löhr, J. Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M.; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J.; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-01-01

    Background:There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on Harmonizing diagnosis and treatment of chronic

  15. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

    NARCIS (Netherlands)

    Lohr, J.M.; Dominguez-Munoz, E.; Rosendahl, J.; Besselink, M.; Mayerle, J.; Lerch, M.M.; Haas, S.; Akisik, F.; Kartalis, N.; Iglesias-Garcia, J.; Keller, J.; Boermeester, M.; Werner, J.; Dumonceau, J.M.; Fockens, P.; Drewes, A.; Ceyhan, G.; Lindkvist, B.; Drenth, J.P.; Ewald, N.; Hardt, P.; Madaria, E. de; Witt, H.; Schneider, A.; Manfredi, R.; Brondum, F.J.; Rudolf, S.; Bollen, T.; Bruno, M.

    2017-01-01

    BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic

  16. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version.

    Science.gov (United States)

    Werner, R N; Stockfleth, E; Connolly, S M; Correia, O; Erdmann, R; Foley, P; Gupta, A K; Jacobs, A; Kerl, H; Lim, H W; Martin, G; Paquet, M; Pariser, D M; Rosumeck, S; Röwert-Huber, H-J; Sahota, A; Sangueza, O P; Shumack, S; Sporbeck, B; Swanson, N A; Torezan, L; Nast, A

    2015-11-01

    Actinic keratosis (AK) is a frequent health condition attributable to chronic exposure to ultraviolet radiation. Several treatment options are available and evidence based guidelines are missing. The goal of these evidence- and consensus-based guidelines was the development of treatment recommendations appropriate for different subgroups of patients presenting with AK. A secondary aim of these guidelines was the implementation of knowledge relating to the clinical background of AK, including consensus-based recommendations for the histopathological definition, diagnosis and the assessment of patients. The guidelines development followed a pre-defined and structured process. For the underlying systematic literature review of interventions for AK, the methodology suggested by the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was adapted. All recommendations were consented during a consensus conference using a formal consensus methodology. Strength of recommendations was expressed based on the GRADE approach. If expert opinion without external evidence was incorporated into the reasoning for making a certain recommendation, the rationale was provided. The Guidelines underwent open public review and approval by the commissioning societies. Various interventions for the treatment of AK have been assessed for their efficacy. The consenting procedure led to a treatment algorithm as shown in the guidelines document. Based on expert consensus, the present guidelines present recommendations on the classification of patients, diagnosis and histopathological definition of AK. Details on the methods and results of the systematic literature review and guideline development process have been published separately. International guidelines are intended to be adapted to national or regional

  17. From market access to patient access: overview of evidence-based approaches for the reimbursement and pricing of pharmaceuticals in 36 European countries.

    Science.gov (United States)

    Panteli, Dimitra; Eckhardt, Helene; Nolting, Alexandra; Busse, Reinhard; Kulig, Michael

    2015-09-25

    Coverage decisions determining the benefit baskets of health systems have been increasingly relying on evidence regarding patient benefit and costs. Relevant structures, methodologies, and processes have especially been established for pharmaceuticals but approaches differ. The objective of this work was thus to identify institutions in a broad range of European countries (n = 36) in charge of determining the value of pharmaceuticals for pricing and reimbursement purposes and to map their decision-making process; to examine the different approaches and consider national and supranational possibilities for best practice. Institutions were identified through websites of international networks, ministries, and published literature. Details on institutional practices were supplemented with information from institution websites and linked online sources. The type and extent of information available varied considerably across countries. Different types of public regulatory bodies are involved in pharmaceutical coverage decisions, assuming a range of responsibilities. As a rule, the assessment of scientific evidence is kept structurally separate from its appraisal. Recommendations on value are uniformly issued by specific committees within or commissioned by responsible institutions; these institutions often also act as decision-makers on reimbursement status and level or market price. While effectiveness and costs are important criteria in all countries, the latter are often considered on a case-by-case basis. In all countries, manufacturer applications, including relevant evidence, are used as one of the main sources of information for the assessment. Transparency of evidence-based coverage decisions should be enhanced. International collaboration can facilitate knowledge exchange, improve efficiency of information production, and strengthen new or developing systems.

  18. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa

    DEFF Research Database (Denmark)

    Gulliver, Wayne; Zouboulis, Christos C.; Prens, Errol

    2016-01-01

    Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due...

  19. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa

    NARCIS (Netherlands)

    W.P. Gulliver (Wayne P.); C.C. Zouboulis (Christos C.); E.P. Prens (Errol); G.B.E. Jemec (Gregor); T. Tzellos (Thrasivoulos)

    2016-01-01

    textabstractHidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is

  20. A critical appraisal of evidence-based guidelines for the treatment of psoriasis vulgaris: 'AGREE-ing' on a common base for European evidence-based psoriasis treatment guidelines

    NARCIS (Netherlands)

    Nast, A.; Spuls, Ph; Ormerod, A. D.; Reytan, N.; Saiag, P. H.; Smith, C. H.; Rzany, B.

    2009-01-01

    BACKGROUND: To further improve the standard of care provided to psoriasis patients in Europe, the European Dermatology Forum and the European Academy of Dermatology and Venereology have initiated a project to develop common European psoriasis guidelines. OBJECTIVE: This paper aims to assess the

  1. The interdependence of major european stock markets: evidence for Greece

    OpenAIRE

    Καινούργιος, Δημήτριος Φ.; Σαμίτας, Αριστείδης Γ.

    2003-01-01

    This paper provides new evidence on the relationship between the Greek "blue chip" stock market and the six relative European markets by applying cointegration tests. The time period examined is 1998 to 2000, which marks the entry of Greece to the European Exchange Rates Mechanism II. The empirical results indicate that the Athens Stock Exchange has no considerable links, except for one case, with any other European developed markets examined. These findings have some significa...

  2. Commentary on the "Evidence- and Consensus-Based (S3) Guidelines for the Treatment of Actinic Keratosis" Published by the International League of Dermatological Societies in Cooperation with the European Dermatology Forum.

    Science.gov (United States)

    Diepgen, Thomas L; Kresken, Joachim; Krutmann, Jean; Merk, Hans F; Senger, Erik; Surber, Christian; Szeimies, Rolf-Markus

    2018-04-03

    In 2015, the International League of Dermatological Societies and the European Dermatology Forum published a guideline for the treatment of actinic keratosis, which is classified as an evidence- and consensus-based S3 guideline. From the point of view of the GD Task Force "Licht.Hautkrebs.Prävention," an interdisciplinary expert panel of the Society for Dermopharmacy for the prevention and treatment of skin cancer, this guideline reveals strengths and weaknesses but, in summary, does not meet the claim for an evidence- and consensus-based S3 guideline. © 2018 S. Karger AG, Basel.

  3. Ownership and environmental regulation: Evidence from the European electricity industry

    International Nuclear Information System (INIS)

    Clò, Stefano; Ferraris, Matteo; Florio, Massimo

    2017-01-01

    The paper investigates how ownership affects the environmental performance in developed countries where environmental regulation is introduced in the form of market-based instrument. By looking at a cross-country panel dataset of 29 power markets around Europe over the period 1990–2012, we find empirical evidence that an increase of public ownership, as measured by the OECD ETCR index, is associated with a reduction of both greenhouse gas emissions and carbon intensity. We also find that the implementation of the European Emissions Trading Scheme (ETS) had a limited impact on emissions' reduction due to lax allocation of allowances. The positive effect of public ownership on environmental performance has been significant even after the introduction of the ETS, giving additional incentives to mitigate emissions when the ETS cap was not stringent enough. This evidence suggests that government control over power companies in Europe can has created idiosyncratic incentives to improve environmental quality, complementing environmental regulation in the achievement of environmental goals when the latter was absent or sub-optimal. - Highlights: • We analyse the power industry's environmental performance in 29 European countries. • Public ownership is associated with lower emissions than private ownership. • Mixed oligopoly is superior to private oligopoly in environmental terms. • The ETS had a limited impact on emissions' reduction due to over-allocation. • Public ownership mitigates the effects of sub-optimal environmental regulation.

  4. [Evidence-based management of ST-segment elevation myocardial infarction (STEMI). Latest guidelines of the European Society of Cardiology (ESC) 2010].

    Science.gov (United States)

    Silber, S

    2010-12-01

    Acute myocardial infarction and its consequences (death, chronic ischemic coronary artery disease, heart failure) are still the number 1 causes of death and of cardiovascular diseases in Germany. In this context, patients with STEMI are at the highest risk. The first-line management of STEMI patients often determines if the outcome is life or death. This overview presents the current optimal evidence-based management of STEMI patients as a practice-oriented extract according to the latest ESC guidelines, fully published some weeks ago (http://www.escardio.org).All efforts must be made to keep the respective time intervals between the onset of symptoms and the beginning of reperfusion therapy as short as possible, i.e. best within a dedicated STEMI network. Two of the time intervals are particularly essential: the time delay between the onset of symptoms and the first medical contact (FMC) and the time delay between FMC and the beginning of reperfusion. The time delay between the onset of symptoms and FMC depends on the patient as well as on the organization of the emergency medical service (EMS). Unfortunately, too many patients/bystanders still hesitate to immediately call the EMS. More intense measures must therefore be taken to educate the public. The optimal FMC by medical doctors or paramedics reacts quickly and ideally arrives with ECG equipment for immediate diagnosis of STEMI (persistent ST-segment elevation or presumably new left bundle branch block) before hospital admission. Unfortunately in many cases, the FMC is the emergency room of a hospital. Further decisions can be made without laboratory findings. In Germany, the average time delay between onset of symptoms and FMC is 100 min and therefore longer than in some other European countries.The next critical time interval is that between FMC and the beginning of reperfusion: this interval depends solely on the EMS organization and the distance to the next catheter laboratory with 24 h PCI (percutaneous

  5. Evidence-based radiography

    International Nuclear Information System (INIS)

    Hafslund, Bjorg; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica

    2008-01-01

    Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain

  6. Corporate Negative Equity: The Evidence from the European Union

    Directory of Open Access Journals (Sweden)

    Natalia Mokhova

    2016-01-01

    Full Text Available After the Global Financial Crisis the frequency of reported losses of companies has increased significantly in countries of the European Union. Moreover, the financial leverage of companies have increased and even exceeded 100% in several countries. The reason of this development is negative equity that companies find themselves to report. At first sight negative equities are caused by accumulated losses from prior periods. However, there are some other reasons that can result in increasing negative equities in companies. They remain adequate as long as a company is able to pay its bills. Nevertheless, a company with negative equity is exposed to risks. This paper investigates whether the corporate negative equity is a sign of the future failure of a company. We examine non-financial manufactured companies from selected countries of the European Union within the period 2005–2012 from database Amadeus (Czech Republic, Slovakia, Hungary, Poland and Germany. By the means of comparison between negative and positive equities we applied descriptive statistics and Pearson correlation analysis. We find that in all surveyed countries the size positively influences the equity of companies. Other factors as profitability and growth opportunities do not influence the corporate equity. In addition the binary logistic regression analysis has been conducted based on the evidence from Czech companies. Our results indicate that negative equities are not a sign of bankruptcy or insolvency of a company. But the low profitability or low business activities (that are predictors of bankruptcy might lead to negative equities in the balance sheet.

  7. TRENDS IN AUTHORITARIANISM: EVIDENCE FROM 31 EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Sabrina de Regt

    2011-01-01

    Full Text Available To date, few studies have been conducted on trendsin authoritarian attitudes,despite the importance of this research in our understanding of undemocraticmovements in society. Studies that have surveyed trends in authoritarianism arealready rather outdated, often based on student samples and conducted in only alimited number of countries. Furthermore, until now, no study had tested whetherthe meaning of authoritarianism is invariant acrosstime. Using theEuropeanValues Study,we examined trends in authoritarianism in 31 European countriesover the last decade (1999-2008, based on representative samples. It was foundthat in many Western European countries, with the exception of the Netherlands,authoritarianism declined significantly over the last decade. However, in some,mostly Eastern European countries, levels of authoritarianism actually increasedsignificantly during the last decade. Changing levels of authoritarianism werelinked to extreme-right and anti-democratic sentiment in European societies.

  8. Molecular evidence on the evolutionary and biogeographical patterns of European cyprinids.

    Science.gov (United States)

    Zardoya, R; Doadrio, I

    1999-08-01

    The phylogenetic relationships of 106 European cyprinid taxa were determined based on the complete nucleotide sequence (1140 bp) of the mitochondrial cytochrome b gene. The molecular phylogeny was used (1) to revise the current systematics of European cyprinids, (2) to establish the phylogenetic utility of traditional morphological characters that are widely used in Cyprinidae systematics, and (3) to discuss alternative hypotheses on the biogeography of the family in Europe. The age of the major lineages within European cyprinids was tentatively estimated with a molecular clock and showed full agreement with the fossil record of the group. Moreover, the results provided unambiguous evidence for a close phylogenetic affinity of some Caucasian and Greek endemic cyprinid taxa (e.g., B. capito and B. brachycephalus and Leuciscus keadicus, Barbus graecus, and B. albanicus, respectively) to Iberian and North African, but not Central European, cyprinids. The existence of such unexpected phylogenetic relationships refutes the classical hypothesis on the biogeography of European cyprinids, which assumes a dispersal of the cyprinid fauna from central Europe to southern Europe and northern Africa during the Miocene (and, hence, predicts a close phylogenetic relationship of all Caucasian, Greek, Iberian, and North African cyprinids to central European taxa). Instead, the existence of a Mediterranean realm independent of the central European route seems plausible based on the molecular evidence. It is likely that the new biogeographical scenario proposed here might apply to other primary freshwater European animals with low dispersal abilities, including fish, amphibians, and invertebrates.

  9. Evidence-Based Toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

    Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

  10. 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...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  11. VALUE RELEVANCE OF GROUP FINANCIAL STATEMENTS BASED ON ENTITY VERSUS PARENT COMPANY THEORY: EVIDENCE FROM THE LARGEST THREE EUROPEAN CAPITAL MARKETS

    Directory of Open Access Journals (Sweden)

    Müller Victor-Octavian

    2012-07-01

    Full Text Available Financial statementsn#8217; main objective is to give information on the financial position, performance and changes in financial position of the reporting entity, which is useful to investors and other users in making economic decisions. In order to be useful, financial information needs to be relevant to the decision-making process of users in general, and investors in particular. Regarding consolidated financial statements, the accounting theory knows four perspectives (theories on which the preparation of those statements is based, namely, the proprietary theory, the parent company theory, the parent company extension theory and the entity theory (Baxter and Spinney, 1975. Of practical importance are especially the parent company extension perspective and the entity perspective. The IASB and FASB decided (within an ED regarding the Improvement of the Conceptual Framework that consolidated financial statements should be presented from the perspective of the group entity, and not from the perspective of the parent-company. However, this support for the entity theory is to our knowledge not backed by empirical findings in the academic literature. Therefore, in our paper we set to contribute with empirical arguments to finding an actual answer to the question about the superior market value relevance of one of the two concurrent perspectives (theories. We set to carry out an empirical association study on the problem of market value relevance of consolidated financial statements based on the entity theory respectively on the parent company (extension theory, searching for an answer to the above question. In this sense, we pursued an analysis of market value relevance of consolidated accounting information (based on the two perspectives of listed entities between 2003-2008 on the largest three European Stock Exchanges (London, Paris and Frankfurt. The obtained results showed that a n#8222;restrainedn#8221; entity perspective, which would combine

  12. Evidence-based policy

    DEFF Research Database (Denmark)

    Vohnsen, Nina Holm

    2013-01-01

    -makers and the research community (e.g. Boden & Epstein 2006; House of Commons 2006; Cartwright et al 2009; Rod 2010; Vohnsen 2011). This article intends to draw out some general pitfalls in the curious meeting of science and politics by focusing on a particular attempt to make evidence-based legislation in Denmark (for...

  13. 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

  14. Evidence-based surgery

    Directory of Open Access Journals (Sweden)

    Miran Rems

    2007-04-01

    Full Text Available Background: Surgery is setting a new ground by the reign of evidence that was brought up by the Evidence Based Medicine (EBM. While experiences and opinion of an expert count the least by the principles of EBM, randomized controlled trials (RCT and other comparative studies have gained their importance. Recommendations that were included in guidelines represent a demanding shift in surgeon’s professional thinking. Their thinking and classical education have not yet been completely based on the results of such studies and are still very very much master-pupil centred. Assessment of someone’s own experiences is threatened by objectivity as negative experiences get recorded in deeper memory. Randomized studies and meta-analyses do appear also in surgery. However, they demand an extra knowledge about critical assessment.Conclusions: Setting a patient to the foreground brings a surgeon’s decision to the field of EBM. The process has already begun and cannot be avoided. Decision hierarchy moves from the experience field to the evidence territory but to a lesser extent when compared to the rest of medicine. There exist objective restrictions with approving a new paradigm. However, these should not stop the process of EBM implementation. Finally, there is an ethic issue to be considered. Too slow activities in research, education and critical assessment can bring the surgeon to the position when a well-informed patient loses his/her trust.

  15. European wet deposition maps based on measurements

    NARCIS (Netherlands)

    Leeuwen EP van; Erisman JW; Draaijers GPJ; Potma CJM; Pul WAJ van; LLO

    1995-01-01

    To date, wet deposition maps on a European scale have been based on long-range transport model results. For most components wet deposition maps based on measurements are only available on national scales. Wet deposition maps of acidifying components and base cations based on measurements are needed

  16. Evidence-based management.

    Science.gov (United States)

    Pfeffer, Jeffrey; Sutton, Robert I

    2006-01-01

    For the most part, managers looking to cure their organizational ills rely on obsolete knowledge they picked up in school, long-standing but never proven traditions, patterns gleaned from experience, methods they happen to be skilled in applying, and information from vendors. They could learn a thing or two from practitioners of evidence-based medicine, a movement that has taken the medical establishment by storm over the past decade. A growing number of physicians are eschewing the usual, flawed resources and are instead identifying, disseminating, and applying research that is soundly conducted and clinically relevant. It's time for managers to do the same. The challenge is, quite simply, to ground decisions in the latest and best knowledge of what actually works. In some ways, that's more difficult to do in business than in medicine. The evidence is weaker in business; almost anyone can (and many people do) claim to be a management expert; and a motley crew of sources--Shakespeare, Billy Graham,Jack Welch, Attila the Hunare used to generate management advice. Still, it makes sense that when managers act on better logic and strong evidence, their companies will beat the competition. Like medicine, management is learned through practice and experience. Yet managers (like doctors) can practice their craft more effectively if they relentlessly seek new knowledge and insight, from both inside and outside their companies, so they can keep updating their assumptions, skills, and knowledge.

  17. REVERSE LEVERAGED BUYOUT RETURN BEHAVIOR: SOME EUROPEAN EVIDENCE

    Directory of Open Access Journals (Sweden)

    Trevor W. Chamberlain

    2017-12-01

    Full Text Available This study investigates the stock performance of reverse leveraged buyouts (RLBOs before, during, and after the global financial crisis. An RLBO consists of the return to public investors (i.e. the offering of stocks to the public of a company that had gone private after a leveraged buyout (LBO led by a private equity fund. The value created by an RLBO resides in the changes brought by the LBO fund while it owns the company. After a “repackaging” of the bought company, the private equity fund sells the company’s shares to the public. Most of the research on this topic, based on RLBOs that occurred between 1980 and 2005 in the US, has shown that RLBOs outperform their peers (i.e. other IPOs and outperform the market after going public again. Focusing on RLBO companies in Europe in the financial crisis era, this study investigates whether they also outperform other IPOs and the market. The study is based on a sample of 421 IPOs occurring between 2001 and 2011 in France, Germany and the UK, of which 52 are RLBOs. We examine RLBO performance one day, one month, one year and three years after the offering. We also use event study methods to investigate the impact of the global financial crisis on RLBO performance. We find that European RLBOs outperform both their peers (i.e. “classic” IPOs and the market during the period studied. This outperformance does not diminish in the long-term. The global financial crisis appears to have affected RLBO performance, which weakened between 2007 and 2009, though RLBOs still outperformed the market. In addition, multivariable regressions were used to examine various extant explanations for RLBO outperformance. This analysis did not support any of the prevailing theories. In particular, the value created by RLBOs does not appear to be linked to LBO duration, sponsor reputation, or to the level of leverage employed. There is no evidence of time or industry effects. Moreover, RLBO performance shows no

  18. Determinants of SME Finance: Evidence from Three Central European Countries

    Directory of Open Access Journals (Sweden)

    Rahman Ashiqur

    2017-09-01

    Full Text Available This paper explores the determinants of access to finance for small and medium enterprises (SMEs in the context of three Central European countries: Czech Republic, Slovak Republic, and Hungary. The data set of the research is obtained from the BEEPS survey, which is conducted by the World Bank and the European Bank for Reconstruction and Development. This paper empirically analyses firms not only from the SMEs point of view, but also shows results for micro, small and medium enterprises separately. Additionally, we have analysed the determinants of access to finance for SMEs at each country level for an in-depth understanding of country-level variations in SME financing. The results indicate that micro firms and firms owned and operated by women are experiencing a shortage of credits from banks. On the other hand, we found a positive relationship between the pledge of collateral and access to finance. With respect to the medium firms, we found evidence that innovative firms have a larger amount of credit from banks. The empirical results also suggest that the loan size increases as the interest rates increase in particular for SMEs on the whole and for micro-firms, although the interest rate is in a negative relationship with the loan size in Czech Republic.

  19. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey.

    Science.gov (United States)

    Nappi, R E; Palacios, S; Panay, N; Particco, M; Krychman, M L

    2016-04-01

    The aim of the European REVIVE survey was to achieve a better understanding of vulvovaginal atrophy (VVA), a chronic and progressive condition after menopause. We investigated perceptions, experiences and needs in terms of sexual and vaginal health in a sample of European postmenopausal women. An online internet based survey was conducted in Italy, Germany, Spain and the UK with a total surveyed sample of 3768 postmenopausal women (age: 45-75 years). The most common VVA symptom was vaginal dryness (70%). VVA has a significant impact on the ability to be intimate (62%), to enjoy sexual intercourse (72%) and to feel sexual spontaneity (66%). Postmenopausal women with VVA are sexually active (51%), but their sexual drive is reduced. Health-care professionals (HCPs) have discussed VVA with postmenopausal women (62%), but they initiated the conversation only in 10% of the cases. The most common treatments for VVA are over-the-counter, non-hormonal, local vaginal products. Thirty-two per cent of postmenopausal women were naïve to any kind of treatment, whereas discussion with the HCP was relevant to be on current treatment (60% of postmenopausal women that discussed VVA with a HCP vs. 23% who did not). The top reasons for poor compliance with vaginal treatments were: not bothersome enough symptoms (18%); vaginal changes not therapeutically reversed (18%); relief from VVA symptoms (17%). Approximately 45% were satisfied with treatment. The most frequent disliked aspects of treatment were the route of administration or the messiness. The fear of hormones was common in postmenopausal women using vaginal prescription products. The European REVIVE survey confirmed that VVA symptoms are frequent in postmenopausal women and demonstrates a significant impact on quality of life and sexual life. However, the condition is still under-diagnosed and under-treated, with a high rate of dissatisfaction for actual available treatments in the four European countries surveyed. The

  20. Knowledge based economy in European Union

    Directory of Open Access Journals (Sweden)

    Ecaterina Stănculescu

    2012-04-01

    Full Text Available Nowadays we assist at a fundamental change from the economy based mainly on resources to the one based mostly on knowledge. The concept has been launched in the last decade of the past century. The knowledge became a production agent and a value creation instrument for whatever country and of course for an entire community like European Union which is constantly concerned by its development and competitiveness. This paper presents the principal characteristics of the present EU preoccupations with the expansion of a knowledge based economy through the 2020 European Development Strategy for smart, sustainable and inclusive economy, and especially for the Framework Programs (Framework Programme 7 and Competitiveness and Innovation Framework Programme.

  1. Practice Patterns Compared with Evidence-based Strategies for the Management of Androgen Deprivation Therapy-Induced Side Effects in Prostate Cancer Patients: Results of a European Web-based Survey

    NARCIS (Netherlands)

    Bultijnck, R.; Surcel, C.; Ploussard, G.; Briganti, A.; Visschere, P. De; Futterer, J.J.; Ghadjar, P.; Giannarini, G.; Isbarn, H.; Massard, C.; Sooriakumaran, P.; Valerio, M.; Bergh, R. van den; Ost, P.

    2016-01-01

    BACKGROUND: Evidence-based recommendations are available for the management of androgen deprivation therapy (ADT)-induced side effects; however, there are no data on the implementation of the recommendations into daily practice patterns. OBJECTIVE: To compare practice patterns in the management of

  2. Evidence based medical imaging (EBMI)

    International Nuclear Information System (INIS)

    Smith, Tony

    2008-01-01

    Background: The evidence based paradigm was first described about a decade ago. Previous authors have described a framework for the application of evidence based medicine which can be readily adapted to medical imaging practice. Purpose: This paper promotes the application of the evidence based framework in both the justification of the choice of examination type and the optimisation of the imaging technique used. Methods: The framework includes five integrated steps: framing a concise clinical question; searching for evidence to answer that question; critically appraising the evidence; applying the evidence in clinical practice; and, evaluating the use of revised practices. Results: This paper illustrates the use of the evidence based framework in medical imaging (that is, evidence based medical imaging) using the examples of two clinically relevant case studies. In doing so, a range of information technology and other resources available to medical imaging practitioners are identified with the intention of encouraging the application of the evidence based paradigm in radiography and radiology. Conclusion: There is a perceived need for radiographers and radiologists to make greater use of valid research evidence from the literature to inform their clinical practice and thus provide better quality services

  3. Evolution of the european data base

    International Nuclear Information System (INIS)

    Bonnefous, S.; Despres, A.

    1991-01-01

    Works connected with the data base on the European grid are carried on following several ways: 1. Enrichment of the data base, with the inclusion of new data (milk products, agricultural products). Progress along this line is depending on the progress made within EUROSTAT. 2. Elaboration of the data base on a finer grid (10 km * 10 km), for the meshes that are estimated more critical (because they include important potential sources of pollution), or for very non-homogeneous meshes (costal areas). 3. Development and/or acquisition of softwares allowing an exploitation and an easy consultation of the data base. At the present state, installation of the data base with 10 000 km 2 meshes on the PARADOX system is in progress. (PARADOX is a software for data base maintenance). A graphical representation software (cartography) completes the system, allowing the visualization of the data. The paper presents the current state of development of this work

  4. Evidence-based guidelines

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  5. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    , and single clinics. Accordingly, there is an urgent need to improve this situation. Guidelines for Good Clinical (Research) Practice, conduct of more trials as multicentre trials, The Consort Statement, and The Cochrane Collaboration may all help in the application of the best research evidence in clinical......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...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....

  6. Evidence-based radiology: why and how?

    International Nuclear Information System (INIS)

    Sardanelli, Francesco; Di Leo, Giovanni; Hunink, Myriam G.; Gilbert, Fiona J.; Krestin, Gabriel P.

    2010-01-01

    To provide an overview of evidence-based medicine (EBM) in relation to radiology and to define a policy for adoption of this principle in the European radiological community. Starting from Sackett's definition of EBM we illustrate the top-down and bottom-up approaches to EBM as well as EBM's limitations. Delayed diffusion and peculiar features of evidence-based radiology (EBR) are defined with emphasis on the need to shift from the demonstration of the increasing ability to see more and better, to the demonstration of a significant change in treatment planning or, at best, of a significant gain in patient outcome. The ''as low as reasonably achievable'' (ALARA) principle is thought as a dimension of EBR while EBR is proposed as part of the core curriculum of radiology residency. Moreover, we describe the process of health technology assessment in radiology with reference to the six-level scale of hierarchy of studies on diagnostic tests, the main sources of bias in studies on diagnostic performance, and levels of evidence and degrees of recommendations according to the Centre for Evidence-Based Medicine (Oxford, UK) as well as the approach proposed by the GRADE working group. Problems and opportunities offered by evidence-based guidelines in radiology are considered. Finally, we suggest nine points to be actioned by the ESR in order to promote EBR. Radiology will benefit greatly from the improvement in practice that will result from adopting this more rigorous approach to all aspects of our work. (orig.)

  7. The New 2016 European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines: Enough Guidance? Enough Evidence?

    Science.gov (United States)

    Castellá, Manuel

    2018-04-01

    For the first time, the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have joined forces to develop consensus guidelines for the management of atrial fibrillation (AF). One of the main issues is the integrated care of patients with AF, with emphasis on multidisciplinary teams of general physicians, cardiologists, stroke specialists and surgeons, together with the patient's involvement for better management of AF. These guidelines also help in the detection of risk factors and concomitant cardiovascular diseases, stroke prevention therapies, including anticoagulation and antiplatelet therapies after acute coronary episodes, major haemorrhages or strokes. In the field of ablation, surgery plays an important role as concomitant with other surgical procedures, and it should be considered in symptomatic patients with the highest level of evidence. Asymptomatic patients with mitral insufficiency should also be considered for combined mitral and AF surgery if they have new-onset AF. In patients with stand-alone AF, recommendations for minimally invasive ablation have an increased level of recommendation and should be considered as the same level as catheter ablation in patients with persistent or long-standing persistent AF or with paroxysmal AF who fail catheter ablation. Surgical occlusion or exclusion of the left atrial appendage may be considered for stroke prevention in patients with AF about to have surgery. Nevertheless, not enough is known to avoid long-term anticoagulation in patients at risk of stroke even if the left atrial appendage has been excluded. These Guidelines provide a full spectrum of recommendations on the management of patients with AF including prevention, treatment and complications based on the latest published evidence.

  8. Cultural and gender convergence in adolescent drunkenness: evidence from 23 European and North American countries.

    Science.gov (United States)

    Kuntsche, Emmanuel; Kuntsche, Sandra; Knibbe, Ronald; Simons-Morton, Bruce; Farhat, Tilda; Hublet, Anne; Bendtsen, Pernille; Godeau, Emmanuelle; Demetrovics, Zsolt

    2011-02-01

    To investigate time-trend changes in the frequency of drunkenness among European and North American adolescents. Cross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC). High schools in 23 countries. A sample of 77 586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling. The frequency of drunkenness. We observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls. The confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.

  9. Evidence-based cancer imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shinagare, Atul B.; Khorasani, Ramin [Dept. of Radiology, Brigham and Women' s Hospital, Boston (Korea, Republic of)

    2017-01-15

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

  10. Socioeconomic Gradients in Eastern European Countries: Evidence from PIRLS 2006

    Science.gov (United States)

    Caro, Daniel H.; Mirazchiyski, Plamen

    2012-01-01

    This article analyses educational inequalities related to socioeconomic status (SES) in 12 Eastern European countries that participated in the International Reading Literacy Study (PIRLS) 2006. Economies and educational systems of these countries have undergone critical transformations since the fall of communism. The authors' analyses, using data…

  11. Efficient Market Hypothesis: Some Evidences from Emerging European Forex Markets

    OpenAIRE

    Anoop S Kumar; Bandi Kamaiah

    2014-01-01

    This study attempts to analyze the presence of weak form efficiency in the forex markets of a set of select European emerging markets namely Bulgaria, Croatia, Czech Republic, Hungary Poland, Romania, Russia, Slovakia and Slovenia using the monthly NEER data ranging from jan-1994 to Dec-2013. We employ a two step comprehensive methodology where in the first place we test for weak form efficiency using a family of individual and joint variance ratio tests. The results show that while the marke...

  12. Explaining European Emission Allowance Price Dynamics: Evidence from Phase II

    OpenAIRE

    Wilfried Rickels; Dennis Görlich; Gerrit Oberst

    2010-01-01

    In 2005, the European Emission Trading Scheme (EU-ETS) established a new commodity: the right to emit a ton of CO2 (EUA). Since its launch, the corresponding price has shown rather turbulent dynamics, including nervous reactions to policy announcements and a price collapse after a visible over-allocation in Phase I. As a consequence, the question whether fundamental factors (fossil fuel prices, economic activity, weather) affect the EUA price remained partially unresolved. Today, being halfwa...

  13. Do oil price shocks matter? Evidence for some European countries

    International Nuclear Information System (INIS)

    Cunado, Juncal; Gracia, Fernando Perez de

    2003-01-01

    This paper analyzes the oil price-macro economy relationship by means of analyzing the impact of oil prices on inflation and industrial production indexes for many European countries using quarterly data for the period 1960-1999. First, we test for cointegration allowing for structural breaks among the variables. Second, and in order to account for the possible non-linear relationships, we use different transformation of oil price data. The main results suggest that oil prices have permanent effects on inflation and short run but asymmetric effects on production growth rates. Furthermore, significant differences are found among the responses of the countries to these shocks. (Author)

  14. Evidence-based playground design

    DEFF Research Database (Denmark)

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

    2015-01-01

    , 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...

  15. 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...

  16. Anatomy of an Evidence Base

    Science.gov (United States)

    Malouf, David B.; Taymans, Juliana M.

    2016-01-01

    An analysis was conducted of the What Works Clearinghouse (WWC) research evidence base on the effectiveness of replicable education interventions. Most interventions were found to have little or no support from technically adequate research studies, and intervention effect sizes were of questionable magnitude to meet education policy goals. These…

  17. Evidence-Based Psychological Assessment.

    Science.gov (United States)

    Bornstein, Robert F

    2017-01-01

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

  18. Evidence-based clinical practice

    DEFF Research Database (Denmark)

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

    2016-01-01

    was considered through literature searches combined with personal files. Treatments should generally not be chosen based only on evidence from observational studies or single randomised clinical trials. Systematic reviews with meta-analysis of all identifiable randomised clinical trials with Grading...

  19. European Union Emissions Trading Scheme (EU-ETS) Futures Liquidity Effects: Evidence from the European Energy Exchange (EEX)

    OpenAIRE

    Ibikunle, Gbenga; Gregoriou, Andros

    2011-01-01

    We examine liquidity effects after the onset of trading in phase II of the EU-ETS for European Union Allowance (EUA) futures contracts. We obtain evidence of long-term improvement in liquidity of the EEX EUA December 2008 futures contract after the commencement of trading in phase II. Our results suggest the application of a new regime of trading rules in Phase II led to the improvements in liquidity.

  20. Growing like mushrooms? Sectoral evidence from four large European economies

    NARCIS (Netherlands)

    Castaldi, C.; Sapio, S.

    This paper follows a stream of literature on the empirics of sectoral growth rates, originated by Castaldi and Dosi (Income levels and income growth. Some new cross-country evidence and some interpretative puzzles. LEM Working Paper 2004-18, Sant’Anna School of Advanced Studies, Pisa, Italy, 2004)

  1. Growing like mushrooms? Sectoral evidence from four large European economies

    NARCIS (Netherlands)

    Castaldi, C.; Sapio, S.

    2008-01-01

    This paper follows a stream of literature on the empirics of sectoral growth rates, originated by Castaldi and Dosi (Income levels and income growth. Some new cross-country evidence and some interpretative puzzles. LEM Working Paper 2004-18, Sant’Anna School of Advanced Studies, Pisa, Italy, 2004)

  2. Efficient Market Hypothesis: Some Evidences from Emerging European Forex Markets

    Directory of Open Access Journals (Sweden)

    Anoop S Kumar

    2014-06-01

    Full Text Available This study attempts to analyze the presence of weak form efficiency in the forex markets of a set of select European emerging markets namely Bulgaria, Croatia, Czech Republic, Hungary Poland, Romania, Russia, Slovakia and Slovenia using the monthly NEER data ranging from jan-1994 to Dec-2013. We employ a two step comprehensive methodology where in the first place we test for weak form efficiency using a family of individual and joint variance ratio tests. The results show that while the markets of Croatia, Czech Republic and Bulgaria may be weak form efficient at a shorter lag, the other six markets are not informationally efficient. In the next stage, we estimate a measure of relative efficiency to show the extent to which a market is weak-form inefficient. From the results, it is found that the forex markets of Croatia, Czech Republic and Bulgaria are least weak form inefficient compared to others. The findings of the study are of relevance as it shows that even after roughly two decades of free market economic policies, majority of the forex markets in the area remains informationally inefficient.

  3. The European hadron therapy community touches base

    CERN Multimedia

    Audrey Ballantine, Manuela Cirilli, Evangelia Dimovasili, Manjit Dosanjh, Seamus Hegarty

    2010-01-01

    The European hadron therapy community gathered in Stockholm from 3 to 5 September for the annual ENLIGHT workshops. Three of the four EC-funded projects born under the umbrella of ENLIGHT (see box) were discussed in the prestigious Nobel Forum at the Karolinska Institutet.   Souvenir photo from the ENLIGHT workshops On its second birthday, the PARTNER Initial Training Network was especially under the spotlight, as the European Commission conducted a formal project review bringing together the institutes, companies and young researchers involved. The 21 PARTNER researchers experienced the thrill of presenting their work in this privileged setting. During the coffee breaks, they joked about this being their only chance in life to speak in the Nobel Forum – but who knows what these brilliant young minds will achieve! They certainly impressed the European Commission’s Project Officer Gianluca Coluccio and Expert Reviewer Kaisa Hellevuo, who stated that PARTNER is a showcase proj...

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

    Science.gov (United States)

    Eldredge, J D

    2000-01-01

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

  5. The evidence base for diabetes care

    National Research Council Canada - National Science Library

    Williams, D. R. R. (David Robert Rhys)

    2002-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix 1. The Evidence Base for Diabetes Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rhys Williams, William Herman, Ann-Louise Kinmonth...

  6. Strategic marketing types: Evidence from the European meat processing industry

    DEFF Research Database (Denmark)

    Strandskov, Jesper; Hundahl, Lone; Laursen, Christina

    performance might differ between firms pursuing any strategy type has a strong academic and practical business interest. There is still a need to explore the basic question of whether generic types of mark strategies exist. Also there is a lack of empirical evidence which examines a wide range of strategic...... marketing strategies, (2) places these clusters in a strategic typology in order to better understand their position in the marketplace, and (3) analyses these strategic marketing types in terms of performance outcomes and differences in corporate attitudes and goals. 3. The meat processing sector in Europe....... Integrating previous definitions and findings on key strategy dimensions, three main marketing strategy components are used in the analysis: Strategic focus/objective marketing targeting and marketing positioning. The variables are split up in the following main groups: Marketing strategy variables, Corporate...

