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....

Inference-based procedural modeling of solids

KAUST Repository

Biggers, Keith

2011-11-01

As virtual environments become larger and more complex, there is an increasing need for more automated construction algorithms to support the development process. We present an approach for modeling solids by combining prior examples with a simple sketch. Our algorithm uses an inference-based approach to incrementally fit patches together in a consistent fashion to define the boundary of an object. This algorithm samples and extracts surface patches from input models, and develops a Petri net structure that describes the relationship between patches along an imposed parameterization. Then, given a new parameterized line or curve, we use the Petri net to logically fit patches together in a manner consistent with the input model. This allows us to easily construct objects of varying sizes and configurations using arbitrary articulation, repetition, and interchanging of parts. The result of our process is a solid model representation of the constructed object that can be integrated into a simulation-based environment. © 2011 Elsevier Ltd. All rights reserved.

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

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.

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'.

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...

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.

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.

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.

Novel solid – solid phase change material based on polyethylene glycol and cellulose used for temperature stabilisation

Directory of Open Access Journals (Sweden)

Wojda Marta

2014-01-01

Full Text Available Thermal management is one of crucial issues in the development of modern electronic devices. In the recent years interest in phase change materials (PCMs as alternative cooling possibility has increased significantly. Preliminary results concerning the research into possibility of the use of solid-solid phase change materials (S-S PCMs for stabilisation temperature of electronic devices has been presented in the paper. Novel solid-solid phase change material based on polyethylene glycol and cellulose has been synthesized. Attempt to improve its thermal conductivity has been taken. Material has been synthesized for the purpose of stabilisation of temperature of electronic devices.

Carbon-based strong solid acid for cornstarch hydrolysis

Science.gov (United States)

Nata, Iryanti Fatyasari; Irawan, Chairul; Mardina, Primata; Lee, Cheng-Kang

2015-10-01

Highly sulfonated carbonaceous spheres with diameter of 100-500 nm can be generated by hydrothermal carbonization of glucose in the presence of hydroxyethylsulfonic acid and acrylic acid at 180 °C for 4 h. The acidity of the prepared carbonaceous sphere C4-SO3H can reach 2.10 mmol/g. It was used as a solid acid catalyst for the hydrolysis of cornstarch. Total reducing sugar (TRS) concentration of 19.91 mg/mL could be obtained by hydrolyzing 20 mg/mL cornstarch at 150 °C for 6 h using C4-SO3H as solid acid catalyst. The solid acid catalyst demonstrated good stability that only 9% decrease in TRS concentration was observed after five repeat uses. The as-prepared carbon-based solid acid catalyst can be an environmentally benign replacement for homogeneous catalyst.

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.

Rocket Solid Propellant Alternative Based on Ammonium Dinitramide

Directory of Open Access Journals (Sweden)

Grigore CICAN

2017-03-01

Full Text Available Due to the continuous run for a green environment the current article proposes a new type of solid propellant based on the fairly new synthesized oxidizer, ammonium dinitramide (ADN. Apart of having a higher specific impulse than the worldwide renowned oxidizer, ammonium perchlorate, ADN has the advantage, of leaving behind only nitrogen, oxygen and water after decomposing at high temperatures and therefore totally avoiding the formation of hydrogen chloride fumes. Based on the oxidizer to fuel ratios of the current formulations of the major rocket solid booster (e.g. Space Shuttle’s SRB, Ariane 5’s SRB which comprises mass variations of ammonium perchlorate oxidizer (70-75%, atomized aluminum powder (10-18% and polybutadiene binder (12-20% a new solid propellant was formulated. As previously stated, the new propellant formula and its variations use ADN as oxidizer and erythritol tetranitrate as fuel, keeping the same polybutadiene as binder.

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.

Zirconia-based solid state chemical gas sensors

CERN Document Server

Zhuiykov, S

2000-01-01

This paper presents an overview of chemical gas sensors, based on solid state technology, that are sensitive to environmental gases, such as O sub 2 , SO sub x , NO sub x , CO sub 2 and hydrocarbons. The paper is focussed on performance of electrochemical gas sensors that are based on zirconia as a solid electrolyte. The paper considers sensor structures and selection of electrode materials. Impact of interfaces on sensor performance is discussed. This paper also provides a brief overview of electrochemical properties of zirconia and their effect on sensor performance. Impact of auxiliary materials on sensors performance characteristics, such as sensitivity, selectivity, response time and recovery time, is also discussed. Dual gas sensors that can be applied for simultaneous monitoring of the concentration of both oxygen and other gas phase components, are briefly considered

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.

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.

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.

Development of hydrazinium nitroformate based solid propellants

NARCIS (Netherlands)

Schöyer, H.F.R.; Schnorhk, A.J.; Korting, P.A.O.G.; Lit, P.J. van; Mul, J.M.; Gadiot, G.; Meulenbrugge, J.J.

1995-01-01

The development of new high-performance propellant combinations requires the establishment of safety and handling characteristics and thermodynamic decomposition and explosive properties. This paper addresses the early development phases of a new composite solid propellant based on HNF as oxidizer

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.

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.

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.

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.

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.

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.

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...

Solid tumors after chemotherapy or surgery for testicular nonseminoma: a population-based study.

Science.gov (United States)

Fung, Chunkit; Fossa, Sophie D; Milano, Michael T; Oldenburg, Jan; Travis, Lois B

2013-10-20

Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminoma patients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility.

Mathematical modeling of ethanol production in solid-state fermentation based on solid medium' dry weight variation.

Science.gov (United States)

Mazaheri, Davood; Shojaosadati, Seyed Abbas; Zamir, Seyed Morteza; Mousavi, Seyyed Mohammad

2018-04-21

In this work, mathematical modeling of ethanol production in solid-state fermentation (SSF) has been done based on the variation in the dry weight of solid medium. This method was previously used for mathematical modeling of enzyme production; however, the model should be modified to predict the production of a volatile compound like ethanol. The experimental results of bioethanol production from the mixture of carob pods and wheat bran by Zymomonas mobilis in SSF were used for the model validation. Exponential and logistic kinetic models were used for modeling the growth of microorganism. In both cases, the model predictions matched well with the experimental results during the exponential growth phase, indicating the good ability of solid medium weight variation method for modeling a volatile product formation in solid-state fermentation. In addition, using logistic model, better predictions were obtained.

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.

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…

Electrical conduction in solid materials physicochemical bases and possible applications

CERN Document Server

Suchet, J P

2013-01-01

Electrical Conduction in Solid Materials (Physicochemical Bases and Possible Applications) investigates the physicochemical bases and possible applications of electrical conduction in solid materials, with emphasis on conductors, semiconductors, and insulators. Topics range from the interatomic bonds of conductors to the effective atomic charge in conventional semiconductors and magnetic transitions in switching semiconductors. Comprised of 10 chapters, this volume begins with a description of electrical conduction in conductors and semiconductors, metals and alloys, as well as interatomic bon

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.

Novel Nanostructured Solid Materials for Modulating Oral Drug Delivery from Solid-State Lipid-Based Drug Delivery Systems.

Science.gov (United States)

Dening, Tahnee J; Rao, Shasha; Thomas, Nicky; Prestidge, Clive A

2016-01-01

Lipid-based drug delivery systems (LBDDS) have gained significant attention in recent times, owing to their ability to overcome the challenges limiting the oral delivery of poorly water-soluble drugs. Despite the successful commercialization of several LBDDS products over the years, a large discrepancy exists between the number of poorly water-soluble drugs displaying suboptimal in vivo performances and the application of LBDDS to mitigate their various delivery challenges. Conventional LBDDS, including lipid solutions and suspensions, emulsions, and self-emulsifying formulations, suffer from various drawbacks limiting their widespread use and commercialization. Accordingly, solid-state LBDDS, fabricated by adsorbing LBDDS onto a chemically inert solid carrier material, have attracted substantial interest as a viable means of stabilizing LBDDS whilst eliminating some of the various limitations. This review describes the impact of solid carrier choice on LBDDS performance and highlights the importance of appropriate solid carrier material selection when designing hybrid solid-state LBDDS. Specifically, emphasis is placed on discussing the ability of the specific solid carrier to modulate drug release, control lipase action and lipid digestion, and enhance biopharmaceutical performance above the original liquid-state LBDDS. To encourage the interested reader to consider their solid carrier choice on a higher level, various novel materials with the potential for future use as solid carriers for LBDDS are described. This review is highly significant in guiding future research directions in the solid-state LBDDS field and fostering the translation of these delivery systems to the pharmaceutical marketplace.

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...

A solid state actuator based on polypyrrole (PPy) and a solid electrolyte NBR working in air

Science.gov (United States)

Cho, Misuk; Nam, Jaedo; Choi, Hyouk Ryeol; Koo, Jachoon; Lee, Youngkwan

2005-05-01

The solid polymer electrolyte based conducting polymer actuator was presented. In the preparation of acutuator module, an ionic liquid impregnated a synthetic rubber (NBR) and PPy were used as a solid polymer electrolyte and conducting polymer, respectively. An ionic liquid, 1-butyl-3-methylimidazolium bis (trifluoromethyl sulfonyl)imide (BMITFSI) is gradually dispersed into the NBR film and the conducting polymer, PPy was synthesized on the surface of NBR. The ionic conductivity of new type solid polymer electrolyte as a function of the immersion time was investigated. The cyclic voltammetry responsed and the redox switching dynamics of PEDOT in NBR matrix were studied. The displacement of the actuator was measured by laser beam.

Recent progress in sulfide-based solid electrolytes for Li-ion batteries

Energy Technology Data Exchange (ETDEWEB)

Liu, D., E-mail: liu.dongqiang@ireq.ca; Zhu, W.; Feng, Z.; Guerfi, A.; Vijh, A.; Zaghib, K.

2016-11-15

Graphical abstract: Li{sub 2}S-GeS{sub 2}-P{sub 2}S{sub 5} ternary diagram showing various sulphide compounds as solid electrolytes for Li-ion batteries. - Highlights: • Recent progress of sulfide-based solid electrolytes is described from point of view of structure. • Thio-LISICON type electrolytes exhibited high ionic conductivity due to their bcc sublattice and unique Li{sup +} diffusion pathway. • “Mixed-anion effect” is also an effective way to modify the energy landscape as well as the ionic conductivity. - Abstract: Sulfide-based ionic conductors are one of most attractive solid electrolyte candidates for all-solid-state batteries. In this review, recent progress of sulfide-based solid electrolytes is described from point of view of structure. In particular, lithium thio-phosphates such as Li{sub 7}P{sub 3}S{sub 11}, Li{sub 10}GeP{sub 2}S{sub 12} and Li{sub 11}Si{sub 2}PS{sub 12} etc. exhibit extremely high ionic conductivity of over 10{sup −2} S cm{sup −1} at room temperature, even higher than those of commercial organic carbonate electrolytes. The relationship between structure and unprecedented high ionic conductivity is delineated; some potential drawbacks of these electrolytes are also outlined.

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.

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

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

Hurdles of CAR-T cell-based cancer immunotherapy directed against solid tumors.

Science.gov (United States)

Zhang, Bing-Lan; Qin, Di-Yuan; Mo, Ze-Ming; Li, Yi; Wei, Wei; Wang, Yong-Sheng; Wang, Wei; Wei, Yu-Quan

2016-04-01

Recent reports on the impressive efficacy of chimeric antigen receptor (CAR)-modified T cells against hematologic malignancies have inspired oncologists to extend these efforts for the treatment of solid tumors. Clinical trials of CAR-T-based cancer immunotherapy for solid tumors showed that the efficacies are not as remarkable as in the case of hematologic malignancies. There are several challenges that researchers must face when treating solid cancers with CAR-T cells, these include choosing an ideal target, promoting efficient trafficking and infiltration, overcoming the immunosuppressive microenvironment, and avoiding associated toxicity. In this review, we discuss the obstacles imposed by solid tumors on CAR-T cell-based immunotherapy and strategies adopted to improve the therapeutic potential of this approach. Continued investigations are necessary to improve therapeutic outcomes and decrease the adverse effects of CAR-T cell therapy in patients with solid malignancies in the future.

Transforming lipid-based oral drug delivery systems into solid dosage forms: an overview of solid carriers, physicochemical properties, and biopharmaceutical performance.

Science.gov (United States)

Tan, Angel; Rao, Shasha; Prestidge, Clive A

2013-12-01

The diversity of lipid excipients available commercially has enabled versatile formulation design of lipid-based drug delivery systems for enhancing the oral absorption of poorly water-soluble drugs, such as emulsions, microemulsions, micelles, liposomes, niosomes and various self-emulsifying systems. The transformation of liquid lipid-based systems into solid dosage forms has been investigated for several decades, and has recently become a core subject of pharmaceutical research as solidification is regarded as viable means for stabilising lipid colloidal systems while eliminating stringent processing requirements associated with liquid systems. This review describes the types of pharmaceutical grade excipients (silica nanoparticle/microparticle, polysaccharide, polymer and protein-based materials) used as solid carriers and the current state of knowledge on the liquid-to-solid conversion approaches. Details are primarily focused on the solid-state physicochemical properties and redispersion capacity of various dry lipid-based formulations, and how these relate to the in vitro drug release and solubilisation, lipid carrier digestion and cell permeation performances. Numerous in vivo proof-of-concept studies are presented to highlight the viability of these dry lipid-based formulations. This review is significant in directing future research work in fostering translation of dry lipid-based formulations into clinical applications.

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.

Safety - a Neglected Issue When Introducing Solid Biomass Fuel in Thermal Power Plants? Some Evidence of an Emerging Risk

DEFF Research Database (Denmark)

Hedlund, Frank Huess; Astad, John

2013-01-01

The paper examines recent evidence from Denmark and abroad with climate change projects that aim to reduce global carbon dioxide emissions by converting coal fired thermal power plants to solid biomass fuel. The paper argues that projects appear to be pursued narrow-mindedly with insufficient att...

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

[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.

Atomic and molecular effects in the VUV spectra of solids

International Nuclear Information System (INIS)

Sonntag, B.

1977-10-01

The VUV spectra of solids are often dominated by atomic or molecular effects, which clearly manifest themselves in the gross features of the spectra and the fine structure at inner shell excitation thresholds. Evidence for the influence of atomic and molecular matrix elements, multiplet-splitting and correlation is presented. Special emphasis is given to the direct experimental verification based on the comparison of atomic and solid state spectra. (orig.) [de

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

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

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

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

Application progress of solid 29Si, 27Al NMR in the research of cement-based materials

International Nuclear Information System (INIS)

Feng Chunhua; Wang Xijian; Li Dongxu

2014-01-01

Background: The solid-state Nuclear Magnetic Resonance (NMR) is an effective method for the research of cement-based materials. Now it focuses on using solid 29 Si and 27 Al NMR to research the hydration structure of the cement-based materials in cement chemistry. Purpose: A theoretical guidance is proposed for solid 29 Si and 27 Al NMR technology used in cement chemistry research. Methods: We reviewed the application of solid 29 Si and 27 Al NMR in the cement-based materials and analyzed the problem among the researches. Results: This paper introduced an fundamental, relevant-conditions and basic parameters of NMR, and studied the technical parameters of solid 29 Si and 27 Ai NMR together with the relationship among the hydration structure of cement based material. Moreover, this paper reviewed the related domestic and overseas achievements in the research of hydration structure of the cement-based materials using solid 29 Si and 27 Al NMR. Conclusion: There were some problems in the research on cement-based materials by technology of solid 29 Si and 27 Al NMR. NMR will promote the Hydration theory of cement-based material greatly. (authors)

Irradiation and accretion of solids in space based on observations of lunar rocks and grains

International Nuclear Information System (INIS)

Lal, D.

1977-01-01

Clues to a wide range of questions relating to the origin and evolution of the solar system and dynamic physical and electromagnetic processes occurring concurrently and in the past in our galaxy have been provided by a study of the lunar samples. This information is deduced from a variety of complementary physical and chemical evidence. In this presentation greatest emphasis is laid on information based on effects arising from interactions of low energy cosmic rays with lunar surface materials. The present discussions concern the nature of experimental data to date and implications thereof to the charged particle environment of the Moon, ancient magnetic fields and the nature of time scales involved in the irradiation and accretion of solids in space, based on lunar regolith dynamics. It becomes clear that there does not yet exist any consensus on the absolute values of charged particle or the meteorite fluxes, and also about the details of the evolution of the lunar regolith. The complex history of evolution of lunar material is slowly being understood and it is hoped that a great deal of quantitative information will soon be available which will in turn allow discussion of evolution of solid bodies in the solar system. (author)

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.

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.

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

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 ...

Solid-melt interface structure and growth of Cu alloy single crystals

International Nuclear Information System (INIS)

Tomimitsu, Hiroshi; Kamada, Kohji.

1983-01-01

Crystal-melt interface behavior during the growth of Cu-base solid solutions by the Bridgman method is discussed on the basis of experimental evidence obtained by neutron diffraction topography. Advantages of neutron diffraction topography for the characterization of large single crystals, such as dealt with in this paper, are emphasized. Evidence was odserved of extremely regular crystal growth along directions, irrespective of the macroscopic growth direction. This contrasts with the previously believed (110) normal growth which is a conclusion of growth theory based on molecular kinetics at the solid-melt interface. In consequence, we believe that the kinetics at the interface is a minor factor in the meltgrowth of metal single crystals. Revised melt-growth theory should include both the growth and the formation of the regular structure as evidenced by neutron diffraction topography. (author)

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.

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.

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.

[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.

Evidence based medicine (EBM) and evidence based radiology (EBR) in the follow-up of the patients after surgery for lung and colon-rectal carcinoma

International Nuclear Information System (INIS)

Giovagnoni, Andrea; Ottaviani, Letizia; Mensa', Anna; Durastanti, Martina; Floriani, Irene; Cascinu, Stefano

2005-01-01

Purpose: a) To define the role of diagnostic imaging modalities in the follow-up of patients after surgery for solid cancer, using an Evidence Based Medicine (EBM) approach; b) to asses the possible discrepancies between the theoretical model and the clinical protocols currently used for the follow-up of treated patients; c) to compare the real costs of the radiological examinations performed in a group of cancer patients followed up after surgery and the theoretical costs that would have been incurred had the patients been followed up according to the theoretical (evidence-based) follow-up programme. Materials and methods: We searched traditional and secondary databases for research papers and guidelines by international scientific societies published in the last 10 years and concerning the clinical impact of follow-up programs in patients operated on for colorectal and lung carcinoma. The papers were selected based on level of evidence using the systematic review approach of EBM. In each paper selected, we considered the overall survival and disease-free survival, quality of life, side and toxic effects of therapy, cost and psychological aspects to formulate a judgement on the usefulness the radiological tests. Subsequently, the clinical and imaging follow-up of 40 patients who had undergone surgical resection for colorectal cancer (20 patients) and lung cancer (20 patients) between 1998 and 2004 were retrospectively reviewed, and the costs of the follow-up programs for the two groups, were analysed and compared with those of the theoretical evidence-based programmes. Results: Of the 41 papers selected after systematic review only nine datasets were considered for our final analysis. The majority of papers (7 out of 9) and all the guidelines published by International Scientific Societies agreed on the poor value of closed imaging in the follow-up of patients who have undergone surgery for colorectal and lung cancer. A significant difference was found between the

Enhanced solubility and bioavailability of sibutramine base by solid dispersion system with aqueous medium.

Science.gov (United States)

Li, Dong Xun; Jang, Ki-Young; Kang, Wonku; Bae, Kyoungjin; Lee, Mann Hyung; Oh, Yu-Kyoung; Jee, Jun-Pil; Park, Young-Joon; Oh, Dong Hoon; Seo, Youn Gee; Kim, Young Ran; Kim, Jong Oh; Woo, Jong Soo; Yong, Chul Soon; Choi, Han-Gon

2010-01-01

To develop a novel sibutramine base-loaded solid dispersion with improved solubility bioavailability, various solid dispersions were prepared with water, hydroxypropylmethyl cellulose (HPMC), poloxamer and citric acid using spray-drying technique. The effect of HPMC, poloxamer and citric acid on the aqueous solubility of sibutramine was investigated. The physicochemical properties of solid dispersion were investigated using scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and X-ray powder diffraction. The dissolution and pharmacokinetics in rats of solid dispersion were evaluated compared to the sibutramine hydrochloride monohydrate-loaded commercial product (Reductil). The sibutramine base-loaded solid dispersion gave two type forms. Like conventional solid dispersion system, one type appeared as a spherical shape with smooth surface, as the carriers and drug with relatively low melting point were soluble in water and formed it. The other appeared as an irregular form with relatively rough surface. Unlike conventional solid dispersion system, this type changed no crystalline form of drug. Our results suggested that this type was formed by attaching hydrophilic carriers to the surface of drug without crystal change, resulting from changing the hydrophobic drug to hydrophilic form. The sibutramine-loaded solid dispersion at the weight ratio of sibutramine base/HPMC/poloxamer/citric acid of 5/3/3/0.2 gave the maximum drug solubility of about 3 mg/ml. Furthermore, it showed the similar plasma concentration, area under the curve (AUC) and C(max) of parent drug, metabolite I and II to the commercial product, indicating that it might give the similar drug efficacy compared to the sibutramine hydrochloride monohydrate-loaded commercial product in rats. Thus, this solid dispersion system would be useful to deliver poorly water-soluble sibutramine base with enhanced bioavailability.

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...

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....

Molecular Solid EOS based on Quasi-Harmonic Oscillator approximation for phonons

Energy Technology Data Exchange (ETDEWEB)

Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2014-09-02

A complete equation of state (EOS) for a molecular solid is derived utilizing a Helmholtz free energy. Assuming that the solid is nonconducting, phonon excitations dominate the specific heat. Phonons are approximated as independent quasi-harmonic oscillators with vibrational frequencies depending on the specific volume. The model is suitable for calibrating an EOS based on isothermal compression data and infrared/Raman spectroscopy data from high pressure measurements utilizing a diamond anvil cell. In contrast to a Mie-Gruneisen EOS developed for an atomic solid, the specific heat and Gruneisen coefficient depend on both density and temperature.

Solid formation in piperazine rate-based simulation

DEFF Research Database (Denmark)

Gaspar, Jozsef; Thomsen, Kaj; von Solms, Nicolas

2014-01-01

of view but also from a modeling perspective. The present work develops a rate-based model for CO2 absorption and desorption modeling for gas-liquid-solid systems and it is demonstrated for the piperazine CO2 capture process. This model is an extension of the DTU CAPCO2 model to precipitating systems....... It uses the extended UNIQUAC thermodynamic model for phase equilibria and thermal properties estimation. The mass and heat transfer phenomena is implemented in a film model approach, based on second order reactions kinetics. The transfer fluxes are calculated using the concentration of the dissolved...

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.

Model study on transesterification of soybean oil to biodiesel with methanol using solid base catalyst.

Science.gov (United States)

Liu, Xuejun; Piao, Xianglan; Wang, Yujun; Zhu, Shenlin

2010-03-25

Modeling of the transesterification of vegetable oils to biodiesel using a solid base as a catalyst is very important because the mutual solubilities of oil and methanol will increase with the increasing biodiesel yield. The heterogeneous liquid-liquid-solid reaction system would become a liquid-solid system when the biodiesel reaches a certain content. In this work, we adopted a two-film theory and a steady state approximation assumption, then established a heterogeneous liquid-liquid-solid model in the first stage. After the diffusion coefficients on the liquid-liquid interface and the liquid-solid interface were calculated on the basis of the properties of the system, the theoretical value of biodiesel productivity changing with time was obtained. The predicted values were very near the experimental data, which indicated that the proposed models were suitable for the transesterification of soybean oil to biodiesel when solid bases were used as catalysts. Meanwhile, the model indicated that the transesterification reaction was controlled by both mass transfer and reaction. The total resistance will decrease with the increase in biodiesel yield in the liquid-liquid-solid stage. The solid base catalyst exhibited an activation energy range of 9-20 kcal/mol, which was consistent with the reported activation energy range of homogeneous catalysts.

CAD-based Monte Carlo automatic modeling method based on primitive solid

International Nuclear Information System (INIS)

Wang, Dong; Song, Jing; Yu, Shengpeng; Long, Pengcheng; Wang, Yongliang

2016-01-01

Highlights: • We develop a method which bi-convert between CAD model and primitive solid. • This method was improved from convert method between CAD model and half space. • This method was test by ITER model and validated the correctness and efficiency. • This method was integrated in SuperMC which could model for SuperMC and Geant4. - Abstract: Monte Carlo method has been widely used in nuclear design and analysis, where geometries are described with primitive solids. However, it is time consuming and error prone to describe a primitive solid geometry, especially for a complicated model. To reuse the abundant existed CAD models and conveniently model with CAD modeling tools, an automatic modeling method for accurate prompt modeling between CAD model and primitive solid is needed. An automatic modeling method for Monte Carlo geometry described by primitive solid was developed which could bi-convert between CAD model and Monte Carlo geometry represented by primitive solids. While converting from CAD model to primitive solid model, the CAD model was decomposed into several convex solid sets, and then corresponding primitive solids were generated and exported. While converting from primitive solid model to the CAD model, the basic primitive solids were created and related operation was done. This method was integrated in the SuperMC and was benchmarked with ITER benchmark model. The correctness and efficiency of this method were demonstrated.

