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Sample records for weak evidence base

  1. Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges.

    PubMed

    Babor, Thomas F; Caetano, Raul

    2005-01-01

    The objectives of this article are to describe the evidence base for alcohol policy in the Americas, to evaluate the extent to which national policies are likely to have an impact on public health, and to identify areas where alcohol policies could be improved. The paper begins with a brief review of epidemiological surveys of the prevalence of alcohol problems in the Americas. This is followed by an analysis of 32 prevention strategies and interventions in terms of the evidence for their effectiveness, amount of research support, cost to implement, and other feasibility issues. Overall, the strategies and interventions with the greatest amount of empirical support are low blood alcohol concentration levels for driving while intoxicated, controls on alcohol availability, age limits on alcohol purchases, and relatively high alcohol prices. The implications of the evidence are next discussed in relation to alcohol policy initiatives in the Americas, based on an analysis of the extent to which strategies and interventions currently used in 25 countries of the Americas are likely to have a public health impact on alcohol-related problems. The countries that have adopted the policies with the highest expected impact overall are Colombia, Costa Rica, Venezuela, and El Salvador. Nevertheless, the analysis indicates that almost all the countries of the Americas could improve the likelihood of preventing alcohol-related problems. Policy efforts in the developing countries of Latin America should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on physical availability. For the developed, high-income countries of North America the goal should be to prevent deterioration of current drinking patterns and to reduce the overall volume of drinking. Given the low to moderate cost of many of the policies reviewed in this article, it now seems possible for communities and nations to substantially reduce the

  2. A Radio-Based Search finds no evidence for intrinsically weak TGFs in the Fermi GBM Data

    NASA Astrophysics Data System (ADS)

    Briggs, Michael; Omar, Kareem

    2016-04-01

    We analyze gamma-ray data from the Fermi Gamma-ray Burst Monitor (GBM) around the times of VLF radio sferics. The gamma-ray photons are time-aligned to the times of radio sferics, with correction for the light travel time to Fermi, and accumulated. Gamma-ray photons from TGFs already known from the standard GBM TGF offline search are excluded from the accumulation. We use sferic signals from both the World Wide Lightning Location Network (WWLLN) and the Earth Networks Total Lightning Network (ENTLN). No excess signal is found in the accumulation of the gamma-ray data for sferics within 400 km of the Fermi nadir. However, an excess of gamma-rays is found in the co-aligned signal for sferics between 400 and 800 km of the Fermi nadir. Our interpretation of this distance-dependent non-detection / detection pattern is that the standard GBM offline search for TGFs is missing some TGFs that are weak at Fermi due to distance from Fermi and that there is no evidence for a population of TGFs that are intrinsically fainter than the threshold of the search.

  3. Evidence of Filamentary Switching in Oxide-based Memory Devices via Weak Programming and Retention Failure Analysis

    NASA Astrophysics Data System (ADS)

    Younis, Adnan; Chu, Dewei; Li, Sean

    2015-09-01

    Further progress in high-performance microelectronic devices relies on the development of novel materials and device architectures. However, the components and designs that are currently in use have reached their physical limits. Intensive research efforts, ranging from device fabrication to performance evaluation, are required to surmount these limitations. In this paper, we demonstrate that the superior bipolar resistive switching characteristics of a CeO2:Gd-based memory device can be manipulated by means of UV radiation, serving as a new degree of freedom. Furthermore, the metal oxide-based (CeO2:Gd) memory device was found to possess electrical and neuromorphic multifunctionalities. To investigate the underlying switching mechanism of the device, its plasticity behaviour was studied by imposing weak programming conditions. In addition, a short-term to long-term memory transition analogous to the forgetting process in the human brain, which is regarded as a key biological synaptic function for information processing and data storage, was realized. Based on a careful examination of the device’s retention behaviour at elevated temperatures, the filamentary nature of switching in such devices can be understood from a new perspective.

  4. Evidence of Filamentary Switching in Oxide-based Memory Devices via Weak Programming and Retention Failure Analysis

    PubMed Central

    Younis, Adnan; Chu, Dewei; Li, Sean

    2015-01-01

    Further progress in high-performance microelectronic devices relies on the development of novel materials and device architectures. However, the components and designs that are currently in use have reached their physical limits. Intensive research efforts, ranging from device fabrication to performance evaluation, are required to surmount these limitations. In this paper, we demonstrate that the superior bipolar resistive switching characteristics of a CeO2:Gd-based memory device can be manipulated by means of UV radiation, serving as a new degree of freedom. Furthermore, the metal oxide-based (CeO2:Gd) memory device was found to possess electrical and neuromorphic multifunctionalities. To investigate the underlying switching mechanism of the device, its plasticity behaviour was studied by imposing weak programming conditions. In addition, a short-term to long-term memory transition analogous to the forgetting process in the human brain, which is regarded as a key biological synaptic function for information processing and data storage, was realized. Based on a careful examination of the device’s retention behaviour at elevated temperatures, the filamentary nature of switching in such devices can be understood from a new perspective. PMID:26324073

  5. Neutron-Diffraction Evidence for the Ferrimagnetic Ground State of a Molecule-Based Magnet with Weakly Coupled Sublattices

    SciTech Connect

    Fishman, Randy Scott; Campo, Javier; Vos, Thomas E.; Miller, Joel S.

    2012-01-01

    The diruthenium compound [Ru2(O2CMe)4]3[Cr(CN)6] contains two weakly coupled, ferrimag- netically ordered sublattices occupying the same volume. The magnetic field Hc 800 Oe required to align the two sublattice moments is proportional to the antiferromagnetic dipolar interaction Kc B Hc 5 10 3 meV between sublattices. Powder neutron-diffraction measurements on a deuterated sample reveal that the sublattice moments are restricted by the anisotropy of the diruthenium paddle-wheel complexes to the cubic diagonals. Those measurements also suggest that the quantum corrections to the ground state are significant.

  6. Further Evidence for Weak Field Critical Adsorption

    NASA Astrophysics Data System (ADS)

    Franck, Carl; Peach, Sarah; Polak, Robert D.

    1997-03-01

    Following our unexpected discovery of weak short-range surface field effects on the critical mixing transition of a binary liquid,(N.S. Desai, S. Peach, and C. Franck, Phys. Rev. E52), 4129 (1995) we have directly addressed our concern that these results might have been affected by surface heterogeneity. We have used octadecyltrichlorosilane (OTS) to cover borosilicate glass surfaces with partial monolayers. Reference substrates with identical treatment had OTS patches no larger than the bulk correlation length within 40 mK of the critical transition. The present reflectivity experiment employs uncovered reference surfaces for comparison in a single sample cell. We confirm our earlier discovery of a persistent (down to 3 mK above the critical point) deviation of the degree of critical adsorption from the maximum value expected. We have also improved our earlier analysis in order to examine the scaling behavior. Supported by the NSF under DMR-9320910, and through central facilities of the Materials Science Center at Cornell Univ.

  7. Evidence of Weak Habitat Specialisation in Microscopic Animals

    PubMed Central

    Fontaneto, Diego; Westberg, Martin; Hortal, Joaquín

    2011-01-01

    Macroecology and biogeography of microscopic organisms (any living organism smaller than 2 mm) are quickly developing into fruitful research areas. Microscopic organisms also offer the potential for testing predictions and models derived from observations on larger organisms due to the feasibility of performing lab and mesocosm experiments. However, more empirical knowledge on the similarities and differences between micro- and macro-organisms is needed to ascertain how much of the results obtained from the former can be generalised to the latter. One potential misconception, based mostly on anedoctal evidence rather than explicit tests, is that microscopic organisms may have wider ecological tolerance and a lower degree of habitat specialisation than large organisms. Here we explicitly test this hypothesis within the framework of metacommunity theory, by studying host specificify in the assemblages of bdelloid rotifers (animals about 350 µm in body length) living in different species of lichens in Sweden. Using several regression-based and ANOVA analyses and controlling for both spatial structure and the kind of substrate the lichen grow over (bark vs rock), we found evidence of significant but weak species-specific associations between bdelloids and lichens, a wide overlap in species composition between lichens, and wide ecological tolerance for most bdelloid species. This confirms that microscopic organisms such as bdelloids have a lower degree of habitat specialisation than larger organisms, although this happens in a complex scenario of ecological processes, where source-sink dynamics and geographic distances seem to have no effect on species composition at the analysed scale. PMID:21887355

  8. When Good Evidence Goes Bad: The Weak Evidence Effect in Judgment and Decision-Making

    ERIC Educational Resources Information Center

    Fernbach, Philip M.; Darlow, Adam; Sloman, Steven A.

    2011-01-01

    An indispensable principle of rational thought is that positive evidence should increase belief. In this paper, we demonstrate that people routinely violate this principle when predicting an outcome from a weak cause. In Experiment 1 participants given weak positive evidence judged outcomes of public policy initiatives to be less likely than…

  9. Weakness

    MedlinePlus

    Lack of strength; Muscle weakness ... feel weak but have no real loss of strength. This is called subjective weakness. It may be ... flu. Or, you may have a loss of strength that can be noted on a physical exam. ...

  10. Maximal Holevo Quantity Based on Weak Measurements

    PubMed Central

    Wang, Yao-Kun; Fei, Shao-Ming; Wang, Zhi-Xi; Cao, Jun-Peng; Fan, Heng

    2015-01-01

    The Holevo bound is a keystone in many applications of quantum information theory. We propose “ maximal Holevo quantity for weak measurements” as the generalization of the maximal Holevo quantity which is defined by the optimal projective measurements. The scenarios that weak measurements is necessary are that only the weak measurements can be performed because for example the system is macroscopic or that one intentionally tries to do so such that the disturbance on the measured system can be controlled for example in quantum key distribution protocols. We evaluate systematically the maximal Holevo quantity for weak measurements for Bell-diagonal states and find a series of results. Furthermore, we find that weak measurements can be realized by noise and project measurements. PMID:26090962

  11. Weak Acid Ionization Constants and the Determination of Weak Acid-Weak Base Reaction Equilibrium Constants in the General Chemistry Laboratory

    ERIC Educational Resources Information Center

    Nyasulu, Frazier; McMills, Lauren; Barlag, Rebecca

    2013-01-01

    A laboratory to determine the equilibrium constants of weak acid negative weak base reactions is described. The equilibrium constants of component reactions when multiplied together equal the numerical value of the equilibrium constant of the summative reaction. The component reactions are weak acid ionization reactions, weak base hydrolysis…

  12. New Evidence about the Spontaneous Symmetry Breaking: Action of an Asymmetric Weak Heat Source.

    PubMed

    Mineo, Placido; Villari, Valentina; Scamporrino, Emilio; Micali, Norberto

    2015-09-17

    In the present study, we show how, in a stagnant water solution of uncharged aggregated achiral porphyrin-based molecules, a mirror-symmetry breaking (SB) can be induced and controlled by means of a weak asymmetric thermal gradient. In particular, it is shown that the optical activity of the aggregate porphyrin solution can be generated and reversed, in sign, only acting on the thermal ramp direction (heating or cooling). In order to avoid data misinterpretation, the aggregate structure modifications with the temperature change and the linear dichroism contribution to circular dichroism spectra were evaluated. A model simulation, using a finite element analysis approach describing the thermal flows, shows that small thermal gradients are able to give rise to asymmetric heat flow. The results reported here can be considered new evidence about the spontaneous symmetry breaking phenomenon induced by very weak forces having an important role in the natural chiral selective processes. PMID:26315854

  13. Finding evidence for massive neutrinos using 3D weak lensing

    SciTech Connect

    Kitching, T. D.; Heavens, A. F.; Verde, L.; Serra, P.; Melchiorri, A.

    2008-05-15

    In this paper we investigate the potential of 3D cosmic shear to constrain massive neutrino parameters. We find that if the total mass is substantial (near the upper limits from large scale structure, but setting aside the Ly alpha limit for now), then 3D cosmic shear+Planck is very sensitive to neutrino mass and one may expect that a next generation photometric redshift survey could constrain the number of neutrinos N{sub {nu}} and the sum of their masses m{sub {nu}}=im{sub i} to an accuracy of {delta}N{sub {nu}}{approx}0.08 and {delta}m{sub {nu}}{approx}0.03 eV, respectively. If in fact the masses are close to zero, then the errors weaken to {delta}N{sub {nu}}{approx}0.10 and {delta}m{sub {nu}}{approx}0.07 eV. In either case there is a factor 4 improvement over Planck alone. We use a Bayesian evidence method to predict joint expected evidence for N{sub {nu}} and m{sub {nu}}. We find that 3D cosmic shear combined with a Planck prior could provide 'substantial' evidence for massive neutrinos and be able to distinguish 'decisively' between many competing massive neutrino models. This technique should 'decisively' distinguish between models in which there are no massive neutrinos and models in which there are massive neutrinos with |N{sub {nu}}-3| > or approx. 0.35 and m{sub {nu}} > or approx. 0.25 eV. We introduce the notion of marginalized and conditional evidence when considering evidence for individual parameter values within a multiparameter model.

  14. Weak Evidence of Regeneration Habitat but Strong Evidence of Regeneration Niche for a Leguminous Shrub

    PubMed Central

    Delerue, Florian; Gonzalez, Maya; Michalet, Richard; Pellerin, Sylvain; Augusto, Laurent

    2015-01-01

    The identification of an ecological niche specific to the regeneration phase has mobilised significant attention. However, the importance of the regeneration niche concept remains unclear. Our main objective was to study the existence of such a regeneration niche for a leguminous shrub, Ulex europaeus. This study was carried out in southwest France in the context of water and nutrient stresses (mainly phosphorus limitation) due to the presence of nutrient-poor sandy soils. We analysed the regeneration of the species from the germination of seeds and emergence of new seedlings until the seedlings reached young shrub size. Our design included a P fertilisation treatment. We also investigated microsite characteristics (micro-topography and vegetation development) as they can interact with meteorological conditions and determine water availability for seeds and seedlings. We found that P availability controlled seedling growth and the time necessary to reach young shrub size. Water availability appeared to impact the species germination and seedlings survival. We also found that P and water availability depended on the interactions between microsite characteristics and climatic variations. Finally we found evidence that P and water availability are important ecological factors shaping the regeneration niche of the species, but we found weak evidence that any microsite would be appropriate for the regeneration of the species in the long term. Future studies regarding regeneration niches need to distinguish more clearly the ecological factors important for regeneration (the regeneration niche per se) and the physical world where the seedlings appear and develop (the regeneration habitat). PMID:26098877

  15. Weak Evidence of Regeneration Habitat but Strong Evidence of Regeneration Niche for a Leguminous Shrub.

    PubMed

    Delerue, Florian; Gonzalez, Maya; Michalet, Richard; Pellerin, Sylvain; Augusto, Laurent

    2015-01-01

    The identification of an ecological niche specific to the regeneration phase has mobilised significant attention. However, the importance of the regeneration niche concept remains unclear. Our main objective was to study the existence of such a regeneration niche for a leguminous shrub, Ulex europaeus. This study was carried out in southwest France in the context of water and nutrient stresses (mainly phosphorus limitation) due to the presence of nutrient-poor sandy soils. We analysed the regeneration of the species from the germination of seeds and emergence of new seedlings until the seedlings reached young shrub size. Our design included a P fertilisation treatment. We also investigated microsite characteristics (micro-topography and vegetation development) as they can interact with meteorological conditions and determine water availability for seeds and seedlings. We found that P availability controlled seedling growth and the time necessary to reach young shrub size. Water availability appeared to impact the species germination and seedlings survival. We also found that P and water availability depended on the interactions between microsite characteristics and climatic variations. Finally we found evidence that P and water availability are important ecological factors shaping the regeneration niche of the species, but we found weak evidence that any microsite would be appropriate for the regeneration of the species in the long term. Future studies regarding regeneration niches need to distinguish more clearly the ecological factors important for regeneration (the regeneration niche per se) and the physical world where the seedlings appear and develop (the regeneration habitat). PMID:26098877

  16. Wafer weak point detection based on aerial images or WLCD

    NASA Astrophysics Data System (ADS)

    Ning, Guoxiang; Philipp, Peter; Litt, Lloyd C.; Ackmann, Paul; Crell, Christian; Chen, Norman

    2015-10-01

    Aerial image measurement is a key technique for model based optical proximity correction (OPC) verification. Actual aerial images obtained by AIMS (aerial image measurement system) or WLCD (wafer level critical dimension) can detect printed wafer weak point structures in advance of wafer exposure and defect inspection. Normally, the potential wafer weak points are determined based on optical rule check (ORC) simulation in advance. However, the correlation to real wafer weak points is often not perfect due to the contribution of mask three dimension (M3D) effects, actual mask errors, and scanner lens effects. If the design weak points can accurately be detected in advance, it will reduce the wafer fab cost and improve cycle time. WLCD or AIMS tools are able to measure the aerial images CD and bossung curve through focus window. However, it is difficult to detect the wafer weak point in advance without defining selection criteria. In this study, wafer weak points sensitive to mask mean-to-nominal values are characterized for a process with very high MEEF (normally more than 4). Aerial image CD uses fixed threshold to detect the wafer weak points. By using WLCD through threshold and focus window, the efficiency of wafer weak point detection is also demonstrated. A novel method using contrast range evaluation is shown in the paper. Use of the slope of aerial images for more accurate detection of the wafer weak points using WLCD is also discussed. The contrast range can also be used to detect the wafer weak points in advance. Further, since the mean to nominal of the reticle contributes to the effective contrast range in a high MEEF area this work shows that control of the mask error is critical for high MEEF layers such as poly, active and metal layers. Wafer process based weak points that cannot be detected by wafer lithography CD or WLCD will be discussed.

  17. Evidence of the accelerated expansion of the Universe from weak lensing tomography with COSMOS

    NASA Astrophysics Data System (ADS)

    Schrabback, T.; Hartlap, J.; Joachimi, B.; Kilbinger, M.; Simon, P.; Benabed, K.; Bradač, M.; Eifler, T.; Erben, T.; Fassnacht, C. D.; High, F. William; Hilbert, S.; Hildebrandt, H.; Hoekstra, H.; Kuijken, K.; Marshall, P. J.; Mellier, Y.; Morganson, E.; Schneider, P.; Semboloni, E.; van Waerbeke, L.; Velander, M.

    2010-06-01

    We present a comprehensive analysis of weak gravitational lensing by large-scale structure in the Hubble Space Telescope Cosmic Evolution Survey (COSMOS), in which we combine space-based galaxy shape measurements with ground-based photometric redshifts to study the redshift dependence of the lensing signal and constrain cosmological parameters. After applying our weak lensing-optimized data reduction, principal-component interpolation for the spatially, and temporally varying ACS point-spread function, and improved modelling of charge-transfer inefficiency, we measured a lensing signal that is consistent with pure gravitational modes and no significant shape systematics. We carefully estimated the statistical uncertainty from simulated COSMOS-like fields obtained from ray-tracing through the Millennium Simulation, including the full non-Gaussian sampling variance. We tested our lensing pipeline on simulated space-based data, recalibrated non-linear power spectrum corrections using the ray-tracing analysis, employed photometric redshift information to reduce potential contamination by intrinsic galaxy alignments, and marginalized over systematic uncertainties. We find that the weak lensing signal scales with redshift as expected from general relativity for a concordance ΛCDM cosmology, including the full cross-correlations between different redshift bins. Assuming a flat ΛCDM cosmology, we measure σ_8(Ω_m/0.3)0.51 = 0.75±0.08 from lensing, in perfect agreement with WMAP-5, yielding joint constraints Ω_m = 0.266+0.025-0.023, σ_8 = 0.802+0.028-0.029 (all 68.3% conf.). Dropping the assumption of flatness and using priors from the HST Key Project and Big-Bang nucleosynthesis only, we find a negative deceleration parameter q0 at 94.3% confidence from the tomographic lensing analysis, providing independent evidence of the accelerated expansion of the Universe. For a flat wCDM cosmology and prior w ∈ [-2,0], we obtain w <-0.41 (90% conf.). Our dark energy

  18. Evidence-based medicine.

    PubMed

    Sackett, D L

    1997-02-01

    Evidence-based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgment that we individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatment and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer. Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best external evidence, practice risks becoming rapidly out of date, to the detriment of patients. The practice of evidence-based medicine is a process of life-long, self-directed learning in which caring for our own patients creates the need for

  19. Evidence based vaccinology.

    PubMed

    Nalin, David R

    2002-02-22

    Evidence based vaccinology (EBV) is the identification and use of the best evidence in making and implementing decisions during all of the stages of the life of a vaccine, including pre-licensure vaccine development and post-licensure manufacture and research, and utilization of the vaccine for disease control. Vaccines, unlike most pharmaceuticals, are in a continuous process of development both before and after licensure. Changes in biologics manufacturing technology and changes that vaccines induce in population and disease biology lead to periodic review of regimens (and sometimes dosage) based on changing immunologic data or public perceptions relevant to vaccine safety and effectiveness. EBV includes the use of evidence based medicine (EBM) both in clinical trials and in national disease containment programs. The rationale for EBV is that the highest evidentiary standards are required to maintain a rigorous scientific basis of vaccine quality control in manufacture and to ensure valid determination of vaccine efficacy, field effectiveness and safety profiles (including post-licensure safety monitoring), cost-benefit analyses, and risk:benefit ratios. EBV is increasingly based on statistically validated, clearly defined laboratory, manufacturing, clinical and epidemiological research methods and procedures, codified as good laboratory practices (GLP), good manufacturing practices (GMP), good clinical research practices (GCRP) and in clinical and public health practice (good vaccination practices, GVP). Implementation demands many data-driven decisions made by a spectrum of specialists pre- and post-licensure, and is essential to maintaining public confidence in vaccines. PMID:11858871

  20. Evidence-based dentistry.

    PubMed

    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

  1. School-Based Sexuality Education in Portugal: Strengths and Weaknesses

    ERIC Educational Resources Information Center

    Rocha, Ana Cristina; Leal, Cláudia; Duarte, Cidália

    2016-01-01

    Portugal, like many other countries, faces obstacles regarding school-based sexuality education. This paper explores Portuguese schools' approaches to implementing sexuality education at a local level, and provides a critical analysis of potential strengths and weaknesses. Documents related to sexuality education in a convenience sample of 89…

  2. A Weak Value Based QKD Protocol Robust Against Detector Attacks

    NASA Astrophysics Data System (ADS)

    Troupe, James

    2015-03-01

    We propose a variation of the BB84 quantum key distribution protocol that utilizes the properties of weak values to insure the validity of the quantum bit error rate estimates used to detect an eavesdropper. The protocol is shown theoretically to be secure against recently demonstrated attacks utilizing detector blinding and control and should also be robust against all detector based hacking. Importantly, the new protocol promises to achieve this additional security without negatively impacting the secure key generation rate as compared to that originally promised by the standard BB84 scheme. Implementation of the weak measurements needed by the protocol should be very feasible using standard quantum optical techniques.

  3. Hydrogen sensing array based on weak fiber Bragg grating

    NASA Astrophysics Data System (ADS)

    Bai, Wei; Yang, Minghong; Hu, Chenyuan; Dai, Jixiang; Li, Zhi; Yu, Haihu

    2015-09-01

    Optical fiber hydrogen sensing system based on weak fiber Bragg grating (WFBG) array deposited with palladium (Pd) film is proposed and experimentally demonstrated. For multi-point measurement, three hydrogen WFBG sensors array are weld in a single optical fiber. A time-division multiplexing (TDM) interrogation system is employed to demodulate the sensing array. Sensing experiments to different hydrogen concentrations ranging from 0 to 3.6% are conducted, and the results show good agreement with standard FBG technology. Due to its strong multiplexing capability of weak FBG, the system is possible to integrate thousands of WFBG hydrogen sensors in a single optical fiber.

  4. Evidence-based management.

    PubMed

    Cohen, Frank

    2012-01-01

    It's OK to be lucky when you're lucky, but it's not OK when the issues are critical. Too often, we manage by anecdote, which is OK when you can afford to be wrong, but when finances are tight, or the market is overregulated, or a lot is at stake, making mistakes is not an option. Evidence-based management depends on attention to three components: analytics, decision making, and problem solving. These are skills that should be required of everyone who assumes a management position, no matter how high or low one is on the totem pole. Understanding basic analytical techniques, knowing how to apply these techniques to making good decisions, and learning how to become a skilled problem solver ensure that, when we manage our businesses, we minimize the risk of mistakes and maximize the potential for positive outcomes. PMID:22594062

  5. Weak Hard X-Ray Emission from Broad Absorption Line Quasars: Evidence for Intrinsic X-Ray Weakness

    NASA Astrophysics Data System (ADS)

    Luo, B.; Brandt, W. N.; Alexander, D. M.; Stern, D.; Teng, S. H.; Arévalo, P.; Bauer, F. E.; Boggs, S. E.; Christensen, F. E.; Comastri, A.; Craig, W. W.; Farrah, D.; Gandhi, P.; Hailey, C. J.; Harrison, F. A.; Koss, M.; Ogle, P.; Puccetti, S.; Saez, C.; Scott, A. E.; Walton, D. J.; Zhang, W. W.

    2014-10-01

    We report NuSTAR observations of a sample of six X-ray weak broad absorption line (BAL) quasars. These targets, at z = 0.148-1.223, are among the optically brightest and most luminous BAL quasars known at z < 1.3. However, their rest-frame ≈2 keV luminosities are 14 to >330 times weaker than expected for typical quasars. Our results from a pilot NuSTAR study of two low-redshift BAL quasars, a Chandra stacking analysis of a sample of high-redshift BAL quasars, and a NuSTAR spectral analysis of the local BAL quasar Mrk 231 have already suggested the existence of intrinsically X-ray weak BAL quasars, i.e., quasars not emitting X-rays at the level expected from their optical/UV emission. The aim of the current program is to extend the search for such extraordinary objects. Three of the six new targets are weakly detected by NuSTAR with <~ 45 counts in the 3-24 keV band, and the other three are not detected. The hard X-ray (8-24 keV) weakness observed by NuSTAR requires Compton-thick absorption if these objects have nominal underlying X-ray emission. However, a soft stacked effective photon index (Γeff ≈ 1.8) for this sample disfavors Compton-thick absorption in general. The uniform hard X-ray weakness observed by NuSTAR for this and the pilot samples selected with <10 keV weakness also suggests that the X-ray weakness is intrinsic in at least some of the targets. We conclude that the NuSTAR observations have likely discovered a significant population (gsim 33%) of intrinsically X-ray weak objects among the BAL quasars with significantly weak <10 keV emission. We suggest that intrinsically X-ray weak quasars might be preferentially observed as BAL quasars.

  6. Weak hard X-ray emission from broad absorption line quasars: evidence for intrinsic X-ray weakness

    SciTech Connect

    Luo, B.; Brandt, W. N.; Scott, A. E.; Alexander, D. M.; Gandhi, P.; Stern, D.; Teng, S. H.; Arévalo, P.; Bauer, F. E.; Boggs, S. E.; Craig, W. W.; Christensen, F. E.; Comastri, A.; Farrah, D.; Hailey, C. J.; Harrison, F. A.; Koss, M.; Ogle, P.; Puccetti, S.; Saez, C.; and others

    2014-10-10

    We report NuSTAR observations of a sample of six X-ray weak broad absorption line (BAL) quasars. These targets, at z = 0.148-1.223, are among the optically brightest and most luminous BAL quasars known at z < 1.3. However, their rest-frame ≈2 keV luminosities are 14 to >330 times weaker than expected for typical quasars. Our results from a pilot NuSTAR study of two low-redshift BAL quasars, a Chandra stacking analysis of a sample of high-redshift BAL quasars, and a NuSTAR spectral analysis of the local BAL quasar Mrk 231 have already suggested the existence of intrinsically X-ray weak BAL quasars, i.e., quasars not emitting X-rays at the level expected from their optical/UV emission. The aim of the current program is to extend the search for such extraordinary objects. Three of the six new targets are weakly detected by NuSTAR with ≲ 45 counts in the 3-24 keV band, and the other three are not detected. The hard X-ray (8-24 keV) weakness observed by NuSTAR requires Compton-thick absorption if these objects have nominal underlying X-ray emission. However, a soft stacked effective photon index (Γ{sub eff} ≈ 1.8) for this sample disfavors Compton-thick absorption in general. The uniform hard X-ray weakness observed by NuSTAR for this and the pilot samples selected with <10 keV weakness also suggests that the X-ray weakness is intrinsic in at least some of the targets. We conclude that the NuSTAR observations have likely discovered a significant population (≳ 33%) of intrinsically X-ray weak objects among the BAL quasars with significantly weak <10 keV emission. We suggest that intrinsically X-ray weak quasars might be preferentially observed as BAL quasars.

  7. Analysis of Strengths, Weaknesses, Opportunities, and Threats as a Tool for Translating Evidence into Individualized Medical Strategies (I-SWOT)

    PubMed Central

    von Kodolitsch, Yskert; Bernhardt, Alexander M.; Robinson, Peter N.; Kölbel, Tilo; Reichenspurner, Hermann; Debus, Sebastian; Detter, Christian

    2015-01-01

    Background It is the physicians’ task to translate evidence and guidelines into medical strategies for individual patients. Until today, however, there is no formal tool that is instrumental to perform this translation. Methods We introduce the analysis of strengths (S) and weaknesses (W) related to therapy with opportunities (O) and threats (T) related to individual patients as a tool to establish an individualized (I) medical strategy (I-SWOT). The I-SWOT matrix identifies four fundamental types of strategy. These comprise “SO” maximizing strengths and opportunities, “WT” minimizing weaknesses and threats, “WO” minimizing weaknesses and maximizing opportunities, and “ST” maximizing strengths and minimizing threats. Each distinct type of strategy may be considered for individualized medical strategies. Results We describe four steps of I-SWOT to establish an individualized medical strategy to treat aortic disease. In the first step, we define the goal of therapy and identify all evidence-based therapeutic options. In a second step, we assess strengths and weaknesses of each therapeutic option in a SW matrix form. In a third step, we assess opportunities and threats related to the individual patient, and in a final step, we use the I-SWOT matrix to establish an individualized medical strategy through matching “SW” with “OT”. As an example we present two 30-year-old patients with Marfan syndrome with identical medical history and aortic pathology. As a result of I-SWOT analysis of their individual opportunities and threats, we identified two distinct medical strategies in these patients. Conclusion I-SWOT is a formal but easy to use tool to translate medical evidence into individualized medical strategies. PMID:27069939

  8. Seismic evidence for a weak radial differential rotation in intermediate-mass core helium burning stars

    NASA Astrophysics Data System (ADS)

    Deheuvels, S.; Ballot, J.; Beck, P. G.; Mosser, B.; Østensen, R.; García, R. A.; Goupil, M. J.

    2015-08-01

    Context. The detection of mixed modes that are split by rotation in Kepler red giants has made it possible to probe the internal rotation profiles of these stars, which brings new constraints on the transport of angular momentum in stars. Rotation rates in the central regions of intermediate-mass core helium burning stars (secondary clump stars) have recently been measured. Aims: Our aim is to exploit the rotational splittings of mixed modes to estimate the amount of radial differential rotation in the interior of secondary clump stars using Kepler data in order to place constraints on angular momentum transport in intermediate-mass stars. Methods: We select a subsample of Kepler secondary clump stars with mixed modes that are clearly rotationally split. By applying a thorough statistical analysis, we show that the splittings of gravity-dominated modes (trapped in central regions) and of p-dominated modes (trapped in the envelope) can be measured. We then use these splittings to estimate the amount of differential rotation by using inversion techniques and by applying a simplified approach based on asymptotic theory. Results: We obtain evidence for a weak radial differential rotation for six of the seven targets that were selected, with the central regions rotating from 1.8 ± 0.3 to 3.2 ± 1.0 times faster than the envelope. The last target is found to be consistent with a solid-body rotation. Conclusions: This demonstrates that an efficient redistribution of angular momentum occurs after the end of the main sequence in the interior of intermediate-mass stars, either during the short-lived subgiant phase or once He-burning has started in the core. In either case, this should bring constraints on the angular momentum transport mechanisms that are at work.

  9. An analytic function approach to weak mutually unbiased bases

    NASA Astrophysics Data System (ADS)

    Olupitan, T.; Lei, C.; Vourdas, A.

    2016-08-01

    Quantum systems with variables in Z(d) are considered, and three different structures are studied. The first is weak mutually unbiased bases, for which the absolute value of the overlap of any two vectors in two different bases is 1 /√{ k } (where k | d) or 0. The second is maximal lines through the origin in the Z(d) × Z(d) phase space. The third is an analytic representation in the complex plane based on Theta functions, and their zeros. It is shown that there is a correspondence (triality) that links strongly these three apparently different structures. For simplicity, the case where d =p1 ×p2, where p1 ,p2 are odd prime numbers different from each other, is considered.

  10. Direct Evidence of the Transition from Weak to Strong Magnetohydrodynamic Turbulence

    NASA Astrophysics Data System (ADS)

    Meyrand, Romain; Galtier, Sébastien; Kiyani, Khurom H.

    2016-03-01

    One of the most important predictions in magnetohydrodynamics is that in the presence of a uniform magnetic field b0e^∥ a transition from weak to strong wave turbulence should occur when going from large to small perpendicular scales. This transition is believed to be a universal property of several anisotropic turbulent systems. We present, for the first time, direct evidence of such a transition using a decaying three-dimensional direct numerical simulation of incompressible balanced magnetohydrodynamic turbulence with a grid resolution of 30722×256 . From large to small scales, the change of regime is characterized by (i) a change of slope in the energy spectrum going from approximately -2 to -3 /2 , (ii) an increase of the ratio between the wave and nonlinear times, with a critical ratio of χc˜1 /3 , (iii) a modification of the isocontours of energy revealing a transition from a purely perpendicular cascade to a cascade compatible with the critical-balance-type phenomenology, and (iv) an absence followed by a dramatic increase of the communication between Alfvén modes. The changes happen at approximately the same transition scale and can be seen as manifest signatures of the transition from weak to strong wave turbulence. Furthermore, we observe a significant nonlocal three-wave coupling between strongly and weakly nonlinear modes resulting in an inverse transfer of energy from small to large scales.

  11. Direct Evidence of the Transition from Weak to Strong Magnetohydrodynamic Turbulence.

    PubMed

    Meyrand, Romain; Galtier, Sébastien; Kiyani, Khurom H

    2016-03-11

    One of the most important predictions in magnetohydrodynamics is that in the presence of a uniform magnetic field b_{0}e[over ^]_{∥} a transition from weak to strong wave turbulence should occur when going from large to small perpendicular scales. This transition is believed to be a universal property of several anisotropic turbulent systems. We present, for the first time, direct evidence of such a transition using a decaying three-dimensional direct numerical simulation of incompressible balanced magnetohydrodynamic turbulence with a grid resolution of 3072^{2}×256. From large to small scales, the change of regime is characterized by (i) a change of slope in the energy spectrum going from approximately -2 to -3/2, (ii) an increase of the ratio between the wave and nonlinear times, with a critical ratio of χ_{c}∼1/3, (iii) a modification of the isocontours of energy revealing a transition from a purely perpendicular cascade to a cascade compatible with the critical-balance-type phenomenology, and (iv) an absence followed by a dramatic increase of the communication between Alfvén modes. The changes happen at approximately the same transition scale and can be seen as manifest signatures of the transition from weak to strong wave turbulence. Furthermore, we observe a significant nonlocal three-wave coupling between strongly and weakly nonlinear modes resulting in an inverse transfer of energy from small to large scales. PMID:27015486

  12. Hidden link prediction based on node centrality and weak ties

    NASA Astrophysics Data System (ADS)

    Liu, Haifeng; Hu, Zheng; Haddadi, Hamed; Tian, Hui

    2013-01-01

    Link prediction has been widely used to extract missing information, identify spurious interactions, evaluate network evolving mechanisms, and so on. In this context, similarity-based algorithms have become the mainstream. However, most of them take into account the contributions of each common neighbor equally to the connection likelihood of two nodes. This paper proposes a model for link prediction, which is based on the node centrality of common neighbors. Three node centralities are discussed: degree, closeness and betweenness centrality. In our model, each common neighbor plays a different role to the node connection likelihood according to their centralities. Moreover, the weak-tie theory is considered for improving the prediction accuracy. Finally, extensive experiments on five real-world networks show that the proposed model can outperform the Common Neighbor (CN) algorithm and gives competitively good prediction of or even better than Adamic-Adar (AA) index and Resource Allocation (RA) index.

  13. Evidence-Based Language Practice

    ERIC Educational Resources Information Center

    Pollock, Eric J.

    2005-01-01

    The purpose of this paper was to examine evidence-based procedures in medicine and to demonstrate that the same protocols can be used in English language instruction. In the evidence-based methodology, studies are divided into those that address specific language problems. Integrated studies are presented as a systematic overview, meta-analysis,…

  14. Risk Assessment: Evidence Base

    NASA Technical Reports Server (NTRS)

    Johnson-Throop, Kathy A.

    2007-01-01

    Human systems PRA (Probabilistic Risk Assessment: a) Provides quantitative measures of probability, consequence, and uncertainty; and b) Communicates risk and informs decision-making. Human health risks rated highest in ISS PRA are based on 1997 assessment of clinical events in analog operational settings. Much work remains to analyze remaining human health risks identified in Bioastronautics Roadmap.

  15. Geomagnetic field behaviour preceding a Superchron: new evidence for a weak Devonian geomagnetic field

    NASA Astrophysics Data System (ADS)

    Hawkins, L.; Anwar, T.; Scherbakova, V.; Biggin, A. J.; Kravchinsky, V. A.; Shatsillo, A.; Holt, J.; Pavlov, V.

    2015-12-01

    The ~50 million year transition from the peak in reversal frequency in the Middle Jurassic (~170Ma), associated with a weak geomagnetic field, to the stable and apparently strong field during the Cretaceous Normal Superchron (84-121Ma), represents a dramatic change in time-averaged geomagnetic field behaviour during the Mesozoic Era. New evidence from Siberian samples suggests there is a similar transition in geomagnetic field behaviour during the Palaeozoic, with a weak geomagnetic field in the Upper Devonian preceding the Permo-Carboniferous Superchron (262-318Ma). Both sites, the Viluy Traps and the Zharovsk complex of the Patom Margin, have seemingly reliable, published palaeomagnetic directions and new age constraints, 364.4 ± 1.7Ma (40Ar/39A) 371-377Ma (U-Pb) respectively. The samples were measured using the Thermal Thellier-Coe protocol with partial thermo-remanent magnetisation (pTRM) and tail checks and the Microwave Thellier-IZZI protocol with pTRM checks. Accepted Arai plots show positive pTRM checks, a clear relation between distinct primary directional and palaeointensity components and little to no zig-zagging. Three distinct magneto-mineralogical types were identified from SEM and rock magnetic techniques; low Ti- and intermediate Ti- titanomagnetite and possible maghemite, with mineral type affecting the success rate of samples but resulting in no significant variation in palaeointensity results. The Arai plots also commonly have a distinct two-slope concave-up shape, although non-heating, pseudo-Thellier experiments have supported this resulting from a strong overprint component rather than alteration or multi-domain effects. Results from these experiments give low site mean values between 2.3-29.9μT (Virtual Dipole Moments 4-50.6 ZAm2). The apparently periodic (~180 million years) transitions in geomagnetic field behaviour may indicate the influence of mantle convection changing heat flow across the Core Mantle Boundary.