  7. Historical perspectives on evidence-based nursing.

    Science.gov (United States)

    Beyea, Suzanne C; Slattery, Mary Jo

    2013-04-01

    The authors of this article offer a review and historical perspective on research utilization and evidence-based practice in nursing. They present the evolution of research utilization to the more contemporary framework of evidence-based nursing practice. The authors address the role of qualitative research in the context of evidence-based practice. Finally, some approaches and resources for learning more about the fundamentals of evidence-based healthcare are provided.

  8. 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. Copyright © 2016. Published by Elsevier B.V.

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

    Directory of Open Access Journals (Sweden)

    Eui Geum Oh, PhD, RN

    2016-06-01

    Full Text Available 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.

  10. Evidence based practice readiness: A concept analysis.

    Science.gov (United States)

    Schaefer, Jessica D; Welton, John M

    2018-01-15

    To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

  11. The Wage Premium of Globalization: Evidence from European Mergers and Acquisitions

    OpenAIRE

    Oberhofer, Harald; Stöckl, Matthias; Winner, Hannes

    2012-01-01

    We provide evidence on the impact of globalization on labor market outcomes analyzing pay differences between foreign-acquired and domestically-owned firms. For this purpose, we use firm level data from 16 European countries over the time period 1999 to 2006. Applying propensity score matching techniques we estimate positive wage premia of cross-boarder merger and acquisitions (M&As), suggesting that foreign acquired firms exhibit higher short-run (post-acquisition) wages than their domestic ...

  12. Evidence-based practice of periodontics.

    Science.gov (United States)

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

    2010-01-01

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

  13. A germ for young European scientists: Drawing-based modelling.

    NARCIS (Netherlands)

    van Joolingen, Wouter

    2017-01-01

    An important movement in European science education is that learning should be inquiry-based and represents realistic scientific practice. The inquiry-based nature of science education is essential to interest more young people for a career in science and technology. Creating models is broadly seen

  14. 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.

  15. 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.

  16. Evidence-Based Psychotherapy: Advantages and Challenges.

    Science.gov (United States)

    Cook, Sarah C; Schwartz, Ann C; Kaslow, Nadine J

    2017-07-01

    Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.

  17. No evidence-based restoration without a sound evidence base: a reply to Guldemond et al.

    CSIR Research Space (South Africa)

    Ntshotsho, P

    2012-03-01

    Full Text Available Evidence-based practice is not possible without an evidence base. Guldemond et al. confuse our attempt at assessing the status of the evidence base of restoration programs in South Africa with attempting to assess whether restoration is evidence...

  18. 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'.

  19. The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide

    DEFF Research Database (Denmark)

    Korreman, Stine; Rasch, Coen; McNair, Helen

    2010-01-01

    The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics...

  20. Evidence-Based Dentistry in Everyday Practice.

    Science.gov (United States)

    Gudray, Kiran; Walmsley, Anthony Damien

    2016-12-01

    This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.

  1. Evidence-Based Practice: Management of Vertigo

    Science.gov (United States)

    Nguyen-Huynh, Anh T.

    2012-01-01

    Synopsis 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. PMID:22980676

  2. Evidence-based recommendations to facilitate professional ...

    African Journals Online (AJOL)

    Rachel Magdalena (Dalena) van Rooyen

    Purpose of the research: To develop evidence-based recommendations ... attitudes by not referring patients to traditional practitioners based on lack of knowledge ...... Longman Dictionary of Contemporary English. ... A case study from Chile.

  3. Evidence-based management - healthcare manager viewpoints.

    Science.gov (United States)

    Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

    2018-06-11

    Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

  4. Towards Evidence Based Usability in Health Informatics?

    NARCIS (Netherlands)

    Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.

    2015-01-01

    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still

  5. Quality of evidence-based pediatric guidelines

    NARCIS (Netherlands)

    Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

    2005-01-01

    Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

  6. Organisational-Level Attributes of Micro-Multinationals. The Evidence From European SMEs

    Directory of Open Access Journals (Sweden)

    Wąsowska Aleksandra

    2017-03-01

    Full Text Available This paper investigates organisational-level attributes that allow European SMEs to choose equity-based modes of entry to foreign markets, thus becoming micro-multinationals. We hypothesize that international R&D cooperation (hypothesis 1 and using digital marketing (hypothesis 2 by SMEs increase their likelihood of becoming a mMNE. These hypotheses are tested through a logistic regression analysis based on a large sample of European companies drawn from the Flash Eurobarometer study. Separate regression models are estimated for companies originating from EU-13 and EU-15. Hypothesis 1 is supported by both samples. Hypothesis 2 is supported in the EU-15 sample. Our identification of organisational-level attributes that increase the likelihood of SMEs choosing equity-based internationalisation contributes to International Entrepreneurship entry mode literature.

  7. 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......, cost-efficiency and measurable quality. Thus, today, evidence-based practice has become an expectation and fashion, often used to emphasize the grounding of practice in research based knowledge that provides measurable evidence for best practice. But at the same time, there is a growing distrust...... of the supremacy of this kind of knowledge, and traditional monopolies of knowledge are challenged (Gabbay & May, 2010). In the literature, there is an on-going debate about professional knowledge enacted in diverse settings. This debate presents a wide range of epistemological terminologies and typologies, which...

  8. 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.

  9. Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 European countries.

    Science.gov (United States)

    Heggebø, Kristian; Dahl, Espen

    2015-11-04

    Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 european countries. People with ill health tend to be overrepresented among the unemployment population. The relationship between health and unemployment might, however, be sensitive to the overall economic condition. Specifically, the health composition of the unemployment population could change dramatically when the economy takes a turn for the worse. Using EU-SILC cross sectional data from 2007 (pre-crisis) and 2011 (during crisis) and linear regression models, this paper investigates the relationship between health and unemployment probabilities under differing economic conditions in 28 European countries. The countries are classified according to (i) the level of and (ii) increase in unemployment rate (i.e. >10 percent and doubling of unemployment rate = crisis country). Firstly, the unemployment likelihood for people with ill health is remarkably stable over time in Europe: the coefficients are very similar in pre-crisis and crisis years. Secondly, people with ill health have experienced unemployment to a lesser extent than those with good health status in the crisis year (when we pool the data and compare 2007 and 2011), but only in the countries with a high and rising unemployment rate. The health composition of the unemployment population changes significantly for the better, but only in those European countries that have been severely hit by the current economic crisis.

  10. Perceived discrimination and self-rated health in Europe: evidence from the European Social Survey (2010.

    Directory of Open Access Journals (Sweden)

    Javier Alvarez-Galvez

    Full Text Available INTRODUCTION: Studies have shown that perceived discrimination has an impact on our physical and mental health. A relevant part of literature has highlighted the influence of discrimination based on race or ethnicity on mental and physical health outcomes. However, the influence of other types of discrimination on health has been understudied. This study is aimed to explore how different types of discrimination are related to our subjective state of health, and so to compare the intensity of these relationships in the European context. METHODS: We have performed a multilevel ordered analysis on the fifth wave of the European Social Survey (ESS 2010. This dataset has 52,458 units at individual level that are grouped in 26 European countries. In this study, the dependent variable is self-rated health (SRH that is analyzed in relationship to ten explanatory variables of perceived discrimination: color or race, nationality, religion, language, ethnic group, age, gender, sexuality, disability and others. RESULTS: The model identifies statistically significant differences in the effect that diverse types of perceived discrimination can generate on the self-rated health of Europeans. Specifically, this study identifies three well-defined types of perceived discrimination that can be related to poor health outcomes: (1 age discrimination; (2 disability discrimination; and (3 sexuality discrimination. In this sense, the effect on self-rated health of perceived discrimination related to aging and disabilities seems to be more relevant than other types of discrimination in the European context with a longer tradition in literature (e.g. ethnic and/or race-based. CONCLUSION: The present study shows that the relationship between perceived discrimination and health inequities in Europe are not random, but systematically distributed depending on factors such as age, sexuality and disabilities. Therefore the future orientation of EU social policies should aim

  11. The determinants of capital structure: the evidence from the European Union

    Directory of Open Access Journals (Sweden)

    Natalia Mokhova

    2013-01-01

    Full Text Available The aim of this study is to indicate the influence of several internal determinants on capital structure in different European countries and retrace its tendency taking into consideration the membership of the European Union. Nowadays there are a lot of debates according the future of the European Union. The recent global financial crisis and the following European debt crisis show the significance of the country financial stability and its impact on the private sector. The paper investigates 32 countries of European Union dividing them into three groups as (1 old EU members (15 countries, (2 new EU members (12 countries and (3 EU candidates (4 candidate countries and 1 acceding country.The managers make their financial decisions according to the source of financing and capital structure based on the macroeconomic conditions and country specifics and obviously on company’s advantages and disadvantages, i.e. its internal characteristics. Based on the analysis of previous studies we have chosen several significant internal determinants of capital structure as profitability, tangibility, growth opportunities, non-debt tax shields and firm’s size.The findings show that the country’s specifics, EU membership and corporate debt structure influence the relation between capital structure and its internal characteristics. The capital structure in all countries has tendency to increase, furthermore the old members rely more on debt then candidates or new members.There is no doubt that the majority of countries support Pecking Order Theory then Trade off Theory regarding investigated relations. In most countries the profitability and size have negative and significant influence on corporate capital structure. At the same time tangibility, growth opportunities and non-debt tax shields split up: selected countries experience positive impact, another part negative, supporting different theories.

  12. Perceived discrimination and self-rated health in Europe: evidence from the European Social Survey (2010).

    Science.gov (United States)

    Alvarez-Galvez, Javier; Salvador-Carulla, Luis

    2013-01-01

    Studies have shown that perceived discrimination has an impact on our physical and mental health. A relevant part of literature has highlighted the influence of discrimination based on race or ethnicity on mental and physical health outcomes. However, the influence of other types of discrimination on health has been understudied. This study is aimed to explore how different types of discrimination are related to our subjective state of health, and so to compare the intensity of these relationships in the European context. We have performed a multilevel ordered analysis on the fifth wave of the European Social Survey (ESS 2010). This dataset has 52,458 units at individual level that are grouped in 26 European countries. In this study, the dependent variable is self-rated health (SRH) that is analyzed in relationship to ten explanatory variables of perceived discrimination: color or race, nationality, religion, language, ethnic group, age, gender, sexuality, disability and others. The model identifies statistically significant differences in the effect that diverse types of perceived discrimination can generate on the self-rated health of Europeans. Specifically, this study identifies three well-defined types of perceived discrimination that can be related to poor health outcomes: (1) age discrimination; (2) disability discrimination; and (3) sexuality discrimination. In this sense, the effect on self-rated health of perceived discrimination related to aging and disabilities seems to be more relevant than other types of discrimination in the European context with a longer tradition in literature (e.g. ethnic and/or race-based). The present study shows that the relationship between perceived discrimination and health inequities in Europe are not random, but systematically distributed depending on factors such as age, sexuality and disabilities. Therefore the future orientation of EU social policies should aim to reduce the impact of these social determinants on health

  13. Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

    Science.gov (United States)

    Margetts, B; Warm, D; Yngve, A; Sjöström, M

    2001-12-01

    The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

  14. Evidence-based management: a literature review.

    Science.gov (United States)

    Young, Sam K

    2002-05-01

    This paper presents a review of evidence-based management (EBM), exploring whether management activities within healthcare have been, or can be, subject to the same scientific framework as clinical practice. The evidence-based approach was initially examined, noting the hierarchy of evidence ranging from randomized control trials to clinical anecdote. The literature varied in its degree of criticism of this approach; the most common concern referring to the assumed superiority of positivism. However, evidence-based practice was generally accepted as the best way forward. Stewart (1998) offered the only detailed exposition of EBM, outlining a necessary 'attitude of mind' both for EBM and for the creation of a research culture. However, the term 'clinical effectiveness' emerged as a possible replacement buzz-word for EBM (McClarey 1998). The term appears to encompass the sentiments of the evidence-based approach, but with a concomitant concern for economic factors. In this paper the author has examined the divide between those who viewed EBM as an activity for managers to make their own practice accountable and those who believed it to be a facilitative practice to help clinicians with evidence-based practice. Most papers acknowledged the limited research base for management activities within the health service and offered some explanation such as government policy constraints and lack of time. Nevertheless, the overall emphasis is that ideally there should be a management culture firmly based in evidence.

  15. Patterns of Long Term Care in 29 European countries: evidence from an exploratory study

    Directory of Open Access Journals (Sweden)

    Damiani Gianfranco

    2011-11-01

    Full Text Available Abstract Background The challenges posed by the rapidly ageing population, and the increased preponderance of disabled people in this group, coupled with the rising level of public expenditure required to service the complex organization of long term care (LTC delivery are causing increased pressure on LTC systems in Europe. A pan-European survey was carried out to evaluate whether patterns of LTC can be identified across Europe and what are the trends of the countries along them. Methods An ecological study was conducted on the 27 EU Member States plus Norway and Iceland, referring to the period 2003-2007. Several variables related to organizational features, elderly needs and expenditure were drawn from OECD Health Data and the Eurostat Statistics database and combined using Multiple Factor Analysis (MFA. Results Two global Principal Components were taken into consideration given that their expressed total variance was greater than 60%. They were interpreted according to the higher (more than 0.5 positive or negative correlation coefficients between them and the original variables; thus patterns of LTC were identified. High alignment between old age related expenditure and elderly needs characterizes Nordic and Western European countries, the former also having a higher level of formal care than the latter. Mediterranean as well as Central and South Eastern European countries show lower alignment between old age related expenditure and elderly needs, coupled with a level of provision of formal care that is around or slightly above the average European level. In the dynamic comparison, linear, stable or unclear trends were shown for the studied countries. Conclusions The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy

  16. History of evidence-based medicine

    Directory of Open Access Journals (Sweden)

    Roger L Sur

    2011-01-01

    Full Text Available This essay reviews the historical circumstances surrounding the introduction and evolution of evidence-based medicine. Criticisms of the approach are also considered. Weaknesses of existing standards of clinical practice and efforts to bring more certainty to clinical decision making were the foundation for evidence-based medicine, which integrates epidemiology and medical research. Because of its utility in designing randomized clinical trials, assessing the quality of the literature, and applying medical research at the bedside, evidence-based medicine will continue to have a strong influence on everyday clinical practice.

  17. When the waves of European Neolithization met: first paleogenetic evidence from early farmers in the southern Paris Basin.

    Directory of Open Access Journals (Sweden)

    Maïté Rivollat

    Full Text Available An intense debate concerning the nature and mode of Neolithic transition in Europe has long received much attention. Recent publications of paleogenetic analyses focusing on ancient European farmers from Central Europe or the Iberian Peninsula have greatly contributed to this debate, providing arguments in favor of major migrations accompanying European Neolithization and highlighting noticeable genetic differentiation between farmers associated with two archaeologically defined migration routes: the Danube valley and the Mediterranean Sea. The aim of the present study was to fill a gap with the first paleogenetic data of Neolithic settlers from a region (France where the two great currents came into both direct and indirect contact with each other. To this end, we analyzed the Gurgy 'Les Noisats' group, an Early/Middle Neolithic necropolis in the southern part of the Paris Basin. Interestingly, the archaeological record from this region highlighted a clear cultural influence from the Danubian cultural sphere but also notes exchanges with the Mediterranean cultural area. To unravel the processes implied in these cultural exchanges, we analyzed 102 individuals and obtained the largest Neolithic mitochondrial gene pool so far (39 HVS-I mitochondrial sequences and haplogroups for 55 individuals from a single archaeological site from the Early/Middle Neolithic period. Pairwise FST values, haplogroup frequencies and shared informative haplotypes were calculated and compared with ancient and modern European and Near Eastern populations. These descriptive analyses provided patterns resulting from different evolutionary scenarios; however, the archaeological data available for the region suggest that the Gurgy group was formed through equivalent genetic contributions of farmer descendants from the Danubian and Mediterranean Neolithization waves. However, these results, that would constitute the most ancient genetic evidence of admixture between farmers

  18. Prices and E-Cigarette Demand: Evidence From the European Union.

    Science.gov (United States)

    Stoklosa, Michal; Drope, Jeffrey; Chaloupka, Frank J

    2016-10-01

    Many European Union (EU) Member States have expressed the need for EU legislation to clarify the issue of e-cigarette taxation, but the economic evidence to inform creation of such policies has been lacking. To date, only one study-on the United States only-has examined responsiveness of e-cigarette demand to price changes. We used 2011-2014 pooled time-series data on e-cigarette sales, as well as e-cigarette and cigarette prices for six EU markets (Estonia, Ireland, Latvia, Lithuania, Sweden, and the United Kingdom). We utilized static and dynamic fixed-effects models to estimate the own and cross-price elasticity of demand for e-cigarettes. In a separate model for Sweden, we examined the effects of snus prices on e-cigarette sales. Based on static models, every 10% increase in e-cigarette prices is associated with a drop in e-cigarettes sales of approximately 8.2%, while based on dynamic models, the drop is 2.7% in the short run and 11.5% in the long run. Combustible cigarette prices are positively associated with sales of e-cigarettes. Snus prices are positively associated with sales of e-cigarettes in Sweden. Our results indicate that the sales of e-cigarettes are responsive to price changes, which suggests that excise taxes can help governments to mitigate an increase in e-cigarette use. E-cigarettes and regular cigarettes are substitutes, with higher cigarette prices being associated with increased e-cigarette sales. Making combustible cigarettes more expensive compared to e-cigarettes could be effective in moving current combustible smokers to e-cigarettes, which might have positive health effects. This study is an exploratory analysis of the issues around e-cigarette taxation in Europe. Our results suggest that taxation is a measure that could potentially address the concerns of both opponents and proponents of e-cigarettes: taxes on e-cigarettes could be used to raise prices so as to deter e-cigarette initiation by never users, while concomitant greater

  19. European Climate - Energy Security Nexus. A model based scenario analysis

    International Nuclear Information System (INIS)

    Criqui, Patrick; Mima, Silvana

    2011-01-01

    In this research, we have provided an overview of the climate-security nexus in the European sector through a model based scenario analysis with POLES model. The analysis underline that under stringent climate policies, Europe take advantage of a double dividend in its capacity to develop a new cleaner energy model and in lower vulnerability to potential shocks on the international energy markets. (authors)

  20. The evidence base for diabetes care

    National Research Council Canada - National Science Library

    Williams, D. R. R. (David Robert Rhys)

    2002-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3. Evidence-Based Definition and Classification: A Commentary . . . . . . Steve O'Rahilly 37 PART II: PREVENTION OF DIABETES 4. Prevention of Type 1 Diabetes...

  1. Evidence-based librarianship: an overview.

    Science.gov (United States)

    Eldredge, J D

    2000-10-01

    To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.

  2. Can Scholarly Communication be Evidence Based? (Editorial)

    OpenAIRE

    Denise Koufogiannakis

    2010-01-01

    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 sc...

  3. [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.

  4. The religion of evidence-based practice

    DEFF Research Database (Denmark)

    Wigram, Tony; Gold, Christian

    2012-01-01

    This chapter begins by outlining the challenges of preparing a chapter on evidence-based practice (EBP) to underpin the use of music as a therapeutic tool in treatment, in the overall frame of music, health, and wellbeing. It then reviews the terminology of EBP and evidence-based medicine...... practice as health, education, and social services tighten their belts and the demand on their resources grows, there is increasing interest in the value of music for health and wellbeing, despite even less ‘hard’ evidence that it is effective against illness and disability....

  5. Cross-border integration in the European electricity market. Evidence from the pricing behavior of Norwegian and Swiss exporters

    International Nuclear Information System (INIS)

    Balaguer, Jacint

    2011-01-01

    This paper examines the electricity market integration process in two European areas based on the pricing behavior of Norwegian and Swiss exporters. The aim is to gain evidence for the period after the adoption of the 'Second Legislative Package' (2003). The pricing behavior of Norwegian exporters indicates that the wholesale markets for Denmark and Sweden are highly integrated. Moreover, results are fully compatible with the existence of a very competitive marketplace for electricity. This clearly contrasts with the evidence provided by Swiss exporters. In this last case, analysis revealed differences in pricing-to-market behavior between Italy, France and Germany, which indicates that exporters take advantage of international market segmentation and divergences between market structures. This outcome provides a reasonable explanation as to why price differences between countries cannot be fully attributed to transmission costs, as has been claimed in previous research. We also found cross-country convergence in levels of markups and in pricing-to-market behavior of the Swiss exporters for the first part of the period that was analyzed. The evidence is fully consistent with an initial impulse toward market integration originated by reforms implemented at the beginning of the last decade. - Highlights: → We exploit a model based on pricing-to-market behavior. → Price discrimination by Swiss exporters is found. → Nordic electricity markets are found to be already highly integrated. → Market integration was recently improved in continental area. → Results are consistent with reforms under the 'Second Legislative Package'.

  6. Cross-border integration in the European electricity market. Evidence from the pricing behavior of Norwegian and Swiss exporters

    Energy Technology Data Exchange (ETDEWEB)

    Balaguer, Jacint, E-mail: jacint.balaguer@eco.uji.es [Department of Economics, Universitat Jaume I, 12071 Castellon (Spain)

    2011-09-15

    This paper examines the electricity market integration process in two European areas based on the pricing behavior of Norwegian and Swiss exporters. The aim is to gain evidence for the period after the adoption of the 'Second Legislative Package' (2003). The pricing behavior of Norwegian exporters indicates that the wholesale markets for Denmark and Sweden are highly integrated. Moreover, results are fully compatible with the existence of a very competitive marketplace for electricity. This clearly contrasts with the evidence provided by Swiss exporters. In this last case, analysis revealed differences in pricing-to-market behavior between Italy, France and Germany, which indicates that exporters take advantage of international market segmentation and divergences between market structures. This outcome provides a reasonable explanation as to why price differences between countries cannot be fully attributed to transmission costs, as has been claimed in previous research. We also found cross-country convergence in levels of markups and in pricing-to-market behavior of the Swiss exporters for the first part of the period that was analyzed. The evidence is fully consistent with an initial impulse toward market integration originated by reforms implemented at the beginning of the last decade. - Highlights: > We exploit a model based on pricing-to-market behavior. > Price discrimination by Swiss exporters is found. > Nordic electricity markets are found to be already highly integrated. > Market integration was recently improved in continental area. > Results are consistent with reforms under the 'Second Legislative Package'.

  7. Trade and foreign direct investment: Evidence from South East European countries and new European Union member states

    Directory of Open Access Journals (Sweden)

    Bardhyl Dauti

    2016-06-01

    Full Text Available The goal of this research is to provide an empirical assessment of the complementarity or substituting relationship between Trade and FDI in a link to country characteristics, using bilateral level data between FDI and trade for the period 1994 – 2010. In the research, an augmented gravity model has been used to test the relationship between Trade (both export and import, FDI stock and country characteristics between OECD-20 countries and SEE-5 and EU-NMS-10 countries. The empirical model considers how the relationship between FDI and Trade determine whether type of FDI into SEE-5 and EU-NMS-10 from core OECD-20 countries, is vertical or horizontal. With regard to the relationship between exports and FDI, the findings of the research showed mixed evidence, thus supporting vertical FDI for EU-NMS-10 countries, and horizontal FDI for SEE-5 countries. On the other hand, based on the relationship between imports and FDI, the results of the research supported vertical FDI for both EU-NMS-10 and SEE-5 group of countries. The basic conclusion is that the research provides an empirical evidence on the mixed nature of FDI into the host SEE-5 and EU-NMS-10 countries, supporting both complementary and substituting relationship between trade and FDI in the host countries.

  8. Professionalism and evidence-based practice

    DEFF Research Database (Denmark)

    Rasmussen, Palle

    2015-01-01

    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......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...... to displace important educational objectives. In other cases, the methods are reflectively adjusted to a given context. Used in this way only, evid ence-based practice and methodology is a valuable resource for professional practice in education. From such a perspective, at least some types of research based...

  9. HERDING BEHAVIOR UNDER MARKETS CONDITION: EMPIRICAL EVIDENCE ON THE EUROPEAN FINANCIAL MARKETS

    Directory of Open Access Journals (Sweden)

    Moatemri Ouarda

    2013-01-01

    Full Text Available This study presents four main contributions to the literature of behavior herding. Firstly, it extends the behavioral researches of herding of the investors on a developed market and mainly on a European market as a whole. Secondly, we are interested in examination of herding behavior at the level of sectors by using data at the levels of companies. Thirdly, this document estimates the implications of herding behavior in terms of returns, volatility and volume of transaction. Fourthly, the herding behavior is revealed as well during the period of the recent global financial crisis in 2007-2008 and of Asian crisis. Our results reveal a strong evidence of herding behavior sharply contributed to a bearish situation characterized by a strong volatility and a trading volume. The repercussion of herding during the period of the recent financial crisis is clearly revealed for the sectors of the finance and the technology.

  10. Combined dendro-documentary evidence of Central European hydroclimatic springtime extremes over the last millennium

    Science.gov (United States)

    Büntgen, Ulf; Brázdil, Rudolf; Heussner, Karl-Uwe; Hofmann, Jutta; Kontic, Raymond; Kyncl, Tomáš; Pfister, Christian; Chromá, Kateřina; Tegel, Willy

    2011-12-01

    A predicted rise in anthropogenic greenhouse gas emissions and associated effects on the Earth's climate system likely imply more frequent and severe weather extremes with alternations in hydroclimatic parameters expected to be most critical for ecosystem functioning, agricultural yield, and human health. Evaluating the return period and amplitude of modern climatic extremes in light of pre-industrial natural changes is, however, limited by generally too short instrumental meteorological observations. Here we introduce and analyze 11,873 annually resolved and absolutely dated ring width measurement series from living and historical fir ( Abies alba Mill.) trees sampled across France, Switzerland, Germany, and the Czech Republic, which continuously span the AD 962-2007 period. Even though a dominant climatic driver of European fir growth was not found, ring width extremes were evidently triggered by anomalous variations in Central European April-June precipitation. Wet conditions were associated with dynamic low-pressure cells, whereas continental-scale droughts coincided with persistent high-pressure between 35 and 55°N. Documentary evidence independently confirms many of the dendro signals over the past millennium, and further provides insight on causes and consequences of ambient weather conditions related to the reconstructed extremes. A fairly uniform distribution of hydroclimatic extremes throughout the Medieval Climate Anomaly, Little Ice Age and Recent Global Warming may question the common believe that frequency and severity of such events closely relates to climate mean stages. This joint dendro-documentary approach not only allows extreme climate conditions of the industrial era to be placed against the backdrop of natural variations, but also probably helps to constrain climate model simulations over exceptional long timescales.

  11. Environmental regulation and competitiveness: Empirical evidence on the Porter Hypothesis from European manufacturing sectors

    International Nuclear Information System (INIS)

    Rubashkina, Yana; Galeotti, Marzio; Verdolini, Elena

    2015-01-01

    This paper investigates the “weak” and “strong” versions of Porter Hypothesis (PH) focusing on the manufacturing sectors of 17 European countries between 1997 and 2009. The hypothesis that well-crafted and well-enforced regulation would benefit both the environment and the firm was originally proposed by Porter (1991) and Porter and van der Linde (1995). To date, the literature has analyzed the impact of environmental regulation on innovation and on productivity mostly in separate analyses and focusing on the USA. The few existing contributions on Europe study the effect of environmental regulation either on green innovation or on performance indicators such as exports. We instead look at overall innovation and productivity impacts. First, focusing on overall innovative activity allows us to account for potential opportunity costs of induced innovations. Second, productivity impacts are arguably the most relevant indicators for the “strong” PH. As a proxy of environmental policy stringency we use pollution abatement and control expenditures (PACE), one of the few sectoral level indicators available. We remedy upon its main drawback, namely potential endogeneity, by adopting an instrumental variable estimation approach. We find evidence of a positive impact of environmental regulation on the output of innovation activity, as proxied by patents, thus providing support in favor of the “weak” PH. This result is in line with most of the literature. On the other front, we find no evidence in favor of the “strong” PH, as productivity appears to be unaffected by the degree of pollution control and abatement efforts. -- Highlights: •Weak and strong Porter Hypothesis. •Panel of manufacturing sectors of 17 European countries between 1997 and 2009. •Look at overall innovation and productivity impacts. •Pollution abatement & control expenditures proxy of environmental policy stringency. •Account for potential endogeneity of PACE by adopting

  12. Validity evidence based on test content.

    Science.gov (United States)

    Sireci, Stephen; Faulkner-Bond, Molly

    2014-01-01

    Validity evidence based on test content is one of the five forms of validity evidence stipulated in the Standards for Educational and Psychological Testing developed by the American Educational Research Association, American Psychological Association, and National Council on Measurement in Education. In this paper, we describe the logic and theory underlying such evidence and describe traditional and modern methods for gathering and analyzing content validity data. A comprehensive review of the literature and of the aforementioned Standards is presented. For educational tests and other assessments targeting knowledge and skill possessed by examinees, validity evidence based on test content is necessary for building a validity argument to support the use of a test for a particular purpose. By following the methods described in this article, practitioners have a wide arsenal of tools available for determining how well the content of an assessment is congruent with and appropriate for the specific testing purposes.

  13. Gadolinium retention after administration of contrast agents based on linear chelators and the recommendations of the European Medicines Agency

    International Nuclear Information System (INIS)

    Dekkers, Ilona A.; Roos, Rick; Molen, Aart J. van der

    2018-01-01

    The Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) earlier this year recommended to suspend some marketing authorisations for Gadolinium Containing Contrast Agents (GCCAs) based on linear chelators due to the potential risk of gadolinium retention in the human body. These recommendations have recently been re-evaluated by EMA's Committee for Medicinal Products for Human Use (CHMP), and confirmed the final opinion of the European Medicines Agency. This editorial provides an overview of the available GCCAs and summarises the recent evidence of gadolinium retention. Moreover, a critical appraisal of the strengths and limitations of the scientific evidence currently available on gadolinium retention is given. (orig.)

  14. Decisions by regulatory agencies: are they evidence-based?

    Directory of Open Access Journals (Sweden)

    Furberg Curt D

    2007-04-01

    Full Text Available Abstract Contradictory statements about the non-steroidal anti-inflammatory drugs from the European Medicines Agency and the United States Food and Drug Administration have raised questions about whether regulatory decisions are evidence-based. For the selective COX-2 inhibitors, there are clear contraindications and warnings in Europe, but only a vaguely worded Black Box warning in the United States. All the non-selective agents are given an almost "clean bill of health" in Europe, while all of them are judged to have a similar risk-benefit ratio as celecoxib in the United States. The regulatory agencies have failed to recognize the clinical trial evidence that the risk of cardiovascular events varies substantially among the non-selective agents, with diclofenac carrying the highest risk of harm.

  15. Evidence-based Practice of Radiology.

    Science.gov (United States)

    Lavelle, Lisa P; Dunne, Ruth M; Carroll, Anne G; Malone, Dermot E

    2015-10-01

    Current health care reform in the United States is producing a shift in radiology practice from the traditional volume-based role of performing and interpreting a large number of examinations to providing a more affordable and higher-quality service centered on patient outcomes, which is described as a value-based approach to the provision of health care services. In the 1990 s, evidence-based medicine was defined as the integration of current best evidence with clinical expertise and patient values. When these methods are applied outside internal medicine, the process is called evidence-based practice (EBP). EBP facilitates understanding, interpretation, and application of the best current evidence into radiology practice, which optimizes patient care. It has been incorporated into "Practice-based Learning and Improvement" and "Systems-based Practice," which are two of the six core resident competencies of the Accreditation Council for Graduate Medical Education and two of the 12 American Board of Radiology milestones for diagnostic radiology. Noninterpretive skills, such as systems-based practice, are also formally assessed in the "Quality and Safety" section of the American Board of Radiology Core and Certifying examinations. This article describes (a) the EBP framework, with particular focus on its relevance to the American Board of Radiology certification and maintenance of certification curricula; (b) how EBP can be integrated into a residency program; and (c) the current value and likely place of EBP in the radiology information technology infrastructure. Online supplemental material is available for this article. © RSNA, 2015.

  16. European Working Time Directive and doctors' health: a systematic review of the available epidemiological evidence.

    Science.gov (United States)

    Rodriguez-Jareño, Maria Cruz; Demou, Evangelia; Vargas-Prada, Sergio; Sanati, Kaveh A; Skerjanc, Alenka; Reis, Pedro G; Helimäki-Aro, Ritva; Macdonald, Ewan B; Serra, Consol

    2014-07-07

    To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians. A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria. Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included. The total number of participants was 14 338. Health effects classified under the International Classification of Diseases (ICD-10). Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified. LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or 'dose-response' relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy. Policymakers should consider safety issues when working on relaxing EWTD for doctors. Published by the

  17. European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence

    Science.gov (United States)

    Rodriguez-Jareño, Maria Cruz; Demou, Evangelia; Vargas-Prada, Sergio; Sanati, Kaveh A; Škerjanc, Alenka; Reis, Pedro G; Helimäki-Aro, Ritva; Macdonald, Ewan B; Serra, Consol

    2014-01-01

    Objective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians. Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria. Setting Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included. Participants The total number of participants was 14 338. Primary and secondary outcome measures Health effects classified under the International Classification of Diseases (ICD-10). Results Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified. Conclusions LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or ‘dose–response’ relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy

  18. Queer challenges to evidence-based practice.

    Science.gov (United States)

    Zeeman, Laetitia; Aranda, Kay; Grant, Alec

    2014-06-01

    This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley

  19. Evidence-based dentistry: Future aspects

    Directory of Open Access Journals (Sweden)

    Kanika Mohindra

    2017-01-01

    Full Text Available Traditionally, clinical decisions in dentistry have been based on the experience of the dentist. If the given treatment works, it was utilized again, but if the results were disappointing, the procedure was deserted. Evaluating clinical treatment in this fashion is difficult because it is hard to know which factors are important for success and which contribute to failure. This came with the concept of evidence-based approach which facilitates conclusions for clinical practice based on sound research studies.

  20. Detecting New Evidences for Evidence-Based Medical Guidelines with Journal Filtering

    NARCIS (Netherlands)

    Hu, Qing; Huang, Zisheng; ten Teije, Annette; van Harmelen, Frank; Riaño, David; Lenz, Richard; Reichert, Manfred

    2017-01-01

    Evidence-based medical guidelines are systematically developed recommendations with the aim to assist practitioner and patients decisions regarding appropriate health care for specific clinical circumstances, and are based on evidence described in medical research papers. Evidence-based medical

  1. Evidence-Based Advances in Ferret Medicine.

    Science.gov (United States)

    Huynh, Minh; Chassang, Lucile; Zoller, Graham

    2017-09-01

    This literature review covers approximately 35 years of veterinary medicine. This article develops the current state of knowledge in pet ferret medicine regarding the most common diseases according to evidence-based data and gives insight into further axis of research. Literature review was conducted through identification of keywords (title + ferret) with Web-based database searching. To appreciate the methodological quality and the level of evidence of each article included in the review, full-text versions were reviewed and questions addressed in the articles were formulated. Analysis of the articles' content was performed by the authors, and relevant clinical information was extracted. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Epistemologic inquiries in evidence-based medicine.

    Science.gov (United States)

    Djulbegovic, Benjamin; Guyatt, Gordon H; Ashcroft, Richard E

    2009-04-01

    Since the term "evidence-based medicine" (EBM) first appeared in the scientific literature in 1991, the concept has had considerable influence in many parts of the world. Most professional societies, the public,and funding agencies have accepted EBM with remarkable enthusiasm. The concept of evidence-based practice is now applied in management, education, criminology, and social work. Yet, EBM has attracted controversy: its critics allege that EBM uses a narrow concept of evidence and a naive conception of the relationships between evidence, theory, and practice. They also contend that EBM presents itself as a radical restructuring of medical knowledge that discredits more traditional ways of knowing in medicine, largely in the interests of people with a particular investment in the enterprise of large-scale clinical trials. Because EBM proposes aspecific relationship between theory, evidence, and knowledge, its theoretical basis can be understood as an epistemological system. Undertaking epistemological inquiry is important because the adoption of a particular epistemological view defines how science is conducted. In this paper, we challenge this critical view of EBM by examining how EBM fits into broad epistemological debates within the philosophy of science. We consider how EBM relates to some classical debates regarding the nature of science and knowledge. We investigate EBM from the perspective of major epistemological theories (logical-positivism/inductivism, deductivism/falsificationism/theory-ladeness of observations, explanationism/holism, instrumentalism, underdetermination theory by evidence). We first explore the relationship between evidence and knowledge and discuss philosophical support for the main way that evidence is used in medicine: (1) in the philosophical tradition that "rational thinkers respect their evidence," we show that EBM refers to making medical decisions that are consistent with evidence, (2) as a reliable sign, symptom, or mark to

  3. Reproductive Biology Including Evidence for Superfetation in the European Badger Meles meles (Carnivora: Mustelidae.

    Directory of Open Access Journals (Sweden)

    Leigh A L Corner

    Full Text Available The reproductive biology of the European badger (Meles meles is of wide interest because it is one of the few mammal species that show delayed implantation and one of only five which are suggested to show superfetation as a reproductive strategy. This study aimed to describe the reproductive biology of female Irish badgers with a view to increasing our understanding of the process of delayed implantation and superfetation. We carried out a detailed histological examination of the reproductive tract of 264 female badgers taken from sites across 20 of the 26 counties in the Republic of Ireland. The key results show evidence of multiple blastocysts at different stages of development present simultaneously in the same female, supporting the view that superfetation is relatively common in this population of badgers. In addition we present strong evidence that the breeding rate in Irish badgers is limited by failure to conceive, rather than failure at any other stages of the breeding cycle. We show few effects of age on breeding success, suggesting no breeding suppression by adult females in this population. The study sheds new light on this unusual breeding strategy of delayed implantation and superfetation, and highlights a number of significant differences between the reproductive biology of female Irish badgers and those of Great Britain and Swedish populations.

  4. [What else is Evidence-based Medicine?].

    Science.gov (United States)

    Hauswaldt, Johannes

    2010-01-01

    The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence. Strange enough, scientific discussion focuses on external evidence from systematic research, but neglects its counterpart, i.e., individual clinical expertise. Apart from a lack of appropriate intellectual tools for approaching the latter, this might be due to the mutual concealment of thought and action, of sensor and motor activity (Viktor von Weizsaecker's principle of the revolving door). Behind this, and incommensurably different from each other, lie the world of physics and the world of biology with an ego animal, that is, the dilemma of the self-conscious subject in a world of objects. When practicing medicine, this dilemma of self-reference is being resolved but only through a holistic approach combining rational and external evidence with biographical, spiritual, emotional and pre-rational elements represented in the physician's individual clinical expertise. Copyright © 2010. Published by Elsevier GmbH.