Environmentally Benign Bifunctional Solid Acid and Base Catalysts

NARCIS (Netherlands)

Elmekawy, A.; Shiju, N.R.; Rothenberg, G.; Brown, D.R.

2014-01-01

Solid bifunctional acid-​base catalysts were prepd. in two ways on an amorphous silica support: (1) by grafting mercaptopropyl units (followed by oxidn. to propylsulfonic acid) and aminopropyl groups to the silica surface (NH2-​SiO2-​SO3H)​, and (2) by grafting only aminopropyl groups and then

Synchrotron radiography of direct-shear in semi-solid alloys

International Nuclear Information System (INIS)

Gourlay, C M; Nagira, T; Nakatsuka, N; Yasuda, H; Dahle, A K; Uesugi, K

2012-01-01

Understanding phenomena occurring at the scale of the crystals during the deformation of semi-solid alloys is important for the development of physically-based rheological models. A range of deformation mechanisms have been proposed including agglomeration and disagglomeration, viscoplastic deformation of the solid skeleton, and granular phenomena such as jamming and dilatancy. This paper overviews in-situ experiments that directly image crystal-scale deformation mechanisms in equiaxed Al alloys at solid fractions shortly after the crystals have impinged to form a loose crystal network. Direct evidence is presented for granular deformation mechanisms including shear-induced dilation in both equiaxed-dendritic and globular microstructures. Modelling approaches suitable for capturing this behaviour are then discussed.

Polycarbonate-based polyurethane as a polymer electrolyte matrix for all-solid-state lithium batteries

Science.gov (United States)

Bao, Junjie; Shi, Gaojian; Tao, Can; Wang, Chao; Zhu, Chen; Cheng, Liang; Qian, Gang; Chen, Chunhua

2018-06-01

Four kinds of polycarbonate-based polyurethane with 8-14 wt% hard segments content are synthesized via reactions of polycarbonatediol, hexamethylene diisocyanate and diethylene glycol. The mechanical strength of the polyurethanes increase with the increase of hard segments content. Solid polymer electrolytes composed of the polycarbonate-based polyurethanes and LiTFSI exhibits fascinating characteristics for all-solid-state lithium batteries with a high ionic conductivity of 1.12 × 10-4 S cm-1 at 80 °C, an electrochemical stability window up to 4.5 V (vs. Li+/Li), excellent mechanical strength and superior interfacial stability against lithium metal. The all-solid-state batteries using LiFePO4 cathode can deliver high discharge capacities (161, 158, 134 and 93 mAh g-1 at varied rates of 0.2, 0.5, 1 and 2 C) at 80 °C and excellent cycling performance (with 91% capacity retention after 600 cycles at 1 C). All the results indicate that such a polyurethane-based solid polymer electrolyte can be a promising candidate for all-solid-state lithium batteries.

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.

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

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.

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…

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...

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.

A Model of Solid Waste Management Based Multilateral Co-Operation in Semi-Urban Community

Science.gov (United States)

Kanchanabhandhu, Chanchai; Woraphong, Seree

2016-01-01

The purpose of this research was to construct a model of solid waste management based on multilateral cooperation in semi-urban community. Its specific objectives were to 1) study the solid waste situation and involvement of community in the solid waste management in Wangtaku Sub-district, Muang District, Nakhon Pathom Province; 2) construct a…

General aspects of solid on liquid growth mechanisms

International Nuclear Information System (INIS)

Laux, E; Charmet, J; Haquette, H; Banakh, O; Jeandupeux, L; Graf, B; Keppner, H

2009-01-01

Liquids, in general, tend to have a lower density as solids and therefore it is not straightforward to deposit solid over liquids in a way that the liquid becomes hermetically sealed under the solid layer. The authors review that several phenomena that can easily be observed in nature are only due to particular anomalies and solid on liquid is rather an exception as the rule. Natural solid on liquid systems are lacking of thermal, mechanical or chemical stability. It is not surprising, that one is not at all used thinking about to e.g. replace the gate oxide in a thin film transistor by a thin film of oil, or, to find in other microsystems functional liquids between a stack of thin solid films. However, once this becomes a serious option, a large variety of new Microsystems with new functionalities can be easily designed. In another paper (this conference and [1]) the authors pioneered that the polymer Parylene (poly(p-xylylene)) can be deposited on liquids coming already quite close to the above mentioned vision. In this paper the authors ask if one can synthesize other solid on liquid systems and surprisingly conclude, based on experimental evidence, that solid on liquid deposition seems to rather be the rule and not the exception.

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.)

Opto-mechatronics issues in solid immersion lens based near-field recording

Science.gov (United States)

Park, No-Cheol; Yoon, Yong-Joong; Lee, Yong-Hyun; Kim, Joong-Gon; Kim, Wan-Chin; Choi, Hyun; Lim, Seungho; Yang, Tae-Man; Choi, Moon-Ho; Yang, Hyunseok; Rhim, Yoon-Chul; Park, Young-Pil

2007-06-01

We analyzed the effects of an external shock on a collision problem in a solid immersion lens (SIL) based near-field recording (NFR) through a shock response analysis and proposed a possible solution to this problem with adopting a protector and safety mode. With this proposed method the collision between SIL and media can be avoided. We showed possible solution for contamination problem in SIL based NFR through a numerical air flow analysis. We also introduced possible solid immersion lens designs to increase the fabrication and assembly tolerances of an optical head with replicated lens. Potentially, these research results could advance NFR technology for commercial product.

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

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...

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...

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 ...

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...

Kinetics of aging of metastable, zirconium-dioxide-based solid electrolytes

International Nuclear Information System (INIS)

Vlasov, A.N.; Inozemtsev, M.V.

1985-01-01

The kinetics of aging of zirconium-dioxide-based metastable solid oxide electrolytes stabilized with 8 to 10 mole % of yttrium, holmium, or scandium oxide were studied over the temperature range from 1200 to 1373 0 K. Kinetic equations were proposed which describe the conduction behavior of two-phase solid electrolytes in a wide time range. The processes were found to occur independently at the initial stage of aging in the cubic solution, viz., an increase in the number of nuclei of the new phase, and a growth in volume of nuclei of the new phase. After a long time the former process ceases, and the kinetics of aging of the electrolyte only are determined by the kinetics of volume growth of the inclusions of new phase. The time-dependent behavior of two-phase solid solutions is discussed theoretically and examined experimentally

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

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

Perception Of Nursing Middle Managers About The Evidence-Based Management

Directory of Open Access Journals (Sweden)

Wilza Carla Spiri

2017-02-01

Full Text Available Objective: to comprehend the experience of nursing middle managers of an accredited public hospital, from São Paulo state, about the evidence-based management. Method: case study and analysis of thematic content in the stages of unity of meaning, condensed meaning unity, interpretation of the underlying meaning, sub-theme and theme. Nine manager nurses participated. The data collection was done through a script with questions that, according to the convenience of the participants, were answered by electronic mail. The data were analyzed in the light of the theoretical reference of the managerial process in nursing and the evidence-based management. Results: six themes were revealed: Evidence-based management and management process; Evidence-based management strengths; Evidence-based management challenges; the leader and the Evidence-based management; Hospital accreditation and evidence-based management and Experiences with the evidence-based management. Conclusion: the scientific knowledge and the experiences in the work are sources of evidences that interfere, positively, in the quality and safety of the patient. Leadership training, planning, team empowerment and involvement are essential for the development of this practice. Strategies need to be discussed and implemented so that the management process is based on evidences.

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.

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

Fluid, solid and fluid-structure interaction simulations on patient-based abdominal aortic aneurysm models.

Science.gov (United States)

Kelly, Sinead; O'Rourke, Malachy

2012-04-01

This article describes the use of fluid, solid and fluid-structure interaction simulations on three patient-based abdominal aortic aneurysm geometries. All simulations were carried out using OpenFOAM, which uses the finite volume method to solve both fluid and solid equations. Initially a fluid-only simulation was carried out on a single patient-based geometry and results from this simulation were compared with experimental results. There was good qualitative and quantitative agreement between the experimental and numerical results, suggesting that OpenFOAM is capable of predicting the main features of unsteady flow through a complex patient-based abdominal aortic aneurysm geometry. The intraluminal thrombus and arterial wall were then included, and solid stress and fluid-structure interaction simulations were performed on this, and two other patient-based abdominal aortic aneurysm geometries. It was found that the solid stress simulations resulted in an under-estimation of the maximum stress by up to 5.9% when compared with the fluid-structure interaction simulations. In the fluid-structure interaction simulations, flow induced pressure within the aneurysm was found to be up to 4.8% higher than the value of peak systolic pressure imposed in the solid stress simulations, which is likely to be the cause of the variation in the stress results. In comparing the results from the initial fluid-only simulation with results from the fluid-structure interaction simulation on the same patient, it was found that wall shear stress values varied by up to 35% between the two simulation methods. It was concluded that solid stress simulations are adequate to predict the maximum stress in an aneurysm wall, while fluid-structure interaction simulations should be performed if accurate prediction of the fluid wall shear stress is necessary. Therefore, the decision to perform fluid-structure interaction simulations should be based on the particular variables of interest in a given

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.

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...

Community-Based Solid Waste Management: A Training Facilitator's Guide.

Science.gov (United States)

Peace Corps, Washington, DC. Information Collection and Exchange Div.

Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

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.

Investigation of samarium solubility in the magnesium based solid solution

International Nuclear Information System (INIS)

Rokhlin, L.L.; Padezhnova, E.M.; Guzej, L.S.

1976-01-01

Electric resistance measurements and microscopic analysis were used to investigate the solubility of samarium in a magnesium-based solid solution. The constitutional diagram Mg-Sm on the magnesium side is of an eutectic type with the temperature of the eutectic transformation of 542 deg C. Samarium is partly soluble in solid magnesium, the less so, the lower is the temperature. The maximum solubility of samarium in magnesium (at the eutectic transformation point) is 5.8 % by mass (0.99 at. %). At 200 deg C, the solubility of samarium in magnesium is 0.4 % by mass (0.063 at. %)

Modified calcium oxide as stable solid base catalyst for Aldol ...

Indian Academy of Sciences (India)

A highly efficient and stable solid-base catalyst for Aldol condensation was ... was bonded on surface of CaO chemically and almost no Ca(OH)2 formed during the modification process. ... cation, corrosion and waste generation attract great.

Solid Lithium Ion Conductors (SLIC) for Lithium Solid State Batteries

Data.gov (United States)

National Aeronautics and Space Administration — To identify the most lithium-ion conducting solid electrolytes for lithium solid state batteries from the emerging types of solid electrolytes, based on a...

Kinetics of aging of metastable solid electrolytes based on zirconium dioxide

International Nuclear Information System (INIS)

Vlasov, A.N.; Inozemtsev, M.V.

1985-01-01

Kinetics of aging of metastable solid electrolytes on the base of zirconium dioxide stabilized with 8-10 mol.%of yttrium, holmium, and scandium oxides has been studied within the 1200-1373 K temperature range. Kinetic equations describibg behaviour of electric conductivity of two-phase solid electrolytes within a wide temperature interval have been suggested. It has been established that at the initial stage of ageing in cubic solid solution two processes proceed independently of one another: growth of a number of new phase centres and of a volume of new phase centres. At large times growth of a number of new phase centres stops, and kinetics of electrolyte aging is defined only by the growth kinetics of a volume of new phase inclusions

Synthesis of Dimethyl Glutarate from Cyclobutanone and Dimethyl Carbonate over Solid Base Catalysts

International Nuclear Information System (INIS)

Zhi, Chen; Dudu, Wu

2012-01-01

A facile route for the synthesis of dimethyl glutarate (DMG) from cyclobutanone and dimethyl carbonate (DMC) in the presence of solid base catalysts has been developed. It was found that the intermediate carbomethoxycyclobutanone (CMCB) was produced from cyclobutanone with DMC in the first step, and then CMCB was further converted to DMG by reacting with a methoxide group. The role of the basic catalysts can be mainly ascribed to the activation of cyclobutanone via the abstraction of a proton in the α-position by base sites, and solid bases with moderate strength, such as MgO, favor the formation of DMG

Synthesis of Dimethyl Glutarate from Cyclobutanone and Dimethyl Carbonate over Solid Base Catalysts

Energy Technology Data Exchange (ETDEWEB)

Zhi, Chen; Dudu, Wu [Guangdong Medical College, Dongguan (China)

2012-06-15

A facile route for the synthesis of dimethyl glutarate (DMG) from cyclobutanone and dimethyl carbonate (DMC) in the presence of solid base catalysts has been developed. It was found that the intermediate carbomethoxycyclobutanone (CMCB) was produced from cyclobutanone with DMC in the first step, and then CMCB was further converted to DMG by reacting with a methoxide group. The role of the basic catalysts can be mainly ascribed to the activation of cyclobutanone via the abstraction of a proton in the {alpha}-position by base sites, and solid bases with moderate strength, such as MgO, favor the formation of DMG

Evidence-based monitoring and evaluation of the faith-based ...

African Journals Online (AJOL)

Background: The Islamic Medical Association of Uganda, has been implementing the faith-based approach to HIV prevention without baseline data on expected positive outcomes. Objectives: To establish evidence-based baseline data on expected positive outcomes of the faith-based approach to HIV prevention. Methods: ...

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...

Experimental evidence of beam-foil plasma creation during ion-solid interaction

Energy Technology Data Exchange (ETDEWEB)

Sharma, Prashant, E-mail: prashant@iuac.res.in; Nandi, Tapan [Inter University Accelerator Centre, Aruna Asaf Ali Marg, New Delhi 110067 (India)

2016-08-15

Charge state evolution of the energetic projectile ions during the passage through thin carbon foils has been revisited using the X-ray spectroscopy technique. Contributions from the bulk and the solid surface in the charge changing processes have been segregated by measuring the charge state distribution of the projectile ions in the bulk of the target during the ion–solid interaction. Interestingly, the charge state distribution measured in the bulk exhibits Lorentzian profile in contrast to the well-known Gaussian structure observed using the electromagnetic methods and the theoretical predictions. The occurrence of such behavior is a direct consequence of the imbalance between charge changing processes, which has been seen in various cases of the laboratory plasma. It suggests that the ion-solid collisions constitute high-density, localized plasma in the bulk of the solid target, called the beam-foil plasma. This condensed beam-foil plasma is similar to the high-density solar and stellar plasma which may have practical implementations in various fields, in particular, plasma physics and nuclear astrophysics. The present work suggests further modification in the theoretical charge state distribution calculations by incorporating the plasma coupling effects during the ion–solid interactions. Moreover, the multi-electron capture from the target exit surface has been confirmed through comparison between experimentally measured and theoretically predicted values of the mean charge state of the projectile ions.

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.

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

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.

Solid solution strengthening and diffusion in nickel- and cobalt-based superalloys

Energy Technology Data Exchange (ETDEWEB)

Rehman, Hamad ur

2016-07-01

Nickel and cobalt-based superalloys with a γ-γ{sup '} microstructure are known for their excellent creep resistance at high temperatures. Their microstructure is engineered using different alloying elements, that partition either to the fcc γ matrix or to the ordered γ{sup '} phase. In the present work the effect of alloying elements on their segregation behaviour in nickel-based superalloys, diffusion in cobalt-based superalloys and the temperature dependent solid solution strengthening in nickel-based alloys is investigated. The effect of dendritic segregation on the local mechanical properties of individual phases in the as-cast, heat treated and creep deformed state of a nickel-based superalloy is investigated. The local chemical composition is characterized using Electron Probe Micro Analysis and then correlated with the mechanical properties of individual phases using nanoindentation. Furthermore, the temperature dependant solid solution hardening contribution of Ta, W and Re towards fcc nickel is studied. The room temperature hardening is determined by a diffusion couple approach using nanoindentation and energy dispersive X-ray analysis for relating hardness to the chemical composition. The high temperature properties are determined using compression strain rate jump tests. The results show that at lower temperatures, the solute size is prevalent and the elements with the largest size difference with nickel, induce the greatest hardening consistent with a classical solid solution strengthening theory. At higher temperatures, the solutes interact with the dislocations such that the slowest diffusing solute poses maximal resistance to dislocation glide and climb. Lastly, the diffusion of different technically relevant solutes in fcc cobalt is investigated using diffusion couples. The results show that the large atoms diffuse faster in cobalt-based superalloys similar to their nickel-based counterparts.

Solid solution strengthening and diffusion in nickel- and cobalt-based superalloys

International Nuclear Information System (INIS)

Rehman, Hamad ur

2016-01-01

Nickel and cobalt-based superalloys with a γ-γ ' microstructure are known for their excellent creep resistance at high temperatures. Their microstructure is engineered using different alloying elements, that partition either to the fcc γ matrix or to the ordered γ ' phase. In the present work the effect of alloying elements on their segregation behaviour in nickel-based superalloys, diffusion in cobalt-based superalloys and the temperature dependent solid solution strengthening in nickel-based alloys is investigated. The effect of dendritic segregation on the local mechanical properties of individual phases in the as-cast, heat treated and creep deformed state of a nickel-based superalloy is investigated. The local chemical composition is characterized using Electron Probe Micro Analysis and then correlated with the mechanical properties of individual phases using nanoindentation. Furthermore, the temperature dependant solid solution hardening contribution of Ta, W and Re towards fcc nickel is studied. The room temperature hardening is determined by a diffusion couple approach using nanoindentation and energy dispersive X-ray analysis for relating hardness to the chemical composition. The high temperature properties are determined using compression strain rate jump tests. The results show that at lower temperatures, the solute size is prevalent and the elements with the largest size difference with nickel, induce the greatest hardening consistent with a classical solid solution strengthening theory. At higher temperatures, the solutes interact with the dislocations such that the slowest diffusing solute poses maximal resistance to dislocation glide and climb. Lastly, the diffusion of different technically relevant solutes in fcc cobalt is investigated using diffusion couples. The results show that the large atoms diffuse faster in cobalt-based superalloys similar to their nickel-based counterparts.

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...

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.

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.

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.

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

DEFF Research Database (Denmark)

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

2014-01-01

Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case......-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy...

Replacing HDDs with Solid-State Flash Disks in PXIbus-Based Systems

International Nuclear Information System (INIS)

Zhao, Z W; Zeng, L

2006-01-01

New security features, constantly decreasing prices, solid-state Flash disks are becoming a popular alternative for replacing failure-prone mechanical Hard Disk Drives (HDDs) in PXIbus-based military systems. The key component in high-capacity solid-state Flash disks is NAND Flash, but with a specification that shows only 100,000-300,000 write/erase cycles, engineers may be concerned that the lifetime of Flash disks cannot meet their application requirements. With the right Flash management, Flash disks are able to provide the reliability and endurance that military applications need

Development of novel sibutramine base-loaded solid dispersion with gelatin and HPMC: physicochemical characterization and pharmacokinetics in beagle dogs.

Science.gov (United States)

Lim, Hyun-Tae; Balakrishnan, Prabagar; Oh, Dong Hoon; Joe, Kwan Hyung; Kim, Young Ran; Hwang, Doo Hyung; Lee, Yong-Bok; Yong, Chul Soon; Choi, Han-Gon

2010-09-15

To develop a novel sibutramine base-loaded solid dispersion with enhanced solubility and bioavailability, various solid dispersions were prepared using a spray drying technique with hydrophilic polymers such as gelatin, HPMC and citric acid. Their solubility, thermal characteristics and crystallinity were investigated. The dissolution and pharmacokinetics of the sibutramine base-loaded solid dispersion were then compared with a sibutramine hydrochloride monohydrate-loaded commercial product (Reductil). The solid dispersions prepared with gelatin gave higher drug solubility than those prepared without gelatin, irrespective of the amount of polymer. The sibutramine base-loaded solid dispersions containing hydrophilic polymer and citric acid showed higher drug solubility compared to sibutramine base and sibutramine hydrochloride monohydrate. Among the formulations tested, the solid dispersion composed of sibutramine base/gelatin/HPMC/citric acid at the weight ratio of 1/0.8/0.2/0.5 gave the highest solubility of 5.03+/-0.24 mg/ml. Our DSC and powder X-ray diffraction results showed that the drug was present in an altered amorphous form in this solid dispersion. The difference factor (f(1)) values between solid dispersion and commercial product were 2.82, 6.65 and 6.31 at pH 1.2, 4.0 and 6.8, respectively. Furthermore, they had the similarity factor (f(2)) value of 65.68, 53.43 and 58.97 at pH 1.2, 4.0 and 6.8, respectively. Our results suggested that the solid dispersion and commercial product produced a similar correlation of dissolution profiles at all pH ranges. The AUC, C(max) and T(max) of the parent drug and metabolite I and II from the solid dispersion were not significantly different from those of the commercial product, suggesting that the solid dispersion might be bioequivalent to the commercial product in beagle dogs. Thus, the sibutramine base-loaded solid dispersion prepared with gelatin, HPMC and citric acid is a promising candidate for improving the

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.

Evidence for vitreous type orientational ordering in solid hydrogen and deuterium

International Nuclear Information System (INIS)

Devoret, M.

1982-09-01

This shown a new region in the concentration-temperature phase diagram for solid mixtures of ortho and para-hydrogen. This region is characterized by a vitreous type orientational, ordering, with the quadrupoles of the ortho molecules frozen in a random fashion. This new vitreous state is called a quadrupolar glass, with the degrees of freedom of quadrupolar moments frozen in solid hydrogen [fr

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

Science.gov (United States)

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

2015-01-01

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

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

Solid-State Quantum Computer Based on Scanning Tunneling Microscopy

Energy Technology Data Exchange (ETDEWEB)

Berman, G. P.; Brown, G. W.; Hawley, M. E.; Tsifrinovich, V. I.

2001-08-27

We propose a solid-state nuclear-spin quantum computer based on application of scanning tunneling microscopy (STM) and well-developed silicon technology. It requires the measurement of tunneling-current modulation caused by the Larmor precession of a single electron spin. Our envisioned STM quantum computer would operate at the high magnetic field ({approx}10 T) and at low temperature {approx}1 K .

Solid-State Quantum Computer Based on Scanning Tunneling Microscopy

International Nuclear Information System (INIS)

Berman, G. P.; Brown, G. W.; Hawley, M. E.; Tsifrinovich, V. I.

2001-01-01

We propose a solid-state nuclear-spin quantum computer based on application of scanning tunneling microscopy (STM) and well-developed silicon technology. It requires the measurement of tunneling-current modulation caused by the Larmor precession of a single electron spin. Our envisioned STM quantum computer would operate at the high magnetic field (∼10 T) and at low temperature ∼1 K

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

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.

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.

Physicochemical pretreatments and hydrolysis of furfural residues via carbon-based sulfonated solid acid.

Science.gov (United States)

Ma, Bao Jun; Sun, Yuan; Lin, Ke Ying; Li, Bing; Liu, Wan Yi

2014-03-01

Potential commercial physicochemical pretreatment methods, NaOH/microwave and NaOH/ultrasound were developed, and the carbon-based sulfonated solid acid catalysts were prepared for furfural residues conversion into reducing sugars. After the two optimum pretreatments, both the content of cellulose increased (74.03%, 72.28%, respectively) and the content of hemicellulose (94.11%, 94.17% of removal rate, respectively) and lignin (91.75%, 92.09% of removal rate, respectively) decreased in furfural residues. The reducing sugar yields of furfural residues with the two physicochemical pretreatments on coal tar-based solid acid reached 33.94% and 33.13%, respectively, higher than that pretreated via NaOH alone (27%) and comparable to that pretreated via NaOH/H2O2 (35.67%). The XRD patterns, IR spectra and SEM images show microwave and ultrasound improve the pretreatment effect. The results demonstrate the carbon-based sulfonated solid acids and the physicochemical pretreatments are green, effective, low-cost for furfural residues conversion. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Particle-based solid for nonsmooth multidomain dynamics

Science.gov (United States)

Nordberg, John; Servin, Martin

2018-04-01

A method for simulation of elastoplastic solids in multibody systems with nonsmooth and multidomain dynamics is developed. The solid is discretised into pseudo-particles using the meshfree moving least squares method for computing the strain tensor. The particle's strain and stress tensor variables are mapped to a compliant deformation constraint. The discretised solid model thus fit a unified framework for nonsmooth multidomain dynamics simulations including rigid multibodies with complex kinematic constraints such as articulation joints, unilateral contacts with dry friction, drivelines, and hydraulics. The nonsmooth formulation allows for impact impulses to propagate instantly between the rigid multibody and the solid. Plasticity is introduced through an associative perfectly plastic modified Drucker-Prager model. The elastic and plastic dynamics are verified for simple test systems, and the capability of simulating tracked terrain vehicles driving on a deformable terrain is demonstrated.