  16. Evidence-Based Management of Anticoagulant Therapy

    PubMed Central

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Rolfe, Gary

    1999-01-01

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

  18. Evidence-Based Chinese Medicine for Hypertension

    PubMed Central

    Wang, Jie; Xiong, Xingjiang

    2013-01-01

    Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go. PMID:23861720

  19. Evidence-based chinese medicine for hypertension.

    PubMed

    Wang, Jie; Xiong, Xingjiang

    2013-01-01

    Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go. PMID:23861720

  20. Indirect evidences for existence of exotic mesons in hadronic weak decays of K and charm mesons

    SciTech Connect

    Terasaki, K.

    1998-05-29

    It is demonstrated that hadronic weak decays of K and charm mesons are intimately related to hadron spectroscopy. Long standing puzzles in hadronic weak decays of charm mesons can be solved by taking account of dynamical contributions of various hadrons including non-qq-bar mesons.

  1. School Centered Evidence Based Accountability

    ERIC Educational Resources Information Center

    Milligan, Charles

    2015-01-01

    Achievement scores drive much of the effort in today's accountability system, however, there is much more that occurs in every school, every day. School Centered Evidence Based Accountability can be used from micro to macro giving School Boards and Administration a process for monitoring the results of the entire school operation effectively and…

  2. Evidence for weak magnetic fields in early-type emission stars

    NASA Astrophysics Data System (ADS)

    Hubrig, S.; Yudin, R. V.; Pogodin, M.; Schöller, M.; Peters, G. J.

    2007-12-01

    We report the results of our study of magnetic fields in a sample of 15 Be stars using spectropolarimetric data obtained at the European Southern Observatory with the multi-mode instrument FORS 1 installed at the 8 m Kueyen telescope. We detect weak photospheric magnetic fields in four stars, HD 56014, HD 148184, HD 155806, and HD 181615. We note that for HD 181615 the evolutionary status is not obvious due to the fact that it is a binary system currently observed in the initial rapid phase of mass exchange between the two components. Further, we notify the possible presence of distinct circular polarisation features in the circumstellar components of Ca II H&K in three stars, HD 58011, HD 117357, and HD 181615, hinting at a probable presence of magnetic fields in the circumstellar mass loss disks of these stars. We emphasize the need for future spectropolarimetric observations of Be stars with detected magnetic fields to study the temporal evolution of their magnetic fields and the correlation of magnetic field properties with dynamical phenomena taking place in the gaseous circumstellar disks of these stars. Based on observations collected at ESO, Paranal, Chile (ESO programmes Nos. 075.D-0507 and 077.D-0406).

  3. Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease.

    PubMed

    Hanquet, Germaine; Stefanoff, Pawel; Hellenbrand, Wiebke; Heuberger, Sigrid; Lopalco, Pierluigi; Stuart, James M

    2015-01-01

    The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low. PMID:26693485

  4. Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

    PubMed Central

    Hanquet, Germaine; Stefanoff, Pawel; Hellenbrand, Wiebke; Heuberger, Sigrid; Lopalco, Pierluigi; Stuart, James M.

    2015-01-01

    The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low. PMID:26693485

  5. Algorithm of weak edge detection based on the Nilpotent minimum fusion

    NASA Astrophysics Data System (ADS)

    Sun, Genyun; Zhang, Aizhu; Han, Xujun

    2011-11-01

    To overcome the shortcoming in traditional edge detection, such as the losing of weak edges and the too rough detected edges, a new edge detection method is proposed in this paper. The new algorithm is based on the Nilpotent minimum fusion. First of all, based on the space fuzzy relation of weak edges, the algorithm makes decision fusion to improve the structure of weak edges by using the Nilpotent minimum operator. Secondly, detect edges based on the fusion results. As a result, the weak edges are detected. Experiments on a variety of weak edge images show that the new algorithm can actually overcome the shortcoming in traditional edge detection, for the results are much better than traditional methods. On one hand, some of the weak edges of complex images, such as medical images, are detected. On the other hand, the edges detected by the new algorithm are thinner.

  6. Virtually-synchronous communication based on a weak failure suspector

    NASA Technical Reports Server (NTRS)

    Schiper, Andre; Ricciardi, Aleta

    1993-01-01

    Failure detectors (or, more accurately Failure Suspectors (FS)) appear to be a fundamental service upon which to build fault-tolerant, distributed applications. This paper shows that a FS with very weak semantics (i.e., that delivers failure and recovery information in no specific order) suffices to implement virtually-synchronous communication (VSC) in an asynchronous system subject to process crash failures and network partitions. The VSC paradigm is particularly useful in asynchronous systems and greatly simplifies building fault-tolerant applications that mask failures by replicating processes. We suggest a three-component architecture to implement virtually-synchronous communication: (1) at the lowest level, the FS component; (2) on top of it, a component (2a) that defines new views; and (3) a component (2b) that reliably multicasts messages within a view. The issues covered in this paper also lead to a better understanding of the various membership service semantics proposed in recent literature.

  7. Evidence-Based Practice and School Nursing

    ERIC Educational Resources Information Center

    Adams, Susan; McCarthy, Ann Marie

    2005-01-01

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

  8. Hemispheric Differences in Strong versus Weak Semantic Priming: Evidence from Event-Related Brain Potentials

    ERIC Educational Resources Information Center

    Frishkoff, Gwen A.

    2007-01-01

    Goals: Research with lateralized word presentation has suggested that strong ("close") and weak ("remote") semantic associates are processed differently in the left and right cerebral hemispheres [e.g., Beeman, M. j., & Chiarello, C. (1998). Complementary right- and left-hemisphere language comprehension. "Current Directions in Psychological…

  9. Evidence for a weakly stratified Europan ocean sustained by seafloor heat flux

    NASA Astrophysics Data System (ADS)

    Thomson, Richard E.; Delaney, John R.

    2001-06-01

    We interpret chaos-type features on the surface of Europa as melt-through structures formed by rotationally confined, steady and/or episodic oceanic plumes that rise to the base of the ice shell from magmatically heated regions of the seafloor. Smaller lenticular features in the vicinity of chaos-type regions might be formed by baroclinically unstable vortices that spin off the main convective plume or by persistent heating from localized hydrothermal venting sites. The ocean is assumed to be weakly stratified because of turbulent convection generated by heating from below and cooling from above. Seafloor heating, maintained by tidal dissipation in the rocky interior, generates an estimated global heat flux of 8.7×1012W and limits the mean ice thickness to 2-5 km. For seafloor heat sources with radii r that are less than the ocean's deformation radius, rD=ND/|f| (N is the Brunt-Väisälä frequency, D is the water depth, and f is the Coriolis parameter), the diameters of chaos-type regions are expected to diminish from O(100km) within equatorial regions to O(10km) at high latitudes (assuming spatially uniform water depth and density structure). Where r>rD, the scale of the source region determines the scale of the melt-through features. Provided there is sufficient time before refreezing, ice rafts in large melt-through regions are imbedded in episodes of preferentially anticyclonic circulation, corresponding to clockwise (counterclockwise) motions in the northern (southern) hemisphere. We calculate that 1021J were required to melt the ice in the ~100 km diameter Conamara Chaos region and that for a steady, localized heat flux F~1011W (~1% of the global heat flux) it took ~1000 years for the initial melt-through to occur. Assuming that ice raft displacements in Conamara Chaos occurred during a major melt-through event, maximum current speeds in the region were O(10cms-1), and refreezing occurred within ~20 hours. A lack of well-defined ice drift in other major

  10. Systematic Reviews and Meta-Analyses - Literature-based Recommendations for Evaluating Strengths, Weaknesses, and Clinical Value.

    PubMed

    Beitz, Janice M; Bolton, Laura L

    2015-11-01

    Good quality systematic reviews (SRs) summarizing best available evidence can help inform clinical decisions, improv- ing patient and wound outcomes. Weak SRs can misinform readers, undermining care decisions and evidence-based practice. To examine the strengths and weaknesses of SRs and meta-analyses and the role of SRs in contemporary evidence-based wound care practice, and using the search terms systematic review, meta-analysis, and evidence-based practice, the authors searched Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for important terminology and recommendations to help clinicians evaluate SRs with meta-analysis. Reputable websites, recent textbooks, and synthesized available literature also were reviewed to describe and summarize SR strengths and weaknesses. After developing a checklist for critically evaluating SR objectives, inclusion/exclusion criteria, study quality, data extraction and synthesis methods, meta-analysis homogeneity, accuracy of results, interpretation, and consistency between significant findings and abstract or conclusions, the checklist was applied to topical wound care SRs identified in Cochrane and MEDLINE searches. Best available evidence included in the SRs from 169 randomized controlled trials on 11,571 patients supporting topical intervention healing effects on burns, surgical sites, and diabetic, venous, or pressure ulcers was summarized and showed SRs and clinical trials can demonstrate different outcomes because the information/data are compiled differently. The results illustrate how evidence insufficient to support firm conclusions may still meet immediate needs to guide carefully considered clinical wound and patient care decisions while encouraging better future science. PMID:26544016

  11. ATLAS diboson excesses as an evidence for a heavy WW resonance with the weak isospin 2

    NASA Astrophysics Data System (ADS)

    Arbuzov, Boris A.; Zaitsev, Ivan V.

    2015-12-01

    Recently reported diboson excesses at LHC are interpreted as indications for heavy resonance with weak isospin 2 due to would-be anomalous interaction of the weak bosons, which is defined by a constant λ. In the framework of an approach to the spontaneous generation of such interaction, we obtain estimates for the effect, which qualitatively agrees with ATLAS data. Effects are predicted in inclusive production of W+W+, W+(Z,γ), W+W-, (Z,γ)(Z,γ), W-(Z,γ), W-W- resonances in the vicinity of MR ≃ 2TeV, which could be reliably checked at the upgraded LHC with s = 13TeV.

  12. CCO Pulsars as Anti-Magnetars: Evidence of Neutron Stars Weakly Magnetized at Birth

    NASA Astrophysics Data System (ADS)

    Gotthelf, E. V.; Halpern, J. P.

    2008-02-01

    Our new study of the two central compact object pulsars, PSR J1210-5226 (P = 424 ms) and PSR J1852+0040 (P = 105 ms), leads us to conclude that a weak natal magnetic field shaped their unique observational properties. In the dipole spin-down formalism, the 2-sigma upper limits on their period derivatives, <2×10-16 for both pulsars, implies surface magnetic field strengths of Bs<3×1011 G and spin periods at birth equal to their present periods to three significant digits. Their X-ray luminosities exceed their respective spin-down luminosities, implying that their thermal spectra are derived from residual cooling and perhaps partly from accretion of supernova debris. For sufficiently weak magnetic fields an accretion disk can penetrate the light cylinder and interact with the magnetosphere while resulting torques on the neutron star remain within the observed limits. We propose the following as the origin of radio-quiet CCOs: the magnetic field, derived from a turbulent dynamo, is weaker if the NS is formed spinning slowly, which enables it to accrete SN debris. Accretion excludes neutron stars born with both Bs<1011 G and P>0.1 s from radio pulsar surveys, where such weak fields are not encountered except among very old (>40 Myr) or recycled pulsars. We predict that these birth properties are common, and may be attributes of the youngest detected neutron star, the CCO in Cassiopeia A, as well as an undetected infant neutron star in the SN 1987A remnant. In view of the far-infrared light echo discovered around Cas A and attributed to an SGR-like outburst, it is especially important to determine via timing whether Cas A hosts a magnetar or not. If not a magnetar, the Cas A NS may instead have undergone a one-time phase transition (corequake) that powered the light echo.

  13. Evidence-based Science Communication

    NASA Astrophysics Data System (ADS)

    Kahan, D.

    2012-12-01

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

  14. The evidence-based paradox.

    PubMed

    Hinojosa, Jim

    2013-01-01

    Many occupational therapy practitioners consider evidence-based practice (EBP) to be the means by which occupational therapy can prove the validity of its services and thus support the legitimacy of our profession. The unquestioned acceptance of EBP as the way to establish credibility concerns me; unchallenged acceptance of any idea concerns me. Do practitioners accept EBP as the paradigm for guiding occupational therapy practice and research solely because it is presented as what we must do? I believe that practitioners must examine the implications for our profession of accepting EBP without question. In this article, I review EBP, present criticisms and concerns voiced by other professions and, finally, examine the implications of adopting an EBP perspective that replaces theory-directed practice. PMID:23433283

  15. Weak Hard X-ray Emission from Broad Absorption Line Quasars Observed with NuSTAR: Evidence for Intrinsic X-ray Weakness

    NASA Astrophysics Data System (ADS)

    Luo, Bin; Brandt, W. Niel; Alexander, David M; Stern, Daniel; Teng, Stacy H.; Arevalo, Patricia; Bauer, Franz E.; Boggs, Steven E.; Christensen, Finn; Comastri, Andrea; Craig, William W.; Farrah, Duncan; Gandhi, Poshak; Hailey, Charles James; Harrison, Fiona; Koss, Michael; Ogle, Patrick M.; Puccetti, Simonetta; Saez, Cristian; Scott, Amy; Walton, Dom; Zhang, William

    2014-08-01

    We report NuSTAR observations of a sample of six X-ray weak broad absorption line (BAL) quasars. These targets, at z=0.148-1.223, are among the optically brightest and most luminous BAL quasars known at z<1.3. However, their rest-frame 2 keV luminosities are 14 to >330 times weaker than expected for typical quasars. Our results from a pilot NuSTAR study of two low-redshift BAL quasars, a Chandra stacking analysis of a sample of high-redshift BAL quasars, and a NuSTAR spectral analysis of the local BAL quasar Mrk 231 have already suggested the existence of intrinsically X-ray weak BAL quasars, i.e., quasars not emitting X-rays at the level expected from their optical/UV emission. The aim of the current program is to extend the search for such extraordinary objects. Three of the six new targets are weakly detected by NuSTAR with <45 counts in the 3-24 keV band, and the other three are not detected. The hard X-ray (8-24 keV) weakness observed by NuSTAR requires Compton-thick absorption if these objects have nominal underlying X-ray emission. However, a soft stacked effective photon index (Γ 1.8) for this sample disfavors Compton-thick absorption in general. The uniform hard X-ray weakness observed by NuSTAR for this and the pilot samples selected with <10 keV weakness also suggests that the X-ray weakness is intrinsic in at least some of the targets. We conclude that the NuSTAR observations have likely discovered a significant population (>33%) of intrinsically X-ray weak objects among the BAL quasars with significantly weak <10 keV emission. We suggest that intrinsically X-ray weak quasars might be preferentially observed as BAL quasars.

  16. Experimental Evidence of Weak Excluded Volume Effects for Nanochannel Confined DNA

    NASA Astrophysics Data System (ADS)

    Gupta, Damini; Miller, Jeremy J.; Muralidhar, Abhiram; Mahshid, Sara; Reisner, Walter; Dorfman, Kevin D.

    In the classical de Gennes picture of weak polymer nanochannel confinement, the polymer contour is envisioned as divided into a series of isometric blobs. Strong excluded volume interactions are present both within a blob and between blobs. In contrast, for semiflexible polymers like DNA, excluded volume interactions are of borderline strength within a blob but appreciable between blobs, giving rise to a chain description consisting of a string of anisometric blobs. We present experimental validation of this subtle effect of excluded volume for DNA nanochannel confinement by performing measurements of variance in chain extension of T4 DNA molecules as a function of effective nanochannel size (305-453 nm). Additionally, we show an approach to systematically reduce the effect of molecular weight dispersity of DNA samples, a typical experimental artifact, by combining confinement spectroscopy with simulations.

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

    PubMed

    Oh, Eui Geum

    2016-06-01

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

  18. Evidence-Based Integrative Dermatology

    PubMed Central

    Narahari, Saravu R; Prasanna, Kodimoole S; Sushma, Kandathu V

    2013-01-01

    American recognition for medical pluralism arrived in 1991. The National Center for Complementary and Alternative Medicine was established under the National Institutes of Health in 1998. Following this, patients and researchers began exploring use of integrative medicine. Terence Ryan with Gerry Bodeker in Europe, Brian Berman in America, and the Indian council of Medical Research advocated traditional medicine and integrative medicine. The Institute of Applied Dermatology (IAD), Kerala has developed integrated allopathic (biomedical) and ayurvedic therapies to treat Lymphatic Filariasis, Lichen planus, and Vitiligo. Studies conducted at the IAD have created a framework for evidence-based and integrative dermatology (ID). This paper gives an overview of advances in ID with an example of Lichen Planus, which was examined jointly by dermatologists and Ayurveda doctors. The clinical presentation in these patients was listed in a vikruthi table of comparable biomedical terms. A vikruthi table was used for drug selection in ayurvedic dermatology. A total of 19 patients were treated with ayurvedic prescriptions to normalize the vatha-kapha for 3 months. All patients responded and no side effects were recorded. In spite of advancing knowledge on ID, several challenges remain for its use on difficult to treat chronic skin diseases. The formation of new integrative groups and financial support are essential for the growth of ID in India. PMID:23716802

  19. The Acid-Base Titration of a Very Weak Acid: Boric Acid

    ERIC Educational Resources Information Center

    Celeste, M.; Azevedo, C.; Cavaleiro, Ana M. V.

    2012-01-01

    A laboratory experiment based on the titration of boric acid with strong base in the presence of d-mannitol is described. Boric acid is a very weak acid and direct titration with NaOH is not possible. An auxiliary reagent that contributes to the release of protons in a known stoichiometry facilitates the acid-base titration. Students obtain the…

  20. Evidence for the Strangeness-Changing Weak Decay Ξb-→Λb0π-

    NASA Astrophysics Data System (ADS)

    Aaij, R.; Abellán Beteta, C.; Adeva, B.; Adinolfi, M.; Affolder, A.; Ajaltouni, Z.; Akar, S.; Albrecht, J.; Alessio, F.; Alexander, M.; Ali, S.; Alkhazov, G.; Alvarez Cartelle, P.; Alves, A. A.; Amato, S.; Amerio, S.; Amhis, Y.; An, L.; Anderlini, L.; Anderson, J.; Andreassi, G.; Andreotti, M.; Andrews, J. E.; Appleby, R. B.; Aquines Gutierrez, O.; Archilli, F.; d'Argent, P.; Artamonov, A.; Artuso, M.; Aslanides, E.; Auriemma, G.; Baalouch, M.; Bachmann, S.; Back, J. J.; Badalov, A.; Baesso, C.; Baldini, W.; Barlow, R. J.; Barschel, C.; Barsuk, S.; Barter, W.; Batozskaya, V.; Battista, V.; Bay, A.; Beaucourt, L.; Beddow, J.; Bedeschi, F.; Bediaga, I.; Bel, L. J.; Bellee, V.; Belloli, N.; Belyaev, I.; Ben-Haim, E.; Bencivenni, G.; Benson, S.; Benton, J.; Berezhnoy, A.; Bernet, R.; Bertolin, A.; Bettler, M.-O.; van Beuzekom, M.; Bien, A.; Bifani, S.; Billoir, P.; Bird, T.; Birnkraut, A.; Bizzeti, A.; Blake, T.; Blanc, F.; Blouw, J.; Blusk, S.; Bocci, V.; Bondar, A.; Bondar, N.; Bonivento, W.; Borghi, S.; Borisyak, M.; Borsato, M.; Bowcock, T. J. V.; Bowen, E.; Bozzi, C.; Braun, S.; Britsch, M.; Britton, T.; Brodzicka, J.; Brook, N. H.; Buchanan, E.; Burr, C.; Bursche, A.; Buytaert, J.; Cadeddu, S.; Calabrese, R.; Calvi, M.; Calvo Gomez, M.; Campana, P.; Campora Perez, D.; Capriotti, L.; Carbone, A.; Carboni, G.; Cardinale, R.; Cardini, A.; Carniti, P.; Carson, L.; Carvalho Akiba, K.; Casse, G.; Cassina, L.; Castillo Garcia, L.; Cattaneo, M.; Cauet, Ch.; Cavallero, G.; Cenci, R.; Charles, M.; Charpentier, Ph.; Chefdeville, M.; Chen, S.; Cheung, S.-F.; Chiapolini, N.; Chrzaszcz, M.; Cid Vidal, X.; Ciezarek, G.; Clarke, P. E. L.; Clemencic, M.; Cliff, H. V.; Closier, J.; Coco, V.; Cogan, J.; Cogneras, E.; Cogoni, V.; Cojocariu, L.; Collazuol, G.; Collins, P.; Comerma-Montells, A.; Contu, A.; Cook, A.; Coombes, M.; Coquereau, S.; Corti, G.; Corvo, M.; Couturier, B.; Cowan, G. A.; Craik, D. C.; Crocombe, A.; Cruz Torres, M.; Cunliffe, S.; Currie, R.; D'Ambrosio, C.; Dall'Occo, E.; Dalseno, J.; David, P. N. Y.; Davis, A.; De Aguiar Francisco, O.; De Bruyn, K.; De Capua, S.; De Cian, M.; De Miranda, J. M.; De Paula, L.; De Simone, P.; Dean, C.-T.; Decamp, D.; Deckenhoff, M.; Del Buono, L.; Déléage, N.; Demmer, M.; Derkach, D.; Deschamps, O.; Dettori, F.; Dey, B.; Di Canto, A.; Di Ruscio, F.; Dijkstra, H.; Donleavy, S.; Dordei, F.; Dorigo, M.; Dosil Suárez, A.; Dossett, D.; Dovbnya, A.; Dreimanis, K.; Dufour, L.; Dujany, G.; Durante, P.; Dzhelyadin, R.; Dziurda, A.; Dzyuba, A.; Easo, S.; Egede, U.; Egorychev, V.; Eidelman, S.; Eisenhardt, S.; Eitschberger, U.; Ekelhof, R.; Eklund, L.; El Rifai, I.; Elsasser, Ch.; Ely, S.; Esen, S.; Evans, H. M.; Evans, T.; Falabella, A.; Färber, C.; Farley, N.; Farry, S.; Fay, R.; Ferguson, D.; Fernandez Albor, V.; Ferrari, F.; Ferreira Rodrigues, F.; Ferro-Luzzi, M.; Filippov, S.; Fiore, M.; Fiorini, M.; Firlej, M.; Fitzpatrick, C.; Fiutowski, T.; Fohl, K.; Fol, P.; Fontana, M.; Fontanelli, F.; Forshaw, D. C.; Forty, R.; Frank, M.; Frei, C.; Frosini, M.; Fu, J.; Furfaro, E.; Gallas Torreira, A.; Galli, D.; Gallorini, S.; Gambetta, S.; Gandelman, M.; Gandini, P.; Gao, Y.; García Pardiñas, J.; Garra Tico, J.; Garrido, L.; Gascon, D.; Gaspar, C.; Gauld, R.; Gavardi, L.; Gazzoni, G.; Gerick, D.; Gersabeck, E.; Gersabeck, M.; Gershon, T.; Ghez, Ph.; Gianı, S.; Gibson, V.; Girard, O. G.; Giubega, L.; Gligorov, V. V.; Göbel, C.; Golubkov, D.; Golutvin, A.; Gomes, A.; Gotti, C.; Grabalosa Gándara, M.; Graciani Diaz, R.; Granado Cardoso, L. A.; Graugés, E.; Graverini, E.; Graziani, G.; Grecu, A.; Greening, E.; Gregson, S.; Griffith, P.; Grillo, L.; Grünberg, O.; Gui, B.; Gushchin, E.; Guz, Yu.; Gys, T.; Hadavizadeh, T.; Hadjivasiliou, C.; Haefeli, G.; Haen, C.; Haines, S. C.; Hall, S.; Hamilton, B.; Han, X.; Hansmann-Menzemer, S.; Harnew, N.; Harnew, S. T.; Harrison, J.; He, J.; Head, T.; Heijne, V.; Hennessy, K.; Henrard, P.; Henry, L.; van Herwijnen, E.; Heß, M.; Hicheur, A.; Hill, D.; Hoballah, M.; Hombach, C.; Hulsbergen, W.; Humair, T.; Hussain, N.; Hutchcroft, D.; Hynds, D.; Idzik, M.; Ilten, P.; Jacobsson, R.; Jaeger, A.; Jalocha, J.; Jans, E.; Jawahery, A.; John, M.; Johnson, D.; Jones, C. R.; Joram, C.; Jost, B.; Jurik, N.; Kandybei, S.; Kanso, W.; Karacson, M.; Karbach, T. M.; Karodia, S.; Kecke, M.; Kelsey, M.; Kenyon, I. R.; Kenzie, M.; Ketel, T.; Khairullin, E.; Khanji, B.; Khurewathanakul, C.; Klaver, S.; Klimaszewski, K.; Kochebina, O.; Kolpin, M.; Komarov, I.; Koopman, R. F.; Koppenburg, P.; Kozeiha, M.; Kravchuk, L.; Kreplin, K.; Kreps, M.; Krocker, G.; Krokovny, P.; Kruse, F.; Krzemien, W.; Kucewicz, W.; Kucharczyk, M.; Kudryavtsev, V.; Kuonen, A. K.; Kurek, K.; Kvaratskheliya, T.; Lacarrere, D.; Lafferty, G.; Lai, A.; Lambert, D.; Lanfranchi, G.; Langenbruch, C.; Langhans, B.; Latham, T.; Lazzeroni, C.; Le Gac, R.; van Leerdam, J.; Lees, J.-P.; Lefèvre, R.; Leflat, A.; Lefrançois, J.; Lemos Cid, E.; Leroy, O.; Lesiak, T.; Leverington, B.; Li, Y.; Likhomanenko, T.; Liles, M.; Lindner, R.; Linn, C.; Lionetto, F.; Liu, B.; Liu, X.; Loh, D.; Longstaff, I.; Lopes, J. H.; Lucchesi, D.; Lucio Martinez, M.; Luo, H.; Lupato, A.; Luppi, E.; Lupton, O.; Lusiani, A.; Machefert, F.; Maciuc, F.; Maev, O.; Maguire, K.; Malde, S.; Malinin, A.; Manca, G.; Mancinelli, G.; Manning, P.; Mapelli, A.; Maratas, J.; Marchand, J. F.; Marconi, U.; Marin Benito, C.; Marino, P.; Marks, J.; Martellotti, G.; Martin, M.; Martinelli, M.; Martinez Santos, D.; Martinez Vidal, F.; Martins Tostes, D.; Massafferri, A.; Matev, R.; Mathad, A.; Mathe, Z.; Matteuzzi, C.; Mauri, A.; Maurin, B.; Mazurov, A.; McCann, M.; McCarthy, J.; McNab, A.; McNulty, R.; Meadows, B.; Meier, F.; Meissner, M.; Melnychuk, D.; Merk, M.; Michielin, E.; Milanes, D. A.; Minard, M.-N.; Mitzel, D. S.; Molina Rodriguez, J.; Monroy, I. A.; Monteil, S.; Morandin, M.; Morawski, P.; Mordà, A.; Morello, M. J.; Moron, J.; Morris, A. B.; Mountain, R.; Muheim, F.; Müller, D.; Müller, J.; Müller, K.; Müller, V.; Mussini, M.; Muster, B.; Naik, P.; Nakada, T.; Nandakumar, R.; Nandi, A.; Nasteva, I.; Needham, M.; Neri, N.; Neubert, S.; Neufeld, N.; Neuner, M.; Nguyen, A. D.; Nguyen, T. D.; Nguyen-Mau, C.; Niess, V.; Niet, R.; Nikitin, N.; Nikodem, T.; Novoselov, A.; O'Hanlon, D. P.; Oblakowska-Mucha, A.; Obraztsov, V.; Ogilvy, S.; Okhrimenko, O.; Oldeman, R.; Onderwater, C. J. G.; Osorio Rodrigues, B.; Otalora Goicochea, J. M.; Otto, A.; Owen, P.; Oyanguren, A.; Palano, A.; Palombo, F.; Palutan, M.; Panman, J.; Papanestis, A.; Pappagallo, M.; Pappalardo, L. L.; Pappenheimer, C.; Parker, W.; Parkes, C.; Passaleva, G.; Patel, G. D.; Patel, M.; Patrignani, C.; Pearce, A.; Pellegrino, A.; Penso, G.; Pepe Altarelli, M.; Perazzini, S.; Perret, P.; Pescatore, L.; Petridis, K.; Petrolini, A.; Petruzzo, M.; Picatoste Olloqui, E.; Pietrzyk, B.; Pilař, T.; Pinci, D.; Pistone, A.; Piucci, A.; Playfer, S.; Plo Casasus, M.; Poikela, T.; Polci, F.; Poluektov, A.; Polyakov, I.; Polycarpo, E.; Popov, A.; Popov, D.; Popovici, B.; Potterat, C.; Price, E.; Price, J. D.; Prisciandaro, J.; Pritchard, A.; Prouve, C.; Pugatch, V.; Puig Navarro, A.; Punzi, G.; Qian, W.; Quagliani, R.; Rachwal, B.; Rademacker, J. H.; Rama, M.; Ramos Pernas, M.; Rangel, M. S.; Raniuk, I.; Rauschmayr, N.; Raven, G.; Redi, F.; Reichert, S.; Reid, M. M.; dos Reis, A. C.; Ricciardi, S.; Richards, S.; Rihl, M.; Rinnert, K.; Rives Molina, V.; Robbe, P.; Rodrigues, A. B.; Rodrigues, E.; Rodriguez Lopez, J. A.; Rodriguez Perez, P.; Roiser, S.; Romanovsky, V.; Romero Vidal, A.; Ronayne, J. W.; Rotondo, M.; Ruf, T.; Ruiz Valls, P.; Saborido Silva, J. J.; Sagidova, N.; Sail, P.; Saitta, B.; Salustino Guimaraes, V.; Sanchez Mayordomo, C.; Sanmartin Sedes, B.; Santacesaria, R.; Santamarina Rios, C.; Santimaria, M.; Santovetti, E.; Sarti, A.; Satriano, C.; Satta, A.; Saunders, D. M.; Savrina, D.; Schiller, M.; Schindler, H.; Schlupp, M.; Schmelling, M.; Schmelzer, T.; Schmidt, B.; Schneider, O.; Schopper, A.; Schubiger, M.; Schune, M.-H.; Schwemmer, R.; Sciascia, B.; Sciubba, A.; Semennikov, A.; Serra, N.; Serrano, J.; Sestini, L.; Seyfert, P.; Shapkin, M.; Shapoval, I.; Shcheglov, Y.; Shears, T.; Shekhtman, L.; Shevchenko, V.; Shires, A.; Siddi, B. G.; Silva Coutinho, R.; Silva de Oliveira, L.; Simi, G.; Sirendi, M.; Skidmore, N.; Skwarnicki, T.; Smith, E.; Smith, E.; Smith, I. T.; Smith, J.; Smith, M.; Snoek, H.; Sokoloff, M. D.; Soler, F. J. P.; Soomro, F.; Souza, D.; Souza De Paula, B.; Spaan, B.; Spradlin, P.; Sridharan, S.; Stagni, F.; Stahl, M.; Stahl, S.; Stefkova, S.; Steinkamp, O.; Stenyakin, O.; Stevenson, S.; Stoica, S.; Stone, S.; Storaci, B.; Stracka, S.; Straticiuc, M.; Straumann, U.; Sun, L.; Sutcliffe, W.; Swientek, K.; Swientek, S.; Syropoulos, V.; Szczekowski, M.; Szumlak, T.; T'Jampens, S.; Tayduganov, A.; Tekampe, T.; Teklishyn, M.; Tellarini, G.; Teubert, F.; Thomas, C.; Thomas, E.; van Tilburg, J.; Tisserand, V.; Tobin, M.; Todd, J.; Tolk, S.; Tomassetti, L.; Tonelli, D.; Topp-Joergensen, S.; Torr, N.; Tournefier, E.; Tourneur, S.; Trabelsi, K.; Tran, M. T.; Tresch, M.; Trisovic, A.; Tsaregorodtsev, A.; Tsopelas, P.; Tuning, N.; Ukleja, A.; Ustyuzhanin, A.; Uwer, U.; Vacca, C.; Vagnoni, V.; Valenti, G.; Vallier, A.; Vazquez Gomez, R.; Vazquez Regueiro, P.; Vázquez Sierra, C.; Vecchi, S.; Velthuis, J. J.; Veltri, M.; Veneziano, G.; Vesterinen, M.; Viaud, B.; Vieira, D.; Vieites Diaz, M.; Vilasis-Cardona, X.; Volkov, V.; Vollhardt, A.; Volyanskyy, D.; Voong, D.; Vorobyev, A.; Vorobyev, V.; Voß, C.; de Vries, J. A.; Waldi, R.; Wallace, C.; Wallace, R.; Walsh, J.; Wandernoth, S.; Wang, J.; Ward, D. R.; Watson, N. K.; Websdale, D.; Weiden, A.; Whitehead, M.; Wilkinson, G.; Wilkinson, M.; Williams, M.; Williams, M. P.; Williams, M.; Williams, T.; Wilson, F. F.; Wimberley, J.; Wishahi, J.; Wislicki, W.; Witek, M.; Wormser, G.; Wotton, S. A.; Wright, S.; Wyllie, K.; Xie, Y.; Xu, Z.; Yang, Z.; Yu, J.; Yuan, X.; Yushchenko, O.; Zangoli, M.; Zavertyaev, M.; Zhang, L.; Zhang, Y.; Zhelezov, A.; Zhokhov, A.; Zhong, L.; Zucchelli, S.; LHCb Collaboration

    2015-12-01

    Using a p p collision data sample corresponding to an integrated luminosity of 3.0 fb-1 , collected by the LHCb detector, we present the first search for the strangeness-changing weak decay Ξb-→Λb0π-. No b hadron decay of this type has been seen before. A signal for this decay, corresponding to a significance of 3.2 standard deviations, is reported. The relative rate is measured to be f/Ξb- fΛb0 B (Ξb-→Λb0π-)=(5.7 ±1. 8-0.9+0.8)×10-4, where fΞb- and fΛb0 are the b →Ξb- and b →Λb0 fragmentation fractions, and B (Ξb-→Λb0π-) is the branching fraction. Assuming fΞb-/fΛb0 is bounded between 0.1 and 0.3, the branching fraction B (Ξb-→Λb0π-) would lie in the range from (0.57 ±0.21 )% to (0.19 ±0.07 )%.

  1. Evidence for the Strangeness-Changing Weak Decay Ξ_{b}^{-}→Λ_{b}^{0}π^{-}.

    PubMed

    Aaij, R; Abellán Beteta, C; Adeva, B; Adinolfi, M; Affolder, A; Ajaltouni, Z; Akar, S; Albrecht, J; Alessio, F; Alexander, M; Ali, S; Alkhazov, G; Alvarez Cartelle, P; Alves, A A; Amato, S; Amerio, S; Amhis, Y; An, L; Anderlini, L; Anderson, J; Andreassi, G; Andreotti, M; Andrews, J E; Appleby, R B; Aquines Gutierrez, O; Archilli, F; d'Argent, P; Artamonov, A; Artuso, M; Aslanides, E; Auriemma, G; Baalouch, M; Bachmann, S; Back, J J; Badalov, A; Baesso, C; Baldini, W; Barlow, R J; Barschel, C; Barsuk, S; Barter, W; Batozskaya, V; Battista, V; Bay, A; Beaucourt, L; Beddow, J; Bedeschi, F; Bediaga, I; Bel, L J; Bellee, V; Belloli, N; Belyaev, I; Ben-Haim, E; Bencivenni, G; Benson, S; Benton, J; Berezhnoy, A; Bernet, R; Bertolin, A; Bettler, M-O; van Beuzekom, M; Bien, A; Bifani, S; Billoir, P; Bird, T; Birnkraut, A; Bizzeti, A; Blake, T; Blanc, F; Blouw, J; Blusk, S; Bocci, V; Bondar, A; Bondar, N; Bonivento, W; Borghi, S; Borisyak, M; Borsato, M; Bowcock, T J V; Bowen, E; Bozzi, C; Braun, S; Britsch, M; Britton, T; Brodzicka, J; Brook, N H; Buchanan, E; Burr, C; Bursche, A; Buytaert, J; Cadeddu, S; Calabrese, R; Calvi, M; Calvo Gomez, M; Campana, P; Campora Perez, D; Capriotti, L; Carbone, A; Carboni, G; Cardinale, R; Cardini, A; Carniti, P; Carson, L; Carvalho Akiba, K; Casse, G; Cassina, L; Castillo Garcia, L; Cattaneo, M; Cauet, Ch; Cavallero, G; Cenci, R; Charles, M; Charpentier, Ph; Chefdeville, M; Chen, S; Cheung, S-F; Chiapolini, N; Chrzaszcz, M; Cid Vidal, X; Ciezarek, G; Clarke, P E L; Clemencic, M; Cliff, H V; Closier, J; Coco, V; Cogan, J; Cogneras, E; Cogoni, V; Cojocariu, L; Collazuol, G; Collins, P; Comerma-Montells, A; Contu, A; Cook, A; Coombes, M; Coquereau, S; Corti, G; Corvo, M; Couturier, B; Cowan, G A; Craik, D C; Crocombe, A; Cruz Torres, M; Cunliffe, S; Currie, R; D'Ambrosio, C; Dall'Occo, E; Dalseno, J; David, P N Y; Davis, A; De Aguiar Francisco, O; De Bruyn, K; De Capua, S; De Cian, M; De Miranda, J M; De Paula, L; De Simone, P; Dean, C-T; Decamp, D; Deckenhoff, M; Del Buono, L; Déléage, N; Demmer, M; Derkach, D; Deschamps, O; Dettori, F; Dey, B; Di Canto, A; Di Ruscio, F; Dijkstra, H; Donleavy, S; Dordei, F; Dorigo, M; Dosil Suárez, A; Dossett, D; Dovbnya, A; Dreimanis, K; Dufour, L; Dujany, G; Durante, P; Dzhelyadin, R; Dziurda, A; Dzyuba, A; Easo, S; Egede, U; Egorychev, V; Eidelman, S; Eisenhardt, S; Eitschberger, U; Ekelhof, R; Eklund, L; El Rifai, I; Elsasser, Ch; Ely, S; Esen, S; Evans, H M; Evans, T; Falabella, A; Färber, C; Farley, N; Farry, S; Fay, R; Ferguson, D; Fernandez Albor, V; Ferrari, F; Ferreira Rodrigues, F; Ferro-Luzzi, M; Filippov, S; Fiore, M; Fiorini, M; Firlej, M; Fitzpatrick, C; Fiutowski, T; Fohl, K; Fol, P; Fontana, M; Fontanelli, F; Forshaw, D C; Forty, R; Frank, M; Frei, C; Frosini, M; Fu, J; Furfaro, E; Gallas Torreira, A; Galli, D; Gallorini, S; Gambetta, S; Gandelman, M; Gandini, P; Gao, Y; García Pardiñas, J; Garra Tico, J; Garrido, L; Gascon, D; Gaspar, C; Gauld, R; Gavardi, L; Gazzoni, G; Gerick, D; Gersabeck, E; Gersabeck, M; Gershon, T; Ghez, Ph; Gianì, S; Gibson, V; Girard, O G; Giubega, L; Gligorov, V V; Göbel, C; Golubkov, D; Golutvin, A; Gomes, A; Gotti, C; Grabalosa Gándara, M; Graciani Diaz, R; Granado Cardoso, L A; Graugés, E; Graverini, E; Graziani, G; Grecu, A; Greening, E; Gregson, S; Griffith, P; Grillo, L; Grünberg, O; Gui, B; Gushchin, E; Guz, Yu; Gys, T; Hadavizadeh, T; Hadjivasiliou, C; Haefeli, G; Haen, C; Haines, S C; Hall, S; Hamilton, B; Han, X; Hansmann-Menzemer, S; Harnew, N; Harnew, S T; Harrison, J; He, J; Head, T; Heijne, V; Hennessy, K; Henrard, P; Henry, L; van Herwijnen, E; Heß, M; Hicheur, A; Hill, D; Hoballah, M; Hombach, C; Hulsbergen, W; Humair, T; Hussain, N; Hutchcroft, D; Hynds, D; Idzik, M; Ilten, P; Jacobsson, R; Jaeger, A; Jalocha, J; Jans, E; Jawahery, A; John, M; Johnson, D; Jones, C R; Joram, C; Jost, B; Jurik, N; Kandybei, S; Kanso, W; Karacson, M; Karbach, T M; Karodia, S; Kecke, M; Kelsey, M; Kenyon, I R; Kenzie, M; Ketel, T; Khairullin, E; Khanji, B; Khurewathanakul, C; Klaver, S; Klimaszewski, K; Kochebina, O; Kolpin, M; Komarov, I; Koopman, R F; Koppenburg, P; Kozeiha, M; Kravchuk, L; Kreplin, K; Kreps, M; Krocker, G; Krokovny, P; Kruse, F; Krzemien, W; Kucewicz, W; Kucharczyk, M; Kudryavtsev, V; Kuonen, A K; Kurek, K; Kvaratskheliya, T; Lacarrere, D; Lafferty, G; Lai, A; Lambert, D; Lanfranchi, G; Langenbruch, C; Langhans, B; Latham, T; Lazzeroni, C; Le Gac, R; van Leerdam, J; Lees, J-P; Lefèvre, R; Leflat, A; Lefrançois, J; Lemos Cid, E; Leroy, O; Lesiak, T; Leverington, B; Li, Y; Likhomanenko, T; Liles, M; Lindner, R; Linn, C; Lionetto, F; Liu, B; Liu, X; Loh, D; Longstaff, I; Lopes, J H; Lucchesi, D; Lucio Martinez, M; Luo, H; Lupato, A; Luppi, E; Lupton, O; Lusiani, A; Machefert, F; Maciuc, F; Maev, O; Maguire, K; Malde, S; Malinin, A; Manca, G; Mancinelli, G

    2015-12-11

    Using a pp collision data sample corresponding to an integrated luminosity of 3.0  fb^{-1}, collected by the LHCb detector, we present the first search for the strangeness-changing weak decay Ξ_{b}^{-}→Λ_{b}^{0}π^{-}. No b hadron decay of this type has been seen before. A signal for this decay, corresponding to a significance of 3.2 standard deviations, is reported. The relative rate is measured to be f_{Ξ_{b}^{-}}/f_{Λ_{b}^{0}}B(Ξ_{b}^{-}→Λ_{b}^{0}π^{-})=(5.7±1.8_{-0.9}^{+0.8})×10^{-4},where f_{Ξ_{b}^{-}} and f_{Λ_{b}^{0}} are the b→Ξ_{b}^{-} and b→Λ_{b}^{0} fragmentation fractions, and B(Ξ_{b}^{-}→Λ_{b}^{0}π^{-}) is the branching fraction. Assuming f_{Ξ_{b}^{-}}/f_{Λ_{b}^{0}} is bounded between 0.1 and 0.3, the branching fraction B(Ξ_{b}^{-}→Λ_{b}^{0}π^{-}) would lie in the range from (0.57±0.21)% to (0.19±0.07)%. PMID:26705625

  2. Strength of iron at core pressures and evidence for a weak Earth’s inner core

    SciTech Connect

    Gleason, A. E.; Mao, W. L.