  5. Evidence-based medicine Training: Kazakhstan experience.

    Science.gov (United States)

    Kamalbekova, G; Kalieva, M

    2015-01-01

    Understanding principles of evidence-based medicine is of vital importance for improving quality of care, promoting public health and health system development. Understanding principles of evidence-based medicine allows using the most powerful information source, which have ever existed in medicine. To evaluate the effectiveness of teaching Evidence-Based Medicine, including long-term outcomes of training. The study was conducted at the Medical University of Astana, where the Scientific and Educational Center of Evidence-Based Medicine was established in 2010 with the help of the corresponding project of the World Bank. The participants of the study were the faculty trained in Evidence-Based Medicine at the workshop "Introduction to Evidence-Based Medicine" for the period of 2010-2015 years. There were a total of 16 workshops during the period, and 323 employees were trained. All participants were asked to complete our questionnaire two times: before the training - pre-training (to determine the initial level of a listener) and after the training - post-training (to determine the acquired level and get the feedback). Questionnaires were prepared in such a way, that the majority of questions before and after training were identical. Thus, it provided a clear picture of the effectiveness of training. Questions in the survey were open-ended so that the respondents had the opportunity to freely and fully express their views. The main part of the questionnaires included the following questions: "Do you understand what evidence-based medicine is", "how do you understand what the study design means", "what is randomization", "how research is classified", "do you know the steps of decision-making according to Evidence-Based Medicine, list them", "what literature do you prefer to use when searching for information (print, electronic, etc.)", "what resources on the Internet do you prefer to use". Only 30-35% of respondents gave correct answers to the questions on

  6. Evidence for natural selection at the melanocortin-3 receptor gene in European and African populations.

    Science.gov (United States)

    Yoshiuchi, Issei

    2016-08-01

    Obesity is increasing steadily in worldwide prevalence and is known to cause serious health problems in association with type 2 diabetes mellitus (T2DM), including hypertension, stroke, and cardiovascular diseases. According to the thrifty gene hypothesis, the natural selection of obesity-related genes is important during feast and famine because they control body weight and fat levels. Past human adaptations to environmental changes in food supply, lifestyle, and geography may have influenced the selection of genes associated with the metabolism of glucose, lipids, and energy. The melanocortin-3 receptor gene (MC3R) is associated with obesity, with MC3R-deficient mice showing increased fat mass. MC3R variations are also linked with childhood obesity and insulin resistance. Here, we aimed to uncover evidence of selection at MC3R. We performed a three-step method to detect selection at MC3R using HapMap population data. We used Wright's F statistics as a measure of population differentiation, the long-range haplotype test to identify extended haplotypes, and the integrated haplotype score (iHS) to detect selection at MC3R. We observed high population differentiation between European and African populations at two MC3R childhood obesity- and insulin resistance-associated single-nucleotide polymorphisms (rs3746619 and rs3827103) using Wright's F statistics. The iHS revealed evidence of natural selection at MC3R. These findings provide evidence for natural selection at MC3R. Further investigation is warranted into adaptive evolution at T2DM- and obesity-associated genes.

  7. Evidence-based practice within nutrition

    DEFF Research Database (Denmark)

    Laville, Martine; Segrestin, Berenice; Alligier, Maud

    2017-01-01

    BACKGROUND: Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities for im...

  8. The influence of mitigation evidence, ethnicity, and SES on death penalty decisions by European American and Latino venire persons.

    Science.gov (United States)

    Espinoza, Russ K E; Willis-Esqueda, Cynthia

    2015-04-01

    The purpose of the research was to determine whether European American and Latino mock jurors would demonstrate bias in death penalty decision making when mitigation evidence and defendant ethnicity and socioeconomic status (SES) were varied. A total of 561 actual venire persons acted as mock jurors and read a trial transcript that varied a defendant's case information (mitigating circumstances: strong/weak, defendant ethnicity: European American/Latino, and defendant SES: low/high). European American jurors recommended the death penalty significantly more often for the low SES Latino defendant when strength of mitigation evidence was weak. In addition, they also assigned this defendant higher culpability ratings and lower ratings on positive personality trait measures compared with all other conditions. Strong mitigation evidence contributed to lower guilt ratings by European American jurors for the high SES European American defendant. Latino jurors did not differ in their death penalty sentencing across defendant mitigation, ethnicity, or SES conditions. Discussion of in-group favoritism and out-group derogation, as well as suggestions for procedures to diminish juror bias in death penalty cases, is provided. (c) 2015 APA, all rights reserved).

  9. Morphea: Evidence-based recommendations for treatment

    OpenAIRE

    Nicole M Fett

    2012-01-01

    Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on ran...

  10. A European core curriculum in cariology: the knowledge base

    NARCIS (Netherlands)

    Anderson, P.; Beeley, J.; Monteiro, P.M.; de Soet, H.; Andrian, S.; Amaechi, B.; Huysmans, M.C.D.N.J.M.

    2011-01-01

    This paper is part of a series of papers towards a European Core Curriculum in Cariology for undergraduate dental students. The European Core Curriculum in Cariology is the outcome of a joint workshop of the European Organization for Caries Research (ORCA) together with the Association for Dental

  11. 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.

  12. 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.

  13. Are In-House and Outsourcing Innovation Strategies Correlated? Evidence from the European Agri-Food Sector

    NARCIS (Netherlands)

    Materia, Valentina C.; Pascucci, Stefano; Dries, Liesbeth

    2017-01-01

    We analyse European agri-food firms’ choices about innovation in-house or through outsourcing and provide empirical evidence about the correlation between these strategies. The relationship between the innovation strategy and firm-, industry- and innovation-specific characteristics is analysed

  14. 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.

  15. 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.

  16. 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

  17. Promoting evidence-based practice in pharmacies.

    Science.gov (United States)

    Toklu, Hale Zerrin

    2015-01-01

    Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive "medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community." Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs.

  18. Promoting evidence-based practice in pharmacies

    Directory of Open Access Journals (Sweden)

    Toklu HZ

    2015-09-01

    Full Text Available Hale Zerrin Toklu Department of Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive “medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.” Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs. Keywords: pharmacist, rational use of medicine, pharmacotherapy, pharmaceutical, outcome

  19. 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…

  20. Evidence-based pathology: umbilical cord coiling.

    Science.gov (United States)

    Khong, T Y

    2010-12-01

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

  1. 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.

  2. Radiographers' preconditions for evidence-based radiography

    International Nuclear Information System (INIS)

    Ahonen, Sanna-Mari; Liikanen, Eeva

    2010-01-01

    Evidence-based practice (EBP) is essential in today's health care, but its establishment requires several preconditions from individuals and organizations (e.g. knowledge, understanding, attitudes, abilities, self-confidence, support, and resources). Previous studies suggest that radiographers do generate and use evidence in their work, but evidence-based radiography (EBR) is not yet used routinely as established practice, especially in terms of research utilization. This paper aims to describe radiographers' preconditions for EBR, and their participation in research activities. Main focus is on research utilization. Using an electronic questionnaire developed for this study, a survey was conducted: data collected from Finnish radiographers and radiotherapists (N = 438) were analysed both statistically and qualitatively. The final response rate was 39%. The results suggest radiographers' preconditions for EBR to consist of knowledge of research, significance of research activities, research-orientated way of working, and support. In addition, adequate resourcing is essential. Reading scientific journals, participation in research activities, a higher degree of education, and senior post seem to be significant promoters of EBR and research utilization. The results support the notion that EBR, and especially research utilization, are not yet well-established in Finland, and radiographers' viewpoints concerning the role and significance of research evidence and research activities still seem to vary.

  3. Evidence-Based Advances in Reptile Medicine.

    Science.gov (United States)

    Mitchell, Mark A; Perry, Sean M

    2017-09-01

    Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 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...

  5. Evidence-based hypnotherapy for depression.

    Science.gov (United States)

    Alladin, Assen

    2010-04-01

    Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.

  6. THE IMPACT OF THE ECONOMIC ENVIRONMENT ON ENTREPRENEURSHIP: EVIDENCE FROM EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    ANGELA ROMAN

    2016-07-01

    Full Text Available The significant importance of entrepreneurship for the economic development, job creation and innovation have increased the concerns of researchers and decision makers at different levels for the understanding and investigation of the factors that could have an impact on the level of entrepreneurial activity. Our study aims to empirically investigate the impact of some main macroeconomic and business environment factors on the level of the entrepreneurial activity in 18 EU member states in the period from 2002 - 2014. Our research is based on the data provided by the Global Entrepreneurship Monitor (GEM and by the World Bank and uses panel data estimation techniques. We took into consideration, as dependent variable for an econometric model, three indicators that are used as proxy variables of the level of entrepreneurial activity, namely: Total Entrepreneurial Activity rate, Nascent entrepreneurship rate, and New business ownership rate. We investigated eleven macroeconomic and business environment indicators, as the explanatory variables of our models, that could influence the level of the entrepreneurial activity in European countries: GDP growth, GDP per capita, unemployment, inflation, domestic credit to private sector by banks, fear of failure, entrepreneurial intentions, perceived capabilities, cost of business start-up procedures and time required to start a business. The empirical results highlight the fact that a large part of the explicative variables are significantly affecting the entrepreneurial activity, in agreement with the results of other empirical studies. Thus, the total entrepreneurial activity is influenced by unemployment rate, total tax rate, entrepreneurial intentions, perceived capabilities, cost of business start-up procedures and domestic credit to private sector. The other two dependent variables register some differences, however, overall, our study reveals that the key determinants of the entrepreneurial activity

  7. Morphea: Evidence-based recommendations for treatment

    Directory of Open Access Journals (Sweden)

    Nicole M Fett

    2012-01-01

    Full Text Available Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.

  8. An Evidence-Based Framework for Evidence-Based Management in ...

    African Journals Online (AJOL)

    2018-05-01

    May 1, 2018 ... BACKGROUND: Evidence-based management (EBMgt) is a growing literature ... organization and management, especially in the last decade (1-6). One of these models is ..... Organizational Behavior. 2017;4(1):235-61.

  9. An Evidence-Based Framework for Evidence-Based Management in ...

    African Journals Online (AJOL)

    2018-05-01

    May 1, 2018 ... BACKGROUND: Evidence-based management (EBMgt) is a growing literature concept in ... principles are developing across disciplines such as education, criminology ..... Australian Health Review. 2012;36(3):284-90. 17.

  10. Pharmacists performing quality spirometry testing: an evidence based review.

    Science.gov (United States)

    Cawley, Michael J; Warning, William J

    2015-10-01

    The scope of pharmacist services for patients with pulmonary disease has primarily focused on drug related outcomes; however pharmacists have the ability to broaden the scope of clinical services by performing diagnostic testing including quality spirometry testing. Studies have demonstrated that pharmacists can perform quality spirometry testing based upon international guidelines. The primary aim of this review was to assess the published evidence of pharmacists performing quality spirometry testing based upon American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines. In order to accomplish this, the description of evidence and type of outcome from these services were reviewed. A literature search was conducted using five databases [PubMed (1946-January 2015), International Pharmaceutical Abstracts (1970 to January 2015), Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews] with search terms including pharmacy, spirometry, pulmonary function, asthma or COPD was conducted. Searches were limited to publications in English and reported in humans. In addition, Uniform Resource Locators and Google Scholar searches were implemented to include any additional supplemental information. Eight studies (six prospective multi-center trials, two retrospective single center studies) were included. Pharmacists in all studies received specialized training in performing spirometry testing. Of the eight studies meeting inclusion and exclusion criteria, 8 (100%) demonstrated acceptable repeatability of spirometry testing based upon standards set by the ATS/ERS guidelines. Acceptable repeatability of seven studies ranged from 70 to 99% consistent with published data. Available evidence suggests that quality spirometry testing can be performed by pharmacists. More prospective studies are needed to add to the current evidence of quality spirometry testing performed by

  11. The effects of ill health on entering and maintaining paid employment: Evidence in European countries

    NARCIS (Netherlands)

    M. Schuring (Merel); A. Burdorf (Alex); A.E. Kunst (Anton); J.P. Mackenbach (Johan)

    2007-01-01

    textabstractObjectives: To examine the effects of ill health on selection into paid employment in European countries. Methods: Five annual waves (1994-8) of the European Community Household Panel were used to select two populations: (1) 4446 subjects unemployed for at least 2 years, of which 1590

  12. The effects of ill health on entering and maintaining paid employment: evidence in European countries

    NARCIS (Netherlands)

    Schuring, Merel; Burdorf, Lex; Kunst, Anton; Mackenbach, Johan

    2007-01-01

    OBJECTIVES: To examine the effects of ill health on selection into paid employment in European countries. METHODS: Five annual waves (1994-8) of the European Community Household Panel were used to select two populations: (1) 4446 subjects unemployed for at least 2 years, of which 1590 (36%) subjects

  13. Towards evidence-based medicine in specific grass pollen immunotherapy.

    Science.gov (United States)

    Calderon, M; Mösges, R; Hellmich, M; Demoly, P

    2010-04-01

    When initiating grass pollen immunotherapy for seasonal allergic rhinoconjunctivitis, specialist physicians in many European countries must choose between modalities of differing pharmaceutical and regulatory status. We applied an evidence-based medicine (EBM) approach to commercially available subcutaneous and sublingual Gramineae grass pollen immunotherapies (SCIT and SLIT) by evaluating study design, populations, pollen seasons, treatment doses and durations, efficacy, quality of life, safety and compliance. After searching MEDLINE, Embase and the Cochrane Library up until January 2009, we identified 33 randomized, double-blind, placebo-controlled trials (including seven paediatric trials) with a total of 440 specific immunotherapy (SIT)-treated subjects in seven trials (0 paediatric) for SCIT with natural pollen extracts, 168 in three trials (0 paediatric) for SCIT with allergoids, 906 in 16 trials (five paediatric) for natural extract SLIT drops, 41 in two trials (one paediatric) for allergoid SLIT tablets and 1605 in five trials (two paediatric) for natural extract SLIT tablets. Trial design and quality varied significantly within and between SIT modalities. The multinational, rigorous trials of natural extract SLIT tablets correspond to a high level of evidence in adult and paediatric populations. The limited amount of published data on allergoids prevented us from judging the level of evidence for this modality.

  14. 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.

  15. An evidence-based review: distracted driver.

    Science.gov (United States)

    Llerena, Luis E; Aronow, Kathy V; Macleod, Jana; Bard, Michael; Salzman, Steven; Greene, Wendy; Haider, Adil; Schupper, Alex

    2015-01-01

    Cell phone use and texting are prevalent within society and have thus pervaded the driving population. This technology is a growing concern within the confines of distracted driving, as all diversions from attention to the road have been shown to increase the risk of crashes. Adolescent, inexperienced drivers, who have the greatest prevalence of texting while driving, are at a particularly higher risk of crashes because of distraction. Members of the Injury Control Violence Prevention Committee of the Eastern Association for the Surgery of Trauma performed a PubMed search of articles related to distracted driving and cell phone use as a distractor of driving between 2000 and 2013. A total of 19 articles were found to merit inclusion as evidence in the evidence-based review. These articles provided evidence regarding the relationship between distracted driving and crashes, cell phone use contributing to automobile accidents, and/or the relationship between driver experience and automobile accidents. (Adjust methods/results sections to the number of articles that correctly corresponds to the number of references, as well as the methodology for reference inclusion.) Based on the evidence reviewed, we can recommend the following. All drivers should minimize all in-vehicle distractions while on the road. All drivers should not text or use any touch messaging system (including the use of social media sites such as Facebook and Twitter) while driving. Younger, inexperienced drivers should especially not use cell phones, texting, or any touch messaging system while driving because they pose an increased risk for death and injury caused by distractions while driving.

  16. Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

    DEFF Research Database (Denmark)

    Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

    2017-01-01

    AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...

  17. Psychiatric mental health evidence-based practice.

    Science.gov (United States)

    Rice, Michael J

    2008-05-01

    This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

  18. Insulin resistance in Chileans of European and indigenous descent: evidence for an ethnicity x environment interaction.

    Directory of Open Access Journals (Sweden)

    Carlos A Celis-Morales

    Full Text Available BACKGROUND: Effects of urbanisation on diabetes risk appear to be greater in indigenous populations worldwide than in populations of European origin, but the reasons are unclear. This cross-sectional study aimed to determine whether the effects of environment (Rural vs. Urban, adiposity, fitness and lifestyle variables on insulin resistance differed between individuals of indigenous Mapuche origin compared to those of European origin in Chile. METHODOLOGY/PRINCIPAL FINDINGS: 123 Rural Mapuche, 124 Urban Mapuche, 91 Rural European and 134 Urban European Chilean adults had blood taken for determination of HOMA-estimated insulin resistance (HOMA(IR and underwent assessment of physical activity/sedentary behaviour (using accelerometry, cardiorespiratory fitness, dietary intake and body composition. General linear models were used to determine interactions with ethnicity for key variables. There was a significant "ethnicity x environment" interaction for HOMA(IR (Mean±SD; Rural Mapuche: 1.65±2.03, Urban Mapuche: 4.90±3.05, Rural European: 0.82±0.61, Urban European: 1.55±1.34, p((interaction = 0.0003, such that the effect of urbanisation on HOMA(IR was greater in Mapuches than Europeans. In addition, there were significant interactions (all p<0.004 with ethnicity for effects of adiposity, sedentary time and physical activity on HOMA(IR, with greater effects seen in Mapuches compared to Europeans, an observation that persisted after adjustment for potential confounders. CONCLUSIONS/SIGNIFICANCE: Urbanisation, adiposity, physical activity and sedentary behaviour influence insulin resistance to a greater extent in Chilean Mapuches than Chileans of European descent. These findings have implications for the design and implementation of lifestyle strategies to reduce metabolic risk in different ethnic groups, and for understanding of the mechanisms underpinning human insulin resistance.

  19. Insulin resistance in Chileans of European and indigenous descent: evidence for an ethnicity x environment interaction.

    Science.gov (United States)

    Celis-Morales, Carlos A; Perez-Bravo, Francisco; Ibañes, Luis; Sanzana, Ruth; Hormazabal, Edison; Ulloa, Natalia; Calvo, Carlos; Bailey, Mark E S; Gill, Jason M R

    2011-01-01

    Effects of urbanisation on diabetes risk appear to be greater in indigenous populations worldwide than in populations of European origin, but the reasons are unclear. This cross-sectional study aimed to determine whether the effects of environment (Rural vs. Urban), adiposity, fitness and lifestyle variables on insulin resistance differed between individuals of indigenous Mapuche origin compared to those of European origin in Chile. 123 Rural Mapuche, 124 Urban Mapuche, 91 Rural European and 134 Urban European Chilean adults had blood taken for determination of HOMA-estimated insulin resistance (HOMA(IR)) and underwent assessment of physical activity/sedentary behaviour (using accelerometry), cardiorespiratory fitness, dietary intake and body composition. General linear models were used to determine interactions with ethnicity for key variables. There was a significant "ethnicity x environment" interaction for HOMA(IR) (Mean±SD; Rural Mapuche: 1.65±2.03, Urban Mapuche: 4.90±3.05, Rural European: 0.82±0.61, Urban European: 1.55±1.34, p((interaction)) = 0.0003), such that the effect of urbanisation on HOMA(IR) was greater in Mapuches than Europeans. In addition, there were significant interactions (all pMapuches compared to Europeans, an observation that persisted after adjustment for potential confounders. Urbanisation, adiposity, physical activity and sedentary behaviour influence insulin resistance to a greater extent in Chilean Mapuches than Chileans of European descent. These findings have implications for the design and implementation of lifestyle strategies to reduce metabolic risk in different ethnic groups, and for understanding of the mechanisms underpinning human insulin resistance.

  20. Evidence-Based Advances in Rabbit Medicine.

    Science.gov (United States)

    Summa, Noémie M; Brandão, João

    2017-09-01

    Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Evidence-Based Advances in Avian Medicine.

    Science.gov (United States)

    Summa, Noémie M; Guzman, David Sanchez-Migallon

    2017-09-01

    This article presents relevant advances in avian medicine and surgery over the past 5 years. New information has been published to improve clinical diagnosis in avian diseases. This article also describes new pharmacokinetic studies. Advances in the understanding and treatment of common avian disorders are presented in this article, as well. Although important progress has been made over the past years, there is still much research that needs to be done regarding the etiology, pathophysiology, diagnosis, and treatment of avian diseases and evidence-based information is still sparse in the literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Leading change: evidence-based transition.

    Science.gov (United States)

    Lewis, Brennan; Allen, Stephanie

    2015-01-01

    The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders

  3. Evidence-based prevention of childhood malnutrition.

    Science.gov (United States)

    Imdad, Aamer; Sadiq, Kamran; Bhutta, Zulfiqar A

    2011-05-01

    Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field. Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease. There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions.

  4. Evidence-Based Management of Anticoagulant Therapy

    Science.gov (United States)

    Schulman, Sam; Witt, Daniel M.; Vandvik, Per Olav; Fish, Jason; Kovacs, Michael J.; Svensson, Peter J.; Veenstra, David L.; Crowther, Mark; Guyatt, Gordon H.

    2012-01-01

    Background: High-quality anticoagulation management is required to keep these narrow therapeutic index medications as effective and safe as possible. This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: Most practical clinical questions regarding the management of anticoagulation, both oral and parenteral, have not been adequately addressed by randomized trials. We found sufficient evidence for summaries of recommendations for 23 questions, of which only two are strong rather than weak recommendations. Strong recommendations include targeting an international normalized ratio of 2.0 to 3.0 for patients on vitamin K antagonist therapy (Grade 1B) and not routinely using pharmacogenetic testing for guiding doses of vitamin K antagonist (Grade 1B). Weak recommendations deal with such issues as loading doses, initiation overlap, monitoring frequency, vitamin K supplementation, patient self-management, weight and renal function adjustment of doses, dosing decision support, drug interactions to avoid, and prevention and management of bleeding complications. We also address anticoagulation management services and intensive patient education. Conclusions: We offer guidance for many common anticoagulation-related management problems. Most anticoagulation management questions have not been adequately studied. PMID:22315259

  5. Evidence-Based Laboratory Medicine: Is It Working in Practice?

    OpenAIRE

    Price, Christopher P

    2012-01-01

    The principles of Evidence-Based Medicine have been established for about two decades, with the need for evidence-based clinical practice now being accepted in most health systems around the world. These principles can be employed in laboratory medicine. The key steps in evidence-based practice, namely (i) formulating the question; (ii) searching for evidence; (iii) appraising evidence; (iv) applying evidence; and (v) assessing the experience are all accepted but, as yet, translation into dai...

  6. Do inattention and hyperactivity symptoms equal scholastic impairment? evidence from three European cohorts

    Directory of Open Access Journals (Sweden)

    Henriksen Tine

    2007-11-01

    Full Text Available Abstract Background Attention Deficit/Hyperactivity Disorder (ADHD affects many children, adolescents, and adults and is associated with a number of impairments. Poor academic performance is related to ADHD in clinical samples. However, it is unclear to what extent core ADHD symptoms and scholastic impairment are related in non-referred school-aged children. Methods Data come from three population-based cohorts from Sweden, Denmark, and Finland, which are part of the Nordic Network on ADHD. The combined sample size was 13,087 children who were studied at ages 7–8 or 10–12 years. Teachers rated children on inattention and hyperactivity symptoms and reported children's scholastic performance on basic skills. Results There was a significant association in all cohorts between core ADHD symptoms and scholastic impairment in reading, writing, and mathematics. Particularly, inattention was related to a two to tenfold increase in scholastic impairment. Prevalence of hyperactivity symptoms was similar across the three cohorts, but inattention was lowest among children from the Finnish cohort, after stratification on living conditions. Conclusion These results extend previous reports of scholastic impairment among children with clinically diagnosed ADHD to non-referred population samples from three European countries. Surveillance policies should be implemented in school systems to catch children in need of behavioral or scholastic support early.

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

    NARCIS (Netherlands)

    van Enst, W.A.

    2014-01-01

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

  8. Information provision in medical libraries: An evidence based ...

    African Journals Online (AJOL)

    The paper examined information provision in special libraries such as medical libraries. It provides an overview of evidence based practice as a concept for information provision by librarians. It specifically proffers meaning to the term evidence as used in evidence based practice and to evidence based medicine from where ...

  9. Ethical reflections on Evidence Based Medicine

    Directory of Open Access Journals (Sweden)

    S. Corrao

    2013-05-01

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

  10. The ethical approach to evidence-based medicine

    African Journals Online (AJOL)

    research findings as the basis for clinical decisions”.2 The practice ... paper will explore the role of evidence-based medicine in ethical practice of health care professionals. ... based medicine is used for “evidence-based purchasing”, it will.

  11. Facility Service Market an European Overview based on EU Statistics

    Directory of Open Access Journals (Sweden)

    Alexander Redlein

    2017-01-01

    Full Text Available The macro-economic impact of facility management and facility services in special was not scientifically analysed by now. Some studies analysed single countries but were mainly lacking solid data. Especially a Pan European comparison is lacking. This paper presents the results of an in depth analysis of the Eurostat figures. It compares the facility service industry with other industries in particular the construction industry. It also compares the largest European economies (Germany, France and Italy. The study concentrates on the outsourced services only, as these are listed in the European Statistics. The results show big differences between the European countries. It also highlights that the facility service industry is the third largest regarding number of employees and the fourth largest regarding value added.

  12. Using scientific evidence to inform public policy on the long distance transportation of animals: role of the European Food Safety Authority.

    Science.gov (United States)

    Ribò, Oriol; Candiani, Denise; Aiassa, Elisa; Correia, Sandra; Afonso, Ana; De Massis, Fabrizio; Serratosa, Jordi

    2008-01-01

    The authors review the work of the previous Scientific Committee on Animal Health and Animal Welfare and the current European Food Safety Authority (EFSA) in providing scientific advice on the welfare aspects of animal transport and the impact of this advice on the European Union (EU) regulatory framework. Through its Protocol on the Protection and Welfare of Animals, the Treaty of Amsterdam obliges European institutions to pay full regard to the welfare requirements of animals when formulating and implementing EU legislation. Regulation 1/2005 states that EU legislation should be amended to take into account new scientific evidence. Provisions for poultry, cats and dogs take into account the recommendations included in EFSA's Scientific Opinion which considers different species (poultry, deer, rabbits, dogs and cats, fish and exotic animals). Examples of the effect of the scientifically based conclusions and recommendations from the Scientific Opinion on the measures in Regulation 1/2005 are summarised and show the impact of scientific evidence on EU legislation.

  13. Using scientific evidence to inform public policy on the long distance transportation of animals: role of the European Food Safety Authority

    Directory of Open Access Journals (Sweden)

    Oriol Ribò

    2008-03-01

    Full Text Available The authors review the work of the previous Scientific Committee on Animal Health and Animal Welfare and the current European Food Safety Authority (EFSA in providing scientific advice on the welfare aspects of animal transport and the impact of this advice on the European Union (EU regulatory framework. Through its Protocol on the Protection and Welfare of Animals, the Treaty of Amsterdam obliges European institutions to pay full regard to the welfare requirements of animals when formulating and implementing EU legislation. Regulation 1/2005 states that EU legislation should be amended to take into account new scientific evidence. Provisions for poultry, cats and dogs take into account the recommendations included in EFSA's Scientific Opinion which considers different species (poultry, deer, rabbits, dogs and cats, fish and exotic animals. Examples of the effect of the scientifically based conclusions and recommendations from the Scientific Opinion on the measures in Regulation 1/2005 are summarised and show the impact of scientific evidence on EU legislation.

  14. 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

  15. The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

    OpenAIRE

    Masvidal, Daniel; Lavie, Carl J.

    2012-01-01

    Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care.

  16. The evidence-based practice ideologies.

    Science.gov (United States)

    Mantzoukas, Stefanos

    2007-10-01

    This paper puts forward the argument that there are various, competing, and antithetical evidence-based practice (EBP) definitions and acknowledges that the different EBP definitions are based on different epistemological perspectives. However, this is not enough to understand the way in which nurse professionals choose between the various EBP formations and consequently facilitate them in choosing the most appropriate for their needs. Therefore, the current article goes beyond and behind the various EBP epistemologies to identify how individuals choose an epistemology, which consequently will assist our understanding as to how an individual chooses a specific EBP formation. Individuals choose an epistemology on the mere belief that the specific epistemology offers the ideals or ideas of best explaining or interpreting daily reality. These ideals or ideas are termed by science, history, and politics as ideology. Similarly, individual practitioners choose or should choose between the different EBP formations based on their own personal ideology. Consequently, this article proceeds to analyse the various ideologies behind different EBP definitions as to conclude that there are two broad ideologies that inform the various EBP formations, namely the ideology of truth and the ideology of individual emancipation. These two ideologies are analysed and their connections to the various EBP formations are depicted. Eventually, the article concludes that the in-depth, critical, and intentional analysis by individual nurses of their own ideology will allow them to choose the EBP formation that is most appropriate and fitting for them, and their specific situation. Hence, the conscious analysis of individual ideology becomes the criterion for choosing between competing EBP formations and allows for best evidence to be implemented in practice. Therefore, the best way to teach EBP courses is by facilitating students to analyse their own ideology.

  17. Evidence-Based Practice in Liposuction.

    Science.gov (United States)

    Collins, Patrick S; Moyer, Kurtis E

    2018-01-24

    The goal of this study is to examine the existing peer reviewed literature comparing modern adjunctive techniques in liposuction including laser-assisted liposuction (LAL) and ultrasound-assisted liposuction (UAL) to standard suction-assisted liposuction (SAL). We intend to interpret these findings into a literature-based clinical application to influence practice patterns. A literature review was conducted using a keyword search in PubMed. Keyword search items included liposuction, lipoplasty, suction assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction, tumescent, liposuction comparison, liposuction review, and combinations therein. Exclusion criteria included articles with a primary focus on histologic effects of energy devices, primary animal models, primary opinion papers with no reference to available data, and industry-sponsored publications. Inclusion criteria included articles with direct comparison of liposuction modalities, randomized or blinded studies, and studies with objective outcomes. Twenty-five articles that met the inclusion criteria comparing SAL to UAL or LAL out of 9972 articles identified were obtained. The selected literature was assigned into 3 categories: evidence demonstrating an advantage of 1 modality (SAL, UAL, or LAL) over another, evidence that showed no benefit of 1 modality over another, and evidence that demonstrated risks of complications of 1 modality over another. The benefits of UAL and LAL over SAL include the following: (1) UAL over SAL in the treatment of gynecomastia, (2) LAL and UAL over SAL with decreased hemoglobin/hematocrit in high-volume lipoaspirates, and (3) LAL over SAL with skin tightening in select areas specifically the submental area. Otherwise, the literature demonstrates equivocal results among the described techniques with no clear benefit to set one apart from the other. There appears to be no demonstrable added benefit to the addition of either UAL or LAL that would urge a

  18. An evidence-based recommendation on bed head elevation for mechanically ventilated patients

    OpenAIRE

    Ni?l-Weise, Barbara S; Gastmeier, Petra; Kola, Axel; Vonberg, Ralf P; Wille, Jan C; van den Broek, Peterhans J

    2011-01-01

    Introduction A semi-upright position in ventilated patients is recommended to prevent ventilator-associated pneumonia (VAP) and is one of the components in the Ventilator Bundle of the Institute for Health Care Improvement. This recommendation, however, is not an evidence-based one. Methods A systematic review on the benefits and disadvantages of semi-upright position in ventilated patients was done according to PRISMA guidelines. Then a European expert panel developed a recommendation based ...

  19. Evidence-based medicine: Mandible fractures.

    Science.gov (United States)

    Morrow, Brad T; Samson, Thomas D; Schubert, Warren; Mackay, Donald R

    2014-12-01

    After studying this article, the participant should be able to: 1. Describe the anatomy and subunits of the mandible. 2. Review the cause and epidemiology of mandible fractures. 3. Discuss the preoperative evaluation and diagnostic imaging. 4. Understand the principles and techniques of mandible fracture reduction and fixation. The management of mandibular fractures has undergone significant improvement because of advancements in plating technology, imaging, and instrumentation. As the techniques in management continue to evolve, it is imperative for the practicing physician to remain up-to-date with the growing body of scientific literature. The objective of this Maintenance of Certification article is to present a review of the literature so that the physician may make treatment recommendation based on the best evidence available. Pediatric fractures have been excluded from this article.

  20. Colon Trauma: Evidence-Based Practices.

    Science.gov (United States)

    Yamamoto, Ryo; Logue, Alicia J; Muir, Mark T

    2018-01-01

    Colon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.

  1. 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.

  2. 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.

  3. Evidence Based Cataloguing: Moving Beyond the Rules

    Directory of Open Access Journals (Sweden)

    Kathy Carter

    2010-12-01

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

  4. 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

  5. Gender and the Intensification of Work: Evidence from the European Working Conditions Surveys

    OpenAIRE

    Brendan Burchell; Colette Fagan

    2004-01-01

    This paper uses the European Working Conditions Surveys to examine the intensity of work for male and female employees. The first section gives an overview of the usefulness of the survey for examining European Union (EU) working conditions and shows how women's intensity of work has been increasing faster than that of men, so that by the year 2000 there was little gender difference in the speed of work. Section two demonstrates that the intensity of work has a negative effect on health and w...

  6. Increasing power and taking a lead - What are practitioners really doing? Empirical evidence from European communications managers

    NARCIS (Netherlands)

    Moreno, Á.; Verhoeven, P.; Tench, R.; Zerfass, A.

    2014-01-01

    The aims of the paper and presented research are to monitor trends in communication management and to evaluate specific topics that include decision-making style, leadership style, role enactment and the power of communication departments in Europe. This paper is based on data from the European

  7. European Strategy for Accelerator-Based Neutrino Physics

    CERN Document Server

    Bertolucci, Sergio; Cervera, Anselmo; Donini, Andrea; Dracos, Marcos; Duchesneau, Dominique; Dufour, Fanny; Edgecock, Rob; Efthymiopoulos, Ilias; Gschwendtner, Edda; Kudenko, Yury; Long, Ken; Maalampi, Jukka; Mezzetto, Mauro; Pascoli, Silvia; Palladino, Vittorio; Rondio, Ewa; Rubbia, Andre; Rubbia, Carlo; Stahl, Achim; Stanco, Luca; Thomas, Jenny; Wark, David; Wildner, Elena; Zito, Marco

    2012-01-01

    Massive neutrinos reveal physics beyond the Standard Model, which could have deep consequences for our understanding of the Universe. Their study should therefore receive the highest level of priority in the European Strategy. The discovery and study of leptonic CP violation and precision studies of the transitions between neutrino flavours require high intensity, high precision, long baseline accelerator neutrino experiments. The community of European neutrino physicists involved in oscillation experiments is strong enough to support a major neutrino long baseline project in Europe, and has an ambitious, competitive and coherent vision to propose. Following the 2006 European Strategy for Particle Physics (ESPP) recommendations, two complementary design studies have been carried out: LAGUNA/LBNO, focused on deep underground detector sites, and EUROnu, focused on high intensity neutrino facilities. LAGUNA LBNO recommends, as first step, a conventional neutrino beam CN2PY from a CERN SPS North Area Neutrino Fac...

  8. The European Nuclear Science network touches base at CERN

    CERN Multimedia

    Antonella Del Rosso

    2012-01-01

    ENSAR (European Nuclear Science and Applications Research) is an EU-supported project, which aims at fostering cooperation within the European low-energy nuclear physics community through the active sharing of expertise and best practices. The project also includes a transnational access programme to allow a large community of users to access the participating facilities, which include CERN’s ISOLDE. In the last week of April, CERN hosted the General Assembly and Programme Coordination Committee meetings, about 18 months after the project’s kick-off.   Participants in the ENSAR project. ENSAR involves 30 partner institutes, which include the seven large nuclear physics facilities in Europe. A large part of the European nuclear physics community is represented in ENSAR, in particular scientists who are performing research related to nuclear structure, nuclear astrophysics and applications of nuclear science. In 2010, the project was awarded 8 million euros from the Europe...

  9. Contagion across and integration of Central and Eastern European stock markets: evidence from intraday data

    Czech Academy of Sciences Publication Activity Database

    Égert, B.; Kočenda, Evžen

    -, č. 798 (2005), s. 1-30 Institutional research plan: CEZ:MSM0021620846 Keywords : contagion and spillover effects * market integration * European emerging market s Subject RIV: AH - Economics http://www.bus.umich.edu/KresgeLibrary/Collections/WorkingPapers/wdinum.htm

  10. The Performance of the European Market for Corporate Control : Evidence from the 5th Takeover Wave

    NARCIS (Netherlands)

    Martynova, M.; Renneboog, L.D.R.

    2006-01-01

    For the 5th takeover wave, European M&As were expected to create significant takeover value: the announcement reactions were strongly positive for target shareholders (more than 35%) and the bidding shareholders also expected to gain a small though significant increase in market value of 0.5%.While,

  11. The Performance of the European Market for Corporate Control : Evidence from the 5th Takeover Wave

    NARCIS (Netherlands)

    Martynova, M.; Renneboog, L.D.R.

    2006-01-01

    Abstract: For the 5th takeover wave, European M&As were expected to create significant takeover value: the announcement reactions were strongly positive for target shareholders (more than 8%) and the bidding shareholders also expected to gain a small though significant increase in market value of

  12. The Link between Unemployment and Returns to Education: Evidence from 14 European Countries.

    Science.gov (United States)

    Weber, Bernhard A.

    2002-01-01

    Estimates for 14 European countries used three models introducing unemployment, youth unemployment, and unemployment benefits respectively. Differences in unemployment probabilities at different educational levels and youth unemployment both appear to be important for a better understanding of the incentive structure behind educational decisions.…

  13. Profitability of Western European banking systems: panel evidence on structural and cyclical determinants

    OpenAIRE

    Beckmann, Rainer

    2007-01-01

    This paper analyses structural and cyclical determinants of banking profitability in 16 Western European countries. We find that financial structure matters, particularly through the beneficial effect of the capital market orientation in the respective national financial system. Furthermore, higher diversification regarding banks' income sources shows a positive effect. The industry concentration of national banking systems, though, does not significantly affect aggregate profitability. Busin...

  14. Improving the explanatory power of bargaining models - New evidence from European Union studies

    NARCIS (Netherlands)

    Selck, TJ

    Focusing on recent studies of European Union legislative decision-making, this research note evaluates the current literature that attempts to improve the explanatory power of bargaining models by integrating game-theoretic spatial models with micro-level data gained from expert interviews or from

  15. Teaching evidence-based medicine more effectively.

    Science.gov (United States)

    Hatmi, Zinat Nadia; Tahvildari, Sousan; Dabiran, Soheila; Soheili, Suraya; Sabouri Kashani, Ahmad; Raznahan, Maedeh

    2010-01-01

    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. The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84). Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.