Solids-based concentrated solar power receiver

Science.gov (United States)

None

2018-04-10

A concentrated solar power (CSP) system includes channels arranged to convey a flowing solids medium descending under gravity. The channels form a light-absorbing surface configured to absorb solar flux from a heliostat field. The channels may be independently supported, for example by suspension, and gaps between the channels are sized to accommodate thermal expansion. The light absorbing surface may be sloped so that the inside surfaces of the channels proximate to the light absorbing surface define downward-slanting channel floors, and the flowing solids medium flows along these floors. Baffles may be disposed inside the channels and oriented across the direction of descent of the flowing solids medium. The channels may include wedge-shaped walls forming the light-absorbing surface and defining multiple-reflection light paths for solar flux from the heliostat field incident on the light-absorbing surface.

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

Solid electrolytes general principles, characterization, materials, applications

CERN Document Server

Hagenmuller, Paul

1978-01-01

Solid Electrolytes: General Principles, Characterization, Materials, Applications presents specific theories and experimental methods in the field of superionic conductors. It discusses that high ionic conductivity in solids requires specific structural and energetic conditions. It addresses the problems involved in the study and use of solid electrolytes. Some of the topics covered in the book are the introduction to the theory of solid electrolytes; macroscopic evidence for liquid nature; structural models; kinetic models; crystal structures and fast ionic conduction; interstitial motion in

All-Solid-State Lithium-Sulfur Battery based on a nanoconfined LiBH 4 Electrolyte

NARCIS (Netherlands)

Das, Supti; Ngene, Peter; Norby, Poul; Vegge, Tejs; de Jongh, P.E.; Blanchard, Didier

2016-01-01

In this work we characterize all-solid-state lithium-sulfur batteries based on nano-confined LiBH4in mesoporous silica as solid electrolytes. The nano-confined LiBH4has fast ionic lithium conductivity at room temperature, 0.1 mScm-1, negligible electronic conductivity and its cationic transport

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.

Theromdynamics of carbon in nickel-based multicomponent solid solutions

International Nuclear Information System (INIS)

Bradley, D.J.

1978-04-01

The activity coefficient of carbon in nickel, nickel-titanium, nickel-titanium-chromium, nickel-titanium-molybdenum and nickel-titanium-molybdenum-chromium alloys has been measured at 900, 1100 and 1215 0 C. The results indicate that carbon obeys Henry's Law over the range studied (0 to 2 at. percent). The literature for the nickel-carbon and iron-carbon systems are reviewed and corrected. For the activity of carbon in iron as a function of composition, a new relationship based on re-evaluation of the thermodynamics of the CO/CO 2 equilibrium is proposed. Calculations using this relationship reproduce the data to within 2.5 percent, but the accuracy of the calibrating standards used by many investigators to analyze for carbon is at best 5 percent. This explains the lack of agreement between the many precise sets of data. The values of the activity coefficient of carbon in the various solid solutions are used to calculate a set of parameters for the Kohler-Kaufman equation. The calculations indicate that binary interaction energies are not sufficient to describe the thermodynamics of carbon in some of the nickel-based solid solutions. The results of previous workers for carbon in nickel-iron alloys are completely described by inclusion of ternary terms in the Kohler-Kaufman equation. Most of the carbon solid solution at high temperatures in nickel and nickel-titantium alloys precipitates from solution on quenching in water. The precipitate is composed of very small particles (greater than 2.5 nm) of elemental carbon. The results of some preliminary thermomigration experiments are discussed and recommendations for further work are presented

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.

Contact angles on stretched solids

Science.gov (United States)

Mensink, Liz; Snoeijer, Jacco

2017-11-01

The surface energy of solid interfaces plays a central role in wetting, as they dictate the liquid contact angle. Yet, it has been challenging to measure the solid surface energies independently, without making use of Young's law. Here we present Molecular Dynamics (MD) simulations by which we measure the surface properties for all interfaces, including the solids. We observe change in contact angles upon stretching the solid substrates, showing that the surface energy is actually strain dependent. This is clear evidence of the so-called Shuttleworth effect, making it necessary to distinguish surface energy from surface tension. We discuss how this effect gives rise to a new class of elasto-capillary phenomena. ERC Consolidator Grant No. 616918.

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

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.

Modified calcium oxide as stable solid base catalyst for Aldol

Indian Academy of Sciences (India)

A highly efficient and stable solid-base catalyst for Aldol condensation was prepared by modifying commercial CaO with benzyl bromide in a simple way. It was found that modified CaO can effectively catalyse the Aldol condensation of cyclohexanone and benzaldehyde, as well as various benzaldehydes, to produce ...

Household air pollution from solid fuel use and risk of adverse pregnancy outcomes: a systematic review and meta-analysis of the empirical evidence.

Science.gov (United States)

Amegah, Adeladza K; Quansah, Reginald; Jaakkola, Jouni J K

2014-01-01

About 41% of households globally, mainly in developing countries rely on solid fuels for cooking with consequences for fetal growth and development. Previous reviews were limited in scope, assessing only two outcomes (birth weight, stillbirth). With important evidence accumulating, there is a need to improve the previous estimates and assess additional outcomes. We conducted a systematic review and meta-analysis to evaluate the quality and strength of available evidence on household air pollution (HAP) and the whole range of adverse pregnancy outcomes. PubMed, Ovid Medline, Scopus and CINAHL were searched from their inception to the end of April 2013. All epidemiological study designs were eligible for inclusion in the review. The random-effects model was applied in computing the summary-effect estimates (EE) and their corresponding 95% confidence interval (CI). Of 1505 studies screened, 19 studies satisfied the inclusion criteria. Household combustion of solid fuels resulted in an 86.43 g (95% CI: 55.49, 117.37) reduction in birth weight, and a 35% (EE = 1.35, 95% CI: 1.23, 1.48) and 29% (EE = 1.29, 95% CI: 1.18, 1.41) increased risk of LBW and stillbirth respectively. Combustion of solid fuels at home increases the risk of a wide range of adverse pregnancy outcomes. Access to clean household energy solutions is the surest way to combat HAP and mitigate their adverse effects.

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.

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.

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

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.

2nd International Workshop on Evidence-Based Technology Enhanced Learning

CERN Document Server

Gennari, Rosella; Marenzi, Ivana; Mascio, Tania; Prieta, Fernando

2013-01-01

Research on Technology Enhanced Learning (TEL) investigates how information and communication technologies can be designed in order to support pedagogical activities. The Evidence Based Design (EBD) of a system bases its decisions on empirical evidence and effectiveness. The evidence-based TEL workshop (ebTEL) brings together TEL and EBD.   The first edition of ebTEL collected contributions in the area of TEL from computer science, artificial intelligence, evidence-based medicine, educational psychology and pedagogy. Like the previous edition, this second edition, ebTEL’13, wants to be a forum in which TEL researchers and practitioners alike can discuss innovative evidence-based ideas, projects, and lessons related to TEL.   The workshop took place in Salamanca, Spain, on May 22nd-24th 2013.  

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...

Evidence of two-stage melting of Wigner solids

Science.gov (United States)

Knighton, Talbot; Wu, Zhe; Huang, Jian; Serafin, Alessandro; Xia, J. S.; Pfeiffer, L. N.; West, K. W.

2018-02-01

Ultralow carrier concentrations of two-dimensional holes down to p =1 ×109cm-2 are realized. Remarkable insulating states are found below a critical density of pc=4 ×109cm-2 or rs≈40 . Sensitive dc V-I measurement as a function of temperature and electric field reveals a two-stage phase transition supporting the melting of a Wigner solid as a two-stage first-order transition.

[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.

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.

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.

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.

[Preparation of Oenothera biennis Oil Solid Lipid Nanoparticles Based on Microemulsion Technique].

Science.gov (United States)

Piao, Lin-mei; Jin, Yong; Cui, Yan-lin; Yin, Shou-yu

2015-06-01

To study the preparation of Oenothera biennis oil solid lipid nanoparticles and its quality evaluation. The solid lipid nanoparticles were prepared by microemulsion technique. The optimum condition was performed based on the orthogonal design to examine the entrapment efficiency, the mean diameter of the particles and so on. The optimal preparation of Oenothera biennis oil solid lipid nanoparticles was as follows: Oenothera biennis dosage 300 mg, glycerol monostearate-Oenothera biennis (2: 3), Oenothera biennis -RH/40/PEG-400 (1: 2), RH-40/PEG-400 (1: 2). The resulting nanoparticles average encapsulation efficiency was (89.89 ± 0.71)%, the average particle size was 44.43 ± 0.08 nm, and the Zeta potential was 64.72 ± 1.24 mV. The preparation process is simple, stable and feasible.

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...

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.

The meaning of evidence-based management to Brazilian senior nurse leaders.

Science.gov (United States)

Spiri, Wilza Carla; MacPhee, Maura

2013-09-01

The study objective was to understand the meaning of evidence-based management for senior nurse leaders in accredited, public hospitals in the State of Sao Paulo, Brazil. A phenomenological approach was used to analyze interviews conducted with 10 senior nurse leaders between August 2011 and March 2012. The analytic method was developed by the Brazilian phenomenologist, Martins. Senior nurse leaders described how they critically appraise many sources of evidence when making managerial decisions. They emphasized the importance of working with their teams to locally adapt and evaluate best evidence associated with managerial decision making and organizational innovations. Their statements also demonstrated how they use evidence-based management to support the adoption of evidence-based practices. They did not, however, provide specific strategies for seeking out and obtaining evidence. Notable challenges were traditional cultures and rigid bureaucracies, while major facilitators included accreditation, teamwork, and shared decision making. Evidence-based management necessitates a continuous process of locating, implementing, and evaluating evidence. In this study leaders provided multiple, concrete examples of all these processes except seeking out and locating evidence. They also gave examples of other leadership skills associated with successful adoption of evidence-based practice and management, particularly interdisciplinary teamwork and shared decision making. This study demonstrates senior nurse leaders' awareness and utilization of evidence-based management. The study also suggests what aspects of evidence-based management need further development, such as more active identification of potential, new organizational innovations. © 2013 Sigma Theta Tau International.

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

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.

All-solid-state reference electrodes based on conducting polymers.

Science.gov (United States)

Kisiel, Anna; Marcisz, Honorata; Michalska, Agata; Maksymiuk, Krzysztof

2005-12-01

A novel construction of solution free (pseudo)reference electrodes, compatible with all-solid-state potentiometric indicator electrodes, has been proposed. These electrodes use conducting polymers (CP): polypyrrole (PPy) or poly(3,4-ethylenedioxythiophene) (PEDOT). Two different arrangements have been tested: solely based on CP and those where the CP phase is covered with a poly(vinyl chloride) based outer membrane of tailored composition. The former arrangement was designed to suppress or compensate cation- and anion-exchange, using mobile perchlorate ions and poly(4-styrenesulfonate) or dodecylbenzenesulfonate anions as immobilized dopants. The following systems were used: (i) polypyrrole layers doped simultaneously by two kinds of anions, both mobile and immobilized in the polymer layer; (ii) bilayers of polypyrrole with anion exchanging inner layer and cation-exchanging outer layer; (iii) polypyrrole doped by surfactant dodecylbenzenesulfonate ions, which inhibit ion exchange on the polymer/solution interface. For the above systems, recorded potentials have been found to be practically independent of electrolyte concentration. The best results, profound stability of potentials, have been obtained for poly(3,4-ethylenedioxythiophene) or polypyrrole doped by poly(4-styrenesulfonate) anions covered by a poly(vinyl chloride) based membrane, containing both anion- and cation-exchangers as well as solid potassium chloride and silver chloride with metallic silver. Differently to the cases (i)-(iii) these electrodes are much less sensitive to the influence of redox and pH interferences. This arrangement has been also characterized using electrochemical impedance spectroscopy and chronopotentiometry.

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...

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...

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

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.

All-solid-state flexible supercapacitors based on papers coated with carbon nanotubes and ionic-liquid-based gel electrolytes

International Nuclear Information System (INIS)

Kang, Yu Jin; Kim, Woong; Chung, Haegeun; Han, Chi-Hwan

2012-01-01

All-solid-state flexible supercapacitors were fabricated using carbon nanotubes (CNTs), regular office papers, and ionic-liquid-based gel electrolytes. Flexible electrodes were made by coating CNTs on office papers by a drop-dry method. The gel electrolyte was prepared by mixing fumed silica nanopowders with ionic liquid, 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([EMIM][NTf 2 ]). This supercapacitor showed high power and energy performance as a solid-state flexible supercapacitor. The specific capacitance of the CNT electrodes was 135 F g −1 at a current density of 2 A g −1 , when considering the mass of active materials only. The maximum power and energy density of the supercapacitors were 164 kW kg −1 and 41 Wh kg −1 , respectively. Interestingly, the solid-state supercapacitor with the gel electrolyte showed comparable performance to the supercapacitors with ionic-liquid electrolyte. Moreover, the supercapacitor showed excellent stability and flexibility. The CNT/paper- and gel-based supercapacitors may hold great potential for low-cost and high-performance flexible energy storage applications. (paper)

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

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…

Contributions of qualitative research to evidence-based practice in nursing

Directory of Open Access Journals (Sweden)

Ailinger Rita L.

2003-01-01

Full Text Available AIM: This article aims to identify the contributions of qualitative research to evidence-based practice in nursing. BACKGROUND: Qualitative research dates back to the 1920s and 1930s, when anthropologists and sociologists used qualitative research methods to study human phenomena in naturalistic settings and from a holistic viewpoint. Afterwards, other subject matters, including nursing, adopted qualitative methods to answer their research questions. The restructuring of health care over the past decade has brought about increased accountability in nursing research. One method for increasing this accountability is evidence-based practice. METHOD: The method used was a search in the Cumulative Index to Nursing and Allied Health Literature database from 1999-present. The search resulted in 61 citations for evidence-based practice in nursing research; however, only 5 citations focused on evidence-based practice and qualitative research. FINDINGS: The authors' findings revealed six contributions of qualitative research to evidence-based practice: generation of hypotheses; development and validation of instruments; provision of context for evaluation; development of nursing interventions; development of new research questions; and application of Qualitative Outcome Analysis. CONCLUSION: Qualitative research makes important contributions to the quality of evidence-based practice.

Evidence-based interventions in pediatric psychology: progress over the decades.

Science.gov (United States)

Palermo, Tonya M

2014-09-01

This introduction to the special issue on Evidence-Based Interventions in Pediatric Psychology provides background on the process used to develop the special issue, a summary of the key findings from the series of reviews, and discussion of the implications for evidence-based practice. Authors followed a three-phase approach to develop their systematic reviews using rigorous systematic review methodology drawn heavily from the Cochrane Collaboration. The strength of the evidence for each pediatric psychology intervention was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The introduction discusses the progress that has been made in the evidence base for pediatric psychology interventions since the first special series published in 1999. Recommendations to stimulate further research and expand and strengthen the quality of the evidence base are described. The introduction concludes with implications from the special issue for pediatric psychology training in evidence-based practice. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Solid Silica-based Sulphonic Acid as an Efficient Green Catalyst for ...

African Journals Online (AJOL)

NJD

Solid Silica-based Sulphonic Acid as an Efficient Green. Catalyst for the Selective Oxidation of Sulphides to. Sulphoxides using NaCIO in Aqueous Media. Ali Amoozadeh* and Firouzeh Nemati. Department of Chemistry, Faculty of Science, Semnan University, Semnan, Iran. Received 21 October 2008, revised 6 December ...

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.

[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.

Evidence-based toxicology for the 21st century: opportunities and challenges.

Science.gov (United States)

Stephens, Martin L; Andersen, Melvin; Becker, Richard A; Betts, Kellyn; Boekelheide, Kim; Carney, Ed; Chapin, Robert; Devlin, Dennis; Fitzpatrick, Suzanne; Fowle, John R; Harlow, Patricia; Hartung, Thomas; Hoffmann, Sebastian; Holsapple, Michael; Jacobs, Abigail; Judson, Richard; Naidenko, Olga; Pastoor, Tim; Patlewicz, Grace; Rowan, Andrew; Scherer, Roberta; Shaikh, Rashid; Simon, Ted; Wolf, Douglas; Zurlo, Joanne

2013-01-01

The Evidence-based Toxicology Collaboration (EBTC) was established recently to translate evidence-based approaches from medicine and health care to toxicology in an organized and sustained effort. The EBTC held a workshop on "Evidence-based Toxicology for the 21st Century: Opportunities and Challenges" in Research Triangle Park, North Carolina, USA on January 24-25, 2012. The presentations largely reflected two EBTC priorities: to apply evidence-based methods to assessing the performance of emerging pathway-based testing methods consistent with the 2007 National Research Council report on "Toxicity Testing in the 21st Century" as well as to adopt a governance structure and work processes to move that effort forward. The workshop served to clarify evidence-based approaches and to provide food for thought on substantive and administrative activities for the EBTC. Priority activities include conducting pilot studies to demonstrate the value of evidence-based approaches to toxicology, as well as conducting educational outreach on these approaches.

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.

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.

A community of learners in the evidence-based dental clinic

NARCIS (Netherlands)

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

2012-01-01

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

Three-body interactions in liquid and solid hydrogen: Evidence from vibrational spectroscopy

Science.gov (United States)

Hinde, Robert

2008-03-01

In the cryogenic low-density liquid and solid phases of H2 and D2, the H2 and D2 molecules retain good rotational and vibrational quantum numbers that characterize their internal degrees of freedom. High-resolution infrared and Raman spectroscopic experiments provide extremely sensitive probes of these degrees of freedom. We present here fully-first-principles calculations of the infrared and Raman spectra of liquid and solid H2 and D2, calculations that employ a high-quality six-dimensional coupled-cluster H2-H2 potential energy surface and quantum Monte Carlo treatments of the single-molecule translational degrees of freedom. The computed spectra agree very well with experimental results once we include three-body interactions among the molecules, interactions which we also compute using coupled-cluster quantum chemical methods. We predict the vibrational spectra of liquid and solid H2 at several temperatures and densities to provide a framework for interpreting recent experiments designed to search for superfluid behavior in small H2 droplets. We also present preliminary calculations of the spectra of mixed H2/D2 solids that show how positional disorder affects the spectral line shapes in these systems.

All solid supercapacitor based on polyaniline and crosslinked sulfonated poly[ether ether ketone

International Nuclear Information System (INIS)

Sivaraman, P.; Kushwaha, R.K.; Shashidhara, K.; Hande, V.R.; Thakur, A.P.; Samui, A.B.; Khandpekar, M.M.

2010-01-01

All solid supercapacitor based on polyaniline (PANI) and crosslinked sulfonated poly[ether ether ketone] (XSPEEK,) is reported in this paper. The crosslinker used for sulfonated poly[ether ether ketone] (SPEEK) is 1,4-bis(hydroxymethyl) benzene. The XSPEEK is used as both solid electrolyte and separator membrane. Supercapacitors are fabricated using various PANI/XSPEEK weight ratios. These are characterized by cyclic voltammetry and galvanostatic charge-discharge studies. The supercapacitor with PANI/XSPEEK weight ratio 1:0.5, exhibit a specific capacitance of 480 F g -1 of PANI. To the best of authors' knowledge, the value reported here is the highest for a supercapacitor based on a proton conducting solid polymer electrolyte and PANI. Detailed electrochemical impedance spectroscopy analysis is carried out. The analysis shows that the complex capacitance of the supercapacitor depends on the XSPEEK content. The time constant (t 0 ), derived from the imaginary part of complex capacitance decreases with increase in the XSPEEK content in the supercapacitor. Cycle life characteristics of the supercapacitor show a decrease in specific capacitance during initial cycles and get stabilized during later cycles.

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.

Attitudes of mental health occupational therapists toward evidence-based practice.

Science.gov (United States)

Hitch, Danielle P

2016-02-01

Evidence-based practice is an important driver in modern health care and has become a priority in mental health occupational therapy in recent years. The aim of this study was to measure the attitudes of a cohort of mental health occupational therapists toward evidence-based practice. Forty-one mental health occupational therapists were surveyed using the Evidence-Based Practice Attitude Scale (EBPAS). Mann-Whitney U tests and Spearman's rho were used to analyze the data. The occupational therapy respondents had generally positive attitudes toward evidence-based practices comparable to established norms. Respondents with further qualifications beyond their professional degree were significantly more likely to try new interventions (p = .31). Significant negative correlations were found also for the subscales of Appeal and Openness in relation to years of occupational therapy practice (rho = -.354, p = .023; rho = -.344, p = 0.28) and mental health experience (rho = -.390, p = 0.12; rho = -.386, p = .013). Therapist factors can significantly impact attitudes toward evidence-based practice. © CAOT 2015.

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.

An evidence-based public health approach to climate change adaptation.

Science.gov (United States)

Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

2014-11-01

Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

Evidence-based decision making in health care settings: from theory to practice.

Science.gov (United States)

Kohn, Melanie Kazman; Berta, Whitney; Langley, Ann; Davis, David

2011-01-01

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

Theory of normal and superconducting properties of fullerene-based solids

International Nuclear Information System (INIS)

Cohen, M.L.

1992-10-01

Recent experiments on the normal-state and superconducting properties of fullerene-based solids are used to constrain the proposal theories of the electronic nature of these materials. In general, models of superconductivity based on electron pairing induced by phonons are consistent with electronic band theory. The latter experiments also yield estimates of the parameters characterizing these type H superconductors. It is argued that, at this point, a ''standard model'' of phonons interacting with itinerant electrons may be a good first approximation for explaining the properties of the metallic fullerenes

CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

Energy Technology Data Exchange (ETDEWEB)

Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Asan Medical Center, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Seoul National University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Park, Young Sik [Seoul National University Hospital, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of)

2017-12-15

To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

International Nuclear Information System (INIS)

Lee, Sang Min; Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo; Kim, Young Tae; Park, Young Sik

2017-01-01

To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

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.

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…

A Quantitative Analysis of Evidence-Based Testing Practices in Nursing Education

Science.gov (United States)

Moore, Wendy

2017-01-01

The focus of this dissertation is evidence-based testing practices in nursing education. Specifically, this research study explored the implementation of evidence-based testing practices between nursing faculty of various experience levels. While the significance of evidence-based testing in nursing education is well documented, little is known…

[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.

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.

Simulation based engineering in solid mechanics

CERN Document Server

Rao, J S

2017-01-01

This book begins with a brief historical perspective of the advent of rotating machinery in 20th century Solid Mechanics and the development of the discipline of the Strength of Materials. High Performance Computing (HPC) and Simulation Based Engineering Science (SBES) have gradually replaced the conventional approach in Design bringing science directly into engineering without approximations. A recap of the required mathematical principles is given. The science of deformation, strain and stress at a point under the application of external traction loads is next presented. Only one-dimensional structures classified as Bars (axial loads), Rods (twisting loads) and Beams (bending loads) are considered in this book. The principal stresses and strains and von Mises stress and strain that used in design of structures are next presented. Lagrangian solution was used to derive the governing differential equations consistent with assumed deformation field and solution for deformations, strains and stresses were obtai...

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.

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.

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.

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 ...

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…

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

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

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.

Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice

Science.gov (United States)

Aarons, Gregory A.

2006-01-01

Objective Leadership in organizations is important in shaping workers’ perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers’ attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers’ attitudes toward adopting evidence-based practice. Methods Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers’ characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors’ leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers’ characteristics. Results Both transformational and transactional leadership were positively associated with providers’ having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers’ perception of difference between the providers’ current practice and evidence-based practice. Conclusions Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices. PMID:16870968

[Why controlled studies may lead to misleading and unconfirmed therapeutic concepts--a critical view of evidence-based medicine].

Science.gov (United States)

Flachskampf, F A

2002-03-01

The concept of evidence-based medicine has gathered widespread support during recent years. While this concept has clear merits in compiling and qualifying up-to-date information for clinical decisions, it should be viewed with caution as the sole valid knowledge source for clinical decision-making. The limitations of such an approach are particularly striking when reviewing two key developments in modern cardiology, fibrinolysis and acute percutaneous intervention in acute myocardial infarction. In both cases, early studies and meta-analyses showed no benefit for these therapeutic interventions over earlier treatment. Only after further refinement (mainly in dosage, time window, concomitant heparin therapy for fibrinolysis, and the introduction of stents and IIb/IIIa inhibitors for acute intervention) did these therapies become universally acknowledged. It is therefore crucial to understand that especially for physicians actively participating in the development of a clinical field clinical decisions cannot be exclusively based on published evidence. Another important problem to consider is the time gap between the emergence of new therapies and the publication and reception by the medical audience, in particular in rapidly evolving fields as cardiology. While it is clear that clinical decision-making must be backed by solid knowledge of the published evidence, in particular the specialist involved in-depth in the field may use not yet proven therapeutic concepts and measures to the patient's advantage.

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...

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

The History of Evidence-Based Practice in Nursing Education and Practice.

Science.gov (United States)

Mackey, April; Bassendowski, Sandra

Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

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).

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.

Fee-based solid waste collection in economically developing countries: The case of Accra metropolis

Directory of Open Access Journals (Sweden)

Oduro-Appiah, K.