    2013-05-12

    The strength of iron at extreme conditions is crucial information for interpreting geophysical observations of the Earth’s core and understanding how the solid inner core deforms. However, the strength of iron, on which deformation depends, is challenging to measure and accurately predict at high pressure. Here we present shear strength measurements of iron up to pressures experienced in the Earth’s core. Hydrostatic X-ray spectroscopy and non-hydrostatic radial X-ray diffraction measurements of the deviatoric strain in hexagonally close-packed iron uniquely determine its shear strength to pressures above 200 GPa at room temperature. Applying numerical modelling of the rheologic behaviour of iron under pressure, we extrapolate our experimental results to inner-core pressures and temperatures, and find that the bulk shear strength of hexagonally close-packed iron is only ~ 1 GPa at the conditions of the Earth’s centre, 364 GPa and 5,500 K. This suggests that the inner core is rheologically weak, which supports dislocation creep as the dominant creep mechanism influencing deformation.

  3. Evidence-based periodontal therapy: An overview

    PubMed Central

    Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma

    2008-01-01

    Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947

  4. Evidence for weak genetic recombination at the PTP2 locus of Nosema ceranae.

    PubMed

    Gómez-Moracho, Tamara; Bartolomé, Carolina; Martín-Hernández, Raquel; Higes, Mariano; Maside, Xulio

    2015-04-01

    The microsporidian Nosema ceranae is an emergent pathogen that threatens the health of honeybees and other pollinators all over the world. Its recent rapid spread across a wide variety of host species and environments demonstrated an enhanced ability of adaptation, which seems to contradict the lack of evidence for genetic recombination and the absence of a sexual stage in its life cycle. Here we retrieved fresh data of the patterns of genetic variation at the PTP2 locus in naturally infected Apis mellifera colonies, by means of single genome amplification. This technique, designed to prevent the formation of chimeric haplotypes during polymerase chain reaction (PCR), provides more reliable estimates of the diversity levels and haplotype structure than standard PCR-cloning methods. Our results are consistent with low but significant rates of recombination in the history of the haplotypes detected: estimates of the population recombination rate are of the order of 30 and support recent evidence for unexpectedly high levels of variation of the parasites within honeybee colonies. These observations suggest the existence of a diploid stage at some point in the life cycle of this parasite and are relevant for our understanding of the dynamics of its expanding population. PMID:25052231

  5. In Vivo Predictive Dissolution: Comparing the Effect of Bicarbonate and Phosphate Buffer on the Dissolution of Weak Acids and Weak Bases.

    PubMed

    Krieg, Brian J; Taghavi, Seyed Mohammad; Amidon, Gordon L; Amidon, Gregory E

    2015-09-01

    Bicarbonate is the main buffer in the small intestine and it is well known that buffer properties such as pKa can affect the dissolution rate of ionizable drugs. However, bicarbonate buffer is complicated to work with experimentally. Finding a suitable substitute for bicarbonate buffer may provide a way to perform more physiologically relevant dissolution tests. The dissolution of weak acid and weak base drugs was conducted in bicarbonate and phosphate buffer using rotating disk dissolution methodology. Experimental results were compared with the predicted results using the film model approach of (Mooney K, Mintun M, Himmelstein K, Stella V. 1981. J Pharm Sci 70(1):22-32) based on equilibrium assumptions as well as a model accounting for the slow hydration reaction, CO2 + H2 O → H2 CO3 . Assuming carbonic acid is irreversible in the dehydration direction: CO2 + H2 O ← H2 CO3 , the transport analysis can accurately predict rotating disk dissolution of weak acid and weak base drugs in bicarbonate buffer. The predictions show that matching the dissolution of weak acid and weak base drugs in phosphate and bicarbonate buffer is possible. The phosphate buffer concentration necessary to match physiologically relevant bicarbonate buffer [e.g., 10.5 mM (HCO3 (-) ), pH = 6.5] is typically in the range of 1-25 mM and is very dependent upon drug solubility and pKa . PMID:25980464

  6. Implementing Evidence-Based Social Work Practice

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  7. Evidence-Based Research in Education.

    ERIC Educational Resources Information Center

    Research Exchange, 2003

    2003-01-01

    This educational newsletter highlights a lead article, "Evidence-Based Research in Education." The article explains that evidence-based research emerged in the field of medicine over 50 years ago, resulting in major advances in the treatment and prevention of disease. It adds that clinical guidelines and protocols are based on the results of…

  8. The Young, the Weak and the Sick: Evidence of Natural Selection by Predation

    PubMed Central

    Genovart, Meritxell; Negre, Nieves; Tavecchia, Giacomo; Bistuer, Ana; Parpal, Luís; Oro, Daniel

    2010-01-01

    It is assumed that predators mainly prey on substandard individuals, but even though some studies partially support this idea, evidence with large sample sizes, exhaustive analysis of prey and robust analysis is lacking. We gathered data from a culling program of yellow-legged gulls killed by two methods: by the use of raptors or by shooting at random. We compared both data sets to assess whether birds of prey killed randomly or by relying on specific individual features of the prey. We carried out a meticulous post-mortem examination of individuals, and analysing multiple prey characteristics simultaneously we show that raptors did not hunt randomly, but rather preferentially predate on juveniles, sick gulls, and individuals with poor muscle condition. Strikingly, gulls with an unusually good muscle condition were also predated more than expected, supporting the mass-dependent predation risk theory. This article provides a reliable example of how natural selection may operate in the wild and proves that predators mainly prey on substandard individuals. PMID:20333305

  9. Evidence of hypoxic tolerance in weak upper airway muscle from young mdx mice.

    PubMed

    Burns, David P; O'Halloran, Ken D

    2016-06-01

    Duchenne muscular dystrophy (DMD) is a genetic disease characterised by deficiency in the protein dystrophin. The respiratory system is weakened and patients suffer from sleep disordered breathing and hypoventilation culminating in periods of hypoxaemia. We examined the effects of an acute (6h) hypoxic stress on sternohyoid muscle function (representative pharyngeal dilator). 8 week old male, wild-type (WT; C57BL/10ScSnJ; n=18) and mdx (C57BL/10ScSn-Dmd(mdx)/J; n=16) mice were exposed to sustained hypoxia (FIO2=0.10) or normoxia. Muscle functional properties were examined ex vivo. Additional WT (n=5) and mdx (n=5) sternohyoid muscle was exposed to an anoxic challenge. Sternohyoid dysfunction was observed in mdx mice with significant reductions in force and power. Following exposure to the acute in vivo hypoxic stress, WT sternohyoid muscle showed evidence of functional impairment (reduced force, work and power). Conversely, mdx sternohyoid showed an apparent tolerance to the acute hypoxic stress. This tolerance was not maintained for mdx following a severe hypoxic stress. A dysfunctional upper airway muscle phenotype is present at 8 weeks of age in the mdx mouse, which may have implications for the control of airway patency in DMD. Hypoxic tolerance in mdx respiratory muscle is suggestive of adaptation to chronic hypoxia, which could be present due to respiratory morbidity. We speculate a role for hypoxia in mdx respiratory muscle morbidity. PMID:26691169

  10. Huge capacity fiber-optic sensing network based on ultra-weak draw tower gratings

    NASA Astrophysics Data System (ADS)

    Yang, Minghong; Bai, Wei; Guo, Huiyong; Wen, Hongqiao; Yu, Haihu; Jiang, Desheng

    2016-03-01

    This paper reviews the work on huge capacity fiber-optic sensing network based on ultra-weak draw tower gratings developed at the National Engineering Laboratory for Fiber Optic Sensing Technology (NEL-FOST), Wuhan University of Technology, China. A versatile drawing tower grating sensor network based on ultra-weak fiber Bragg gratings (FBGs) is firstly proposed and demonstrated. The sensing network is interrogated with time- and wavelength-division multiplexing method, which is very promising for the large-scale sensing network.

  11. Allelic association but only weak evidence for linkage to the apolipoprotein E locus in late-onset Swedish Alzheimer families

    SciTech Connect

    Liu, L.; Forsell, C.; Lilius, L.

    1996-05-31

    An association between the {epsilon}4 allele of the apolipoprotein E gene (APOE) and late-onset Alzheimer`s disease (AD) was recently demonstrated. In order to confirm the association and to gauge the ability of standard genetic linkage methods to identify susceptibility genes, we investigated 15 Swedish late-onset AD families. We found an association of familial AD to the APOE {epsilon}4 allele (P = 0.01) but no indication of linkage to the APOE region using 2-point linkage analysis, and only weak evidence using the affected pedigree-member (APM) method. Our results confirm an APOE {epsilon}4 association with late-onset familial AD and indicate that susceptibility genes can easily be missed when using standard lod score and APM genetic linkage analysis. 19 refs., 1 fig., 4 tabs.

  12. Sicily statement on evidence-based practice

    PubMed Central

    Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

    2005-01-01

    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'. PMID:15634359

  13. Evidence-based management of patients with osteoporosis.

    PubMed

    Guyatt, G H

    1998-01-01

    Evidence-based medicine (EBM) offers an approach to solving clinical problems that places a high value on systematic clinical investigation. Evidence-based clinicians look to the highest rung on a hierarchy of evidence to guide their patient management. When considering therapeutic decisions, randomized control trials examining impact on outcomes that patients feel are important are at the top of the hierarchy of individual studies. Systematic reviews of such trials provide the best evidence for patient care decisions. Systematic reviews include explicit eligibility criteria for studies they include, a comprehensive search, an explicit rating of the methodological quality of the individual trials, and explicit strategies for pooling data. Inferences are weakened if study design is weak (trials are not blinded or we have only observational studies on which to rely), if results are inconsistent across studies, or if studies rely on substitute end points (bone density rather than long-bone fractures). Evidence-based clinicians consider not only the strength of evidence, but the patients' risk of adverse target outcomes and the magnitude of treatment effects in making their therapeutic decisions. EBM encourages quantitative approaches to trading off benefits and risks. For example, in deciding whether to recommend hormone replacement therapy to a 50-yr-old, an evidence-based clinician would consider that the woman has a 15% lifetime risk of fracturing her hip and the median age of the fracture is 79. Observational studies suggest that long-term estrogen therapy will reduce this risk by 25%, and we must therefore treat 25 women for 30 yr to prevent a single fracture. Evidence-based clinicians are also aware that evidence never provides an adequate guide for treatment decisions when considered on its own. Each therapeutic decision involves a trade-off between benefits and risks, and value judgments are invariably involved in making that trade-off. PMID:15304887

  14. Making Evidence-based Practice Educational.

    ERIC Educational Resources Information Center

    Elliott, John

    2001-01-01

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

  15. Evidence-Based Clearinghouses in Social Work

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  16. What's New about Evidence-Based Assessment?

    ERIC Educational Resources Information Center

    Barlow, David H.

    2005-01-01

    A clear consensus has emerged around the world concerning the desirability and even the urgency of basing health care delivery systems on evidence. Among behavioral health care providers such as psychologists, evidence-based practice (EBP) has been focused largely on interventions. Psychologists have long emphasized a scientifically based…

  17. Evidence-based medicine and levels of evidence.

    PubMed

    Wallace, David K

    2010-01-01

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

  18. Highly photoluminescent polysilsesquioxane hybrids based on weakly fluorescent 1,8-naphthalic anhydride derivatives

    NASA Astrophysics Data System (ADS)

    Pan, Fei; Huang, Miao; Song, Jianhui; Wu, Meng; Xu, Min

    2016-07-01

    A series of highly fluorescent polysilsesquioxane materials based on 1,8-naphthalic anhydride derivatives(XNA) have been prepared. The XNAs were chemically bonded with the polysiloxane. Though the fluorescent intensities of the solution of XNAs with different substitutes make a great difference, some of them are even very weakly emissive, the fluorescent intensities of the corresponding solid polysilsesquioxane materials are strong. In this case, the electronic effect of the substitute became non-important. With restricted molecular motion and J-aggregation, some traditionally weakly fluorescent or non-fluorescent chromophoric organics due to the substituent effect may be used to prepare highly fluorescent materials.

  19. Parameter-induced stochastic resonance based on spectral entropy and its application to weak signal detection

    SciTech Connect

    Zhang, Jinjing; Zhang, Tao

    2015-02-15

    The parameter-induced stochastic resonance based on spectral entropy (PSRSE) method is introduced for the detection of a very weak signal in the presence of strong noise. The effect of stochastic resonance on the detection is optimized using parameters obtained in spectral entropy analysis. Upon processing employing the PSRSE method, the amplitude of the weak signal is enhanced and the noise power is reduced, so that the frequency of the signal can be estimated with greater precision through spectral analysis. While the improvement in the signal-to-noise ratio is similar to that obtained using the Duffing oscillator algorithm, the computational cost reduces from O(N{sup 2}) to O(N). The PSRSE approach is applied to the frequency measurement of a weak signal made by a vortex flow meter. The results are compared with those obtained applying the Duffing oscillator algorithm.

  20. Born energy, acid-base equilibrium, structure and interactions of end-grafted weak polyelectrolyte layers.

    PubMed

    Nap, R J; Tagliazucchi, M; Szleifer, I

    2014-01-14

    This work addresses the effect of the Born self-energy contribution in the modeling of the structural and thermodynamical properties of weak polyelectrolytes confined to planar and curved surfaces. The theoretical framework is based on a theory that explicitly includes the conformations, size, shape, and charge distribution of all molecular species and considers the acid-base equilibrium of the weak polyelectrolyte. Namely, the degree of charge in the polymers is not imposed but it is a local varying property that results from the minimization of the total free energy. Inclusion of the dielectric properties of the polyelectrolyte is important as the environment of a polymer layer is very different from that in the adjacent aqueous solution. The main effect of the Born energy contribution on the molecular organization of an end-grafted weak polyacid layer is uncharging the weak acid (or basic) groups and consequently decreasing the concentration of mobile ions within the layer. The magnitude of the effect increases with polymer density and, in the case of the average degree of charge, it is qualitatively equivalent to a small shift in the equilibrium constant for the acid-base equilibrium of the weak polyelectrolyte monomers. The degree of charge is established by the competition between electrostatic interactions, the polymer conformational entropy, the excluded volume interactions, the translational entropy of the counterions and the acid-base chemical equilibrium. Consideration of the Born energy introduces an additional energetic penalty to the presence of charged groups in the polyelectrolyte layer, whose effect is mitigated by down-regulating the amount of charge, i.e., by shifting the local-acid base equilibrium towards its uncharged state. Shifting of the local acid-base equilibrium and its effect on the properties of the polyelectrolyte layer, without considering the Born energy, have been theoretically predicted previously. Account of the Born energy leads

  1. Born energy, acid-base equilibrium, structure and interactions of end-grafted weak polyelectrolyte layers

    SciTech Connect

    Nap, R. J.; Tagliazucchi, M.; Szleifer, I.

    2014-01-14

    This work addresses the effect of the Born self-energy contribution in the modeling of the structural and thermodynamical properties of weak polyelectrolytes confined to planar and curved surfaces. The theoretical framework is based on a theory that explicitly includes the conformations, size, shape, and charge distribution of all molecular species and considers the acid-base equilibrium of the weak polyelectrolyte. Namely, the degree of charge in the polymers is not imposed but it is a local varying property that results from the minimization of the total free energy. Inclusion of the dielectric properties of the polyelectrolyte is important as the environment of a polymer layer is very different from that in the adjacent aqueous solution. The main effect of the Born energy contribution on the molecular organization of an end-grafted weak polyacid layer is uncharging the weak acid (or basic) groups and consequently decreasing the concentration of mobile ions within the layer. The magnitude of the effect increases with polymer density and, in the case of the average degree of charge, it is qualitatively equivalent to a small shift in the equilibrium constant for the acid-base equilibrium of the weak polyelectrolyte monomers. The degree of charge is established by the competition between electrostatic interactions, the polymer conformational entropy, the excluded volume interactions, the translational entropy of the counterions and the acid-base chemical equilibrium. Consideration of the Born energy introduces an additional energetic penalty to the presence of charged groups in the polyelectrolyte layer, whose effect is mitigated by down-regulating the amount of charge, i.e., by shifting the local-acid base equilibrium towards its uncharged state. Shifting of the local acid-base equilibrium and its effect on the properties of the polyelectrolyte layer, without considering the Born energy, have been theoretically predicted previously. Account of the Born energy leads

  2. Born energy, acid-base equilibrium, structure and interactions of end-grafted weak polyelectrolyte layers

    NASA Astrophysics Data System (ADS)

    Nap, R. J.; Tagliazucchi, M.; Szleifer, I.

    2014-01-01

    This work addresses the effect of the Born self-energy contribution in the modeling of the structural and thermodynamical properties of weak polyelectrolytes confined to planar and curved surfaces. The theoretical framework is based on a theory that explicitly includes the conformations, size, shape, and charge distribution of all molecular species and considers the acid-base equilibrium of the weak polyelectrolyte. Namely, the degree of charge in the polymers is not imposed but it is a local varying property that results from the minimization of the total free energy. Inclusion of the dielectric properties of the polyelectrolyte is important as the environment of a polymer layer is very different from that in the adjacent aqueous solution. The main effect of the Born energy contribution on the molecular organization of an end-grafted weak polyacid layer is uncharging the weak acid (or basic) groups and consequently decreasing the concentration of mobile ions within the layer. The magnitude of the effect increases with polymer density and, in the case of the average degree of charge, it is qualitatively equivalent to a small shift in the equilibrium constant for the acid-base equilibrium of the weak polyelectrolyte monomers. The degree of charge is established by the competition between electrostatic interactions, the polymer conformational entropy, the excluded volume interactions, the translational entropy of the counterions and the acid-base chemical equilibrium. Consideration of the Born energy introduces an additional energetic penalty to the presence of charged groups in the polyelectrolyte layer, whose effect is mitigated by down-regulating the amount of charge, i.e., by shifting the local-acid base equilibrium towards its uncharged state. Shifting of the local acid-base equilibrium and its effect on the properties of the polyelectrolyte layer, without considering the Born energy, have been theoretically predicted previously. Account of the Born energy leads

  3. Evidence for Non-neutral Evolution in a Sodium Channel Gene in African Weakly Electric Fish (Campylomormyrus, Mormyridae).

    PubMed

    Paul, Christiane; Kirschbaum, Frank; Mamonekene, Victor; Tiedemann, Ralph

    2016-08-01

    Voltage-gated sodium channels, Nav1, play a crucial role in the generation and propagation of action potentials and substantially contribute to the shape of their rising phase. The electric organ discharge (EOD) of African weakly electric fish (Mormyroidea) is the sum of action potentials fired from all electrocytes of the electric organ at the same time and hence voltage-gated sodium channels are one factor-together with the electrocyte's morphology and innervation pattern-that determines the properties of these EODs. Due to the fish-specific genome duplication, teleost fish possess eight copies of sodium channel genes (SCN), which encode for Nav1 channels. In mormyroids, SCN4aa is solely expressed in the electrocytes of the adult electric organ. In this study, we compared entire SCN4aa sequences of six species of the genus Campylomormyrus and identified nonsynonymous substitutions among them. SCN4aa in Campylomormyrus exhibits a much higher evolutionary rate compared to its paralog SCN4ab, whose expression is not restricted to the electric organ. We also found evidence for strong positive selection on the SCN4aa gene within Mormyridae and along the lineage ancestral to the Mormyridae. We have identified sites at which all nonelectric teleosts are monomorphic in their amino acid, but mormyrids have different amino acids. Our findings confirm the crucial role of SCN4aa in EOD evolution among mormyrid weakly electric fish. The inferred positive selection within Mormyridae makes this gene a prime candidate for further investigation of the divergent evolution of pulse-type EODs among closely related species. PMID:27481396

  4. Evidence-based policymaking: a critique.

    PubMed

    Greenhalgh, Trisha; Russell, Jill

    2009-01-01

    The idea that policy should be based on best research evidence might appear to be self-evident. But a closer analysis reveals a number of problems and paradoxes inherent in the concept of "evidence-based policymaking." The current conflict over evidence-based policymaking parallels a long-standing "paradigm war" in social research between positivist, interpretivist, and critical approaches. This article draws from this debate in order to inform the discussions over the appropriateness of evidence- based policymaking and the related question of what is the nature of policymaking. The positivist, empiricist worldview that underpins the theory and practice of evidence-based medicine (EBM) fails to address key elements of the policymaking process. In particular, a narrowly "evidence-based" framing of policymaking is inherently unable to explore the complex, context-dependent, and value-laden way in which competing options are negotiated by individuals and interest groups. Sociolinguistic tools such as argumentation theory offer opportunities for developing richer theories about how policymaking happens. Such tools also have potential practical application in the policymaking process: by enhancing participants' awareness of their own values and those of others, the quality of the collective deliberation that lies at the heart of policymaking may itself improve. PMID:19395827

  5. Evidence-Based Teaching: Rhetoric and Reality

    ERIC Educational Resources Information Center

    Wrigley, Terry

    2015-01-01

    This essay connects a number of recent books relating, in different ways, to the contentious issue of how teaching might be better guided by research evidence. In order to shed light on this problematic area, Terry Wrigley begins by pointing out that raising awkward questions about terms such as "evidence- based teaching" is not the same…

  6. Practice-Based Evidence: Delivering What Works

    ERIC Educational Resources Information Center

    Brendtro, Larry K.; Mitchell, Martin L.

    2012-01-01

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

  7. Evidence-based librarianship: an overview

    PubMed Central

    Eldredge, Jonathan D.

    2000-01-01

    Objective: 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. Method: 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. Results: 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. Conclusions: 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. PMID:11055296

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

    PubMed

    Coiera, Enrico

    2016-03-01

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

  9. Dispersion-corrected first-principles calculation of terahertz vibration, and evidence for weak hydrogen bond formation

    NASA Astrophysics Data System (ADS)

    Takahashi, Masae; Ishikawa, Yoichi; Ito, Hiromasa

    2013-03-01

    A weak hydrogen bond (WHB) such as CH-O is very important for the structure, function, and dynamics in a chemical and biological system WHB stretching vibration is in a terahertz (THz) frequency region Very recently, the reasonable performance of dispersion-corrected first-principles to WHB has been proven. In this lecture, we report dispersion-corrected first-principles calculation of the vibrational absorption of some organic crystals, and low-temperature THz spectral measurement, in order to clarify WHB stretching vibration. The THz frequency calculation of a WHB crystal has extremely improved by dispersion correction. Moreover, the discrepancy in frequency between an experiment and calculation and is 10 1/cm or less. Dispersion correction is especially effective for intermolecular mode. The very sharp peak appearing at 4 K is assigned to the intermolecular translational mode that corresponds to WHB stretching vibration. It is difficult to detect and control the WHB formation in a crystal because the binding energy is very small. With the help of the latest intense development of experimental and theoretical technique and its careful use, we reveal solid-state WHB stretching vibration as evidence for the WHB formation that differs in respective WHB networks The research was supported by the Ministry of Education, Culture, Sports, Science and Technology of Japan (Grant No. 22550003).

  10. The Recovery of Weak Impulsive Signals Based on Stochastic Resonance and Moving Least Squares Fitting

    PubMed Central

    Jiang, Kuosheng.; Xu, Guanghua.; Liang, Lin.; Tao, Tangfei.; Gu, Fengshou.

    2014-01-01

    In this paper a stochastic resonance (SR)-based method for recovering weak impulsive signals is developed for quantitative diagnosis of faults in rotating machinery. It was shown in theory that weak impulsive signals follow the mechanism of SR, but the SR produces a nonlinear distortion of the shape of the impulsive signal. To eliminate the distortion a moving least squares fitting method is introduced to reconstruct the signal from the output of the SR process. This proposed method is verified by comparing its detection results with that of a morphological filter based on both simulated and experimental signals. The experimental results show that the background noise is suppressed effectively and the key features of impulsive signals are reconstructed with a good degree of accuracy, which leads to an accurate diagnosis of faults in roller bearings in a run-to failure test. PMID:25076220

  11. A Quantum Proxy Weak Blind Signature Scheme Based on Controlled Quantum Teleportation

    NASA Astrophysics Data System (ADS)

    Cao, Hai-Jing; Yu, Yao-Feng; Song, Qin; Gao, Lan-Xiang

    2015-04-01

    Proxy blind signature is applied to the electronic paying system, electronic voting system, mobile agent system, security of internet, etc. A quantum proxy weak blind signature scheme is proposed in this paper. It is based on controlled quantum teleportation. Five-qubit entangled state functions as quantum channel. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, so it could guarantee not only the unconditional security of the scheme but also the anonymity of the messages owner.

  12. A Quantum Proxy Weak Blind Signature Scheme Based on Controlled Quantum Teleportation

    NASA Astrophysics Data System (ADS)

    Cao, Hai-Jing; Yu, Yao-Feng; Song, Qin; Gao, Lan-Xiang

    2014-09-01

    Proxy blind signature is applied to the electronic paying system, electronic voting system, mobile agent system, security of internet, etc. A quantum proxy weak blind signature scheme is proposed in this paper. It is based on controlled quantum teleportation. Five-qubit entangled state functions as quantum channel. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, so it could guarantee not only the unconditional security of the scheme but also the anonymity of the messages owner.

  13. New Y-function based MOSFET parameter extraction method from weak to strong inversion range

    NASA Astrophysics Data System (ADS)

    Henry, J. B.; Rafhay, Q.; Cros, A.; Ghibaudo, G.

    2016-09-01

    A new Y-function based MOSFET parameter extraction method is proposed. This method relies on explicit expressions of inversion charge and drain current versus Yc(=Qi√Cgc)-function and Y(=Id/√gm)-function, respectively, applicable from weak to strong inversion range. It enables a robust MOSFET parameter extraction even for low gate voltage overdrive, whereas conventional extraction techniques relying on strong inversion approximation fail.

  14. Multi Dark Lens Simulations: weak lensing light-cones and data base presentation

    NASA Astrophysics Data System (ADS)

    Giocoli, Carlo; Jullo, Eric; Metcalf, R. Benton; de la Torre, Sylvain; Yepes, Gustavo; Prada, Francisco; Comparat, Johan; Göttlober, Stefan; Kyplin, Anatoly; Kneib, Jean-Paul; Petkova, Margarita; Shan, Huan Yuan; Tessore, Nicolas

    2016-09-01

    In this paper we present a large data base of weak lensing light cones constructed using different snapshots from the Big MultiDark simulation (BigMDPL). The ray-tracing through different multiple plane has been performed with the GLAMER code accounting both for single source redshifts and for sources distributed along the cosmic time. This first paper presents weak lensing forecasts and results according to the geometry of the VIPERS-W1 and VIPERS-W4 field of view. Additional fields will be available on our data base and new ones can be run upon request. Our data base also contains some tools for lensing analysis. In this paper we present results for convergence power spectra, one point and high order weak lensing statistics useful for forecasts and for cosmological studies. Covariance matrices have also been computed for the different realizations of the W1 and W4 fields. In addition we compute also galaxy-shear and projected density contrasts for different halo masses at two lens redshift according to the CFHTLS source redshift distribution both using stacking and cross-correlation techniques, finding very good agreement.

  15. Evidence-Based Practice and Chiropractic Care

    PubMed Central

    LeFebvre, Ron; Peterson, David; Haas, Mitchell

    2013-01-01

    Evidence-based practice has had a growing impact on chiropractic education and the delivery of chiropractic care. For evidence-based practice to penetrate and transform a profession, the penetration must occur at 2 levels. One level is the degree to which individual practitioners possess the willingness and basic skills to search and assess the literature. Chiropractic education received a significant boost in this realm in 2005 when the National Center for Complementary and Alternative Medicine awarded 4 chiropractic institutions R25 education grants to strengthen their research/evidence-based practice curricula. The second level relates to whether the therapeutic interventions commonly employed by a particular health care discipline are supported by clinical research. A growing body of randomized controlled trials provides evidence of the effectiveness and safety of manual therapies. PMID:23875117

  16. Evidence-based equine dentistry: preventive medicine.

    PubMed

    Carmalt, James L

    2007-08-01

    Dental problems are some of the most common reasons for a horse to be presented to an equine veterinarian. Despite the importance of anecdotal evidence as a starting point, the science of equine dentistry (especially prophylactic dentistry) has remained poorly supported by evidence-based approaches to diagnosis and treatment. In the 21st century, veterinarians have an ethical responsibility to promote and use the results of evidence-based research and not propagate statements attesting to the purported benefits of intervention without supporting research. Consider also that society is becoming more litigious and therefore is basing treatment plans and advice on published research, which protects the profession from legal challenges concerning our professional conduct. This article reviews the current published evidence concerning the role of equine dentistry in feed digestibility and performance. PMID:17616326

  17. Evidence-Based Practices and Autism

    ERIC Educational Resources Information Center

    Mesibov, Gary B.; Shea, Victoria

    2011-01-01

    Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…

  18. Need for Evidence-Based Teaching

    ERIC Educational Resources Information Center

    Groccia, James E.; Buskist, William

    2011-01-01

    Educators believe that rather than being a mere possibility to improve as teachers, it is always "necessary" to improve. One way of improving teaching is to adopt teaching methods that are based on or supported by evidence of success in enhancing student learning. Most teachers base their instructional practices on tradition, the opinion of…

  19. Evidence-based Practice of Radiology.

    PubMed

    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. PMID:26466187

  20. Queer challenges to evidence-based practice.

    PubMed

    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. PMID:23738815

  1. Enhancing the effect of radionuclide tumor targeting, using lysosomotropic weak bases

    SciTech Connect

    Sundberg, Asa Liljegren . E-mail: Asa.Liljegren@bms.uu.se; Steffen, Ann-Charlott

    2007-01-01

    Purpose: The aim of the present study was to investigate if treatment with lysosomotropic weak bases could increase the intracellular retention of radiohalogens and thereby increase the therapeutic effect of radionuclide tumor targeting. Methods and Materials: Four different lysosomotropic bases, chloroquine, ammonium chloride, amantadine, and thioridazine, were investigated for their ability to increase radiohalogen retention in vitro. The two most promising substances, chloroquine and ammonium chloride, were studied in several cell lines (A431, U343MGaCl2:6, SKOV-3, and SKBR-3) in combination with radiolabeled epidermal growth factor (EGF) or the HER2 binding affibody (Z{sub HER2:4}){sub 2}. Results: The uptake and retention of radionuclides was found to be substantially increased by simultaneous treatment with the lysosomotropic bases. The effect was, however, more pronounced in the epidermal growth factor:epidermal growth factor receptor (EGF:EGFR) system than in the (Z{sub HER2:4}){sub 2}:HER2 system. The therapeutic effect of ammonium chloride treatment combined with {sup 211}At-EGF was also studied. The effect obtained after combined treatment was found to be much better than after {sup 211}At-EGF treatment alone. Conclusions: The encouraging results from the present study indicate that the use of lysosomotropic weak bases is a promising approach for increasing the therapeutic effect of radionuclide targeting with radiohalogens.

  2. Weak bump quasars

    NASA Technical Reports Server (NTRS)

    Wilkes, B. J.; Mcdowell, J.

    1994-01-01

    Research into the optical, ultraviolet and infrared continuum emission from quasars and their host galaxies was carried out. The main results were the discovery of quasars with unusually weak infrared emission and the construction of a quantitative estimate of the dispersion in quasar continuum properties. One of the major uncertainties in the measurement of quasar continuum strength is the contribution to the continuum of the quasar host galaxy as a function of wavelength. Continuum templates were constructed for different types of host galaxy and individual estimates made of the decomposed quasar and host continua based on existing observations of the target quasars. The results are that host galaxy contamination is worse than previously suspected, and some apparent weak bump quasars are really normal quasars with strong host galaxies. However, the existence of true weak bump quasars such as PHL 909 was confirmed. The study of the link between the bump strength and other wavebands was continued by comparing with IRAS data. There is evidence that excess far infrared radiation is correlated with weaker ultraviolet bumps. This argues against an orientation effect and implies a probable link with the host galaxy environment, for instance the presence of a luminous starburst. However, the evidence still favors the idea that reddening is not important in those objects with ultraviolet weak bumps. The same work has led to the discovery of a class of infrared weak quasars. Pushing another part of the envelope of quasar continuum parameter space, the IR-weak quasars have implications for understanding the effects of reddening internal to the quasars, the reality of ultraviolet turnovers, and may allow further tests of the Phinney dust model for the IR continuum. They will also be important objects for studying the claimed IR to x-ray continuum correlation.

  3. Retrieval-based face annotation by weak label regularized local coordinate coding.

    PubMed

    Wang, Dayong; Hoi, Steven C H; He, Ying; Zhu, Jianke; Mei, Tao; Luo, Jiebo

    2014-03-01

    Auto face annotation, which aims to detect human faces from a facial image and assign them proper human names, is a fundamental research problem and beneficial to many real-world applications. In this work, we address this problem by investigating a retrieval-based annotation scheme of mining massive web facial images that are freely available over the Internet. In particular, given a facial image, we first retrieve the top $(n)$ similar instances from a large-scale web facial image database using content-based image retrieval techniques, and then use their labels for auto annotation. Such a scheme has two major challenges: 1) how to retrieve the similar facial images that truly match the query, and 2) how to exploit the noisy labels of the top similar facial images, which may be incorrect or incomplete due to the nature of web images. In this paper, we propose an effective Weak Label Regularized Local Coordinate Coding (WLRLCC) technique, which exploits the principle of local coordinate coding by learning sparse features, and employs the idea of graph-based weak label regularization to enhance the weak labels of the similar facial images. An efficient optimization algorithm is proposed to solve the WLRLCC problem. Moreover, an effective sparse reconstruction scheme is developed to perform the face annotation task. We conduct extensive empirical studies on several web facial image databases to evaluate the proposed WLRLCC algorithm from different aspects. The experimental results validate its efficacy. We share the two constructed databases "WDB" (714,454 images of 6,025 people) and "ADB" (126,070 images of 1,200 people) with the public. To further improve the efficiency and scalability, we also propose an offline approximation scheme (AWLRLCC) which generally maintains comparable results but significantly reduces the annotation time. PMID:24457510

  4. [Methods of brain stimulation based on weak electric current--future tool for the clinician?].

    PubMed

    Kotilainen, Tuukka; Lehto, Soili M

    2016-01-01

    Methods of brain stimulation based on a weak electric current are non-invasive neuromodulation techniques. They include transcranial direct current, alternating current and random noise stimulation. These methods modify the membrane potential of neurons without triggering the action potential, and have been successfully utilized to influence cognition and regulation of emotions in healthy experimental subjects. In clinical studies, indications of the efficacy of these techniques have been obtained in the treatment of depression, schizophrenia, memory disorders and pain as well as in stroke rehabilitation. It is hoped that these techniques will become established as part of the care and rehabilitation of psychiatric and neurologic patients in the future. PMID:27017784

  5. The nanosecond optical parametric amplifier of a weak signal based on BBO crystals

    NASA Astrophysics Data System (ADS)

    Bagdasarov, V. Kh; Bel’kov, S. A.; Garanin, S. G.; Garnov, S. V.; Nikolaev, D. A.; Orlov, S. N.; Polivanov, Y. N.; Shcherbakov, I. A.; Tsvetkov, V. B.

    2016-09-01

    Parameters of the optical parametric amplifier (OPA), based on two BBO crystals were studied. The OPA was made with the schematic of the extraordinary wave walk off compensation. Efficient amplification of the weak signal (λ  =  1053 nm) in the field of the strong pumping wave (λ  =  532 nm) was obtained. The measured value of the amplification was equal to ~106. The noise level of the parametric amplifier was less than 10‑3 from the signal level.