  16. Teaching Evidence-Based Medicine More Effectively

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2010-09-01

    Full Text Available "nEvidence-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<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84. Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conclusions: Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.

  17. 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

  18. Residents' Dissatisfaction and All-Cause Mortality. Evidence from 74 European Cities

    Directory of Open Access Journals (Sweden)

    Ana I. Ribeiro

    2018-01-01

    Full Text Available Background: About 2/3 of the Europeans reside in cities. Thus, we must expand our knowledge on how city characteristics affect health and well-being. Perceptions about cities' resources and functioning might be related with health, as they capture subjective experiences of the residents. We characterized the health status of 74 European cities, using all-cause mortality as indicator, and investigated the association of mortality with residents' dissatisfaction with key domains of urban living.Methods: We considered 74 European cities from 29 countries. Aggregated data on residents' dissatisfaction was obtained from the Flash Eurobarometer, Quality of life in European cities (2004–2015. For each city a global dissatisfaction score and a dissatisfaction score by domain (environment, social, economic, healthcare, and infrastructures/services were calculated. Data on mortality and population was obtained from the Eurostat. Standardized Mortality Ratios, SMR, and 95% Confidence Intervals (95% CI were calculated. The association between dissatisfaction scores and SMR was estimated using Generalized Linear Models.Results: SMR varied markedly (range: 73.2–146.5, being highest in Eastern Europe and lowest in the South and Western European cities. Residents' dissatisfaction levels also varied greatly. We found a significant association between city SMR and residents' dissatisfaction with healthcare (β = 0.334; IC 95% 0.030–0.639 and social environment (β = 0.239; IC 95% 0.015–0.464. No significant association was found with the dissatisfaction scores related with the physical and economic environment and the infrastructures/services.Conclusions: We found a significant association between city levels of mortality and residents' dissatisfaction with certain urban features, suggesting subjective assessments can be also used to comprehend urban health.

  19. European Marketing Authorizations Granted Based on a Single Pivotal Clinical Trial: The Rule or the Exception?

    Science.gov (United States)

    Morant, Anne Vinther; Vestergaard, Henrik Tang

    2018-07-01

    A minimum of two positive, adequate, and well-controlled clinical trials has historically been the gold standard for providing substantial evidence to support regulatory approval of a new medicine. Nevertheless, the present analysis of European Marketing Authorizations granted between 2012 and 2016 showed that 45% of new active substances were approved based on a single pivotal clinical trial. For therapeutic areas such as oncology and cardiovascular diseases, approvals based on a single pivotal trial are the rule rather than the exception, whereas new medicines within the nervous system area were generally supported by two or more pivotal trials. While overall similar trends have been observed in the US, the recent US Food and Drug Administration approvals of nervous system medicines based on a single pivotal trial suggest that a case-by-case scientific evaluation of the totality of evidence is increasingly applied to facilitate faster access of new medicines to patients suffering from serious diseases. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  20. Evidence-based diagnostics: adult septic arthritis.

    Science.gov (United States)

    Carpenter, Christopher R; Schuur, Jeremiah D; Everett, Worth W; Pines, Jesse M

    2011-08-01

    Acutely swollen or painful joints are common complaints in the emergency department (ED). Septic arthritis in adults is a challenging diagnosis, but prompt differentiation of a bacterial etiology is crucial to minimize morbidity and mortality. The objective was to perform a systematic review describing the diagnostic characteristics of history, physical examination, and bedside laboratory tests for nongonococcal septic arthritis. A secondary objective was to quantify test and treatment thresholds using derived estimates of sensitivity and specificity, as well as best-evidence diagnostic and treatment risks and anticipated benefits from appropriate therapy. Two electronic search engines (PUBMED and EMBASE) were used in conjunction with a selected bibliography and scientific abstract hand search. Inclusion criteria included adult trials of patients presenting with monoarticular complaints if they reported sufficient detail to reconstruct partial or complete 2 × 2 contingency tables for experimental diagnostic test characteristics using an acceptable criterion standard. Evidence was rated by two investigators using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS). When more than one similarly designed trial existed for a diagnostic test, meta-analysis was conducted using a random effects model. Interval likelihood ratios (LRs) were computed when possible. To illustrate one method to quantify theoretical points in the probability of disease whereby clinicians might cease testing altogether and either withhold treatment (test threshold) or initiate definitive therapy in lieu of further diagnostics (treatment threshold), an interactive spreadsheet was designed and sample calculations were provided based on research estimates of diagnostic accuracy, diagnostic risk, and therapeutic risk/benefits. The prevalence of nongonococcal septic arthritis in ED patients with a single acutely painful joint is approximately 27% (95% confidence interval [CI] = 17

  1. Sovereign debt and corporate capital structure: The evidence from selected European countries during the Gglobal Financial and Economic Crisis

    Directory of Open Access Journals (Sweden)

    Natalia Mokhova

    2017-05-01

    Full Text Available The recent Global financial crisis and the following European debt crisis show the significance of country financial stability and its impact on the private sector. Moreover, the sovereign debt as an essential element of government macroeconomic policy influences the financial performances of the companies and their future development and growth. The capital structure and financing decisions represent one of the most significant parts of company’s financial policy and its key to financial strength. There are a lot of external factors influencing the capital structure; however, due to the European debt crisis the aim of this study is to indicate the influence of sovereign debt on capital structure of the private held companies in different European countries. This study examines the evidence from European developed countries and emerging markets for the period 2005–2012, in order to compare the level of its impact on the capital structure according to the countries’ specifics. We find that after Global Financial Crisis the sovereign debt has tendency to increase in all investigated countries. Greece and Italy have the highest level of debt and it exceeds their Gross Domestic Product (GDP. In addition to that, the Czech Republic has the lowest level of sovereign debt to GDP, but at the same time the corporate capital structure exceeds 100%. The sovereign debt levels are strongly and statistically significantly correlated with each other, however, Hungarian debt has weaker relation with other countries. The findings also show the integration and interdependence of European countries. Moreover, Hungarian, Czech and German private sectors are the most depended on the level of sovereign debt.

  2. Development of a water quality index based on a European ...

    African Journals Online (AJOL)

    This index has advantages over pre-existing indices by reflecting the appropriateness of water for specific use, e.g. drinking water supply rather than general supply, and has been developed by studying the supranational standard, i.e. the European Community Standard. Three classification schemes for water quality are ...

  3. E-Learning and Evidence Based Practice in Schools

    Science.gov (United States)

    Quong, Terrence

    2016-01-01

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

  4. Effectiveness of Evidence-Based Asthma Interventions.

    Science.gov (United States)

    Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman

    2017-06-01

    Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.

  5. European macroeconomic imbalances at a sectorial level: Evidence from German and Spanish food industry

    Directory of Open Access Journals (Sweden)

    Juan Aznar

    2018-02-01

    Originality/value: The last decade has accentuated the macroeconomic differences, in terms of long term interest rates or levels of unemployment between the core of Europe, Germany, and the periphery, including countries like Spain. This research is one the first ones in analyzing how these differences are affecting financial performance and structural differences in a particular industry, that is one of the most important exporters of the European Union.

  6. Determinants of cash holdings in the accommodation industry: evidence from Southerm European Countries

    OpenAIRE

    Morais, Flávio

    2013-01-01

    This study analyzes the determinants of cash holdings for the accommodation industry in Southern European countries (Spain, Greece, Italy and Portugal) using a sample of 5964 firms during the period 2003-2011. A fixed-effects panel data model revealed that larger companies, higher leveraged, where most debt is short-term and that maintain better relationships with financial institutions exhibit lower cash to assets ratios. Liquid assets substitutes, capital expenditures and asset tangibility ...

  7. Economic development in the European super-periphery: Evidence from the Western Balkans

    OpenAIRE

    Bartlett Will

    2009-01-01

    This paper argues that the conflicts that afflicted the Western Balkan region in the 1990s pushed the countries into the European 'super-periphery', characterized by deindustrialization and high unemployment, ethnic and regional fragmentation, political turmoil, and instability. Integration into international trade has been disrupted, leading to chronic balance of payments deficits. Low inflows of international capital, due to high country risk, have hindered technological catch-up and weaken...

  8. Negotiated forms of worker involvement in the European Company (SE): First empirical evidence and conclusions

    OpenAIRE

    Keller, Berndt; Werner, Frank

    2008-01-01

    This article analyses the negotiations on worker involvement in the first almost four years of the European Company SE and their outcomes. First, some basic institutional aspects of the SE itself and its current empirical situation are described and explained. Then, the focus is on questions of employee involvement in this new legal form. Again some main institutional provisions on employee involvement are assessed, before a detailed empirical analysis on specific issues is presented. A final...

  9. The effects of ill health on entering and maintaining paid employment: evidence in European countries.

    Science.gov (United States)

    Schuring, Merel; Burdorf, Lex; Kunst, Anton; Mackenbach, Johan

    2007-07-01

    To examine the effects of ill health on selection into paid employment in European countries. Five annual waves (1994-8) of the European Community Household Panel were used to select two populations: (1) 4446 subjects unemployed for at least 2 years, of which 1590 (36%) subjects found employment in the next year, and (2) 57 436 subjects employed for at least 2 years, of which 6191 (11%) subjects left the workforce in the next year because of unemployment, (early) retirement or having to take care of household. The influence of a perceived poor health and a chronic health problem on employment transitions was studied using logistic regression analysis. An interaction between health and sex was observed, with women in poor health (odds ratio (OR) 0.4), men in poor health (OR 0.6) and women (OR 0.6) having less chance to enter paid employment than men in good health. Subjects with a poor health and low/intermediate education had the highest risks of unemployment or (early) retirement. Taking care of the household was only influenced by health among unmarried women. In most European countries, a poor health or a chronic health problem predicted staying or becoming unemployed and the effects of health were stronger with a lower national unemployment level. In most European countries, socioeconomic inequalities in ill health were an important determinant for entering and maintaining paid employment. In public health measures for health equity, it is of paramount importance to include people with poor health in the labour market.

  10. Mandatory Fair Value Accounting and Information Asymmetry: Evidence from the European Real Estate Industry

    OpenAIRE

    Karl A. Muller, III; Edward J. Riedl; Thorsten Sellhorn

    2011-01-01

    We examine the effects of mandating the provision of fair value information for long-lived tangible assets on firms' information asymmetry. Specifically, we investigate whether European real estate firms' compulsory adoption of International Accounting Standard 40 (IAS 40; Investment Property), which mandated the provision of investment property fair values in 2005, resulted in reduced information asymmetry across market participants. Using as a control group firms that voluntarily provided t...

  11. Bank regulatory Capital Buffer and Liquidity: Evidence from US and European Publicly Traded Banks

    OpenAIRE

    Distinguin , Isabelle; Roulet , Caroline; Tarazi , Amine

    2012-01-01

    The theory of financial intermediation highlights various channels through which capital and liquidity are interrelated. Using a simultaneous equations framework, we investigate the relationship between bank regulatory capital buffer and liquidity for European and U.S. publicly traded commercial banks. Previous research studying the determinants of bank capital buffer has neglected the role of liquidity. On the whole, we find that banks do not strengthen their regulatory capital buffer when t...

  12. Changes in Inflation Dynamics under Inflation Targeting? Evidence from Central European Countries

    Czech Academy of Sciences Publication Activity Database

    Baxa, Jaromír; Plašil, M.; Vašíček, B.

    2015-01-01

    Roč. 44, č. 1 (2015), s. 116-130 ISSN 0264-9993 R&D Projects: GA ČR(CZ) GBP402/12/G097 Institutional support: RVO:67985556 Keywords : Bayesian model averaging * Central European countries * Inflation Dynamics Subject RIV: AH - Economics Impact factor: 0.997, year: 2015 http://library.utia.cas.cz/separaty/2015/E/baxa-0449816.pdf

  13. The Impact of Bribery on Firm Performance: Evidence from Central and Eastern European Countries

    OpenAIRE

    Anna Kochanova

    2012-01-01

    I examine the relation between bureaucratic corruption ('to get things done') and firm performance in Central and Eastern European countries. While previous re- search relies on data from the BEEPS survey, which suffers from excessive non- reporting of corporate performance, I combine the information on bribery practices from the BEEPS with reliable firm performance data from the Amadeus database. The estimates, identified from within-firm variation, suggest that bureaucratic cor- ruption neg...

  14. Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

    Science.gov (United States)

    Gambrill, E

    1999-03-01

    Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

  15. Evidence of ancient DNA reveals the first European lineage in Iron Age Central China.

    Science.gov (United States)

    Xie, C Z; Li, C X; Cui, Y Q; Zhang, Q C; Fu, Y Q; Zhu, H; Zhou, H

    2007-07-07

    Various studies on ancient DNA have attempted to reconstruct population movement in Asia, with much interest focused on determining the arrival of European lineages in ancient East Asia. Here, we discuss our analysis of the mitochondrial DNA of human remains excavated from the Yu Hong tomb in Taiyuan, China, dated 1400 years ago. The burial style of this tomb is characteristic of Central Asia at that time. Our analysis shows that Yu Hong belonged to the haplogroup U5, one of the oldest western Eurasian-specific haplogroups, while his wife can be classified as haplogroup G, the type prevalent in East Asia. Our findings show that this man with European lineage arrived in Taiyuan approximately 1400 years ago, and most probably married a local woman. Haplogroup U5 was the first west Eurasian-specific lineage to be found in the central part of ancient China, and Taiyuan may be the easternmost location of the discovered remains of European lineage in ancient China.

  16. From scientifically based research to evidence based learning

    Directory of Open Access Journals (Sweden)

    Rosa Cera

    2016-02-01

    Full Text Available This essay is a reflection on the peculiarities of the scientifically based research and on the distinctive elements of the EBL (evidence based learning, methodology used in the study on the “Relationship between Metacognition, Self-efficacy and Self-regulation in Learning”. The EBL method, based on the standardization of data, explains how the students’ learning experience can be considered as a set of “data” and can be used to explain how and when the research results can be considered generalizable and transferable to other learning situations. The reflections present in this study have also allowed us to illustrate the impact that its results have had on the micro and macro level of reality. They helped to fill in the gaps concerning the learning/teaching processes, contributed to the enrichment of the scientific literature on this subject and allowed to establish standards through rigorous techniques such as systematic reviews and meta-analysis.

  17. Evidence-based surgery: Dissemination, communication, decision aids

    NARCIS (Netherlands)

    Knops, A.M.

    2013-01-01

    Surgeons are expected to make treatment decisions that are based on the best available evidence. Moreover, they are called to recognise that important decisions should also be shared with patients. While dissemination of evidence-based surgery and communication of evidence to patients have been

  18. Evidence based policy-making: A review

    CSIR Research Space (South Africa)

    Strydom, FW

    2010-04-01

    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...

  19. Internationalization and Firm Performance in Agribusiness: Empirical Evidence from European Cooperatives

    Directory of Open Access Journals (Sweden)

    Matthias Heyder

    2011-10-01

    Full Text Available  The ongoing internationalization of markets has become a major issue also for companies of the agribusiness. Nevertheless, neither the degree of internationalization of agribusiness firms nor the internationalization-performance relationship in the agribusiness sector have been analyzed thoroughly so far. To help fill this void, we use panel data compiled from annual reports and balance sheets to investigate the internationalization as well as the internationalization-performance relationship of 21 leading European cooperatives in the dairy and meat sectors. Our results indicate that internationalization has a significant positive impact on firm performance.

  20. CORRUPTION AND FOREIGN DIRECT INVESTMENT. EVIDENCE FROM CENTRAL AND EASTERN EUROPEAN STATES

    Directory of Open Access Journals (Sweden)

    Cristina Mihaela Amarandei

    2013-09-01

    Full Text Available This paper examines the impact of corruption on foreign direct investment inflows for ten Central and Eastern European states. The paper attempts to answer the question: what is the role of corruption in attracting foreign direct investments? Using the data from UNCTAD for foreign direct investment and Corruption Perception Index from Transparency International, for a period of 12 years, 2000-2012, we evaluate the specific impact of corruptions on FDI using GDP as control variable. Our results confirm the majority of literature and show a negative significant relation between the variables analyzed, but at a lower intensity than expected.

  1. Evidence Based Management as a Tool for Special Libraries

    Directory of Open Access Journals (Sweden)

    Bill Fisher

    2007-12-01

    Full Text Available Objective ‐ To examine the evidence based management literature, as an example of evidence based practice, and determine how applicable evidence based management might be in the special library environment. Methods ‐ Recent general management literature and the subject‐focused literature of evidence based management were reviewed; likewise recent library/information science management literature and the subject‐focused literature of evidence based librarianshipwere reviewed to identify relevant examples of the introduction and use of evidence based practice in organizations. Searches were conducted in major business/management databases, major library/information science databases, and relevant Web sites, blogs and wikis. Citation searches on key articles and follow‐up searches on cited references were also conducted. Analysis of the retrieved literature was conducted to find similarities and/or differences between the management literature and the library/information scienceliterature, especially as it related to special libraries.Results ‐ The barriers to introducing evidence based management into most organizations were found to apply to many special libraries and are similar to issues involved with evidence based practice in librarianship in general. Despite these barriers, a set of resources to assist special librarians in accessing research‐based information to help them use principles of evidence based management is identified.Conclusion ‐ While most special librarians are faced with a number of barriers to using evidence based management, resources do exist to help overcome these obstacles.

  2. The impacts of football point systems on the competitive balance: evidence from some European footbal leagues

    OpenAIRE

    HALICIOGLU, Ferda

    2006-01-01

    Introduction. – 1. Outcome of uncertainty and competitive balance in professional team sports. – 2. Measurement of competitive balance in professional team sports. – 3. Football point systems and competitive balance: empirical evidence . – 4. Some concluding remarks.

  3. The impact of football point systems on the competitive balance: evidence from some european football leagues

    OpenAIRE

    Ferda Halicioglu

    2006-01-01

    Introduction - 1 Outcome of uncertainty and competitive balance in professional team sports - 2 Measurement of competitive balance in professional team sports - 3 Football point systems and competitive balance: empirical evidence - 4. Concluding remarks

  4. Audit quality and the audit partner effect : Evidence from European listed companies

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business case of audit partners. As a result, three audit partner archetypes have been identified: liberal, high quality and conservative. This paper will provide evidence that 50% of the audit partners (53% ...

  5. Underpricing and Firm’s Distance from Financial Centre: Evidence from three European Countries

    OpenAIRE

    Antonio Acconcia; Alfredo Del Monte; Luca Pennacchio

    2011-01-01

    We provide international evidence on the relationship between the extent of underpricing related to initial public offerings (IPOs) and the distance of the issuing firm from the financial centre of a country: for France, Germany and Italy, the higher the distance, the higher the level of underpricing. Under the maintained assumption that headquarters of institutional investors and underwriters are part of a financial centre, our evidence is consistent with the hypothesis that ex ante uncertai...

  6. Economic development in the European super-periphery: Evidence from the Western Balkans

    Directory of Open Access Journals (Sweden)

    Bartlett Will

    2009-01-01

    Full Text Available This paper argues that the conflicts that afflicted the Western Balkan region in the 1990s pushed the countries into the European 'super-periphery', characterized by deindustrialization and high unemployment, ethnic and regional fragmentation, political turmoil, and instability. Integration into international trade has been disrupted, leading to chronic balance of payments deficits. Low inflows of international capital, due to high country risk, have hindered technological catch-up and weakened international competitiveness. An unattractive environment for productive entrepreneurship has created barriers to the entry of SMEs, and at the same time large informal economies. Several countries have become labour-export economies, with significant outflows of skilled labour. Economic development follows a low-skill growth path. The current global economic crisis is having a further deleterious effect as export revenues, foreign direct investment, and labour remittances all diminish. Furthermore, as transition has proceeded, disparities between capital cities and rural areas have increased, while weak administrative capacities have hindered the implementation of effective local development policies to counteract these effects. Endogenous local development cannot provide an alternative to greater engagement with the global economy. The conclusion is that the countries of the region have been left out of the most beneficial elements of the globalisation process, while simultaneously suffering from its main defects. Without a faster process of accession to the EU, local disparities are likely to widen, and the region may remain within the European super-periphery for the foreseeable future.

  7. ANALYSIS OF FREE ROUTE AIRSPACE AND PERFORMANCE BASED NAVIGATION IMPLEMENTATION IN THE EUROPEAN AIR NAVIGATION SYSTEM

    Directory of Open Access Journals (Sweden)

    Svetlana Pavlova

    2014-12-01

    Full Text Available European Air Traffic Management system requires continuous improvements as air traffic is increasingday by day. For this purpose it was developed by international organizations Free Route Airspace and PerformanceBased Navigation concepts that allow to offer a required level of safety, capacity, environmental performance alongwith cost-effectiveness. The aim of the article is to provide detailed analysis of Free Route Airspace and PerformanceBased Navigation implementation status within European region including Ukrainian air navigation system.

  8. Bariatric surgery: an evidence-based analysis.

    Science.gov (United States)

    2005-01-01

    To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Obesity is defined as a body mass index (BMI) of at last 30 kg/m(2).() Morbid obesity is defined as a BMI of at least 40 kg/m(2) or at least 35 kg/m(2) with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m(2) has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m(2). An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999-2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25-29.9 kg/m(2)) or obese (BMI ≥ 30 kg/m(2)). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the "normal" range may begin at slightly above 18.5 kg/m(2) and extend into the "overweight" range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their height and under-report their weight

  9. THE IMPACT OF THE EUROPEAN REGIONAL DEVELOPMENT FUND ON SMES – EVIDENCE FROM ROMANIA

    Directory of Open Access Journals (Sweden)

    Ciocoiu Cristina-Elena

    2015-07-01

    Full Text Available As the first programming period for Romania is reaching its end, more information becomes available regarding the effects of the European Union funds on the Romanian economy. Going beyond the mathematical absorption rate, it is important to analyse these effects, especially with regard to the small and medium-sized enterprises (SMEs, in order to improve the future implementation documents for 2014-2020. The purpose of this article is to measure the impact of the European Regional Development Fund (ERDF, granted within one of the 2007-2013 operational programmes, on the net turnover, number of staff and gross profit of the small and medium-sized enterprises from one Romanian county – Iasi. Overcoming the difficulties of gathering reliable data, the empirical research presented in this article tests three hypotheses. The first one is that the EU funding provided to an SME leads to an increase in its net turnover, number of staff and gross profit. The second hypothesis is that there is a direct relationship between the amount of the grant given to an SME and the evolution of the three previously mentioned parameters. The third and last tested hypothesis is that the SMEs that implemented more than one EU-funded project have a better evolution than the ones that implemented only one. The conclusions of our study include recommendations for the implementation guides that are currently being drafted by the responsible national authorities. They also include suggestions with regard to the availability of data concerning the EU-funded projects, especially in the context of the new requirements of the European Union regarding e-cohesion and information and communication. In this context, we also explore the potential benefits of implementing projects that complement each other instead of independent projects. As such, the research presented in this article aims to contribute to a better understanding of the impact of the EU regional development policy

  10. An evidence-based update on vitamins.

    Science.gov (United States)

    Orr, K Kelly; Hume, Anne L

    2010-04-01

    American adults take many types of vitamin supplements, despite limited evidence of their efficacy, especially in preventing chronic diseases such as cardiovascular disease and cancer. Supplements contain significant amounts of vitamins when consumed from multiple sources. Excess consumption of some vitamins may have detrimental health effects. Use of MMVM products appears to be safe; however, clinical outcomes have not been established. Although vitamin D and preconception folic acid may be appropriate for self care, a health care provider should monitor other vitamin supplements for disease prevention, such as niacin. Beyond supplementation as treatment for vitamin deficiencies, evidence is lacking.

  11. Armington elasticities for energy policy modeling: Evidence from four European countries

    International Nuclear Information System (INIS)

    Welsch, Heinz

    2008-01-01

    Elasticities of substitution among imports and competing domestic production (Armington elasticities) play an important role in computable general equilibrium (CGE) assessments of energy and climate policy. This paper provides estimates of Armington elasticities for 15 commodity groups in four European countries. Since Armington elasticities are found to be rather low on average, researchers may want to reconsider the device of using high values of Armington elasticities in CGE models to avoid unrealistic competitiveness effects or emission leakage rates associated with energy or carbon taxes or other forms of energy-related regulation. Estimated elasticities tend to be higher in the case of machinery and other investment goods than in the case of primary products, ores and chemicals, as well as consumer goods

  12. Publication patterns in the social sciences and humanities: evidence from eight European countries

    DEFF Research Database (Denmark)

    Kulczycki, Emanuel; Engels, Tim; Polonen, Janne

    2018-01-01

    This study investigates patterns in the language and type of social sciences and humanities (SSH) publications in non-English speaking European countries to demonstrate that such patterns are related not only to discipline but also to each country’s cultural and historic heritage. We investigate...... publication patterns that occur across SSH publications of the whole of the SSH and of economics and business, law, and philosophy and theology publications in the Czech Republic, Denmark, Finland, Flanders (Belgium), Norway, Poland, Slovakia, and Slovenia. We use data from 74,022 peer-reviewed publications...... from 2014registered in at least one of the eight countries’ national databases and for 272,376 peer- reviewed publications from the period of 2011–2014 registered in at least one of the seven countries’ national databases (for all countries except Slovakia). Our findings show that publication patterns...

  13. THE INFLUENCE OF DIFFERENT INNOVATION TYPES UPON THE INNOVATIVE PERFORMANCE – EVIDENCE FROM EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Gabriela Lucia SIPOS

    2015-06-01

    Full Text Available Innovation represents a widely debated topic in the context of current economy, being an opportunity to achieve corporate competitiveness within an environment of uncertainty. The main purpose of this paper is to analyze the impact of different innovation types on the innovative performance in the case of 31 European countries, using the simple and the multiple linear regressions across countries. In this regard we have considered different types of innovation, such as product, process, marketing and organizational innovation, while the innovative performance was synthetically expressed by Summary Innovation Index 2013.The main result of our study is that in order to achieve high innovative performance it is necessarily to implement product and process innovation simultaneously with organizational and marketing innovation. Thus, the findings of this paper can represent a guidance for companies to identify the most appropriate types of innovation that have the greatest influence on achieving high innovative performance.

  14. The Impact of Social Factors on Economic Growth: Empirical Evidence for Romania and European Union Countries

    Directory of Open Access Journals (Sweden)

    Ana-Maria Popa

    2012-12-01

    Full Text Available This study analyzes the relationship between the social factors and the economic growth. A summary of social and economic environment is presented for Romania. As such, the paper analyzes the global evolution of social and economic environment over time and establishes a direct correlation between human development and economic welfare. An econometric model and a clustering model are tested for European Union countries. The results of the paper reveal the social factors that are positively correlated with the economic growth (i.e. the expected years of schooling and the life expectancy and, respectively, the factors that are negatively correlated with the economic growth (i.e. the population at risk of poverty and the unemployment rate.

  15. The Long-Run Superneutrality of Money Revised: the Extended European Evidence

    Directory of Open Access Journals (Sweden)

    Deev Oleg

    2016-09-01

    Full Text Available This article investigates the validity of the money superneutrality concept for the large panel of European economies. While focusing exclusively on endogenous growth theories including the Mundell-Tobin effect, we examine the long-run response of real output to a permanent inflation shock in every studied country using a structural vector autoregressive framework. For the majority of countries in our sample, the longrun superneutrality concept is confirmed since the original increase/decrease in output growth fades in time. We also test the additional hypothesis of whether the group of countries with smaller in-sample inflation mean forms the exception to the long-run money superneutrality. As the result, modern economies might be better described from the viewpoint of Sidrauski.

  16. Are immigrants and descendants with ill health more prone to unemployment? Evidence from 18 European countries.

    Science.gov (United States)

    Heggebø, Kristian

    2017-08-01

    Previous research has established that both ill health and minority status are associated with unemployment. Less is known, however, about the interplay between having ill health and being from minority background. The present study examines whether immigrants and descendants with ill health are particularly prone to unemployment during an economic downturn in Europe. The European Union Statistics on Income and Living Conditions (EU-SILC) cross-sectional data material is utilized, and linear probability models are estimated. The analysis is run for countries in which the two minority samples are acceptably large (N ≥ 100), resulting in 18 included European countries. The year 2011 is chosen because it is possible to identify both immigrants and descendants in EU-SILC due to a module on intergenerational transfer of disadvantages. The results indicate - as expected - that both ill health and minority status are independently related to higher unemployment likelihood. Immigrants and descendants with ill health, however, are not particularly likely to be unemployed. This finding is robust to a number of sensitivity tests, and the empirical pattern is very similar across the 18 included countries. Both minority status and ill health are associated with high unemployment probability in Europe. However, there does not seem to exist a 'double disadvantage' for immigrants and descendants with ill health, which is in line with a human capital perspective on how employers evaluate potential employees. Both a non-native-sounding name and bad health status are interpreted as a risk factor, but there is no reason to expect ill health to lower the productivity level more if the applicant is a descendant or immigrant.

  17. Statistical regularities of Carbon emission trading market: Evidence from European Union allowances

    Science.gov (United States)

    Zheng, Zeyu; Xiao, Rui; Shi, Haibo; Li, Guihong; Zhou, Xiaofeng

    2015-05-01

    As an emerging financial market, the trading value of carbon emission trading market has definitely increased. In recent years, the carbon emission allowances have already become a way of investment. They are bought and sold not only by carbon emitters but also by investors. In this paper, we analyzed the price fluctuations of the European Union allowances (EUA) futures in European Climate Exchange (ECX) market from 2007 to 2011. The symmetric and power-law probability density function of return time series was displayed. We found that there are only short-range correlations in price changes (return), while long-range correlations in the absolute of price changes (volatility). Further, detrended fluctuation analysis (DFA) approach was applied with focus on long-range autocorrelations and Hurst exponent. We observed long-range power-law autocorrelations in the volatility that quantify risk, and found that they decay much more slowly than the autocorrelation of return time series. Our analysis also showed that the significant cross correlations exist between return time series of EUA and many other returns. These cross correlations exist in a wide range of fields, including stock markets, energy concerned commodities futures, and financial futures. The significant cross-correlations between energy concerned futures and EUA indicate the physical relationship between carbon emission and energy production process. Additionally, the cross-correlations between financial futures and EUA indicate that the speculation behavior may become an important factor that can affect the price of EUA. Finally we modeled the long-range volatility time series of EUA with a particular version of the GARCH process, and the result also suggests long-range volatility autocorrelations.

  18. Risk-based decision making and risk management of European Union regional programs

    Directory of Open Access Journals (Sweden)

    Michalopoulos Evangelos

    2008-01-01

    Full Text Available This paper presents a generalized method for management decision making incorporating risk assessment techniques. The risk based decision making methodology is applied to European Union expenditure programs used to implement its regional policy, such as the community support framework, community initiatives, special initiatives and other European policies. An example is presented for the development of an audit (inspection program in the region of West Macedonia, Greece, during the implementation of the 3rd Community Structural Support Framework Operational Program. The generic nature of the method permits its use in the management of similar European regional programs in Greece and other European countries. It is also applicable to many other industries interested in applying risk-based management decisions to physical or process based systems. .

  19. is planning in Nigeria becoming evidence based?

    African Journals Online (AJOL)

    related Millennium Development Goals high on the policy agendas of many developing nations, the costs and as well as benefits of these health interventions are extremely vital in resource poor settings such as Nigeria. Despite the body of evidence ...

  20. 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…

  1. An evidence-based view on hyperbilirubinaemia

    NARCIS (Netherlands)

    Dijk, Peter H.; Hulzebos, Christian V.

    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.

  2. Weighted Evidence Combination Rule Based on Evidence Distance and Uncertainty Measure: An Application in Fault Diagnosis

    Directory of Open Access Journals (Sweden)

    Lei Chen

    2018-01-01

    Full Text Available Conflict management in Dempster-Shafer theory (D-S theory is a hot topic in information fusion. In this paper, a novel weighted evidence combination rule based on evidence distance and uncertainty measure is proposed. The proposed approach consists of two steps. First, the weight is determined based on the evidence distance. Then, the weight value obtained in first step is modified by taking advantage of uncertainty. Our proposed method can efficiently handle high conflicting evidences with better performance of convergence. A numerical example and an application based on sensor fusion in fault diagnosis are given to demonstrate the efficiency of our proposed method.

  3. Commentary to Wetter et al. (2014): Limited tree-ring evidence for a 1540 European 'Megadrought'

    Czech Academy of Sciences Publication Activity Database

    Büntgen, Ulf; Tegel, W.; Carrera, M.; Krusic, P. J.; Hayes, M.; Esper, J. D.

    2015-01-01

    Roč. 131, č. 2 (2015), s. 183-190 ISSN 0165-0009 Institutional support: RVO:67179843 Keywords : last millennium * documentary evidence * climate sensitivity * forest trees * drought * summer * extremes * temperatures * variability * responses Subject RIV: EH - Ecology, Behaviour Impact factor: 3.344, year: 2015

  4. Audit quality and the audit partner effect : Evidence from European listed companies

    NARCIS (Netherlands)

    Buuren, van J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business

  5. Combined dendro-documentary evidence of Central European hydroclimatic springtime extremes over the last millennium

    Czech Academy of Sciences Publication Activity Database

    Buentgen, U.; Brázdil, Rudolf; Heussner, K. U.; Hofmann, J.; Kontic, R.; Kyncl, T.; Pfister, Ch.; Chromá, K.; Tegel, W.

    2011-01-01

    Roč. 30, 27-28 (2011), s. 3947-3959 ISSN 0277-3791 Institutional research plan: CEZ:AV0Z60870520 Keywords : Climate change * Dendroarchaeology * Dendroclimatology * Documentary evidence * Drought spells * Forest growth * Historical climatology * Palaeoclimatic reconstruction Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 3.973, year: 2011

  6. The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

    Science.gov (United States)

    Masvidal, Daniel; Lavie, Carl J.

    2012-01-01

    Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care. PMID:22438783

  7. Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry.

    Science.gov (United States)

    Duggal, M; Tong, H J; Al-Ansary, M; Twati, W; Day, P F; Nazzal, H

    2017-06-01

    This systematic review was undertaken in order to develop guidelines for the European Academy of Paediatric Dentistry for the management of non-vital permanent anterior teeth with incomplete root development. Three techniques were considered; apexification by single or multiple applications of calcium hydroxide, use of Mineral Trioxide Aggregate (MTA) for the creation of an apical plug followed by obturation of the root canal, and finally a Regenerative Endodontic Technique (RET). Scottish Intercollegiate Guideline Network (SIGN) Guidelines (2008) were used for the synthesis of evidence and grade of recommendation. Variable levels of evidence were found and generally evidence related to these areas was found to be weak and of low quality. It was not possible to produce evidence-based guidelines based on the strength of evidence that is currently available for the management of non-vital immature permanent incisors. Based on the available evidence the European Academy of Paediatric Dentistry proposes Good Clinical Practice Points as a guideline for the management of such teeth. It is proposed that the long term use of calcium hydroxide in the root canals of immature teeth should be avoided and apexification with calcium hydroxide is no longer advocated. The evidence related to the use of a Regenerative Endodontic Technique is currently extremely weak and therefore this technique should only be used in very limited situations where the prognosis with other techniques is deemed to be extremely poor. The current review supports the use of MTA followed by root canal obturation as the treatment of choice.

  8. Introduction: evidence-based action in humanitarian crises

    NARCIS (Netherlands)

    Dijkzeul, D.; Hilhorst, D.; Walker, P.

    2013-01-01

    This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the

  9. Evidence-based care: an innovation to improve nursing practice ...

    African Journals Online (AJOL)

    Evidence-based care: an innovation to improve nursing practice globally. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... best available evidence from research findings, expert ideas from specialists in the various health ... need to be addressed to enhance utilization of the best available evidence in nursing practice.

  10. Continuity or discontinuity in the European Early Pleistocene human settlement: the Atapuerca evidence

    Science.gov (United States)

    Bermúdez de Castro, José María; Martinón-Torres, María; Blasco, Ruth; Rosell, Jordi; Carbonell, Eudald

    2013-09-01

    The nature, timing, pattern, favourable circumstances and impediments of the human occupation of the European continent during the Early Pleistocene are hot topics in Quaternary studies. In particular, the problem of the (dis) continuity of the settlement of Europe in this period is an important matter of discussion, which has been approached in the last decade from different points of view. The Gran Dolina (TD) and Sima del Elefante (TE) cave sites in the Sierra de Atapuerca, (Spain) include large and quasi-continuous stratigraphic sequences that stretch back from at least 1.2 million years ago (Ma) to the Matuyama/Brunhes boundary. The archaeological and paleontological record from these sites can help to test different hypotheses about the character of the human settlement in this region and period. Furthermore, the TD6 level has yielded a large collection of human fossil remains attributed to Homo antecessor. According to different geochronological methods, as well as to paleomagnetic and biostratigraphical analyses, these hominins belong to an age range of 0.96-0.80 Ma. Unfortunately, the finding in 2007 of some human fossil remains in the TE9 level, dated to about 1.22 Ma, was not enough to conclude whether H. antecessor had deep roots in the European Early Pleistocene. A set of derived features of H. antecessor shared with both the Neanderthal lineage and modern humans suggests that this species is related, and not far, from the most recent common ancestor (MRCA) of Homo neanderthalensis and Homo sapiens. If we assume that there was a lineal biological relationship between the TE9 and TD6 hominins, we should reconsider many of the conclusions achieved in previous paleontological and genetic studies. In addition, we would be obliged to build a highly complicated paleogeographical scenario for the origin of the MRCA. Although continuity in the settlement of Europe during the entire late Early Pleistocene is not discarded (e.g. in refuge areas), it seems that

  11. [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.

  12. Does Culture Affect Divorce Decisions? Evidence from European Immigrants in the US

    OpenAIRE

    Furtado, Delia; Marcén, Miriam; Sevilla-Sanz, Almudena

    2011-01-01

    This paper explores the role of culture in determining divorce decisions by examining country of origin differences in divorce rates of immigrants in the United States. Because childhood-arriving immigrants are all exposed to a common set of US laws and institutions, we interpret relationships between their divorce tendencies and home country divorce rates as evidence of the effect of culture. Our results are robust to controlling for several home country variables including average church at...