2013-06-01

Full Text Available Fee-based solid waste collection, a system that holds great promise to reducing the financial burden of solid waste management on the municipalities of developing countries is reviewed in this research study. It is to promote financial sustainability through partial or full cost sharing of solid waste collection services and intended to serve as a guide to policy makers and waste management authorities in Ghana and other countries with developing economies. Information through survey and questionnaires from residents across the socio-economic divide was collected to determine willingness and ability to pay for solid waste collection services. A critical assessment of the various capital and operational cost components that come into play in the collection process were considered and computed to determine the economic and social tariff that will be enough to offset the cost of collection, transportation and disposal of solid waste unto landfills. Residents of the metropolis have the ability and are willing to pay an economically affordable user charge of US$1.10 per household per month to offset and remove the financial burden of solid waste collection off the metropolitan assembly. Consistent and efficient collection service is recommended to ensure residents cooperation towards implementation of the system in Ghana.

Persistent misunderstandings about evidence-based (sorry: informed!) policy-making.

Science.gov (United States)

Bédard, Pierre-Olivier; Ouimet, Mathieu

2016-01-01

The field of research on knowledge mobilization and evidence-informed policy-making has seen enduring debates related to various fundamental assumptions such as the definition of 'evidence', the relative validity of various research methods, the actual role of evidence to inform policy-making, etc. In many cases, these discussions serve a useful purpose, but they also stem from serious disagreement on methodological and epistemological issues. This essay reviews the rationale for evidence-informed policy-making by examining some of the common claims made about the aims and practices of this perspective on public policy. Supplementing the existing justifications for evidence-based policy making, we argue in favor of a greater inclusion of research evidence in the policy process but in a structured fashion, based on methodological considerations. In this respect, we present an overview of the intricate relation between policy questions and appropriate research designs. By closely examining the relation between research questions and research designs, we claim that the usual points of disagreement are mitigated. For instance, when focusing on the variety of research designs that can answer a range of policy questions, the common critical claim about 'RCT-based policy-making' seems to lose some, if not all of its grip.

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

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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.

Isostructural solid-solid transition of (colloidal) simple fluids

International Nuclear Information System (INIS)

Tejero, C.F.; Daanoun, A.; Lakkerkerker, H.N.W.; Baus, M.

1995-01-01

A variational approach based on the Gibbs-Bogoliubov inequality is used in order to evaluate the free energy of simple fluids described by a double-Yukawa pair potential. A hard-sphere reference fluid is used to describe the fluid phases, and an Einstein reference crystal to describe the solid phases. Apart from the usual type of phase diagram, typical of atomic simple fluids with long-ranged attractions, we find two types of phase diagrams, specific to colloidal systems with intermediate and short-ranged attractions. One of the latter phase diagrams exhibits an isostructural solid-solid transition, which has not yet been observed experimentally

Effects of accelerated degradation on metal supported thin film-based solid oxide fuel cell

DEFF Research Database (Denmark)

Reolon, R. P.; Sanna, S.; Xu, Yu

2018-01-01

A thin film-based solid oxide fuel cell is deposited on a Ni-based metal porous support by pulsed laser deposition with a multi-scale-graded microstructure design. The fuel cell, around 1 μm in thickness, is composed of a stabilized-zirconia/doped-ceria bi-layered dense electrolyte and nanostruct......A thin film-based solid oxide fuel cell is deposited on a Ni-based metal porous support by pulsed laser deposition with a multi-scale-graded microstructure design. The fuel cell, around 1 μm in thickness, is composed of a stabilized-zirconia/doped-ceria bi-layered dense electrolyte......, electrochemical performances are steady, indicating the stability of the cell. Under electrical load, a progressive degradation is activated. Post-test analysis reveals both mechanical and chemical degradation of the cell. Cracks and delamination of the thin films promote a significant nickel diffusion and new...

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.

[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.

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.

Controllable Solid Propulsion Combustion and Acoustic Knowledge Base Improvements

Science.gov (United States)

McCauley, Rachel; Fischbach, Sean; Fredrick, Robert

2012-01-01

Controllable solid propulsion systems have distinctive combustion and acoustic environments that require enhanced testing and analysis techniques to progress this new technology from development to production. In a hot gas valve actuating system, the movement of the pintle through the hot gas exhibits complex acoustic disturbances and flow characteristics that can amplify induced pressure loads that can damage or detonate the rocket motor. The geometry of a controllable solid propulsion gas chamber can set up unique unsteady flow which can feed acoustic oscillations patterns that require characterization. Research in this area aids in the understanding of how best to design, test, and analyze future controllable solid rocket motors using the lessons learned from past government programs as well as university research and testing. This survey paper will give the reader a better understanding of the potentially amplifying affects propagated by a controllable solid rocket motor system and the knowledge of the tools current available to address these acoustic disturbances in a preliminary design. Finally the paper will supply lessons learned from past experiences which will allow the reader to come away with understanding of what steps need to be taken when developing a controllable solid rocket propulsion system. The focus of this survey will be on testing and analysis work published by solid rocket programs and from combustion and acoustic books, conference papers, journal articles, and additionally from subject matter experts dealing currently with controllable solid rocket acoustic analysis.

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.

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…

Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

Science.gov (United States)

Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

2018-04-01

The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

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...

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

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

Practice and application of problem-based learning in evidence-based medicine teaching

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Tian-Ao Li

2014-10-01

Full Text Available AIM:To investigate the effect of problem-based learning(PBLused in the teaching of medical students' evidence-based medicine(EBM.METHODS: Five classes(total 147 studentswere randomly selected as experimental(PBLgroup, at the same time, another 5 classes(total 149 studentswere also randomly selected as control group, using traditional teaching method(lecture-based learning, LBLin 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self-administered questionnaire to obtain their evaluation for PBL practice. SPSS13.0 software was used for statistical analysis.RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable(P>0.05. Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students(P>0.05, for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re-evaluating the evidence, and the total scores between the two groups, there were significant statistically differences(PP>0.05in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference(PPCONCLUSION:PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.

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

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.

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.

A GIS- Based suitability analysis for siting a solid waste in an urban area

Directory of Open Access Journals (Sweden)

M. Salemi

2017-01-01

Full Text Available An appropriate solid waste disposal has been a major problem in municipal environment. The use of landfills is the most economical and environmentally acceptable method for the disposal of solid waste all over the world. The analysis of spatial data and consideration of regulation and accepted criteria are part of the important elements in the site selection. The aim of this paper is to show how application of geographic information system could be used for siting solid waste disposal in Abadan city. In this paper, we consider types of soil suitable for solid waste disposals, land use/ land cover, transportation routes and proximity to surface water. Relative importance weight of each criteria in the geographic information system was determined and finally suitability map was prepared. Based on the final suitability map, appropriate solid waste landfill site was located in north east part of the study area. Select the best landfill site among the candidate ones, and   the output results can enable decision makers to make appropriate decisions to reduce the costs both in   economic and environmental criteria.

CSBB-ConeExclusion, adapting structure based solution virtual screening to libraries on solid support.

Science.gov (United States)

Shave, Steven; Auer, Manfred

2013-12-23

Combinatorial chemical libraries produced on solid support offer fast and cost-effective access to a large number of unique compounds. If such libraries are screened directly on-bead, the speed at which chemical space can be explored by chemists is much greater than that addressable using solution based synthesis and screening methods. Solution based screening has a large supporting body of software such as structure-based virtual screening tools which enable the prediction of protein-ligand complexes. Use of these techniques to predict the protein bound complexes of compounds synthesized on solid support neglects to take into account the conjugation site on the small molecule ligand. This may invalidate predicted binding modes, the linker may be clashing with protein atoms. We present CSBB-ConeExclusion, a methodology and computer program which provides a measure of the applicability of solution dockings to solid support. Output is given in the form of statistics for each docking pose, a unique 2D visualization method which can be used to determine applicability at a glance, and automatically generated PyMol scripts allowing visualization of protein atom incursion into a defined exclusion volume. CSBB-ConeExclusion is then exemplarically used to determine the optimum attachment point for a purine library targeting cyclin-dependent kinase 2 CDK2.

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...

"They just know": the epistemological politics of "evidence-based" non-formal education.

Science.gov (United States)

Archibald, Thomas

2015-02-01

Community education and outreach programs should be evidence-based. This dictum seems at once warranted, welcome, and slightly platitudinous. However, the "evidence-based" movement's more narrow definition of evidence--privileging randomized controlled trials as the "gold standard"--has fomented much debate. Such debate, though insightful, often lacks grounding in actual practice. To address that lack, the purpose of the study presented in this paper was to examine what actually happens, in practice, when people support the implementation of evidence-based programs (EBPs) or engage in related efforts to make non-formal education more "evidence-based." Focusing on three cases--two adolescent sexual health projects (one in the United States and one in Kenya) and one more general youth development organization--I used qualitative methods to address the questions: (1) How is evidence-based program and evidence-based practice work actually practiced? (2) What perspectives and assumptions about what non-formal education is are manifested through that work? and (3) What conflicts and tensions emerge through that work related to those perspectives and assumptions? Informed by theoretical perspectives on the intersection of science, expertise, and democracy, I conclude that the current dominant approach to making non-formal education more evidence-based by way of EBPs is seriously flawed. Copyright © 2014 Elsevier Ltd. All rights reserved.

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...

[A new vision of nursing: the evolution and development of evidence-based nursing].

Science.gov (United States)

Chiang, Li-Chi

2014-08-01

The concept and principles of evidence-based medicine (EBM), first introduced in 1996 in the UK and Canada, have greatly impacted healthcare worldwide. Evidence-based care is a new approach to healthcare that works to reduce the gap between evidence and practice in order to further the scientific credentials and practices of the nursing profession. The revolution in healthcare has perhaps most noticeably impacted the nursing sciences. Today, new methodologies are increasingly synthesizing knowledge, while expanded access to publication resources is creating a new era in evidence-based nursing. Therefore, we expect to see in Taiwan the increased sharing of innovative implementations of evidence-based nursing practice and promotion campaigns and the exploration of a new evidence-based nursing paradigm for incorporating evidence-based concepts into the policymaking process, nursing practice, and nursing education. All scientists in clinical care, education, and research are responsible to establish scientific nursing knowledge in support of the evidence-based nursing practice.

Evidence-based policy? The use of mobile phones in hospital

NARCIS (Netherlands)

Ettelt, Stefanie; Nolte, Ellen; McKee, Martin; Haugen, Odd Arild; Karlberg, Ingvar; Klazinga, Niek; Ricciardi, Walter; Teperi, Juha

2006-01-01

BACKGROUND: Evidence-based policies have become increasingly accepted in clinical practice. However, policies on many of the non-clinical activities that take place in health care facilities may be less frequently evidence based. METHODS: We carried out a review of literature on safety of mobile

Complex interventions required to comprehensively educate allied health practitioners on evidence-based practice

Directory of Open Access Journals (Sweden)

Dizon JM

2011-05-01

Full Text Available Janine Margarita Dizon1,2, Karen Grimmer-Somers11International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 2University of Santo Tomas, Manila, PhilippinesAbstract: There is currently no strong evidence regarding the most effective training approach for allied health professionals that will support them to consistently apply the best research evidence in daily practice. Current evidence-based practice training tends to be 'one size fits all', and is unlikely to be appropriate for all allied health disciplines because of the variability in their tasks and scope of practice. The scant body of evidence regarding the effectiveness of evidence-based practice training for allied health practitioners provides some support for improving knowledge and skills, but equivocal evidence about influencing behaviors and attitudes. We propose a new model of evidence-based practice training, based on the concept of complex interventions reported in the literature. We believe that by offering training in evidence-based practice based on complex interventions relevant to the needs of the attendees, using fixed and variable components, there may be greater success in significantly influencing knowledge skills, attitudes, and behaviors.Keywords: complex interventions, evidence-based practice training, allied health

A systematic literature search on psychological first aid: lack of evidence to develop guidelines.

Science.gov (United States)

Dieltjens, Tessa; Moonens, Inge; Van Praet, Koen; De Buck, Emmy; Vandekerckhove, Philippe

2014-01-01

Providing psychological first aid (PFA) is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible. To identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies. Systematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N) were conducted from inception to July 2013. Five practice guidelines were included which were found to vary in the development process (AGREE II score 20-53%) and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices. The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

A systematic literature search on psychological first aid: lack of evidence to develop guidelines.

Directory of Open Access Journals (Sweden)

Tessa Dieltjens

Full Text Available Providing psychological first aid (PFA is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible.To identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies.Systematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N were conducted from inception to July 2013.Five practice guidelines were included which were found to vary in the development process (AGREE II score 20-53% and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices.The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.

Role of ideas and ideologies in evidence-based health policy.

Science.gov (United States)

Prinja, S

2010-01-01

Policy making in health is largely thought to be driven by three 'I's namely ideas, interests and institutions. Recent years have seen a shift in approach with increasing reliance being placed on role of evidence for policy making. The present article ascertains the role of ideas and ideologies in shaping evidence which is used to aid in policy decisions. The article discusses different theories of research-policy interface and the relative freedom of research-based evidence from the influence of ideas. Examples from developed and developed countries are cited to illustrate the contentions made. The article highlights the complexity of the process of evidence-based policy making, in a world driven by existing political, social and cultural ideologies. Consideration of this knowledge is paramount where more efforts are being made to bridge the gap between the 'two worlds' of researchers and policy makers to make evidence-based policy as also for policy analysts.

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.

Tunable ultraviolet solid-state dye laser based on MPMMA doped with pyrromethene 597

International Nuclear Information System (INIS)

Jiang, Y G; Fan, R W; Xia, Y Q; Chen, D Y

2011-01-01

Solid-state dye sample based on modified polymethyl methacrylate (MPMMA) co-doped with pyrromethene 597 (PM597), and coumarin 460 (C460) were prepared. A frequency-doubled pulsed Nd:YAG laser is used to pump solid-state dye sample, and the narrow linewidth dye laser of 94.4 mJ was obtained at 582 nm in an oscillator-amplifier configuration. Using a beta-BaB 2 O 4 (BBO) crystal to frequency double the dye laser into ultraviolet (UV), a tuning range from 279 to 305 nm was demonstrated from a single doped PM597 dye. To the best of our knowledge, the UV tuning range is the best under the same condition so far. The conversion slope efficiency from solid dye laser to UV laser was 8.9% and the highest UV laser output energy reached 6.94 mJ at 291 nm

Valorization of Calcium Carbonate-Based Solid Wastes for the Treatment of Hydrogen Sulfide from the Gas Phase

OpenAIRE

Pham Xuan , Huynh; Pham Minh , Doan; Galera Martinez , Marta; Nzihou , Ange; Sharrock , Patrick

2015-01-01

International audience; This paper focuses on the valorization of calcium carbonate-based solid wastes for theremoval of hydrogen sulfide from gas phase. Two solid wastes taken from industrial sites for theproduction of sodium carbonate and sodium bicarbonate by the Solvay process® were analyzedby different physico-chemical methods. Calcium carbonate was found as the main component ofboth the solid wastes. Trace amounts of other elements such as Mg, Al, Fe, Si, Cl, Na etc. werealso present in...

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

Nitridated fibrous silica (KCC-1) as a sustainable solid base nanocatalyst

KAUST Repository

Bouhrara, Mohamed; Ranga, Chanakya; Fihri, Aziz; Shaikh, Rafik; Sarawade, Pradip; Emwas, Abdul-Hamid M.; Hedhili, Mohamed N.; Polshettiwar, Vivek

2013-01-01

We observed that support morphology has dramatic effects on the performance of nitridated silica as a base. By simply replacing conventional silica supports (such as SBA-15 and MCM-41) with fibrous nanosilica (KCC-1), we observed multifold enhancement in the catalytic activity of the nitridated solid base for Knoevenagel condensations and transesterification reactions. This enhancement of the activity can be explained by amine accessibility, which is excellent in KCC-1 due to its open and flexible fibrous structure, that facilitates penetration and interaction with basic amine sites. © 2013 American Chemical Society.

Nitridated fibrous silica (KCC-1) as a sustainable solid base nanocatalyst

KAUST Repository

Bouhrara, Mohamed

2013-09-03

We observed that support morphology has dramatic effects on the performance of nitridated silica as a base. By simply replacing conventional silica supports (such as SBA-15 and MCM-41) with fibrous nanosilica (KCC-1), we observed multifold enhancement in the catalytic activity of the nitridated solid base for Knoevenagel condensations and transesterification reactions. This enhancement of the activity can be explained by amine accessibility, which is excellent in KCC-1 due to its open and flexible fibrous structure, that facilitates penetration and interaction with basic amine sites. © 2013 American Chemical Society.

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.

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.

The Developing Role of Evidence-Based Environmental Health

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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.

Inference-based procedural modeling of solids

KAUST Repository

Biggers, Keith; Keyser, John

2011-01-01

As virtual environments become larger and more complex, there is an increasing need for more automated construction algorithms to support the development process. We present an approach for modeling solids by combining prior examples with a simple

Electrochemical hydrogen isotope sensor based on solid electrolytes

International Nuclear Information System (INIS)

Matsumoto, Hiroshige; Hayashi, Hiroyuki; Iwahara, Hiroyasu

2002-01-01

An electrochemical sensor of hydrogen isotopes based on solid electrolytes for determining the hydrogen isotope ratios and/or total hydrogen pressures in gases has been developed. This paper describes the methodology of the hydrogen isotope sensing together with experimental results. When hydrogen isotope gases are introduced to an electrochemical cell using a proton-conducting electrolyte (hydrogen isotope cell), the electromotive force (EMF) of the cell agrees with that theoretically estimated. The EMF signals can be used for the determination of the hydrogen isotope ratio in gases if the total hydrogen pressure is predetermined. By supplementary use of an oxide ion conductor cell, both the ratio and total pressure of the hydrogen isotopes can be simultaneously determined. (author)

Integration of an Evidence Base into a Probabilistic Risk Assessment Model. The Integrated Medical Model Database: An Organized Evidence Base for Assessing In-Flight Crew Health Risk and System Design

Science.gov (United States)

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

2011-01-01

This slide presentation reviews the Integrated Medical Model (IMM) database, which is an organized evidence base for assessing in-flight crew health risk. The database is a relational database accessible to many people. The database quantifies the model inputs by a ranking based on the highest value of the data as Level of Evidence (LOE) and the quality of evidence (QOE) score that provides an assessment of the evidence base for each medical condition. The IMM evidence base has already been able to provide invaluable information for designers, and for other uses.

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.

What constitutes evidence-based patient information? Overview of discussed criteria.

Science.gov (United States)

Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

2010-03-01

To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

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.

[A Study of the Evidence-Based Nursing Practice Competence of Nurses and Its Clinical Applications].

Science.gov (United States)

Hsu, Li-Ling; Hsieh, Suh-Ing; Huang, Ya-Hsuan

2015-10-01

Nurses must develop competence in evidence-based nursing in order to provide the best practice medical care to patients. Evidence-based nursing uses issue identification, data mining, and information consolidation from the related medical literature to help nurses find the best evidence. Therefore, for medical institutions to provide quality clinical care, it is necessary for nurses to develop competence in evidence-based nursing. This study aims to explore the effect of a fundamental evidence-based nursing course, as a form of educational intervention, on the development of evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, and outcome expectations of evidence-based practice in nurse participants. Further the competence of these nurses in overcoming obstacles in evidence-based nursing practice. This quasi-experimental study used a pre-post test design with a single group of participants. A convenience sample of 34 nurses from a municipal hospital in northern Taiwan received 8 hours of a fundamental evidence-based nursing course over a two-week period. Participants were asked to complete four questionnaires before and after the intervention. The questionnaires measured the participants' basic demographics, experience in mining the medical literature, evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, outcome expectations of evidence-based practice, competence in overcoming obstacles in evidence-based nursing practice, and learning satisfaction. Collected data was analyzed using paired t, Wilcoxon Signed Rank, and McNemar tests to measure the differences among participants' evidence-based nursing knowledge and practice activities before and after the workshop. The nurses demonstrated significantly higher scores from pre-test to post-test in evidence-based nursing knowledge II, self-efficacy in evidence-based nursing practice activities, and outcome expectations of evidence-based practice

Hexahedral connection element based on hybrid-stress theory for solid structures

International Nuclear Information System (INIS)

Wu, D; Sze, K Y; Lo, S H

2010-01-01

For building structures, high-performance hybrid-stress hexahedral solid elements are excellent choices for modelling joints, beams/columns walls and thick slabs if the exact geometrical representation is required. While it is straight-forward to model beam-column structures of uniform member size with solid hexahedral elements, joining up beams and columns of various cross-sections at a common point proves to be a challenge for structural modelling using hexahedral elements with specified dimensions. In general, the joint has to be decomposed into 27 smaller solid elements to cater for the necessary connection requirements. This will inevitably increase the computational cost and introduce element distortions when elements of different sizes have to be used at the joint. Hexahedral connection elements with arbitrary specified connection interfaces will be an ideal setup to connect structural members of different sizes without increasing the number of elements or introducing highly distorted elements. In this paper, based on the hybrid-stress element theory, a general way to construct hexahedral connection element with various interfaces is introduced. Following this way, a 24-node connection element is presented and discussed in detail. Performance of the 24-node connection element equipped with different number of stress modes will be assessed with worked examples.

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

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.

Teaching Evidence-Based Medicine Skills through a Residency-Developed Guideline.

Science.gov (United States)

Epling, John; Smucny, John; Patil, Anita; Tudiver, Fred

2002-01-01

Describes a curriculum intended to culminate in a resident-produced, evidence-based guideline for the care of patients with diabetes. Evaluation of the curriculum showed that learners appreciated the skills and knowledge gained in devising guidelines in an evidence-based manner but were uncertain that their searches were complete. Clinical…

Monte Carlo-based investigation of water-equivalence of solid phantoms at 137Cs energy

International Nuclear Information System (INIS)

Vishwakarma, Ramkrushna S.; Palani Selvam, T.; Sahoo, Sridhar; Mishra, Subhalaxmi; Chourasiya, Ghanshyam

2013-01-01

Investigation of solid phantom materials such as solid water, virtual water, plastic water, RW1, polystyrene, and polymethylmethacrylate (PMMA) for their equivalence to liquid water at 137 Cs energy (photon energy of 662 keV) under full scatter conditions is carried out using the EGSnrc Monte Carlo code system. Monte Carlo-based EGSnrc code system was used in the work to calculate distance-dependent phantom scatter corrections. The study also includes separation of primary and scattered dose components. Monte Carlo simulations are carried out using primary particle histories up to 5 x 10 9 to attain less than 0.3% statistical uncertainties in the estimation of dose. Water equivalence of various solid phantoms such as solid water, virtual water, RW1, PMMA, polystyrene, and plastic water materials are investigated at 137 Cs energy under full scatter conditions. The investigation reveals that solid water, virtual water, and RW1 phantoms are water equivalent up to 15 cm from the source. Phantom materials such as plastic water, PMMA, and polystyrene phantom materials are water equivalent up to 10 cm. At 15 cm from the source, the phantom scatter corrections are 1.035, 1.050, and 0.949 for the phantoms PMMA, plastic water, and polystyrene, respectively. (author)

Role of Hydroxamate-Based Histone Deacetylase Inhibitors (Hb-HDACIs) in the Treatment of Solid Malignancies

Energy Technology Data Exchange (ETDEWEB)

Grassadonia, Antonino [Department of Experimental and Clinical Sciences, University ’G. d’Annunzio’, I-66013 Chieti (Italy); Cioffi, Pasquale; Simiele, Felice [Hospital Pharmacy, “SS. Annunziata” Hospital, I-66013 Chieti (Italy); Iezzi, Laura; Zilli, Marinella [Oncology Department, “SS. Annunziata” Hospital, I-66013 Chieti (Italy); Natoli, Clara, E-mail: natoli@unich.it [Department of Experimental and Clinical Sciences, University ’G. d’Annunzio’, I-66013 Chieti (Italy)

2013-07-25

Hydroxamate-based histone deacetylase inhibitors (Hb-HDACIs), such as vorinostat, belinostat and panobinostat, have been previously shown to have a wide range of activity in hematologic malignancies such as cutaneous T-cell lymphoma and multiple myeloma. Recent data show that they synergize with a variety of cytotoxic and molecular targeted agents in many different solid tumors, including breast, prostate, pancreatic, lung and ovarian cancer. Hb-HDACIs have a quite good toxicity profile and are now being tested in phase I and II clinical trials in solid tumors with promising results in selected neoplasms, such as hepatocarcinoma. This review will focus on their clinical activity and safety in patients with advanced solid neoplasms.