  6. General Analytical Procedure for Determination of Acidity Parameters of Weak Acids and Bases

    PubMed Central

    Pilarski, Bogusław; Kaliszan, Roman; Wyrzykowski, Dariusz; Młodzianowski, Janusz; Balińska, Agata

    2015-01-01

    The paper presents a new convenient, inexpensive, and reagent-saving general methodology for the determination of pKa values for components of the mixture of diverse chemical classes weak organic acids and bases in water solution, without the need to separate individual analytes. The data obtained from simple pH-metric microtitrations are numerically processed into reliable pKa values for each component of the mixture. Excellent agreement has been obtained between the determined pKa values and the reference literature data for compounds studied. PMID:25692072

  7. Coherent Random Fiber Laser Based on Nanoparticles Scattering in the Extremely Weakly Scattering Regime

    NASA Astrophysics Data System (ADS)

    Hu, Zhijia; Zhang, Qun; Miao, Bo; Fu, Qiang; Zou, Gang; Chen, Yang; Luo, Yi; Zhang, Douguo; Wang, Pei; Ming, Hai; Zhang, Qijin

    2012-12-01

    We demonstrate the realization of a coherent random fiber laser (RFL) in the extremely weakly scattering regime, which contains a dispersive solution of polyhedral oligomeric silsesquioxanes nanoparticles (NPs) and laser dye pyrromethene 597 in carbon disulfide that was injected into a hollow optical fiber. Multiple scattering of polyhedral oligomeric silsesquioxanes NPs greatly enhanced by the waveguide confinement effect was experimentally verified to account for coherent lasing observed in our RFL system. This Letter extends the NPs-based RFLs from the incoherent regime to the coherent regime.

  8. Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.; Steele Shernoff, Elisa

    2004-01-01

    We present an overview of issues related to evidence-based practice and the role that the school psychology profession can play in developing and disseminating evidence based interventions (EBIs). Historical problems relating to and the recurring debate about the integration of research into practice are presented as a context for the current…

  9. Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.; Shernoff, Elisa Steele

    2003-01-01

    We present an overview of issues related to evidence-based practice and the role that the school psychology profession can play in developing and disseminating evidence-based interventions (EBIs). Historical problems relating to and the recurring debate about the integration of research into practice are presented as a context for the current…

  10. Evidence-Based Special Education in the Context of Scarce Evidence-Based Practices

    ERIC Educational Resources Information Center

    TEACHING Exceptional Children, 2014

    2014-01-01

    Evidence-based practices (EBPs) are supported as generally effective for populations of learners by bodies of high-quality and experimental research and, when aligned with stakeholder values and practical needs, should be prioritized for implementation. However, evidence-based practices are not currently available for all learner types in all…

  11. Oncology Nursing Is Evidence-Based Care.

    PubMed

    Kennedy Sheldon, Lisa; Brown, Carlton G

    2016-06-01

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

  12. Evidence Based Education Request Desk. EBE #741

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

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

  13. Evidence-Based Practice Goes beyond Google

    ERIC Educational Resources Information Center

    Klitzing, Sandra

    2012-01-01

    Evidence-based practice (EBP) is applying research to assist in the selection of interventions that result in increased client quality care. Recently the Commission on Accreditation of Allied Health Education Programs (2010), a new accreditation body for recreational therapy education, included standards that state students should obtain knowledge…

  14. Evidence-Based Classroom Behaviour Management Strategies

    ERIC Educational Resources Information Center

    Parsonson, Barry S.

    2012-01-01

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

  15. Statewide Implementation of Evidence-Based Programs

    ERIC Educational Resources Information Center

    Fixsen, Dean; Blase, Karen; Metz, Allison; van Dyke, Melissa

    2013-01-01

    Evidence-based programs will be useful to the extent they produce benefits to individuals on a socially significant scale. It appears the combination of effective programs and effective implementation methods is required to assure consistent uses of programs and reliable benefits to children and families. To date, focus has been placed primarily…

  16. Evidence Based Education Request Desk. EBE #555

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

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

  17. Time for evidence-based cytology

    PubMed Central

    Dey, Pranab

    2007-01-01

    Evidence-based medicine (EBM) is a fashionable and an extremely hot topic for clinicians, patients and the health service planners. Evidence-based cytology (EBC) is an offshoot of EBM. The EBC is concerned with generating a reproducible, high quality and clinically relevant test result in the field of cytology. This is a rapidly evolving area with high practical importance. EBC is based entirely on research data. The various professional bodies on cytology design and recommend guidelines on the basis of evidences. Once the guideline is implemented and practiced then the experiences of the practicing cytopathologists may be used as a feed back to alter the existing guideline. The various facets of EBC are sampling and specimen adequacy, morphological identification and computer based expert system, integrated reporting, identification of the controversial areas and high quality researches for evidences. It is the duty of the individuals and institutions to practice EBC for better diagnosis and management of the patients. In this present paper, the various aspects of EBC have been discussed. PMID:17210074

  18. Finding Evidence-Based Practice Information

    ERIC Educational Resources Information Center

    Childs, Gary M.

    2009-01-01

    Locating sources that are rich in evidence-based practice information can be more difficult for physical as well as occupational therapists in practice settings in which there is not direct access to a health sciences library. In addition, once information has been found, there may not be an easy way to access the data. This commentary will…

  19. The Evidence Base for Positive Peer Culture

    ERIC Educational Resources Information Center

    Laursen, Erik K.

    2010-01-01

    This article explores the evidence base for Positive Peer Culture (PPC) which is a total system for developing positive youth cultures in youth serving organizations. It challenges a popular belief among some researchers that group programs which bring together troubled youth are inherently negative.

  20. Implementing Evidence-Based Treatments in Organizations

    ERIC Educational Resources Information Center

    Woolston, Joseph L.

    2005-01-01

    Several case studies in implementing evidence-based treatments (EBTs) in organizations are presented. Two erroneous presuppositions about treatments with proven efficacy (henceforth called EBTs) frequently lead to major problems (Hoagwood et al., 2001). The first is that the development of an EBT has taken into account the fit between the…

  1. The Evidence-Based Manifesto for School Librarians

    ERIC Educational Resources Information Center

    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…

  2. Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses 1

    PubMed Central

    Cónsul-Giribet, María; Medina-Moya, José Luis

    2014-01-01

    OBJECTIVE: to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. METHOD: an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. RESULTS: the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. CONCLUSIONS: the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life. PMID:25493666

  3. RFM-Based Block Adjustment for Spaceborne Images with Weak Convergent Geometry

    NASA Astrophysics Data System (ADS)

    Cheng, C. Q.; Zhang, J. X.; Huang, G. M.

    2015-06-01

    Block adjustment is one of the most important processing steps in topographic mapping. In order to achieve precise 3D photogrammetry points, the ratio of base-to-height(RBH) or the forward intersection angle(FIA) of stereo images should meet the requirement of specifications for topographic maps when the block images are used. In some fields, overlaps and ratios of base-toheight are often ignored, no gaps among the images are the basic requirements for block images. In this study we give a method to detect the forward intersection angle for homonymous points with RPCs, and create a indicator angler to reflect the level of weak convergence. In order to achieve stable and precise solver for block adjustment under the condition of weak convergence, this paper take the elevation value interpolated from DEM as observed values with errors, combine the height value and measured image coordinates to build adjustment model. The model can be steady solved in ill-pose situation and have little effects from the DEM errors. the model and the methods are validated by simulation and real data including optical ZY1-02C and TerraSAR images.

  4. Patch-based label fusion using local confidence-measures and weak segmentations

    NASA Astrophysics Data System (ADS)

    Mastmeyer, André; Fortmeier, Dirk; Maghsoudi, Ehsan; Simon, Martin; Handels, Heinz

    2013-03-01

    A system for the fully automatic segmentation of the liver and spleen is presented. In a multi-atlas based segmentation framework, several existing segmentations are deformed in parallel to image intensity based registrations targeting the unseen patient. A new locally adaptive label fusion method is presented as the core of this paper. In a patch comparison approach, the transformed segmentations are compared to a weak segmentation of the target organ in the unseen patient. The weak segmentation roughly estimates the hidden truth. Traditional fusion approaches just rely on the deformed expert segmentations only. The result of patch comparison is a confidence weight for a neighboring voxel-label in the atlas label images to contribute to the voxel under study. Fusion is finally carried out in a weighted averaging scheme. The new contribution is the incorporation of locally determined confidence features of the unseen patient into the fusion process. For a small experimental set-up consisting of 12 patients, the proposed method performs favorable to standard classifier label fusion methods. In leave-one-out experiments, we obtain a mean Dice ratio of 0.92 for the liver and 0.82 for the spleen.

  5. Fundamental patterns of knowing in nursing: the challenge of evidence-based practice.

    PubMed

    Porter, Sam

    2010-01-01

    This article reconsiders the fundamental patterns of knowing in nursing in light of the challenge of narrow empirics in the form of evidence-based practice. Objections to the dominance of evidence-based practice are reviewed, and the reasons for it are examined. It is argued that it is partially the result of weaknesses in the alternative patterns of ethical, personal, and esthetic knowing, the ineffability of which compromises accountability. This ineffability can be countered only by introducing a wider form of empirics than countenanced by evidence-based practice into all patterns of knowing, to demonstrate their salience and to make their use in practice transparent. PMID:19996934

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

    PubMed

    Osborn, John

    2002-01-01

    Sir Arthur Conan Doyle, the creator of the fictional detective Sherlock Holmes, studied medicine at the University of Edinburgh between 1876 and 1881 under Doctor Joseph Bell who emphasised in his teaching the importance of observation, deduction and evidence. Sherlock Holmes was modelled on Joseph Bell. The modern notions of Evidence Based Medicine (EBM) are not new. A very brief indication of some of the history of EBM is presented including a discussion of the important and usually overlooked contribution of statisticians to the Popperian philosophy of EBM. PMID:14509997

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

    PubMed

    Henao, Daniel Eduardo; Jaimes, Fabián Alberto

    2009-03-01

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

  8. What is evidence-based behavior analysis?

    PubMed

    Smith, Tristram

    2013-01-01

    Although applied behavior analysts often say they engage in evidence-based practice, they express differing views on what constitutes "evidence" and "practice." This article describes a practice as a service offered by a provider to help solve a problem presented by a consumer. Solving most problems (e.g., increasing or decreasing a behavior and maintaining this change) requires multiple intervention procedures (i.e., a package). Single-subject studies are invaluable in investigating individual procedures, but researchers still need to integrate the procedures into a package. The package must be standardized enough for independent providers to replicate yet flexible enough to allow individualization; intervention manuals are the primary technology for achieving this balance. To test whether the package is effective in solving consumers' problems, researchers must evaluate outcomes of the package as a whole, usually in group studies such as randomized controlled trials. From this perspective, establishing an evidence-based practice involves more than analyzing the effects of discrete intervention procedures on behavior; it requires synthesizing information so as to offer thorough solutions to problems. Recognizing the need for synthesis offers behavior analysts many promising opportunities to build on their existing research to increase the quality and quantity of evidence-based practices. PMID:25729130

  9. Narrow Scale Flow and a Weak Field by the Top of Earth's Core: Evidence from Orsted, Magsat and Secular Variation

    NASA Technical Reports Server (NTRS)

    Voorhies, Coerte V.

    2004-01-01

    As Earth's main magnetic field weakens, our magnetic shield against the onslaught of the solar wind thins. And the field strength needed to fend off battering by solar coronal mass ejections is decreasing, just when the delicate complexity of modem, vulnerable, electro-technological systems is increasing at an unprecedented rate. Recently, a working group of distinguished scientist from across the nation has asked NASA's Solid Earth and Natural Hazards program a key question: What are the dynamics of Earth s magnetic field and its interactions with the Earth system? Paleomagnetic studies of crustal rocks magnetized in the geologic past reveal that polarity reversals have occurred many times during Earth s history. Networked super-computer simulations of core field and flow, including effects of gravitational, pressure, rotational Coriolis, magnetic and viscous forces, suggest how this might happen in detail. And space-based measurements of the real, time-varying magnetic field help constrain estimates of the speed and direction of fluid iron flowing near the top of the core and enable tests of some hypotheses about such flow. Now scientists at NASA s Goddard Space Flight Center have developed and applied methods to test the hypotheses of narrow scale flow and of a dynamically weak magnetic field near the top of Earth s core. Using two completely different methods, C. V. Voorhies has shown these hypotheses lead to specific theoretical forms for the "spectrum" of Earth s main magnetic field and the spectrum of its rate of change. Much as solar physicists use a prism to separate sunlight into its spectrum, from long wavelength red to short wavelength blue light, geophysicists use a digital prism, spherical harmonic analysis, to separate the measured geomagnetic field into its spectrum, from long to short wavelength fields. They do this for the rate of change of the field as well.

  10. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    ERIC Educational Resources Information Center

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  11. Underdetermination in evidence-based medicine.

    PubMed

    Chin-Yee, Benjamin H

    2014-12-01

    This article explores the philosophical implications of evidence-based medicine's (EBM's) epistemology in terms of the problem of underdetermination of theory by evidence as expounded by the Duhem-Quine thesis. EBM hierarchies of evidence privilege clinical research over basic science, exacerbating the problem of underdetermination. Because of severe underdetermination, EBM is unable to meaningfully test core medical beliefs that form the basis of our understanding of disease and therapeutics. As a result, EBM adopts an epistemic attitude that is sceptical of explanations from the basic biological sciences, and is relegated to a view of disease at a population level. EBM's epistemic attitude provides a limited research heuristic by preventing the development of a theoretical framework required for understanding disease mechanism and integrating knowledge to develop new therapies. Medical epistemology should remain pluralistic and include complementary approaches of basic science and clinical research, thus avoiding the limited epistemic attitude entailed by EBM hierarchies. PMID:25406418

  12. Interpolation of PSF based on compressive sampling and its application in weak lensing survey

    NASA Astrophysics Data System (ADS)

    Suksmono, Andriyan B.

    2014-09-01

    We propose a new point spread function (PSF) interpolation method based on compressive sampling (CS). Complex-Valued fractional Brownion motion (CV-fBm) field is used as a model of the PSF spatial distribution. The 1/f property of the fBm implies that it is a compressible field; therefore, CS will be able to fully reconstruct the field based on a small number of random samples. Performance evaluation shows the advantages of the proposed method over boxcar filtering, polynomial fitting, inverse distance weighting, and thin-plate methods. Potential applicability of the proposed method in weak gravitational lensing survey, particularly for interpolating fast varying PSF that represent distortion by turbulent field is also discussed.

  13. Photoinduced strong acid–weak base reactions in a polar aprotic solvent

    NASA Astrophysics Data System (ADS)

    Lee, Young Min; Park, Sun-Young; Kim, Heesu; Gyum Kim, Taeg; Kwon, Oh-Hoon

    2016-06-01

    The excited-state proton transfer (ESPT) of the strong photoacid, N-methyl-7-hydroxyquinolinium, was studied in the presence of different weak bases such as methanol, ethanol, and dimethyl sulfoxide in an aprotic solvent of acetonitrile. Here, we present chemical kinetics analysis of the ESPT mechanism to explain biphasic fluorescence decay of the parent photoacid and the sign reversal of the rise and decay of the resulting conjugate-base fluorescence. The ESPT of the free photoacid showed a molecularity of 2 with reacting alcohol molecules. In the ground state, it was found that a fraction of the photoacid formed 1 : 2 hydrogen-bonded complexes with the residual water present in the aprotic solvent or 1 : 1 complexes with the additive alcohols. In the excited state, these adducts underwent proton transfer when complexed further with diffusing alcohol molecules.

  14. Some Results of Weak Anticipative Concept Applied in Simulation Based Decision Support in Enterprise

    NASA Astrophysics Data System (ADS)

    Kljajić, Miroljub; Kofjač, Davorin; Kljajić Borštnar, Mirjana; Škraba, Andrej

    2010-11-01

    The simulation models are used as for decision support and learning in enterprises and in schools. Tree cases of successful applications demonstrate usefulness of weak anticipative information. Job shop scheduling production with makespan criterion presents a real case customized flexible furniture production optimization. The genetic algorithm for job shop scheduling optimization is presented. Simulation based inventory control for products with stochastic lead time and demand describes inventory optimization for products with stochastic lead time and demand. Dynamic programming and fuzzy control algorithms reduce the total cost without producing stock-outs in most cases. Values of decision making information based on simulation were discussed too. All two cases will be discussed from optimization, modeling and learning point of view.

  15. Weak edge enhancement based on contextual modulation of non-classical receptive field

    NASA Astrophysics Data System (ADS)

    Xiao, Jie; Cai, Chao

    2015-12-01

    Edges and contours of an object contain a lot of information, so the detection and extraction of saliency edges and contours in the image become one of the most active issues in the research field of automatic target recognition. Weak edge enhancement plays an important role in contour detection. Based on psychophysical and physiological findings, a contour detection method which focuses on weak edge enhancement and inspired by the visual mechanism in the primary visual cortex (V1) is proposed in this paper. The method is divided in three steps. Firstly, the response of every single visual neuron in V1 is computed by local energy. Secondly, the local contrast which corresponds to the CRF is computed. If the local contrast in the image is below the low contrast threshold, expand NCRF to change the spatially modulatory range by increasing the NCRF radius. Thirdly, the facilitation and suppression (the contextual influence) on a neuron through horizontal interactions are obtained by using a spatially unified modulating function. We tested it on synthetic images and encouraging results were acquired.

  16. [The philosophical foundations of evidence-based nursing].

    PubMed

    Wang, Linton; Ma, Wei-Fen

    2013-10-01

    As a branch of evidence-based practice, evidence-based nursing emphasizes the integration of patient needs, the evidence for practical problem solving, and the application of nursing expertise. The criteria of evidence and the application of evidence in practice are the central theoretical foundations of evidence-based practice and evidence-based nursing. Therefore, the main philosophical considerations of evidence-based nursing shall focus on the criteria by which evidence supports propositions and how evidence should be applied in practice. In this paper, we explain the criteria of evidence from an epistemological perspective and explain the application of evidence in practice from the perspective of rational decision-making. Finally, we use these philosophical considerations to propose practical guidelines for evidence-based nursing and explain the philosophical significance of nursing practice. PMID:24096459

  17. Hydration and sorption characteristics of a polyfunctional weak-base anion exchanger after the sorption of vanillin and ethylvanillin

    NASA Astrophysics Data System (ADS)

    Rodionova, D. O.; Voronyuk, I. V.; Eliseeva, T. V.

    2016-07-01

    Features of the sorption of substituted aromatic aldehydes by a weak-base anion exchanger under equilibrium conditions are investigated using vanillin and ethylvanillin as examples. Analysis of the sorption isotherms of carbonyl compounds at different temperatures allows us to calculate the equilibrium characteristics of their sorption and assess the entropy and enthalpy contributions to the energy of the process. Hydration characteristics of the macroporous weak-base anion exchanger before and after the sorption of aromatic aldehydes are compared.

  18. Quantum discord with weak measurement operators of quasi-Werner states based on bipartite entangled coherent states

    NASA Astrophysics Data System (ADS)

    Castro, E.; Gómez, R.; Ladera, C. L.; Zambrano, A.

    2013-11-01

    Among many applications quantum weak measurements have been shown to be important in exploring fundamental physics issues, such as the experimental violation of the Heisenberg uncertainty relation and the Hardy paradox, and have also technological implications in quantum optics, quantum metrology and quantum communications, where the precision of the measurement is as important as the precision of quantum state preparation. The theory of weak measurement can be formulated using the pre-and post-selected quantum systems, as well as using the weak measurement operator formalism. In this work, we study the quantum discord (QD) of quasi-Werner mixed states based on bipartite entangled coherent states using the weak measurements operator, instead of the projective measurement operators. We then compare the quantum discord for both kinds of measurement operators, in terms of the entanglement quality, the latter being measured using the concept of concurrence. It's found greater quantum correlations using the weak measurement operators.

  19. Evidence For Weak Ferromagnetic Moment Within The Basal Plane Of Hematite Natural Crystals At Low-Temperature

    NASA Astrophysics Data System (ADS)

    Hernandez, F. M.; Hirt, A. M.

    2013-12-01

    Hematite is an iron oxide (α-Fe2O3) that represents the most oxidized state in the wüstite-magnetite-hematite system. Hematite is antiferromagnetic (AFM) at room temperature with a small canted moment lying within the crystal symmetry plane or basal plane (weak ferromagnetism, WFM). Al low temperatures hematite undergoes a magnetic phase transition from WFM to a pure antiferromagnetic configuration (AF), which is known as the Morin transition. Low-temperature magnetization of hematite within the basal has been studied in a collection of natural crystals by means of torque magnetometry. Comparison between the torque curves at room temperature and at 77 K allows identification of a weak ferromagnetic moment constrained within the basal plane at temperatures well below the Morin transition. Annealing the samples produces the expected reduction of the weak ferromagnetic moment, but there is also a relationship between the ferromagnetic moment before and after annealing. Low temperature measurements after the annealing experiment reveal the presence of a weak ferromagnetic moment that survives the annealing. This observation suggests the magnetic structure of natural hematite crystals below the Morin transition can still be a carrier of magnetization.

  20. What's Wrong with Evidence-Based Medicine?

    PubMed

    Fins, Joseph J

    2016-01-01

    Medicine in the last decades of the twentieth century was ripe for a data sweep that would bring systematic analysis to treatment strategies that seemingly had stood the test of time but were actually unvalidated. Coalescing under the banner of evidence-based medicine, this process has helped to standardize care, minimize error, and promote patient safety. But with this advancement, something of the art of medicine has been lost. PMID:26786040

  1. Evidence-Based Practice for Outpatient Clinical Teams

    ERIC Educational Resources Information Center

    Hamilton, John D.

    2006-01-01

    This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

  2. What Is Evidence-Based Behavior Analysis?

    PubMed Central

    Smith, Tristram

    2013-01-01

    Although applied behavior analysts often say they engage in evidence-based practice, they express differing views on what constitutes “evidence” and “practice.” This article describes a practice as a service offered by a provider to help solve a problem presented by a consumer. Solving most problems (e.g., increasing or decreasing a behavior and maintaining this change) requires multiple intervention procedures (i.e., a package). Single-subject studies are invaluable in investigating individual procedures, but researchers still need to integrate the procedures into a package. The package must be standardized enough for independent providers to replicate yet flexible enough to allow individualization; intervention manuals are the primary technology for achieving this balance. To test whether the package is effective in solving consumers' problems, researchers must evaluate outcomes of the package as a whole, usually in group studies such as randomized controlled trials. From this perspective, establishing an evidence-based practice involves more than analyzing the effects of discrete intervention procedures on behavior; it requires synthesizing information so as to offer thorough solutions to problems. Recognizing the need for synthesis offers behavior analysts many promising opportunities to build on their existing research to increase the quality and quantity of evidence-based practices. PMID:25729130

  3. Evidence-based medicine and tort law.

    PubMed

    Foucar, Elliott; Wick, Mark R

    2005-05-01

    Recent statutes and legal decisions have been aimed at bettering the quality of tort-law decisions by substantively improving "expert" testimony. However, in analogy to the experience of physicians attempting to upgrade medical practice using the principles of evidence-based medicine, lawyers and the courts have found it much easier to describe ideal science than to actualize it. This is particularly so in a system (the Law) that has traditionally not been very discerning about scientific rigor, and which has established procedural priorities that are often incompatible with strict scientific standards. This overview will examine the American tort system from an evidence-based perspective. We include a discussion of standards that could be used for "outcomes analysis" in the Law; recognition and classification of errors made by the courts themselves; the relationship between medical errors, "negligence," and standard of care; and the problem of reconciling the rights of plaintiffs with medical-scientific facts. We also consider selected impediments to developing a legal system that is capable of consistently reaching evidence-based decisions concerning complex scientific information, including pathologic interpretation of tissue specimens. PMID:16639995

  4. Thermooptic-based differential measurements of weak solute absorptions with an interferometer.

    PubMed

    Cremers, D A; Keller, R A

    1982-05-01

    An interferometric method of measuring small differences between weak optical absorptions of solutions has been developed using the thermooptic effect. To record the small changes in optical path length ~lambda/200 due to heating, it was necessary to stabilize the fringe pattern with respect to slow thermal drift using a galvanometer-driven compensator plate controlled by a closed feedback loop. Fringe shifts from background absorptions were nulled out to better than 1 part in 400, permitting the measurement of differences in absorptions between two solutions that were l/100th of background. Using laser powers of 100 mW, absorptions approximately 5 x 10(-6) cm(-1) (base e) could be measured with CC1(4) solutions. PMID:20389912

  5. Canadian Tire Money: An Analogy for Use When Discussing Weak Acid Strong Base Titrations

    NASA Astrophysics Data System (ADS)

    Last, Arthur M.

    2003-12-01

    A simple analogy can often provide an instructor with a means of helping students to understand an unfamiliar concept. An analogy involving money can be particularly helpful as most students have experience in dealing with a range of financial transactions in their everyday lives. In this article, use is made of the practice of one well-known Canadian retail chain in returning to its customers a small percentage of an item's purchase price in the form of imitation bank notes that can subsequently be spent in the chain's stores. An analogy is drawn between this practice and the determination of the pKa of a weak acid by titrating it with a strong base, taking into account the hydrolysis of the anion produced.

  6. Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics

    PubMed Central

    Goldenberg, Maya J

    2005-01-01

    Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for

  7. Thermodynamics of hydrogen bonding of weak bases in alcohol solutions: Calorimetry of solution, IR-spectroscopy and vapor pressure analysis

    NASA Astrophysics Data System (ADS)

    Zaitseva, Ksenia V.; Varfolomeev, Mikhail A.; Solomonov, Boris N.

    2012-06-01

    The properties of solutes and their reactivity in aliphatic alcohols significantly depend on the formation of hydrogen bonds. In this work, calorimetric, FTIR-spectroscopic and gas chromatographic vapor pressure studies of hydrogen bonds of weak bases in solution of aliphatic alcohols were carried out. Enthalpies of solutions at infinite dilution of ketones, nitriles and acetates in methanol and octan-1-ol were measured. Obtained from the calorimetric data, the enthalpies of specific interaction of weak bases in aliphatic alcohols unexpectedly found to be positive. IR spectra of solutions of ketones in aliphatic alcohols at infinite dilution were measured at different temperatures. Enthalpies of specific interaction in studied systems obtained from the spectroscopic data confirmed the endothermic process and are in good agreement with calorimetric results. Gibbs energies and entropies of specific interaction of weak bases in aliphatic alcohols were determined. Obtained results show, that the hydrogen bonding process of weak bases in aliphatic alcohols differs substantially from the formation of complexes 1:1 ROH⋯B (B - weak proton acceptor) in aprotic media. The complicated process of hydrogen bonding of weak bases in aliphatic alcohols apparently is controlled by the entropy factor, because these values are above zero.

  8. [Acupressure and Evidence-Based Nursing].

    PubMed

    Chen, Li-Li; Lin, Jun-Dai

    2015-12-01

    Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice. PMID:26645442

  9. A fast weak motif-finding algorithm based on community detection in graphs

    PubMed Central

    2013-01-01

    Background Identification of transcription factor binding sites (also called ‘motif discovery’) in DNA sequences is a basic step in understanding genetic regulation. Although many successful programs have been developed, the problem is far from being solved on account of diversity in gene expression/regulation and the low specificity of binding sites. State-of-the-art algorithms have their own constraints (e.g., high time or space complexity for finding long motifs, low precision in identification of weak motifs, or the OOPS constraint: one occurrence of the motif instance per sequence) which limit their scope of application. Results In this paper, we present a novel and fast algorithm we call TFBSGroup. It is based on community detection from a graph and is used to discover long and weak (l,d) motifs under the ZOMOPS constraint (zero, one or multiple occurrence(s) of the motif instance(s) per sequence), where l is the length of a motif and d is the maximum number of mutations between a motif instance and the motif itself. Firstly, TFBSGroup transforms the (l, d) motif search in sequences to focus on the discovery of dense subgraphs within a graph. It identifies these subgraphs using a fast community detection method for obtaining coarse-grained candidate motifs. Next, it greedily refines these candidate motifs towards the true motif within their own communities. Empirical studies on synthetic (l, d) samples have shown that TFBSGroup is very efficient (e.g., it can find true (18, 6), (24, 8) motifs within 30 seconds). More importantly, the algorithm has succeeded in rapidly identifying motifs in a large data set of prokaryotic promoters generated from the Escherichia coli database RegulonDB. The algorithm has also accurately identified motifs in ChIP-seq data sets for 12 mouse transcription factors involved in ES cell pluripotency and self-renewal. Conclusions Our novel heuristic algorithm, TFBSGroup, is able to quickly identify nearly exact matches for long

  10. 3D modeling method for computer animate based on modified weak structured light method

    NASA Astrophysics Data System (ADS)

    Xiong, Hanwei; Pan, Ming; Zhang, Xiangwei

    2010-11-01

    A simple and affordable 3D scanner is designed in this paper. Three-dimensional digital models are playing an increasingly important role in many fields, such as computer animate, industrial design, artistic design and heritage conservation. For many complex shapes, optical measurement systems are indispensable to acquiring the 3D information. In the field of computer animate, such an optical measurement device is too expensive to be widely adopted, and on the other hand, the precision is not as critical a factor in that situation. In this paper, a new cheap 3D measurement system is implemented based on modified weak structured light, using only a video camera, a light source and a straight stick rotating on a fixed axis. For an ordinary weak structured light configuration, one or two reference planes are required, and the shadows on these planes must be tracked in the scanning process, which destroy the convenience of this method. In the modified system, reference planes are unnecessary, and size range of the scanned objects is expanded widely. A new calibration procedure is also realized for the proposed method, and points cloud is obtained by analyzing the shadow strips on the object. A two-stage ICP algorithm is used to merge the points cloud from different viewpoints to get a full description of the object, and after a series of operations, a NURBS surface model is generated in the end. A complex toy bear is used to verify the efficiency of the method, and errors range from 0.7783mm to 1.4326mm comparing with the ground truth measurement.

  11. Seeking best practices: a conceptual framework for planning and improving evidence-based practices.

    PubMed

    Spencer, Lorine M; Schooley, Michael W; Anderson, Lynda A; Kochtitzky, Chris S; DeGroff, Amy S; Devlin, Heather M; Mercer, Shawna L

    2013-01-01

    How can we encourage ongoing development, refinement, and evaluation of practices to identify and build an evidence base for best practices? On the basis of a review of the literature and expert input, we worked iteratively to create a framework with 2 interrelated components. The first - public health impact - consists of 5 elements: effectiveness, reach, feasibility, sustainability, and transferability. The second - quality of evidence - consists of 4 levels, ranging from weak to rigorous. At the intersection of public health impact and quality of evidence, a continuum of evidence-based practice emerges, representing the ongoing development of knowledge across 4 stages: emerging, promising, leading, and best. This conceptual framework brings together important aspects of impact and quality to provide a common lexicon and criteria for assessing and strengthening public health practice. We hope this work will invite and advance dialogue among public health practitioners and decision makers to build and strengthen a diverse evidence base for public health programs and strategies. PMID:24331280

  12. Who needs evidence-based health care?

    PubMed Central

    Tsafrir, J; Grinberg, M

    1998-01-01

    The vast amount of published material in clinical and biomedical sciences, and conflicting results on diagnostic and therapeutic procedures may introduce doubts in decision-making for patient care. Information retrieving skills and the critical appraisal of published literature, together with elaboration of practice guidelines based on epidemiological methodology, form the basis of the trend towards evidence-based health care, which aims to overcome these problems. A survey conducted by questionnaire at the Chaim Sheba Medical Center analyzed which types of information sources are considered most relevant and useful for patient care by a cross-section of physicians with varying degrees of experience. They considered review articles and meta-analyses extremely reliable for information purposes, while for practical patient-care purposes they tended to rely more on the opinions of peers and experts. As the requirements of evidence-based health care may influence the attitudes of clinicians to the published literature and its evaluation, they have implications for medical libraries and information centers. Specifically, information specialists will be called upon more and more to impart information-retrieval and critical appraisal skills to clinicians. The involvement of information specialists in information gathering and selection will provide added value to the expertise and knowledge of in-house experts for decision-making. PMID:9549011

  13. Organometallic electrochemistry based on electrolytes containing weakly-coordinating fluoroarylborate anions.

    PubMed

    Geiger, William E; Barrière, Frédéric

    2010-07-20

    -deficient organometallic compounds are subject to nucleophilic attack by the traditional family of electrolyte anions. With a view to testing the scope of the much less nucleophililic WCAs in providing a benign electrolyte anion for the generation of organometallic cation radicals, we carried out a series of studies on transition metal sandwich and half-sandwich compounds. The model compounds were chosen both for their fundamental importance and because their radical cations had been neither isolated nor spectrally characterized, despite many previous electrochemical investigations with traditional anions. The oxidation of prototypical organometallic compounds, such as the sandwich-structured ruthenocene and the piano-stool structured Cr(eta(6)-C(6)H(6))(CO)(3), Mn(eta(5)-C(5)H(5))(CO)(3), Re(eta(5)-C(5)H(5))(CO)(3), and Co(eta(5)-C(5)H(5))(CO)(2), gave the first definitive in situ characterization of their radical cations. In several cases, the kinetic stabilization of the anodic products allowed the identification of dimers or unique dimer radicals having weak metal-metal bonds and provided new preparative options for organometallic systems. In terms of thermodynamic effects, the lower ion-pairing abilities of WCAs and their good solubility in a broad range of solvents, including those of lower polarity, permitted a systematic study that yielded an integrated model of how to use solvent-electrolyte combinations to manipulate the E(1/2) differences of compounds undergoing multiple electron-transfer reactions. Although the efficacy of WCA-based electrolytes in organometallic anodic chemistry is now established, WCAs might further expand applications of organic redox chemistry. Other WCAs, including those derived from carboranes and fluorinated alkoxyaluminates, merit additional studies. PMID:20345126

  14. [Evidence based medicine for the gastroenterologist].

    PubMed

    Curioso, Walter H; Montori, Víctor M; Curioso, Walter I

    2004-01-01

    Evidence-based medicine (EBM) integrates the best available external evidence in the care of individual patients with the individual clinical expertise and the patient preferences. This method has been designed for use in daily clinical practice. We describe the rationale for EBM and its principles and application in this article. EBM enables gastroenterologists to update the knowledge required to provide patients with high quality medical care. EBM requires four steps: a) formulating a clinical question arising from a doubt concerning a patient; b) conducting an efficient literature search to answer this question; c) critically appraising this evidence using explicit methods to selected articles to determine the validity of their design and the clinical relevance of their results; and d) applying these results to the patient (taking into account their values and preferences and personal and social circumstances). In this paper, we explain the principles and basic concepts of EBM and their application to gastroenterology and we provide an extensive compilation of internet databases of valid information relevant to gastroenterologists. We also provide a selection of useful tools for self-directed learning of critical appraisal skills. Link updates can be accessed at the following URL: http://www.enlacesmedicos.com/e.htm PMID:15098043

  15. Progress in evidence based reproductive surgery

    PubMed Central

    Bosteels, J.; Weyers, S.; Siristatidis, C.; Bhattacharya, S.; D’Hooghe, T.

    2011-01-01

    The Consolidated Standards of Reporting Trials (CONSORT) was introduced in 1996 to improve the methodological quality of published reports of randomised controlled trials. By doing a systematic review of randomised controlled trials on reproductive surgery, our group can demonstrate that the overall quality of the published reports of randomised studies on reproductive surgical interventions has improved after CONSORT. Nevertheless, some problems still remain. By discussing the benefits and pitfalls of randomised trials in reproductive surgery, our opinion paper aims to stimulate the reader’s further interest in evidence-based practice in reproductive surgery. PMID:24753872

  16. Managing and reviewing evidence-based changes.

    PubMed

    Carter, Helen; Price, Lynda

    Nurses lead many projects to manage change aimed at improving patient safety and care. This two-part series offers practical guidance on how to bring about an evidence-based change in practice, and how to demonstrate the success, or otherwise, of that change. Part 2 is concerned with discovering why the practice is falling short, how to implement improvements and measure the effect of the changes. It also highlights ways in which nurses can use their work as part of the revalidation process. PMID:27089753

  17. Colposcopy: an evidence-based update.

    PubMed

    Dresang, Lee T

    2005-01-01

    Colposcopy is a diagnostic procedure, most commonly used in the diagnosis of cervical intraepithelial neoplasia and lower genital tract carcinoma. In this article, evidence-based management strategies are updated with discussion of the 2001 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. Practice management issues include methods to improve cervical cancer screening rates, coding and billing, and telemedicine. Textbooks, CD-ROMs, and courses are listed for new learners and experienced providers who want to update and sharpen their skills. PMID:16148248

  18. Comparative effectiveness research: decision-based evidence.

    PubMed

    Kowalski, Charles Joseph; Mrdjenovich, Adam Joel

    2014-01-01

    In the clinical research context, comparative effectiveness research (CER) refers to the comparison of several health-care interventions administered under real-world conditions to individuals representative of the day-to-day clinical practice target population. We provide a brief history of CER and argue that CER can be used to deliver useful, but currently lacking information. Three study designs that can accomplish this are discussed, and incorporating CER into cost-benefit analyses is examined. The relationships between CER and evidence-based and personalized medicine are also considered, as is the challenge of implementing CER results into routine clinical practice. PMID:25544326

  19. Cost Evaluation of Evidence-Based Treatments

    PubMed Central

    Sindelar, Jody L.; Ball, Samuel A.

    2010-01-01

    Many treatment programs have adopted or are considering adopting evidence-based treatments (EBTs). When a program evaluates whether to adopt a new intervention, it must consider program objectives, operational goals, and costs. This article examines cost concepts, cost estimation, and use of cost information to make the final decision on whether to adopt an EBT. Cost categories, including variable and fixed, accounting and opportunity, and costs borne by patients and others, are defined and illustrated using the example of expenditures for contingency management. Ultimately, cost is one consideration in the overall determination of whether implementing an EBT is the best use of a program’s resources. PMID:22002453

  20. Normal childbirth and evidence based practice.

    PubMed

    Waldenström, Ulla

    2007-12-01

    This paper was presented at a Health Conference in March 2007, celebrating the 150th birthday of the Royal Women's Hospital in Melbourne. It discusses the definition of "normal childbirth", and the pros and cons of three medical technologies: caesarean section, epidural analgesia during labour and routine ultrasound screening during pregnancy, and whether clinical practices, in Australia and Sweden (author is Swedish), in relation to these methods are evidence based. It also discusses the impact of non-scientific reasons, such as anxiety, on clinical decision making. PMID:17913612

  1. Evidence for weakly bound electrons in non-irradiated alkane crystals: The electrons as a probe of structural differences in crystals

    SciTech Connect

    Pietrow, M. Misiak, L. E.; Gagoś, M.; Kornarzyński, K.; Szurkowski, J.; Grzegorczyk, M.; Rochowski, P.

    2015-02-14

    It is generally assumed that weakly bound (trapped) electrons in organic solids come only from radiolytical (or photochemical) processes like ionization caused by an excited positron entering the sample. This paper presents evidence for the presence of these electrons in non-irradiated samples of docosane. This can be due to the triboelectrification process. We argue that these electrons can be located (trapped) either in interlamellar gaps or in spaces made by non-planar conformers. Electrons from the former ones are bound more weakly than electrons from the latter ones. The origin of Vis absorption for the samples is explained. These spectra can be used as a probe indicating differences in the solid structures of hydrocarbons.