  13. Does Culture Affect Divorce Decisions? Evidence from European Immigrants in the US

    OpenAIRE

    Almudena Sevilla-Sanz; Delia Furtado and Miriam Marcen

    2010-01-01

    This paper explores the role of culture in determining divorce decisions by examining differences in divorce rates by country of origin of immigrants in the United States. Because immigrants who arrived in the US at a young age are all exposed to a common set of American laws and institutions, we interpret cross-ancestry differences in divorce rates as evidence of the effect of culture. The quantitatively significant estimated effects of culture are robust to controlling for a large number of...

  14. A REGIONAL APPROACH TO THE METROPOLITAN ECONOMIC GROWTH: EVIDENCE FROM THE EUROPEAN UNION

    Directory of Open Access Journals (Sweden)

    Florin Teodor Boldeanu

    2016-09-01

    Full Text Available The main goal of this study is to contribute to metropolitan economic growth literature by carrying out an analysis for 271 areas located in the EU between 2000 and 2013. For this objective the study uses several panel data estimation techniques, namely the GMM, System GMM and the QML estimation. To check the robustness of the results, the time period is divided in two (post and ante economic crisis and by splitting the sample of metropolitan regions in two components, the Western more developed regions and the Central and South-Eastern (the formal communist states, except for Cyprus areas. The results indicate that the industrial, construction and wholesale and retail trade sectors are positively linked with metropolitan growth. The agricultural, fishery and forestry sector is negatively influencing growth. The manufacturing and ITC sectors and migration are not statistically significant. Furthermore population density and size is more important than population growth and European enlargement did not have a substantial positive impact on metropolitan growth for the Central and South-Eastern regions.

  15. Do Forwarders Improve Sustainability Efficiency? Evidence from a European DEA Malmquist Index Calculation

    Directory of Open Access Journals (Sweden)

    Matthias Klumpp

    2017-05-01

    Full Text Available Sustainability performance and efficiency is an important topic in transportation and for forwarders. This is shown, for example, by the fact that major logistics service providers LSP publish sustainability reports, often within the annual legal business report. However, in depth research is missing regarding the efficiency of forwarders regarding the established triple bottom line approach for sustainability, including economic, social, and ecology performance areas. This is especially true for a dynamic time-series perspective, as usually only static analyses for one point in time are presented (in most cases single business years. Therefore, the operations research technique of a data envelopment analysis (DEA Malmquist index calculation is used in order to provide a longitudinal calculation of efficiency, incorporating multiple objectives regarding the triple bottom line approach for European forwarders. Several indicators are tested, including total revenues and assets as input types, profit (EBIT and dividend volume (economic dimension, employment and gender equality in management (social, and carbon-equivalent emissions (environmental as output types.

  16. AN EXAMINATION OF OKUN’S LAW: EVIDENCE FROM EUROPEAN TARGET COUNTRIES

    Directory of Open Access Journals (Sweden)

    Persico Tony Ernesto

    2012-12-01

    Full Text Available In this paper Okun’s law is tested for six European selected countries in order to compare the responsiveness of unemployment to economic growth over the period 1981-2010. In the first section there is a survey of scientific works that have observed the empirical relationship between growth and unemployment. The countries selected are representative of different socio-economic contexts today existing in Europe, i.e. EU member countries, countries that adopt the Euro, and others which are candidates to join the EU or that although EU members have chosen not to adopt the Euro. Finally, we also refer to the U.S. and Canada, which are country-systems where the regularity of Okun’s rule of thumb was conceived. In particular, we intend to represent the data of the macroeconomic variables GDP and unemployment rate in their annual variations for a time series sufficiently long to show the occurrence of the supposed regularity, and then to investigate specific cases, which represent changes compared to the expected variations. In addition to any changes occurred over time in the studied relationship, these empirical observations, along with the reported literature, will help to draw conclusions about the differences regarding the inflexibility and responsiveness to changes in the aggregated output by the labor market of the countries involved in the study.

  17. [The role of animacy in European Portuguese relative clause attachment: evidence from production and comprehension tasks].

    Science.gov (United States)

    Soares, Ana Paula; Fraga, Isabel; Comesaña, Montserrat; Piñeiro, Ana

    2010-11-01

    This work presents an analysis of the role of animacy in attachment preferences of relative clauses to complex noun phrases in European Portuguese (EP). The study of how the human parser solves this kind of syntactic ambiguities has been focus of extensive research. However, what is known about EP is both limited and puzzling. Additionally, as recent studies have stressed the importance of extra-syntactic variables in this process, two experiments were carried out to assess EP attachment preferences considering four animacy conditions: Study 1 used a sentence-completion-task, and Study 2 a self-paced reading task. Both studies indicate a significant preference for high attachment in EP. Furthermore, they showed that this preference was modulated by the animacy of the host NP: if the first host was inanimate and the second one was animate, the parser's preference changed to low attachment preference. These findings shed light on previous results regarding EP and strengthen the idea that, even in early stages of processing, the parser seems to be sensitive to extra-syntactic information.

  18. The second leg home advantage: evidence from European football cup competitions.

    Science.gov (United States)

    Page, Lionel; Page, Katie

    2007-12-01

    The home advantage is a widely acknowledged sporting phenomenon, especially in association football. Here, we examine the second leg home advantage, an effect that is discussed in the public domain but which has received very little scientific attention. The second leg home advantage effect occurs when on average teams are more likely to win a two-stage knock-out competition when they play at home in the second leg. That is, both teams have a home advantage but this advantage is significantly greater for the team that plays at home second. Examining data from three different European Cup football competitions spanning 51 years, we show that the second leg home advantage is a real phenomenon. The second leg home team has more than a 50% probability to qualify for the next round in the competition even after controlling for extra time and team ability as possible alternative explanations. The second leg home advantage appears, however, to have decreased significantly over the past decade. Possible reasons for its existence and subsequent decline are presented.

  19. In the teeth of the evidence: the curious case of evidence-based medicine.

    Science.gov (United States)

    Davidoff, F

    1999-03-01

    For a very long time, evidence from research has contributed to clinical decision making. Over the past 50 years, however, the nature of clinical research evidence has drastically changed compared with previous eras: its standards are higher, the tools for assembling and analyzing it are more powerful, and the context in which it is used is less authoritarian. The consequence has been a shift in both the concept and the practice of clinical decision making known as evidence-based medicine. Evidence-based decisions, by definition, use the strongest available evidence, are often more quantitatively informed than decisions made in the traditional fashion; and sometimes run counter to expert opinion. The techniques of evidence-based medicine are also helpful in resolving conflicting opinions. Evidence-based medicine did not simply appear in vacuo; its roots extend back at least as far as the great French Encyclopedia of the 18th century, and the subsequent work of Pierre Louis in Paris in the early 19th century. The power of the evidence-based approach has been enhanced in recent years by the development of the techniques of systematic review and meta-analysis. While this approach has its critics, we would all want the best available evidence used in making decisions about our care if we got sick. It is only fair that the patients under our care receive nothing less.

  20. Probiotics and Diverticular Disease: Evidence-based?

    Science.gov (United States)

    Lahner, Edith; Annibale, Bruno

    Diverticular disease (DD) is a common gastrointestinal condition. Clinical spectrum ranges from asymptomatic diverticulosis to symptomatic uncomplicated or complicated DD. Symptoms related to uncomplicated DD are not specific and may be indistinguishable from those of irritable bowel syndrome. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors potentially contributing to symptoms. Probiotics may modify the gut microbial balance leading to health benefits. Probiotics, due to their anti-inflammatory effects and ability to maintain an adequate bacterial colonization in the colon, are promising treatment options for DD. This review focuses on the available evidence on the efficacy of prebiotics in uncomplicated DD.

  1. Price formation and intertemporal arbitrage within a low-liquidity framework. Empirical evidence from European natural gas markets

    Energy Technology Data Exchange (ETDEWEB)

    Nick, Sebastian

    2013-08-15

    In this study, the informational efficiency of the European natural gas market is analyzed by empirically investigating price formation and arbitrage efficiency between spot and futures markets. Econometric approaches are specified that explicitly account for nonlinearities and the low liquidity framework of the considered gas hubs. The empirical results reveal that price discovery takes place on the futures market, while the spot price subsequently follows the futures market price. Furthermore, there is empirical evidence of significant market frictions hampering intertemporal arbitrage. UK's NBP seems to be the hub at which arbitrage opportunities are exhausted most efficiently, although there is convergence in the degree of intertemporal arbitrage efficiency over time at the hubs investigated.

  2. Evidence-based interventions of threatened miscarriage

    Directory of Open Access Journals (Sweden)

    Juan Li

    2017-05-01

    Full Text Available Threatened miscarriage is the commonest complication of early pregnancy and affects about 20% of pregnancies. It presents with vaginal bleeding with or without abdominal cramps. Increasing age of women, smoking, obesity or polycystic ovary syndrome (PCOS and a previous history of miscarriage are risk factors for threatened miscarriage. The pathophysiology has been associated with changes in levels of cytokines or maternal immune dysfunction. Clinical history and examination, maternal serum biochemistry and ultrasound findings are important to determine the treatment options and provide valuable information for the prognosis. Bed rest is the commonest advice, but there is little evidence of its value. Other options include progesterone, human chorionic gonadotropin (HCG and muscle relaxants. The complementary and alternative medicine (CAM therapies such as acupuncture and Chinese herbs have also been tried. There is some evidence from clinical studies indicating that CAM therapies may reduce the rate of miscarriage, but the quality of studies is poor. Thus, further double-blind, randomized-controlled trials are necessary to confirm its effectiveness, especially acupuncture and Chinese herbs.

  3. Evidence-based treatments for cluster headache

    Directory of Open Access Journals (Sweden)

    Gooriah R

    2015-11-01

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

  4. Which parenting style is more protective against adolescent substance use? Evidence within the European context.

    Science.gov (United States)

    Calafat, Amador; García, Fernando; Juan, Montse; Becoña, Elisardo; Fernández-Hermida, José Ramón

    2014-05-01

    This study examines whether authoritative parenting style (characterized by warmth and strictness) is more protective against adolescent substances use than authoritarian (strictness but not warmth), indulgent (warmth but not strictness) and neglectful (neither warmth nor strictness) parenting styles. Emergent research in diverse cultural contexts (mainly Southern European and Latin American countries) questions the fact that authoritative would always be the optimum parenting style. Multi-factorial MANOVAs. A sample of 7718 adolescents, 3774 males (48.9%), 11-19 year-olds (M=14.63 year-olds, SD=1.9 years) from Sweden, United Kingdom, Spain, Portugal, Slovenia, and the Czech Republic. Parenting style dimensions (warmth and strictness) and adolescent substance use (alcohol, tobacco, and illegal drugs); additionally another three adolescent outcomes were also measured (self-esteem, school performance and personal disturbances) all of them related in the literature with substance use. Both indulgent and authoritative parenting styles were associated with better outcomes than authoritarian and neglectful parenting in all the countries studied. Overall, our results support the idea that in Europe the indulgent parenting style performs as well as the authoritative one since adolescents' scores in the youth outcomes were equal (on substance use and personal disturbances) or even better (on self esteem and school performance) than for authoritative parenting style. Parenting styles relate to substance use and other outcomes in the same way in different countries explored. The so-called indulgent parenting style appears to be as good as the authoritative in protecting against substance abuse. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. The impact of citizenship on intermarriage: Quasi-experimental evidence from two European Union Eastern enlargements

    Directory of Open Access Journals (Sweden)

    Davide Azzolini

    2017-04-01

    Full Text Available Background: According to assimilation theory, the more immigrants are integrated within host countries the more likely they are to intermarry. However, status exchange theory argues instead that when integration is low, immigrants may use intermarriage as a means of improving their integration prospects in host countries, in which case an increase in levels of integration would reduce immigrants' propensity to intermarry. Objective: To test these two hypotheses, this paper assesses the causal effect of a positive shift in immigrants' level of integration, namely the acquisition of citizenship, on intermarriage in Italy. Over the past 20 years Italy has experienced an unprecedented growth in intermarriage involving primarily Eastern European women. Methods: We study two EU Eastern enlargements, following which citizens of the new EU member countries became EU citizens and thus experienced a marked improvement in their legal status. We apply the synthetic control method to data on marriages between native men and foreign women. Results: We find that the acquisition of citizenship has a significant negative impact on immigrant women's propensity to marry native men. That impact is much greater for immigrants coming from less affluent countries. Conclusions: Our results support the status exchange hypothesis. This can be explained by the poor socioeconomic integration and precarious legal status of immigrants in Italy. Contribution: The growth of intermarriage per se cannot be seen as an indicator of greater immigrant integration. The negative impact of citizenship acquisition on immigrants' propensity to intermarry also calls for a rethinking of the role of institutions such as marriage and citizenship in the process of immigrant integration.

  6. Further Evidence of Subphenotype Association with Systemic Lupus Erythematosus Susceptibility Loci: A European Cases Only Study

    Science.gov (United States)

    Alonso-Perez, Elisa; Suarez-Gestal, Marian; Calaza, Manuel; Ordi-Ros, Josep; Balada, Eva; Bijl, Marc; Papasteriades, Chryssa; Carreira, Patricia; Skopouli, Fotini N.; Witte, Torsten; Endreffy, Emöke; Marchini, Maurizio; Migliaresi, Sergio; Sebastiani, Gian Domenico; Santos, Maria Jose; Suarez, Ana; Blanco, Francisco J.; Barizzone, Nadia; Pullmann, Rudolf; Ruzickova, Sarka; Lauwerys, Bernard R.; Gomez-Reino, Juan J.; Gonzalez, Antonio

    2012-01-01

    Introduction Systemic Lupus Erythematosus (SLE) shows a spectrum of clinical manifestations that complicate its diagnosis, treatment and research. This variability is likely related with environmental exposures and genetic factors among which known SLE susceptibility loci are prime candidates. The first published analyses seem to indicate that this is the case for some of them, but results are still inconclusive and we aimed to further explore this question. Methods European SLE patients, 1444, recruited at 17 centres from 10 countries were analyzed. Genotypes for 26 SLE associated SNPs were compared between patients with and without each of 11 clinical features: ten of the American College of Rheumatology (ACR) classification criteria (except ANAs) and age of disease onset. These analyses were adjusted for centre of recruitment, top ancestry informative markers, gender and time of follow-up. Overlap of samples with previous studies was excluded for assessing replication. Results There were three new associations: the SNPs in XKR6 and in FAM167A-BLK were associated with lupus nephritis (OR = 0.76 and 1.30, Pcorr = 0.007 and 0.03, respectively) and the SNP of MECP2, which is in chromosome X, with earlier age of disease onset in men. The previously reported association of STAT4 with early age of disease onset was replicated. Some other results were suggestive of the presence of additional associations. Together, the association signals provided support to some previous findings and to the characterization of lupus nephritis, autoantibodies and age of disease onset as the clinical features more associated with SLE loci. Conclusion Some of the SLE loci shape the disease phenotype in addition to increase susceptibility to SLE. This influence is more prominent for some clinical features than for others. However, results are only partially consistent between studies and subphenotype specific GWAS are needed to unravel their genetic component. PMID:23049788

  7. Lifespan mercury accumulation pattern in Liza aurata : Evidence from two southern European estuaries

    Science.gov (United States)

    Tavares, S.; Oliveira, H.; Coelho, J. P.; Pereira, M. E.; Duarte, A. C.; Pardal, M. A.

    2011-10-01

    Mercury accumulation throughout the lifespan of Liza aurata (Risso, 1810) was analysed in four tissues (muscle, gills, liver and brain) in two southern European coastal ecosystems with distinct mercury contamination. Specimens from four to five age classes were captured in two sampling sites in the Ria de Aveiro (Laranjo bay and Mira), a system historically contaminated by industrial mercury, and in one site in the Mondego estuary, assumed as a mercury-free ecosystem. Mercury concentration in all tissues was found to be significantly higher in the Ria de Aveiro (Laranjo bay) compared to the Mondego, in accordance with the environmental contamination (water, sediments and suspended particulate matter). Significant differences inside the Ria de Aveiro (between the Mira and Laranjo bay) were only detected in the liver. This tissue registered the highest levels of mercury (ranging from 0.11 to 4.2 μg g -1 ) in all sampling sites, followed by muscle, brain, and gills. In all sampling sites and tissues was denoted a mercury dilution pattern along the lifecycle (except in liver at the Mondego, the reference area where the concentrations are always very low). An exponential trend was found in the metal age variation patterns in Laranjo (the most contaminated area) and a linear trend in the Mira and the Mondego (the least contaminated areas). Organic mercury concentration in muscle generally accounted for over 95% of total mercury concentration, and followed the same accumulation pattern of total mercury. This fish species is of lesser importance in mercury transfer to adjacent coastal areas and although the consumption of fish from Laranjo may present some risk for the humans, this risk decreases with fish age/size.

  8. From evidence-based medicine to genomic medicine

    OpenAIRE

    Kumar, Dhavendra

    2007-01-01

    The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about t...

  9. Annotating Evidence Based Clinical Guidelines : A Lightweight Ontology

    NARCIS (Netherlands)

    Hoekstra, R.; de Waard, A.; Vdovjak, R.; Paschke, A.; Burger, A.; Romano, P.; Marshall, M.S.; Splendiani, A.

    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

  10. 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 evid...

  11. Evidence-based Paradigm In Orthodontics | Ajayi | Nigerian ...

    African Journals Online (AJOL)

    The need to integrate the accrued scientific evidence into clinical orthodontic practice is amongst the challenges facing orthodontists in the 21st century. The evidence-based health care approach aims to improve patient care based upon informed decision-making. This article therefore highlights the importance and ...

  12. Evidence-based clinical guidelines for eating disorders : International comparison

    NARCIS (Netherlands)

    Hilbert, Anja; Hoek, Hans W.; Schmidt, Ricarda

    2017-01-01

    Purpose of review: The current systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders. Recent findings: Nine evidence-based clinical treatment guidelines for eating disorders were located through a systematic search. The

  13. De scientist practitioner en de evidence-based practice

    NARCIS (Netherlands)

    Hutschemaekers, G.J.M.; Nijnatten, C.H.C.J. van

    2008-01-01

    Het principe van evidence-based werken heeft kenmerken gekregen van een paradigma en de scientist practitioner lijkt plaatsgemaakt te hebben voor de louter uitvoerende evidence-based practitioner. Dat werkt eerder passiviteit dan wetenschappelijkheid in de hand. Er zijn zes belangrijke problemen met

  14. Illicit Drugs, Policing and the Evidence-Based Policy Paradigm

    Science.gov (United States)

    Ritter, Alison; Lancaster, Kari

    2013-01-01

    The mantra of evidence-based policy (EBP) suggests that endeavours to implement evidence-based policing will produce better outcomes. However there is dissonance between the rhetoric of EBP and the actuality of policing policy. This disjuncture is critically analysed using the case study of illicit drugs policing. The dissonance may be ameliorated…

  15. 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…

  16. Building a culture of evidence-based planning in Nigeria

    International Development Research Centre (IDRC) Digital Library (Canada)

    care, it is essential to base plans on evidence of what is ... For six years, the Nigerian Evidence- based Health ... best to respond to findings they participated in generating. Nigeria .... It also uses this data in evaluating ... Decision-makers work with researchers to plan the implementation ... of Nursing Services from Bauchi.

  17. Breast abscess: evidence based management recommendations.

    Science.gov (United States)

    Lam, Elaine; Chan, Tiffany; Wiseman, Sam M

    2014-07-01

    Literature review was carried out and studies reporting on treatment of breast abscesses were critically appraised for quality and their level of evidence using the Strength of Recommendation Taxonomy guidelines, and key recommendations were summarized. Needle aspiration either with or without ultrasound guidance should be employed as first line treatment of breast abscesses. This approach has the potential benefits of: superior cosmesis, shorter healing time, and avoidance of general anaesthesia. Multiple aspiration sessions may be required for cure. Ultrasound-guided percutaneous catheter placement may be considered as an alternative approach for treatment of larger abscesses (>3 cm). Surgical incision and drainage should be considered for first line therapy in large (>5 cm), multiloculated, or long standing abscesses, or if percutaneous drainage is unsuccessful. All patients should be treated concurrently with antibiotics. Patients with recurrent subareolar abscesses and fistulas should be referred for consideration of surgical treatment.

  18. Accounting basis adjustments and deficit reliability: Evidence from southern European countries

    Directory of Open Access Journals (Sweden)

    Maria Antónia Jesus

    2016-01-01

    The main findings point to the need for standardised procedures to convert cash-based (GA into accrual-based (NA data as a crucial step, preventing accounting manipulation, thus increasing reliability of informative outputs for both micro and macro purposes.

  19. CONVERGENCE AND DIVERGENCE IN EUROPEAN UNION: EVIDENCE FOR BETA CONVERGENCE AMONG NEW EU MEMBER STATES

    Directory of Open Access Journals (Sweden)

    Ioana Sorina Mihuț

    2013-07-01

    Full Text Available Abstract: Convergence may be considered a central issue of the current economic literature, and not only, concentrating upon income distribution within different economies, but also focusing on different aspects of polarity and inequality that characterize especially the emerging economies. Testing convergence within economies may serve as a useful instrument for the validation of the economic growth models. While convergence was considered a defining element of the neoclassical growth models, the majority of the new endogenous growth models argue in favour of divergence across different economies. Testing convergence among European Union is even more challenging due to the high degree of heterogeneity that characterizes these economies. The recent accessions with ten new countries in 2004 and with another two in 2007 were considered only the first step towards assuring a sustainable convergence and finally adopting a common currency-the euro. A series of empirical studies concentrated upon testing convergence among EU, using as benchmark the real convergence quantified by the level of GDP/capita as an indicator for the living standards of every economy. The most popular approach rely on Beta and Sigma convergence, the first one being and indicator of the GDP/capita dispersion between different economies, and the later one being an estimator of the reverse relationship between GDP/capita and its initial level. The main purpose of this paper is to test Beta converge among the new EU member states, in order to obtained more information about the fact whether the poor countries are trying to catch-up with the more developed one. Also Beta convergence indicator embodies useful information about conditional and un-conditional convergence, two leading hypothesis within the neoclassical and endogenous growth models. For Beta convergence hypothesis to be valid it should be taken into consideration a ”catch-up” mechanism over a longer period of time

  20. ASSETS AND LIABILITIES DEPENDENCE: EVIDENCE FROM AN EUROPEAN SAMPLE OF BANKS

    Directory of Open Access Journals (Sweden)

    Cociuba Mihail Ioan

    2014-12-01

    Full Text Available In this paper we analyzed the correlation between asset and liabilities using the canonical correlation method, in the case of correlation we analyze the interdependence between two variables, by using canonical correlation analyses we study the interdependence between two groups of variables, X consisting of p variables and Y with q variables from which the best linear combination can be constructed to maximize the correlation between X and Y. While on the financial markets the relation between variables may be linear or non-linear and although canonical correlation analyses only the linear combination of variables it is a more efficient tool than then simple correlation.The asset group which we analyze is composed of different types of loans, derivatives and other earning assets, while in the group of liabilities we have deposits (short and long term, interest bearing liabilities and trading liabilities. We find that the assets and liabilities in the banking sector are directly linked. In the context of the global financial crisis (2007-2008 and the afterwards financial recession this direct correlation between assets and liabilities created a vicious cycle in which the losses from assets had a direct impact on the liabilities which also influenced the levels of assets.The behavior of different variables is important, especially in the financial markets, mainly due to the structure of financial markets. The banking sector and the systemic risk associated with it can affect the financial system and even the whole economy so the study of the correlation of assets and liabilities may give us insights on the causes of the financial crises. We use a panel of fifty-nine European banks for the 2004-2011 period and we analyses the correlation between assets and liabilities. We find that there exists a direct and strong connection between different classes of assets held by banks and the structure of liabilities. The impact of the economic crisis on

  1. Does culture affect divorce? evidence from European immigrants in the United States.

    Science.gov (United States)

    Furtado, Delia; Marcén, Miriam; Sevilla, Almudena

    2013-06-01

    This article explores the role of culture in determining divorce by examining country-of-origin differences in divorce rates of immigrants in the United States. Because childhood-arriving immigrants are all exposed to a common set of U.S. laws and institutions, we interpret relationships between their divorce tendencies and home-country divorce rates as evidence of the effect of culture. Our results are robust to controlling for several home-country variables, including average church attendance and gross domestic product (GDP). Moreover, specifications with country-of-origin fixed effects suggest that immigrants from countries with low divorce rates are especially less likely to be divorced if they reside among a large number of coethnics. Supplemental analyses indicate that divorce culture has a stronger impact on the divorce decisions of females than of males, pointing to a potentially gendered nature of divorce taboos.

  2. How to proceed when evidence-based practice is required but very little evidence available?

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Lanlo, Olivier; Walker, Bruce F

    2013-01-01

    All clinicians of today know that scientific evidence is the base on which clinical practice should rest. However, this is not always easy, in particular in those disciplines, where the evidence is scarce. Although the last decades have brought an impressive production of research that is of inte...

  3. Towards the implementation of an integrated ecosystem fleet-based management of European fisheries

    NARCIS (Netherlands)

    Gascuel, D.; Merino, G.; Döring, R.D.; Druon, D.N.; Goti, L.; Guénette, S.; Macher, C.; Soma, K.; Travers-Trolet, M.; Mackinson, S.

    2012-01-01

    Using the Celtic Sea and the North Sea as case studies, the fleet-based approach is shown to be the pathway to implement an effective ecosystem approach to fisheries management (EAFM) in European seas. First, a diagnostic on the health of each ecosystem is proposed based on the reconstruction of

  4. Spatially based methods to assess the ecological status of riverine fish assemblages in European ecoregions

    NARCIS (Netherlands)

    Schmutz, S.; Beier, U.; Bohmer, J.; Leeuw, de J.J.

    2007-01-01

    The objective was to develop spatially based (type-specific) methods to assess the ecological status of European rivers according to the EU Water Framework Directive. Some 15 000 samples from about 8000 sites were pre-classified within a five-tiered classification system based on hydromorphological

  5. Organisational support for evidence-based practice: occupational therapists perceptions.

    Science.gov (United States)

    Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

    2016-02-01

    Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

  6. Mistakes, Errors and Foul-Ups: Practice-Based Evidence for Evidence Based Practice

    Directory of Open Access Journals (Sweden)

    Mark Turner

    2016-11-01

    Full Text Available In human medicine, the management of care to ensure safety for the service-user constitutes an important element of the patient ‘journey.’ The name given to this discipline is patient safety. It is founded upon those elements of good medical practice which help avoid or mitigate human error.  Investigations in the U.S. first highlighted the alarming extent of medical error: Brennan et al. (1991 concluded that in the state of New York, the overall rate of adverse events was approximately 4% for hospitalised patients, which equated to over 13,000 deaths a year. Doctors looked to other safety critical industries and aviation in particular (Reason 1995, to address this phenomenon: there is now a wealth of research on the impact of various safety initiatives on measurable rates of harm. The World Health Organisation’s ‘Safe Surgery Saves Lives’ initiative - a campaign that advocates the use of a surgical checklist to standardise aspects of peri-operative care - is one example of aviation methodology successfully employed in a clinical setting (van Klei et al. 2012. The critical importance of effective communication, leadership and situational awareness has also been discussed at length in the human patient safety literature.ObjectivesVeterinary patient safety is an analogous discipline and researchers have attempted to understand more about the topic of veterinary medical error. However, the evidence-base for veterinary patient safety is sparse.  This presentation aims to summarise the evidence to date and highlight the benefits in practice of an emerging subject. MethodA search of the terms veterinary patient safety on the PubMed database from 1990 to 2016 was performed.Findings15 articles were identified as contributing to the veterinary patient safety literature.OutcomeThe available literature has addressed a number of areas. The use of checklists in a clinical setting has been proven to reduce the incidence of specific undesirable

  7. The lending channel and budget balance: empirical evidences from Central and Eastern European economies

    Directory of Open Access Journals (Sweden)

    Bogdan-Gabriel MOINESCU

    2013-03-01

    Full Text Available The study aims to deepen the analysis on the indirect dependence of government budget balance on private sector credit flow in the countries of Central and Eastern Europe. The added value of this approach consists of two elements. First, the analysis suggests developing the traditional analytical framework of assessing risks to public finance stability by including second round effects of negative fiscal impulses on credit to private sector during recession periods. Second, the study provides empirical evidence on the importance of economic growth transmission channel for the impact of credit accelerator effects on primary deficit. At the same time, nonperforming loans channel proved to be insignificant, especially in relation to the persistency of last year’s budget deficit and the effects of budget allocations pro-cyclicality. However, loan portfolio quality seems to be more relevant in the case of public debt service, through its influence on the evolution of the yield on long-term government securities that is closely related to sovereign risk premium. Nevertheless, strengthening the financial safety net by the introduction of resolution funds will most probably break the link investors saw between credit portfolio quality and the impending increase in budget spending. This expected development across not only CEE countries, but at the EU level also, will facilitate the isolation of sovereign risk premium from non-performing loans’ dynamics.

  8. The European Regulatory Environment of RNA-Based Vaccines.

    Science.gov (United States)

    Hinz, Thomas; Kallen, Kajo; Britten, Cedrik M; Flamion, Bruno; Granzer, Ulrich; Hoos, Axel; Huber, Christoph; Khleif, Samir; Kreiter, Sebastian; Rammensee, Hans-Georg; Sahin, Ugur; Singh-Jasuja, Harpreet; Türeci, Özlem; Kalinke, Ulrich

    2017-01-01

    A variety of different mRNA-based drugs are currently in development. This became possible, since major breakthroughs in RNA research during the last decades allowed impressive improvements of translation, stability and delivery of mRNA. This article focuses on antigen-encoding RNA-based vaccines that are either directed against tumors or pathogens. mRNA-encoded vaccines are developed both for preventive or therapeutic purposes. Most mRNA-based vaccines are directly administered to patients. Alternatively, primary autologous cells from cancer patients are modified ex vivo by the use of mRNA and then are adoptively transferred to patients. In the EU no regulatory guidelines presently exist that specifically address mRNA-based vaccines. The existing regulatory framework, however, clearly defines that mRNA-based vaccines in most cases have to be centrally approved. Interestingly, depending on whether RNA-based vaccines are directed against tumors or infectious disease, they are formally considered gene therapy products or not, respectively. Besides an overview on the current clinical use of mRNA vaccines in various therapeutic areas a detailed discussion of the current regulatory situation is provided and regulatory perspectives are discussed.

  9. Implementing and up-scaling evidence-based eMental health in Europe

    DEFF Research Database (Denmark)

    Vis, Christiaan; Kleiboer, Annet; Prior, Reinhard

    2015-01-01

    Background: Depressive disorder is a major societal challenge. Despite the availability of clinically and cost-effective treatments including Internet interventions, the number of patients receiving treatment is limited. Evidence-based Internet interventions promise wide availability and high...... efficiency of treatments. However, these interventions often do not enter routine mental healthcare delivery at a large scale. The MasterMind project aims to provide insight into the factors that promote or hinder the uptake and implementation of evidence-based Internet interventions by mental healthcare...... practice. Internet-based Cognitive Behaviour Therapy (iCBT) and videoconferencing facilitating collaborative care (ccVC) will be implemented in routine mental healthcare. The services will be offered to 5230 depressed adults in 15 European regions. The current paper describes the evaluation protocol...

  10. A MACROPRUDENTIAL SUPERVISION MODEL. EMPIRICAL EVIDENCE FROM THE CENTRAL AND EASTERN EUROPEAN BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Trenca Ioan

    2013-07-01

    Full Text Available One of the positive effects of the financial crises is the increasing concern of the supervisors regarding the financial system’s stability. There is a need to strengthen the links between different financial components of the financial system and the macroeconomic environment. Banking systems that have an adequate capitalization and liquidity level may face easier economic and financial shocks. The purpose of this empirical study is to identify the main determinants of the banking system’s stability and soundness in the Central and Eastern Europe countries. We asses the impact of different macroeconomic variables on the quality of capital and liquidity conditions and examine the behaviour of these financial stability indicators, by analyzing a sample of 10 banking systems during 2000-2011. The availability of banking capital signals the banking system’s resiliency to shocks. Capital adequacy ratio is the main indicator used to assess the banking fragility. One of the causes of the 2008-2009 financial crisis was the lack of liquidity in the banking system which led to the collapse of several banking institutions and macroeconomic imbalances. Given the importance of liquidity for the banking system, we propose several models in order to determine the macroeconomic variables that have a significant influence on the liquid reserves to total assets ratio. We found evidence that GDP growth, inflation, domestic credit to private sector, as well as the money and quasi money aggregate indicator have significant impact on the banking stability. The empirical regression confirms the high level of interdependence of the real sector with the financial-banking sector. Also, they prove the necessity for an effective macro prudential supervision at country level which enables the supervisory authorities to have an adequate control over the macro prudential indicators and to take appropriate decisions at the right time.

  11. Evidence - based medicine/practice in sports physical therapy.

    Science.gov (United States)

    Manske, Robert C; Lehecka, B J

    2012-10-01

    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 clinical experience with conscientious, explicit, and judicious use of research evidence in order to make clearly informed decisions in order to help maximize and optimize patient well-being. One of the more common reasons for not using evidence in clinical practice is the perceived lack of skills and knowledge when searching for or appraising research. This clinical commentary was developed to educate the readership on what constitutes evidence-based practice, and strategies used to seek evidence in the daily clinical practice of sports physical therapy.

  12. On evidence and evidence-based medicine: lessons from the philosophy of science.

    Science.gov (United States)

    Goldenberg, Maya J

    2006-06-01

    The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920-1950). At the same time, the term "evidence-based medicine" has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should be challenged on the grounds of how 'evidence' has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause.

  13. Dealing with Uncertainty and Accounting for Social Value Judgments in Assessments of Orphan Drugs: Evidence from Four European Countries.

    Science.gov (United States)

    Nicod, Elena; Berg Brigham, Karen; Durand-Zaleski, Isabelle; Kanavos, Panos

    To better understand the reasons for differences in reimbursement decisions for orphan drugs in four European countries that were not readily apparent from health technology assessment (HTA) reports and operating procedures. Semistructured interviews with representatives of HTA bodies in England, Scotland, Sweden, and France were conducted. An interview topic guide was developed on the basis of findings from a systematic comparison of HTA decisions for 10 orphan drugs. Qualitative thematic data analysis was applied to the interview transcripts using the framework approach. Eight representatives from the four HTA bodies were interviewed between March and June 2015. Evidentiary requirements and approaches to dealing with imperfect or incomplete evidence were explored, including trial design and duration, study population and subgroups, comparators, and end points. Interviewees agreed that decisions regarding orphan drugs are made in a context of lower quality evidence, and the threshold of acceptable uncertainty varied by country. Some countries imposed higher evidentiary standards for greater clinical claims, which may be more challenging for orphan diseases. The acceptability of surrogate end points was not consistent across countries nor were the validation requirements. The most common social value judgments identified related to innovation, disease severity, and unmet need. Differences were seen in the way these concepts were defined and accounted for across countries. Although agreement was seen in evidentiary requirements or preferences, there were subtle differences in the circumstances in which uncertain evidence may be considered acceptable, possibly explaining differences in HTA recommendations across countries. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Revision of the Late Jurassic crocodyliform Alligatorellus, and evidence for allopatric speciation driving high diversity in western European atoposaurids.

    Science.gov (United States)

    Tennant, Jonathan P; Mannion, Philip D

    2014-01-01

    Atoposaurid crocodyliforms represent an important faunal component of Late Jurassic to Early Cretaceous Laurasian semi-aquatic to terrestrial ecosystems, with numerous spatiotemporally contemporaneous atoposaurids known from western Europe. In particular, the Late Jurassic of France and Germany records evidence for high diversity and possible sympatric atoposaurid species belonging to Alligatorellus, Alligatorium and Atoposaurus. However, atoposaurid taxonomy has received little attention, and many species are in need of revision. As such, this potentially high European diversity within a narrow spatiotemporal range might be a taxonomic artefact. Here we provide a taxonomic and anatomical revision of the Late Jurassic atoposaurid Alligatorellus. Initially described as A. beaumonti from the Kimmeridgian of Cerin, eastern France, additional material from the Tithonian of Solnhofen, south-eastern Germany, was subsequently referred to this species, with the two occurrences differentiated as A. beaumonti beaumonti and A. beaumonti bavaricus, respectively. We provide a revised diagnosis for the genus Alligatorellus, and note a number of anatomical differences between the French and German specimens, including osteoderm morphology and the configuration and pattern of sculpting of cranial elements. Consequently, we restrict the name Alligatorellus beaumonti to include only the French remains, and raise the rank of the German material to a distinct species: Alligatorellus bavaricus. A new diagnosis is provided for both species, and we suggest that a recently referred specimen from a coeval German locality cannot be conclusively referred to Alligatorellus. Although it has previously been suggested that Alligatorellus, Alligatorium and Atoposaurus might represent a single growth series of one species, we find no conclusive evidence to support this proposal, and provide a number of morphological differences to distinguish these three taxa that appear to be independent of

  15. Fossil and renewable energy consumption, GHGs (greenhouse gases) and economic growth: Evidence from a panel of EU (European Union) countries

    International Nuclear Information System (INIS)

    Bölük, Gülden; Mert, Mehmet

    2014-01-01

    Recently a great number of empirical research studies have been conducted on the relationship between certain indicators of environmental degradation and income. The EKC (Environmental Kuznets Curve) hypothesis has been tested for various types of environmental degradation. The EKC hypothesis states that the relationship between environmental degradation and income per capita takes the form of an inverted U shape. In this paper the EKC hypothesis was investigated with regards to the relationship between carbon emissions, income and energy consumption in 16 EU (European Union) countries. We conducted panel data analysis for the period of 1990–2008 by fixing the multicollinearity problem between the explanatory variables using their centered values. The main contribution of this paper is that the EKC hypothesis has been investigated by separating final energy consumption into renewable and fossil fuel energy consumption. Unfortunately, the inverted U-shape relationship (EKC) does not hold for carbon emissions in the 16 EU countries. The other important finding is that renewable energy consumption contributes around 1/2 less per unit of energy consumed than fossil energy consumption in terms of GHG (greenhouse gas) emissions in EU countries. This implies that a shift in energy consumption mix towards alternative renewable energy technologies might decrease the GHG emissions. - Highlights: • We investigate the EKC (Environmental Kuznets Curve) hypothesis for 16 EU (European Union) countries. • We fix the multicollinearity problem between explanatory variables. • We found no evidence to support the EKC hypothesis in EU between 1990 and 2008 periods. • Renewable energy contributes less to GHGs (greenhouse gases) around ½ that of a unit of fossil energy

  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. Implementing Evidence-Based Practices for People With Schizophrenia

    Science.gov (United States)

    Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

    2009-01-01

    Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

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

    Science.gov (United States)

    Packard, Thomas; Shih, Amber

    2014-01-01

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

  19. Evidence-based music therapy practice: an integral understanding.

    Science.gov (United States)

    Abrams, Brian

    2010-01-01

    The American Music Therapy Association has recently put into action a plan called its Research Strategic Priority, with one of its central purposes to advance the music therapy field through research promoting Evidence-Based Practice of music therapy. The extant literature on music therapy practice, theory, and research conveys a range of very different perspectives on what may count as the "evidence" upon which practice is based. There is therefore a need to conceptualize evidence-based music therapy practice in a multifaceted, yet coherent and balanced way. The purpose of this paper is to illustrate a framework based upon four distinct epistemological perspectives on evidence-based music therapy practice that together represent an integral understanding.