Role of Hydroxamate-Based Histone Deacetylase Inhibitors (Hb-HDACIs) in the Treatment of Solid Malignancies

International Nuclear Information System (INIS)

Grassadonia, Antonino; Cioffi, Pasquale; Simiele, Felice; Iezzi, Laura; Zilli, Marinella; Natoli, Clara

2013-01-01

Hydroxamate-based histone deacetylase inhibitors (Hb-HDACIs), such as vorinostat, belinostat and panobinostat, have been previously shown to have a wide range of activity in hematologic malignancies such as cutaneous T-cell lymphoma and multiple myeloma. Recent data show that they synergize with a variety of cytotoxic and molecular targeted agents in many different solid tumors, including breast, prostate, pancreatic, lung and ovarian cancer. Hb-HDACIs have a quite good toxicity profile and are now being tested in phase I and II clinical trials in solid tumors with promising results in selected neoplasms, such as hepatocarcinoma. This review will focus on their clinical activity and safety in patients with advanced solid neoplasms

Role of Hydroxamate-Based Histone Deacetylase Inhibitors (Hb-HDACIs in the Treatment of Solid Malignancies

Directory of Open Access Journals (Sweden)

Marinella Zilli

2013-07-01

Full Text Available Hydroxamate-based histone deacetylase inhibitors (Hb-HDACIs, such as vorinostat, belinostat and panobinostat, have been previously shown to have a wide range of activity in hematologic malignancies such as cutaneous T-cell lymphoma and multiple myeloma. Recent data show that they synergize with a variety of cytotoxic and molecular targeted agents in many different solid tumors, including breast, prostate, pancreatic, lung and ovarian cancer. Hb-HDACIs have a quite good toxicity profile and are now being tested in phase I and II clinical trials in solid tumors with promising results in selected neoplasms, such as hepatocarcinoma. This review will focus on their clinical activity and safety in patients with advanced solid neoplasms.

Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

Science.gov (United States)

Brooke, Joanne Mary; Mallion, Jaimee

2016-08-01

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses. © 2016 John Wiley & Sons Australia, Ltd.

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.

Attitudes and barriers to evidence-based practice in optometry educators.

Science.gov (United States)

Suttle, Catherine M; Challinor, Kirsten L; Thompson, Rachel E; Pesudovs, Konrad; Togher, Leanne; Chiavaroli, Neville; Lee, Adrian; Junghans, Barbara; Stapleton, Fiona; Watt, Kathleen; Jalbert, Isabelle

2015-04-01

Evidence-based practice (EBP) is an essential component of good quality, patient-centered health care. This requires practitioners to acquire EBP skills and knowledge during undergraduate and continuing education. Evidence-based practice education exists in a range of health care disciplines, including optometry. Evidence-based practice education, however, depends on relevant skills and knowledge in educators. Courses and workshops exist for the development of EBP teaching skills in some areas of health care but not in optometry. Here, we describe a pilot workshop designed to enhance the teaching of EBP and to investigate the perspectives of optometric educators on EBP including their attitudes and perceived barriers to EBP and its teaching. Twenty-seven optometric educators including 8 facilitators participated. Of these, 14 were academics (including the 8 facilitators) and 13 were practitioners. Evidence-based practice attitudes were assessed using the Evidence-Based Practice Attitude Scale-50 with appropriate modifications for optometry. Workshop design incorporated strategies to trigger discussion among participants. A nominal group technique was used to identify, prioritize, and reach consensus on barriers to EBP. Although some participants expressed reservations about EBP, a common understanding of the contemporary definition of EBP emerged in educators. Thirty-five barriers to EBP were identified; "time" was selected in the top five barriers by most participants and attracted the highest total score, well above any other barrier (negative attitude to EBP, volume of evidence, integration with clinical practice, and lack of lifelong learning mind-set). Attitudes toward EBP were generally positive and negatively correlated with age and time since graduation, respectively. A group of optometrists and academics new to implementing education in EBP displayed positive attitudes to EBP but considered that its application and teaching could be significantly hindered

Supporting decision-making processes for evidence-based mental health promotion.

Science.gov (United States)

Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

2011-12-01

The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

Taking Evidence-Based Practices to School: Using Expert Opinion to Develop a Brief, Evidence-Informed School-Based Mental Health Intervention

Science.gov (United States)

Lyon, Aaron R.; Bruns, Eric J.; Weathers, Ericka S.; Canavas, Nick; Ludwig, Kristy; Vander Stoep, Ann; Cheney, Douglas; McCauley, Elizabeth

2014-01-01

School-based mental health services offer unparalleled opportunities for providing accessible care to children and adolescents. Research indicates that services available in schools are rarely based on evidence of effectiveness and are typically disconnected from the larger school context. To address these issues, the current paper presents…

Design of an SolidWorks-based household substrate cultivation device

Science.gov (United States)

Yi, Guo; Yueying, Wang

2018-03-01

Rapid urbanization has caused increasingly severe environmental problems and smaller tillable land area. Even worse, negative reports on vegetable production are repeatedly found. In this case, home gardening has become an inexorable trend. To meet demand for vegetable cultivation in the home environment, an SolidWorks-based household substrate cultivation device has been designed. This device is composed of the cultivation tank, upright post, base, irrigation system, supplemental lighting system and control system. The household substrate cultivation device manufactured based on the design results has shown in practice that this device features an esthetic appearance, low cost, automatic irrigation and lighting supplementation, good vegetable growing conditions, full of ornamental value and practicability and thus is suitable for vegetable growing in the home environment. Hence it has a higher promotion value in the home gardening field.

All-solid-state lithium-sulfur battery based on a nanoconfined LiBH4 electrolyte

DEFF Research Database (Denmark)

Das, Supti; Ngene, Peter; Norby, Poul

2016-01-01

In this work we characterize all-solid-state lithium-sulfur batteries based on nano-confined LiBH4 in mesoporous silica as solid electrolytes. The nano-confined LiBH4 has fast ionic lithium conductivity at room temperature, 0.1 mScm-1, negligible electronic conductivity and its cationic transport...... number (t+ = 0.96), close to unity, demonstrates a purely cationic conductor. The electrolyte has an excellent stability against lithium metal. The behavior of the batteries is studied by cyclic voltammetry and repeated charge/discharge cycles in galvanostatic conditions. The batteries show very good...

Solid lipid nanoparticles for parenteral drug delivery

NARCIS (Netherlands)

Wissing, S.A.; Kayser, Oliver; Muller, R.H.

2004-01-01

This review describes the use of nanoparticles based on solid lipids for the parenteral application of drugs. Firstly, different types of nanoparticles based on solid lipids such as "solid lipid nanoparticles" (SLN), "nanostructured lipid carriers" (NLC) and "lipid drug conjugate" (LDC)

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

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.

Recent Application of Solid Phase Based Techniques for Extraction and Preconcentration of Cyanotoxins in Environmental Matrices.

Science.gov (United States)

Mashile, Geaneth Pertunia; Nomngongo, Philiswa N

2017-03-04

Cyanotoxins are toxic and are found in eutrophic, municipal, and residential water supplies. For this reason, their occurrence in drinking water systems has become a global concern. Therefore, monitoring, control, risk assessment, and prevention of these contaminants in the environmental bodies are important subjects associated with public health. Thus, rapid, sensitive, selective, simple, and accurate analytical methods for the identification and determination of cyanotoxins are required. In this paper, the sampling methodologies and applications of solid phase-based sample preparation methods for the determination of cyanotoxins in environmental matrices are reviewed. The sample preparation techniques mainly include solid phase micro-extraction (SPME), solid phase extraction (SPE), and solid phase adsorption toxin tracking technology (SPATT). In addition, advantages and disadvantages and future prospects of these methods have been discussed.

Information demands of occupational health physicians and their attitude towards evidence-based medicine.

Science.gov (United States)

Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

2004-08-01

This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated the type and number of questions encountered in daily practice, the actions taken in response, the physicians' experience in using scientific databases on the Internet, and their attitude towards evidence-based medicine. The occupational health physicians' questions concerned medical, legal, and rehabilitation topics in particular. In pursuing answers to their questions, they generally chose to contact colleagues. Scientific databases were not consulted very often, although, in general, the attitude towards evidence-based medicine was positive. In addition to known barriers for practicing evidence-based medicine, occupational health physicians perceive a lack of scientific evidence in their field. The extensiveness of the field of knowledge in occupational health care was not regarded as an obstacle to their application of evidence-based medicine. Occupational health physicians have a demand for information on a broad range of topics, and, in most cases, their attitude towards evidence-based medicine is fairly positive. Besides education and training in evidence-based medicine, access to the Internet and the presence of a good knowledge infrastructure would help occupational health physicians use evidence-based medicine.

Laundry Detergency of Solid Non-Particulate Soil Using Microemulsion-Based Formulation.

Science.gov (United States)

Chanwattanakit, Jarussri; Chavadej, Sumaeth

2018-02-01

Laundry detergency of solid non-particulate soil on polyester and cotton was investigated using a microemulsion-based formulation, consisting of an anionic extended surfactant (C 12,13 -4PO-SO 4 Na) and sodium mono-and di-methyl naphthalene sulfonate (SMDNS) as the hydrophilic linker, to provide a Winsor Type III microemulsion with an ultralow interfacial tension (IFT). In this work, methyl palmitate (palmitic acid methyl ester) having a melting point around 30°C, was used as a model solid non-particulate (waxy) soil. A total surfactant concentration of 0.35 wt% of the selected formulation (4:0.65 weight ratio of C 12,13 -4PO-SO 4 Na:SMDNS) with 5.3 wt% NaCl was able to form a middle phase microemulsion at a high temperature (40°C),which provided the highest oil removal level with the lowest oil redeposition and the lowest IFT, and was much higher than that with a commercial detergent or de-ionized water. Most of the detached oil, whether in liquid or solid state, was in an unsolubilized form. Hence, the dispersion stability of the detached oil droplets or solidified oil particles that resulted from the surfactant adsorption played an important role in the oil redeposition. For an oily detergency, the lower the system IFT, the higher the oil removal whereas for a waxy (non-particulate) soil detergency, the lower the contact angle, the higher the solidified oil removal. For a liquefied oil, the detergency mechanism was roll up and emulsification with dispersion stability, while that for the waxy soil (solid oil) was the detachment by wettability with dispersion stability.

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.

Reconstruction of structure and function in tissue engineering of solid organs: Toward simulation of natural development based on decellularization.

Science.gov (United States)

Zheng, Chen-Xi; Sui, Bing-Dong; Hu, Cheng-Hu; Qiu, Xin-Yu; Zhao, Pan; Jin, Yan

2018-04-27

Failure of solid organs, such as the heart, liver, and kidney, remains a major cause of the world's mortality due to critical shortage of donor organs. Tissue engineering, which uses elements including cells, scaffolds, and growth factors to fabricate functional organs in vitro, is a promising strategy to mitigate the scarcity of transplantable organs. Within recent years, different construction strategies that guide the combination of tissue engineering elements have been applied in solid organ tissue engineering and have achieved much progress. Most attractively, construction strategy based on whole-organ decellularization has become a popular and promising approach, because the overall structure of extracellular matrix can be well preserved. However, despite the preservation of whole structure, the current constructs derived from decellularization-based strategy still perform partial functions of solid organs, due to several challenges, including preservation of functional extracellular matrix structure, implementation of functional recellularization, formation of functional vascular network, and realization of long-term functional integration. This review overviews the status quo of solid organ tissue engineering, including both advances and challenges. We have also put forward a few techniques with potential to solve the challenges, mainly focusing on decellularization-based construction strategy. We propose that the primary concept for constructing tissue-engineered solid organs is fabricating functional organs based on intact structure via simulating the natural development and regeneration processes. Copyright © 2018 John Wiley & Sons, Ltd.

???????????? SolidWorks/SolidWorks Flow Simulation/SolidWorks Simulation ??? ?????????? ???????? ?? ????????????? ???

OpenAIRE

????????????, ?. ?.; ????????, ?. ?.; ?????, ?. ?.

2012-01-01

? ?????? ???????? ??????? ??????? ???????? ?? ???????????? ??????????? ????????? SolidWorks/SolidWorks Flow Simulation (COSMOSFloWorks)/SolidWorks Simulation ??? ?????????? ???????? ?? ????????????? ???. ??? ???????? ????????? ???????? ?????????? ?? ?????? ???????? ??????? ? ????????????? ?????? ? ????????????? ????????????? ?????????? ???????????? SolidWorks Flow Simulation (COSMOSFloWorks). ??? ???????????? ??????????? ????????????? ?????? ?? ????????? ??????????? ??????? ?? ??????????? ...

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

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

An Economic Analysis of Municipal Solid Waste Management of Toyohashi City, Japan: Evidences from Environmental Kuznets Curve

OpenAIRE

Miyata, Yuzuru; Shibusawa, Hiroyuki; Hossain, Nahid

2013-01-01

The study of Toyohashi cityfs economic growth and resultant growth in municipal solid waste management were empirically examined by the relation between city economic growth, city expenditure for solid waste management and municipal solid waste. The growth in the economy and the population has increased discharge of municipal solid waste in Toyohashi city. The economic size of the city is identified as a strong explanatory variable. Various kinds of municipal solid waste were generated with ...

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.

Reference Electrodes Based on Solid Amalgams

Czech Academy of Sciences Publication Activity Database

Josypčuk, Bohdan; Novotný, Ladislav

2004-01-01

Roč. 16, č. 3 (2004), s. 238-241 ISSN 1040-0397 Grant - others:GIT(AR) 101/02/U111/CZ Institutional research plan: CEZ:AV0Z4040901 Keywords : solid amalgam * reference electrode * voltammetry Subject RIV: CG - Electrochemistry Impact factor: 2.038, year: 2004

Using Gemba Boards to Facilitate Evidence-Based Practice in Critical Care.

Science.gov (United States)

Bourgault, Annette M; Upvall, Michele J; Graham, Alison

2018-06-01

Tradition-based practices lack supporting research evidence and may be harmful or ineffective. Engagement of key stakeholders is a critical step toward facilitating evidence-based practice change. Gemba , derived from Japanese, refers to the real place where work is done. Gemba boards (visual management tools) appear to be an innovative method to engage stakeholders and facilitate evidence-based practice. To explore the use of gemba boards and gemba huddles to facilitate practice change. Twenty-two critical care nurses participated in interviews in this qualitative, descriptive study. Thematic analysis was used to code and categorize interview data. Two researchers reached consensus on coding and derived themes. Data were managed with qualitative analysis software. The code gemba occurred most frequently; a secondary analysis was performed to explore its impact on practice change. Four themes were derived from the gemba code: (1) facilitation of staff, leadership, and interdisciplinary communication, (2) transparency of outcome data, (3) solicitation of staff ideas and feedback, and (4) dissemination of practice changes. Gemba boards and gemba huddles became part of the organizational culture for promoting and disseminating evidence-based practices. Unit-based, publicly located gemba boards and huddles have become key components of evidence-based practice culture. Gemba is both a tool and a process to engage team members and the public to generate clinical questions and to plan, implement, and evaluate practice changes. Future research on the effectiveness of gemba boards to facilitate evidence-based practice is warranted. ©2018 American Association of Critical-Care Nurses.

Viscoelastic response of HTPB based solid fuel to horizontal and vertical storage slumping conditions and it's affect on service life

International Nuclear Information System (INIS)

Nawaz, Q.; Nizam, F.

2011-01-01

Frequent use of solid fuels as thrust generating energy source in modern day space vehicle systems has created a need to assess their serviceability for long term storage under various conditions. Solid fuel grain, the most important part of any solid fuel system, responds visco elastically to any loading condition. For the assessment of the service life of any solid fuel system, the solid fuel grain has to be structurally evaluated in applied storage conditions. Structural integrity of the grain is exceptionally significant to guarantee the successful operation of the solid fuel system. In this work, numerical simulations have been performed to assess the mechanical stresses and strains induced in an HTPB based solid fuel grain during service life employing ABAQUS standard FEA software using 4-node bilinear quadrilateral elements. For finite element analysis (FEA), typical 2-D and p/nth axisymmetric section of 5-point (n) star grain geometry is considered. Mechanical loads include the horizontal or vertical 1-g (solid fuel weight) storage condition. The simulation results are compared with the analytical results for the same grain geometry. Analytically measured slump deflections in grain segment at various storage times have been found in good relation with the FEA based simulation results. This proves the validity of the procedure adopted and is helpful in assessment of the service life of solid fuel systems. (author)

Flexible all solid-state supercapacitors based on chemical vapor deposition derived graphene fibers.

Science.gov (United States)

Li, Xinming; Zhao, Tianshuo; Chen, Qiao; Li, Peixu; Wang, Kunlin; Zhong, Minlin; Wei, Jinquan; Wu, Dehai; Wei, Bingqing; Zhu, Hongwei

2013-11-07

Flexible all-solid-state supercapacitors based on graphene fibers are demonstrated in this study. Surface-deposited oxide nanoparticles are used as pseudo-capacitor electrodes to achieve high capacitance. This supercapacitor electrode has an areal capacitance of 42 mF cm(-2), which is comparable to the capacitance for fiber-based supercapacitors reported to date. During the bending and cycling of the fiber-based supercapacitor, the stability could be maintained without sacrificing the electrochemical performance, which provides a novel and simple way to develop flexible, lightweight and efficient graphene-based devices.

Thermoacoustics of solids: A pathway to solid state engines and refrigerators

Science.gov (United States)

Hao, Haitian; Scalo, Carlo; Sen, Mihir; Semperlotti, Fabio

2018-01-01

Thermoacoustic oscillations have been one of the most exciting discoveries of the physics of fluids in the 19th century. Since its inception, scientists have formulated a comprehensive theoretical explanation of the basic phenomenon which has later found several practical applications to engineering devices. To date, all studies have concentrated on the thermoacoustics of fluid media where this fascinating mechanism was exclusively believed to exist. Our study shows theoretical and numerical evidence of the existence of thermoacoustic instabilities in solid media. Although the underlying physical mechanism exhibits some interesting similarities with its counterpart in fluids, the theoretical framework highlights relevant differences that have important implications on the ability to trigger and sustain the thermoacoustic response. This mechanism could pave the way to the development of highly robust and reliable solid-state thermoacoustic engines and refrigerators.

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.

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.

Current status of evidence-based sports medicine.

Science.gov (United States)

Harris, Joshua D; Cvetanovich, Gregory; Erickson, Brandon J; Abrams, Geoffrey D; Chahal, Jaskarndip; Gupta, Anil K; McCormick, Frank M; Bach, Bernard R

2014-03-01

The purpose of this investigation is to determine the proportion of sports medicine studies that are labeled as Level I Evidence in 5 journals and compare the quality of surgical and nonsurgical studies using simple quality assessment tools (Consolidated Standards of Reporting Trials [CONSORT] and Jadad). By use of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines over the prior 2 years in the top 5 (citation and impact factor based) sports medicine journals, only Level I Evidence studies were eligible for inclusion and were analyzed. All study types (therapeutic, prognostic, diagnostic, and economic) were analyzed. Study quality was assessed with the level of evidence, Jadad score, and CONSORT 2010 guidelines. Study demographic data were compared among journals and between surgical and nonsurgical studies by use of χ(2), 1-way analysis of variance, and 2-sample Z tests. We analyzed 190 Level I Evidence studies (10% of eligible studies) (119 randomized controlled trials [RCTs]). Therapeutic, nonsurgical, single-center studies from the United States were the most common studies published. Sixty-two percent of studies reported a financial conflict of interest. The knee was the most common body part studied, and track-and-field/endurance sports were the most common sports analyzed. Significant differences (P journals reviewed. Overall, the Jadad and CONSORT scores were 2.71 and 77%, respectively. No differences (P > .05) were shown among journals based on the proportion of Level I studies or appropriate randomization. Significant strengths and limitations of RCTs were identified. This study showed that Level I Evidence and RCTs comprise 10% and 6% of contemporary sports medicine literature, respectively. Therapeutic, nonsurgical, single-center studies are the most common publications with Level I Evidence. Significant differences across sports medicine journals were found in study quality. Surgical studies appropriately described

Hijacked evidence-based medicine: stay the course and throw the pirates overboard.

Science.gov (United States)

Ioannidis, John P A

2017-04-01

The article discusses a number of criticisms that have been raised against evidence-based medicine, such as focusing on benefits and ignoring adverse events; being interested in averages and ignoring the wide variability in individual risks and responsiveness; ignoring clinician-patient interaction and clinical judgement; leading to some sort of reductionism; and falling prey to corruption from conflicts of interest. I argue that none of these deficiencies are necessarily inherent to evidence-based medicine. In fact, work in evidence-based medicine has contributed a lot towards minimizing these deficiencies in medical research and medical care. However, evidence-based medicine is paying the price of its success: having become more widely recognized, it is manipulated and misused to support subverted or perverted agendas that are hijacking its reputation value. Sometimes the conflicts behind these agendas are so strong that one worries about whether the hijacking of evidence-based medicine is reversible. Nevertheless, evidence-based medicine is a valuable conceptual toolkit and it is worth to try to remove the biases of the pirates who have hijacked its ship. Copyright © 2017 Elsevier Inc. All rights reserved.

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…

Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

Science.gov (United States)

André, Beate; Aune, Anne G; Brænd, Jorunn A

2016-05-01

Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.

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...

Interactions between lanthanum gallate based solid electrolyte and ceria

Energy Technology Data Exchange (ETDEWEB)

Hrovat, M.; Ahmad-Khanlou, A.; Samardzija, Z.; Holc, J.

1999-10-01

Possible interactions between La{sub 0.9}Sr{sub 0.1}Ga{sub 0.8}Mg{sub 0.2}O{sub 2.85} and Gd{sub 2}O{sub 3}-doped CeO{sub 2} (solid electrolyte and anode binding materials, respectively, for solid oxide fuel cells (SOFC)) at 1,300 C were studied with diffusion couples and fired powder mixtures. The SrLaGa{sub 3}O{sub 7} compound was detected and its formation was attributed to the diffusion of La{sub 2}O{sub 3} from La{sub 0.9}Sr{sub 0.1}Ga{sub 0.8}Mg{sub 0.2}O{sub 2.85} into Ce{sub 1{minus}x}La{sub x}O{sub 2{minus}x/2} solid solution. As the resistivity of SrLaGa{sub 3}O{sub 7} is rather high, around 1 M{center_dot}ohm at 800 C, its presence in the solid electrolyte/anode interface could significantly increase the internal resistivity of an SOFC.

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...

Ignition and wave processes in combustion of solids

CERN Document Server

Rubtsov, Nickolai M; Alymov, Michail I

2017-01-01

This book focuses on the application of classical combustion theory to ignition and flame propagation in solid-solid and gas-solid systems. It presents experimental investigations in the areas of local ignition, filtration combustion, self-propagating high temperature synthesis and nanopowders protection. The authors highlight analytical formulas used in different areas of combustion in solids and propose an approach based on classical combustion theory. The book attempts to analyze the basic approaches to understanding of solid-solid and solid - gas combustion presented in contemporary literature in a unified approach based on classical combustion theory. .

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.

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

Energy Technology Data Exchange (ETDEWEB)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A [Div. for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul (Korea, Republic of); and others

2017-01-15

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure.

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

International Nuclear Information System (INIS)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A

2017-01-01

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure

Impact of evidence-based interventions on wound complications after cesarean delivery.

Science.gov (United States)

Temming, Lorene A; Raghuraman, Nandini; Carter, Ebony B; Stout, Molly J; Rampersad, Roxane M; Macones, George A; Cahill, Alison G; Tuuli, Methodius G

2017-10-01

A number of evidence-based interventions have been proposed to reduce post-cesarean delivery wound complications. Examples of such interventions include appropriate timing of preoperative antibiotics, appropriate choice of skin antisepsis, closure of the subcutaneous layer if subcutaneous depth is ≥2 cm, and subcuticular skin closure with suture rather than staples. However, the collective impact of these measures is unclear. We sought to estimate the impact of a group of evidence-based surgical measures (prophylactic antibiotics administered before skin incision, chlorhexidine-alcohol for skin antisepsis, closure of subcutaneous layer, and subcuticular skin closure with suture) on wound complications after cesarean delivery and to estimate residual risk factors for wound complications. We conducted a secondary analysis of data from a randomized controlled trial of chlorhexidine-alcohol vs iodine-alcohol for skin antisepsis at cesarean delivery from 2011-2015. The primary outcome for this analysis was a composite of wound complications that included surgical site infection, cellulitis, seroma, hematoma, and separation within 30 days. Risk of wound complications in women who received all 4 evidence-based measures (prophylactic antibiotics within 60 minutes of cesarean delivery and before skin incision, chlorhexidine-alcohol for skin antisepsis with 3 minutes of drying time before incision, closure of subcutaneous layer if ≥2 cm of depth, and subcuticular skin closure with suture) were compared with those women who did not. We performed logistic regression analysis limited to patients who received all the evidence-based measures to estimate residual risk factors for wound complications and surgical site infection. Of 1082 patients with follow-up data, 349 (32.3%) received all the evidence-based measures, and 733 (67.7%) did not. The risk of wound complications was significantly lower in patients who received all the evidence-based measures compared with those who

The value of gynecologic cancer follow-up: evidence-based ignorance?

DEFF Research Database (Denmark)

Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie

2010-01-01

To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients.......To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients....

Flexible solid-state supercapacitors based on three-dimensional graphene hydrogel films.