  2. Numerical simulation of fluid-structure interaction for axial flow blade based on weak coupling

    NASA Astrophysics Data System (ADS)

    Zheng, X. B.; Guo, P. C.; Luo, X. Q.

    2012-11-01

    Numerical simulation of three-dimensional flow in whole flow passage of axial flow hydraulic turbine was conducted based on the Reynolds-averaged N-S equations and the standard k-ε model. Stress analysis of axial flow blade were carried on by elasticity unsteady FEM. The fluid domain and solid domain were calculated by sequential iteration. Based on weak coupling technology, the fluid-structure interaction analysis of the axial flow blade was conducted. Instantaneous flow field characteristic and stress distribution on blade were analyzed. According to the comparing with the results of pure flow numerical simulation, the pressure difference between press side and suction side increases after considering the FSI, to a certain extent, which will worsen cavitations performance of the blade. Meanwhile, stress distribution on the blades do not change significantly, but the maximum stress value increases markedly, and the maximum displacement reduces slightly. The research demonstrates that the FSI not only changes the distribution of the flow field in blade area, but also have a greater impact on the stress of the blades.

  3. Total phenol analysis of weakly supported water using a laccase-based microband biosensor.

    PubMed

    Sekretaryova, Alina N; Volkov, Anton V; Zozoulenko, Igor V; Turner, Anthony P F; Vagin, Mikhail Yu; Eriksson, Mats

    2016-02-11

    The monitoring of phenolic compounds in wastewaters in a simple manner is of great importance for environmental control. Here, a novel screen printed laccase-based microband array for in situ, total phenol estimation in wastewaters and for water quality monitoring without additional sample pre-treatment is presented. Numerical simulations using the finite element method were utilized for the characterization of micro-scale graphite electrodes. Anodization followed by covalent modification was used for the electrode functionalization with laccase. The functionalization efficiency and the electrochemical performance in direct and catechol-mediated oxygen reduction were studied at the microband laccase electrodes and compared with macro-scale electrode structures. The reduction of the dimensions of the enzyme biosensor, when used under optimized conditions, led to a significant improvement in its analytical characteristics. The elaborated microsensor showed fast responses towards catechol additions to tap water - a weakly supported medium - characterized by a linear range from 0.2 to 10 μM, a sensitivity of 1.35 ± 0.4 A M(-1) cm(-2) and a dynamic range up to 43 μM. This enhanced laccase-based microsensor was used for water quality monitoring and its performance for total phenol analysis of wastewater samples from different stages of the cleaning process was compared to a standard method. PMID:26803001

  4. Weak-coherent-state-based time-frequency quantum key distribution

    NASA Astrophysics Data System (ADS)

    Zhang, Yequn; Djordjevic, Ivan B.; Neifeld, Mark A.

    2015-11-01

    We study large-alphabet quantum key distribution (QKD) based on the use of weak-coherent states and the time-frequency uncertainty relation. The large alphabet is achieved by dividing time and spectrum into M bins resulting in a frame similar to traditional pulse-position modulation (in time domain). However, the non-uniform occurrence of a photon prepared in a time/frequency bin creates the space for eavesdropping. By analysis, we show that a new intercept-resend attack strategy exists, which is stronger than that has been reported in the literature and hence the secret key rate of time-frequency QKD (TF-QKD) can be more tightly bounded. We then analyse the secret key rates of TF-QKD under various practical issues, such as channel loss, background noise, jitter and atmospheric turbulence in order to better understand the applicability of TF-QKD. Further, we discuss the information reconciliation for TF-QKD. Specifically, we investigate the layered coding scheme for TF-QKD based on quasi-cyclic low-density parity-check codes against jitter and atmospheric turbulence. By simulation, we demonstrate that information reconciliation can be efficiently achieved.

  5. Weak network efficiency in young children with Autism Spectrum Disorder: Evidence from a functional near-infrared spectroscopy study.

    PubMed

    Li, Yanwei; Yu, Dongchuan

    2016-10-01

    Functional near infrared spectroscopy (fNIRS) is particularly suited for the young population and ecological measurement. However, thus far, not enough effort has been given to the clinical diagnosis of young children with Autism Spectrum Disorder (ASD) by using fNIRS. The current study provided some insights into the quantitative analysis of functional networks in young children (ages 4.8-8.0years old) with and without ASD and, in particular, investigated the network efficiency and lobe-level connectivity of their functional networks while watching a cartoon. The main results included that: (i) Weak network efficiency was observed in young children with ASD, even for a wide range of threshold for the binarization of functional networks; (ii) A maximum classification accuracy rate of 83.3% was obtained for all participants by using the k-means clustering method with network efficiencies as the feature parameters; and (iii) Weak lobe-level inter-region connections were uncovered in the right prefrontal cortex, including its linkages with the left prefrontal cortex and the bilateral temporal cortex. Such results indicate that the right prefrontal cortex might make a major contribution to the psychopathology of young children with ASD at the functional network architecture level, and at the functional lobe-connectivity level, respectively. PMID:27474793

  6. [Philosophical background of evidence-based medicine].

    PubMed

    Kwon, Sang-Ok

    2004-12-01

    Through the whole history of medicine, there runs a long struggle between two principal tendencies - empiricism and rationalism. The empirical trend lays its emphasis on "experience" for the cure of the sick. The rationalistic trend lays its main emphasis on "mechanism" for the causes of diseases. The term "evidence-based (EBM)", defined as "the conscious, explicit and judicious use of the best current evidence in making decisions about the individual patients", was introduced about ten years ago. The proponents has been described EBM as a "paradigm shift" that will change medical practice in the years ahead. But there has been considerable debate about the value of EBM. The modern medicine, following philosophy of modern science such as the 'realism controlled by empiricism', has developed biomedical model. But the EBM wrapped with clinical epidemiology and statistics, represents response of empiricism to the rationalism (realism). The roots of EBM extend back at least as far as the Paris clinical school, and the work of Pierre Louis in Paris in the early 19th century.Is EBM a paradigm shift? To answer this question, we have to specify the alternative with which we are comparing EBM. The alternative to EBM is the basic science approach: studying the pathophysiological mechanism of the body. But EBM is so clearly intertwined with and complementary to the basic science that it would make little sense to see EBM as a paradigm shift away from basic science. In a sense, evidence-based medicine shows only methodological contribution aimed at improving the gathering and sorting of the best information published by biomedical scientists and clinical epidemiologists for use in clinical practice. Although EBM and the traditional medicine embody different approaches, this does not mean that they are competitors. In fact, the two approach need each; neither can stand alone for the development of clinical practice. PMID:15726761

  7. Evidence-based medicine: medical librarians providing evidence at the point of care.

    PubMed

    Yaeger, Lauren H; Kelly, Betsy

    2014-01-01

    Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence. PMID:25438362

  8. Evidence-based medicine: medical librarians providing evidence at the point of care.

    PubMed

    Yaeger, Lauren H; Kelly, Betsy

    2014-01-01

    Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence. PMID:25507879

  9. Reconstructing data: evidence-based medicine and evidence-based public health in context.

    PubMed

    Nadav, Davidovitch; Dani, Filc

    2006-01-01

    The emergence of Evidence-Based Medicine (EBM) as the gold-standard practice in biomedicine and public health practices represents a significant epistemological turn in modern medicine. The development of Evidence-Based Public Health (EBPH) followed the emergence of Evidence-Based Medicine, as an attempt to ground health policies and interventions on "sound facts". The present paper analyzes the historical and sociological roots of this turn. We evaluate the ethical and social consequences of this transformation, both within the medical profession (the polarization between a medical elite which strengthened its professional status, and a rank and file which experienced a process of "de-professionalization") and in its relationship to the welfare state (the link between the medical elite, EBM, EBPH and the commodification of health care and public health). PMID:17214142

  10. Evidence-Based Practice Guidelines and School Nursing

    ERIC Educational Resources Information Center

    Adams, Susan; McCarthy, Ann Marie

    2007-01-01

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

  11. An Examination of the Bases of Evidence-Based Interventions.

    ERIC Educational Resources Information Center

    Wampold, Bruce E.

    2002-01-01

    School psychology has proposed a system to aid in the identification of evidence-based interventions (Kratochwill & Stoiber, this issue; Lewis-Snyder, Stoiber, & Kratochwill, this issue; Shernoff, Kratochwill, & Stoiber, this issue). In this commentary, issues related to the politics of exclusion, design and theory, methods, and multiculturalism…

  12. Nurse-led elective cardioversion: an evidence-based practice review.

    PubMed

    Smallwood, Andrew

    2005-01-01

    By posing a clinical practice question, this article aims to document and explore the published evidence base supporting nurse-led cardioversion. A literature review was undertaken to determine the best evidence for practice. Five articles and two conference abstracts describing practice were found to be pertinent to the question. Description of the methodology used was a weakness of all the articles studied, with only one article purported to be framed as a research study. The remainder describe a planned change in nursing practice to encompass the delivery of a service previously, organizationally viewed as, physician led. Evaluations of practice were descriptive and supported by audit data in most articles, however, appropriate evidential comparisons were not offered. These articles were critically appraised in relation to safety and efficacy. Whilst the evidence may be seen to be limited and weak, it does add credence to the notion that a nurse with a suitable experiential background and knowledge base can make a significant contribution to the care of this group of patients. It is clearly evident that further developments in practice should be framed within a research context to support and strengthen the evidence base. Four prominent themes emerged from the review, 'change milieu', 'reshaping boundaries', 'nurse-led', 'efficacy of practice', which are modelled into a conceptual framework. Nursing roles are expanding within the cardiological setting, affording practitioners unprecedented practice opportunities within a supportive organizational framework, however, these roles must be subject to appropriate evaluation in order to continue informing a robust evidence base. PMID:16161378

  13. Evidence of weak ferromagnetism in doped plasticized polyaniline (PANI-DDoESSA)0.5 from electron spin resonance measurements.

    PubMed

    Santana, V T; Nascimento, O R; Djurado, D; Travers, J P; Pron, A; Walmsley, L

    2013-03-20

    X-band electron spin resonance (ESR) measurements have been performed on a conducting free-standing film of polyaniline plasticized and protonated with di-n-dodecyl ester of sulfosuccinic acid (DDoESSA). The magnetic field was applied parallel and perpendicular to the plane of the film. At around 75 K a transition is observed from Pauli susceptibility to a localized state in which the spin 1/2 polarons behave as spin 1/2 dimers. A rough estimation of the intradimer and interdimer exchange constants is obtained. Below 5 K, ESR data reveal a weak ferromagnetism with the Dzyaloshinskii-Moriya vector mainly oriented in the plane of the film. The existence of a relatively well-defined n-fold axis along the chain direction in the crystalline regions confers a symmetry compatible with such analysis. PMID:23423800

  14. Evidence for weak electron confinement in spin valves having Co90 Fe10 /Cu/ Co90 Fe10 trilayers

    NASA Astrophysics Data System (ADS)

    Maat, S.; Zeltser, A.; Li, J.; Nix, L.; Gurney, B. A.

    2004-07-01

    The temperature and spacer-layer thickness dependences of the free layer coupling field in spin valves having Co90Fe10/Cu/Co90Fe10 pinned-/spacer-/free layer trilayer structures have been measured. Our data verify a previously made theoretical prediction that the coupling field depends on both the shape of the Fermi surface of the spacer layer and the degree of confinement of the magnetic carriers in the spacer quantum well. In weakly confining systems such as Co90Fe10/Cu/Co90Fe10 the latter mechanism can be large in the temperature range of interest and can have a significant impact on the temperature and spacer-layer thickness dependence of interlayer coupling fields. Including both mechanisms we are able to quantify the contribution of both the oscillatory interlayer and the Néel coupling field as well as the temperature-dependent data for the phase of the oscillations.

  15. Evidence for weak electron confinement in spin-valves having CoFe10/Cu/CoFe10 trilayers

    NASA Astrophysics Data System (ADS)

    Maat, Stefan; Zeltser, Alexander; Li, Jinshan; Nix, Lamar; Gurney, Bruce A.

    2004-03-01

    The temperature and spacer-layer thickness dependence of the free layer coupling field in spin-valves having CoFe10/Cu/CoFe10 pinned-/spacer-/free layer trilayer structures has been measured. Our data verifies a previously made theoretical prediction that the coupling field depends on both the shape of the Fermi surface of the spacer layer and the degree of confinement of the magnetic carriers in the spacer quantum well. In weakly confining systems such as CoFe10/Cu/CoFe10 the latter mechanism can be large in the temperature range on interest and can have a significant impact on the temperature and spacer-layer dependence of interlayer coupling fields. Including both mechanisms we are able to quantify the contribution of both the oscillatory interlayer and the Néel coupling field as well as the temperature dependent data for the phase of the oscillations.

  16. Weak transient fault feature extraction based on an optimized Morlet wavelet and kurtosis

    NASA Astrophysics Data System (ADS)

    Qin, Yi; Xing, Jianfeng; Mao, Yongfang

    2016-08-01

    Aimed at solving the key problem in weak transient detection, the present study proposes a new transient feature extraction approach using the optimized Morlet wavelet transform, kurtosis index and soft-thresholding. Firstly, a fast optimization algorithm based on the Shannon entropy is developed to obtain the optimized Morlet wavelet parameter. Compared to the existing Morlet wavelet parameter optimization algorithm, this algorithm has lower computation complexity. After performing the optimized Morlet wavelet transform on the analyzed signal, the kurtosis index is used to select the characteristic scales and obtain the corresponding wavelet coefficients. From the time-frequency distribution of the periodic impulsive signal, it is found that the transient signal can be reconstructed by the wavelet coefficients at several characteristic scales, rather than the wavelet coefficients at just one characteristic scale, so as to improve the accuracy of transient detection. Due to the noise influence on the characteristic wavelet coefficients, the adaptive soft-thresholding method is applied to denoise these coefficients. With the denoised wavelet coefficients, the transient signal can be reconstructed. The proposed method was applied to the analysis of two simulated signals, and the diagnosis of a rolling bearing fault and a gearbox fault. The superiority of the method over the fast kurtogram method was verified by the results of simulation analysis and real experiments. It is concluded that the proposed method is extremely suitable for extracting the periodic impulsive feature from strong background noise.

  17. Density functional method including weak interactions: Dispersion coefficients based on the local response approximation

    NASA Astrophysics Data System (ADS)

    Sato, Takeshi; Nakai, Hiromi

    2009-12-01

    A new method to calculate the atom-atom dispersion coefficients in a molecule is proposed for the use in density functional theory with dispersion (DFT-D) correction. The method is based on the local response approximation due to Dobson and Dinte [Phys. Rev. Lett. 76, 1780 (1996)], with modified dielectric model recently proposed by Vydrov and van Voorhis [J. Chem. Phys. 130, 104105 (2009)]. The local response model is used to calculate the distributed multipole polarizabilities of atoms in a molecule, from which the dispersion coefficients are obtained by an explicit frequency integral of the Casimir-Polder type. Thus obtained atomic polarizabilities are also used in the damping function for the short-range singularity. Unlike empirical DFT-D methods, the local response dispersion (LRD) method is able to calculate the dispersion energy from the ground-state electron density only. It is applicable to any geometry, free from physical constants such as van der Waals radii or atomic polarizabilities, and computationally very efficient. The LRD method combined with the long-range corrected DFT functional (LC-BOP) is applied to calculations of S22 weakly bound complex set [Phys. Chem. Chem. Phys. 8, 1985 (2006)]. Binding energies obtained by the LC-BOP+LRD agree remarkably well with ab initio references.

  18. Density functional method including weak interactions: Dispersion coefficients based on the local response approximation

    NASA Astrophysics Data System (ADS)

    Sato, Takeshi; Nakai, Hiromi

    2009-12-01

    A new method to calculate the atom-atom dispersion coefficients in a molecule is proposed for the use in density functional theory with dispersion (DFT-D) correction. The method is based on the local response approximation due to Dobson and Dinte [Phys. Rev. Lett. 76, 1780 (1996)], with modified dielectric model recently proposed by Vydrov and van Voorhis [J. Chem. Phys. 130, 104105 (2009)]. The local response model is used to calculate the distributed multipole polarizabilities of atoms in a molecule, from which the dispersion coefficients are obtained by an explicit frequency integral of the Casimir-Polder type. Thus obtained atomic polarizabilities are also used in the damping function for the short-range singularity. Unlike empirical DFT-D methods, the local response dispersion (LRD) method is able to calculate the dispersion energy from the ground-state electron density only. It is applicable to any geometry, free from physical constants such as van der Waals radii or atomic polarizabilities, and computationally very efficient. The LRD method combined with the long-range corrected DFT functional (LC-BOP) is applied to calculations of S22 weakly bound complex set [Phys. Chem. Chem. Phys. 8, 1985 (2006)]. Binding energies obtained by the LC-BOP + LRD agree remarkably well with ab initio references.

  19. Evaluating the Quality of Evidence from Correlational Research for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Thompson, Bruce; Diamond, Karen E.; McWilliam, Robin; Snyder, Patricia; Snyder, Scott W.

    2005-01-01

    Only true experiments offer definitive evidence for causal inferences, but not all educational interventions are readily amenable to experiments. Correlational evidence can at least tentatively inform evidence-based practice when sophisticated causal modeling or exclusion methods are employed. Correlational evidence is most informative when…

  20. Rapid Linguistic Ambiguity Resolution in Young Children with Autism Spectrum Disorder: Eye Tracking Evidence for the Limits of Weak Central Coherence.

    PubMed

    Hahn, Noemi; Snedeker, Jesse; Rabagliati, Hugh

    2015-12-01

    Individuals with autism spectrum disorders (ASD) have often been reported to have difficulty integrating information into its broader context, which has motivated the Weak Central Coherence theory of ASD. In the linguistic domain, evidence for this difficulty comes from reports of impaired use of linguistic context to resolve ambiguous words. However, recent work has suggested that impaired use of linguistic context may not be characteristic of ASD, and is instead better explained by co-occurring language impairments. Here, we provide a strong test of these claims, using the visual world eye tracking paradigm to examine the online mechanisms by which children with autism resolve linguistic ambiguity. To address concerns about both language impairments and compensatory strategies, we used a sample whose verbal skills were strong and whose average age (7; 6) was lower than previous work on lexical ambiguity resolution in ASD. Participants (40 with autism and 40 controls) heard sentences with ambiguous words in contexts that either strongly supported one reading or were consistent with both (John fed/saw the bat). We measured activation of the unintended meaning through implicit semantic priming of an associate (looks to a depicted baseball glove). Contrary to the predictions of weak central coherence, children with ASD, like controls, quickly used context to resolve ambiguity, selecting appropriate meanings within a second. We discuss how these results constrain the generality of weak central coherence. PMID:25820816

  1. Reducing Emergency Department Crowding: Evidence Based Strategies.

    PubMed

    Khalifa, Mohamed; Zabani, Ibrahim

    2016-01-01

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

  2. Sepsis management: An evidence-based approach.

    PubMed

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

    2016-03-01

    The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care units are not adequately equipped and financial concerns limit implementation of expensive treatment strategies. Healthcare policy-makers should be notified in order to alleviate financial restrictions and ensure delivery of standard care to septic patients. PMID:26968289

  3. Evidence Base Update for Autism Spectrum Disorder.

    PubMed

    Smith, Tristram; Iadarola, Suzannah

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Schoenwald, Sonja K.

    2008-01-01

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

  5. Home-based telehealth to deliver evidence-based psychotherapy in veterans with PTSD.

    PubMed

    Strachan, Martha; Gros, Daniel F; Yuen, Erica; Ruggiero, Kenneth J; Foa, Edna B; Acierno, Ron

    2012-03-01

    Although medical service delivery via home-based telehealth technology (HBT) is gaining wider acceptance in managing chronic illnesses such as diabetes or chronic obstructive pulmonary disease, few studies have tested HBT applications of psychotherapy. Clinicians, administrators, and researchers question whether delivering psychotherapeutic services to patients in their homes via video-conferencing technology compromises patient safety, potency of treatment, or data security. Despite these concerns, HBT service delivery may increase access to evidence-based psychotherapies for veterans with posttraumatic stress disorder (PTSD), who may be less willing or less able to receive weekly treatment at a VA medical center or outpatient clinic due to symptom severity or other similar barriers to care. Indeed, although combat-exposed service members endorse high rates of psychiatric disorders, few appear to initiate mental health services or receive an adequate dose of treatment. Thus, using HBT technologies to administer evidence-based therapies remains uncharted territory in both the clinical and research arenas. This manuscript describes an ongoing four year randomized controlled trial comparing in-person Prolonged Exposure (PE) - a specialized evidence-based psychotherapy for PTSD - and PE delivered via HBT, with a particular focus on the selection, application, and strengths/weaknesses of HBT procedures. PMID:22101225

  6. Evidence-Based Medicine in the Education of Psychiatrists

    ERIC Educational Resources Information Center

    Srihari, Vinod

    2008-01-01

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

  7. The ABCs of Evidence-Based Practice for Teachers

    ERIC Educational Resources Information Center

    Kretlow, Allison G.; Blatz, Sharon L.

    2011-01-01

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

  8. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  9. 75 FR 79455 - OPEN GOVERNMENT AND EVIDENCE-BASED REGULATION

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... From the Federal Register Online via the Government Publishing Office ] OPEN GOVERNMENT AND EVIDENCE-BASED REGULATION There is a close connection, even an inextricable relationship, between open government and evidence- based regulation. If regulatory choices are based on careful analysis of the evidence, and if opportunities are provided...

  10. Basis of antimalarial action: non-weak base effects of chloroquine on acid vesicle pH

    SciTech Connect

    Krogstad, D.J.; Schlesinger, P.H.

    1987-03-01

    Biologically active concentrations of chloroquine increase the pH of the parasite's acid vesicles within 3-5 min. This increase in pH results from two mechanisms, one of which is markedly reduced in chloroquine-resistant parasites. Because chloroquine is a weak base, it increases vesicle pH by that mechanism in chloroquine-susceptible and resistant parasites and mammalian cells (based on its two pKs and on the delta pH between the acid vesicle and the extracellular environment). In chloroquine-susceptible parasites, but not resistant parasites or mammalian cells, chloroquine increases the pH of acid vesicles 700- to 800-fold more than can be accounted for by its properties as a weak base. The increase in acid vesicle pH caused by these non-weak base effects of nanomolar chloroquine in susceptible parasites suggests that chloroquine acts by interfering with acid vesicle functions in the parasite such as the endocytosis and proteolysis of hemoglobin, and the intracellular targeting of lysosomal enzymes. The non-weak base effects of nanomolar chloroquine on parasite vesicle pH are also responsible for its safety because these chloroquine concentrations do not affect mammalian cells.

  11. Oligomers Based on a Weak Hydrogen Bond Network: the Rotational Spectrum of the Tetramer of Difluoromethane

    NASA Astrophysics Data System (ADS)

    Feng, Gang; Evangelisti, Luca; Caminati, Walther; Cacelli, Ivo; Carbonaro, Laura; Prampolini, Giacomo

    2013-06-01

    Following the investigation of the rotational spectra of three conformers (so-called ``book'', ``prism'' and ``cage'') of the water hexamer, and of some other water oligomers, we report here the rotational spectrum of the tetramer of a freon molecule. The pulse jet Fourier transform microwave (pj-FTMW) spectrum of an isomer of the difluoromethane tetramer has been assigned. This molecular system is made of units of a relatively heavy asymmetric rotor, held together by a network of weak hydrogen bonds. The search of the rotational spectrum has been based on a high-level reference method, the CCSD(T)/CBS protocol. It is interesting to outline that the rotational spectrum of the water tetramer was not observed, probably because the minimum energy structures of this oligomer is effectively nonpolar in its ground states, or because of high energy tunnelling splittings. The rotational spectra of the monomer, dimer, trimer and tetramer of difluoromethane have been assigned in 1952, 1999, 2007, and 2013 (present work), with a decreasing time spacing between the various steps, looking then promising for a continuous and rapid extension of the size limits of molecular systems accessible to MW spectroscopy. C. Pérez, M. T. Muckle, D. P. Zaleski, N. A. Seifert, B. Temelso, G. C. Shields, Z. Kisiel, B. H. Pate, Science {336} (2012) 897. D. R. Lide, Jr., J. Am. Chem. Soc. {74} (1952) 3548. W. Caminati, S. Melandri, P. Moreschini, P. G. Favero, Angew. Chem. Int. Ed. {38} (1999) 2924. S. Blanco, S. Melandri, P. Ottaviani, W. Caminati, J. Am. Chem. Soc. {129} (2007) 2700.

  12. A compensation-based power flow method for weakly meshed distribution and transmission networks

    SciTech Connect

    Shirmohammadi, D.; Hong, H.W.; Semlyen, A.; Luo, G.X.

    1988-05-01

    This paper describes a new power flow method for solving weakly meshed distribution and transmission networks, using a multi-port compensation technique and basic formulation of Kirchhoff's laws. This method has excellent convergence characteristics and is very robust. A computer program implementing this power flow solution scheme was developed and successfully applied to several practical distribution networks with radial and weakly meshed structure. This program was also successfully used for solving radial and weakly meshed transmission networks. The method can be applied to the solution of both the three-phase (unbalanced) and single-phase (balanced) representation of the network. In this paper, however, only the single phase representation is treated in detail.

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

    PubMed

    Ross, Jacqueline

    2010-04-01

    Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas. PMID:20359640

  14. Building a Performance-Based Assessment System To Diagnose Strengths and Weaknesses in Reading Achievement.

    ERIC Educational Resources Information Center

    Hennings, Sara S.; Hughes, Kay E.

    This paper provides a brief description of the development of the Diagnostic Assessments of Reading with Trial Teaching Strategies (DARTTS) program by F. G. Roswell and J. S. Chall. It also describes the editorial and statistical procedures that were used to validate the program for determining students' strengths and weaknesses in important areas…

  15. Creating Evidence-Based Research in Adapted Physical Activity

    ERIC Educational Resources Information Center

    Reid, Greg; Bouffard, Marcel; MacDonald, Catherine

    2012-01-01

    Professional practice guided by the best research evidence is a usually referred to as evidence-based practice. The aim of the present paper is to describe five fundamental beliefs of adapted physical activity practices that should be considered in an 8-step research model to create evidence-based research in adapted physical activity. The five…

  16. Evidence-based guidelines: Improving AGREEment on consistence evaluation

    PubMed Central

    Vincenzi, Bruno; Napolitano, Andrea; Santini, Daniele; Maiello, Evaristo; Torri, Valter; Tonini, Giuseppe

    2012-01-01

    Modern clinical practice relies on evidence-based medicine (EBM) and evidence-based guidelines (EBGs). The critical evaluation of EBGs value is therefore an essential step to further improve clinical practice. In our opinion, correlating levels of evidence and grades of recommendation can be an easy tool to quickly display internal consistence of EBGs. PMID:26909252

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  18. Controlling biofilm with evidence-based dentifrices.

    PubMed

    Ciancio, Sebastian G

    2011-01-01

    This review summarizes research that has assessed the effectiveness of various antimicrobial-containing dentifrices in preventing and/or reducing a number of oral health problems facing our patients today. The results of these studies indicate that, when compared with a conventional fluoride dentifrice, the triclosan/copolymer/fluoride dentifrice is the one with the most evidence to support its ability to deliver significant oral health benefits with no adverse effects. The benefits maybe summarized as follows: improved levels ofsupragingival plaque control; improved gingival health; reducedlikelihood of gingivitis progressing to periodontitis; arrest progression of periodontitis; prevention of supragingival calculus; and reduction in oral malodor. With increased interest in the association of oral health with systemic health, this dentifrice is well-positioned to help reduce the likelihood of gingivitis establishing itself and possibly developing into periodontitis (Figure 1). It also has the potential to have beneficial effects on general health because of its anti-inflammatory properties. Based on the results presented in this article, it is clear that the general population can derive significant clinical benefits from the daily use of a triclosan/copolymer/fluoride dentifrice. The dental profession should feel confident to recommend its use to patients to improve oral health and maintain or promote overall health. PMID:21462625

  19. Subjective evidence based ethnography: method and applications.

    PubMed

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

    2015-06-01

    Subjective Evidence Based Ethnography (SEBE) is a method designed to access subjective experience. It uses First Person Perspective (FPP) digital recordings as a basis for analytic Replay Interviews (RIW) with the participants. This triggers their memory and enables a detailed step by step understanding of activity: goals, subgoals, determinants of actions, decision-making processes, etc. This paper describes the technique and two applications. First, the analysis of professional practices for know-how transferring purposes in industry is illustrated with the analysis of nuclear power-plant operators' gestures. This shows how SEBE enables modelling activity, describing good and bad practices, risky situations, and expert tacit knowledge. Second, the analysis of full days lived by Polish mothers taking care of their children is described, with a specific focus on how they manage their eating and drinking. This research has been done on a sub-sample of a large scale intervention designed to increase plain water drinking vs sweet beverages. It illustrates the interest of SEBE as an exploratory technique in complement to other more classic approaches such as questionnaires and behavioural diaries. It provides the detailed "how" of the effects that are measured at aggregate level by other techniques. PMID:25579747

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

    PubMed

    Devisch, Ignaas; Murray, Stuart J

    2009-12-01

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

  1. Will reducing sugar-sweetened beverage consumption reduce obesity? Evidence supporting conjecture is strong, but evidence when testing effect is weak

    PubMed Central

    Kaiser, Kathryn A.; Shikany, James M.; Keating, Karen D.; Allison, David B.

    2014-01-01

    We provide arguments to the debate question and update a previous meta-analysis with recently published studies on effects of sugar-sweetened beverages (SSBs) on body weight/composition indices (BWIs). We abstracted data from randomized controlled trials examining effects of consumption of SSBs on BWIs. Six new studies met these criteria: 1) human trials, 2) 3 weeks duration, 3) random assignment to conditions differing only in consumption of SSBs, and 4) including a BWI outcome. Updated meta-analysis of a total of seven studies that added SSBs to persons’ diets showed dose-dependent increases in weight. Updated meta-analysis of eight studies attempting to reduce SSB consumption showed an equivocal effect on BWIs in all randomized subjects. When limited to subjects overweight at baseline, meta-analysis showed a significant effect of roughly 0.25 standard deviations (more weight loss/less weight gain) relative to controls. Evidence to date is equivocal in showing that decreasing SSB consumption will reduce the prevalence of obesity. Although new evidence suggests that an effect may yet be demonstrable in some populations, the integrated effect size estimate remains very small and of equivocal statistical significance. Problems in this research area and suggestions for future research are highlighted. PMID:23742715

  2. Space-Time Correlation of Stable Boundary-Layer, Weak Wind Data from Ground Based Acoustic Sensors

    NASA Astrophysics Data System (ADS)

    Smoot, A. R.; Thomas, C. K.

    2011-12-01

    We present data collected using ground based acoustic sensing in order to connect near-surface motions including turbulence and sub-meso modes under stable, weak wind conditions to possible external forcing mechanisms from aloft. Under stable stratification and weak wind conditions the generation of the weak, intermittent turbulence is poorly understood, but critical to understanding and modeling the dispersion and diffusion of pollutants and other trace gases. Recent studies have suggested that the driving processes behind weak wind turbulence may include external forcing on the sub-meso scale. The forcing mechanisms may include gravity waves, 2 dimensional horizontal modes, solitons, or interactions between surface flow and low-level jets. Efforts to detect weak wind, sub-meso scale processes have failed so far due to a lack of sufficient spatial coverage necessary for capturing these events. This research has taken an unconventional observational approach by using a pair of SODAR (Sound Detection And Ranging) units. The SODARs have collected data on short time scales with a significant vertical (15 - 300 meters) and horizontal (200 - 1000 meters) coverage. The experiment took place on Oregon State University's Research Farms located roughly a mile to the east of OSU's campus. The site was chosen for its homogenous terrain which allowed the two SODAR's to be separated across the domain without their measurements being contaminated by influence from surface heterogeneity. The experiment has provided a data set comprised of more than 3 months of semi-continuous SODAR data. By making use of the Multi-resolution Decomposition method we will present results on the space-time correlations of the boundary-layer winds on multiple different time scales. The results will be a significant step towards improving the predictability of weak wind meanderings, identifying scaling parameters for sub-meso scale motions, and help to improve air quality and diffusion models.

  3. Influence of Weak External Magnetic Field on Amorphous and Nanocrystalline Fe-based Alloys

    SciTech Connect

    Degmova, J.; Sitek, J.

    2010-07-13

    Nanoperm, Hitperm and Finamet amorphous and nanocrystalline alloys were measured by Moessbauer spectrometry in a weak external magnetic field of 0.5 T. It was shown that the most sensitive parameters of Moessbauer spectra are the intensities of the 2nd and the 5th lines. Rather small changes were observed also in the case of internal magnetic field values. The spectrum of nanocrystalline Nanoperm showed the increase in A{sub 23} parameter (ratio of line intensities) from 2.4 to 3.7 and decrease of internal magnetic field from 20 to 19 T for amorphous subspectrum under the influence of magnetic field. Spectrum of nanocrystalline Finemet shown decrease in A{sub 23} parameter from 3.5 to 2.6 almost without a change in the internal magnetic field value. In the case of amorphous Nanoperm and Finemet samples, the changes are almost negligible. Hitperm alloy showed the highest sensitivity to the weak magnetic field, when the A{sub 23} parameter increased from 0.4 to 2.5 in the external magnetic fields. The A{sub 23} parameter of crystalline subspectrum increased from 2.7 to 3.8 and the value of internal magnetic field corresponding to amorphous subspectrum increased from 22 to 24 T. The behavior of nanocrystalline alloys under weak external magnetic field was analyzed within the three-level relaxation model of magnetic dynamics in an assembly of single-domain particles.

  4. MultiDarkLens Simulations: weak lensing light-cones and data base presentation

    NASA Astrophysics Data System (ADS)

    Giocoli, Carlo; Jullo, Eric; Metcalf, R. Benton; de la Torre, Sylvain; Yepes, Gustavo; Prada, Francisco; Comparat, Johan; Göttlober, Stefan; Kyplin, Anatoly; Kneib, Jean-Paul; Petkova, Margarita; Shan, HuanYuan; Tessore, Nicolas

    2016-06-01

    In this paper we present a large database of weak lensing light cones constructed using different snapshots from the Big MultiDark simulation (BigMDPL). The ray-tracing through different multiple plane has been performed with the GLAMER code accounting both for single source redshifts and for sources distributed along the cosmic time. This first paper presents weak lensing forecasts and results according to the geometry of the VIPERS-W1 and VIPERS-W4 field of view. Additional fields will be available on our database and new ones can be run upon request. Our database also contains some tools for lensing analysis. In this paper we present results for convergence power spectra, one point and high order weak lensing statistics useful for forecasts and for cosmological studies. Covariance matrices have also been computed for the different realisations of the W1 and W4 fields. In addition we compute also galaxy-shear and projected density contrasts for different halo masses at two lens redshift according to the CFHTLS source redshift distribution both using stacking and cross-correlation techniques, finding very good agreement.

  5. Detection of weak transient signals based on wavelet packet transform and manifold learning for rolling element bearing fault diagnosis

    NASA Astrophysics Data System (ADS)

    Wang, Yi; Xu, Guanghua; Liang, Lin; Jiang, Kuosheng

    2015-03-01

    The kurtogram-based methods have been proved powerful and practical to detect and characterize transient components in a signal. The basic idea of the kurtogram-based methods is to use the kurtosis as a measure to discover the presence of transient impulse components and to indicate the frequency band where these occur. However, the performance of the kurtogram-based methods is poor due to the low signal-to-noise ratio. As the weak transient signal with a wide spread frequency band can be easily masked by noise. Besides, selecting signal just in one frequency band will leave out some transient features. Aiming at these shortcomings, different frequency bands signal fusion is adopted in this paper. Considering that manifold learning aims at discovering the nonlinear intrinsic structure which embedded in high dimensional data, this paper proposes a waveform feature manifold (WFM) method to extract the weak signature from waveform feature space which obtained by binary wavelet packet transform. Minimum permutation entropy is used to select the optimal parameter in a manifold learning algorithm. A simulated bearing fault signal and two real bearing fault signals are used to validate the improved performance of the proposed method through the comparison with the kurtogram-based methods. The results show that the proposed method outperforms the kurtogram-based methods and is effective in weak signature extraction.

  6. Evidence base in guideline generation in diabetes.

    PubMed

    Mühlhauser, I; Meyer, G

    2013-06-01

    During recent years much emphasis has been on the validity, reliability, reproducibility, clinical applicability, clarity, multidisciplinary process, scheduled review and documentation of clinical practice guidelines (CPGs). Still, CPGs show substantial variance in methodological quality. The present paper mainly focuses on two aspects that are particularly critical and contemporary from the perspective of evidence-based medicine: patient centredness and shared decision making, and conflict of interest. Sophisticated patient and consumer involvement at all stages of CPG development could be judged as being the gold standard. However, co-opting patients or consumer representatives and using other techniques of active patient involvement does not replace individual patient preferences in clinical decision-making processes. Current CPGs do not meet patient needs, since they do not provide concise, easy-to-read summaries of the benefits and risks of medicines together with more comprehensive scientific data as a prerequisite for informed or shared decision making. The vast majority of CPG panels have a financial conflict of interest (COI) and under-reporting is common. Not all organisations producing CPGs have set up COI policies, and existing policies vary widely. To solve the problem, CPG experts have recommended that methodologists without any important COI should lead the development process and have primary responsibility. There is a lot of room for other improvements through network transnational activities in the field of CPG development. Waste of time and resources should be avoided through sharing published and unpublished data identified, appraised and extracted for guideline development. The EASD could provide such a clearing house. PMID:23475367

  7. Evidence based management of Bell's palsy.

    PubMed

    McCaul, James A; Cascarini, Luke; Godden, Daryl; Coombes, Darryl; Brennan, Peter A; Kerawala, Cyrus J

    2014-05-01

    Bell's palsy (idiopathic facial paralysis) is caused by the acute onset of lower motor neurone weakness of the facial nerve with no detectable cause. With a lifetime risk of 1 in 60 and an annual incidence of 11-40/100,000 population, the condition resolves completely in around 71% of untreated cases. In the remainder facial nerve function will be impaired in the long term. We summarise current published articles regarding early management strategies to maximise recovery of facial nerve function and minimise long-term sequelae in the condition. PMID:24685475

  8. Prediction of oral absorption of cinnarizine--a highly supersaturating poorly soluble weak base with borderline permeability.