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

    Science.gov (United States)

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

    2006-06-01

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

  1. Evidence-based medicine: the fourth revolution in American medicine?

    Science.gov (United States)

    Chung, Kevin C; Ram, Ashwin N

    2009-01-01

    The use of evidence has become a force in American medicine to improve the quality of health care. Funding decisions from payers will demand studies with high-level evidence to support many of the costly interventions in medicine. Plastic surgery is certainly not immune to this national tidal wave to revamp the health care system by embracing evidence-based medicine in our practices. In scientific contributions of plastic surgery research, application of evidence-based principles should enhance the care of all patients by relying on science rather than opinions. In this article, the genesis of evidence-based medicine is discussed to guide plastic surgery in this new revolution in American medicine.

  2. Building an evidence base for occupational health interventions

    NARCIS (Netherlands)

    Verbeek, Jos; Husman, Kaj; van Dijk, Frank; Jauhiainen, Merja; Pasternack, Iris; Vainio, Harri

    2004-01-01

    This article summarizes arguments for building an evidence base for occupational health. Evidence is needed on the most effective ways of eliminating health hazards in the workplace and at work, enhancing healthy behavior or the empowerment of workers, and preventing and treating occupational

  3. Evidence-Based Clinical Voice Assessment: A Systematic Review

    Science.gov (United States)

    Roy, Nelson; Barkmeier-Kraemer, Julie; Eadie, Tanya; Sivasankar, M. Preeti; Mehta, Daryush; Paul, Diane; Hillman, Robert

    2013-01-01

    Purpose: To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method: The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language…

  4. How to Reach Evidence-Based Usability Evaluation Methods

    NARCIS (Netherlands)

    Marcilly, Romaric; Peute, Linda

    2017-01-01

    This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing

  5. What is new about covered interest parity condition in the European Union? Evidence from fractal cross-correlation regressions

    Science.gov (United States)

    Ferreira, Paulo; Kristoufek, Ladislav

    2017-11-01

    We analyse the covered interest parity (CIP) using two novel regression frameworks based on cross-correlation analysis (detrended cross-correlation analysis and detrending moving-average cross-correlation analysis), which allow for studying the relationships at different scales and work well under non-stationarity and heavy tails. CIP is a measure of capital mobility commonly used to analyse financial integration, which remains an interesting feature of study in the context of the European Union. The importance of this features is related to the fact that the adoption of a common currency is associated with some benefits for countries, but also involves some risks such as the loss of economic instruments to face possible asymmetric shocks. While studying the Eurozone members could explain some problems in the common currency, studying the non-Euro countries is important to analyse if they are fit to take the possible benefits. Our results point to the CIP verification mainly in the Central European countries while in the remaining countries, the verification of the parity is only residual.

  6. EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis.

    Science.gov (United States)

    Párniczky, Andrea; Abu-El-Haija, Maisam; Husain, Sohail; Lowe, Mark; Oracz, Grzegorz; Sahin-Tóth, Miklós; Szabó, Flóra K; Uc, Aliye; Wilschanski, Michael; Witt, Heiko; Czakó, László; Grammatikopoulos, Tassos; Rasmussen, Ib Christian; Sutton, Robert; Hegyi, Péter

    2018-03-01

    Pediatric pancreatitis is an underdiagnosed disease with variable etiology. In the past 10-15 years the incidence of pediatric pancreatitis has increased, it is now 3.6-13.3 cases per 100,000 children. Up-to-date evidence based management guidelines are lacking for the pediatric pancreatitis. The European Pancreatic Club, in collaboration with the Hungarian Pancreatic Study Group organized a consensus guideline meeting on the diagnosis and management of pancreatitis in the pediatric population. Pediatric Pancreatitis was divided into three main clinical categories: acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis. Fifteen relevant topics (acute pancreatitis: diagnosis; etiology; prognosis; imaging; complications; therapy; biliary tract management; acute recurrent pancreatitis: diagnosis; chronic pancreatitis: diagnosis, etiology, treatment, imaging, intervention, pain, complications; enzyme replacement) were defined. Ten experts from the USA and Europe reviewed and summarized the available literature. Evidence was classified according to the GRADE classification system. Within fifteen topics, forty-seven relevant clinical questions were defined. The draft of the updated guideline was presented and discussed at the consensus meeting held during the 49th Meeting of European Pancreatic Club, in Budapest, on July 1, 2017. These evidence-based guidelines provides the current state of the art of the diagnosis and management of pediatric pancreatitis. Copyright © 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  7. Evidence based of chemoradiotherapy in cervix carcinoma

    International Nuclear Information System (INIS)

    Joly-Lobbedez, F.

    2009-01-01

    Since 10 years, the combination of chemoradiotherapy has become a standard of treatment of the advanced localized cervical cancer. Two systematic reviews of the literature (including the results of the different clinical trials) have already been published. The aim of this article is to present the results of the recent meta-analysis based on individual patient data and to discuss the perspectives. This meta-analysis was rigorously designed: trials selected had the same control arm with the same radiotherapy without concomitant chemotherapy, the definition of the primary outcome (overall survival) was homogeneous and analysis was made in intent to treat. The results confirm the advantage in overall survival in favor of the chemoradiotherapy with an absolute 5-year overall survival benefit of 6% (60-66%) and 8% of 5-year disease-free survival (50-58%). Interestingly, even if cisplatin seems to be the most active drug, a significant advantage is also observed with no platinum chemotherapy. A polychemotherapy is not more active than a mono chemotherapy and there was a suggestion of a difference in the size of the survival benefit with tumor stage. Larger benefits were seen for the few trials in which additional chemotherapy was administered after chemoradiotherapy, but results have to be confirmed by other clinical trials. Late toxicity was not well evaluated and a long-term follow-up of the patients is important to assess the real incidence of long-term side effects of the chemoradiotherapy and the impact on quality of life. New strategies combining new chemotherapy protocols or targeted therapy with radiation are promising but have to be evaluated in comparative clinical trials before use in routine. (authors)

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

    Science.gov (United States)

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

    2011-11-01

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

  9. Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries

    Directory of Open Access Journals (Sweden)

    Zoi Dorothea Pana

    2016-11-01

    Full Text Available Abstract Background Mucormycosis has emerged as a rare but frequently fatal invasive fungal disease. Current knowledge on paediatric mucormycosis is based on case reports and small series reported over several decades. Contemporary data on a large cohort of patients is lacking. Methods Two large international registries (Zygomyco.net and FungiScope™ were searched for mucormycosis cases in ≤19 year-old patients. Cases enrolled between 2005 and 2014 were extracted, and dual entries in the two databases merged. Epidemiology, clinical characteristics, diagnostic procedures, therapeutic management and final outcome were recorded and analysed with SPSS v.12. Results Sixty-three unique cases (44 proven and 19 probable were enrolled from 15 countries (54 in European and 9 in non-European countries. Median age was 13 years [Interquartile Range (IQR 7.7] with a slight predominance (54.1 % of females. Underlying conditions were haematological malignancies (46 %, other malignancies (6.3 %, haematopoietic stem cell transplantation (15.9 %, solid organ transplantation, trauma/surgery and diabetes mellitus (4.8 % each and a variety of other diseases (7.9 %; in 9.5%, no underlying medical condition was found. Neutropenia was recorded in 46 % of the patients. The main sites of infection were lungs (19 %, skin and soft tissues (19 %, paranasal sinus/sino-orbital region (15.8 % and rhino-cerebral region (7.9 %. Disseminated infection was present in 38.1 %. Mucormycosis diagnosis was based on several combinations of methods; culture combined with histology was performed in 31 cases (49.2 %. Fungal isolates included Rhizopus spp. (39.7 %, Lichtheimia spp. (17.5 %, Mucor spp. (12.7 %, Cunninghamella bertholletiae (6.3 % and unspecified (23.8 %. Treatment comprised amphotericin B (AmB monotherapy in 31.7 % or AmB in combination with other antifungals in 47.7 % of the cases, while 14.3 % received no antifungals. Surgery alone was performed in 6.3 %, and combined

  10. Socioeconomic Inequalities in Green Space Quality and Accessibility-Evidence from a Southern European City.

    Science.gov (United States)

    Hoffimann, Elaine; Barros, Henrique; Ribeiro, Ana Isabel

    2017-08-15

    Background : The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods : Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall's tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results : Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions : Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health.

  11. Clinical librarians as facilitators of nurses' evidence-based practice.

    Science.gov (United States)

    Määttä, Sylvia; Wallmyr, Gudrun

    2010-12-01

    The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.

  12. BUILDING A CULTURE OF EVIDENCE-BASED PLANNING

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Nigeria Evidence-based Health System Initiative (NEHSI) is a ..... PAC structure was tested during the planning phase; the structure .... the research and training organization CIET, engaging ..... scorecards, equipment and office supplies.

  13. Identifying Challenges to Building an Evidence Base for Restoration Practice

    CSIR Research Space (South Africa)

    Ntshotsho, P

    2015-11-01

    Full Text Available Global acknowledgement of ecological restoration, as an important tool to complement conservation efforts, requires an effort to increase the effectiveness of restoration interventions. Evidence-based practice is purported to promote effectiveness...

  14. Moving Zimbabwe Forward : an Evidence Based Policy Dialogue ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Moving Zimbabwe Forward : an Evidence Based Policy Dialogue ... levels of poverty, unemployment, inflation and poor service provision in the areas of education, ... International Water Resources Association, in close collaboration with IDRC, ...

  15. The ethical approach to evidence-based medicine | Kruger | South ...

    African Journals Online (AJOL)

    Abstract. This paper will explore the role of evidence-based medicine in ethical practice of health care professionals. It will also address some of its limitations and potential for negative impact on health care.

  16. The Care and Feeding of Evidence Based Medicine

    OpenAIRE

    Tabrah, Frank L

    2012-01-01

    Wide interest in evidence based medicine (EBM) and its value in patient care, insurance payment decisions, and public health planning has triggered intense medical journal and media coverage that merits review, explanation, and comment.

  17. Advancing Evidence Based Policymaking and Regulation to Ensure ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Advancing Evidence Based Policymaking and Regulation to Ensure Greater ... which is Communications Policy Research South (CPRsouth), a yearly conference that ... policy intellectuals through tutorials for young scholars and internships.

  18. Evidence Based Practice: Valuable and Successful Examples from ...

    African Journals Online (AJOL)

    Keywords: evidence-based practice, nursing, midwifery, education, quality improvement, ... developed by Deming, the father of quality control. ... representative of the total population. .... and helped the management engage in key areas of.

  19. Hydrological deformation signals in karst systems: new evidence from the European Alps

    Science.gov (United States)

    Serpelloni, E.; Pintori, F.; Gualandi, A.; Scoccimarro, E.; Cavaliere, A.; Anderlini, L.; Belardinelli, M. E.; Todesco, M.

    2017-12-01

    The influence of rainfall on crustal deformation has been described at local scales, using tilt and strain meters, in several tectonic settings. However, the literature on the spatial extent of rainfall-induced deformation is still scarce. We analyzed 10 years of displacement time-series from 150 continuous GPS stations operating across the broad zone of deformation accommodating the N-S Adria-Eurasia convergence and the E-ward escape of the Eastern Alps toward the Pannonian basin. We applied a blind-source-separation algorithm based on a variational Bayesian Independent Component Analysis method to the de-trended time-series, being able to characterize the temporal and spatial features of several deformation signals. The most important ones are a common mode annual signal, with spatially uniform response in the vertical and horizontal components and a time-variable, non-cyclic, signal characterized by a spatially variable response in the horizontal components, with stations moving (up to 8 mm) in the opposite directions, reversing the sense of movement in time. This implies a succession of extensional/compressional strains, with variable amplitudes through time, oriented normal to rock fractures in karst areas. While seasonal displacements in the vertical component (with an average amplitude of 4 mm over the study area) are satisfactorily reproduced by surface hydrological loading, estimated from global assimilation models, the non seasonal signal is associated with groundwater flow in karst systems, and is mainly influencing the horizontal component. The temporal evolution of this deformation signal is correlated with cumulated precipitation values over periods of 200-300 days. This horizontal deformation can be explained by pressure changes associated with variable water levels within vertical fractures in the vadose zones of karst systems, and the water level changes required to open or close these fractures are consistent with the fluctuations of precipitation

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

    Science.gov (United States)

    Fitch, Dale

    2014-01-01

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

  1. Introduction to evidence-based medicine(EBM)

    International Nuclear Information System (INIS)

    Choe, Jae Gol

    2001-01-01

    EBM is 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.' EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures

  2. Evidence-Based Scholarly Communication: Information Professionals Unlocking Translational Research

    OpenAIRE

    Philip J. Kroth; Holly E. Phillips; Jonathan D. Eldredge

    2010-01-01

    The Evidence-Based Scholarly Communication Conference (EBSCC) was held March 11-12, 2010 in Albuquerque, NM. The conference addressed the perceived gap in knowledge and training for scholarly communication principles in the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) Program. The EBSCC brought together librarians and information specialists to share evidence based strategies for developing effective local scholarly communication support and training and...

  3. EULAR evidence-based recommendations for the management of fibromyalgia syndrome

    DEFF Research Database (Denmark)

    Carville, S.F.; Arendt-Nielsen, S.; Bliddal, H.

    2008-01-01

    Objective: To develop evidence-based recommendations for the management of fibromyalgia syndrome. Methods: A multidisciplinary task force was formed representing 11 European countries. The design of the study, including search strategy, participants, interventions, outcome measures, data collection...... quality studies were used to base recommendations on. When there was insufficient evidence from the literature, a Delphi process was used to provide basis for recommendation. Results: 146 studies were eligible for the review. 39 pharmacological intervention studies and 59 non-pharmacological were included......-pharmacological''. In many studies sample size was small and the quality of the study was insufficient for strong recommendations to be made. Conclusions: Nine recommendations for the management of fibromyalgia syndrome were developed using a systematic review and expert consensus Udgivelsesdato: 2008/4...

  4. Economic Growth and Environmental Quality in the European Union Countries – Is there Evidence for the Environmental Kuznets Curve?

    Directory of Open Access Journals (Sweden)

    Mazur Anna

    2015-03-01

    Full Text Available This research empirically explores the relation between carbon dioxide emission and economic growth during the period 1992-2010, using panel data on the European Union countries. Both fixed and random effect models are employed to test the Environmental Kuznets Curve (EKC relationship between CO2 emissions and GDP per capita. While no U-shaped EKC was confirmed empirically for all 28 current EU member states, the graphical analysis demonstrates a justified turning point for CO2 emissions as GDP per capita reaches the level of 23,000 USD. Furthermore, there is a firm empirical ground for the EKC hypothesis based on data from 16 older, relatively high-income EU states. Thus, though not empirically confirmed, there is ample data verifying the existence of the EKC in EU economies.

  5. Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

    NARCIS (Netherlands)

    Keygnaert, I.; Dias, S.F.; Degomme, O.; Devillé, W.; Kennedy, P.; Kovats, A.; Meyer, S. de; Vettenburg, N.; Roelens, K.; Temmerman, M.

    2015-01-01

    Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and

  6. Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

    NARCIS (Netherlands)

    Keygnaert, I.; Dias, S.F.; Degomme, O.; Devillé, W.; Kennedy, P.; Kováts, A.; De Meyer, S.; Vettenburg, N.; Roelens, K.; Temmerman, M.

    2014-01-01

    Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and

  7. Sexual and gender-based violence in the European asylum and reception sector : A perpetuum mobile?

    NARCIS (Netherlands)

    Keygnaert, Ines; Dias, Sonia F.; Degomme, Olivier; Devillé, Walter; Kennedy, Patricia; Kováts, András; De Meyer, Sara; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

    2015-01-01

    Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and

  8. Developing a Competency-Based Pan-European Accreditation Framework for Health Promotion

    Science.gov (United States)

    Battel-Kirk, Barbara; Van der Zanden, Gerard; Schipperen, Marielle; Contu, Paolo; Gallardo, Carmen; Martinez, Ana; Garcia de Sola, Silvia; Sotgiu, Alessandra; Zaagsma, Miriam; Barry, Margaret M.

    2012-01-01

    Background: The CompHP Pan-European Accreditation Framework for Health Promotion was developed as part of the CompHP Project that aimed to develop competency-based standards and an accreditation system for health promotion practice, education, and training in Europe. Method: A phased, multiple-method approach was employed to facilitate consensus…

  9. Evidence-based medicine and epistemological imperialism: narrowing the divide between evidence and illness.

    Science.gov (United States)

    Crowther, Helen; Lipworth, Wendy; Kerridge, Ian

    2011-10-01

    Evidence-based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine. © 2011 Blackwell Publishing Ltd.

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

    Science.gov (United States)

    Uzunay, Yusuf; Incebacak, Davut; Bicakci, Kemal

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

  11. Have Sanctions Modified Iran’s Trade Policy? An Evidence of Asianization and De-Europeanization through the Gravity Model

    Directory of Open Access Journals (Sweden)

    Liudmila Popova

    2016-10-01

    Full Text Available This study is an empirical attempt to find out whether under sanctions Iran’s trade direction has shifted away from Europe (trade policy of de-Europeanization towards Asia (trade policy of Asianization. The analysis is conducted using a panel-gravity trade model to analyze bilateral trade pattern between Iran and 50 countries from the EU and Asia during the period 2006–2013. To this end, the authors use an extended gravity model by adding new variables, including the index of Chinn–Ito (KAOPEN as an indicator of financial openness, and the composite trade intensity (CTI as an indicator of trade openness. Our findings reveal that the gravity equation fits the data reasonably well. The empirical evidence indicates a significant negative effect of sanctions on Iran–EU bilateral trade (by an average of 46.9%, while it has a positive impact on trade between Iran and the Asian countries (by an average of 85.2%. Overall, these findings confirm that the imposition of various sanctions related to Iran’s nuclear program has pushed the country’s foreign trade to reorient away from Europe towards Asia.

  12. Population Trends of Central European Montane Birds Provide Evidence for Adverse Impacts of Climate Change on High-Altitude Species.

    Directory of Open Access Journals (Sweden)

    Jiří Flousek

    Full Text Available Climate change is among the most important global threats to biodiversity and mountain areas are supposed to be under especially high pressure. Although recent modelling studies suggest considerable future range contractions of montane species accompanied with increased extinction risk, data allowing to test actual population consequences of the observed climate changes and identifying traits associated to their adverse impacts are very scarce. To fill this knowledge gap, we estimated long-term population trends of montane birds from 1984 to 2011 in a central European mountain range, the Giant Mountains (Krkonoše, where significant warming occurred over this period. We then related the population trends to several species' traits related to the climate change effects. We found that the species breeding in various habitats at higher altitudes had more negative trends than species breeding at lower altitudes. We also found that the species moved upwards as a response to warming climate, and these altitudinal range shifts were associated with more positive population trends at lower altitudes than at higher altitudes. Moreover, long-distance migrants declined more than residents or species migrating for shorter distances. Taken together, these results indicate that the climate change, besides other possible environmental changes, already influences populations of montane birds with particularly adverse impacts on high-altitude species such as water pipit (Anthus spinoletta. It is evident that the alpine species, predicted to undergo serious climatically induced range contractions due to warming climate in the future, already started moving along this trajectory.

  13. A European collaboration research programme to study and test large scale base isolated structures

    International Nuclear Information System (INIS)

    Renda, V.; Verzeletti, G.; Papa, L.

    1995-01-01

    The improvement of the technology of innovative anti-seismic mechanisms, as those for base isolation and energy dissipation, needs of testing capability for large scale models of structures integrated with these mechanisms. These kind experimental tests are of primary importance for the validation of design rules and the setting up of an advanced earthquake engineering for civil constructions of relevant interest. The Joint Research Centre of the European Commission offers the European Laboratory for Structural Assessment located at Ispra - Italy, as a focal point for an international european collaboration research programme to test large scale models of structure making use of innovative anti-seismic mechanisms. A collaboration contract, opened to other future contributions, has been signed with the national italian working group on seismic isolation (Gruppo di Lavoro sull's Isolamento Sismico GLIS) which includes the national research centre ENEA, the national electricity board ENEL, the industrial research centre ISMES and producer of isolators ALGA. (author). 3 figs

  14. Criteria for evidence-based practice in Iranian traditional medicine.

    Science.gov (United States)

    Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh

    2015-07-01

    The major difference between Iranian traditional medicine and allopathic medicine is in the application  of  evidence  and  documents.  In  this  study,  criteria  for  evidence-based  practice  in  Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.

  15. Bridging the gap to evidence-based eye care

    Directory of Open Access Journals (Sweden)

    Richard Wormald

    2004-10-01

    Full Text Available In the first article in this series, I touched on the enormous challenge to make access to information equal for those who need it at the time and place when they need it. Only if this is achieved can we successfully promote an evidence-based approach to health care. The move towards open access publishing is taking us some way to achieving this. However, there are further gaps to be bridged if we are to turn eye care workers into evidence-based practitioners. We can define an evidence-based practitioner as one who combines their individual knowledge and expertise with the best available external clinical evidence from systematic research.

  16. Health decision making: lynchpin of evidence-based practice.

    Science.gov (United States)

    Spring, Bonnie

    2008-01-01

    Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

  17. Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses

    Directory of Open Access Journals (Sweden)

    van Dijk Frank JH

    2009-01-01

    Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important method used by occupational physicians (OPs to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice. Methods Thirty-six OPs from ten countries, planning to attend an EBM course and to a large extent recruited via the European Association of Schools of Occupational Medicine (EASOM, participated in a cross-sectional study. Results Research and development institutes, and knowledge products and tools are used by respectively more than 72% and more than 80% of the OPs and they are rated as being important for EBM practice (more than 65 points (range 0–100. Conventional knowledge access facilities, like traditional libraries, are used often (69% but are rated as less important (46.8 points (range 0–100 compared to the use of more novel facilities, like question-and-answer facilities (25% that are rated as more important (48.9 points (range 0–100. To solve cases, OPs mostly use non evidence-based sources. However, they regard the evidence-based sources that are not often used, e.g. the Cochrane library, as important enablers for practising EBM. The main barriers are lack of time, payment for full-text articles, language barrier (most texts are in English, and lack of skills and support. Conclusion This first exploratory study shows that OPs use many knowledge infrastructure facilities and rate them as being important for their EBM practice. However, they are not used to use evidence-based sources in their practice and face many barriers that are comparable to the barriers physicians face in primary health care.

  18. Invitation strategies and coverage in the population-based cancer screening programmes in the European Union.

    Science.gov (United States)

    Vale, Diama B; Anttila, Ahti; Ponti, Antonio; Senore, Carlo; Sankaranaryanan, Rengaswamy; Ronco, Guglielmo; Segnan, Nereo; Tomatis, Mariano; Žakelj, Maja P; Elfström, Klara M; Lönnberg, Stefan; Dillner, Joakim; Basu, Partha

    2018-03-21

    The aim of this study was to describe the compliance of the population-based cancer screening programmes in the European Union Member States to the invitation strategies enumerated in the European Guidelines and the impact of such strategies on the invitational coverage. Experts in screening programme monitoring from the respective countries provided data. Coverage by invitation was calculated as the proportion of individuals in the target age range receiving a screening invitation over the total number of annualized eligible population. The invitation strategies of 30 breasts, 25 cervical and 27 colorectal national or regional population-based screening programmes are described. Individual mail invitations are sent by 28 breasts, 20 cervical and 25 colorectal screening programmes. Faecal occult blood test kits are sent by post in 17 of the colorectal cancer screening programmes. The majority of programmes claimed to have a population registry, although some use health insurance data as the database for sending invitations. At least 95% invitation coverage was reached by 16 breast, six cervical and five colorectal screening programmes. Majority of the programmes comply with the invitation strategies enumerated in the European guidelines, although there is still scope for improvements. Coverage by invitation is below the desirable level in many population-based cancer screening programmes in European Union.

  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. Possible ways of corporate tax base harmonization in the European Union

    Directory of Open Access Journals (Sweden)

    Danuše Nerudová

    2008-01-01

    Full Text Available The possible ways of corporate tax base harmonization in the European Union are presented in the paper. Present situation when there are 27 different taxation systems used in the EU increases compliance costs of taxation to the companies and therefore decreases their competitiveness. It was proved, that there is negative correlation between the size of the company and the size of the compliance costs of taxation. Based on that, the European Commission has decided for twin-track strategy – to introduce home state taxation in the short term and common consolidated corporate tax base in the long term. In respect to the fact, that the pilot project in the frame of home state taxation system has not started yet, the attention has been turned to the common consolidated corporate tax base. The paper discusses the possible attitudes and methods of consolidated tax base allocation. Based on mentioned arguments the formulary apportionment with factors which generate the taxable income of the group (assets, payroll, turnover, etc. seems to be the best solution. Factors and their weight should become the subject of further discussion in the European Union. The aim of the paper is to present the possible harmonization models and further to discuss the methods which could be used for allocation of the consolidated tax base under CCCTB.

  1. Assessing the potential impact of increased participation in higher education on mortality: evidence from 21 European populations.

    Science.gov (United States)

    Kulhánová, Ivana; Hoffmann, Rasmus; Judge, Ken; Looman, Caspar W N; Eikemo, Terje A; Bopp, Matthias; Deboosere, Patrick; Leinsalu, Mall; Martikainen, Pekka; Rychtaříková, Jitka; Wojtyniak, Bogdan; Menvielle, Gwenn; Mackenbach, Johan P

    2014-09-01

    Although higher education has been associated with lower mortality rates in many studies, the effect of potential improvements in educational distribution on future mortality levels is unknown. We therefore estimated the impact of projected increases in higher education on mortality in European populations. We used mortality and population data according to educational level from 21 European populations and developed counterfactual scenarios. The first scenario represented the improvement in the future distribution of educational attainment as expected on the basis of an assumption of cohort replacement. We estimated the effect of this counterfactual scenario on mortality with a 10-15-year time horizon among men and women aged 30-79 years using a specially developed tool based on population attributable fractions (PAF). We compared this with a second, upward levelling scenario in which everyone has obtained tertiary education. The reduction of mortality in the cohort replacement scenario ranged from 1.9 to 10.1% for men and from 1.7 to 9.0% for women. The reduction of mortality in the upward levelling scenario ranged from 22.0 to 57.0% for men and from 9.6 to 50.0% for women. The cohort replacement scenario was estimated to achieve only part (4-25% (men) and 10-31% (women)) of the potential mortality decrease seen in the upward levelling scenario. We concluded that the effect of on-going improvements in educational attainment on average mortality in the population differs across Europe, and can be substantial. Further investments in education may have important positive side-effects on population health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Evidence conflict measure based on OWA operator in open world.

    Directory of Open Access Journals (Sweden)

    Wen Jiang

    Full Text Available Dempster-Shafer evidence theory has been extensively used in many information fusion systems since it was proposed by Dempster and extended by Shafer. Many scholars have been conducted on conflict management of Dempster-Shafer evidence theory in past decades. However, how to determine a potent parameter to measure evidence conflict, when the given environment is in an open world, namely the frame of discernment is incomplete, is still an open issue. In this paper, a new method which combines generalized conflict coefficient, generalized evidence distance, and generalized interval correlation coefficient based on ordered weighted averaging (OWA operator, to measure the conflict of evidence is presented. Through ordered weighted average of these three parameters, the combinatorial coefficient can still measure the conflict effectively when one or two parameters are not valid. Several numerical examples demonstrate the effectiveness of the proposed method.

  3. Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information.

    Science.gov (United States)

    Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li

    2011-05-01

    To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

  4. Ethics issues in scientific data and service provision: evidence and challenges for the European Plate Observing System (EPOS)

    Science.gov (United States)

    Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos

    2016-04-01

    Addressing Ethics issues is nowadays a relevant challenge for any initiative, program or project dealing with scientific data and products provision, access to services for scientific purposes and communication with different stakeholders, including society. This is corroborated by the evidence that Ethics has very high priority in EU funded research. Indeed, all the activities carried out under Horizon 2020 must comply with ethical principles and national, Union and international legislation. This implies that "For all activities funded by the European Union, Ethics is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence." Here, we present the experience of EPOS, a public pan-European research infrastructure. EPOS aims at integrating data, data products, services and software (DDSS) for solid Earth science generated and provided by monitoring networks, observing systems and facilities belonging to European countries. EPOS fosters the integrated use of multidisciplinary solid Earth data to improve the understanding of physical and chemical processes controlling earthquakes, volcanic eruptions, tsunamis as well as those driving tectonics and surface dynamics. The EPOS integration plan will make significant contributions to understanding and mitigating geo-hazards, yielding data for hazard assessment, data products for engaging different stakeholders, and services for training, education and communication to society. Numerous national research infrastructures engaged in EPOS are deployed for the monitoring of areas prone to geo-hazards and for the surveillance of the national territory including areas used for exploiting geo-resources. The EPOS community is therefore already trained to provide services to public (civil defence agencies, local and national authorities) and private (petroleum industry, mining industry, geothermal companies, aviation security) stakeholders. Our ability to

  5. Community and evidence-based approaches to healthcare ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-29

    Apr 29, 2016 ... This project developed community connections, shared cross-cultural teaching experiences, and fostered local community partnerships. Participants in the course were encouraged to continue providing evidence-based care throughout their careers. UniLúrio now plans to include the community-based ...

  6. An evidence-based rehabilitation program for tracheoesophageal speakers

    NARCIS (Netherlands)

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

    2008-01-01

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

  7. Evidence-Based Practice: A Framework for Making Effective Decisions

    Science.gov (United States)

    Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.

    2012-01-01

    The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…

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

    NARCIS (Netherlands)

    Achterberg, T. van; Schoonhoven, L.; 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

  9. Promoting Sustainability Transparency in European Local Governments: An Empirical Analysis Based on Administrative Cultures

    Directory of Open Access Journals (Sweden)

    Andrés Navarro-Galera

    2017-03-01

    Full Text Available Nowadays, the transparency of governments with respect to the sustainability of public services is a very interesting issue for stakeholders and academics. It has led to previous research and international organisations (EU, IMF, OECD, United Nations, IFAC, G-20, World Bank to recommend promotion of the online dissemination of economic, social and environmental information. Based on previous studies about e-government and the influence of administrative cultures on governmental accountability, this paper seeks to identify political actions useful to improve the practices of transparency on economic, social and environmental sustainability in European local governments. We perform a comparative analysis of sustainability information published on the websites of 72 local governments in 10 European countries grouped into main three cultural contexts (Anglo-Saxon, Southern European and Nordic. Using international sustainability reporting guidelines, our results reveal significant differences in local government transparency in each context. The most transparent local governments are the Anglo-Saxon ones, followed by Southern European and Nordic governments. Based on individualized empirical results for each administrative style, our conclusions propose useful policy interventions to enhance sustainability transparency within each cultural tradition, such as development of legal rules on transparency and sustainability, tools to motivate local managers for online diffusion of sustainability information and analysis of information needs of stakeholders.

  10. 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, ...

  11. The Validity of Observational Measures in Detecting Optimal Maternal Communication Styles: Evidence from European Americans and Latinos

    Science.gov (United States)

    Nadeem, Erum; Romo, Laura F.; Sigman, Marian; Lefkowitz, Eva S.; Au, Terry K.

    2007-01-01

    This study examined the sensitivity of an observational coding system for assessing positive and negative maternal behaviors of Latino and European American mothers toward their adolescent children. Ninety Latino (54 Spanish speaking and 35 English speaking) and 20 European American mother-adolescent dyads participated in an observational study of…

  12. THE FLAT TAX EFFECTS a€“ THEORETICAL AND EMPIRICAL EVIDENCE IN WESTERN AND EASTERN EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Moga Aura Carmen

    2009-05-01

    Full Text Available This paper takes a close look at the advantages and disadvantages of the flat tax and looks at its proven benefits and failings in some European countries which adopted it and its theoretical or possible effects on the economies of other European countrie

  13. Environmental impacts of rare earth mining and separation based on Eudialyte. A new European way

    International Nuclear Information System (INIS)

    Schreiber, Andrea; Marx, Josefine; Zapp, Petra; Hake, Juergen Friedrich; Vossenkaul, Daniel; Friedrich, Bernd

    2016-01-01

    Neodymium and dysprosium are two rare earth elements (REEs), out of a group of 17 elements with similar chemical properties. Due to their unique properties, REEs gained increasing importance in many new technologies like wind turbines, batteries, lighting, and medical technique. However, the production of REEs requires high material and energy consumption and is associated with considerably environmental burdens e.g. radioactive loaded dust and tailings. Due to the Chinese hegemony regarding REE production and the strong dependency of European industry on Chinese REE exports this paper presents a possible European production chain of REEs based on the mineral Eudialyte found in Norra Karr (Sweden). Because almost 90% of the total mines production of 109,000 t REO equivalents in 2013 [USGS, 2013] occurred in China, the European production is compared to the Chinese route. Bayan Obo is the largest REE deposit in China located near Baotou in Inner Mongolia. Using the Life Cycle Assessment method (LCA), the environmental impacts of both production lines are assessed. Although LCA is a well-known methodology to determine environmental aspects from cradle-to-grave, there are only a few LCA studies available considering REE production, almost all based on process information gathered in the 1990s. This study presents newly estimated data of a possible European Eudialyte based production route collected in a corporate 4-year project together with Siemens AG, RWTH Aachen University and Forschungszentrum Julich. The results for the new European process route show reduced environmental burdens although the total REE content in Eudialyte is much smaller than in the Chinese deposit. Especially, the results for dysprosium from Eudialyte outreach those for Bayan Obo, due to the higher content of heavy rare earth elements (HREEs).

  14. Environmental impacts of rare earth mining and separation based on Eudialyte. A new European way

    Energy Technology Data Exchange (ETDEWEB)

    Schreiber, Andrea; Marx, Josefine; Zapp, Petra; Hake, Juergen Friedrich [Forschungszentrum Juelich (Germany). Inst. of Energy and Climate Research - Systems Analysis and Technology Evaluation (IKE-STE); Vossenkaul, Daniel; Friedrich, Bernd [RWTH Aachen (Germany). Inst. of Process Metallurgy and Metal Recycling

    2016-07-01

    Neodymium and dysprosium are two rare earth elements (REEs), out of a group of 17 elements with similar chemical properties. Due to their unique properties, REEs gained increasing importance in many new technologies like wind turbines, batteries, lighting, and medical technique. However, the production of REEs requires high material and energy consumption and is associated with considerably environmental burdens e.g. radioactive loaded dust and tailings. Due to the Chinese hegemony regarding REE production and the strong dependency of European industry on Chinese REE exports this paper presents a possible European production chain of REEs based on the mineral Eudialyte found in Norra Karr (Sweden). Because almost 90% of the total mines production of 109,000 t REO equivalents in 2013 [USGS, 2013] occurred in China, the European production is compared to the Chinese route. Bayan Obo is the largest REE deposit in China located near Baotou in Inner Mongolia. Using the Life Cycle Assessment method (LCA), the environmental impacts of both production lines are assessed. Although LCA is a well-known methodology to determine environmental aspects from cradle-to-grave, there are only a few LCA studies available considering REE production, almost all based on process information gathered in the 1990s. This study presents newly estimated data of a possible European Eudialyte based production route collected in a corporate 4-year project together with Siemens AG, RWTH Aachen University and Forschungszentrum Julich. The results for the new European process route show reduced environmental burdens although the total REE content in Eudialyte is much smaller than in the Chinese deposit. Especially, the results for dysprosium from Eudialyte outreach those for Bayan Obo, due to the higher content of heavy rare earth elements (HREEs).

  15. 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.

  16. [Glocalization: the outlook for Taiwan evidence based health care].

    Science.gov (United States)

    Chen, Chiehfeng

    2014-12-01

    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

  17. Barriers to evidence-based medicine: a systematic review.

    Science.gov (United States)

    Sadeghi-Bazargani, Homayoun; Tabrizi, Jafar Sadegh; Azami-Aghdash, Saber

    2014-12-01

    Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Different database searching methods and also manual search were employed in this study using the search words ('evidence-based' or 'evidence-based medicine' or 'evidence-based practice' or 'evidence-based guidelines' or 'research utilization') and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled. © 2014 John Wiley & Sons, Ltd.

  18. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

    International Nuclear Information System (INIS)

    Polgar, Csaba; Limbergen, Erik Van; Poetter, Richard; Kovacs, Gyoergy; Polo, Alfredo; Lyczek, Jaroslaw; Hildebrandt, Guido; Niehoff, Peter; Guinot, Jose Luis; Guedea, Ferran; Johansson, Bengt; Ott, Oliver J.; Major, Tibor; Strnad, Vratislav

    2010-01-01

    Purpose: To give recommendations on patient selection criteria for the use of accelerated partial-breast irradiation (APBI) based on available clinical evidence complemented by expert opinion. Methods and materials: Overall, 340 articles were identified by a systematic search of the PubMed database using the keywords 'partial-breast irradiation' and 'APBI'. This search was complemented by searches of reference lists of articles and handsearching of relevant conference abstracts and book chapters. Of these, 3 randomized and 19 prospective non-randomized studies with a minimum median follow-up time of 4 years were identified. The authors reviewed the published clinical evidence on APBI, complemented by relevant clinical and pathological studies of standard breast-conserving therapy and, through a series of personal communications, formulated the recommendations presented in this article. Results: The GEC-ESTRO Breast Cancer Working Group recommends three categories guiding patient selection for APBI: (1) a low-risk group for whom APBI outside the context of a clinical trial is an acceptable treatment option; including patients ageing at least 50 years with unicentric, unifocal, pT1-2 (≤30 mm) pN0, non-lobular invasive breast cancer without the presence of an extensive intraductal component (EIC) and lympho-vascular invasion (LVI) and with negative surgical margins of at least 2 mm, (2) a high-risk group, for whom APBI is considered contraindicated; including patients ageing ≤40 years; having positive margins, and/or multicentric or large (>30 mm) tumours, and/or EIC positive or LVI positive tumours, and/or 4 or more positive lymph nodes or unknown axillary status (pNx), and (3) an intermediate-risk group, for whom APBI is considered acceptable only in the context of prospective clinical trials. Conclusions: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized

  19. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis

    DEFF Research Database (Denmark)

    Whittle, Samuel L; Colebatch, Alexandra N; Buchbinder, Rachelle

    2012-01-01

    Objective. To develop evidence-based recommendations for pain management by pharmacotherapy in patients with inflammatory arthritis (IA).Methods. A total of 453 rheumatologists from 17 countries participated in the 2010 3e (Evidence, Expertise, Exchange) Initiative. Using a formal voting process......, 89 rheumatologists representing all 17 countries selected 10 clinical questions regarding the use of pain medications in IA. Bibliographic fellows undertook a systematic literature review for each question, using MEDLINE, EMBASE, Cochrane CENTRAL and 2008-09 European League Against Rheumatism (EULAR...... to each recommendation. The recommendations related to the efficacy and safety of various analgesic medications, pain measurement scales and pain management in the pre-conception period, pregnancy and lactation. Finally, an algorithm for the pharmacological management of pain in IA was developed. Twenty...