Science.gov (United States)

Xu, Yuxi; Lin, Zhaoyang; Huang, Xiaoqing; Liu, Yuan; Huang, Yu; Duan, Xiangfeng

2013-05-28

Flexible solid-state supercapacitors are of considerable interest as mobile power supply for future flexible electronics. Graphene or carbon nanotubes based thin films have been used to fabricate flexible solid-state supercapacitors with high gravimetric specific capacitances (80-200 F/g), but usually with a rather low overall or areal specific capacitance (3-50 mF/cm(2)) due to the ultrasmall electrode thickness (typically a few micrometers) and ultralow mass loading, which is not desirable for practical applications. Here we report the exploration of a three-dimensional (3D) graphene hydrogel for the fabrication of high-performance solid-state flexible supercapacitors. With a highly interconnected 3D network structure, graphene hydrogel exhibits exceptional electrical conductivity and mechanical robustness to make it an excellent material for flexible energy storage devices. Our studies demonstrate that flexible supercapacitors with a 120 μm thick graphene hydrogel thin film can exhibit excellent capacitive characteristics, including a high gravimetric specific capacitance of 186 F/g (up to 196 F/g for a 42 μm thick electrode), an unprecedented areal specific capacitance of 372 mF/cm(2) (up to 402 mF/cm(2) for a 185 μm thick electrode), low leakage current (10.6 μA), excellent cycling stability, and extraordinary mechanical flexibility. This study demonstrates the exciting potential of 3D graphene macrostructures for high-performance flexible energy storage devices.

Evidence-based medicine – are we boiling the frog? | Muckart ...

African Journals Online (AJOL)

Evidence-based medicine has been defined as 'The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' There are two major assumptions in this statement. First, it is assumed that the evidence is in fact the best. Unfortunately this is not necessarily so, ...

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

LENUS (Irish Health Repository)

Yadav, B L

2012-03-01

Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

Evidence-based policy versus morality policy: the case of syringe access programs.

Science.gov (United States)

de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

2015-01-01

Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

Synthesis of POSS-based ionic conductors with low glass transition temperatures for efficient solid-state dye-sensitized solar cells.

Science.gov (United States)

Zhang, Wei; Wang, Zhong-Sheng

2014-07-09

Replacing liquid-state electrolytes with solid-state electrolytes has been proven to be an effective way to improve the durability of dye-sensitized solar cells (DSSCs). We report herein the synthesis of amorphous ionic conductors based on polyhedral oligomeric silsesquioxane (POSS) with low glass transition temperatures for solid-state DSSCs. As the ionic conductor is amorphous and in the elastomeric state at the operating temperature of DSSCs, good pore filling in the TiO2 film and good interfacial contact between the solid-state electrolyte and the TiO2 film can be guaranteed. When the POSS-based ionic conductor containing an allyl group is doped with only iodine as the solid-state electrolyte without any other additives, power conversion efficiency of 6.29% has been achieved with good long-term stability under one-sun soaking for 1000 h.

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.

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.

Edible fat structures at high solid fat concentrations: Evidence for the existence of oil-filled nanospaces

Science.gov (United States)

Peyronel, Fernanda; Quinn, Bonnie; Marangoni, Alejandro G.; Pink, David A.

2015-01-01

We have characterized the surfaces of grain boundaries in edible oils with high solid fat content by combining ultra-small angle x-ray scattering (USAXS) with theoretical modelling and computer simulation. Our results will lead to understand the solid structures formed at the time of manufacturing fats like confectionery fats as well as pave the way for the engineering of innovative fat products. Edible fats are complex semi-solid materials where a solid structure entraps liquid oil. It was not until USAXS combined with modelling was used that the nano- to meso-structures for systems with less than 20% solids were understood. The interpretation of those results utilized models of crystalline nanoplatelets represented by rigid close-packed flat aggregates made of spheres and was allowed to aggregate using the Metropolis Monte Carlo technique. Here, we report on systems containing between 50% and 90% solids. We modelled the solid phase as being formed from seeds onto which solids condensed thereby giving rise to oil-filled nanospaces. The models predicted that the system (a) exhibits structures with fractal dimensions approximately 2, (b) a broad peak somewhat masking that slope, and (c) for smaller values of q, indications that the structures with fractal dimension approximately 2 are uniformly distributed in space. The interpretation of the experimental data was completely driven by these results. The computer simulation predictions were used in conjunction with the USAXS observations to conclude that the systems studied scattered from oil-cavities with sizes between ˜800 and ˜16 000 Å and possessed rough 2-dimensional walls.

Edge detection of solid motor' CT image based on gravitation model

International Nuclear Information System (INIS)

Yu Guanghui; Lu Hongyi; Zhu Min; Liu Xudong; Hou Zhiqiang

2012-01-01

In order to detect the edge of solid motor' CT image much better, a new edge detection operator base on gravitation model was put forward. The edge of CT image is got by the new operator. The superiority turned out by comparing the edge got by ordinary operator. The comparison among operators with different size shows that higher quality CT images need smaller size operator while the lower need the larger. (authors)

Municipal solid waste development phases: Evidence from EU27.

Science.gov (United States)

Vujić, Goran; Gonzalez-Roof, Alvaro; Stanisavljević, Nemanja; Ragossnig, Arne M

2015-12-01

Many countries in the European Union (EU) have very developed waste management systems. Some of its members have managed to reduce their landfilled waste to values close to zero during the last decade. Thus, European Union legislation is very stringent regarding waste management for their members and candidate countries, too. This raises the following questions: Is it possible for developing and developed countries to comply with the European Union waste legislation, and under what conditions? How did waste management develop in relation to the economic development in the countries of the European Union? The correlation between waste management practices and economic development was analysed for 27 of the European Union Member States for the time period between 1995 and 2007. In addition, a regression analysis was performed to estimate landfilling of waste in relation to gross domestic product for every country. The results showed a strong correlation between the waste management variables and the gross domestic product of the EU27 members. The definition of the municipal solid waste management development phases followed a closer analysis of the relation between gross domestic product and landfilled waste. The municipal solid waste management phases are characterised by high landfilling rates at low gross domestic product levels, and landfilling rates near zero at high gross domestic product levels. Hence the results emphasize the importance of wider understanding of what is required for developing countries to comply with the European Union initiatives, and highlight the importance of allowing developing countries to make their own paths of waste management development. © The Author(s) 2015.

Stabilization of lead in an alkali-activated municipal solid waste incineration fly ash-Pyrophyllite-based system.

Science.gov (United States)

Shiota, Kenji; Nakamura, Takafumi; Takaoka, Masaki; Aminuddin, Siti Fatimah; Oshita, Kazuyuki; Fujimori, Takashi

2017-10-01

This work focuses on the stabilization and speciation of lead (Pb) in a composite solid produced from an alkali-activated municipal solid waste incineration fly ash (MSWIFA)-pyophyllite-based system. The solid product was synthesized after mixtures of raw materials (dehydrated pyrophyllite, MSWIFA, 14 mol/L aqueous sodium hydroxide, and sodium silicate solution) were cured at 105 °C for 24 h. The product could reduce the leaching of Pb and the Pb concentration in the leachate was 7.0 × 10 -3 using the Japanese leaching test and 9.7 × 10 -4  mg/L using toxicity characteristics leaching procedure method, which satisfied the respective test criteria and successfully stabilized Pb in this system. The solid product had a compressive strength of 2 MPa and consisted mainly of crystalline phases. Scanning electron microscopy with X-ray analysis and X-ray absorption fine structure suggested that Pb was present along with Al, Si, and O, and that the atomic environment around the Pb was similar to that of PbSiO 3 . These results suggest that the alkali-activated MSWIFA-pyrophyllite-based system could be used to stabilize Pb in MSWIFA. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of an evidence-based review with recommendations using an online iterative process.

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L

2011-01-01

The practice of modern medicine is governed by evidence-based principles. Due to the plethora of medical literature, clinicians often rely on systematic reviews and clinical guidelines to summarize the evidence and provide best practices. Implementation of an evidence-based clinical approach can minimize variation in health care delivery and optimize the quality of patient care. This article reports a method for developing an "Evidence-based Review with Recommendations" using an online iterative process. The manuscript describes the following steps involved in this process: Clinical topic selection, Evidence-hased review assignment, Literature review and initial manuscript preparation, Iterative review process with author selection, and Manuscript finalization. The goal of this article is to improve efficiency and increase the production of evidence-based reviews while maintaining the high quality and transparency associated with the rigorous methodology utilized for clinical guideline development. With the rise of evidence-based medicine, most medical and surgical specialties have an abundance of clinical topics which would benefit from a formal evidence-based review. Although clinical guideline development is an important methodology, the associated challenges limit development to only the absolute highest priority clinical topics. As outlined in this article, the online iterative approach to the development of an Evidence-based Review with Recommendations may improve productivity without compromising the quality associated with formal guideline development methodology. Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

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.

Developing evidence-based maternity care in Iran: a quality improvement study

Directory of Open Access Journals (Sweden)

Mohammad Kazem

2008-06-01

Full Text Available Abstract Background Current Iranian perinatal statistics indicate that maternity care continues to need improvement. In response, we implemented a multi-faceted intervention to improve the quality of maternity care at an Iranian Social Security Hospital. Using a before-and-after design our aim was to improve the uptake of selected evidence based practices and more closely attend to identified women's needs and preferences. Methods The major steps of the study were to (1 identify women's needs, values and preferences via interviews, (2 select through a process of professional consensus the top evidence-based clinical recommendations requiring local implementation (3 redesign care based on the selected evidence-based recommendations and women's views, and (4 implement the new care model. We measured the impact of the new care model on maternal satisfaction and caesarean birth rates utilising maternal surveys and medical record audit before and after implementation of the new care model. Results Twenty women's needs and requirements as well as ten evidence-based clinical recommendations were selected as a basis for improving care. Following the introduction of the new model of care, women's satisfaction levels improved significantly on 16 of 20 items (p Conclusion The introduction of a quality improvement care model improved compliance with evidence-based guidelines and was associated with an improvement in women's satisfaction levels and a reduction in rates of caesarean birth.

Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

Directory of Open Access Journals (Sweden)

Said Shahtahmasebi

2010-01-01

Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.

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.

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.

Immobilizing Organic-Based Molecular Switches into Metal-Organic Frameworks: A Promising Strategy for Switching in Solid State.

Science.gov (United States)

Gui, Bo; Meng, Yi; Xie, Yang; Du, Ke; Sue, Andrew C-H; Wang, Cheng

2018-01-01

Organic-based molecular switches (OMS) are essential components for the ultimate miniaturization of nanoscale electronics and devices. For practical applications, it is often necessary for OMS to be incorporated into functional solid-state materials. However, the switching characteristics of OMS in solution are usually not transferrable to the solid state, presumably because of spatial confinement or inefficient conversion in densely packed solid phase. A promising way to circumvent this issue is harboring the functional OMS within the robust and porous environment of metal-organic frameworks (MOFs) as their organic components. In this feature article, recent research progress of OMS-based MOFs is briefly summarized. The switching behaviors of OMS under different stimuli (e.g., light, redox, pH, etc.) in the MOF state are first introduced. After that, the technological applications of these OMS-based MOFs in different areas, including CO 2 adsorption, gas separation, drug delivery, photodynamic therapy, and sensing, are outlined. Finally, perspectives and future challenges are discussed in the conclusion. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Evidence-based guidelines for wise use of electronic games by children.

Science.gov (United States)

Straker, Leon; Abbott, Rebecca; Collins, Rachel; Campbell, Amity

2014-01-01

Electronic games (e-games) are widely used by children, often for substantial durations, yet to date there are no evidence-based guidelines regarding their use. The aim of this paper is to present guidelines for the wise use of e-games by children based on a narrative review of the research. This paper proposes a model of factors that influence child-e-games interaction. It summarises the evidence on positive and negative effects of use of e-games on physical activity and sedentary behaviour, cardio-metabolic health, musculoskeletal health, motor coordination, vision, cognitive development and psychosocial health. Available guidelines and the role of guidelines are discussed. Finally, this information is compiled into a clear set of evidence-based guidelines, about wise use of e-games by children, targeting children, parents, professionals and the e-game industry. These guidelines provide an accessible synthesis of available knowledge and pragmatic guidelines based on e-game specific evidence and related research.

Integrative review of implementation strategies for translation of research-based evidence by nurses.

Science.gov (United States)

Wuchner, Staci S

2014-01-01

The purpose of this review was to synthesize and critique experimental and/or quasi-experimental research that has evaluated implementation strategies for translation of research-based evidence into nursing practice. Successfully implementing evidence-based research can improve patient outcomes. Identifying successful implementation strategies is imperative to move research-based evidence into practice. As implementation science gains popularity, it is imperative to understand the strategies that most effectively translate research-based evidence into practice. The review used the CINAHL and MEDLINE (Ovid) databases. Articles were included if they were experimental and/or quasi-experimental research designs, were written in English, and measured nursing compliance to translation of research-based evidence. An independent review was performed to select and critique the included articles. A wide array of interventions were completed, including visual cues, audit and feedback, educational meetings and materials, reminders, outreach, and leadership involvement. Because of the complex multimodal nature of the interventions and the variety of research topics, comparison across interventions was difficult. Many difficulties exist in determining what implementation strategies are most effective for translation of research-based evidence into practice by nurses. With these limited findings, further research is warranted to determine which implementation strategies most successfully translate research-based evidence into practice.

Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

Science.gov (United States)

Williams, Nathaniel J

2016-05-05

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p adoption at a 12-month follow-up (R (2) = .17, p adopt EBTs. Discussion focuses on research and practice applications.

Exceptional Durability of Solid Oxide Cells

DEFF Research Database (Denmark)

Ebbesen, Sune; Mogensen, Mogens Bjerg

2010-01-01

Extensive efforts to resolve the degradation normally associated with solid oxide electrolysis cells (SOECs) have been conducted during the past decade. To date, the degradation is assumed to be caused by adsorption of impurities in the cathode, although no firm evidence for this degradation...

Solid State Pathways towards Molecular Complexity in Space

Science.gov (United States)

Linnartz, Harold; Bossa, Jean-Baptiste; Bouwman, Jordy; Cuppen, Herma M.; Cuylle, Steven H.; van Dishoeck, Ewine F.; Fayolle, Edith C.; Fedoseev, Gleb; Fuchs, Guido W.; Ioppolo, Sergio; Isokoski, Karoliina; Lamberts, Thanja; Öberg, Karin I.; Romanzin, Claire; Tenenbaum, Emily; Zhen, Junfeng

2011-12-01

It has been a long standing problem in astrochemistry to explain how molecules can form in a highly dilute environment such as the interstellar medium. In the last decennium more and more evidence has been found that the observed mix of small and complex, stable and highly transient species in space is the cumulative result of gas phase and solid state reactions as well as gas-grain interactions. Solid state reactions on icy dust grains are specifically found to play an important role in the formation of the more complex ``organic'' compounds. In order to investigate the underlying physical and chemical processes detailed laboratory based experiments are needed that simulate surface reactions triggered by processes as different as thermal heating, photon (UV) irradiation and particle (atom, cosmic ray, electron) bombardment of interstellar ice analogues. Here, some of the latest research performed in the Sackler Laboratory for Astrophysics in Leiden, the Netherlands is reviewed. The focus is on hydrogenation, i.e., H-atom addition reactions and vacuum ultraviolet irradiation of interstellar ice analogues at astronomically relevant temperatures. It is shown that solid state processes are crucial in the chemical evolution of the interstellar medium, providing pathways towards molecular complexity in space.

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.

Radiosynoviorthesis in the reflection of Evidence-based Medicine (EbM)

International Nuclear Information System (INIS)

Kampen, W.U.

2006-01-01

This paper summarizes the literature on clinical efficacy of radiosynoviorthesis with respect to the criteria of evidence-based medicine (EbM). Each therapy has to face up to the success and the costs of other treatment modalities, especially in times of scarce financial resources of our health care system. For many physicians and scientists, evidence-based medicine, which means weighting clinical trials by several quality factors like randomization, blinding or comparison with a placebo seems to be the ''philosophers'stone'' to some extent. Concerning radiosynoviorthesis, the existence of clinical studies with a high quality according to the EbM is sometimes negated. However, this statement cannot be abided after extensive revision of the literature. The nuclear medicine physician practising radiosynoviorthesis should be provided with arguments from the literature supporting his personal experience for successful discussions with referring colleques. This is achieved by listing the respective papers especially of evidence classes Ib and IIa with a short summary of each of them. Some critical remarks on evidence-based medicine if used as the only basis of therapeutic practise complete this paper. (orig.)

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.

Evidence based mental healthcare and service innovation: review of concepts and challenges.

Science.gov (United States)

Kouimtsidis, Ch; John-Smith, St; Kemp, P; Ikkos, G

2013-01-01

Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will

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.

Relationship among Translational Medicine, Evidence-Based Medicine and Precision Medicine

OpenAIRE

Xin-en HUANG

2016-01-01

Translational medicine is a new concept in international medical field. It integrates experimental research results and clinical guidance into the optimal implementation criteria for promoting the prediction, prevention and treatment of diseases. Based on people’s higher demand for medicine and health, appearance of translational medicine changes the mode of medical research.Evidence-based medicine (EBM) refers to cautious and accurate application of the current best research evidence and com...

[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.

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.

Self-association and infrared spectres of some heterocyclic compounds based on pyrrol in solid state

International Nuclear Information System (INIS)

Mulloev, N.; Nurulloev, M.; Narziev, B.N.

1993-01-01

Present article is devoted to self-association and infrared spectres of some heterocyclic compounds based on pyrrol in solid state. The study results of self-association specified by molecular hydrogen bonds of some heterocyclic compounds based on pyrrol on spectres of infrared absorption of stretching vibrations of N-H group were considered.

Informed Systems: Enabling Collaborative Evidence Based Organizational Learning

Directory of Open Access Journals (Sweden)

Mary M. Somerville

2015-12-01

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

PRELIMINARY STUDIES FOR PRODUCING CRUDE LIPASE FROM TEMPE’S MOULD CULTIVATED IN RICE-HUSK-BASED SOLID MEDIA

Directory of Open Access Journals (Sweden)

Teuku Beuna Bardant

2010-06-01

Full Text Available The goal of these preliminary studies is to support Indonesian program for increasing palm oil added value through independent production technology based on Indonesian natural resources. Various palm oil derivatives could be synthesized enzymatically using lipase from microbes that available in Indonesia. Tempe's mould is available in abundance in Indonesia and had already been proved for producing lipase. This paper provides information about producing crude lipase from Tempe's mould cultivated in rice-husk-based solid media using palm oil as carbon source. Observed variables include solid media composition, optimum fermentation time, extraction and enriching process of crude lipase. The crude lipase was analyzed its hydrolysis activity on coconut oil and palm oil. The result of these preliminary studies shows that this production process is a simple and tough process and very potential to be developed.   Keywords: lipase, Tempe's mould, palm oil, solid fermentation, rice husk

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.

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.

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...

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,

The Estimation of Knowledge Solidity Based on the Comparative Analysis of Different Test Results

Directory of Open Access Journals (Sweden)

Y. K. Khenner

2012-01-01

Full Text Available At present, the testing techniques of knowledge estimation are widely spread in educational system. However, this method is seriously criticized including its application to the Unified State Examinations. The research is aimed at studying the limitations of testing techniques. The authors recommend a new way of knowledge solid- ity estimation bases on the comparative results analysis of various kinds of tests. While testing the large group of students, the authors found out that the results of the closed and open tests substantially differ. The comparative analysis demonstrates that the open tests assessment of the knowledge solidity is more adequate than that of the closed ones. As the research is only based on a single experiment, the authors recommend using this method further, substantiating the findings concerning the differences in tests results, and analyzing the advantages and disadvantages of the tests in question. 

Motivational Interviewing: An Evidence-Based Practice for Improving Student Practice Skills

Science.gov (United States)

Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth

2015-01-01

Motivational interviewing (MI) is an evidence-based communication method to assist clients in resolving their ambivalence regarding change. With a school emphasis on evidence-based practice and learning outcomes, a social work department implemented a semester-long course on MI. The purpose of this study was to determine baseline skills and…

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, ...

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

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 ...

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…

Evidence-based dentistry for planning restorative treatments: barriers and potential solutions.

Science.gov (United States)

Afrashtehfar, K I; Eimar, H; Yassine, R; Abi-Nader, S; Tamimi, F

2017-11-01

Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

“Evidence-Based Dentistry in Oral Surgery: Could We Do Better?”

Science.gov (United States)

Nocini, Pier Francesco; Verlato, Giuseppe; Frustaci, Andrea; de Gemmis, Antonio; Rigoni, Giovanni; De Santis, Daniele

2010-01-01

Evidence-based Dentistry (EBD), like Evidence-based Medicine (EBM), was born in order to seek the “best available research evidence” in the field of dentistry both in research and clinical routine. But evidence is not clearly measurable in all fields of healthcare: in particular, while drug effect is rather independent from clinician’s characteristics, the effectiveness of surgical procedures is strictly related to surgeon’s expertise, which is difficult to quantify. The research problems of dentistry have a lot in common with other surgical fields, where at the moment the best therapeutic recommendations and guidelines originates from an integration of evidence-based medicine and data from consensus conferences. To cope with these problems, new instruments have been developed, aimed at standardizing clinical procedures (CAD-CAM technology) and at integrating EBM achievements with the opinions of expert clinicians (GRADE System). One thing we have to remember however: it is necessary to use the instruments developed by evidence-based medicine but is impossible to produce sound knowledge without considering clinical expertise and quality of surgical procedures simultaneously. Only in this way we will obtain an evidence-based dentistry both in dental research and clinical practice, which is up to third millennium standards. PMID:20871758

Handling a challenging context: experiences of facilitating evidence-based elderly care.

Science.gov (United States)

Nygårdh, Annette; Ahlström, Gerd; Wann-Hansson, Christine

2016-03-01

To explore improvement facilitators' experiences of handling their commission to implement evidence-based practice in elderly care for frail older persons. Improvement facilitators were put in place across Sweden in a time-limited project by the government, with one part of the project being to evaluate the model before establishing this facilitation of evidence-based practice in elderly care. Two focus groups were interviewed twice. Each group comprised three respondents. The interviews were analysed using qualitative content analysis. A main theme, 'Moving forward by adjusting to the circumstances', described how the improvement facilitators handle their commitment. Five subthemes emerged: identifying barriers, keeping focus, maintaining motivation, building bridges and finding balance. The improvement facilitators' commitment is ambiguous because of unclear leadership of, and responsibility for the national investment. They have to handle leaders' different approaches and justify the need for evidence-based practice. The improvement facilitators did not reflect on the impact of programme adaptations on evidence-based practice. The findings emphasise the need for collaboration between the improvement facilitator and the nurse manager. To fully implement evidence-based practice, negotiations with current practitioners for adaptation to local conditions are necessary. Furthermore, the value of improving organisational performance needs to be rigorously communicated throughout the organisation. © 2015 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Twelve evidence-based principles for implementing self-management support in primary care.

Science.gov (United States)

Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

Procedures for identifying evidence-based psychological treatments for older adults.

Science.gov (United States)

Yon, Adriana; Scogin, Forrest

2007-03-01

The authors describe the methods used to identify evidence-based psychological treatments for older adults in this contribution to the special section. Coding teams were assembled to review the literature on several problems relevant to mental health and aging. These teams used the manual developed by the Committee on Science and Practice of the Society for Clinical Psychology (Division 12) of the American Psychological Association that provided definitions of key constructs used in coding. The authors provide an overview of the process followed by the review teams and of some of the issues that emerged to illustrate the steps involved in the coding procedure. Identifying evidence-based treatments is a fundamental aspect of promoting evidence-based practice with older adults; such practice is advocated by most health care disciplines, including psychology. ((c) 2007 APA, all rights reserved).

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.

Implementing the Integrated Strategy for the Cultural Adaptation of Evidence-Based Interventions: An Illustration.

Science.gov (United States)

Sidani, Souraya; Ibrahim, Sarah; Lok, Jana; Fan, Lifeng; Fox, Mary

2018-01-01

Background Persons' cultural beliefs about a health problem can affect their perceived acceptability of evidence-based interventions, undermining evidence-based interventions' adherence, and uptake to manage the problem. Cultural adaptation has the potential to enhance the acceptability, uptake, and adherence to evidence-based interventions. Purpose To illustrate the implementation of the first two phases of the integrated strategy for cultural adaptation by examining Chinese Canadians' perceptions of chronic insomnia and evidence-based behavioral therapies for insomnia. Methods Chinese Canadians ( n = 14) with chronic insomnia attended a group session during which they completed established instruments measuring beliefs about sleep and insomnia, and their perceptions of factors that contribute to chronic insomnia. Participants rated the acceptability of evidence-based behavioral therapies and discussed their cultural perspectives regarding chronic insomnia and its treatment. Results Participants actively engaged in the activities planned for the first two phases of the integrated strategy and identified the most significant factor contributing to chronic insomnia and the evidence-based intervention most acceptable for their cultural group. Conclusions The protocol for implementing the two phases of the integrated strategy for cultural adaptation of evidence-based interventions was feasible, acceptable, and useful in identifying culturally relevant evidence-based interventions.

[The historical background and present development of evidence-based healthcare and clinical nursing].

Science.gov (United States)

Tsai, Jung-Mei

2014-12-01

Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.

Evidence-based medicine and hospital reform: tracing origins back to Florence Nightingale.

Science.gov (United States)

Aravind, Maya; Chung, Kevin C

2010-01-01

The use of reliable evidence to evaluate health care interventions has gained strong support within the medical community and in the field of plastic surgery in particular. Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures, and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn't know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for health care reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improving the quality and effectiveness of patient care today.