    PubMed

    Berlin, Mark; Przyklenk, Karl-Heinz; Richtberg, Annette; Baumann, Wolfgang; Dressman, Jennifer B

    2014-11-01

    Two important driving forces for oral absorption of active pharmaceutical ingredients are drug dissolution and permeability in the gastrointestinal tract. Poorly soluble weak bases typically exhibit high solubility under fasted gastric conditions. However, the solubility of such drugs usually decreases drastically in the fasted small intestine, constraining drug absorption. Since there is a discrepancy in solubility between the fasted state stomach and intestine, it is crucial to examine the influence of dissolution, supersaturation and precipitation on the oral absorption of poorly soluble weak bases during and after fasted state gastric emptying. Cinnarizine is a poorly soluble weak base with borderline permeability, exhibiting supersaturation and precipitation under simulated fasted state gastric emptying conditions. Interestingly, supersaturation and precipitation of cinnarizine under fed state conditions is not expected to occur, since the drug shows good solubility in fed state biorelevant media and exhibits a positive food effect in pharmacokinetic studies. The present work is aimed at investigating the dissolution, supersaturation and precipitation behavior of marketed cinnarizine tablets under fasted and fed state conditions using biorelevant dissolution and transfer methods. In order to predict the in vivo performance of these cinnarizine formulations, the in vitro results were then coupled with different physiologically based pharmacokinetic (PBPK) models, which considered either only dissolution or a combination of dissolution, supersaturation and precipitation kinetics. The results of the in silico predictions were then compared with in vivo observations. The study revealed that under fasting conditions, plasma profiles could be accurately predicted only when supersaturation and precipitation as well as dissolution were taken into account. It was concluded that for poorly soluble weak bases with moderate permeability, supersaturation and precipitation

  9. Teachers' Characteristics and Ratings for Evidence-Based Behavioral Interventions

    ERIC Educational Resources Information Center

    Stormont, Melissa; Reinke, Wendy; Herman, Keith

    2011-01-01

    The vast majority of schools today are not prepared to support children's social behavior needs. One challenge is that teachers may not be knowledgeable of evidence-based practices that can be utilized with children. This study explored teachers' agreement ratings for evidence-based and nonevidence-based behavior management practices for children…

  10. Evidence-Based Practice: Integrating Classroom Curriculum and Field Education

    ERIC Educational Resources Information Center

    Tuchman, Ellen; Lalane, Monique

    2011-01-01

    This article describes the use of problem-based learning to teach the scope and consequences of evidence-based practices in mental health through an innovative assignment that integrates classroom and field learning. The authors illustrate the planning and implementation of the Evidence-Based Practice: Integrating Classroom Curriculum and Field…

  11. Investigation of disturbance effects on space-based weak lensing measurements with an integrated model

    NASA Astrophysics Data System (ADS)

    Lieber, Michael; Kaplan, Michael; Sholl, Michael; Bernstein, Gary

    2010-07-01

    Many astrophysicists consider the mystery of accelerated expansion of the universe by a field called dark energy as the greatest challenge to solve in cosmology. Gravitational weak lensing has been identfied as one of the best methods to provide constraints on dark energy model parameters. Weak lensing introduces image shear which can be measured statistically from a large sample of galaxies by determining the ellipticity parameters. Several papers have suggested that a goal in the ability to measure shape biases should be <0.1% - this goal will be reviewed in terms of the observatory "transfer function" with comments interspersed regarding allocation inconsistencies. Time-varying effects introduced by thermoelastic deformations and vibration add bias and noise to the galaxy shape measurements. This is compounded by the wide field-of-view required for the weak lensing science which leads to a spatially varying point spead function (PSF). To fully understand these effects, a detailed integrated model (IM) was constructed which includes a coupled scene/ structure/ optics/ disturbance model. This IM was applied to the Joint Dark Energy Mission (JDEM) Omega design concept. Results indicate that previous models of vibration disturbance effects have been too simplified and the allocation for vibration needs to be re-evaluated. Furthermore, because of the complicated processing required to accurately extract shape parameters, it is argued that an IM is needed for maximizing science return by iterating the telescope/ instrument design against mission cost constraints, and processing e¤ectiveness of shape extraction algorithms, instrument calibration techniques and measurement desensitization of observatory effects.

  12. Why the Evidence-Based Paradigm in Early Childhood Education and Care Is Anything but Evident

    ERIC Educational Resources Information Center

    Vandenbroeck, Michel; Roets, Griet; Roose, Rudi

    2012-01-01

    Praxeological research is a necessary contribution to the research field in early childhood education and care, which is currently dominated by an evidence-based paradigm that tends to consider the measurement of predefined outcomes as the most valid form of research. We analyse the history of the evidence-based paradigm in the field of medicine…

  13. Evidence Based Practice of Chronic Pain

    PubMed Central

    Garg, Rakesh; Joshi, Saurabh; Mishra, Seema; Bhatnagar, Sushma

    2012-01-01

    The patients with chronic pain are increasingly reporting to the physicians for its management. Chronic pain are associated with head, neck and shoulder pain, spinal pain, pain in the joints and extremities, complex regional pain syndrome and phantom pain. The chronic pain is being managed worldwide. The different specialty of medicine is producing a lot of evidence through the published literature but the same is not being published in the field of chronic pain management. Though some evidence is being reported as to different aspects of pain management from different parts of the world but same is lacking from Indian subcontinent. This is in contrast to much done clinical work in this field as well. We present here the available evidence in relation to chronic pain management. PMID:23439674

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

    PubMed

    Barry, Debbie; Houghton, Trish; Warburton, Tyler

    2016-08-17

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

  15. [Strategy for promoting evidence-based nursing practice in hospital].

    PubMed

    Chen, Yu-Chih; Tang, Lee-Chun; Chou, Shin-Shang

    2013-10-01

    Evidence-based practice has been demonstrated to improve quality of care, increase patients' satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice. PMID:24096462

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

    PubMed

    Yang, Hai

    2009-03-01

    Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient. PMID:19565800

  17. Evidence of weak localization in quantum interference effects observed in epitaxial La0.7Sr0.3MnO3 ultrathin films

    PubMed Central

    Niu, Wei; Gao, Ming; Wang, Xuefeng; Song, Fengqi; Du, Jun; Wang, Xinran; Xu, Yongbing; Zhang, Rong

    2016-01-01

    Quantum interference effects (QIEs) dominate the appearance of low-temperature resistivity minimum in colossal magnetoresistance manganites. The T1/2 dependent resistivity under high magnetic field has been evidenced as electron-electron (e-e) interaction. However, the evidence of the other source of QIEs, weak localization (WL), still remains insufficient in manganites. Here we report on the direct experimental evidence of WL in QIEs observed in the single-crystal La0.7Sr0.3MnO3 (LSMO) ultrathin films deposited by laser molecular beam epitaxy. The sharp cusps around zero magnetic field in magnetoresistance measurements is unambiguously observed, which corresponds to the WL effect. This convincingly leads to the solid conclusion that the resistivity minima at low temperatures in single-crystal manganites are attributed to both the e-e interaction and the WL effect. Moreover, the temperature-dependent phase-coherence length corroborates the WL effect of LSMO ultrathin films is within a two-dimensional localization theory. PMID:27181882

  18. Evidence of weak localization in quantum interference effects observed in epitaxial La0.7Sr0.3MnO3 ultrathin films.

    PubMed

    Niu, Wei; Gao, Ming; Wang, Xuefeng; Song, Fengqi; Du, Jun; Wang, Xinran; Xu, Yongbing; Zhang, Rong

    2016-01-01

    Quantum interference effects (QIEs) dominate the appearance of low-temperature resistivity minimum in colossal magnetoresistance manganites. The T(1/2) dependent resistivity under high magnetic field has been evidenced as electron-electron (e-e) interaction. However, the evidence of the other source of QIEs, weak localization (WL), still remains insufficient in manganites. Here we report on the direct experimental evidence of WL in QIEs observed in the single-crystal La0.7Sr0.3MnO3 (LSMO) ultrathin films deposited by laser molecular beam epitaxy. The sharp cusps around zero magnetic field in magnetoresistance measurements is unambiguously observed, which corresponds to the WL effect. This convincingly leads to the solid conclusion that the resistivity minima at low temperatures in single-crystal manganites are attributed to both the e-e interaction and the WL effect. Moreover, the temperature-dependent phase-coherence length corroborates the WL effect of LSMO ultrathin films is within a two-dimensional localization theory. PMID:27181882

  19. Examining hand dominance using dynamometric grip strength testing as evidence for overwork weakness in Charcot-Marie-Tooth disease: a systematic review and meta-analysis.

    PubMed

    Roberts-Clarke, Daniel; Fornusek, Che; Fiatarone Singh, Maria A; Burns, Joshua; Hackett, Daniel A

    2016-09-01

    This systematic review with a meta-analysis of studies was carried out to evaluate the potential of overwork weakness on the basis of grip strength of dominant and nondominant hands in individuals with Charcot-Marie-Tooth disease (CMT). Numerous electronic databases were searched from the earliest records to February 2016. Studies of any design including participants older than 18 years of age with a confirmed diagnosis of CMT that measured grip strength of both hands using dynamometric testing were eligible for inclusion. Of 12 593 articles identified following removal of duplicates, five articles fulfilled the criteria. A total of 166 participants, mostly with CMT1 or CMT2, were described from the studies included. Hand and finger pinch grip strength for the dominant compared with the nondominant hand was not statistically different. There is no definitive evidence that preferential use of the dominant hand in CMT impairs function relative to the nondominant hand. Thus, robust exercise trials of progressive resistance training are needed to understand the extent of adaptations possible and provide evidence of the safety of such regimens. PMID:27177353

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

    PubMed

    Likosky, Donald S

    2006-12-01

    There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. "Research is the only hope that the future will be different than the past"- Daniel Mintz, MD "Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist.... It is ideas not vested interests which are dangerous for good or evil."-John Maynard Keynes. PMID:17312899

  1. Integrating Evidence-Based Perfusion Into Practices: The International Consortium for Evidence-Based Perfusion

    PubMed Central

    Likosky, Donald S.

    2006-01-01

    Abstract: There is surmounting pressure for clinicians domestically and abroad not only to practice evidence-based perfusion, but also to supplement practice with documentation thereof. In this editorial, I shall describe an international initiative aimed at embracing this dictum from patients, regulatory bodies, and payers. “Research is the only hope that the future will be different than the past”—Daniel Mintz, MD “Practical men who believe themselves to be quite exempt from any intellectual influences are usually the slaves of some defunct economist…. It is ideas not vested interests which are dangerous for good or evil.”—John Maynard Keynes PMID:17312899

  2. Investigating the Evidence Base of Social Stories

    ERIC Educational Resources Information Center

    Ali, Shama; Frederickson, Norah

    2006-01-01

    Social stories were developed in order to support individuals with autism to better cope with social situations, an area of particular difficulty for this population. Despite its growing popularity, there is limited research evidence on the effectiveness of this approach. A review of research on social stories undertaken between 1994 and 2004 was…

  3. Justifying Physical Education Based on Neuroscience Evidence

    ERIC Educational Resources Information Center

    Berg, Kris

    2010-01-01

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

  4. Pedagogic Research and Evidence-Based Management

    ERIC Educational Resources Information Center

    Lindsay, Roger; Breen, Rosanna; Paton-Saltzberg, Renee

    2002-01-01

    The introduction of modular schemes and a semesterised academic year are amongst the most fundamental changes ever to occur in UK higher education. There is, however, a notable lack of pedagogic research evidence on the effects upon student learning of course frameworks and the temporal structure of large-scale learning units. In the absence of…

  5. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach.

    PubMed

    Lee, Jun Haeng; Kim, Jae G; Jung, Hye-Kyung; Kim, Jung Hoon; Jeong, Woo Kyoung; Jeon, Tae Joo; Kim, Joon Mee; Kim, Young Il; Ryu, Keun Won; Kong, Seong-Ho; Kim, Hyoung-Il; Jung, Hwoon-Yong; Kim, Yong Sik; Zang, Dae Young; Cho, Jae Yong; Park, Joon Oh; Lim, Do Hoon; Jung, Eun Sun; Ahn, Hyeong Sik; Kim, Hyun Jung

    2014-06-01

    Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase. PMID:25061536

  6. Aperiodic Weak Topological Superconductors.

    PubMed

    Fulga, I C; Pikulin, D I; Loring, T A

    2016-06-24

    Weak topological phases are usually described in terms of protection by the lattice translation symmetry. Their characterization explicitly relies on periodicity since weak invariants are expressed in terms of the momentum-space torus. We prove the compatibility of weak topological superconductors with aperiodic systems, such as quasicrystals. We go beyond usual descriptions of weak topological phases and introduce a novel, real-space formulation of the weak invariant, based on the Clifford pseudospectrum. A nontrivial value of this index implies a nontrivial bulk phase, which is robust against disorder and hosts localized zero-energy modes at the edge. Our recipe for determining the weak invariant is directly applicable to any finite-sized system, including disordered lattice models. This direct method enables a quantitative analysis of the level of disorder the topological protection can withstand. PMID:27391744

  7. Aperiodic Weak Topological Superconductors

    NASA Astrophysics Data System (ADS)

    Fulga, I. C.; Pikulin, D. I.; Loring, T. A.

    2016-06-01

    Weak topological phases are usually described in terms of protection by the lattice translation symmetry. Their characterization explicitly relies on periodicity since weak invariants are expressed in terms of the momentum-space torus. We prove the compatibility of weak topological superconductors with aperiodic systems, such as quasicrystals. We go beyond usual descriptions of weak topological phases and introduce a novel, real-space formulation of the weak invariant, based on the Clifford pseudospectrum. A nontrivial value of this index implies a nontrivial bulk phase, which is robust against disorder and hosts localized zero-energy modes at the edge. Our recipe for determining the weak invariant is directly applicable to any finite-sized system, including disordered lattice models. This direct method enables a quantitative analysis of the level of disorder the topological protection can withstand.

  8. Predictions of high-frequency ground-motion in Taiwan based on weak motion data

    NASA Astrophysics Data System (ADS)

    D'Amico, Sebastiano; Akinci, Aybige; Malagnini, Luca

    2012-04-01

    Following a recent paper we use weak-motion waveforms to calibrate a model for the prediction of earthquake-induced ground-motion in Taiwan, in the 0.25-5.0 Hz frequency range, valid up to Mw 7.6. The excitation/attenuation model is given in terms of frequency-dependent seismic wave attenuation, Qs(f), geometrical spreading, g(r), a magnitude-dependent stress parameters Δσ for the excitation terms, and a site term for each seismic station used in the study. A set of weak-motion data was gathered from about 170 aftershocks of the Chi-Chi earthquake, Mw 7.6, of 1999 September 20, (17:47 UTC), recorded by 10 broad-band seismic stations. The moment magnitudes of the registered aftershocks ranged from Mw 3.0 to 6.5, and the hypocentral distances from a few kilometres to about 250 km. A frequency-dependent crustal quality factor, Q(f) = 350f0.32, was obtained, to be coupled with the geometrical spreading function Earthquake-related excitation spectra were calibrated over our empirical results by using a magnitude-dependent Brune model with a stress drop value of Δσ= 8.0 ± 1.0 MPa for the largest event of Mw 6.5 in our data set and with a near surface attenuation parameter of κ= 0.05 s. Results on region-specific crustal attenuation and source scaling were used to generate stochastic simulations both for point-source and extended-fault ruptures through the computer codes: Stochastic Model SIMulation, SMSIM and Extended-Fault Model Simulation, EXSIM. The absolute peak ground accelerations (PGA), peak ground velocities (PGV) and 5 per cent-damped Spectral Accelerations (SA) at three different frequencies, 0.33 Hz, 1.0 Hz and 3.0 Hz for several magnitudes and distance ranges were predicted at large magnitudes, well beyond magnitude Mw 6.5, the upper limit for the events of our

  9. Exploring Weak Ligand–Protein Interactions by Long-Lived NMR States: Improved Contrast in Fragment-Based Drug Screening**

    PubMed Central

    Buratto, Roberto; Mammoli, Daniele; Chiarparin, Elisabetta; Williams, Glyn; Bodenhausen, Geoffrey

    2014-01-01

    Ligands that have an affinity for protein targets can be screened very effectively by exploiting favorable properties of long-lived states (LLS) in NMR spectroscopy. In this work, we describe the use of LLS for competitive binding experiments to measure accurate dissociation constants of fragments that bind weakly to the ATP binding site of the N-terminal ATPase domain of heat shock protein 90 (Hsp90), a therapeutic target for cancer treatment. The LLS approach allows one to characterize ligands with an exceptionally wide range of affinities, since it can be used for ligand concentrations [L] that are several orders of magnitude smaller than the dissociation constants KD. This property makes the LLS method particularly attractive for the initial steps of fragment-based drug screening, where small molecular fragments that bind weakly to a target protein must be identified, which is a difficult task for many other biophysical methods. PMID:25196717

  10. Evidence-based treatments for cluster headache

    PubMed Central

    Gooriah, Rubesh; Buture, Alina; Ahmed, Fayyaz

    2015-01-01

    Cluster headache (CH), one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition. PMID:26635477

  11. Investigation of a Bubble Detector based on Active Electrolocation of Weakly Electric Fish

    NASA Astrophysics Data System (ADS)

    Mohan, M.; Mayekar, K.; Zhou, R.; von der Emde, G.; Bousack, H.

    2013-04-01

    Weakly electric fish employ active electrolocation for navigation and object detection. They emit an electric signal with their electric organ in the tail and sense the electric field with electroreceptors that are distributed over their skin. We adopted this principle to design a bubble detector that can detect gas bubbles in a fluid or, in principle, objects with different electric conductivity than the surrounding fluid. The evaluation of the influence of electrode diameter on detecting a given bubble size showed that the signal increases with electrode diameter. Therefore it appears that this detector will be more appropriate for large sized applications such as bubble columns than small sized applications such as bubble detectors in dialysis.

  12. Analysis of weak signal detection based on tri-stable system under Levy noise

    NASA Astrophysics Data System (ADS)

    Li-Fang, He; Ying-Ying, Cui; Tian-Qi, Zhang; Gang, Zhang; Ying, Song

    2016-06-01

    Stochastic resonance system is an effective method to extract weak signal. However, system output is directly influenced by system parameters. Aiming at this, the Levy noise is combined with a tri-stable stochastic resonance system. The average signal-to-noise ratio gain is regarded as an index to measure the stochastic resonance phenomenon. The characteristics of tri-stable stochastic resonance under Levy noise is analyzed in depth. First, the method of generating Levy noise, the effect of tri-stable system parameters on the potential function and corresponding potential force are presented in detail. Then, the effects of tri-stable system parameters w, a, b, and Levy noise intensity amplification factor D on the resonant output can be explored with different Levy noises. Finally, the tri-stable stochastic resonance system is applied to the bearing fault detection. Simulation results show that the stochastic resonance phenomenon can be induced by tuning the system parameters w, a, and b under different distributions of Levy noise, then the weak signal can be detected. The parameter intervals which can induce stochastic resonances are approximately equal. Moreover, by adjusting the intensity amplification factor D of Levy noise, the stochastic resonances can happen similarly. In bearing fault detection, the detection effect of the tri-stable stochastic resonance system is superior to the bistable stochastic resonance system. Project supported by the National Natural Science Foundation of China (Grant No. 61371164), the Chongqing Municipal Distinguished Youth Foundation, China (Grant No. CSTC2011jjjq40002), and the Research Project of Chongqing Municipal Educational Commission, China (Grant No. KJ130524).

  13. Evidence Based Medicine in Pediatric Practice: Brief Review

    PubMed Central

    Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin

    2010-01-01

    Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715

  14. Building performance-based accountability with limited empirical evidence: performance measurement for public health preparedness.

    PubMed

    Shelton, Shoshana R; Nelson, Christopher D; McLees, Anita W; Mumford, Karen; Thomas, Craig

    2013-08-01

    Efforts to respond to performance-based accountability mandates for public health emergency preparedness have been hindered by a weak evidence base linking preparedness activities with response outcomes. We describe an approach to measure development that was successfully implemented in the Centers for Disease Control and Prevention Public Health Emergency Preparedness Cooperative Agreement. The approach leverages insights from process mapping and experts to guide measure selection, and provides mechanisms for reducing performance-irrelevant variation in measurement data. Also, issues are identified that need to be addressed to advance the science of measurement in public health emergency preparedness. PMID:24229520

  15. Back to basics: implementing evidence-based practice.

    PubMed

    Spruce, Lisa

    2015-01-01

    As health care transitions from volume-based care to value-based care, it is imperative that perioperative nurses implement evidence-based practices that support effective care. Implementing evidence-based practice is a challenge but improves patient outcomes, standardizes care, and decreases patient care costs. Understanding how care interventions work and how to implement them is important to compete in today's health care market. This "Back to Basics" article discusses how to identify, review, and appraise research; make recommendations to implement new practices; evaluate the outcomes of the implementations; and make necessary changes to facilitate evidence-based practice. PMID:25537331

  16. Report on Evidence-Based Interventions: Recommended Next Steps.

    ERIC Educational Resources Information Center

    Nelson, J. Ron; Epstein, Michael H.

    2002-01-01

    Comments on the work of the Task Force on Evidence-Based Interventions in School Psychology. Discusses the significant advances and errors of commission and omission made by the Task Force in their efforts to develop a framework for the identification of evidence-based interventions (EBIs). This discussion is followed by description of a…

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

    ERIC Educational Resources Information Center

    Prins, David; Ingham, Roger J.

    2009-01-01

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

  18. Towards an Understanding of Evidence-Based Practice

    ERIC Educational Resources Information Center

    Digennaro Reed, Florence D.; Reed, Derek D.

    2008-01-01

    The past two decades have seen a rise in the use of the term "evidence-based practice" and a simultaneous increase in the variations in its definition and evaluation. Subsequently, this rise in interest for evidence-based practices has become a double-edged sword for practitioners--that is, while there are a number of interpretations on the…

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

    ERIC Educational Resources Information Center

    Pape, Tess M.

    2003-01-01

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

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

    ERIC Educational Resources Information Center

    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…

  1. Evidence-based gene predictions in plant genomes

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  2. Barriers and Enablers to Evidence-Based Practices

    ERIC Educational Resources Information Center

    Foster, Robyn

    2014-01-01

    The importance of educational practices based on evidence is well-supported in the literature, however barriers to their implementation in classrooms still exist. This paper examines the phenomenon of evidence-based practice in education highlighting enablers and barriers to their implementation with particular reference to RTLB practice.

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  4. Teaching Evidence-based Medical Care: Description and Evaluation.

    ERIC Educational Resources Information Center

    Grad, Roland; Macaulay, Ann C.; Warner, Michelle

    2001-01-01

    Describes and evaluates a teaching initiative in evidence-based medical care in McGill University's family practice residency program. Discusses results of pre- and post-course self-assessments by students, which indicated significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews,…

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

    PubMed

    Qiu, Yun-Liang; Peng, Ming-Qi

    2013-12-01

    As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks. PMID:24665620

  6. Evidence-based medicine: applications in dietetic practice.

    PubMed

    Gray, Gregory E; Gray, Lorraine K

    2002-09-01

    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." Evidence-based practice requires the ability to apply knowledge of medical informatics (eg, efficiently searching the medical literature) and clinical epidemiology (eg, being able to critically appraise the literature) to the treatment of individual patients. Being able to apply the principles of evidence-based medicine in the dietetic practice adds to the credibility and value of dietetics professionals, is consistent with the dietetic code of ethics, and is empowering. This article provides an introduction to the history, philosophy, and methods of evidence-based medicine as applied to the dietetic practice. This article focuses on a 5-step process to finding the best evidence to answer clinical questions: (a) formulate the question, (b) search for answers, (c) appraise the evidence, (d) apply the results, and (e) assess the outcome. We describe the 4S methodology-a systematic approach to efficiently finding the best evidence to answer clinical questions involving the use of systems (comprehensive, evidence-based resources), synopses (compilations of structured abstracts of high-quality studies), syntheses (systematic reviews), and studies (original research articles). Particular emphasis is given to a method for critically appraising papers that emphasizes validity, importance, and clinical applicability. Resources (including Web sites) for further learning are provided. J Am Diet Assoc. 2002;102:1263-1272. PMID:12792624

  7. The dynamics of stock exchange based on the formalism of weak continuous quantum measurement

    NASA Astrophysics Data System (ADS)

    Melnyk, S.; Tuluzov, I.

    2010-07-01

    The problem of measurement in economic models and the possibility of their quantum-mechanical description are considered. It is revealed that the apparent paradox of such a description is associated with a priori requirement of conformity of the model to all the alternatives of free choice of the observer. The measurement of the state of a trader on a stock exchange is formally defined as his responses to the proposals of sale at a fixed price. It is shown that an analogue of Bell's inequalities for this measurement model is violated at the most general assumptions related to the strategy of the trader and requires a quantum-mechanical description of the dynamics of his condition. In the framework of the theory of weak continuous quantum measurements, the equation of stock price dynamics and the quantum-mechanical generalization of the F. Black and M. Scholes model for pricing options are obtained. The fundamental distinctions between the obtained model and the classical one are discussed.

  8. Phase modulation at the few-photon level for weak-nonlinearity-based quantum computing

    NASA Astrophysics Data System (ADS)

    Venkataraman, Vivek; Saha, Kasturi; Gaeta, Alexander L.

    2013-02-01

    The ability of a few-photon light field to impart an appreciable phase shift on another light field is critical for many quantum information applications. A recently proposed paradigm for quantum computation utilizes weak nonlinearities, where a strong field mediates such cross-phase shifts between single photons. Such a protocol promises to be feasible in terms of scalability to many qubits if a cross-phase shift of 10-5 to 10-2 radians per photon can be achieved. A promising platform to achieve such cross-phase shifts is the hollow-core photonic bandgap fibre, which can highly confine atomic vapours and light over distances much greater than the diffraction length. Here, we produce large cross-phase shifts of 0.3 mrad per photon with a fast response time (<5 ns) using rubidium atoms confined to a hollow-core photonic bandgap fibre, which represents, to our knowledge, the largest such nonlinear phase shift induced in a single pass through a room-temperature medium.

  9. Flow velocimetry for weakly conducting electrolytes based on high resolution Lorentz force measurement.

    NASA Astrophysics Data System (ADS)

    Resagk, Christian; Ebert, Reschad; Vasilyan, Suren; Wiederhold, Andreas

    2013-11-01

    We demonstrate that a flow velocity measurement can be transformed into a non-invasive force measurement by metering the drag force acting on a system of magnets around a flow channel. This method is called Lorentz force velocimetry and has been developed in the last years in our institute. It is a feasible principle for materials with large conductivity like liquid metals. To evolve this method for weakly conducting fluids like salt water or molten glass the drag force measurement is the challenging bottleneck. Here forces of 10-8 and less of the weight force of the magnet system have to be resolved. In this paper different force measurement techniques get tested and compared. For the current setup the magnet system is attached to a state of the art electromagnetic force compensation balance. Different ways of getting the correct force signal out of the two measurement setups will be presented and discussed. For generalization of the measurement principle the Lorentz force is determined for different fluid profiles. In addition to that we have developed new systematic noise reduction methods to increase the resolution of the force measurement techniques by a factor of ten or larger which we will present here.

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

    PubMed

    Thomas, Marie H; Baker, Susan Scott

    2011-01-01

    Evidence-based nursing requires that students think reflectively and use clinical inquiry to develop clinical reasoning and decision-making skills. Likewise, nursing students need a strategy to be successful in passing the NCLEX-RN. The authors identify strategies based on nursing research to facilitate student success. While learning the evidence-based nursing process, the student must begin to think like a nurse while answering clinical practice questions. Using the skills taught for evidence-based nursing can be a powerful tool to approach the NCLEX-RN and succeed. PMID:22024676

  11. Evidence synthesis and its role in evidence-based health care.

    PubMed

    Pearson, Alan

    2014-12-01

    The central role of evidence synthesis (or the systematic review of evidence) in evidence-based health care is often poorly understood. There are numerous examples in the literature of poorly conceived and/or executed systematic reviews and of a lack of awareness of the international standards developed by the international leaders in systematic reviews. The Cochrane Collaboration has played a critical global role in developing and refining systematic review methods in relation to evidence of effects and of diagnostic accuracy. PMID:25458130

  12. Evidence based dental care: integrating clinical expertise with systematic research.

    PubMed

    Kishore, Mallika; Panat, Sunil R; Aggarwal, Ashish; Agarwal, Nupur; Upadhyay, Nitin; Alok, Abhijeet

    2014-02-01

    Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the "gold standard" in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21(st) century, more and more practitioners are joining the train, more education on the subject is being provided to elucidate the knotty areas and there is increasing advocacy for the emergence of the field into a specialty discipline. Evidence-Based Dentistry (EBD), if endorsed by the dental profession, including the research community, may well- influence the extent to which society values dental research. Hence, dental researchers should understand the precepts of EBD, and should also recognize the challenges it presents to the research community to strengthen the available evidence and improve the processes of summarizing the evidence and translating it into practice This paper examines the concept of evidence-based dentistry (EBD), including some of the barriers and will discuss about clinical practice guidelines. PMID:24701551

  13. Evidence-based programs registry: blueprints for Healthy Youth Development.

    PubMed

    Mihalic, Sharon F; Elliott, Delbert S

    2015-02-01

    There is a growing demand for evidence-based programs to promote healthy youth development, but this growth has been accompanied by confusion related to varying definitions of evidence-based and mixed messages regarding which programs can claim this designation. The registries that identify evidence-based programs, while intended to help users sift through the findings and claims regarding programs, has oftentimes led to more confusion with their differing standards and program ratings. The advantages of using evidence-based programs and the importance of adopting a high standard of evidence, especially when taking programs to scale,are described. One evidence-based registry is highlighted--Blueprints for Healthy Youth Development hosted at the University of Colorado Boulder. Unlike any previous initiative of its kind, Blueprints established unmatched standards for identifying evidence-based programs and has acted in a way similar to the FDA--evaluating evidence, data and research to determine which programs meet their high standard of proven efficacy. PMID:25193177

  14. Evidence-based medicine in health care reform.

    PubMed

    Hughes, Gordon B

    2011-10-01

    The Patient Protection and Affordable Care Act of 2010 mandates a national comparative outcomes research project agenda. Comparative effectiveness research includes both clinical trials and observational studies and is facilitated by electronic health records. A national network of electronic health records will create a vast electronic data "warehouse" with exponential growth of observational data. High-quality associations will identify research topics for pragmatic clinical trials, and systematic reviews of clinical trials will provide optimal evidence-based medicine. Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Thus, health care reform will provide a robust environment for comparative effectiveness research, systematic reviews, and evidence-based medicine, and implementation of evidence-based medicine should lead to improved quality of care. PMID:21860057

  15. Evidence for a particle produced in association with weak bosons and decaying to a bottom-antibottom quark pair in higgs boson searches at the tevatron.

    PubMed

    Aaltonen, T; Abazov, V M; Abbott, B; Acharya, B S; Adams, M; Adams, T; Alexeev, G D; Alkhazov, G; Alton, A; Alvarez González, B; Alverson, G; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Apollinari, G; Appel, J A; Arisawa, T; Artikov, A; Asaadi, J; Ashmanskas, W; Askew, A; Atkins, S; Auerbach, B; Augsten, K; Aurisano, A; Avila, C; Azfar, F; Badaud, F; Badgett, W; Bae, T; Bagby, L; Baldin, B; Bandurin, D V; Banerjee, S; Barbaro-Galtieri, A; Barberis, E; Baringer, P; Barnes, V E; Barnett, B A; Barria, P; Bartlett, J F; Bartos, P; Bassler, U; Bauce, M; Bazterra, V; Bean, A; Bedeschi, F; Begalli, M; Behari, S; Bellantoni, L; Bellettini, G; Bellinger, J; Benjamin, D; Beretvas, A; Beri, S B; Bernardi, G; Bernhard, R; Bertram, I; Besançon, M; Beuselinck, R; Bhat, P C; Bhatia, S; Bhatnagar, V; Bhatti, A; Binkley, M; Bisello, D; Bizjak, I; Bland, K R; Blazey, G; Blessing, S; Bloom, K; Blumenfeld, B; Bocci, A; Bodek, A; Boehnlein, A; Boline, D; Boos, E E; Borissov, G; Bortoletto, D; Bose, T; Boudreau, J; Boveia, A; Brandt, A; Brandt, O; Brigliadori, L; Brock, R; Bromberg, C; Bross, A; Brown, D; Brown, J; Brucken, E; Budagov, J; Bu, X B; Budd, H S; Buehler, M; Buescher, V; Bunichev, V; Burdin, S; Burkett, K; Busetto, G; Bussey, P; Buszello, C P; Buzatu, A; Calamba, A; Calancha, C; Camacho-Pérez, E; Camarda, S; Campanelli, M; Campbell, M; Canelli, F; Carls, B; Carlsmith, D; Carosi, R; Carrillo, S; Carron, S; Casal, B; Casarsa, M; Casey, B C K; Castilla-Valdez, H; Castro, A; Catastini, P; Caughron, S; Cauz, D; Cavaliere, V; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chakrabarti, S; Chakraborty, D; Chan, K M; Chandra, A; Chapon, E; Chen, G; Chen, Y C; Chertok, M; Chevalier-Théry, S; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, D K; Cho, K; Cho, S W; Choi, S; Chokheli, D; Choudhary, B; Chung, W H; Chung, Y S; Cihangir, S; Ciocci, M A; Claes, D; Clark, A; Clarke, C; Clutter, J; Compostella, G; Convery, M E; Conway, J; Cooke, M; Cooper, W E; Corbo, M; Corcoran, M; Cordelli, M; Couderc, F; Cousinou, M-C; Cox, C A; Cox, D J; Crescioli, F; Croc, A; Cuevas, J; Culbertson, R; Cutts, D; Dagenhart, D; d'Ascenzo, N; Das, A; Datta, M; Davies, G; de Barbaro, P; de Jong, S J; De La Cruz-Burelo, E; Déliot, F; Dell'orso, M; Demina, R; Demortier, L; Deninno, M; Denisov, D; Denisov, S P; d'Errico, M; Desai, S; Deterre, C; Devaughan, K; Devoto, F; Di Canto, A; Di Ruzza, B; Diehl, H T; Diesburg, M; Ding, P F; Dittmann, J R; Dominguez, A; Donati, S; Dong, P; D'Onofrio, M; Dorigo, M; Dorigo, T; Dubey, A; Dudko, L V; Duggan, D; Duperrin, A; Dutt, S; Dyshkant, A; Eads, M; Ebina, K; Edmunds, D; Elagin, A; Ellison, J; Elvira, V D; Enari, Y; Eppig, A; Erbacher, R; Errede, S; Ershaidat, N; Eusebi, R; Evans, H; Evdokimov, A; Evdokimov, V N; Facini, G; Farrington, S; Feindt, M; Feng, L; Ferbel, T; Fernandez, J P; Ferrazza, C; Fiedler, F; Field, R; Filthaut, F; Fisher, W; Fisk, H E; Flanagan, G; Forrest, R; Fortner, M; Fox, H; Frank, M J; Franklin, M; Freeman, J C; Fuess, S; Funakoshi, Y; Gallinaro, M; Garcia-Bellido, A; Garcia, J E; García-González, J A; García-Guerra, G A; Garfinkel, A F; Garosi, P; Gavrilov, V; Gay, P; Geng, W; Gerbaudo, D; Gerber, C E; Gerberich, H; Gerchtein, E; Gershtein, Y; Giagu, S; Giakoumopoulou, V; Giannetti, P; Gibson, K; Ginsburg, C M; Ginther, G; Giokaris, N; Giromini, P; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldin, D; Goldschmidt, N; Golossanov, A; Golovanov, G; Gomez-Ceballos, G; Gomez, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Goulianos, K; Goussiou, A; Grannis, P D; Greder, S; Greenlee, H; Grenier, G; Grinstein, S; Gris, Ph; Grivaz, J-F; Grohsjean, A; Grosso-Pilcher, C; Group, R C; Grünendahl, S; Grünewald, M W; Guillemin, T; Guimaraes da Costa, J; Gutierrez, G; Gutierrez, P; Hagopian, S; Hahn, S R; Haley, J; Halkiadakis, E; Hamaguchi, A; Han, J Y; Han, L; Happacher, F; Hara, K; Harder, K; Hare, D; Hare, M; Harel, A; Harr, R F; Hatakeyama, K; Hauptman, J M; Hays, C; Hays, J; Head, T; Hebbeker, T; Heck, M; Hedin, D; Hegab, H; Heinrich, J; Heinson, A P; Heintz, U; Hensel, C; Heredia-De La Cruz, I; Herndon, M; Herner, K; Hesketh, G; Hewamanage, S; Hildreth, M D; Hirosky, R; Hoang, T; Hobbs, J D; Hocker, A; Hoeneisen, B; Hogan, J; Hohlfeld, M; Hopkins, W; Horn, D; Hou, S; Howley, I; Hubacek, Z; Hughes, R E; Hurwitz, M; Husemann, U; Hussain, N; Hussein, M; Huston, J; Hynek, V; Iashvili, I; Ilchenko, Y; Illingworth, R; Introzzi, G; Iori, M; Ito, A S; Ivanov, A; Jabeen, S; Jaffré, M; James, E; Jang, D; Jayasinghe, A; Jayatilaka, B; Jeans, D T; Jeon, E J; Jeong, M S; Jesik, R; Jiang, P; Jindariani, S; Johns, K; Johnson, E; Johnson, M; Jonckheere, A; Jones, M; Jonsson, P; Joo, K K; Joshi, J; Jun, S Y; Jung, A W; Junk, T R; Juste, A; Kaadze, K; Kajfasz, E; Kamon, T; Karchin, P E; Karmanov, D; Kasmi, A; Kasper, P A; Kato, Y; Katsanos, I; Kehoe, R; Kermiche, S; Ketchum, W; Keung, J; Khalatyan, N; Khanov, A; Kharchilava, A; Kharzheev, Y N; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, J E; Kim, M J; Kim, S B; Kim, S H; Kim, Y J; Kim, Y K; Kimura, N; Kirby, M; Kiselevich, I; Klimenko, S; Knoepfel, K; Kohli, J M; Kondo, K; Kong, D J; Konigsberg, J; Kotwal, A V; Kozelov, A V; Kraus, J; Kreps, M; Kroll, J; Krop, D; Kruse, M; Krutelyov, V; Kuhr, T; Kulikov, S; Kumar, A; Kupco, A; Kurata, M; Kurča, T; Kuzmin, V A; Kwang, S; Laasanen, A T; Lami, S; Lammel, S; Lammers, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; Lebrun, P; Lecompte, T; Lee, E; Lee, H S; Lee, H S; Lee, J S; Lee, S W; Lee, S W; Lee, W M; Lei, X; Lellouch, J; Leo, S; Leone, S; Lewis, J D; Li, D; Li, H; Li, L; Li, Q Z; Lim, J K; Limosani, A; Lincoln, D; Lin, C-J; Lindgren, M; Linnemann, J; Lipaev, V V; Lipeles, E; Lipton, R; Lister, A; Litvintsev, D O; Liu, C; Liu, H; Liu, H; Liu, Q; Liu, T; Liu, Y; Lobodenko, A; Lockwitz, S; Loginov, A; Lokajicek, M; Lopes de Sa, R; Lubatti, H J; Lucchesi, D; Lueck, J; Lujan, P; Lukens, P; Luna-Garcia, R; Lungu, G; Lyon, A L; Lysak, R; Lys, J; Maciel, A K A; Madar, R; Madrak, R; Maestro, P; Magaña-Villalba, R; Malik, S; Malik, S; Malyshev, V L; Manca, G; Manousakis-Katsikakis, A; Maravin, Y; Margaroli, F; Marino, C; Martínez, M; Martínez-Ortega, J; Mastrandrea, P; Matera, K; Mattson, M E; Mazzacane, A; Mazzanti, P; McCarthy, R; McFarland, K S; McGivern, C L; McIntyre, P; McNulty, R; Mehta, A; Mehtala, P; Meijer, M M; Melnitchouk, A; Menezes, D; Mercadante, P G; Merkin, M; Mesropian, C; Meyer, A; Meyer, J; Miao, T; Miconi, F; Mietlicki, D; Mitra, A; Miyake, H; Moed, S; Moggi, N; Mondal, N K; Mondragon, M N; Moon, C S; Moore, R; Morello, M J; Morlock, J; Movilla Fernandez, P; Mukherjee, A; Mulhearn, M; Muller, Th; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Naganoma, J; Nagy, E; Naimuddin, M; Nakano, I; Napier, A; Narain, M; Nayyar, R; Neal, H A; Negret, J P; Nett, J; Neubauer, M S; Neu, C; Neustroev, P; Nguyen, H T; Nielsen, J; Nodulman, L; Noh, S Y; Norniella, O; Nunnemann, T; Oakes, L; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Orava, R; Orduna, J; Ortolan, L; Osman, N; Osta, J; Padilla, M; Pagan Griso, S; Pagliarone, C; Pal, A; Palencia, E; Papadimitriou, V; Paramonov, A A; Parashar, N; Parihar, V; Park, S K; Partridge, R; Parua, N; Patrick, J; Patwa, A; Pauletta, G; Paulini, M; Paus, C; Pellett, D E; Penning, B; Penzo, A; Perfilov, M; Peters, Y; Petridis, K; Petrillo, G; Pétroff, P; Phillips, T J; Piacentino, G; Pianori, E; Pilot, J; Pitts, K; Plager, C; Pleier, M-A; Podesta-Lerma, P L M; Podstavkov, V M; Pondrom, L; Popov, A V; Poprocki, S; Potamianos, K; Pranko, A; Prewitt, M; Price, D; Prokopenko, N; Prokoshin, F; Ptohos, F; Punzi, G; Qian, J; Quadt, A; Quinn, B; Rahaman, A; Ramakrishnan, V; Rangel, M S; Ranjan, K; Ranjan, N; Ratoff, P N; Razumov, I; Redondo, I; Renkel, P; Renton, P; Rescigno, M; Riddick, T; Rimondi, F; Ripp-Baudot, I; Ristori, L; Rizatdinova, F; Robson, A; Rodriguez, T; Rogers, E; Rolli, S; Rominsky, M; Roser, R; Ross, A; Royon, C; Rubinov, P; Ruchti, R; Ruffini, F; Ruiz, A; Russ, J; Rusu, V; Safonov, A; Sajot, G; Sakumoto, W K; Sakurai, Y; Salcido, P; Sánchez-Hernández, A; Sanders, M P; Santi, L; Santos, A S; Sato, K; Savage, G; Saveliev, V; Savoy-Navarro, A; Sawyer, L; Scanlon, T; Schamberger, R D; Scheglov, Y; Schellman, H; Schlabach, P; Schlobohm, S; Schmidt, A; Schmidt, E E; Schwanenberger, C; Schwarz, T; Schwienhorst, R; Scodellaro, L; Scribano, A; Scuri, F; Seidel, S; Seiya, Y; Sekaric, J; Semenov, A; Severini, H; Sforza, F; Shabalina, E; Shalhout, S Z; Shary, V; Shaw, S; Shchukin, A A; Shears, T; Shepard, P F; Shimojima, M; Shivpuri, R K; Shochet, M; Shreyber-Tecker, I; Simak, V; Simonenko, A; Sinervo, P; Skubic, P; Slattery, P; Sliwa, K; Smirnov, D; Smith, J R; Smith, K J; Snider, F D; Snow, G R; Snow, J; Snyder, S; Soha, A; Söldner-Rembold, S; Song, H; Sonnenschein, L; Sorin, V; Soustruznik, K; Squillacioti, P; St Denis, R; Stancari, M; Stark, J; Stelzer-Chilton, O; Stelzer, B; Stentz, D; Stoyanova, D A; Strauss, M; Strologas, J; Strycker, G L; Sudo, Y; Sukhanov, A; Suslov, I; Suter, L; Svoisky, P; Takahashi, M; Takemasa, K; Takeuchi, Y; Tang, J; Tecchio, M; Teng, P K; Thom, J; Thome, J; Thompson, G A; Thomson, E; Titov, M; Toback, D; Tokar, S; Tokmenin, V V; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Totaro, P; Trovato, M; Tsai, Y-T; Tschann-Grimm, K; Tsybychev, D; Tuchming, B; Tully, C; Ukegawa, F; Uozumi, S; Uvarov, L; Uvarov, S; Uzunyan, S; Van Kooten, R; van Leeuwen, W M; Varelas, N; Varganov, A; Varnes, E W; Vasilyev, I A; Vázquez, F; Velev, G; Vellidis, C; Verdier, P; Verkheev, A Y; Vertogradov, L S; Verzocchi, M; Vesterinen, M; Vidal, M; Vila, I; Vilanova, D; Vilar, R; Vizán, J; Vogel, M; Vokac, P; Volpi, G; Wagner, P; Wagner, R L; Wahl, H D; Wakisaka, T; Wallny, R; Wang, S M; Wang, M H L S; Wang, R-J; Warburton, A; Warchol, J; Waters, D; Watts, G; Wayne, M; Weichert, J; Welty-Rieger, L; Wester, W C; White, A; Whiteson, D; Wick, F; Wicke, D; Wicklund, A B; Wicklund, E; Wilbur, S; Williams, H H; Williams, M R J; Wilson, G W; Wilson, J S; Wilson, P; Winer, B L; Wittich, P; Wobisch, M; Wolbers, S; Wolfe, H; Wood, D R; Wright, T; Wu, X; Wu, Z; Wyatt, T R; Xie, Y; Yamada, R; Yamamoto, K; Yamato, D; Yang, S; Yang, T; Yang, U K; Yang, W-C; Yang, Y C; Yao, W-M; Yasuda, T; Yatsunenko, Y A; Ye, W; Ye, Z; Yeh, G P; Yi, K; Yin, H; Yip, K; Yoh, J; Yorita, K; Yoshida, T; Youn, S W; Yu, G B; Yu, I; Yu, J M; Yu, S S; Yun, J C; Zanetti, A; Zeng, Y; Zennamo, J; Zhao, T; Zhao, T G; Zhou, B; Zhou, C; Zhu, J; Zielinski, M; Zieminska, D; Zivkovic, L; Zucchelli, S