  20. Eschar removal by bromelain based enzymatic debridement (Nexobrid®) in burns: An European consensus.

    Science.gov (United States)

    Hirche, Christoph; Citterio, Antonella; Hoeksema, Henk; Koller, Ján; Lehner, Martina; Martinez, José Ramón; Monstrey, Stan; Murray, Alexandra; Plock, Jan A; Sander, Frank; Schulz, Alexandra; Ziegler, Benjamin; Kneser, Ulrich

    2017-12-01

    Early debridement and/or eschar removal is regarded as a significant step in the treatment of deep partial and full thickness burns. It aims to control wound bioburden and allows early wound closure by conservative treatment or skin grafting. Preservation of viable dermis accompanied by early wound closure, is regarded as a necessary step to reduce scar related complication, e.g. functional limitations and/or unaesthetic scar formation. Aside from the classical techniques of surgical excision as tangential excision for eschar removal, hydro-surgery, maggot therapy, laser, enzymatic debridement have been described as additional techniques in the burn surgeon's armamentarium. It is widely accepted that early eschar removal within 72h improves the outcome of burn wound treatment by reducing bacterial wound colonization, infection and length of hospital stay. In contrast, the right technique for eschar removal is still a matter of debate. There is increasing evidence that enzymatic debridement is a powerful tool to remove eschar in burn wounds, reducing blood loss, the need for autologous skin grafting and the number of wounds requiring surgical excision. In order to assess the role and clinical advantages of enzymatic debridement by a mixture of proteolytic enzymes enriched in Bromelain (Nexobrid ® ) beyond the scope of the literature and in view of users' experience, a European Consensus Meeting was scheduled. The aim was to provide statements for application, based on the mutual experience of applying enzymatic debridement in more than 500 adult and pediatric patients by the consensus panelists. Issues to be addressed were: indications, pain management and anesthesia, timing of application, technique of application, after-intervention care, skin grafting after enzymatic debridement, blood loss, training strategies and learning curve and areas of future research needs. Sixty-eight (68) consensus statements were provided for the use of enzymatic debridement. The

  1. 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…

  2. Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

    Science.gov (United States)

    Fung, Foon Yin; Linn, Yeh Ching

    2015-01-01

    Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

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

    Science.gov (United States)

    Patwardhan, Bhushan

    2014-01-01

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

  4. Developing the skills required for evidence-based practice.

    Science.gov (United States)

    French, B

    1998-01-01

    The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research process. Emphasis on the requirement for rigour in the process of creating new knowledge is assumed to lead to skill in the process of using research information created by others. This article reflects upon the requirements for evidence-based practice, and the degree to which current approaches to teaching research prepare practitioners who are able to find, evaluate and best use currently available research information. The potential for using the principles of systematic review as a teaching and learning strategy for research is explored, and some of the possible strengths and weakness of this approach are highlighted.

  5. Evidence-based policy: implications for nursing and policy involvement.

    Science.gov (United States)

    Hewison, Alistair

    2008-11-01

    Evidence-based policy making is espoused as a central feature of government in the United Kingdom. However, an expectation that this will improve the quality of policy produced and provide a path to increased involvement of nurses in the policy process is misplaced. The purpose of this article is to demonstrate that the emphasis on evidence-based policy is problematic and cannot be regarded as a "new model" of policy making. Also, it could deflect attention from more practical approaches to policy involvement on the part of nurses. Policy development activities, acquisition of skills in policy analysis, and other forms of involvement are needed if nurses are to move along the continuum from policy literacy, through policy acumen, to policy competence. This involves taking a critical stance on the notion of evidence-based policy.

  6. Evidence-Based Scholarly Communication: Information Professionals Unlocking Translational Research

    Directory of Open Access Journals (Sweden)

    Philip J. Kroth

    2010-12-01

    Full Text Available The Evidence-Based Scholarly Communication Conference (EBSCC was held March 11-12, 2010 in Albuquerque, NM. The conference addressed the perceived gap in knowledge and training for scholarly communication principles in the National Institutes of Health (NIH Clinical and Translational Science Award (CTSA Program. The EBSCC brought together librarians and information specialists to share evidence based strategies for developing effective local scholarly communication support and training and, it is hoped, to form new coalitions to address this topic at the local and national levels. This brief communication summarizes the need for theconference, highlights the general sessions in order of presentation, and introduces the EBSCC research papers appearing in this issue of Evidence Based Library and Information Practice (EBLIP. It also includes a description of a unique peer-review process methodology pioneered at EBSCC.

  7. European communion

    DEFF Research Database (Denmark)

    Manners, Ian James

    2013-01-01

    Political theory of European union, through an engagement between political concepts and theoretical understandings, provides a means of identifying the EU as a political object. It is argued that understanding the projects, processes and products of European union, based on ‘sharing’ or ‘communion......’, provides a better means of perceiving the EU as a political object rather than terms such as ‘integration’ or ‘co-operation’. The concept of ‘European communion’ is defined as the ‘subjective sharing of relationships’, understood as the extent to which individuals or groups believe themselves to be sharing...... relations (or not), and the consequences of these beliefs for European political projects, processes and products. By exploring European communion through an engagement with contemporary political theory, using very brief illustrations from the Treaty of Lisbon, the article also suggests that European...

  8. A European perspective on GIS-based walkability and active modes of transport.

    Science.gov (United States)

    Grasser, Gerlinde; van Dyck, Delfien; Titze, Sylvia; Stronegger, Willibald J

    2017-02-01

    The association between GIS-based walkability and walking for transport is considered to be well established in USA and in Australia. Research on the association between walkability and cycling for transport in European cities is lacking. The aim of this study was to test the predictive validity of established walkability measures and to explore alternative walkability measures associated with walking and cycling for transport in a European context. Outcome data were derived from the representative cross-sectional survey ( n  = 843) ‘Radfreundliche Stadt’ of adults in the city of Graz (Austria). GIS-based walkability was measured using both established measures (e.g. gross population density, household unit density, entropy index, three-way intersection density, IPEN walkability index) and alternative measures (e.g. proportion of mixed land use, four-way intersection density, Graz walkability index). ANCOVAs were conducted to examine the adjusted association between walkability measures and outcomes. Household unit density, proportion of mixed land use, three-way intersection density and IPEN walkability index were positively associated with walking for transport, but the other measures were not. All walkability measures were positively associated with cycling for transport. The established walkability measures were applicable to a European city such as Graz. The alternative walkability measures performed well in a European context. Due to measurement issues the association between these walkability measures and walking for transport needs to be investigated further. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  9. European demonstration program on the effect-based and chemical identification and monitoring of organic pollutants in European surface waters

    NARCIS (Netherlands)

    Tousova, Zuzana; Oswald, Peter; Slobodnik, Jaroslav; Blaha, Ludek; Muz, Melis; Hu, Meng; Brack, Werner; Krauss, Martin; Di Paolo, Carolina; Tarcai, Zsolt; Seiler, Thomas Benjamin; Hollert, Henner; Koprivica, Sanja; Ahel, Marijan; Schollée, Jennifer E.; Hollender, Juliane; Suter, Marc J.F.; Hidasi, Anita O.; Schirmer, Kristin; Sonavane, Manoj; Ait-Aissa, Selim; Creusot, Nicolas; Brion, Francois; Froment, Jean; Almeida, Ana Catarina; Thomas, Kevin; Tollefsen, Knut Erik; Tufi, Sara; Ouyang, Xiyu; Leonards, Pim; Lamoree, Marja; Torrens, Victoria Osorio; Kolkman, Annemieke; Schriks, Merijn; Spirhanzlova, Petra; Tindall, Andrew; Schulze, Tobias

    2017-01-01

    Growing concern about the adverse environmental and human health effects of a wide range of micropollutants requires the development of novel tools and approaches to enable holistic monitoring of their occurrence, fate and effects in the aquatic environment. A European-wide demonstration program

  10. 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.

  11. 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

    OBJECTIVE: To give an overview of currently used investigations and treatments offered to women with recurrent pregnancy loss (RPL) and, from an evidence-based point of view, to evaluate the usefulness of these interventions. DESIGN: Ten experts on epidemiologic, genetic, anatomic, endocrinologic......, 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...

  12. Automatic evidence quality prediction to support evidence-based decision making.

    Science.gov (United States)

    Sarker, Abeed; Mollá, Diego; Paris, Cécile

    2015-06-01

    Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance

  13. Towards evidence-based critical thinking medicine? Uses of best evidence in flawless argumentations.

    Science.gov (United States)

    Jenicek, Milos

    2006-08-01

    Uses of informal logic and critical thinking methodology are increasingly taught, learnt and advantageously applied in such diverse domains as law, the military, business, and education. Health sciences are also following this trend. However, production and critical appraisal of evidence as already practiced in Evidence-Based Medicine must be coupled with equally rigorous uses in order to ensure appropriate health problem understanding and decision-making. Making most proposals and decisions in medicine is the conclusion of an argumentation process that lies behind any communication between health professionals working with patients, performing research or sharing ideas about health problems, their interpretations and solutions with numerous stakeholders in public life. Modern critical thinking and decision making in medicine is not instantly mastered, but is instead a learnt experience as anything else in professional and social interactions. The modern argument as outlined, illustrated and applied to health problems in this essay is an extension of a previously established way of thinking in Evidence-Based Medicine. Ideally, health professionals, their patients and all other stakeholders should speak the same language and it is up to us to make this possible. Evidence and critical thinking - based medicine might be a solution. As modern critical thinkers, we are at the forefront and we must see to it that patients and professional and general communities benefit from this more so even than from other remarkable historical and current contributions to the well-being of those under our care.

  14. The prevalence of genetic and serologic markers in an unselected European population-based cohort of IBD patients

    DEFF Research Database (Denmark)

    Riis, Lene; Vind, Ida; Vermeire, Severine

    2007-01-01

    BACKGROUND AND AIM: The aetiology of inflammatory bowel disease (IBD) is unknown, but it has become evident that genetic factors are involved in disease susceptibility. Studies have suggested a north-south gradient in the incidence of IBD, raising the question whether this difference is caused...... by genetic heterogeneity. We aimed to investigate the prevalence of polymorphisms in CARD15 and TLR4 and occurrence of anti-Saccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (pANCA) in a European population-based IBD cohort. METHODS: Individuals from the incident cohort were genotyped...... for three mutations in CARD15 and the Asp299gly mutation in TLR4. Levels of ASCA and pANCA were assessed. Disease location and behaviour at time of diagnosis was obtained from patient files. RESULTS: Overall CARD15 mutation rate was 23.9% for CD and 9.6% for UC patients (P

  15. Weak population structure in European roe deer (Capreolus capreolus and evidence of introgressive hybridization with Siberian roe deer (C. pygargus in northeastern Poland.

    Directory of Open Access Journals (Sweden)

    Juanita Olano-Marin

    Full Text Available We investigated contemporary and historical influences on the pattern of genetic diversity of European roe deer (Capreolus capreolus. The study was conducted in northeastern Poland, a zone where vast areas of primeval forests are conserved and where the European roe deer was never driven to extinction. A total of 319 unique samples collected in three sampling areas were genotyped at 16 microsatellites and one fragment (610 bp of mitochondrial DNA (mtDNA control region. Genetic diversity was high, and a low degree of genetic differentiation among sampling areas was observed with both microsatellites and mtDNA. No evidence of genetic differentiation between roe deer inhabiting open fields and forested areas was found, indicating that the ability of the species to exploit these contrasting environments might be the result of its phenotypic plasticity. Half of the studied individuals carried an mtDNA haplotype that did not belong to C. capreolus, but to a related species that does not occur naturally in the area, the Siberian roe deer (C. pygargus. No differentiation between individuals with Siberian and European mtDNA haplotypes was detected at microsatellite loci. Introgression of mtDNA of Siberian roe deer into the genome of European roe deer has recently been detected in eastern Europe. Such introgression might be caused by human-mediated translocations of Siberian roe deer within the range of European roe deer or by natural hybridization between these species in the past.

  16. Variation, certainty, evidence, and change in dental education: employing evidence-based dentistry in dental education.

    Science.gov (United States)

    Marinho, V C; Richards, D; Niederman, R

    2001-05-01

    Variation in health care, and more particularly in dental care, was recently chronicled in a Readers Digest investigative report. The conclusions of this report are consistent with sound scientific studies conducted in various areas of health care, including dental care, which demonstrate substantial variation in the care provided to patients. This variation in care parallels the certainty with which clinicians and faculty members often articulate strongly held, but very different opinions. Using a case-based dental scenario, we present systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. We also discuss barriers inhibiting these systematic approaches to evidence-based clinical decision making and methods for effectively promoting behavior change in health care professionals.

  17. Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

    Science.gov (United States)

    Cairney, Paul; Oliver, Kathryn

    2017-04-26

    There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions

  18. Evidence-based medicine: the value of vision screening.

    Science.gov (United States)

    Beauchamp, George R; Ellepola, Chalani; Beauchamp, Cynthia L

    2010-01-01

    To review the literature for evidence-based medicine (EBM), to assess the evidence for effectiveness of vision screening, and to propose moving toward value-based medicine (VBM) as a preferred basis for comparative effectiveness research. Literature based evidence is applied to five core questions concerning vision screening: (1) Is vision valuable (an inherent good)?; (2) Is screening effective (finding amblyopia)?; (3) What are the costs of screening?; (4) Is treatment effective?; and (5) Is amblyopia detection beneficial? Based on EBM literature and clinical experience, the answers to the five questions are: (1) yes; (2) based on literature, not definitively so; (3) relatively inexpensive, although some claim benefits for more expensive options such as mandatory exams; (4) yes, for compliant care, although treatment processes may have negative aspects such as "bullying"; and (5) economic productive values are likely very high, with returns of investment on the order of 10:1, while human value returns need further elucidation. Additional evidence is required to ascertain the degree to which vision screening is effective. The processes of screening are multiple, sequential, and complicated. The disease is complex, and good visual outcomes require compliance. The value of outcomes is appropriately analyzed in clinical, human, and economic terms.

  19. 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

  20. EVIDENCE-BASED MEDICINE – II. CLINICAL USE AND CRITICS

    Directory of Open Access Journals (Sweden)

    Angela Čuk

    2004-01-01

    Full Text Available Background. Evidence-based medicine employs systematic searching, evaluation and use of current research findings as the basis for clinical decision-making. However, there are some problems and uncertainties hindering introduction and spreading of the use of the method in clinical practice. Physicians often have no time for literature searching and for use of the method in practice. For certain questions in clinical practice there are no answers in medical literature. Most of the evidences in medical literature are only available in English. Introduction of the method is hampered also by the fact that clinical decision-making is complex and does not allow procedures prescribed in advance. Rigidity and universality of decisions resulting from the evidence may appear impersonal and may affect the relationship between the physician and the patient. Trends towards evidence based medicine are followed also by big multinational pharmaceutical corporations. They carry out large and expensive clinical trials using the results for promotional purposes. In this way, they get the competitive advantage and influence the objectivity of physicians’ clinical decision-making.Conclusions. With introduction of evidence based medicine into clinical practice physicians acquire new information and use a new form of continuing education by following new developments in their field. This way, new findings from medical literature get into clinical practice faster and more efficiently. In addition, physicians get more professional satisfaction and quality in clinical practice is higher.

  1. Determinants of Capital Integration among Strategic Alliance Members in the Retail Sector: Evidence from Central and Southeast European Countries

    Directory of Open Access Journals (Sweden)

    Nikola Butigan

    2016-12-01

    Full Text Available Survival of firms requires continuous search for new and a restructuring of the existing competitive advantages. These can come either from firms’ internal factors or from cooperation with the environment. Cooperation among firms commonly takes place through the formation of strategic alliances. However, such form of cooperation presents only one stage in the integration of business entities. In the long run, strategic alliances can cease to exist or transform into a higher form of association based on capital integration. The objective of this paper is to explore the determinants of capital integration among strategic alliance member firms in retail sectors of several Central and Southeast European countries. Overall, the obtained findings suggest that business entities engage in integration with the aim of reaching hidden knowledge and skills, accessing distribution and supply channels, and developing new products and services. Integration is also driven with the aim of risk diversification and possible better market positioning, achieving the economies of scale, and improving organization and marketing. The opportunistic behavior of partners and limited managerial control represent its strongest barriers.

  2. Web-based Media at European Universities: Systems, Usage, and Motivation

    DEFF Research Database (Denmark)

    Godsk, Mikkel

    2009-01-01

    This paper presents the results of two surveys analyzing the usage of and the systems available for web-based media at European universities, and how the teachers can be motivated to increase their usage of such materials in their teaching practice. The surveys were carried out April-May 2009 among...... obvious. The surveys also show that many teachers are already using web-based media in their teaching practice and by addressing some of their teaching circumstances it would be possible to increase the usage even further. Based on these results the paper presents five initiatives to motivate the teachers...

  3. New flux based dose–response relationships for ozone for European forest tree species

    International Nuclear Information System (INIS)

    Büker, P.; Feng, Z.; Uddling, J.; Briolat, A.; Alonso, R.; Braun, S.; Elvira, S.; Gerosa, G.; Karlsson, P.E.; Le Thiec, D.

    2015-01-01

    To derive O 3 dose–response relationships (DRR) for five European forest trees species and broadleaf deciduous and needleleaf tree plant functional types (PFTs), phytotoxic O 3 doses (PODy) were related to biomass reductions. PODy was calculated using a stomatal flux model with a range of cut-off thresholds (y) indicative of varying detoxification capacities. Linear regression analysis showed that DRR for PFT and individual tree species differed in their robustness. A simplified parameterisation of the flux model was tested and showed that for most non-Mediterranean tree species, this simplified model led to similarly robust DRR as compared to a species- and climate region-specific parameterisation. Experimentally induced soil water stress was not found to substantially reduce PODy, mainly due to the short duration of soil water stress periods. This study validates the stomatal O 3 flux concept and represents a step forward in predicting O 3 damage to forests in a spatially and temporally varying climate. - Highlights: • We present new ozone flux based dose–response relationships for European trees. • The model-based study accounted for the soil water effect on stomatal flux. • Different statistically derived ozone flux thresholds were applied. • Climate region specific parameterisation often outperformed simplified parameterisation. • Findings could help redefining critical levels for ozone effects on trees. - New stomatal flux based ozone dose–response relationships for tree species are derived for the regional risk assessment of ozone effects on European forest ecosystems.

  4. "EUROPART". Airborne particles in the indoor environment. A European interdisciplinary review of scientific evidence on associations between exposure to particles in buildings and health effects

    DEFF Research Database (Denmark)

    Schneider, T.; Sundell, Jan; Bischof, W.

    2003-01-01

    The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers (called EUROPART) by reviewing papers identified in Medline, Toxline, and OSH. Studies...... or number concentrations can be used as generally applicable risk indicators of health effects in non-industrial buildings and consequently that there is inadequate scientific evidence for establishing limit values or guidelines for particulate mass or number concentrations....

  5. A Business Analysis of a SKYLON-based European Launch Service Operator

    Science.gov (United States)

    Hempsell, Mark; Aprea, Julio; Gallagher, Ben; Sadlier, Greg

    2016-04-01

    Between 2012 and 2014 an industrial consortium led by Reaction Engines conducted a feasibility study for the European Space Agency with the objective to explore the feasibility of SKYLON as the basis for a launcher that meets the requirements established for the Next Generation European Launcher. SKYLON is a fully reusable single stage to orbit launch system that is enabled by the unique performance characteristic of the Synergetic Air-Breathing Rocket Engine and is under active development. The purpose of the study which was called ;SKYLON-based European Launch Service Operator (S-ELSO); was to support ESA decision making on launch service strategy by exploring the potential implications of this new launch system on future European launch capability and the European industry that supports it. The study explored both a SKYLON operator (S-ELSO) and SKYLON manufacturer as separate business ventures. In keeping with previous studies, the only strategy that was found that kept the purchase price of the SKYLON low enough for a viable operator business was to follow an ;airline; business model where the manufacturer sells SKYLONs to other operators in addition to S-ELSO. With the assumptions made in the study it was found that the SKYLON manufacturer with a total production run of between 30 and 100 SKYLONs could expect an Internal Rate of Return of around 10%. This was judged too low for all the funding to come from commercial funding sources, but is sufficiently high for a Public Private Partnership. The S-ELSO business model showed that the Internal Rate of Return would be high enough to consider operating without public support (i.e. commercial in operation, irrespective of any public funding of development), even when the average launch price is lowered to match the lowest currently quoted price for expendable systems.

  6. Bureaucratic structure, geographical location and the autonomy of administrative systems. Evidence from the European External Action Service

    OpenAIRE

    Henökl, Thomas; Trondal, Jarle

    2013-01-01

    Presentation on department page: http://www.uia.no/no/portaler/om_universitetet/oekonomi_og_samfunnsvitenskap/statsvitenskap_og_ledelsesfag/ forskning_isl/isl_working_papers_series Formulating and implementing public policy in Europe has historically been a prerogative of national administrations. This paper explores how these prerogatives may have become challenged with the ‘autonomization’ of the European Union’s (EU’s) foreign affairs administration (The European External Action Service...

  7. Evidence-Based Management and Controversies in Blunt Splenic Trauma

    NARCIS (Netherlands)

    Olthof, D. C.; van der Vlies, C. H.; Goslings, J. C.

    2017-01-01

    The study aims to describe the evidence-based management and controversies in blunt splenic trauma. A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt

  8. Decision making in advanced otosclerosis: an evidence-based strategy

    NARCIS (Netherlands)

    Merkus, P.; van Loon, M.C.; Smit, C.F.G.M.; Smits, J.C.M.; de Cock, A.F.C.; Hensen, E.F.

    2011-01-01

    Objectives/Hypothesis: To propose an evidence-based strategy for the management of patients with advanced otosclerosis accompanied by severe to profound hearing loss. Study Design: Systematic review of the literature and development of treatment guidelines. Methods: A systematic review was conducted

  9. Beyond Evidence-Based Interventions for Teen Pregnancy Prevention

    OpenAIRE

    Emily Scribner-O'Pray

    2017-01-01

    This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs); whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.

  10. Implementing an Evidence Based Preceptorship Program in a Military Center

    Science.gov (United States)

    2014-11-05

    want to act in good conscience, always trying to reach their goals without compromising their personal code of ethics . As Concrete Utilitarians ...Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training Leadership, Ethics ...management Education and training Leadership, Ethics , and Mentoring: Health policy Recruitment and retention Preparing tomorrow’s leaders Care of

  11. Interteaching: An Evidence-Based Approach to Instruction

    Science.gov (United States)

    Brown, Thomas Wade; Killingsworth, Kenneth; Alavosius, Mark P.

    2014-01-01

    This paper describes "interteaching" as an evidence-based method of instruction. Instructors often rely on more traditional approaches, such as lectures, as means to deliver instruction. Despite high usage, these methods are ineffective at achieving desirable academic outcomes. We discuss an innovative approach to delivering instruction…

  12. Evidence and/or Experience-Based Knowledge in Lifestyle ...

    African Journals Online (AJOL)

    More precisely, it is argued that what will be “effective” therapy for a person diagnosed as obese cannot be reduced ..... they had come to rely on their experience-based know- ledge. ..... knowledge – “tracking down the best evidence to answer.

  13. Methadone maintenance therapy as evidence based drug abuse ...

    African Journals Online (AJOL)

    Methadone maintenance therapy as evidence based drug abuse planning in ... drugs are being used as artificial problem-solvers such as frustrations, stress or ... Drug use is a problem to users when it begins to cause some damage to their ...

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

    Science.gov (United States)

    Soltani, Akbar; Moayyeri, Alireza

    2007-08-01

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

  15. Implementing evidence-based practice during an economic downturn.

    Science.gov (United States)

    Beck, Mary S; Staffileno, Beth A

    2012-01-01

    Building a sustainable evidence-based practice (EBP) infrastructure during times of financial constraints poses challenges for nurse leaders. To be successful, plans need to be creative and adaptive, while mindful of limited resources. This commentary describes change management strategies used to implement an EBP infrastructure at a hospital after organizational restructuring occurred.

  16. Evidence-Based Secondary Transition Practices for Enhancing School Completion

    Science.gov (United States)

    Test, David W.; Fowler, Catherine H.; White, James; Richter, Sharon; Walker, Allison

    2009-01-01

    Approximately 28% of students with disabilities do not complete high school (National Longitudinal Transition Study-2, 2005). This increases the likelihood that these students will experience low wages, high rates of incarceration, and limited access to postsecondary education. This article reviews evidence-based secondary transition practices…

  17. 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…

  18. Strengthening Research Capacity and Evidence-Based Policy ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... wider Central Asian region lack capacity to conduct empirical analysis and create policies based on research evidence. To address government priorities, the region needs quality research driven by local demands and analytical skills that can inform effective development responses through policy. This 39-month project, ...

  19. Evidence Based Practice: Valuable and Successful Examples from ...

    African Journals Online (AJOL)

    While research is needed and necessary, promoting the value of evidence-based practice (EBP), quality improvement (QI) and project evaluation (PE) initiatives could rapidly and economically further the development of nursing and midwifery disciplines globally, perhaps especially in resource constrained settings.

  20. 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.

  1. Integrating evidence-based principles into the undergraduate ...

    African Journals Online (AJOL)

    Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the ...

  2. Book Review: Deployment Psychology: Evidence-based strategies ...

    African Journals Online (AJOL)

    Book Review: Deployment Psychology: Evidence-based strategies to promote mental health in the Military. AB Adler, PD Bliese, CA Castro. Abstract. Washington, DC: American Psychological Association 2011 294 pages ISBN-13: 978-1-4338-0881-4. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  3. 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.

  4. Evidence-Based Family-School Interventions with Preschool Children

    Science.gov (United States)

    Bates, Stacey L.

    2005-01-01

    Fifteen studies of family-school interventions with preschool children conducted between 1980 and 2002, and published in peer-reviewed journals, were reviewed and evaluated according to the criteria developed by the Task Force on Evidence-Based Intervention in School Psychology (Division 16 and Society for the Study of School Psychology Task…

  5. Evidence-Based Practices Project for Suicide Prevention

    Science.gov (United States)

    Rodgers, Philip L.; Sudak, Howard S.; Silverman, Morton M.; Litts, David A.

    2007-01-01

    Suicide continues to be a serious public health problem. In response to this problem, a myriad of suicide prevention programs have been developed and employed across the United States. Unfortunately, the effectiveness of many of these programs is unknown because they have not been evaluated using rigorous methods. The Evidence-Based Practices…

  6. 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...... the two studies and that from literature to provide initial evidence-based heuristics for EDS selection....

  7. Beyond Evidence-Based Interventions for Teen Pregnancy Prevention

    Directory of Open Access Journals (Sweden)

    Emily Scribner-O'Pray

    2017-04-01

    Full Text Available This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs; whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.

  8. [Evidence-based medicine: an approach without any weakness?].

    Science.gov (United States)

    Junod, A F

    2000-04-06

    Evidence-based medicine is a methodological approach giving access to the best information derived from clinical research for an individual patient. It requires the formulation of a question, a strategy to search for the best information, the selection of the latter, its critical appraisal and its application to the patient. The qualities, but also the limitations of this approach are discussed.

  9. The role of hypnotherapy in evidence-based clinical practice.

    Science.gov (United States)

    Griffiths, M J

    2017-05-01

    The purpose of this review was to discuss the place of hypnotherapy in a modern medical world dominated by so-called evidence-based clinical practice. Hypnosis is an easily learned technique that is a valuable adjuvant to many medical, dental and psychological interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Evidence-based health care: its place within clinical governance.

    Science.gov (United States)

    McSherry, R; Haddock, J

    This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers 'The New NHS: Modern, Dependable' (Department of Health (DoH), 1997) and 'A First Class Service: Quality in the New NHS' (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence. This article also examines what evidence-based practice is and what processes are required to promote effective healthcare interventions. The authors also look at how clinical governance relates to other methods/systems involved in clinical effectiveness. Finally, the importance for nurses and other healthcare professionals of familiarizing themselves with the development of critical appraisal skills, and their implications for developing evidence-based practice, is emphasized.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  12. Evidence-based ICT Policy for Development and Innovation | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Evidence-based ICT Policy for Development and Innovation. The cost of access to information and communication technologies (ITCs) in Africa remains the major impediment to the participation of Africans in the networked society. While Africa is the region with the fastest growing number of mobile phone subscribers in the ...

  13. 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?

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

    Directory of Open Access Journals (Sweden)

    Kaijuan Yuan

    2016-01-01

    Full Text Available 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.

  15. 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. The ....... The purpose of the article is both to qualify existing scepticism and reservations and - maybe - to clarify misunderstandings and objections through the presentation of arguments and data....

  16. 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...

  17. Evidence-based approach for continuous improvement of occupational health.

    Science.gov (United States)

    Manzoli, Lamberto; Sotgiu, Giovanni; Magnavita, Nicola; Durando, Paolo

    2015-01-01

    It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries.

  18. Teaching evidence-based medical care: description and evaluation.

    Science.gov (United States)

    Grad, R; Macaulay, A C; Warner, M

    2001-09-01

    This paper describes and evaluates several years of a seminar series designed to stimulate residents to seek evidence-based answers to their clinical questions and incorporate this evidence into practice. At the first session, 86 of 89 (97%) residents completed a baseline needs assessment questionnaire. Post-course self-assessment questionnaires measured change from the first to the final seminar session in six domains of interest and skill, as well as residents' preferred sources of information for clinical problem solving up to 2 years after the course. Before the seminars, 48% of residents reported that textbooks were their most important source of information for solving clinical problems. A total of 58 of 75 (77%) residents completed the first post-course questionnaire. Residents reported significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews, and deciding when and how to incorporate new findings into practice. Use of secondary sources of information such as "Best Evidence," moved up in importance from before the course to after the course. First-year family practice residents who completed our seminar series have reported increased skill at blending consideration of a clinical problem with the use of secondary sources of information to access evidence to support their health care decisions.

  19. 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.

  20. 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. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  1. Evidence-based review on temporomandibular disorders among musicians.

    Science.gov (United States)

    van Selms, M K A; Ahlberg, J; Lobbezoo, F; Visscher, C M

    2017-07-01

    Playing a musical instrument that loads the masticatory system has frequently been linked to temporomandibular disorders (TMDs). Previous literature reviews on this topic do not conform to the current standards of evidence-based medicine. To investigate the effects of playing a musical instrument (i.e. violin/viola and wind instruments) or singing on the presence of TMDs, based on evidence derived from observational studies. Databases of Medline, Web of Science and Google Scholar were searched using MeSH and other relevant terms. For each study, a quality assessment was undertaken using a modified version of the Newcastle-Ottawa Scale (NOS). Fifteen relevant papers were identified for inclusion in this review. Of the seven possible points that could be scored with the NOS, the majority of these studies scored under half. Based on the available evidence, the purported relationship between the playing of specific musical instruments and TMDs was not as evident as reported in previous literature reviews. There is limited evidence to conclude that playing a wind instrument is a hazard to the temporomandibular system. Furthermore, there is no available evidence to suggest that vocalists experience more TMDs than controls. The studies that investigated the presence of TMDs among violists and violinists yielded ambiguous outcomes; some studies reported no association between the playing of these instruments and the presence of signs and symptoms of TMDs, whereas in studies where a clinical examination was performed (though of lower methodological quality), an association was found. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. A Large Scale Problem Based Learning inter-European Student Satellite Construction Project

    DEFF Research Database (Denmark)

    Nielsen, Jens Frederik Dalsgaard; Alminde, Lars; Bisgaard, Morten

    2006-01-01

    that electronic communication technology was vital within the project. Additionally the SSETI EXPRESS project implied the following problems it didn’t fit to a standard semester - 18 months for the satellite project compared to 5/6 months for a “normal” semester project. difficulties in integrating the tasks......A LARGE SCALE PROBLEM BASED LEARNING INTER-EUROPEAN STUDENT SATELLITE CONSTRUCTION PROJECT This paper describes the pedagogical outcome of a large scale PBL experiment. ESA (European Space Agency) Education Office launched January 2004 an ambitious project: Let students from all over Europe build....... The satellite was successfully launched on October 27th 2005 (http://www.express.space.aau.dk). The project was a student driven project with student project responsibility adding at lot of international experiences and project management skills to the outcome of more traditional one semester, single group...

  3. Navigating Evidence-Based Practice Projects: The Faculty Role.

    Science.gov (United States)

    Moch, Susan D; Quinn-Lee, Lisa; Gallegos, Cara; Sortedahl, Charlotte K

    : An innovative way to facilitate evidence-based practice (EBP) learning and to get evidence into practice is through academic-clinical agency projects involving faculty, undergraduate students, and agency staff. The central role of the faculty is key to successful academic-clinical agency partnerships. Faculty navigate the often difficult process of focusing students and engaging busy staff through initiating, maintaining, and evaluating projects. Students learn valuable EBP skills, staff become engaged in EBP, and the projects are rated highly by agency administrators.

  4. 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.

  5. How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

    Science.gov (United States)

    OʼRourke, Hannah M; Fraser, Kimberly D

    2016-01-01

    Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

  6. 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.

  7. Evidence-based Medicine Search: a customizable federated search engine.

    Science.gov (United States)

    Bracke, Paul J; Howse, David K; Keim, Samuel M

    2008-04-01

    This paper reports on the development of a tool by the Arizona Health Sciences Library (AHSL) for searching clinical evidence that can be customized for different user groups. The AHSL provides services to the University of Arizona's (UA's) health sciences programs and to the University Medical Center. Librarians at AHSL collaborated with UA College of Medicine faculty to create an innovative search engine, Evidence-based Medicine (EBM) Search, that provides users with a simple search interface to EBM resources and presents results organized according to an evidence pyramid. EBM Search was developed with a web-based configuration component that allows the tool to be customized for different specialties. Informal and anecdotal feedback from physicians indicates that EBM Search is a useful tool with potential in teaching evidence-based decision making. While formal evaluation is still being planned, a tool such as EBM Search, which can be configured for specific user populations, may help lower barriers to information resources in an academic health sciences center.

  8. Evidence-Based Assessment of Obsessive–Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Amy M. Rapp

    2016-01-01

    Full Text Available 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.

  9. 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...

  10. Evidence-based practice: the importance of education and leadership.

    Science.gov (United States)

    Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro

    2010-01-01

    To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

  11. Implementation of Evidence-Based Practice From a Learning Perspective.

    Science.gov (United States)

    Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin

    2017-06-01

    For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.

  12. 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...

  13. Pulmonary Metastasectomy: A Common Practice Based on Weak Evidence

    Science.gov (United States)

    Treasure, Tom

    2007-01-01

    The resection of secondary metastases from the lungs is a wide-spread surgical practice. Patients are referred from coloproctology teams to thoracic surgeons specifically for this surgery. What is the expected benefit? I have explored the rationale and searched the literature in order to present these patients with a well-informed opinion for their consideration. I find only weak evidence based on uncontrolled retrospective series which have been interpreted as showing a survival benefit. This has been extrapolated to policy and practice that do not stand up to scrutiny. The practice has never been subjected to randomised trial and I will argue that the present evidence is insufficient to justify the uncontrolled use of an intervention with inescapable short-term morbidity, permanent loss of function, and major cost implications. I propose ways in which the evidence may be improved, including a trial in the areas of most uncertainty. PMID:17999813

  14. Strengths and Limitations of Evidence-Based Dermatology

    Science.gov (United States)

    Williams, Hywel C

    2014-01-01

    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

  15. Exercise for prevention of cardiovascular disease: Evidence-based recommendations

    Directory of Open Access Journals (Sweden)

    Geevar Zachariah

    2017-01-01

    Full Text Available Sedentary lifestyle is one of the major risk factors for cardiovascular disease (CVD. In India, a large percentage of the people are physically inactive with fewer than 10% engaging in recreational physical activity. Physical activity has many beneficial effects on the risk factors for CVD. Apart from improving fitness level, it decreases myocardial oxygen demand and improves myocardial perfusion. There is an inverse association between physical activity and all-cause mortality. In primary prevention, physical inactivity is associated with a two-fold increase in the risk for coronary events. In secondary prevention, data confirm the existence of an inverse dose–response relationship between cardiovascular fitness and the all-cause mortality in large populations of cardiovascular patients. Guidelines from the American authorities as well as the European Society of Cardiology provide specific recommendations for exercise depending on the clinical setting (primary or secondary prevention of CVD and the patient-specific factors (the patient's physical activity level and the perceived CVD risk. The present review summarizes the clinical evidence regarding the role of exercise in CVD prevention and the exercise recommendations from the leading Cardiac societies.

  16. 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

  17. 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.