One-step synthesis of solid state luminescent carbon-based silica nanohybrids for imaging of latent fingerprints

Science.gov (United States)

Li, Feng; Li, Hongren; Cui, Tianfang

2017-11-01

Fluorescent carbon-based nanomaterials(CNs) with tunable visible emission are biocompatible, environment friendly and most suitable for various biomedical applications. Despite the successes in preparing strongly fluorescent CNs, preserving the luminescence in solid materials is still challenging because of the serious emission quenching of CNs in solid state materials. In this work, fluorescent carbon and silica nanohybrids (SiCNHs) were synthesized via a simple one-step hydrothermal approach by carbonizing sodium citrate and (3-aminopropyl)triethoxysilane(APTES), and hydrolysis of tetraethyl orthosilicate(TEOS). The resultant SiCNs were characterized through X-ray diffraction (XRD), transmission electron microscopy (TEM), FT-IR, X-ray photoelectron spectroscopy (XPS), and photoluminescence (PL) spectroscopy. The SiCNs exhibited strong fluorescence in both aqueous and solid states. The luminescent solid state SiCNs power were successfully used as a fluorescent labeling material for enhanced imaging of latent fingerprints(LFPs) on single background colour and multi-coloured surfaces substrates in forensic science for individual identification.

Improved creep strength of nickel-base superalloys by optimized γ/γ′ partitioning behavior of solid solution strengthening elements

International Nuclear Information System (INIS)

Pröbstle, M.; Neumeier, S.; Feldner, P.; Rettig, R.; Helmer, H.E.; Singer, R.F.; Göken, M.

2016-01-01

Solid solution strengthening of the γ matrix is one key factor for improving the creep strength of single crystal nickel-base superalloys at high temperatures. Therefore a strong partitioning of solid solution hardening elements to the matrix is beneficial for high temperature creep strength. Different Rhenium-free alloys which are derived from CMSX-4 are investigated. The alloys have been characterized regarding microstructure, phase compositions as well as creep strength. It is found that increasing the Titanium (Ti) as well as the Tungsten (W) content causes a stronger partitioning of the solid solution strengtheners, in particular W, to the γ phase. As a result the creep resistance is significantly improved. Based on these ideas, a Rhenium-free alloy with an optimized chemistry regarding the partitioning behavior of W is developed and validated in the present study. It shows comparable creep strength to the Rhenium containing second generation alloy CMSX-4 in the high temperature / low stress creep regime and is less prone to the formation of deleterious topologically close packed (TCP) phases. This more effective usage of solid solution strengtheners can enhance the creep properties of nickel-base superalloys while reducing the content of strategic elements like Rhenium.

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, ...

High temperature fuel cell with ceria-based solid electrolyte

International Nuclear Information System (INIS)

Arai, H.; Eguchi, K.; Yahiro, H.; Baba, Y.

1987-01-01

Cation-doped ceria is investigated as an electrolyte for the solid oxide fuel cell. As for application to the fuel cells, the electrolyte are desired to have high ionic conductivity in deriving a large electrical power. A series of cation-doped ceria has higher ionic conductivity than zirconia-based oxides. In the present study, the basic electrochemical properties of cation-doped ceria were studied in relation to the application of fuel cells. The performance of fuel cell with yttria-doped ceria electrolyte was evaluated. Ceria-based oxides were prepared by calcination of oxide mixtures of the components or calcination of co-precipitated hydroxide mixtures from the metal nitrate solution. The oxide mixtures thus obtained were sintered at 1650 0 C for 15 hr in air into disks. Ionic transference number, t/sub i/, was estimated from emf of oxygen concentration cell. Electrical conductivities were measured by dc-4 probe method by varying the oxygen partial pressure. The fuel cell was operated by oxygen and hydrogen

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.

Applying an Evidence-Based Framework to the Early Childhood Coaching Literature

Science.gov (United States)

Artman-Meeker, Kathleen; Fettig, Angel; Barton, Erin E.; Penney, Ashley; Zeng, Songtian

2015-01-01

Professional development (PD) is a critical pathway for promoting the use of evidence-based intervention practices in early childhood (EC) settings. Coaching has been proposed as a type of PD that is especially promising for job-embedded learning. A lack of consensus exists regarding evidence-based EC coaching strategies and what types of support…

Nickel Oxide (NiO nanoparticles prepared by solid-state thermal decomposition of Nickel (II schiff base precursor

Directory of Open Access Journals (Sweden)

Aliakbar Dehno Khalaji

2015-06-01

Full Text Available In this paper, plate-like NiO nanoparticles were prepared by one-pot solid-state thermal decomposition of nickel (II Schiff base complex as new precursor. First, the nickel (II Schiff base precursor was prepared by solid-state grinding using nickel (II nitrate hexahydrate, Ni(NO32∙6H2O, and the Schiff base ligand N,N′-bis-(salicylidene benzene-1,4-diamine for 30 min without using any solvent, catalyst, template or surfactant. It was characterized by Fourier Transform Infrared spectroscopy (FT-IR and elemental analysis (CHN. The resultant solid was subsequently annealed in the electrical furnace at 450 °C for 3 h in air atmosphere. Nanoparticles of NiO were produced and characterized by X-ray powder diffraction (XRD at 2θ degree 0-140°, FT-IR spectroscopy, scanning electron microscopy (SEM and transmission electron microscopy (TEM. The XRD and FT-IR results showed that the product is pure and has good crystallinity with cubic structure because no characteristic peaks of impurity were observed, while the SEM and TEM results showed that the obtained product is tiny, aggregated with plate-like shape, narrow size distribution with an average size between 10-40 nm. Results show that the solid state thermal decomposition method is simple, environmentally friendly, safe and suitable for preparation of NiO nanoparticles. This method can also be used to synthesize nanoparticles of other metal oxides.

Gaseous emissions from management of solid waste: a systematic review.

Science.gov (United States)

Pardo, Guillermo; Moral, Raúl; Aguilera, Eduardo; Del Prado, Agustín

2015-03-01

The establishment of sustainable soil waste management practices implies minimizing their environmental losses associated with climate change (greenhouse gases: GHGs) and ecosystems acidification (ammonia: NH3 ). Although a number of management strategies for solid waste management have been investigated to quantify nitrogen (N) and carbon (C) losses in relation to varied environmental and operational conditions, their overall effect is still uncertain. In this context, we have analyzed the current scientific information through a systematic review. We quantified the response of GHG emissions, NH3 emissions, and total N losses to different solid waste management strategies (conventional solid storage, turned composting, forced aerated composting, covering, compaction, addition/substitution of bulking agents and the use of additives). Our study is based on a meta-analysis of 50 research articles involving 304 observations. Our results indicated that improving the structure of the pile (waste or manure heap) via addition or substitution of certain bulking agents significantly reduced nitrous oxide (N2 O) and methane (CH4 ) emissions by 53% and 71%, respectively. Turned composting systems, unlike forced aerated composted systems, showed potential for reducing GHGs (N2 O: 50% and CH4 : 71%). Bulking agents and both composting systems involved a certain degree of pollution swapping as they significantly promoted NH3 emissions by 35%, 54%, and 121% for bulking agents, turned and forced aerated composting, respectively. Strategies based on the restriction of O2 supply, such as covering or compaction, did not show significant effects on reducing GHGs but substantially decreased NH3 emissions by 61% and 54% for covering and compaction, respectively. The use of specific additives significantly reduced NH3 losses by 69%. Our meta-analysis suggested that there is enough evidence to refine future Intergovernmental Panel on Climate Change (IPCC) methodologies from solid waste

Gaseous emissions from management of solid waste: a systematic review

Science.gov (United States)

Pardo, Guillermo; Moral, Raúl; Aguilera, Eduardo; del Prado, Agustín

2015-01-01

The establishment of sustainable soil waste management practices implies minimizing their environmental losses associated with climate change (greenhouse gases: GHGs) and ecosystems acidification (ammonia: NH3). Although a number of management strategies for solid waste management have been investigated to quantify nitrogen (N) and carbon (C) losses in relation to varied environmental and operational conditions, their overall effect is still uncertain. In this context, we have analyzed the current scientific information through a systematic review. We quantified the response of GHG emissions, NH3 emissions, and total N losses to different solid waste management strategies (conventional solid storage, turned composting, forced aerated composting, covering, compaction, addition/substitution of bulking agents and the use of additives). Our study is based on a meta-analysis of 50 research articles involving 304 observations. Our results indicated that improving the structure of the pile (waste or manure heap) via addition or substitution of certain bulking agents significantly reduced nitrous oxide (N2O) and methane (CH4) emissions by 53% and 71%, respectively. Turned composting systems, unlike forced aerated composted systems, showed potential for reducing GHGs (N2O: 50% and CH4: 71%). Bulking agents and both composting systems involved a certain degree of pollution swapping as they significantly promoted NH3 emissions by 35%, 54%, and 121% for bulking agents, turned and forced aerated composting, respectively. Strategies based on the restriction of O2 supply, such as covering or compaction, did not show significant effects on reducing GHGs but substantially decreased NH3 emissions by 61% and 54% for covering and compaction, respectively. The use of specific additives significantly reduced NH3 losses by 69%. Our meta-analysis suggested that there is enough evidence to refine future Intergovernmental Panel on Climate Change (IPCC) methodologies from solid waste

Numerical simulation of polishing U-tube based on solid-liquid two-phase

Science.gov (United States)

Li, Jun-ye; Meng, Wen-qing; Wu, Gui-ling; Hu, Jing-lei; Wang, Bao-zuo

2018-03-01

As the advanced technology to solve the ultra-precision machining of small hole structure parts and complex cavity parts, the abrasive grain flow processing technology has the characteristics of high efficiency, high quality and low cost. So this technology in many areas of precision machining has an important role. Based on the theory of solid-liquid two-phase flow coupling, a solid-liquid two-phase MIXTURE model is used to simulate the abrasive flow polishing process on the inner surface of U-tube, and the temperature, turbulent viscosity and turbulent dissipation rate in the process of abrasive flow machining of U-tube were compared and analyzed under different inlet pressure. In this paper, the influence of different inlet pressure on the surface quality of the workpiece during abrasive flow machining is studied and discussed, which provides a theoretical basis for the research of abrasive flow machining process.

Gastric emptying of a physiologic mixed solid-liquid meal

Energy Technology Data Exchange (ETDEWEB)

Fisher, R.S.; Malmud, L.S.; Bandini, P.; Rock, E.

1982-05-01

The purposes of this study were to use a noninvasive scintigraphic technique to measure gastric emptying of liquids and solids simultaneously, to study the interactions between emptying of the liquid and solid components of meals in normal subjects, and to employ dual isotope gastric scintigraphy to evaluate gastric emptying of liquids and solids in patients with clinical evidence of gastric outlet obstruction. The solid component of the test meal consisted of chicken liver, labeled in vivo with /sup 99m/Tc sulfur colloid, and the liquid component was water mixed with /sup 111/In DTPA. The rates of emptying were quantitated using a gamma camera on line to a digital computer. Twenty normal subjects were studied using this combined solid-liquid meal. Ten of them also ingested a liquid meal alone and ten a solid meal alone. Liquid emptied from the stomach significantly more rapidly than did solids. The emptying curve for liquids was exponential compared to a linear emptying curve for solids. The gastric emptying rate of the liquid component was slowed significantly by simultaneous ingestion of solids, but the emptying rate of solids was not affected by liquids. Several patients with clinical gastric outlet obstruction were evaluated. Both combined and selective abnormalities for gastric emptying of liquids and solids were demonstrated.

Barriers to Implementing Evidence-Based Intrapartum Care: A Descriptive Exploratory Qualitative Study.

Science.gov (United States)

Iravani, Mina; Janghorbani, Mohsen; Zarean, Ellahe; Bahrami, Masod

2016-02-01

Evidence based practice is an effective strategy to improve the quality of obstetric care. Identification of barriers to adaptation of evidence-based intrapartum care is necessary and crucial to deliver high quality care to parturient women. The current study aimed to explore barriers to adaptation of evidence-based intrapartum care from the perspective of clinical groups that provide obstetric care in Iran. This descriptive exploratory qualitative research was conducted from 2013 to 2014 in fourteen state medical training centers in Iran. Participants were selected from midwives, specialists, and residents of obstetrics and gynecology, with a purposive sample and snowball method. Data were collected through face-to-face semi-structured in-depth interviews and analyzed according to conventional content analysis. Data analysis identified twenty subcategories and four main categories. Main categories included barriers were related to laboring women, persons providing care, the organization environment and health system. The adoption of evidence based intrapartum care is a complex process. In this regard, identifying potential barriers is the first step to determine and apply effective strategies to encourage the compliance evidence based obstetric care and improves maternity care quality.

A Learning Object Approach To Evidence based learning

Directory of Open Access Journals (Sweden)

Zabin Visram

2005-06-01

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

Essential elements for community engagement in evidence-based youth violence prevention.

Science.gov (United States)

Miao, Tai-An; Umemoto, Karen; Gonda, Deanna; Hishinuma, Earl S

2011-09-01

In the field of youth violence prevention, there has been increasing emphasis on "evidence based" programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence-based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence-based youth violence prevention based on their work in a university-community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self-reflection. The authors propose placing greater emphasis on "evaluative thinking" and organizational capacity for evaluation as we pursue evidence-based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.

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.

Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based healthcare.

Science.gov (United States)

Norlyk, Annelise; Haahr, Anita; Dreyer, Pia; Martinsen, Bente

2017-07-01

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously. The other is a course of democratization based on patients' involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence-based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as 'one best way'. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of 'McNursing'. © 2017 John Wiley & Sons Ltd.

Research on the Fusion of Dependent Evidence Based on Rank Correlation Coefficient

Directory of Open Access Journals (Sweden)

Fengjian Shi

2017-10-01

Full Text Available In order to meet the higher accuracy and system reliability requirements, the information fusion for multi-sensor systems is an increasing concern. Dempster–Shafer evidence theory (D–S theory has been investigated for many applications in multi-sensor information fusion due to its flexibility in uncertainty modeling. However, classical evidence theory assumes that the evidence is independent of each other, which is often unrealistic. Ignoring the relationship between the evidence may lead to unreasonable fusion results, and even lead to wrong decisions. This assumption severely prevents D–S evidence theory from practical application and further development. In this paper, an innovative evidence fusion model to deal with dependent evidence based on rank correlation coefficient is proposed. The model first uses rank correlation coefficient to measure the dependence degree between different evidence. Then, total discount coefficient is obtained based on the dependence degree, which also considers the impact of the reliability of evidence. Finally, the discount evidence fusion model is presented. An example is illustrated to show the use and effectiveness of the proposed method.

Research on the Fusion of Dependent Evidence Based on Rank Correlation Coefficient.

Science.gov (United States)

Shi, Fengjian; Su, Xiaoyan; Qian, Hong; Yang, Ning; Han, Wenhua

2017-10-16

In order to meet the higher accuracy and system reliability requirements, the information fusion for multi-sensor systems is an increasing concern. Dempster-Shafer evidence theory (D-S theory) has been investigated for many applications in multi-sensor information fusion due to its flexibility in uncertainty modeling. However, classical evidence theory assumes that the evidence is independent of each other, which is often unrealistic. Ignoring the relationship between the evidence may lead to unreasonable fusion results, and even lead to wrong decisions. This assumption severely prevents D-S evidence theory from practical application and further development. In this paper, an innovative evidence fusion model to deal with dependent evidence based on rank correlation coefficient is proposed. The model first uses rank correlation coefficient to measure the dependence degree between different evidence. Then, total discount coefficient is obtained based on the dependence degree, which also considers the impact of the reliability of evidence. Finally, the discount evidence fusion model is presented. An example is illustrated to show the use and effectiveness of the proposed method.

Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines.

Science.gov (United States)

Hannes, K; Goedhuys, J; Aertgeerts, B

2012-01-01

A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h

Four Thermochromic o-Hydroxy Schiff Bases of α-Aminodiphenylmethane: Solution and Solid State Study

Directory of Open Access Journals (Sweden)

Marija Zbačnik

2017-01-01

Full Text Available More than a hundred years after the first studies of the photo- and thermochromism of o-hydroxy Schiff bases (imines, it is still an intriguing topic that fascinates several research groups around the world. The reasons for such behavior are still under investigation, and this work is a part of it. We report the solution-based and mechanochemical synthesis of four o-hydroxy imines derived from α-aminodiphenylmethane. The thermochromic properties were studied for the single crystal and polycrystalline samples of the imines. The supramolecular impact on the keto-enol tautomerism in the solid state was studied using SCXRD and NMR, while NMR spectroscopy was used for the solution state. All four imines are thermochromic, although the color changes of the single crystals are not as strong as of the polycrystalline samples. One of the imines shows negative thermochromism, and that one is in keto-amine tautomeric form, both in the solid state as in solution.

Synthesis of new solid polymer electrolyte and actuator based on PEDOT/NBR/ionic liquid

Science.gov (United States)

Cho, M. S.; Seo, H. J.; Nam, J. D.; Choi, H. R.; Koo, J. C.; Lee, Y.

2006-03-01

The conducting polymer actuator was presented. The solid polymer electrolyte based on nitrile rubber (NBR) activated with different ionic liquids was prepared. The three different grades of NBR films were synthesized by emulsion polymerization with different amount of acrylonitrile, 23, 35, and 40 mol. %, respectively. The effect of acrylonitrile content on the ionic conductivity and dielectric constant of solid polymer electrolytes was characterized. A conducting polymer, poly(3,4-ethylenedioxythiophene) (PEDOT), was synthesized on the surface of the NBR layer by using a chemical oxidation polymerization technique, and room temperature ionic liquids (RTIL) based on imidazolium salts, e.g. 1-butyl-3-methyl imidazolium X [where X= BF 4 -, PF 6 -, (CF 3SO II) IIN -], were absorbed into the composite film. The effects of the anion size of the ionic liquids on the displacement of the actuator were examined. The displacement increased with increasing the anion-size of the ionic liquids.

Pyridinium ionic liquid-based liquid-solid extraction of inorganic and organic iodine from Laminaria.

Science.gov (United States)

Peng, Li-Qing; Yu, Wen-Yan; Xu, Jing-Jing; Cao, Jun

2018-01-15

A simple, green and effective extraction method, namely, pyridinium ionic liquid- (IL) based liquid-solid extraction (LSE), was first designed to extract the main inorganic and organic iodine compounds (I - , monoiodo-tyrosine (MIT) and diiodo-tyrosine (DIT)). The optimal extraction conditions were as follows: ultrasonic intensity 100W, IL ([EPy]Br) concentration 200mM, extraction time 30min, liquid/solid ratio 10mL/g, and pH value 6.5. The morphologies of Laminaria were studied by scanning electron microscopy and transmission electron microscopy. The recovery values of I - , MIT and DIT from Laminaria were in the range of 88% to 94%, and limits of detection were in the range of 59.40 to 283.6ng/g. The proposed method was applied to the extraction and determination of iodine compounds in three Laminaria. The results showed that IL-based LSE could be a promising method for rapid extraction of bioactive iodine from complex food matrices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Method for calculating solid-solid phase transitions at high temperature: An application to N2O

International Nuclear Information System (INIS)

Kuchta, B.; Etters, R.D.

1992-01-01

Two similar techniques for calculating solid-solid phase transitions at high temperatures are developed, where the contribution of the entropy may be a decisive factor. They utilize an artificial reversible path from one phase to another by application of a control parameter. Thermodynamic averages are calculated using constant-volume and constant-pressure Monte Carlo techniques. An application to N 2 O at room temperature shows that the cubic Pa3 to orthorhombic Cmca transition occurs near 4.9-GPa pressure, very close to the value calculated at very low temperatures. These results support experimental evidence that the transition pressure is virtually independent of temperature

From Evidence-based Management to Management of Non-knowledge

DEFF Research Database (Denmark)

Knudsen, Morten

2017-01-01

Leadership and management are increasingly expected to base themselves on evidence, i.e. knowledge. This article does not disagree that knowledge may be beneficial. Yet, based on sociological insights on the complex relation between knowledge and ignorance, the article argues that more knowledge...

Moving an Evidence-Based Policy Agenda Forward: Leadership Tips From the Field.

Science.gov (United States)

Garrett, Teresa

2018-05-01

Advancing evidence-based policy change is a leadership challenge that nurses should embrace. Key tips to ensure that evidence-based policy changes are successful at the individual, community, and population levels are offered to help nurses through the change process. The public trust in the nursing profession is a leverage point that should be used to advance the use of evidence, expedite change, and improve health for students and across communities.

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

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

Science.gov (United States)

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

2016-01-01

Evidence-based management (EBMgt) is a growing literature stream in management education which contends that management decision making should be informed by the best available scientific evidence (Rousseau, 2006). Encouraged by the success of evidence-based practice in the field of medicine, advocates of EBMgt have increasingly called for…

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…

Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.

Science.gov (United States)

Brownson, Ross C; Allen, Peg; Jacob, Rebekah R; deRuyter, Anna; Lakshman, Meenakshi; Reis, Rodrigo S; Yan, Yan

2017-11-30

Although practitioners in state health departments are ideally positioned to implement evidence-based interventions, few studies have examined how to build their capacity to do so. The objective of this study was to explore how to increase the use of evidence-based decision-making processes at both the individual and organization levels. We conducted a 2-arm, group-randomized trial with baseline data collection and follow-up at 18 to 24 months. Twelve state health departments were paired and randomly assigned to intervention or control condition. In the 6 intervention states, a multiday training on evidence-based decision making was conducted from March 2014 through March 2015 along with a set of supplemental capacity-building activities. Individual-level outcomes were evidence-based decision making skills of public health practitioners; organization-level outcomes were access to research evidence and participatory decision making. Mixed analysis of covariance models was used to evaluate the intervention effect by accounting for the cluster randomized trial design. Analysis was performed from March through May 2017. Participation 18 to 24 months after initial training was 73.5%. In mixed models adjusted for participant and state characteristics, the intervention group improved significantly in the overall skill gap (P = .01) and in 6 skill areas. Among the 4 organizational variables, only access to evidence and skilled staff showed an intervention effect (P = .04). Tailored and active strategies are needed to build capacity at the individual and organization levels for evidence-based decision making. Our study suggests several dissemination interventions for consideration by leaders seeking to improve public health practice.

Teaching evidence-based medicine using a problem-oriented approach.

Science.gov (United States)

Hosny, Somaya; Ghaly, Mona S

2014-04-01

Faculty of Medicine, Suez Canal University is adopting an innovative curriculum. Evidence-based medicine (EBM) has been integrated into problem based learning (PBL) sessions as a responsive innovative paradigm for the practice and teaching of clinical medicine. To integrate EBM in the problem based sessions of the sixth-year students, and to assess students' and tutor satisfaction with this change. EBM training was conducted for sixth-year students (196) including four theoretical, and eight practical sessions. Sixteen EBM educational scenarios (problems) were formulated, according to sixth-year curriculum. Each problem was discussed in two sessions through steps of EBM, namely: formulating PICO questions, searching for and appraising evidence, applying the evidence to the clinical scenario and analysing the practice. Students and tutors satisfaction were evaluated using a 3-point ratings questionnaire. The majority of students and faculty expressed their satisfaction about integrating EBM with PBL and agreed that the problems were more stimulating. However, 33.6% of students indicated that available time was insufficient for searching literatures. Integrating EBM into PBL sessions tends to be more interesting and stimulating than traditional PBL sessions for final year students and helps them to practice and implement EBM in clinical context.

"Insufficient evidence of effectiveness" is not "evidence of no effectiveness:" evaluating computer-based education for patients with severe mental illness.

Science.gov (United States)

Stoltz, Peter; Skärsäter, Ingela; Willman, Ania

2009-01-01

This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Nursing Society (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident where such evidence was misunderstood by Swedish policy and health care decision makers. This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe mental illness. Systematic database searches in Medline, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-text documents, of which 5 were finally included and co-reviewed by two independent researchers. The review found no decisive evidence of effectiveness regarding computer-based education programs designed to assist persons suffering from severe mental illness. Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld, which at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.

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.

Introduction to solid supported membrane based electrophysiology.

Science.gov (United States)

Bazzone, Andre; Costa, Wagner Steuer; Braner, Markus; Călinescu, Octavian; Hatahet, Lina; Fendler, Klaus

2013-05-11

The electrophysiological method we present is based on a solid supported membrane (SSM) composed of an octadecanethiol layer chemisorbed on a gold coated sensor chip and a phosphatidylcholine monolayer on top. This assembly is mounted into a cuvette system containing the reference electrode, a chlorinated silver wire. After adsorption of membrane fragments or proteoliposomes containing the membrane protein of interest, a fast solution exchange is used to induce the transport activity of the membrane protein. In the single solution exchange protocol two solutions, one non-activating and one activating solution, are needed. The flow is controlled by pressurized air and a valve and tubing system within a faraday cage. The kinetics of the electrogenic transport activity is obtained via capacitive coupling between the SSM and the proteoliposomes or membrane fragments. The method, therefore, yields only transient currents. The peak current represents the stationary transport activity. The time dependent transporter currents can be reconstructed by circuit analysis. This method is especially suited for prokaryotic transporters or eukaryotic transporters from intracellular membranes, which cannot be investigated by patch clamp or voltage clamp methods.

Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews.

Science.gov (United States)

Kiriakou, Juliana; Pandis, Nikolaos; Madianos, Phoebus; Polychronopoulou, Argy

2014-10-30

Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

[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.

Operando Spectroscopy of the Gas-Phase Aldol Condensation of Propanal over Solid Base Catalysts

NARCIS (Netherlands)

Hernández-giménez, Ana M.; Ruiz-martínez, Javier; Puértolas, Begoña; Pérez-ramírez, Javier; Bruijnincx, Pieter C. A.; Weckhuysen, Bert M.

2017-01-01

The gas-phase aldol condensation of propanal, taken as model for the aldehyde components in bio-oils, has been studied with a combined operando set-up allowing to perform FT-IR & UV–Vis diffuse reflectance spectroscopy (DRS) with on-line mass spectrometry (MS). The selected solid base catalysts, a

ASSESSMENT OF TANNERY BASED SOLID WASTES MANAGEMENT IN ASILI, NAIROBI KENYA

Directory of Open Access Journals (Sweden)

Richard O. Oruko

2014-06-01

Full Text Available Solid wastes generated in Nairobi and its environs are posing a serious environmental challenge to the authorities and public, especially the hazardous and non-biodegradable solid wastes from leather industries. There were environmental concerns and complaints from workers and residents living adjacent to Asili tanneries limited about degradation of natural and inbuilt environment. This pointed to the effect of environmental pollution by the tannery. The broad objective of study was to assess the effectiveness of tannery based solid wastes management, by identifying and analyzing the concentration levels of sodium chlorides,sulphide, chromium ions and total phenols as selected pollutants along the tanning stages, in Nairobi river, borehole water, and soils around the dump site inside the tannery. Experimental (laboratory analysis design was used.Descriptive statistics was used in analyzing data resulting in means and tables. The means concentration of total Chrome was 2633.38mg/L,Sodium chloride 609.93mg/L, Sulphide 129.77mg/L, total Phenols 10.91mg/L in the soil sampled around the composite dump site.. In Nairobi river water the means of Sodium chloride was 317.48mg/L, Sulphide 24.00mg/L, total Phenol 3.97mg/L and total Chrome Nil, While means concentration in borehole water, had Sodium chloride detected at 354.73mg/L, Sulphide 6.67mg/L, total Phenol 0.03mg/L and total Chrome as Nil, indicating heavily contaminated ecosystems above the discharge set limits of National Environmental Management Authority and Nairobi city water and sewerage company.

Novel thixotropic gel electrolytes based on dicationic bis-imidazolium salts for quasi-solid-state dye-sensitized solar cells

Science.gov (United States)

Kim, Jun Young; Kim, Tae Ho; Kim, Dong Young; Park, Nam-Gyu; Ahn, Kwang-Duk

Novel thixotropic gel electrolytes have been successfully prepared by utilizing oligomeric poly(ethylene oxide) (PEO)-based bis-imidazolium diiodide salts and hydrophilic silica nanoparticles for application in quasi-solid-state dye-sensitized solar cells (DSSCs). The thixotropic gel-state of the ionic liquid-based composite electrolytes is confirmed by observing the typical hysteresis loop and temporary hydrogen bonding. On using the PEO-based composite electrolyte, a quasi-solid-state DSSC exhibited highly improved properties such as easy penetration of the electrolyte into the cell without leakage, long-term stability, high open-circuit voltage without the use of 4- tert-butylpyridine, and a high energy-conversion efficiency of 5.25% under AM 1.5 illumination (100 mW cm -2).

Solid tritium breeder materials-Li2O and LiAlO2: a data base review

International Nuclear Information System (INIS)

Liu, Y.Y.; Billone, M.C.; Clemmer, R.G.; Fischer, A.K.; Hollenberg, G.W.; Tam, S.W.

1985-01-01

The fabrication, properties, and irradiation behavior of Li 2 O and γ-LiAlO 2 are reviewed and assessed to determine the potential of these materials to satisfy the basic solid breeder blanket performance requirements. Based on the data analysis and theoretical modeling, a set of major technical uncertainties is identified. These uncertainties include: fabricability of sphere-pac solid breeders; high fluence and burnup effects on thermal conductivity and microstructural stability; high fluence and burnup effects on tritium diffusion coefficients at low temperature; relationship among purge flow chemistry, surface adsorption, and species of released tritium; and mechanical properties and the loads imposed on the structural materials by the breeder during blanket operation. Resolution of these issues is important in assuring that solid breeder blankets can be designed with confidence

Analytic equation of state for FCC C60 solid based on analytic mean-field potential approach

International Nuclear Information System (INIS)

Sun Jiuxun

2006-01-01

The analytic mean-field approach (AMFP) was applied to the FCC C60 solid. For the intermolecular forces the Girifalco potential has been utilized. The analytic expressions for the Helmholtz free energy, internal energy and equation of state have been derived. The numerical results of thermodynamic quantities are compared with the molecular dynamic (MD) simulations and the unsymmetrized self-consistent field approach (CUSF) in the literature. It is shown that our AMFP results are in good agreement with the MD data both at low and high temperatures. The results of CUSF are in accordance with the AMFP at low temperature, but at high temperature the difference becomes prominent. Especially the AMFP predicted that the FCC C60 solid is stable upto 2202 K, the spinodal temperature, in good agreement with 2320 K from the MD simulation. However, the CUST just gives 1916 K, a temperature evidently lower than the MD data. The AMFP qualifies as a useful approach that can reasonably consider the anharmonic effects at high temperature

Experimental demonstration of line-width modulation in plasmonic lithography using a solid immersion lens-based active nano-gap control

International Nuclear Information System (INIS)

Lee, Won-Sup; Kim, Taeseob; Choi, Guk-Jong; Lim, Geon; Joe, Hang-Eun; Gang, Myeong-Gu; Min, Byung-Kwon; Park, No-Cheol; Moon, Hyungbae; Kim, Do-Hyung; Park, Young-Pil

2015-01-01

Plasmonic lithography has been used in nanofabrication because of its utility beyond the diffraction limit. The resolution of plasmonic lithography depends on the nano-gap between the nanoaperture and the photoresist surface—changing the gap distance can modulate the line-width of the pattern. In this letter, we demonstrate solid-immersion lens based active non-contact plasmonic lithography, applying a range of gap conditions to modulate the line-width of the pattern. Using a solid-immersion lens-based near-field control system, the nano-gap between the exit surface of the nanoaperture and the media can be actively modulated and maintained to within a few nanometers. The line-widths of the recorded patterns using 15- and 5-nm gaps were 47 and 19.5 nm, respectively, which matched closely the calculated full-width at half-maximum. From these results, we conclude that changing the nano-gap within a solid-immersion lens-based plasmonic head results in varying line-width patterns

A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice.

Science.gov (United States)

Duncombe, Daphne C

2018-03-01

To examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas. It is evident from previous studies that a number of factors exist which either obstruct or promote the utilisation of research evidence in nursing practice. Identifying these factors is vital to the successful uptake of evidence-based practice in nursing. Descriptive, comparative study. Data were collected using self-administered questionnaires. A stratified random sample (n = 100) of registered nurses participated; 5-point Likert-like scales were used to examine nurses' perceptions of barriers and facilitators of evidence-based practice. Descriptive statistics were used to describe demographic characteristics and to compare responses of nurses. Participants were predominantly female (98.4%), in the 25 to implement evidence-based practice previously. The greatest barriers identified were as follows: "Inadequate resources for implementing research findings" (85.2%; n = 52) and "Inadequate training in research methods" (83.6%; n = 51). The top facilitators identified were as follows: "Training in research methods" (88.5%; n = 54) and "Organisational policies and protocols that are evidence-based" (86.9%; n = 53). Nurses generally expressed that they required additional training in research and evidence-based practice concepts. Although some nurses had a desire to implement evidence-based practice to provide quality care and improve patient outcomes, many expressed that they lacked the required resources. The study draws attention to the need for prioritisation of evidence-based practice both at institutional and governmental levels. Successful adoption of evidence-based practice implies combined efforts of nurses, healthcare providers and policymakers. Further research is needed to determine the best method for successfully incorporating evidence-based practice into nursing

Agency-University Partnership for Evidence-Based Practice in Social Work

Science.gov (United States)

Bellamy, Jennifer L.; Bledsoe, Sarah E.; Mullen, Edward J.; Fang, Lin; Manuel, Jennifer I.

2008-01-01

Little is known about evidence-based practice (EBP) in social service agencies beyond studies of researcher, practitioner, and educator opinions. The Bringing Evidence for Social Work Training (BEST) Project involved 16 participants from 3 social service agencies. The experiential training, delivered by 2 doctoral students, focused on a…

Integration of evidence-based knowledge management in microsystems: a tele-ICU experience.

Science.gov (United States)

Rincon, Teresa A

2012-01-01

The Institute of Medicine's proposed 6 aims to improve health care are timely, safe, effective, efficient, equitable, and patient-centered care. Unfortunately, it also asserts that improvements in these 6 dimensions cannot be achieved within the existing framework of care systems. These systems are based on unrealistic expectations on human cognition and vigilance, and demonstrate a lack of dependence on computerized systems to support care processes and put information at the point of use. Knowledge-based care and evidence-based clinical decision-making need to replace the unscientific care that is being delivered in health care. Building care practices on evidence within an information technology platform is needed to support sound clinical decision-making and to influence organizational adoption of evidence-based practice in health care. Despite medical advances and evidence-based recommendations for treatment of severe sepsis, it remains a significant cause of mortality and morbidity in the world. It is a complex disease state that has proven difficult to define, diagnose, and treat. Supporting bedside teams with real-time knowledge and expertise to target early identification of severe sepsis and compliance to Surviving Sepsis Campaign, evidence-based practice bundles are important to improving outcomes. Using a centralized, remote team of expert nurses and an open-source software application to advance clinical decision-making and execution of the severe sepsis bundle will be examined.

Evidence-based healthcare and the Cochrane Collaboration: an unfinished journey as yet!

Science.gov (United States)

Meyer, Sascha

2013-11-01

Although evidence-based medicine and the Cochrane Collaboration have become key players in modern medicine, it is important to note that evidencebased medicine and the Cochrane Collaboration are confronted with a number of substantial challenges that need to be addressed. The aim of this work is to highlight some of these problems. This comment is based on a semi-structured literature review and my personal experience in the field of evidence-based medicine. In this comment, 3 important areas of controversy and conflict ("Improving the quality of Cochrane Review"; "Increasing the relevance to middle- and low-income countries"; and "Keeping reviews up to date") will be highlighted, and possible solutions will be presented. With the Cochrane Collaboration now having been at the forefront of promoting and implementing core principles of evidence-based medicine, further organizational, political and administrative efforts will have to be put in place to further improve the impact of evidence-based medicine in the field of health care. This process can best be realized through networking and cooperation of the medical community worldwide, irrespective of geographic origin. When successfully tackling the above mentioned issues and obstacles, the already amazing success story of evidence-based medicine and the Cochrane Collaboration will grow even more substantial. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Solid-state nuclear-spin quantum computer based on magnetic resonance force microscopy

International Nuclear Information System (INIS)

Berman, G. P.; Doolen, G. D.; Hammel, P. C.; Tsifrinovich, V. I.

2000-01-01

We propose a nuclear-spin quantum computer based on magnetic resonance force microscopy (MRFM). It is shown that an MRFM single-electron spin measurement provides three essential requirements for quantum computation in solids: (a) preparation of the ground state, (b) one- and two-qubit quantum logic gates, and (c) a measurement of the final state. The proposed quantum computer can operate at temperatures up to 1 K. (c) 2000 The American Physical Society

Preparing facilitators from community-based organizations for evidence-based intervention training in Second Life.

Science.gov (United States)

Valladares, Angel Felix; Aebersold, Michelle; Tschannen, Dana; Villarruel, Antonia Maria

2014-09-30

A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost

Using Web 2.0 technologies to enhance evidence-based medical information.

Science.gov (United States)

Metzger, Miriam J; Flanagin, Andrew J

2011-01-01

This article invokes research on information seeking and evaluation to address how providers of evidence-based medical information can use Web 2.0 technologies to increase access to, enliven users' experiences with, and enrich the quality of the information available. In an ideal scenario, evidence-based medical information can take appropriate advantage of community intelligence spawned by Web 2.0 technologies, resulting in the ideal combination of scientifically sound, high-quality information that is imbued with experiential insights from a multitude of individuals. To achieve this goal, the authors argue that people will engage with information that they can access easily, and that they perceive as (a) relevant to their information-seeking goals and (b) credible. The authors suggest the utility of Web 2.0 technologies for engaging stakeholders with evidence-based medical information through these mechanisms, and the degree to which the information provided can and should be trusted. Last, the authors discuss potential problems with Web 2.0 information in relation to decision making in health contexts, and they conclude with specific and practical recommendations for the dissemination of evidence-based health information via Web 2.0 technologies.

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....

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

The judgement process in evidence-based medicine and health technology assessment

OpenAIRE

Kelly, Michael P; Moore, Tessa A

2011-01-01

This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver...

The Evidence-Based Approach to Adult-Onset Idiopathic Nephrotic Syndrome.

Science.gov (United States)

Canetta, Pietro A A; Radhakrishnan, Jai

2015-01-01

Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach.

Suspended solids in liquid effluents

International Nuclear Information System (INIS)

McGrath, J.J.

1988-06-01

An international literature review and telephone mail survey was conducted with respect to technical and regulatory aspects of suspended solids in radioactive liquid wastes from nuclear power stations. Results of the survey are summarized and show that suspended solids are an important component of some waste streams. The data available, while limited, show these solids to be associated largely with corrosion products. The solids are highly variable in quantity, size and composition. Filtration is commonly applied for their removal from liquid effluents and is effective. Complex interactions with receiving waters can result in physical/chemical changes of released radionuclides and these phenomena have been seen as reason for not applying regulatory controls based on suspended solids content. 340 refs

Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review.

Science.gov (United States)

Venasse, Myriam; Edwards, Thomas; Pilutti, Lara A

2018-04-10

There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS. We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention. There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.

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.

Lessons Learned from A System-Wide Evidence-Based Practice Program Implementation

Science.gov (United States)

2017-04-25

incorporating scientific evidence, clinical expertise and the patient’s values and preferences to provide quality healthcare . Despite growing...MEMORANDUM FOR ST DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS ATTN: LT COL JACQUELINE KILLIAN...FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 14 FEB 2017 1. Your paper, entitled Lesson Learned From A System-Wide Evidence- Based

SOLID2: an antibody array-based life-detector instrument in a Mars Drilling Simulation Experiment (MARTE).

Science.gov (United States)

Parro, Víctor; Fernández-Calvo, Patricia; Rodríguez Manfredi, José A; Moreno-Paz, Mercedes; Rivas, Luis A; García-Villadangos, Miriam; Bonaccorsi, Rosalba; González-Pastor, José Eduardo; Prieto-Ballesteros, Olga; Schuerger, Andrew C; Davidson, Mark; Gómez-Elvira, Javier; Stoker, Carol R

2008-10-01

A field prototype of an antibody array-based life-detector instrument, Signs Of LIfe Detector (SOLID2), has been tested in a Mars drilling mission simulation called MARTE (Mars Astrobiology Research and Technology Experiment). As one of the analytical instruments on the MARTE robotic drilling rig, SOLID2 performed automatic sample processing and analysis of ground core samples (0.5 g) with protein microarrays that contained 157 different antibodies. Core samples from different depths (down to 5.5 m) were analyzed, and positive reactions were obtained in antibodies raised against the Gram-negative bacterium Leptospirillum ferrooxidans, a species of the genus Acidithiobacillus (both common microorganisms in the Río Tinto area), and extracts from biofilms and other natural samples from the Río Tinto area. These positive reactions were absent when the samples were previously subjected to a high-temperature treatment, which indicates the biological origin and structural dependency of the antibody-antigen reactions. We conclude that an antibody array-based life-detector instrument like SOLID2 can detect complex biological material, and it should be considered as a potential analytical instrument for future planetary missions that search for life.

Sustainability of Evidence-Based Acute Pain Management Practices for Hospitalized Older Adults.

Science.gov (United States)

Shuman, Clayton J; Xie, Xian-Jin; Herr, Keela A; Titler, Marita G

2017-11-01

Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.

Solid tumors are poroelastic solids with a chemo-mechanical feedback on growth.

Science.gov (United States)

Ambrosi, D; Pezzuto, S; Riccobelli, D; Stylianopoulos, T; Ciarletta, P

2017-12-01

The experimental evidence that a feedback exists between growth and stress in tumors poses challenging questions. First, the rheological properties (the "constitutive equations") of aggregates of malignant cells are still a matter of debate. Secondly, the feedback law (the "growth law") that relates stress and mitotic-apoptotic rate is far to be identified. We address these questions on the basis of a theoretical analysis of in vitro and in vivo experiments that involve the growth of tumor spheroids. We show that solid tumors exhibit several mechanical features of a poroelastic material, where the cellular component behaves like an elastic solid. When the solid component of the spheroid is loaded at the boundary, the cellular aggregate grows up to an asymptotic volume that depends on the exerted compression. Residual stress shows up when solid tumors are radially cut, highlighting a peculiar tensional pattern. By a novel numerical approach we correlate the measured opening angle and the underlying residual stress in a sphere. The features of the mechanobiological system can be explained in terms of a feedback of mechanics on the cell proliferation rate as modulated by the availability of nutrient, that is radially damped by the balance between diffusion and consumption. The volumetric growth profiles and the pattern of residual stress can be theoretically reproduced assuming a dependence of the target stress on the concentration of nutrient which is specific of the malignant tissue.

[Autoimmune pancreatitis. Evidence based management guidelines of the Hungarian Pancreatic Study Group].

Science.gov (United States)

Dubravcsik, Zsolt; Farkas, Gyula; Hegyi, Péter; Hritz, István; Kelemen, Dezső; Lásztity, Natália; Morvay, Zita; Oláh, Attila; Pap, Ákos; Párniczky, Andrea; Sahin-Tóth, Miklós; Szentkereszti, Zsolt; Szmola, Richárd; Takács, Tamás; Tiszlavicz, László; Szücs, Ákos; Czakó, László

2015-02-22

Autoimmune pancreatitis is a rare disease which can even mimic pancreatic tumor, however, unlike the latter, it requires not surgical but conservative management. Correct diagnosis and differential diagnosis of autoimmune pancreatitis and treatment of these patients requires up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidences. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 29 relevant clinical questions in 4 topics were defined (Basics; Diagnosis; Differential diagnostics; Therapy). Evidence was classified according to the UpToDate(®) grading system. The draft of the guidelines was presented and discussed at the consensus meeting on September 12, 2014. All clinial questions were accepted with almost total (more than 95%) agreement. The present guideline is the first evidence based autoimmune pancreatitis guideline in Hungary. The guideline may provide very important and helpful data for tuition of autoimmune pancreatitis, for everyday practice and for establishing proper finance. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary.

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.

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 ...

An Exploratory Study Investigating the Non-Clinical Benefits of Evidence-Based Veterinary Medicine

Directory of Open Access Journals (Sweden)

Elizabeth Jackson

2017-05-01

Full Text Available Objective: As little prior research exists about the non-clinical benefits of evidence-based veterinary medicine (EBVM, this exploratory study was conducted to identify non-clinical benefits of EBVM to veterinary practices, as well as highlighting the barriers to further implementation, and ways to overcome them.Background: A PICO-based literature review (Hauser and Jackson, 2016 was conducted to establish current knowledge about the non-clinical benefits of EBVM. It found that while there are some papers suggesting a link between the practice of EBVM and better non-clinical benefits such as client satisfaction and client retention, a single study, focusing on the non-clinical benefits of EBVM, had yet to be conducted.Evidentiary value: This exploratory study provides a solid basis for the further development of a confirmatory study of the themes identified in the interviews. The impact on practice from our findings is significant as it details the key areas where the use of EBVM can yield commercial benefits from the perspective of a group of EBVM experts via interview. It is entirely possible that international veterinary environments which mirror that of the UK will find this research beneficial.Methods: Due to the paucity of data about the non-clinical benefits of EBVM, an exploratory, qualitative approach was taken to this research in order to build a platform for further confirmatory, quantitative investigation (Zikmund, 2003. In February and March 2016 interviews with 16 RCVS Knowledge Group chairs[1] were conducted. The interview guide contained broad, open-ended questions to explore existing tacit knowledge about the non-commercial benefits of EBVM. The interviews were audio recorded and transcribed verbatim and subsequently analysed using NVivo 11 software.Results: This qualitative enquiry showed that the key areas where the use of EBVM can yield non-clinical benefits are through increased client satisfaction and retention, improved

Preparation and evaluation of carvacrol pellets based on PVP solid-dispersion by extrusion-spheronization technique

Directory of Open Access Journals (Sweden)

Z. Taghizadeh*

2017-11-01

Full Text Available Background and objectives: Carvacrol is one of the main pharmacologically active components of Thymus vulgaris essential oil which has shown several therapeutic effects. There are few works regarding the formulation of essential oils as oral solid dosage forms due to their liquid nature, stability and technical problems. The aim of this study was to combine the solid-dispersion approach and extrusion-spheronization technique to produce pellets with desirable physico-mechanical and release properties. Methods: Solid dispersion matrix (30% of carvacrol in polyvinylpyrrolidone K30 was prepared by solvent evaporation. The matrix was mixed with Avicel and lactose and granulated by water. The wet mass was transformed into pellets by extrusion-spheronization. In order to compare the solid dispersion method with the classic approaches, another pellet formulation was prepared by absorption of carvacrol on Aerosil. The pellets were characterized for size (sieve analysis, shape factors (image analysis, mechanical strength, carvacrol content, and release rate (dissolution test. Accelerated stability test of formulations was also carried out. Results: Using suitable composition of solid dispersion matrix and granulation fluid, the pellets with desirable size and shape and mechanical properties could be produced. PVP-based pellets had higher mechanical strength, slower release rate and improved content and stability. The PVP ratio showed considerable effect on release properties of the pellets. Conclusion: Overall, the results revealed the feasibility of preparing desirable pellets containing carvacrol with acceptable content, stability and release properties which can be administered as hard gelatin capsules.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

Science.gov (United States)

Oh, Eui Geum; Kim, Sunah; Kim, So Sun; Kim, Sue; Cho, Eun Yong; Yoo, Ji-Soo; Kim, Hee Soon; Lee, Ju Hee; You, Mi Ae; Lee, Hyejung

2010-07-01

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum. Copyright 2010, SLACK Incorporated.

A systematic review on barriers, facilities, knowledge and attitude toward evidence-based medicine in Iran

Directory of Open Access Journals (Sweden)

Morteza Ghojazadeh

2015-03-01

Full Text Available Introduction: Evidence-based medicine (EBM is the ability and skill in using and integration of the best up-to-date evidences. The aim of this study was a systematic review of barriers, facilities, knowledge and attitude of EBM in Iran. Methods: In this study, database and manual search was used with keywords such as, "evidence-based, EBM, evidence-based nursing, evidence-based practice, evidence-based care, evidence-based activities, evidence-based education" and their combination with the keywords of the barrier, facilitator, attitude, awareness, prospective, knowledge, practice and Iran. The databases of SID (Scientific information database, Magiran, MEDLIB, PubMed, Google scholar, IranMedex and CINAHL (Cumulative index to nursing and allied health literature were used for data collection. Results: Finally, 28 papers were included in this study. The lack of facilities, time and skill in research methodology were the most important barriers to EBM. The most and least important factors were orderly creating ample opportunity and detecting needs and problems. The degree of familiarity with the terminology of evidence-based performance was low (44.2%. The textbooks have been considered as the most significant source of obtaining information. The level of awareness, knowledge, and evidence-based performance was less than 50.0%. Conclusion: There are many various barriers in use of EBM and healthcare providers despite the positive attitude toward EBM had a low level knowledge in EBM setting. Consideration of the importance of EBM proper planning and effective intervention are necessary to removing the barriers and increase the knowledge of healthcare providers.

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.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India.

Science.gov (United States)

Srivastava, P K; Kulshreshtha, K; Mohanty, C S; Pushpangadan, P; Singh, A

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible "threats" into "opportunities" and changing the "weaknesses" into "strengths" regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India

International Nuclear Information System (INIS)

Srivastava, P.K.; Kulshreshtha, K.; Mohanty, C.S.; Pushpangadan, P.; Singh, A.

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible 'threats' into 'opportunities' and changing the 'weaknesses' into 'strengths' regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow

The reductive decomposition of calcium sulphate I. Kinetics of the apparent solid-solid reaction

NARCIS (Netherlands)

Kamphuis, B.; Potma, A.W.; Prins, W.; van Swaaij, Willibrordus Petrus Maria

1992-01-01

The reductive decomposition of calcium sulphate by hydrogen is used for the regeneration of calcium-based atmospheric fluidized bed combustion (AFBC) SO2 sorbents. The apparent solid¿solid reaction between CaS and CaSO4, one of the steps involved in the reaction mechanism of the reductive

Solid acid catalysis from fundamentals to applications

CERN Document Server