    2012-08-17

    We combine searches by the CDF and D0 Collaborations for the associated production of a Higgs boson with a W or Z boson and subsequent decay of the Higgs boson to a bottom-antibottom quark pair. The data, originating from Fermilab Tevatron pp collisions at √s = 1.96 TeV, correspond to integrated luminosities of up to 9.7 fb(-1). The searches are conducted for a Higgs boson with mass in the range 100-150 GeV/c(2). We observe an excess of events in the data compared with the background predictions, which is most significant in the mass range between 120 and 135 GeV/c(2). The largest local significance is 3.3 standard deviations, corresponding to a global significance of 3.1 standard deviations. We interpret this as evidence for the presence of a new particle consistent with the standard model Higgs boson, which is produced in association with a weak vector boson and decays to a bottom-antibottom quark pair. PMID:23006359

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

    PubMed

    Bayne, Stephen C; Fitzgerald, Mark

    2014-01-01

    Evidence-based dentistry (EBD) is reviewed in depth to underscore the limitations for evidence-based dental materials information that exist at this time. Anecdotal estimates of evidence for dental practice are in the range of 8 percent to 10 percent. While the process of evaluating the literature base for dental evidence began 20 years ago, it was not practical to implement it until high-speed wireless connections, open access to journals, and omnipresent connections via smart phones became a reality. EBD includes five stages of information collection and analysis, starting with a careful definition of a clinical question using the PICO(T) approach. Clinical evidence in randomized control trials is considered the best. Clinical trial perspectives (prospective, cross-sectional, retrospective) and outcome designs (RCTs, SCTs, CCTs, cohort studies, case-control studies) are quite varied. Aggregation techniques (including meta-analyses) allow meaningful combinations of clinical data from trials with similar designs but with fewer rigors. Appraisals attempt to assess the entire evidence base without bias and answer clinical questions. Varying intensities to these approaches, Cochrane Collaboration, ADA-EBD Library, UTHSCSA CATs Library, are used to answer questions. Dental materials evidence from clinical trials is infrequent, short-term, and often not compliant with current guidelines (registration, CONSORT, PRISMA). Reports in current evidence libraries indicate less than 5 percent of evidence is related to restorative dental materials. PMID:24571523

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

    PubMed Central

    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 daily clinical and laboratory practice has been slow. Furthermore, the demand for evidence-based laboratory medicine (EBLM) has been slow to develop. There are many contrasting observations about laboratory medicine, for example (i) there is too much testing vs insufficient testing; (ii) testing is expensive vs laboratories are expected to generate income; and (iii) test results have little impact on outcomes vs test results are crucial to clinical decision making. However, there is little evidence to support any of these observations. Integrating the principles of EBLM into routine practice will help to resolve some of these issues by identifying (a) where laboratory medicine fits into the care pathway; (b) where testing is appropriate; (c) the nature and quality of evidence required to demonstrate the clinical utility of a test; (d) how the test result impacts on clinical actions; (e) where changes in the care pathway will occur; and (f) where benefit/value can be achieved. These answers will help to establish the culture of EBLM in clinical and laboratory practice. PMID:22363094

  18. Rotator cuff tears: An evidence based approach

    PubMed Central

    Sambandam, Senthil Nathan; Khanna, Vishesh; Gul, Arif; Mounasamy, Varatharaj

    2015-01-01

    sturdiness should by chosen among the armamentarium of the shoulder surgeon. Grade 1 PTTs do well with debridement while more severe lesions mandate repair either by trans-tendon technique or repair following conversion into FTT. Early repair of repairable FTT can avoid appearance and progression of disability and weakness. The choice of surgery varies from surgeon-to-surgeon with arthroscopy taking the lead in the current scenario. The double-row repairs have an edge over the single-row technique in some patients especially those with massive tears. Stronger, cost-effective and improved functional scores can be obtained by the former. Both early and delayed postoperative rehabilitation programmes have led to comparable outcomes. Guarded results may be anticipated in patients in extremes of age, presence of comorbidities and severe tear patters. Overall, satisfactory results are obtained with timely diagnosis and execution of the appropriate treatment modality. PMID:26716086

  19. Flow Velocimetry for Weakly Conducting Electrolytes Based on High Resolution Lorentzforce Measurement

    NASA Astrophysics Data System (ADS)

    Ebert, R.; Vasilyan, S.; Wiederhold, A.

    We demonstrate that a flow velocity measurement can be transformed into a non-invasive force measurement by metering the dragforce acting on a system of magnets that is arranged around a flow channel. This method is called Lorentzforce velocimetry and has been developed in the last years in our institute. It is a highly feasible principle for materials with large conductivity like liquid metals. To evolve this method for weakly conducting fluids like salt water or molten glass the dragforce measurement is the challenging bottleneck. Here forces of 10-8 and less of the weightforce of the magnet system have to be resolved in the rather noisy environment of the flow channel. In this paper different force measurement techniques get tested and compared. In the first setup the drag-force is acting on the magnets that are hanging as a pendulum with 0.5 m long wires on a mounting. Here the displacement in the range of a few μm can be detected with a laser interferometer and another optical positioning sensor. For the second setup the magnet system is attached to a state of the art electromagnetic force compensation balance. The balance is used in an unusual orientation: It is turned by 90 degrees to measure the horizontally acting Lorentzforce. Different ways of getting the correct force signal out of the two measurement setups will be presented and discussed. For generalization of the measurement principle the Lorentzforce is determined for different fluid profiles. In addition to that we have developed new systematic noise reduction methods to increase the resolution of both force measurement techniques by a factor of ten or larger which we will present here.

  20. Dissemination of Evidence-Based Standards of Care

    PubMed Central

    Barkhordarian, Andre; Hacker, Brett; Chiappelli, Francesco

    2011-01-01

    Standards of care pertain to crafting and implementing patient-centered treatment interventions. Standards of care must take into consideration the patient's gender, ethnicity, medical and dental history, insurance coverage (or socioeconomic level, if a private patient), and the timeliness of the targeted scientific evidence. This resolves into a process by which clinical decision-making about the optimal patient-centered treatment relies on the best available research evidence, and all other necessary inputs and factors to provide the best possible treatment. Standards of care must be evidence-based, and not merely based on the evidence – the dichotomy being critical in contemporary health services research and practice. Evidence-based standards of care must rest on the best available evidence that emerges from a concerted hypothesis-driven process of research synthesis and meta-analysis. Health information technology needs to become an every-day reality in health services research and practice to ensure evidence-based standards of care. Current trends indicate that user-friendly methodologies, for the dissemination of evidence-based standards of care, must be developed, tested and distributed. They should include approaches for the quantification and analysis of the textual content of systematic reviews and of their summaries in the form of critical reviews and lay-language summaries. PMID:22355229

  1. Mind the Gap: Looking for Evidence-Based Practice of Science Literacy for All in Science Teaching Journals

    NASA Astrophysics Data System (ADS)

    Jagger, Susan L.; Yore, Larry D.

    2012-10-01

    Science literacy for all is the central goal of science education reforms, and there is a growing importance of the language arts in science. Furthermore, there are strong calls for teacher professionalism and self-directed professional learning that involve evidence-based best practices. This raises questions about whether science teaching journals' recommendations are anchored to high-quality evidence. We found that (a) most National Science Teacher Association journals' science literacy recommendations have weak or no evidence base and (b) those with evidence reference teaching journals, teacher resource books, and literacy education more often than science education research. We concluded that all participants in the knowledge production cycle and transfer process—authors, editors, and reviewers—need to encourage evidence-based practices anchored to ongoing reforms and to literacy and science education research.

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

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

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

    PubMed

    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. PMID:16384628

  4. Evidence-Based Practice: Separating Science From Pseudoscience

    PubMed Central

    Lee, Catherine M; Hunsley, John

    2015-01-01

    Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821

  5. Evidence-Based Practice: Separating Science From Pseudoscience.

    PubMed

    Lee, Catherine M; Hunsley, John

    2015-12-01

    Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821

  6. The Outcomes Movement and Evidence Based Medicine in Plastic Surgery

    PubMed Central

    Kowalski, Evan.; Chung, Kevin C.

    2012-01-01

    Synopsis Evidence based medicine is analyzed from its inception. The authors take the reader through the early formation of ‘scientific medicine’ that has evolved into the multi-purpose tool it has become today. Early proponents and their intentions that sparked evidence base and outcomes are presented: the work of David Sackett, Brian Haynes, Peter Tugwell, and Victor Neufeld is discussed - how they perceived the need for better clinical outcomes that led to a more formalized evidence based practice. The fundamentals are discussed objectively in detail and potential flaws are presented that guide the reader to deeper comprehension. PMID:23506764

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

    PubMed

    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. PMID:25491004

  8. Using continuous quality improvement to implement evidence-based medicine.

    PubMed

    Quick, Barbara; Nordstrom, Sue; Johnson, Kevin

    2006-01-01

    The importance of implementing evidence-based medicine is being driven by public reporting of outcome data and linking these measures to reimbursement. Most hospitals are faced with many challenges in gaining sponsorship, staffing, creating tools, and reporting of evidence-based outcome measures. This article describes the use of the SSM Health Care (SSMHC) Continuous Quality Improvement model in implementing evidence-based practices at SSM DePaul Health Center, a community hospital member of SSMHC, including successes, opportunities for improvement, and lessons learned. Specifically, the article includes two different processes for data collection and interventions with staff, process requirements for each, and outcome data associated with each model. PMID:17135874

  9. Evidence-Based Management of Phonological Impairment in Children

    ERIC Educational Resources Information Center

    Baker, Elise; McLeod, Sharynne

    2004-01-01

    Evidence-based management of phonological impairment in children is a dynamic process. Speech and language therapists need to evaluate published evidence and use their professional judgement to decide on an intervention plan, evaluate the efficacy of their intervention and re-evaluate decisions. Two case studies are presented to illustrate this…

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

    ERIC Educational Resources Information Center

    Kowalski, Theodore

    2009-01-01

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

  11. Practice-Based Evidence--Overcoming Insecure Attachments

    ERIC Educational Resources Information Center

    Fox, Mark

    2011-01-01

    This article examines educational psychologists' (EPs') engagement with evidence-based practice (EBP). In particular it considers the limitations of randomised controlled trials and the difficulties of obtaining sufficient evidence about the effectiveness of interventions. This means that there is a possibility that EPs continue to use…

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

    ERIC Educational Resources Information Center

    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…

  13. Integrating Evidence-based Decision Making into Allied Health Curricula.

    ERIC Educational Resources Information Center

    Forrest, Jane L.; Miller, Syrene A.

    2001-01-01

    Evidence-based decision making (EBDM) was incorporated into an institute for 42 dental hygiene, occupational therapy, and physical therapy faculty. The 4-day sessions addressed active teaching techniques, formulation of good questions, critical appraisal of evidence, and application, feedback, and evaluation. Most participants felt prepared to…

  14. What Works? Evidence-Based Practice in Education Is Complex

    ERIC Educational Resources Information Center

    Hempenstall, Kerry

    2014-01-01

    There is a nascent movement towards evidence-based practice in education in Australia, evident in Federal and State education documents, if not in classrooms. Such a classroom-level outcome would require a number of conditions to be met. One of the critical requirements is that teachers be provided with knowledge and training in practices that…

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

    ERIC Educational Resources Information Center

    Roberts, Margaret

    2010-01-01

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

  16. Evidence Based Education Request Desk. EBE #652

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

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

  17. Evidence Based Education Request Desk. EBE #791

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

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

  18. [Evidence-based medicine: a critical analysis of the concept of evidence in medicine].

    PubMed

    Federspil, G; Vettor, R

    2001-06-01

    There is currently a lively debate involving scholars from diverse cultural background on the subject of evidence-based medicine. In order to set out the grounds of discussion this paper deals with the problem of "evidence", both the concept and meaning of this term. After a brief history of the idea of "evidence" from antiquity to the present day, it will be underlined how modern day thinking recognizes the existence of two types of "evidence": rational evidence supported first by René Descartes, and perceptible evidence, defended by Francis Bacon. In contemporary epistemology the idea of "evidence" has been conceived above all as perceptible and is closely linked to the idea of fact. The concept of "scientific fact" will therefore be analyzed and will reveal how in science, contrary to prevailing opinion, "pure facts" practically do not exist and how the "facts" which scientists talk about in their research are always "facts depending on theory". Subsequently the capacity of "facts" to prove scientific hypothesis will be examined. In the light of more recent epistemological reflection the thesis will be maintained according to which facts are not capable of definitively proving the truth of a theory. Such reflection leads to the conclusion that in medicine "evidence" is always dependent on the theoretical and practical context in which researchers work. In the final part of the paper the epistemological presumptions and ambitions of evidence-based medicine will be examined. This analysis concludes that the epistemology on which evidence-based medicine relies upon does not grasp the true complexity of the scientific methodology and can weaken in doctors the beneficial stimulus that is doubt. PMID:11460834

  19. [Evidence-based treatment of atrial fibrillation].

    PubMed

    Máquez, Manlio F; Gómez Flores, Jorge

    2006-01-01

    Radiofrequency catheter ablation has emerged as a curative therapy for paroxysmal atrial fibrillation based on studies demonstrating the role of triggering foci in the pulmonary veins for the initiation of atrial fibrillation. Catheter ablation is performed by a trans-septal approach using radiofrequency energy at the ostium of each pulmonary vein. Mapping is guided by special catheters. Sequential radiofrequency applications eliminates or dissociates pulmonary vein muscle activity. Although complications exists, this procedure can be curative for these patients. PMID:17017102

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  1. CDMBE: A Case Description Model Based on Evidence.

    PubMed

    Zhu, Jianlin; Yang, Xiaoping; Zhou, Jing

    2015-01-01

    By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE), which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users' ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model. PMID:26421006

  2. CDMBE: A Case Description Model Based on Evidence

    PubMed Central

    Zhu, Jianlin; Yang, Xiaoping; Zhou, Jing

    2015-01-01

    By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE), which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users' ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model. PMID:26421006

  3. An evidence-based assessment of prescribed grazing practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Synthesis findings regarding the evidence-based assessment of prescribed grazing practices include: 1) stocking rate, in conjunction with appropriate temporal and spatial animal distribution, is a key management variable that influences numerous conservation outcomes, 2) assumptions regarding livest...

  4. Development and evaluation of online evidence based guideline bank system.

    PubMed

    Park, Myonghwa

    2006-01-01

    The purpose of this study was to develop and evaluate the online evidence-based nursing practice guideline bank system to support the best evidence-based decision in the clinical and community practice settings. The main homepage consisted of seven modules for introduction of site, EBN, guideline bank, guideline development, guideline review, related sites, and community. The major contents in the guidelines were purpose, developer, intended audience, method of development, target population, testing, knowledge components, and evaluation. Electronic versions of the guidelines were displayed by XML, PDF, and PDA versions. The system usability were evaluated by general users, guideline developers, and guideline reviewers on the web and the results showed high scores of satisfaction. This online evidence-based guideline bank system could support nurses' best and cost-effective clinical decision using the sharable standardized guidelines with education module of evidence based nursing. PMID:17102227

  5. A regional evidence-based practice fellowship: collaborating competitors.

    PubMed

    Weeks, Susan Mace; Moore, Penny; Allender, Marinda

    2011-01-01

    The authors describe the development of an effort by 21 hospitals and 2 academic institutions in a metropolitan area to strengthen the diffusion of evidence-based practice in their organizations. This has been accomplished by providing collaborative training, mentoring, and support for direct-care RNs through an evidence-based fellowship. The participating direct-care nurses are prepared to take the new knowledge, skills, and abilities they have gained back to the bedside care environment. PMID:21157238

  6. Teaching evidence-based practice: implications for psychology.

    PubMed

    Collins, Frank L; Leffingwell, Thad R; Belar, Cynthia D

    2007-07-01

    A movement advocating the use of evidence-based practice (EBP) is increasingly influencing health care and the practice of psychology. Thus, teaching evidence-based practice in psychology (EBPP) is critical to the preparation of future health service psychologists. In this article, the authors address common myths associated with EBP, propose core components involved in teaching EBPP, and describe an example of how such training can be incorporated into a professional psychology education and training curriculum. PMID:17551942

  7. Weak bump quasars

    NASA Technical Reports Server (NTRS)

    Mcdowell, Jonathan C.; Elvis, Martin; Wilkes, Belinda J.; Willner, Steven P.; Oey, M. S.

    1989-01-01

    The recent emphasis on big bumps dominating the UV continuum of quasars has obscured the facts that bump properties vary widely and that there are objects in which no such component is evident. As part of a survey of quasar continuum spectra, a class of quasars is identified in which the optical-UV continuum big bump feature appears to be weak or absent, relative to both IR and X-ray. These weak bump quasars are otherwise normal objects and constitute a few percent of the quasar population.

  8. A PHYSIOLOGICALLY BASED KINETIC MODEL OF RAT AND MOUSE GESTATION: DISPOSITION OF A WEAK ACID

    EPA Science Inventory

    A physiologically based toxicokinetic model of gestation in the rat mouse has been developed. The model is superimposed on the normal growth curve for nonpregnant females. It describes the entire gestation period including organogenesis. The model consists of uterus, mammary tiss...

  9. Weak Interactions

    DOE R&D Accomplishments Database

    Lee, T. D.

    1957-06-01

    Experimental results on the non-conservation of parity and charge conservation in weak interactions are reviewed. The two-component theory of the neutrino is discussed. Lepton reactions are examined under the assumption of the law of conservation of leptons and that the neutrino is described by a two- component theory. From the results of this examination, the universal Fermi interactions are analyzed. Although reactions involving the neutrino can be described, the same is not true of reactions which do not involve the lepton, as the discussion of the decay of K mesons and hyperons shows. The question of the invariance of time reversal is next examined. (J.S.R.)

  10. Overcoming Challenges to Using Evidence-Based Interventions in Schools.

    ERIC Educational Resources Information Center

    Schaeffer, Cindy M.; Bruns, Eric; Weist, Mark; Stephan, Sharon Hoover; Goldstein, Julie; Simpson, Yolanda

    2005-01-01

    The Center for School Mental Health Assistance at the University of Maryland recently completed a review of evidence-based prevention and treatment programs that can be used by school mental health clinicians. Based on the review, a school-based program operating in 22 Baltimore City schools has purchased and trained clinicians in a number of…

  11. A constructivist model for teaching evidence-based practice.

    PubMed

    Rolloff, Mary

    2010-01-01

    The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education. PMID:21086866

  12. [Iatrogenesis. From Iatromancy to Evidence-Based Medicine, to Iatromancy…].

    PubMed

    Campos, Alberto

    2016-01-01

    The qualities of what is considered evidence change and evolve according to theoretical tools of analysis, but also with what the physician perceives and processes cognitively. This includes models and tools such as statistics and evidence-based medicine. Under the term 'iatromancy' are included here different ways of making inductive inferences to establish diagnoses, be it the divinatory art, heuristics, statistics, Evidence-based Medicine (EBM), or the "clinical eye". The interrelationships of different kinds of experience are discussed as justifications for the beliefs of physicians to form judgments in the decision-making processes. PMID:27160625

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

    NASA Astrophysics Data System (ADS)

    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.

  14. An evidence-based approach to the development of national dietary guidelines.

    PubMed

    Cooper, Marcia Janet; Zlotkin, Stanley Howard

    2003-12-01

    It has become apparent that confusing and conflicted nutritional advice from the media in combination with a quick reversal of policymakers' national nutrition recommendations have the potential to lead to public disbelief and cynicism for both the process and the conclusions. Consequently, poor design of policy can lead to ineffective communications with health professionals and the public. The ultimate result is that the public will ignore the recommendations with potentially adverse outcomes. Formal evidence-based clinical practice guidelines are being used regularly in the medical community. The methodology used to develop these guidelines includes a systematic review of the literature, filtering the literature for relevant articles, assessing the scientific quality of the available evidence, and rating the strength or weakness of the final recommendation. This article suggests that national dietary guidelines may be improved if they are based on a more formal evidence-based approach. Current research that is being conducted to test components of a generic, standardized methodology for developing evidence-based population targeted dietary guidelines is described. PMID:14666497

  15. Web-based Examination System “Check on e” having Self-check Capability of Advantages and Weaknesses

    NASA Astrophysics Data System (ADS)

    Fushimi, Shigeo; Watanabe, Akira; Nouda, Hideo

    NEC Learning Ltd. has developed “Check on e” , web-based examination system. The purpose is to check basic knowledge of young engineers engaged in development of electronic equipments, like digital electronic household appliances, which Japan has some favorable potential. We describe first, benefits and characteristics of “Check on e” . Utilizing this web-based test, young engineers are able to diagnose their advantages and weaknesses. Furthermore, since “Check on e” system sets questions randomly from the database of triple questions of those in actual test, it has sure ability to evaluate result of training or education. Finally, we show some examples on electric circuit field and LSI design (System on a Chip) field, and navigation system to introduce education after taking this examination.

  16. Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy.

    PubMed

    Pringsheim, Tamara; Doja, Asif; Gorman, Daniel; McKinlay, Duncan; Day, Lundy; Billinghurst, Lori; Carroll, Alan; Dion, Yves; Luscombe, Sandra; Steeves, Thomas; Sandor, Paul

    2012-03-01

    This article seeks to provide the practising clinician with guidance on the pharmacological management of tic disorders in children and adults. We performed a systematic review of the literature on the treatment of tic disorders. A multi-institutional group of 14 experts in psychiatry, child psychiatry, neurology, pediatrics, and psychology engaged in a consensus meeting. The evidence was presented and discussed, and nominal group techniques were employed to arrive at consensus on recommendations. A strong recommendation is made when the benefits of treatment clearly outweigh the risks and burdens, and can apply to most patients in most circumstances without reservation. With a weak recommendation, the benefits, risks, and burdens are more closely balanced, and the best action may differ depending on the circumstances. Based on these principles, weak recommendations were made for the use of pimozide, haloperidol, fluphenazine, metoclopramide (children only), risperidone, aripiprazole, olanzapine, quetiapine, ziprasidone, topiramate, baclofen (children only), botulinum toxin injections, tetrabenazine, and cannabinoids (adults only). Strong recommendations were made for the use of clonidine and guanfacine (children only). While the evidence supports the efficacy of many of the antipsychotics for the treatment of tics, the high rates of side effects associated with these medications resulted in only weak recommendations for these drugs. In situations where tics are not severe or disabling, the use of a medication with only a weak recommendation is not warranted. However, when tics are more distressing and interfering, the need for tic suppression to improve quality of life is stronger, and patients and clinicians may be more willing to accept the risks of pharmacotherapy. PMID:22397999

  17. Physiology versus evidence-based guidance for critical care practice

    PubMed Central

    2015-01-01

    Evidence based medicine is an attempt to optimize the medical decision process through methods primarily based on evidence coming from meta-analyses, systematic reviews, and randomized controlled trials ("evidence-based medicine"), rather than on "clinical judgment" alone. The randomized trials are the cornerstones of this process. However, the randomized trials are just a method to prove or disprove a given hypothesis, which, in turn, derives from a general observation of the reality (premises or theories). In this paper we will examine some of the most recent randomized trials performed in Intensive Care, analyzing their premises, hypothesis and outcome. It is quite evident that when the premises are wrong or too vague the unavoidable consequences will be a negative outcome. We should pay when designing the trial an equal attention in defining premises and hypothesis that we pay for the trial conduction. PMID:26729063

  18. Evidence-based practice: a retrograde step? The importance of pluralism in evidence generation for the practice of health care.

    PubMed

    Clarke, J B

    1999-01-01

    The origin of evidence-based medicine is explored and its connection to evidence-based practice examined. Widespread acceptance of the dominant scientific paradigm supporting evidence-based practice is challenged. Knowledge classifications and their relevance for nursing practice are considered, with the need for a critical balance to be pursued. Recommendations are made, regarding the future of evidence for practice, and a brief example of emerging evidence concerning values of professional caring is offered in redressing the balance. PMID:10214174

  19. Weak Convergence of a Mass-Structured Individual-Based Model

    SciTech Connect

    Campillo, Fabien; Fritsch, Coralie

    2015-08-15

    We propose a model of chemostat where the bacterial population is individually-based, each bacterium is explicitly represented and has a mass evolving continuously over time. The substrate concentration is represented as a conventional ordinary differential equation. These two components are coupled with the bacterial consumption. Mechanisms acting on the bacteria are explicitly described (growth, division and washout). Bacteria interact via consumption. We set the exact Monte Carlo simulation algorithm of this model and its mathematical representation as a stochastic process. We prove the convergence of this process to the solution of an integro-differential equation when the population size tends to infinity. Finally, we propose several numerical simulations.

  20. New Gel-Like Polymers as Selective Weak-Base Anion Exchangers

    PubMed Central

    Gierczyk, Błażej; Cegłowski, Michał; Zalas, Maciej

    2015-01-01

    A group of new anion exchangers, based on polyamine podands and of excellent ion-binding capacity, were synthesized. The materials were obtained in reactions between various poly(ethyleneamines) with glycidyl derivatives of cyclotetrasiloxane. The final polymeric, strongly cross-linked materials form gel-like solids. Their structures and interactions with anions adsorbed were studied by spectroscopic methods (CP-MAS NMR, FR-IR, UV-Vis). The sorption isotherms and kinetic parameters were determined for 29 anions. Materials studied show high ion capacity and selectivity towards some important anions, e.g., selenate(VI) or perrhenate. PMID:25946220

  1. Highly efficient SO₂ absorption and its subsequent utilization by weak base/polyethylene glycol binary system.

    PubMed

    Yang, Zhen-Zhen; He, Liang-Nian; Zhao, Ya-Nan; Yu, Bing

    2013-02-01

    A binary system consisting of polyethylene glycol (PEG, proton donor)/PEG-functionalized base with suitable basicity was developed for efficient gas desulfurization (GDS) and can be regarded as an alternative approach to circumvent the energy penalty problem in the GDS process. High capacity for SO(2) capture up to 4.88 mol of SO(2)/mol of base was achieved even under low partial pressure of SO(2). Furthermore, SO(2) desorption runs smoothly under mild conditions (N(2), 25 °C) and no significant drop in SO(2) absorption was observed after five-successive absorption-desorption cycles. On the other hand, the absorbed SO(2) by PEG(150)MeIm/PEG(150), being considered as the activated form of SO(2), can be directly transformed into value-added chemicals under mild conditions, thus eliminating the energy penalty for SO(2) desorption and simultaneously realizing recycle of the absorbents. Thus, this SO(2) capture and utilization (SCU) process offers an alternative way for GDS and potentially enables the SO(2) conversion from flue gas to useful chemicals as a value-added process. PMID:23323771

  2. Optimization-based additive decomposition of weakly coercive problems with applications

    DOE PAGESBeta

    Bochev, Pavel B.; Ridzal, Denis

    2016-01-27

    In this study, we present an abstract mathematical framework for an optimization-based additive decomposition of a large class of variational problems into a collection of concurrent subproblems. The framework replaces a given monolithic problem by an equivalent constrained optimization formulation in which the subproblems define the optimization constraints and the objective is to minimize the mismatch between their solutions. The significance of this reformulation stems from the fact that one can solve the resulting optimality system by an iterative process involving only solutions of the subproblems. Consequently, assuming that stable numerical methods and efficient solvers are available for every subproblem,more » our reformulation leads to robust and efficient numerical algorithms for a given monolithic problem by breaking it into subproblems that can be handled more easily. An application of the framework to the Oseen equations illustrates its potential.« less

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

    PubMed Central

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

    2010-01-01

    The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs. There is weak evidence suggesting that the use of manual therapy may lead to positive short-term effects. Electro-physical agents do not appear to enhance outcomes and are not recommended. Exercise may reduce the occurrence of recurrent ankle sprains and may be effective in managing chronic ankle instability. After surgical fixation for ankle fracture, an early introduction of activity, administered via early weight-bearing or exercise during the immobilization period, may lead to better outcomes. However, the use of a brace or orthosis to enable exercise during the immobilization period may also lead to a higher rate of adverse events, suggesting that this treatment regimen needs to be applied judiciously. After the immobilization period, the focus of treatment for ankle fracture should be on a progressive exercise program. PMID:21655420

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

    PubMed

    Rousseau, Denise M; Gunia, Brian C

    2016-01-01

    Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation. PMID:26361048

  5. Saliency-Aware Nonparametric Foreground Annotation Based on Weakly Labeled Data.

    PubMed

    Cao, Xiaochun; Zhang, Changqing; Fu, Huazhu; Guo, Xiaojie; Tian, Qi

    2016-06-01

    In this paper, we focus on annotating the foreground of an image. More precisely, we predict both image-level labels (category labels) and object-level labels (locations) for objects within a target image in a unified framework. Traditional learning-based image annotation approaches are cumbersome, because they need to establish complex mathematical models and be frequently updated as the scale of training data varies considerably. Thus, we advocate the nonparametric method, which has shown potential in numerous applications and turned out to be attractive thanks to its advantages, i.e., lightweight training load and scalability. In particular, we exploit the salient object windows to describe images, which is beneficial to image retrieval and, thus, the subsequent image-level annotation and localization tasks. Our method, namely, saliency-aware nonparametric foreground annotation, is practical to alleviate the full label requirement of training data, and effectively addresses the problem of foreground annotation. The proposed method only relies on retrieval results from the image database, while pretrained object detectors are no longer necessary. Experimental results on the challenging PASCAL VOC 2007 and PASCAL VOC 2008 demonstrate the advance of our method. PMID:26529788

  6. Weak magnetic fields in Ap/Bp stars. Evidence for a dipole field lower limit and a tentative interpretation of the magnetic dichotomy

    NASA Astrophysics Data System (ADS)

    Aurière, M.; Wade, G. A.; Silvester, J.; Lignières, F.; Bagnulo, S.; Bale, K.; Dintrans, B.; Donati, J. F.; Folsom, C. P.; Gruberbauer, M.; Hui Bon Hoa, A.; Jeffers, S.; Johnson, N.; Landstreet, J. D.; Lèbre, A.; Lueftinger, T.; Marsden, S.; Mouillet, D.; Naseri, S.; Paletou, F.; Petit, P.; Power, J.; Rincon, F.; Strasser, S.; Toqué, N.

    2007-12-01

    Aims:We investigated a sample of 28 well-known spectroscopically-identified magnetic Ap/Bp stars, with weak, poorly-determined or previously undetected magnetic fields. The aim of this study is to explore the weak part of the magnetic field distribution of Ap/Bp stars. Methods: Using the MuSiCoS and NARVAL spectropolarimeters at Télescope Bernard Lyot (Observatoire du Pic du Midi, France) and the cross-correlation technique Least Squares Deconvolution (LSD), we obtained 282 LSD Stokes V signatures of our 28 sample stars, in order to detect the magnetic field and to infer its longitudinal component with high precision (median σ=40 G). Results: For the 28 studied stars, we obtained 27 detections of Stokes V Zeeman signatures from the MuSiCoS observations. Detection of the Stokes V signature of the 28th star (HD 32650) was obtained during science demonstration time of the new NARVAL spectropolarimeter at Pic du Midi. This result clearly shows that when observed with sufficient precision, all firmly classified Ap/Bp stars show detectable surface magnetic fields. Furthermore, all detected magnetic fields correspond to longitudinal fields which are significantly greater than some tens of G. To better characterise the surface magnetic field intensities and geometries of the sample, we phased the longitudinal field measurements of each star using new and previously-published rotational periods, and modeled them to infer the dipolar field intensity (B_d, measured at the magnetic pole) and the magnetic obliquity (β). The distribution of derived dipole strengths for these stars exhibits a plateau at about 1 kG, falling off to larger and smaller field strengths. Remarkably, in this sample of stars selected for their presumably weak magnetic fields, we find only 2 stars for which the derived dipole strength is weaker than 300 G. We interpret this “magnetic threshold” as a critical value necessary for the stability of large-scale magnetic fields, and develop a simple

  7. Evidence of weak superconductivity at the room-temperature grown LaAlO3/SrTiO3 interface

    NASA Astrophysics Data System (ADS)

    Prawiroatmodjo, G. E. D. K.; Trier, F.; Christensen, D. V.; Chen, Y.; Pryds, N.; Jespersen, T. S.

    2016-05-01

    The two-dimensional electron gas at the crystalline LaAlO3/SrTiO3 (c -LAO/STO) interface has sparked large interest due to its exotic properties, including an intriguing gate-tunable superconducting phase. While there is growing evidence of pronounced spatial inhomogeneity in the conductivity at STO-based interfaces, the consequences for superconductivity remain largely unknown. We study interfaces based on amorphous LAO top layers grown at room temperature (a -LAO/STO) and demonstrate a superconducting phase similar to c -LAO/STO, however, with a gate-tunable critical temperature of 460 mK . The dependence of the superconducting critical current on temperature, magnetic field, and back-gate-controlled doping is found to be consistently described by a model of a random array of Josephson-coupled superconducting domains.