  18. Knowledge and Attitude of Medical Students and Lecturers Toward Evidence-Based Medicine: Evidence from Shiraz

    Directory of Open Access Journals (Sweden)

    Ahmad Ghanizadeh

    2009-02-01

    Full Text Available Background and purpose: The application of diagnostic, therapeutic, and prognostic evidence in day-to-day management of patients has been in constant focus during the last two decades. This study is an attempt to investigate attitude and knowledge of post-graduated medical students and lecturers towards evidence-based medicine (EBM and assess their preferences to clinical practice guidelines.Methods: The designed questionnaire was posted to the randomly selected post-graduated medical students and lecturers of medical department at Shiraz University of Medical Sciences.Results: There were one hundred sixty subjects (60% who answered the questionnaire. Sixty nine percent were male, 46.3% were lecturers, and 53.2% were post-graduated medical students.About 66% of the respondents have heard of the term of EBM. Only 7.8% of the respondents have already attended to a course to learn the skills of EBM and one hundred twenty five (78.1% like to attend a course to learn the skills of EBM. The most common perceived reason for use of EBM was lack of enough motivation.Conclusion: They have not yet integrated the use of EBM into their practices widely. Their knowledge is at a high risk of becoming out of data. Education of EBM should be a hot topic among educationalplanning programmers until it becomes a part of university educational curriculum in Iran.Keywords: POST-GRADUATED MEDICAL STUDENT, LECTURER, KNOWLEDGE, ATTITUDE, EVIDENCE-BASED MEDICINE, IRAN.

  19. Evidence-based rehabilitation of athletes with glenohumeral instability.

    Science.gov (United States)

    Cools, Ann M; Borms, Dorien; Castelein, Birgit; Vanderstukken, Fran; Johansson, Fredrik R

    2016-02-01

    To give an overview of current knowledge and guidelines with respect to evidence-based rehabilitation of athletes with glenohumeral instability. This narrative review combines scientific evidence with clinical guidelines based on the current literature to highlight the different components of the rehabilitation of glenohumeral instability. Depending on the specific characteristics of the instability pattern, the severity, recurrence, and direction, the therapeutic approach may be adapted to the needs and demands of the athlete. In general, attention should go to (1) restoration of rotator cuff strength and inter-muscular balance, focusing on the eccentric capacity of the external rotators, (2) normalization of rotational range of motion with special attention to the internal rotation ROM, (3) optimization of the flexibility and muscle performance of the scapular muscles, and (4) gradually increasing the functional sport-specific load on the shoulder girdle. The functional kinetic chain should be implemented throughout all stages of the rehabilitation program. Return to play should be based on subjective assessment as well as objective measurements of ROM, strength, and function. This paper summarizes evidence-based guidelines for treatment of glenohumeral instability. These guidelines may assist the clinician in the prevention and rehabilitation of the overhead athlete. Expert opinion, Level V.

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

    Science.gov (United States)

    Devnani, Preeti; Fernandes, Racheal

    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, 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.

  1. 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.

  2. [Evidence-based aspects of clinical mastitis treatment].

    Science.gov (United States)

    Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

    2015-01-01

    Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.   e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents.

  3. History and development of evidence-based medicine.

    Science.gov (United States)

    Claridge, Jeffrey A; Fabian, Timothy C

    2005-05-01

    This article illustrates the timeline of the development of evidence-based medicine (EBM). The term "evidence-based medicine" is relatively new. In fact, as far as we can tell, investigators from McMaster's University began using the term during the 1990s. EBM was defined as "a systemic approach to analyze published research as the basis of clinical decision making." Then in 1996, the term was more formally defined by Sacket et al., who stated that EBM was "the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients." Ancient era EBM consists of ancient historical or anecdotal accounts of what may be loosely termed EBM. This was followed by the development of the renaissance era of EBM, which began roughly during the seventeenth century. During this era personal journals were kept and textbooks began to become more prominent. This was followed by the 1900s, during an era we term the transitional era of EBM (1900-1970s). Knowledge during this era could be shared more easily in textbooks and eventually peer-reviewed journals. Finally, during the 1970s we enter the modern era of EBM. Technology has had a large role in the advancement of EBM. Computers and database software have allowed compilation of large amounts of data. The Index Medicus has become a medical dinosaur of the past that students of today likely do not recognize. The Internet has also allowed incredible access to masses of data and information. However, we must be careful with an overabundance of "unfiltered" data. As history, as clearly shown us, evidence and data do not immediately translate into evidence based practice.

  4. [Evidence-based medicine: modern scientific methods for determining usefulness].

    Science.gov (United States)

    Schmidt, J G

    1999-01-01

    For quite some time, clinical epidemiology has introduced the art of critical appraisal of evidence as well as the methods of how to design sound clinical studies and trials. Almost unnoticed by most medical institutions a new hierarchy of evidence has emerged which puts well thought out trials, able to document unbiased treatment benefit in terms of patient suffering, above pathophysiological theory. Many controlled trials have shown, in the meantime, that the control of laboratory or other kind of pathologies and the correction of anatomical abnormalities do not necessarily mean a benefit for the patient. Concepts relating to this dissection of evidence include: Surrogate fallacy ("cosmetics" of laboratory results or ligament or cartilage "cosmetics" in surgery), confounding (spurious causal relationships), selection bias (comparison with selected groups) as well as lead-time bias (mistaking earlier diagnosis as increase of survival), length bias (overlooking differences in the aggressiveness of diseases as determinants of disease stage distributions) and overdiagnosis bias (mistaking the increasing detection of clinically silent pathologies as improvement of prognosis). Moreover, absolute instead of relative risk reduction needs to be used to measure patient benefit. The incorporation of decision-analysis and of the concepts or clinical epidemiology will improve the efficiency and quality of medicine much more effectively than the sole focus on technical medical performance. Evidence based medicine is the systematic and critical appraisal of medical interventions, based on the understanding how to avoid the fallacies and biases mentioned.

  5. [Evidence based medicine. A new paradigm for medical practice].

    Science.gov (United States)

    Carneiro, A V

    1998-01-01

    Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.

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

    Science.gov (United States)

    Faggion, C M

    2013-02-01

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

  7. Design of a dynamic model for nuclear energy management based on European Foundation for Quality Management

    International Nuclear Information System (INIS)

    Fam, I. M.; Shekari, A.

    2008-01-01

    The Business excellence model has been developed to improve and promote business levels. In business excellence model such as European Foundation for Quality Management model, the important role of resource management is emphasizes. In this paper, we have tried with consideration to tendency progressive concepts of nuclear energy management; a dynamic model has been presented for energy management within the scope of European Foundation for Quality Management model. Population growth could cause increasing of the level of energy demands. No doubt, the confidence of this developed phenomenon with the limits of environment will create greater challenges for the world and its inhabitants. Considering the shortage of energy supply all over the world, nuclear energy management has been studied with a view to fourth and fifth criterions included in European Foundation for Quality Management model (Partnership and resource and Process criteria's). In addition to it, a dynamic model has been presented for nuclear energy management within the scope of European Foundation for Quality Management model. In this dynamic model, with differential equation definition for each of the presented communications of defined causal model, input variable impacts on output ones have been determined and considered. They can be reviewed, based on six scenario plans, the importance of nuclear energy management of a business has been properly shown, and similarly the rate of investment on systems as a factor affecting the level of attention paid to the future of business enterprises, has been specified. This paper conceives nuclear energy management as an instrument to contribute to the growth and fall of a business. It is therefore, imperative to attach more importance at nuclear energy demand management in the business and an attempt should be made to keep it under our control

  8. An evidence-based elective on dietary supplements.

    Science.gov (United States)

    Bonafede, Machaon; Caron, Whitney; Zeolla, Mario

    2009-08-28

    To implement and evaluate the effectiveness of a pharmacy elective on dietary supplements that emphasized evidence-based care. A 3-credit elective that employed both traditional lectures and a variety of active-learning exercises was implemented. The course introduction provided a background in dietary supplement use and evidence-based medicine principles before addressing dietary supplements by primary indication. Student learning was assessed through quizzes, case assignments, discussion board participation, and completion of a longitudinal group project. Precourse and postcourse surveys were conducted to assess students' opinions, knowledge, and skills related to course objectives. The course was an effective way to increase students' knowledge of dietary supplements and skills and confidence in providing patient care in this area.

  9. 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.

  10. 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....... Special considerations should be given in rapidly developing fields. If started too early the resulting comparison will likely turn out to be irrelevant because the new technology is not fully developed, not mastered or the device may have undergone major modifications rendering the results obsolete....... On the other hand, if started too late there is a chance that data may be lost because the technology has already been introduced into the daily clinics and physicians may be unwilling to recruit patients. Or the opposite, that the technique may have been rejected without a proper trial. In this situation...

  11. Authoritative knowledge, evidence-based medicine, and behavioral pediatrics.

    Science.gov (United States)

    Kennell, J H

    1999-12-01

    Evidence-based medicine is the conscientious and judicious use of current best knowledge in making decisions about the care of individual patients, often from well-designed, randomized, controlled trials. Authoritative medicine is the traditional approach to learning and practicing medicine, but no one authority has comprehensive scientific knowledge. Archie Cochrane proposed that every medical specialty should compile a list of all of the randomized, controlled trials within its field to be available for those who wish to know what treatments are effective. This was done first for obstetrics by a group collecting and critically analyzing all of the randomized trials and then indicating procedures every mother should have and those that no mother should have. Support during labor was used as an example. Similar groups are now active in almost all specialties, with information available on the Internet in the Cochrane Database of Systematic Reviews. Developmental-behavioral pediatrics should be part of this movement to evidence-based medicine.

  12. European regulations on nutraceuticals, dietary supplements and functional foods: A framework based on safety

    International Nuclear Information System (INIS)

    Coppens, Patrick; Fernandes da Silva, Miguel; Pettman, Simon

    2006-01-01

    This article describes the legislation that is relevant in the marketing of functional foods in the European Union (EU), how this legislation was developed as well as some practical consequences for manufacturers, marketers and consumers. It also addresses some concrete examples of how the EU's safety requirements for food products have impacted a range of product categories. In the late nineties, research into functional ingredients was showing promising prospects for the use of such ingredients in foodstuffs. Due mainly to safety concerns, these new scientific developments were accompanied by an urgent call for legislation. The European Commission 2000 White Paper on Food Safety announced some 80 proposals for new and improved legislation in this field. Among others, it foresaw the establishment of a General Food Law Regulation, laying down the principles of food law and the creation of an independent Food Authority endowed with the task of giving scientific advice on issues based upon scientific risk assessment with clearly separated responsibilities for risk assessment, risk management and risk communication. Since then, more than 90% of the White Paper proposals have been implemented. However, there is not, as such, a regulatory framework for 'functional foods' or 'nutraceuticals' in EU Food Law. The rules to be applied are numerous and depend on the nature of the foodstuff. The rules of the general food law Regulation are applicable to all foods. In addition, legislation on dietetic foods, on food supplements or on novel foods may also be applicable to functional foods depending on the nature of the product and on their use. Finally, the two proposals on nutrition and health claims and on the addition of vitamins and minerals and other substances to foods, which are currently in the legislative process, will also be an important factor in the future marketing of 'nutraceuticals' in Europe. The cornerstone of EU legislation on food products, including

  13. ETF Yearbook 2012: Evaluation and Monitoring of Vocational Education and Training Systems and the Role of Evidence-Based Policy in Their Reforms

    Science.gov (United States)

    European Training Foundation, 2012

    2012-01-01

    The "ETF Yearbook 2012" continues the tradition of highlighting a thematic field of particular importance to the work of the European Training Foundation (ETF). The theme of this yearbook is evaluation and monitoring of vocational education and training (VET) systems and the role of evidence-based policy in VET reforms in ETF partner…

  14. Damage estimates for European and U.S.sites using the U.S. high-cycle fatigue data base

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, H J [Wind Energy Technology, Sandia National Lab., Albuquerque, NM (United States)

    1996-09-01

    This paper uses two high-cycle fatigue data bases, one for typical U.S. blade materials and one for European materials, to analyze the service lifetime of a wind turbine blade subjected to the WISPER load spectrum for northern European sites and the WISPER protocol load spectrum for U.S. wind farm sites. The U.S. data base contains over 2200 data points that were obtained using coupon testing procedures. These data are used to construct a Goodman diagram that is suitable for analyzing wind turbine blades. This result is compared to the Goodman diagram derived from the European fatigue data base FACT. The LIFE2 fatigue analysis code for wind turbines is then used to predict the service lifetime of a turbine blade subjected to the two loading histories. The results of this study indicate that the WISPER load spectrum from northern European sites significantly underestimates the WISPER protocol load spectrum from a U.S. wind farm site, i.e., the WISPER load spectrum significantly underestimates the number and magnitude of the loads observed at a U.S. wind farm site. Further, the analysis demonstrate that the European and the U.S. fatigue material data bases are in general agreement for the prediction of tensile failures. However, for compressive failures, the two data bases are significantly different, with the U.S. data base predicting significantly shorter service lifetimes than the European data base. (au) 14 refs.

  15. Clinical data warehousing for evidence based decision making.

    Science.gov (United States)

    Narra, Lekha; Sahama, Tony; Stapleton, Peta

    2015-01-01

    Large volumes of heterogeneous health data silos pose a big challenge when exploring for information to allow for evidence based decision making and ensuring quality outcomes. In this paper, we present a proof of concept for adopting data warehousing technology to aggregate and analyse disparate health data in order to understand the impact various lifestyle factors on obesity. We present a practical model for data warehousing with detailed explanation which can be adopted similarly for studying various other health issues.

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

    OpenAIRE

    Sehon, Scott R; Stanley, Donald E

    2003-01-01

    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 alternat...

  17. Flipped classroom model for learning evidence-based medicine

    OpenAIRE

    Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

    2017-01-01

    Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped cla...

  18. Labour Market Outcomes of Vocational Education in Europe: Evidence from the European Union Labour Force Survey. Research Paper No 32

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2013

    2013-01-01

    This report focuses on the outcomes of vocational education and, in particular, on the transition from education to work in the current employment situation for young adults in the European Union. Using anonymised microdata from the EU labour force survey 2009 ad hoc module, this is one of the first studies to undertake a large cross-country…

  19. Evidence for a close phylogenetic relationship between Melissococcus pluton, the causative agent of European foulbrood disease, and the genus Enterococcus.

    Science.gov (United States)

    Cai, J; Collins, M D

    1994-04-01

    The 16S rRNA gene sequence of Melissococcus pluton, the causative agent of European foulbrood disease, was determined in order to investigate the phylogenetic relationships between this organism and other low-G + C-content gram-positive bacteria. A comparative sequence analysis revealed that M. pluton is a close phylogenetic relative of the genus Enterococcus.

  20. Awareness of General Practitioners concerning cancer patients’ preferences for place of death: evidence from four European countries.

    NARCIS (Netherlands)

    Ko, W.; Beccaro, M.; Miccinesi, G.; Casteren, V. van; Donker, G.A.; Onwuteaka-Philipsen, B.; Espi, M.T.M.; Deliens, L.; Costantini, M.; Block, L. van den

    2013-01-01

    Background: General Practitioners (GPs) are at the first level of contact in many European healthcare systems and they supposedly have a role in supporting cancer patients in achieving their desired place of death. A four-country (Belgium, the Netherlands, Italy and Spain) study was carried out

  1. Awareness of General Practitioners concerning cancer patients' preferences for place of death: Evidence from four European countries

    NARCIS (Netherlands)

    Ko, W.; Beccaro, M.; Miccinesi, G.; van Casteren, V.; Donker, G.A.; Onwuteaka-Philipsen, B.D.; Espi, M.T.; Deliens, L.; Costantini, M.; Block, L.

    2013-01-01

    Background: General Practitioners (GPs) are at the first level of contact in many European healthcare systems and they supposedly have a role in supporting cancer patients in achieving their desired place of death. A four-country (Belgium, the Netherlands, Italy and Spain) study was carried out

  2. Is Door-to-Door Canvassing Effective in Europe? Evidence from a Meta-study across Six European Countries

    DEFF Research Database (Denmark)

    Bhatti, Yosef; Dahlgaard, Jens Olav; Hansen, Jonas Hedegaard

    2016-01-01

    in the two Danish experiments. The article discusses why the effects seem to be different in Europe compared to the United States, and stresses the need for further experiments in Europe as there is still considerable uncertainty regarding the European effects. While one possible explanation...

  3. Gender Differences in Self-Reported Health in the Ukrainian Working-age Population: Evidence from the European Social Survey

    DEFF Research Database (Denmark)

    Mazhak, Iryna

    Gender is a one of the most important social determinants of health inequality. Ukrainian life expectancy gender gap is almost ten years in favor of women. Data from the 2 - 6 rounds (N=5158) of a European Social Survey are used to show gender differences in self-reported health (IBM SPSS 22...

  4. Personal Values as Mitigating Factors in the Link between Income and Life Satisfaction: Evidence from the European Social Survey

    Science.gov (United States)

    Georgellis, Yannis; Tsitsianis, Nicholas; Yin, Ya Ping

    2009-01-01

    Using data from the first two rounds of the European Social Survey, we examine the link between income, reference income and life satisfaction across Western Europe. We find that whilst there is a strong positive relationship between income and life satisfaction, reference or comparison income exerts a strong negative influence. Interestingly, our…

  5. The Multidimensionality of Prosocial Behaviors and Evidence of Measurement Equivalence in Mexican American and European American Early Adolescents

    Science.gov (United States)

    Carlo, Gustavo; Knight, George P.; McGinley, Meredith; Zamboanga, Byron L.; Jarvis, Lorna Hernandez

    2010-01-01

    There is growing recognition of the need to examine distinct forms of prosocial behaviors and to conduct research on prosocial behaviors among ethnic minorities. Middle school students (mean age = 12.67 years; 54% girls; European American, n = 290; Mexican American, n = 152) completed a multidimensional measure of prosocial behavior and measures…

  6. The challenge of financing the implementation of Natura 2000 – Empirical evidence from six European Union Member States

    NARCIS (Netherlands)

    Geitzenauer, Maria; Blondet, Marieke; Koning, De Jessica; Ferranti, Francesca; Sotirov, Metodi; Weiss, Gerhard; Winkel, Georg

    2017-01-01

    Natura 2000, which is the core pillar of the European Union's biodiversity conservation policy, is an ambitious and complex venture that requires funding to be successful. A major challenge is said to be a lack of available funding, and a low uptake of allocated funds is also reported. However, in

  7. Evidence That Loss-of-Function Filaggrin Gene Mutations Evolved in Northern Europeans to Favor Intracutaneous Vitamin D3 Production

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Bikle, Daniel D; Elias, Peter M

    2014-01-01

    Skin pigmentation lightened progressively to a variable extent, as modern humans emigrated out of Africa, but extreme lightening occurred only in northern Europeans. Yet, loss of pigmentation alone cannot suffice to sustain cutaneous vitamin D3 (VD3) formation at the high latitudes of northern...

  8. Apprehensions of nurse managers on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Fernanda Carolina Camargo

    2017-12-01

    Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.

  9. Evidence-Based Supplements for the Enhancement of Athletic Performance.

    Science.gov (United States)

    Peeling, Peter; Binnie, Martyn J; Goods, Paul S R; Sim, Marc; Burke, Louise M

    2018-03-01

    A strong foundation in physical conditioning and sport-specific experience, in addition to a bespoke and periodized training and nutrition program, are essential for athlete development. Once these underpinning factors are accounted for, and the athlete reaches a training maturity and competition level where marginal gains determine success, a role may exist for the use of evidence-based performance supplements. However, it is important that any decisions surrounding performance supplements are made in consideration of robust information that suggests the use of a product is safe, legal, and effective. The following review focuses on the current evidence-base for a number of common (and emerging) performance supplements used in sport. The supplements discussed here are separated into three categories based on the level of evidence supporting their use for enhancing sports performance: (1) established (caffeine, creatine, nitrate, beta-alanine, bicarbonate); (2) equivocal (citrate, phosphate, carnitine); and (3) developing. Within each section, the relevant performance type, the potential mechanisms of action, and the most common protocols used in the supplement dosing schedule are summarized.

  10. [Implementation of evidence based medicine in primary care].

    Science.gov (United States)

    Rinnerberger, Andreas; Grafinger, Michaela; Melchardt, Thomas; Sönnichsen, Andreas

    2009-01-01

    The particular situation of primary care - i.e. decentralized setting, comprehensive medical care, and limited access to continuous medical education - makes it difficult to implement evidence-based medicine into daily practice. Therefore, the Institute of General Practice of the Paracelsus University (PMU) in Salzburg and Actavis GmbH Austria developed "REM" (Rechercheservice evidenzbasierte Medizin). This is a web-based enquiry service offered mainly to GPs who can submit questions arising in daily practice which are answered by the service according to current best evidence. In 8.5 months 176 physicians registered to participate. A total of 31 submitted at least one question. In total, REM processed 134 questions. The number of physicians registered and the frequency of enquiries show that REM can facilitate the implementation of evidence-based medicine in primary care. Nonetheless, only a small proportion of the physicians registered actually made use of the service. Improvements are necessary to promote interest in this new way of continuous medical education.

  11. The Developing Role of Evidence-Based Environmental Health

    Directory of Open Access Journals (Sweden)

    Surindar Dhesi

    2015-10-01

    Full Text Available There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

  12. The challenge of integrating evidence-based design.

    Science.gov (United States)

    Martin, Caren S

    2009-01-01

    This paper discusses the integration of evidence-based design (EBD) into the design process as an innovation, illuminates the significance and progress of the diffusion of this innovation, and identifies EBD advocates and the consequences of meeting the EBD challenge. A free tool for engaging in EBD is explored. Healthcare designers are leading the EBD charge, because their clients depend on it. But not all designers engage in EBD, because it may be beyond the resources of a firm or outside its culture. However, as with other meaningful design innovations, designers who do not practice EBD could fall by the wayside. EBD is a product of the diffusion of the innovation of evidence-based medicine. The academy (i.e., the collective of institutions of higher education), design organizations, design communities, and the media all contribute to the diffusion of EBD. However, the quantity, quality, and understandability of evidence continue to challenge its broad adoption. InformeDesign®, a free, Internet-based tool, presents information to designers in a concise, understandable way. Firms must invest in EBD incrementally as a value-added component of design to meet current and future challenges. It is important for designers to realize that engaging in EBD is not a rejection of creativity, but a means by which to elevate their design solutions. ©2009 VENDOME GROUP, LLC

  13. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. An Evidence-Based Videotaped Running Biomechanics Analysis.

    Science.gov (United States)

    Souza, Richard B

    2016-02-01

    Running biomechanics play an important role in the development of injuries. Performing a running biomechanics analysis on injured runners can help to develop treatment strategies. This article provides a framework for a systematic video-based running biomechanics analysis plan based on the current evidence on running injuries, using 2-dimensional (2D) video and readily available tools. Fourteen measurements are proposed in this analysis plan from lateral and posterior video. Identifying simple 2D surrogates for 3D biomechanic variables of interest allows for widespread translation of best practices, and have the best opportunity to impact the highly prevalent problem of the injured runner. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Neuropsychology 3.0: Evidence-Based Science and Practice

    Science.gov (United States)

    Bilder, Robert M.

    2011-01-01

    Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift towards evidence-based science and practice can be enabled by innovations, including: (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress towards these goals. PMID:21092355

  16. Has airline efficiency affected by the inclusion of aviation into European Union Emission Trading Scheme? Evidences from 22 airlines during 2008–2012

    International Nuclear Information System (INIS)

    Li, Ye; Wang, Yan-zhang; Cui, Qiang

    2016-01-01

    We investigate the impacts of including aviation into European Union Emission Trading Scheme on airline efficiency since 2008. Airline efficiency is divided into three stages: Operations Stage, Services Stage and Sales Stage, and Greenhouse Gases Emission is treated as an undesirable output of Services Stage. Two models, Network Slacks-Based Measure with weak disposability and Network Slacks-Based Measure with strong disposability, are established to evaluate the efficiencies of 22 international airlines from 2008 to 2012. The results show that: (1) Most airlines' efficiencies have increased in the period. (2) The average efficiency of European airlines is much higher than that of non-European airlines. (3) The model with weak disposability is more reasonable in distinguishing the airline efficiency while strong disposability is a more reasonable way in treating undesirable outputs. - Highlights: • A new theoretical model of airlines efficiency is built. • Network Slacks-Based Measure models with weak disposability and strong disposability are proposed. • The efficiencies of 22 airlines from 2008 to 2012 are evaluated. • The impacts of including airlines into European Union Emission Trading Scheme are analyzed.

  17. Risk based microbiological criteria for Campylobacter in broiler meat in the European Union

    DEFF Research Database (Denmark)

    Nauta, Maarten; Sanaa, Moez; Havelaar, Arie H.

    2012-01-01

    Quantitative microbiological risk assessment (QMRA) allows evaluating the public health impact of food safety targets to support the control of foodborne pathogens. We estimate the risk reduction of setting microbiological criteria (MCs) for Campylobacter on broiler meat in 25 European countries......, applying quantitative data from the 2008 EU baseline survey. We demonstrate that risk based MCs can be derived without explicit consideration of Food Safety Objectives or Performance Objectives. Published QMRA models for the consumer phase and dose response provide a relation between Campylobacter...

  18. Should Physical Activity Recommendations for South Asian Adults Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and White European Men and Women.

    Science.gov (United States)

    Iliodromiti, Stamatina; Ghouri, Nazim; Celis-Morales, Carlos A; Sattar, Naveed; Lumsden, Mary Ann; Gill, Jason M R

    2016-01-01

    International public health guidelines recommend that adults undertake at least 150 min.week-1 of moderate-intensity physical activity. However, the underpinning evidence has largely been obtained from studies of populations of white European descent. It is unclear whether these recommendations are appropriate for other ethnic groups, particularly South Asians, who have greater cardio-metabolic risk than white Europeans. The objective of our study was to determine the level of moderate-intensity physical activity required in South Asians adults to confer a similar cardio-metabolic risk profile to that observed in Europeans of similar age and body mass index (BMI) undertaking the currently recommended levels of 150 min.week-1. 148 South Asians and 163 white Europeans aged 18 to 70 years were recruited. Physical activity was measured objectively via vertical axis accelerations from hip-worn accelerometers. Factor analysis was used to summarize the measured risk biomarkers into a single underlying latent "factor" describing overall cardio-metabolic risk. Sex did not modify the association between physical activity and the cardio-metabolic risk factor, so data for both sexes were combined and models adjusted for age, sex, BMI and accelerometer wear time. We estimated that South Asian adults needed to undertake 232 (95% Confidence interval: 200 to 268) min.week-1 in order to obtain the same cardio-metabolic risk factor score as a white European undertaking 150 minutes of moderate-equivalent physical activity per week. The present findings suggest that South Asian men and women need to undertake ~230 minutes of moderate intensity physical activity per week. This equates to South Asians undertaking an extra 10-15 minutes of moderate intensity physical activity per day on top of existing recommendations.

  19. Should Physical Activity Recommendations for South Asian Adults Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and White European Men and Women.

    Directory of Open Access Journals (Sweden)

    Stamatina Iliodromiti

    Full Text Available International public health guidelines recommend that adults undertake at least 150 min.week-1 of moderate-intensity physical activity. However, the underpinning evidence has largely been obtained from studies of populations of white European descent. It is unclear whether these recommendations are appropriate for other ethnic groups, particularly South Asians, who have greater cardio-metabolic risk than white Europeans. The objective of our study was to determine the level of moderate-intensity physical activity required in South Asians adults to confer a similar cardio-metabolic risk profile to that observed in Europeans of similar age and body mass index (BMI undertaking the currently recommended levels of 150 min.week-1. 148 South Asians and 163 white Europeans aged 18 to 70 years were recruited. Physical activity was measured objectively via vertical axis accelerations from hip-worn accelerometers. Factor analysis was used to summarize the measured risk biomarkers into a single underlying latent "factor" describing overall cardio-metabolic risk. Sex did not modify the association between physical activity and the cardio-metabolic risk factor, so data for both sexes were combined and models adjusted for age, sex, BMI and accelerometer wear time. We estimated that South Asian adults needed to undertake 232 (95% Confidence interval: 200 to 268 min.week-1 in order to obtain the same cardio-metabolic risk factor score as a white European undertaking 150 minutes of moderate-equivalent physical activity per week. The present findings suggest that South Asian men and women need to undertake ~230 minutes of moderate intensity physical activity per week. This equates to South Asians undertaking an extra 10-15 minutes of moderate intensity physical activity per day on top of existing recommendations.

  20. 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.

  1. 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

  2. Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.

    Science.gov (United States)

    Lang, Jason M; Connell, Christian M

    2017-01-01

    Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.

  3. Credit risk determinants in Sub-Saharan banking systems: Evidence from five countries and lessons learnt from Central East and South East European countries

    Directory of Open Access Journals (Sweden)

    Eftychia Nikolaidou

    2017-06-01

    Full Text Available Banking systems in Sub-Saharan Africa (SSA have grown notably over the past decades due to benign macroeconomic, regulatory and financial trends. Nonetheless, downside risks remain elevated by structural issues, commodity price fluctuations, reversal of capital flows and spill-over effects from external shocks in a manner similar to the Central East and South East European (CESEE countries. In the light of the 2008–2009 Global Financial Crisis, great attention has been given to understanding the causes of banking instability with most of the research focusing on advanced economies and, to a lesser extent, large emerging markets while little attention has been paid to the bank-based financial sectors of Sub-Saharan Africa. Furthermore, there is scarcity of studies aiming at knowledge-sharing among different emerging economies. This paper aims to identify the determinants of bank credit risk by focusing on five SSA countries: Kenya, Namibia, South Africa, Zambia and Uganda. Using the ARDL approach to cointegration, findings indicate that increased money supply conditions have a decreasing effect on NPLs in all counties, banking industry-specific variables play a significant role in the case of South Africa and Uganda while NPLs are driven by country-specific variables in the case of Kenya, South Africa and Zambia. The effect of the Global Financial Crisis is evidenced indirectly. Drawing on evidence from CESEE countries with long experience in banking crises, reforms and financial deepening process, the paper provides lessons for SSA countries and offers policy recommendations in the direction of strengthening banks’ balance sheets to ensure financial stability.

  4. 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

  5. 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.

  6. 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.

  7. Flipped classroom model for learning evidence-based medicine

    Directory of Open Access Journals (Sweden)

    Rucker SY

    2017-08-01

    Full Text Available Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC, as a pedagogical strategy, has long been used in graduate medical education (GME. As evidence-based medicine (EBM becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice. Keywords: evidence-based medicine, flipped classroom, residency education

  8. Evaluation of nurse engagement in evidence-based practice.

    Science.gov (United States)

    Davidson, Judy E; Brown, Caroline

    2014-01-01

    The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

  9. 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. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

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

    Science.gov (United States)

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

    2012-09-01

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

  11. Extreme events in total ozone over the Northern mid-latitudes: an analysis based on long-term data sets from five European ground-based stations

    Energy Technology Data Exchange (ETDEWEB)

    Rieder, Harald E. (Inst. for Atmospheric and Climate Science, ETH Zurich, Zurich (Switzerland)), e-mail: hr2302@columbia.edu; Jancso, Leonhardt M. (Inst. for Atmospheric and Climate Science, ETH Zurich, Zurich (Switzerland); Inst. for Meteorology and Geophysics, Univ. of Innsbruck, Innsbruck (Austria)); Di Rocco, Stefania (Inst. for Atmospheric and Climate Science, ETH Zurich, Zurich (Switzerland); Dept. of Geography, Univ. of Zurich, Zurich (Switzerland)) (and others)

    2011-11-15

    We apply methods from extreme value theory to identify extreme events in high (termed EHOs) and low (termed ELOs) total ozone and to describe the distribution tails (i.e. very high and very low values) of five long-term European ground-based total ozone time series. The influence of these extreme events on observed mean values, long-term trends and changes is analysed. The results show a decrease in EHOs and an increase in ELOs during the last decades, and establish that the observed downward trend in column ozone during the 1970-1990s is strongly dominated by changes in the frequency of extreme events. Furthermore, it is shown that clear 'fingerprints' of atmospheric dynamics (NAO, ENSO) and chemistry [ozone depleting substances (ODSs), polar vortex ozone loss] can be found in the frequency distribution of ozone extremes, even if no attribution is possible from standard metrics (e.g. annual mean values). The analysis complements earlier analysis for the world's longest total ozone record at Arosa, Switzerland, confirming and revealing the strong influence of atmospheric dynamics on observed ozone changes. The results provide clear evidence that in addition to ODS, volcanic eruptions and strong/moderate ENSO and NAO events had significant influence on column ozone in the European sector

  12. Molecular genetic studies of natives on Easter Island: evidence of an early European and Amerindian contribution to the Polynesian gene pool.

    Science.gov (United States)

    Lie, B A; Dupuy, B M; Spurkland, A; Fernández-Viña, M A; Hagelberg, E; Thorsby, E

    2007-01-01

    Most archaeological and linguistic evidence suggest a Polynesian origin of the population of Easter Island (Rapanui), and this view has been supported by the identification of Polynesian mitochondrial DNA (mtDNA) polymorphisms in prehistoric skeletal remains. However, some evidence of an early South American contact also exists (the sweet potato, bottle gourd etc.), but genetic studies have so far failed to show an early Amerindian contribution to the gene pool on Easter Island. To address this issue, we analyzed mtDNA and Y chromosome markers and performed high-resolution human leukocyte antigen (HLA) genotyping of DNA harvested from previously collected sera of 48 reputedly nonadmixed native Easter Islanders. All individuals carried mtDNA types and HLA alleles previously found in Polynesia, and most men carried Y chromosome markers of Polynesian origin, providing further evidence of a Polynesian origin of the population of Easter Island. A few individuals carried HLA alleles and/or Y chromosome markers of European origin. More interestingly, some individuals carried the HLA alleles A*0212 and B*3905, which are of typical Amerindian origin. The genealogy of some of the individuals carrying these non-Polynesian HLA alleles and their haplotypic backgrounds suggest an introduction into Easter Island in the early 1800s, or earlier. Thus, there may have been an early European and Amerindian contribution to the Polynesian gene pool of Easter Island.

  13. Asylum migration and the construction of the European Common Foreign and Security Policy: evidence from the Greek case

    Directory of Open Access Journals (Sweden)

    Silvia Lucía Forero Castañeda

    2015-12-01

    Full Text Available This article examines how the recent evolution of asylum migration has affected the construction of the European Common Foreign and Security Policy (EU-CFSP, taking the Greek case during the 2001-2012 period as a starting point. With this in mind, the normative progress of the EU-CFSP facing the reception of asylum seekers in Greece is analyzed, under the scope of what Barry Buzan and Ole Waever would call Securitization Process. Both legal and political frameworks on asylum migration in Greece and in the European Union are approached, in the context of the evolution of the EU-CFSP in three main areas: Neighborhood Policy, Development and Cooperation Policy, and Human Rights Protection. The conclusión points toward the partial influence of asylum migration in the configuration of the UE-CFSP during the studied period.

  14. The Evidence-Based Practice of Applied Behavior Analysis.

    Science.gov (United States)

    Slocum, Timothy A; Detrich, Ronnie; Wilczynski, Susan M; Spencer, Trina D; Lewis, Teri; Wolfe, Katie

    2014-05-01

    Evidence-based practice (EBP) is a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients. This framework provides behavior analysts with a structure for pervasive use of the best available evidence in the complex settings in which they work. This structure recognizes the need for clear and explicit understanding of the strength of evidence supporting intervention options, the important contextual factors including client values that contribute to decision making, and the key role of clinical expertise in the conceptualization, intervention, and evaluation of cases. Opening the discussion of EBP in this journal, Smith (The Behavior Analyst, 36, 7-33, 2013) raised several key issues related to EBP and applied behavior analysis (ABA). The purpose of this paper is to respond to Smith's arguments and extend the discussion of the relevant issues. Although we support many of Smith's (The Behavior Analyst, 36, 7-33, 2013) points, we contend that Smith's definition of EBP is significantly narrower than definitions that are used in professions with long histories of EBP and that this narrowness conflicts with the principles that drive applied behavior analytic practice. We offer a definition and framework for EBP that aligns with the foundations of ABA and is consistent with well-established definitions of EBP in medicine, psychology, and other professions. In addition to supporting the systematic use of research evidence in behavior analytic decision making, this definition can promote clear communication about treatment decisions across disciplines and with important outside institutions such as insurance companies and granting agencies.

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

    Science.gov (United States)

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

    2016-03-05

    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 evidence and service policies is weak, and that the notion of EBP rests on a misunderstanding of policy processes. Having explored EBM standards and knowledge requirements for health policy decision-making, we present an empirical point of departure for discussing the relationship between EBM and EBP. In a case study exploring the Norwegian Knowledge Centre for the Health Services (NOKC), an independent government unit, we first searched for information about the background and development of the NOKC to establish a research context. We then identified, selected and organized official NOKC publications as an empirical sample of typical top-of-the-line knowledge delivery adhering to EBM standards. Finally, we explored conclusions in this type of publication, specifically addressing their potential as policy decision tools. From a total sample of 151 SRs published by the NOKC in the period 2004-2013, a purposive subsample from 2012 (14 publications) advised major caution about their conclusions because of the quality or relevance of the underlying documentation. Although the case study did not include a systematic investigation of uptake and policy consequences, SRs were found to be inappropriate as universal tools for health policy decision-making. The case study demonstrates that EBM is not necessarily suited to knowledge provision for every kind of policy decision-making. Our analysis raises the question of whether the evidence-based movement, represented here by an independent government organization, undertakes too broad a range of commissions using

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

    Science.gov (United States)

    Gődény, Sándor; Csenteri, Orsolya Karola

    2015-11-08

    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.

  17. Strengthening the evidence base for health programming in humanitarian crises.

    Science.gov (United States)

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. Copyright © 2014, American Association for the Advancement of Science.

  18. Flipped classroom model for learning evidence-based medicine.

    Science.gov (United States)

    Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

    2017-01-01

    Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice.

  19. Excessive credit growth and countercyclical capital buffers in basel III: an empirical evidence from central and east european countries

    OpenAIRE

    Seidler, Jakub; Gersl, Adam

    2012-01-01

    Excessive credit growth is often considered to be an indicator of future problems in the financial sector. This paper examines the issue of how best to determine whether the observed level of private sector credit is excessive in the context of the “countercyclical capital buffer”, a macroprudential tool proposed in the new regulatory framework of Basel III by the Basel Committee on Banking Supervision. An empirical analysis of selected Central and Eastern European countries, including the Cz...

  20. Value Relevance of Consolidated Versus Parent Company Financial Statements: Evidence from the Largest Three European Capital Markets

    OpenAIRE

    Victor-Octavian MULLER

    2011-01-01

    Within the European Union, parent companies have to prepare and publish both consolidated and individual financial statements. The objective of financial statements with general purpose is to give information regarding the financial position, performance and changes in financial position of the reporting entity, information that is useful to investors and other users in making economic decisions. In order to be useful, financial information needs to be relevant to the decision-making process ...