  8. Evidence-based management of common chronic lower extremity ulcers.

    PubMed

    Richmond, Nicholas A; Maderal, Andrea D; Vivas, Alejandra C

    2013-01-01

    Chronic lower extremity ulcers are a significant burden on patients and health care systems worldwide. Although relatively common, these wounds can be difficult to treat and present a challenge to physicians. Treatment has often been based on anecdotal accounts; however, there is a growing emphasis on using evidence-based conclusions to guide clinical decisions. In this review article, the standard of care and adjuvant therapies of venous leg ulcers and diabetic foot ulcers are presented from an evidence-based perspective. PMID:23742279

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

    PubMed Central

    2013-01-01

    Background 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 interest to chiropractors, there are still many areas such as diagnosis, prognosis, choice of treatment, and management that have not been subjected to extensive scrutiny. Discussion In this paper we argue that a simple system consisting of three questions will help clinicians deal with some of the complexities of clinical practice, in particular what to do when clear clinical evidence is lacking. Question 1 asks: are there objectively tested facts to support the concept? Question 2: are the concepts that form the basis for this clinical act or decision based on scientifically acceptable concepts? And question three; is the concept based on long-term and widely accepted experience? This method that we call the “Traffic Light System” can be applied to most clinical processes. Summary We explain how the Traffic Light System can be used as a simple framework to help chiropractors make clinical decisions in a simple and lucid manner. We do this by explaining the roles of biological plausibility and clinical experience and how they should be weighted in relation to scientific evidence in the clinical decision making process, and in particular how to proceed, when evidence is missing. PMID:23837495

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  11. Construct Definition Using Cognitively Based Evidence: A Framework for Practice

    ERIC Educational Resources Information Center

    Ketterlin-Geller, Leanne R.; Yovanoff, Paul; Jung, EunJu; Liu, Kimy; Geller, Josh

    2013-01-01

    In this article, we highlight the need for a precisely defined construct in score-based validation and discuss the contribution of cognitive theories to accurately and comprehensively defining the construct. We propose a framework for integrating cognitively based theoretical and empirical evidence to specify and evaluate the construct. We apply…

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

    ERIC Educational Resources Information Center

    David-Ferdon, Corinne; Kaslow, Nadine J.

    2008-01-01

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

  13. [Interpretation and judgment formation influence evidence based guidelines].

    PubMed

    Brand, Paul L P

    2012-01-01

    A critical step in the development of evidence based guidelines is the interpretation and weighing-up of the epidemiological evidence. According to the model of human dynamic judgement formation, the personal views, convictions, and choices of the experts developing the guidelines play a part in determining this process. If such views, convictions, and choices are stated explicitly (as is recommended in the GRADE methodology for developing guidelines), physicians are more likely to really follow the guidelines. PMID:22748363

  14. Intramuscular injection technique: an evidence-based approach.

    PubMed

    Ogston-Tuck, Sherri

    2014-09-30

    Intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. This article, the second in a series of two, reviews the evidence base to inform safer practice and to consider the evidence for nursing practice in this area. A framework for safe practice is included, identifying important points for safe technique, patient care and clinical decision making. It also highlights the ongoing debate in selection of intramuscular injection sites, predominately the ventrogluteal and dorsogluteal muscles. PMID:25249123

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

    PubMed

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

    2015-08-01

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

  16. From evidence-based medicine to genomic medicine

    PubMed Central

    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 the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’. PMID:18923934

  17. Epidemiological evidence relating snus to health--an updated review based on recent publications.

    PubMed

    Lee, Peter N

    2013-01-01

    An earlier review summarized evidence relating use of snus (Swedish-type moist snuff) to health and to initiation and cessation of smoking. This update considers the effect recent publications on snus use and health have on the overall evidence. The additional evidence extends the list of neoplastic conditions unassociated with snus use (oropharynx, oesophagus, stomach, lung) to include colorectal cancer and acoustic neuroma, and further undermines the weakly-based argument that snus use increases the risk of pancreatic cancer, although there is a report of poorer cancer survival in users. It remains undemonstrated that "snuff-dipper's lesion" increases risk of oral cancer, and recent publications add to the evidence that snus use has no effect on periodontitis or dental caries. Although onset of acute myocardial infarction is not adversely associated with snus use, there is some evidence of an association with reduced survival. Whether this is a direct effect of snus use or a result of confounding by socioeconomic status or other factors requires further investigation, as does a report of an increased risk of heart failure in snus users. Even if some adverse health effects of snus use do exist, it remains clear that they are far less than those of smoking. PMID:24314326

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

    PubMed

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

    2014-01-01

    Background Evidence-based practice (EBP) is now the accepted orthodoxy in clinical practice and developed from evidence-based medicine. EBP is based on a specific type of evidence that is derived from studies based on randomised controlled trials (RCT). This type of evidence is suited to acute medical care and is more problematic for other clinicians such as nurses and therapists, particularly when they are situated within community or primary care settings. Setting Five stroke care services in England (2), Sweden (2) and Poland (1). Aims To reflect on the evidence gained from these case studies to shed light on various aspects of EBP. This paper focuses on three key issues: (1) the importance of context for evidence, (2) the nature of knowledge, and (3) professional hierarchies. Methods Five qualitative case studies into stroke care were carried out in England, Sweden and Poland. One hundred and twenty semi-structured interviews were carried out with a range of healthcare staff who provided specialised and non-specialised stroke care in acute, community and primary care between October 2010 and September 2011. Medical doctors, nurses and different therapists were included in the samples in all five case studies. For this paper, we reflect on some aspects of this work to illuminate the different interprofessional perspectives relating to EBP in stroke care. Results The lack of RCT-based evidence in the community and primary care sectors can lead to the clinicians working in these sectors being perceived as having a lower status. Clinicians use both tacit and encoded knowledge to guide their practice and there existed both intraand interprofessional tensions in these two types of knowledge. The professional hierarchy of stroke teams varies with national context and the role of the non-specialists is less valued in stroke care. PMID:25949726

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

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

    Brent, David A.; Maalouf, Fadi T.

    2009-01-01

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

  1. Evidence and Rigor: Scrutinizing the Rhetorical Embrace of Evidence-Based Decision Making

    ERIC Educational Resources Information Center

    Baker, Bruce; Welner, Kevin G.

    2012-01-01

    The nation's lawmakers have frequently voiced the basic principle that important policy decisions should be evidence based. In this commentary, the authors describe the approach the U.S. Department of Education has taken in its Increasing Educational Productivity project. The authors argue that the department's actual practice in this instance has…

  2. Untangling the Evidence: Introducing an Empirical Model for Evidence-Based Library and Information Practice

    ERIC Educational Resources Information Center

    Gillespie, Ann

    2014-01-01

    Introduction: This research is the first to investigate the experiences of teacher-librarians as evidence-based practice. An empirically derived model is presented in this paper. Method: This qualitative study utilised the expanded critical incident approach, and investigated the real-life experiences of fifteen Australian teacher-librarians,…

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

    PubMed Central

    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

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

    PubMed

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

    2004-01-01

    The inadequacy of most of traditional sources for medical information, like textbook and review article, do not sustained the clinical decision based on the best evidence current available, exposing the patient to a unnecessary risk. Although not integrated around clinical problem areas in the convenient way of textbooks, current best evidence from specific studies of clinical problems can be found in an increasing number of Internet and electronic databases. The sources that have already undergone rigorous critical appraisal are classified as secondary information sources, others that provide access to original article or abstract, as primary information source, where the quality assessment of the article rely on the clinician oneself . The most useful primary information source are SciELO, the online collection of Brazilian scientific journals, and Medline, the most comprehensive database of the USA National Library of Medicine, where the search may start with use of keywords, that were obtained at the structured answer construction (P.I.C.O.), with the addition of boolean operators "AND", "OR", "NOT". Between the secondary information sources, some of them provide critically appraised articles, like ACP Journal Club, Evidence Based Medicine and InfoPOEMs, others provide evidences organized as online texts, such as "Clinical Evidence" and "UpToDate", and finally, Cochrane Library are composed by systematic reviews of randomized controlled trials. To get studies that could answer the clinical question is part of a mindful practice, that is, becoming quicker and quicker and dynamic with the use of PDAs, Palmtops and Notebooks. PMID:15253037

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

    PubMed

    Solomon, Robert J

    2010-01-01

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

  6. Evidence-based uncertainty in mental health nursing.

    PubMed

    Franks, V

    2004-02-01

    The drive towards evidence-based practice is part of a modern reflective and caring service. However there is a paradox at the heart of the notion of evidence-based care. In order to perform any systemized examination of treatment there has to be a conscious acknowledgement of uncertainty about that treatment. This is uncomfortable and when research does find evidence in favour of a treatment, there is a relief and a return to conviction about what is the best. The paradox is that it seems the most valued research practices are predicated on generalizations about patient treatments and categories. However, nursing care is based on the notion of the uniqueness of the patient and the nurse-patient relationship. Sometimes it is necessary to address the particular and not to rush to generalizations and certainty. The psychoanalytic framework promotes a capacity to tolerate uncertainty and provides a model for understanding conflicting feelings, which can occur within the nurse-patient relationship. The author proposes the psychoanalytic observational method as an adjunct to other research methods. This method places certain kinds of evidence within the rubric of evidence-based nursing practice. The evidence collected in this method is the evidence of the conscious and unconscious experience within the nurse-patient relationship. The author will describe and argue for the place of this research method within the canon of other more widely practised methods within mental health practice. She will propose that for safe practice it is necessary to value and examine the veracity of the feelings and tacit understanding of the nurse. She contends that the current climate of excessive bureaucracy and persecutory risk management is having a damaging effect on both the research process and effective nursing care. PMID:14723645

  7. A prototype system to support evidence-based practice.

    PubMed

    Demner-Fushman, Dina; Seckman, Charlotte; Fisher, Cheryl; Hauser, Susan E; Clayton, Jennifer; Thoma, George R

    2008-01-01

    Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans. PMID:18998835

  8. Evidence-based orthopaedics or 'superstition in the pigeon'.

    PubMed

    Evans, R

    2009-01-01

    Pigeon behavioural conditioning methods are similar to the processes that orthopaedic surgeons use to evaluate new surgical procedures. Alternatively, evidence-based orthopaedics is a tool for surgeons to evaluate procedures in a systematic, patient-centred way that is less instinctive than pigeon behaviour. The objective of this article is to describe evidence-based orthopaedics, and then propose changes to surgical culture with the aim of refining the interpretation of the current literature and improving the quality of future research. The proposals are 'institutional' changes rather than calls for increased funding and more randomised controlled trials. PMID:19750292

  9. Psychosocial factors and diabetes mellitus: evidence-based treatment guidelines.

    PubMed

    Petrak, Frank; Herpertz, Stephan; Albus, Christian; Hirsch, Axel; Kulzer, Bernhard; Kruse, Johannes

    2005-08-01

    The aim of this project was to develop evidence-based guidelines regarding psychosocial aspects of diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. Recommendations address the following topics: patient education, behavioural medicine, and psychiatric disorders of particular relevance to diabetes: depression, anxiety disorders, eating disorders, and dependence on alcohol and nicotine. The present guidelines were developed through an interdisciplinary process of consensus according to the specifications of evidence-based medicine and are recognized by the German Diabetes Association and the German College for Psychosomatic Medicine as their official guidelines. PMID:18220602

  10. Mental Health Clinicians’ Experiences of Implementing Evidence-Based Treatments

    PubMed Central

    Powell, Byron J.; Hausmann-Stabile, Carolina; McMillen, J. Curtis

    2013-01-01

    Implementation research has tremendous potential to bridge the research-practice gap; however, we know more about barriers to evidence-based care than the factors that contribute to the adoption and sustainability of evidence-based treatments (EBTs). This qualitative study explores the experiences of clinicians (N = 11) who were implementing EBTs, highlighting the factors that they perceived to be most critical to successful implementation. The clinicians’ narratives reveal many leverage points that can inform administrators, clinical supervisors, and clinicians who wish to implement EBTs, as well as other stakeholders who wish to develop and test strategies for moving EBTs into routine care. PMID:24066630

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

    PubMed

    Lindoerfer, Doris; Mansmann, Ulrich

    2016-01-01

    This paper discusses an evidence-based approach to software requirements engineering. The approach is called evidence-based, since it uses publications on the specific problem as a surrogate for stakeholder interests, to formulate risks and testing experiences. This complements the idea that agile software development models are more relevant, in which requirements and solutions evolve through collaboration between self-organizing cross-functional teams. The strategy is exemplified and applied to the development of a Software Requirements list used to develop software systems for patient registries. PMID:27577464

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

    PubMed

    Balakas, Karen; Smith, Joan R

    2016-01-01

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

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

    PubMed

    Robb, Meigan; Shellenbarger, Teresa

    2014-10-01

    Evidence-based nursing practice requires the use of effective search strategies to locate relevant resources to guide practice change. Continuing education and staff development professionals can assist nurses to conduct effective literature searches. This article provides suggestions for strategies to aid in identifying search terms. Strategies also are recommended for refining searches by using controlled vocabulary, truncation, Boolean operators, PICOT (Population/Patient Problem, Intervention, Comparison, Outcome, Time) searching, and search limits. Suggestions for methods of managing resources also are identified. Using these approaches will assist in more effective literature searches and may help evidence-based practice decisions. PMID:25221988

  14. Achievements and Limitations of Evidence-Based Medicine.

    PubMed

    Sheridan, Desmond J; Julian, Desmond G

    2016-07-12

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

  15. Evidence integration in model-based tree search

    PubMed Central

    Solway, Alec; Botvinick, Matthew M.

    2015-01-01

    Research on the dynamics of reward-based, goal-directed decision making has largely focused on simple choice, where participants decide among a set of unitary, mutually exclusive options. Recent work suggests that the deliberation process underlying simple choice can be understood in terms of evidence integration: Noisy evidence in favor of each option accrues over time, until the evidence in favor of one option is significantly greater than the rest. However, real-life decisions often involve not one, but several steps of action, requiring a consideration of cumulative rewards and a sensitivity to recursive decision structure. We present results from two experiments that leveraged techniques previously applied to simple choice to shed light on the deliberation process underlying multistep choice. We interpret the results from these experiments in terms of a new computational model, which extends the evidence accumulation perspective to multiple steps of action. PMID:26324932

  16. GRADE in Systematic Reviews of Acupuncture for Stroke Rehabilitation: Recommendations based on High-Quality Evidence

    PubMed Central

    Xin, Zhang; Xue-Ting, Liu; De-Ying, Kang

    2015-01-01

    Systematic reviews (SRs) of randomized controlled trials (RCTs) have demonstrated acupuncture’s effectiveness in stroke rehabilitation. The current study reviews the quality of evidence in SRs of acupuncture in stroke rehabilitation, and rates the strength of recommendation for its use based on this evidence using the GRADE (grading of recommendations, assessment, development and evaluations) approach. A comprehensive literature search was performed using multiple databases (e.g., Medline, Embase) with advanced search strategies. Two authors independently selected articles, collected data, and assessed the methodological quality of each identified SR according to AMSTAR (a measurement tool to assess systematic reviews) and OQAQ (Oxman and Guyatt’s overview quality assessment questionnaire). Outcomes related to stroke rehabilitation were evaluated. SRs of high methodological quality (AMSTAR score ≥9 and OQAQ score ≥7) were graded using GRADE. Ultimately, acupuncture yields benefits in stroke rehabilitation (neurological function improvement: RR = 1.34; swallowing improvement: RR = 1.61, 1.49, 1.07; disability: SMD = 0.49 or 0.07). Poor evidentiary quality and insufficient information about harm led to weak recommendations. In conclusion, acupuncture may improve stroke rehabilitation, as the GRADE approach indicated a weak recommendation for acupuncture’s usage in this context. PMID:26560971

  17. Foundations for evidence-based intraoperative neurophysiological monitoring.

    PubMed

    Howick, Jeremy; Cohen, Bernard Allan; McCulloch, Peter; Thompson, Matthew; Skinner, Stanley A

    2016-01-01

    In this review, we recommend means to enhance the evidence-base for intraoperative neurophysiological monitoring (IONM). We address two preliminary issues: (1) whether IONM should be evaluated as a diagnostic test or an intervention, and (2) the state of the evidence for IONM (as presented in systematic reviews, for example). Three reasons may be suggested to evaluate at least some IONM applications as interventions (or as part of an "interventional cascade"). First, practical barriers limit our ability to measure IONM diagnostic accuracy. Second, IONM results are designed to be correlated with interventions during surgery. Third, IONM should improve patient outcomes when IONM-directed intervention alters the course of surgery. Observational evidence for IONM is growing yet more is required to understand the conditions under which IONM, in its variety of settings, can benefit patients. A multi-center observational cohort study would represent an important initial compromise between the pragmatic difficulties with conducting controlled trials in IONM and the Evidence-Based Medicine (EBM) view that large scale randomized trials are required. Such a cohort study would improve the evidence base and (if justified) provide the rationale for controlled trials. PMID:26268581

  18. EVIDENCEBASED MEDICINE/PRACTICE IN SPORTS PHYSICAL THERAPY

    PubMed Central

    Lehecka, B.J.

    2012-01-01

    A push for the use of evidence‐based medicine and evidence‐based practice patterns has permeated most health care disciplines. The use of evidence‐based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision‐making. In this era of health care utilization sports physical therapists are expected to integrate 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. PMID:23091778

  19. Evidence-based Assessment in Pediatric Psychology: Measures of Psychosocial Adjustment and Psychopathology

    PubMed Central

    Thill, Azure Welborn; Bachanas, Pamela; Garber, Judy; Miller, Karen Bearman; Abad, Mona; Bruno, Elizabeth Franks; Carter, Jocelyn Smith; David-Ferdon, Corinne; Jandasek, Barbara; Mennuti-Washburn, Jean E.; O’Mahar, Kerry; Zukerman, Jill

    2008-01-01

    Objective To provide an evidence-based review of measures of psychosocial adjustment and psychopathology, with a specific focus on their use in the field of pediatric psychology. Methods As part of a larger survey of pediatric psychologists from the Society of Pediatric Psychology e-mail listserv (American Psychological Association, APA, Division 54), 37 measures were selected for this psychometric review. Measures that qualified for the review fell into one of the following three categories: (a) internalizing or externalizing rating scales, (b) broad-band rating scales, and (c) self-related rating scales. Results Psychometric characteristics (i.e., three types of reliability, two types of validity) were strong for the majority of measures reviewed, with 34 of the 37 measures meeting “well-established” evidence-based assessment (EBA) criteria. Strengths and weaknesses of existing measures were noted. Conclusions Recommendations for future work in this area of assessment are presented, including suggestions that more fine-grained EBA criteria be developed and that evidence-based “profiles” be devised for each measure. PMID:17728305

  20. Correlation of self-assessment with attendance in an evidence-based medicine course.

    PubMed

    Ramirez, Beatriz U

    2015-12-01

    In previous studies, correlations between attendance and grades in lectures have given variable results and, when statistically significant, the correlation has been weak. In some studies, a sex effect has been reported. Lectures are a teacher-centered learning activity. Therefore, it appeared interesting to evaluate if a stronger correlation between attendance and grades would occur in a face-to-face "evidence-based medicine" course with few lectures and more time dedicated to active learning methods. Small-group work and peer learning were used to foster deep learning and to engage students in their own learning process. Most of the time, students worked in small groups solving contextualized problems and critically analyzing the quality of published medical literature. Peer learning was also developed in collaborative evaluations, and constant feedback was provided. Therefore, it was hypothesized that high attenders would develop a higher self-perception of learning and obtain higher marks than low attenders. Student self-perceptions of their capacity to apply evidence-based medicine were measured by the application of an online self-assessment survey, and objective learning was measured as the grades obtained in a final accumulative individual test. It was found that male students obtained higher grades and were more confident in their achievements than their female peers, despite male and female student attendance being similar. In addition, attendance was correlated with the perceived capacity to apply evidence-based medicine only in male students and was not correlated with academic outcome. PMID:26628663

  1. Creating evidence-based research in adapted physical activity.

    PubMed

    Reid, Greg; Bouffard, Marcel; MacDonald, Catherine

    2012-04-01

    Professional practice guided by the best research evidence is a usually referred to as evidence-based practice. The aim of the present paper is to describe five fundamental beliefs of adapted physical activity practices that should be considered in an 8-step research model to create evidence-based research in adapted physical activity. The five beliefs are individualization, critical thinking, self-determination, program effectiveness, and multifactor complexity. The research model includes conceptualize the problem, conduct research on the process of the problem, conceptualize and specify the intervention, evaluate intervention outcomes, evaluate intervention processes, determine person-by-treatment interactions, determine context-dependent limitations, and investigate factors related to intervention adoption maintenance. The eight steps are explained with reference to two research programs that used a randomized control group design. PMID:22467832

  2. Feedback informed treatment: evidence-based practice meets social construction.

    PubMed

    Tilsen, Julie; McNamee, Sheila

    2015-03-01

    This article explores the challenges presented by the mandate for evidence-based practice for family therapists who identify with the philosophical stance of social construction. The history of psychotherapy outcome research is reviewed, as are current findings that provide empirical evidence for an engaged, dialogic practice. The authors suggest that the binary between empiricism and social construction may be unhinged by understanding empiricism as a particular discursive frame (i.e., a particular way of talking, acting, and being in the world), one of many available as a way of understanding and talking about our work. Through a case vignette, the authors introduce the evidence-based practice of Feedback Informed Treatment as an elaboration of social construction, and as an example of bridging the gap between the discursive frames of empiricism and social construction. PMID:25394600

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

    PubMed

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

    2012-01-01

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

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

    PubMed

    Gaeta, Rodolfo; Gentile, Nelida

    2016-08-01

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

  5. Using Family Paradigms to Improve Evidence-Based Practice

    ERIC Educational Resources Information Center

    Hidecker, Mary Jo Cooley; Jones, Rebecca S.; Imig, David R.; Villarruel, Francisco A.

    2009-01-01

    Purpose: Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within…

  6. Evidence-Based Library Management: The Leadership Challenge

    ERIC Educational Resources Information Center

    Lakos, Amos

    2007-01-01

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

  7. Evidence-Based Practice in Communication Disorders: Progress Not Perfection

    ERIC Educational Resources Information Center

    Kent, Ray D.

    2006-01-01

    Purpose: This commentary is written in response to a companion paper by Nan Bernstein Ratner ("Evidence-Based Practice: An Examination of its Ramifications for the Practice of Speech-Language Pathology"). Method: The comments reflect my experience as Vice President for Research and Technology of the American Speech-Language-Hearing Association…

  8. Evidence-Based Psychotherapy Practice in College Mental Health

    ERIC Educational Resources Information Center

    Cooper, Stewart E.

    2005-01-01

    This lead off article to the special volume on evidence-based psychotherapy (EBP) in college and university counseling and mental health centers presents an overview of the topic and outlines the structure of this publication. A focus on EBP research and practice generally, and in institutions of higher education specifically, is provided for…

  9. Evidence-Based Practice for Treatment of Eating Disorders

    ERIC Educational Resources Information Center

    Resnick, Jaquelyn Liss

    2005-01-01

    The purpose of this chapter is to review the status of evidence-based practice (EBP) for the treatment of students with eating disorders in university and college counseling centers. Several issues affecting the application of the research findings to service delivery for eating disordered students will be addressed. These include discussion of…

  10. The Evidence-Based Reasoning Framework: Assessing Scientific Reasoning

    ERIC Educational Resources Information Center

    Brown, Nathaniel J. S.; Furtak, Erin Marie; Timms, Michael; Nagashima, Sam O.; Wilson, Mark

    2010-01-01

    Recent science education reforms have emphasized the importance of students engaging with and reasoning from evidence to develop scientific explanations. A number of studies have created frameworks based on Toulmin's (1958/2003) argument pattern, whereas others have developed systems for assessing the quality of students' reasoning to support…

  11. Implementing Evidence-Based Programs: Lessons Learned from the Field

    ERIC Educational Resources Information Center

    Powers, Jane; Maley, Mary; Purington, Amanda; Schantz, Karen; Dotterweich, Jutta

    2015-01-01

    Evidence-based programs (EBPs) are used in many health promotion efforts to ensure that the intended positive behavioral and health outcomes will be achieved. However, because EBPs are developed and tested in research settings, the contextual elements of real world implementation play an important role in their successful delivery in communities.…

  12. An Evidence Based Approach to Sepsis: Educational Program

    ERIC Educational Resources Information Center

    Perez, Dolores

    2015-01-01

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

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

    PubMed Central

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

    2002-01-01

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

  14. Fostering Evidence-Based Practice in Nursing Education.

    ERIC Educational Resources Information Center

    Rambur, Betty

    1999-01-01

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

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

    PubMed

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

    2010-10-01

    Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center. PMID:20880823

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

    ERIC Educational Resources Information Center

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

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

  17. Evidence-Based Practices and Implementation Science in Special Education

    ERIC Educational Resources Information Center

    Cook, Bryan G.; Odom, Samuel L.

    2013-01-01

    Establishing a process for identifying evidence-based practices (EBPs) in special education has been a significant advance for the field because it has the potential for generating more effective educational programs and producing more positive outcomes for students with disabilities. However, the potential benefit of EBPs is bounded by the…

  18. Evidence-Based Kernels: Fundamental Units of Behavioral Influence

    ERIC Educational Resources Information Center

    Embry, Dennis D.; Biglan, Anthony

    2008-01-01

    This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior-influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of…

  19. Evidence-Based Practice Empowers Practitioners: A Response to Epstein

    ERIC Educational Resources Information Center

    Rubin, Allen

    2015-01-01

    Epstein makes a strong argument for the value of clinical data mining (CDM), although he minimizes some of the potential limitations in that methodology, such as attrition. Epstein's portrayal of evidence-based practice (EBP) as practitioner-bashing and treasuring intervention manuals overlooks the emphasis in the EBP process on the need for…

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

    ERIC Educational Resources Information Center

    Kosciulek, John F.

    2010-01-01

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

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

    PubMed

    Beck, Mary S; Staffileno, Beth A

    2012-01-01

    Building a sustainable evidence-based practice (EBP) infrastructure during times of financial constraints poses challenges for nurse leaders. To be successful, plans need to be creative and adaptive, while mindful of limited resources. This commentary describes change management strategies used to implement an EBP infrastructure at a hospital after organizational restructuring occurred. PMID:22832408

  2. Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem

    ERIC Educational Resources Information Center

    Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny

    2013-01-01

    Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

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

    ERIC Educational Resources Information Center

    Finn, Patrick

    2011-01-01

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

  4. Evidence-Based Interprofessional Practice: Learning and Behaviour

    ERIC Educational Resources Information Center

    Littek, Celeste

    2013-01-01

    The purpose of this journal article is to investigate evidence-based practice (EBP) or He Ritenga Whaimohio, as one of the seven principles outlined in the "Resource Teacher: Learning and Behaviour (RTLB) Toolkit" (2011) that guides RTLB practice; and to critique the principle of EBP through practical reflection. (Contains 2 tables and 2…

  5. Disseminating Evidence-Based Practices in Secondary Transition

    ERIC Educational Resources Information Center

    Mustian, April; Mazzotti, Valerie L.; Test, David W.

    2013-01-01

    As educators move into a new era of educational reform, it becomes imperative that teachers use evidence-based instructional practices shown to be effective for students with disabilities. One area that plays a role in this process is secondary transition. The National Secondary Transition Technical Assistance Center has identified 63…

  6. Organizing for Evidence-Based Decision Making and Improvement

    ERIC Educational Resources Information Center

    Leimer, Christina

    2012-01-01

    In today's accountability climate, regional accrediting bodies are requiring colleges and universities to develop and sustain a culture of evidence-based decision making and improvement. But two-thirds of college presidents in a 2011 "Inside Higher Ed" survey said their institutions are not particularly strong at using data for making decisions.…

  7. Evidence-Based Practices in Special Education: Some Practical Considerations

    ERIC Educational Resources Information Center

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

    2008-01-01

    A major tenet of both the Individuals with Disabilities Education Act and the No Child Left Behind Act is the identification and use of evidence-based practices, or those instructional techniques shown by research as most likely to improve student outcomes meaningfully. However, much confusion exists regarding the meaning and potential…

  8. Unraveling Evidence-Based Practices in Special Education

    ERIC Educational Resources Information Center

    Cook, Bryan G.; Cook, Sara Cothren

    2013-01-01

    Evidence-based practices (EBPs) are instructional techniques that meet prescribed criteria related to the research design, quality, quantity, and effect size of supporting research, which have the potential to help bridge the research-to-practice gap and improve student outcomes. In this article, the authors (a) discuss the importance of clear…

  9. Urticaria: an evidence-based update. Conference report.

    PubMed

    Alexandroff, A B; Harman, K E

    2010-08-01

    Summary Evidence-based update meetings are held annually by the Centre of Evidence Based Dermatology, University of Nottingham. Topics are chosen by delegates at the previous year's conference and in the past have included blistering disorders, psoriasis, hair disorders and skin cancers. Once the topic is identified, a trials database search is undertaken with the aim of including speakers who are actively involved in trials that address the subject in question. This year, the eighth Evidence Based Update meeting focused on urticaria and took place in Loughborough University on 14 May 2009. The latest data on the diagnosis and management of acute and chronic urticaria, including cold and solar urticaria, and the impact of food intolerance on chronic urticaria, were presented by an international panel of renowned speakers, who sometimes expressed different viewpoints. The highlights of the meeting included an informal atmosphere, an international perspective, and a practical question and answer session. Over 70% of the delegates stated that they would be changing their clinical practice following on from the meeting. The evidence-based update meeting in 2010 will be devoted to eczema. PMID:20666769

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  11. Interteaching: An Evidence-Based Approach to Instruction

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  12. Evidence-Based Practice in Adapted Physical Education

    ERIC Educational Resources Information Center

    Jin, Jooyeon; Yun, Joonkoo

    2010-01-01

    Although implementation of evidence-based practice (EBP) has been strongly advocated by federal legislation as well as school districts in recent years, the concept has not been well accepted in adapted physical education (APE), perhaps due to a lack of understanding of the central notion of EBP. The purpose of this article is to discuss how APE…

  13. Validation of the Evidence-Based Practice Process Assessment Scale

    ERIC Educational Resources Information Center

    Rubin, Allen; Parrish, Danielle E.

    2011-01-01

    Objective: This report describes the reliability, validity, and sensitivity of a scale that assesses practitioners' perceived familiarity with, attitudes of, and implementation of the evidence-based practice (EBP) process. Method: Social work practitioners and second-year master of social works (MSW) students (N = 511) were surveyed in four sites…

  14. Evidence-Based Practices Project for Suicide Prevention

    ERIC Educational Resources Information Center

    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…

  15. Toward an Evidence-Based Assessment of Pediatric Bipolar Disorder

    ERIC Educational Resources Information Center

    Youngstrom, Eric A.; Findling, Robert L.; Kogos Youngstrom, Jen; Calabrese, Joseph R.

    2005-01-01

    This article outlines a provisional evidence-based approach to the assessment of pediatric bipolar disorder (PBD). Public attention to PBD and the rate of diagnosis have both increased substantially in the past decade. Accurate diagnosis is crucial to avoid harm due to mislabeling or unnecessary medication exposure. Because there are no proven…

  16. Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  17. An Evidence-Based Course in Complementary Medicines

    PubMed Central

    Hughes, Jeff

    2012-01-01

    Objective. To evaluate the impact of an evidence-based course in complementary medicines on the attitudes, knowledge, and professional practice behavior of undergraduate pharmacy students. Design. A required 12-week evidence-based complementary medicine course was designed and introduced into the third-year undergraduate pharmacy curriculum. The course included a combination of traditional lectures, interactive tutorial sessions, and a range of formal assessments. Assessment. Pre- and post-course survey instruments were administered to assess changes in students’ attitudes, perceptions, knowledge, and the likelihood they would recommend the use of complementary medicines in a pharmacy practice environment. Conclusion. Completion of a required evidence-based complementary medicines course resulted in a positive change in pharmacy students’ perceptions of the value of various complementary medicines as well as in their willingness to recommend them, and provided students with the required knowledge to make patient-centered recommendations for use of complementary medicines in a professional pharmacy practice setting. These findings support the need for greater evidence-based complementary medicine education within pharmacy curricula to meet consumer demand and to align with pharmacists’ professional responsibilities. PMID:23275665

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

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2011

    2011-01-01

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

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

    PubMed Central

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

    2016-01-01

    Sensor data fusion plays an important role in fault diagnosis. Dempster–Shafer (D-R) evidence theory is widely used in fault diagnosis, since it is efficient to combine evidence from different sensors. However, under the situation where the evidence highly conflicts, it may obtain a counterintuitive result. To address the issue, a new method is proposed in this paper. Not only the statistic sensor reliability, but also the dynamic sensor reliability are taken into consideration. The evidence distance function and the belief entropy are combined to obtain the dynamic reliability of each sensor report. A weighted averaging method is adopted to modify the conflict evidence by assigning different weights to evidence according to sensor reliability. The proposed method has better performance in conflict management and fault diagnosis due to the fact that the information volume of each sensor report is taken into consideration. An application in fault diagnosis based on sensor fusion is illustrated to show the efficiency of the proposed method. The results show that the proposed method improves the accuracy of fault diagnosis from 81.19% to 89.48% compared to the existing methods. PMID:26797611

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

    PubMed

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

    2016-01-01

    Sensor data fusion plays an important role in fault diagnosis. Dempster-Shafer (D-R) evidence theory is widely used in fault diagnosis, since it is efficient to combine evidence from different sensors. However, under the situation where the evidence highly conflicts, it may obtain a counterintuitive result. To address the issue, a new method is proposed in this paper. Not only the statistic sensor reliability, but also the dynamic sensor reliability are taken into consideration. The evidence distance function and the belief entropy are combined to obtain the dynamic reliability of each sensor report. A weighted averaging method is adopted to modify the conflict evidence by assigning different weights to evidence according to sensor reliability. The proposed method has better performance in conflict management and fault diagnosis due to the fact that the information volume of each sensor report is taken into consideration. An application in fault diagnosis based on sensor fusion is illustrated to show the efficiency of the proposed method. The results show that the proposed method improves the accuracy of fault diagnosis from 81.19% to 89.48% compared to the existing methods. PMID:26797611

  1. DETECTION OF WEAK CIRCUMSTELLAR GAS AROUND THE DAZ WHITE DWARF WD 1124-293: EVIDENCE FOR THE ACCRETION OF MULTIPLE ASTEROIDS

    SciTech Connect

    Debes, J. H.; Kilic, M.; Faedi, F.; Shkolnik, E. L.; Lopez-Morales, M.; Weinberger, A. J.; Slesnick, C.; West, R. G.

    2012-07-20

    Single metal-polluted white dwarfs with no dusty disks are believed to be actively accreting metals from a circumstellar disk of gas caused by the destruction of asteroids perturbed by planetary systems. We report, for the first time, the detection of circumstellar Ca II gas in absorption around the DAZ WD 1124-293, which lacks an infrared excess. We constrain the gas to >7 R{sub WD} and <32000 AU, and estimate it to be at {approx}54 R{sub WD}, well within WD 1124-293's tidal disruption radius. This detection is based on several epochs of spectroscopy around the Ca II H and K lines ({lambda} = 3968 A, 3933 A) with the MIKE spectrograph on the Magellan/Clay Telescope at Las Campanas Observatory. We confirm the circumstellar nature of the gas by observing nearby sightlines and finding no evidence for gas from the local interstellar medium. Through archival data we have measured the equivalent width of the two photospheric Ca lines over a period of 11 years. We see <5%-7% epoch-to-epoch variation in equivalent widths over this time period, and no evidence for long term trends. The presence of a circumstellar gas implies a near edge-on inclination to the system, thus we place limits to short period transiting planetary companions with R > R{sub Circled-Plus} using the Wide Angle Search for Planets survey. The presence of gas in orbit around WD 1124-293 implies that most DAZs could harbor planetary systems. Since 25%-30% of white dwarfs show metal line absorption, the dynamical process for perturbing small bodies must be robust.

  2. Evidence-based medicine and the reconfiguration of medical knowledge.

    PubMed

    Timmermans, Stefan; Kolker, Emily S

    2004-01-01

    Over the past decade, different parties in the health care field have developed and disseminated clinical practice guidelines as part of evidence-based medicine. These formal tools based on a scientific evaluation of the research literature purport to tell health care professionals how to practice medicine. Because clinical practice guidelines shift the knowledge base in the health care field through standardization, they remain controversial within and outside medicine. In this paper, we evaluate the predictive accuracy of four medical professionalization theories--functionalism, Freidson's theory of professional dominance, deprofessionalization theory, and the theory of countervailing powers--to account for (1) the shift from pathophysiology to epidemiology with guidelines, (2) the creation of practice guidelines, and (3) the effects of clinical practice guidelines on the autonomy of health professionals. In light of the mixed predictive record of professionalization theories, we conclude with a need for "evidence-based sociology" and a recalibration of basic premises underlying professionalization theories. PMID:15779473

  3. Evidence-based review of interventions for medically at-risk older drivers.

    PubMed

    Classen, Sherrilene; Monahan, Miriam; Auten, Beth; Yarney, Abraham

    2014-01-01

    OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association's classification criteria (Levels I-V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual-perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. PMID:25005514

  4. Evidence-Based Review of Interventions for Medically At-Risk Older Drivers

    PubMed Central

    Monahan, Miriam; Auten, Beth; Yarney, Abraham

    2014-01-01

    OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual–perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. PMID:25005514

  5. An Evidence-Based Combining Classifier for Brain Signal Analysis

    PubMed Central

    Kheradpisheh, Saeed Reza; Nowzari-Dalini, Abbas; Ebrahimpour, Reza; Ganjtabesh, Mohammad

    2014-01-01

    Nowadays, brain signals are employed in various scientific and practical fields such as Medical Science, Cognitive Science, Neuroscience, and Brain Computer Interfaces. Hence, the need for robust signal analysis methods with adequate accuracy and generalizability is inevitable. The brain signal analysis is faced with complex challenges including small sample size, high dimensionality and noisy signals. Moreover, because of the non-stationarity of brain signals and the impacts of mental states on brain function, the brain signals are associated with an inherent uncertainty. In this paper, an evidence-based combining classifiers method is proposed for brain signal analysis. This method exploits the power of combining classifiers for solving complex problems and the ability of evidence theory to model as well as to reduce the existing uncertainty. The proposed method models the uncertainty in the labels of training samples in each feature space by assigning soft and crisp labels to them. Then, some classifiers are employed to approximate the belief function corresponding to each feature space. By combining the evidence raised from each classifier through the evidence theory, more confident decisions about testing samples can be made. The obtained results by the proposed method compared to some other evidence-based and fixed rule combining methods on artificial and real datasets exhibit the ability of the proposed method in dealing with complex and uncertain classification problems. PMID:24392125

  6. An Evidence Base for Human Spaceflight Risks in Wikipedia

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

  7. Global health: the importance of evidence-based medicine

    PubMed Central

    2013-01-01

    Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes. PMID:24228722

  8. Evaluation of Evidence-Based Nursing Pain Management Practice

    PubMed Central

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

    2014-01-01

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

  9. Music therapy with disorders of consciousness: current evidence and emergent evidence-based practice.

    PubMed

    Magee, Wendy L; O'Kelly, Julian

    2015-03-01

    Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations. PMID:25773642

  10. eEvidence: Information Seeking Support for Evidence-based Practice: An Implementation Case Study

    PubMed Central

    Zhao, Jin; Kan, Min-Yen; Procter, Paula M.; Zubaidah, Siti; Yip, Wai Kin; Li, Goh Mien

    2010-01-01

    We propose to collect freely available articles from the web to build an evidence-based practice resource collection with up-to-date coverage, and then apply automated classification and key information extraction on the collected articles to provide means for sounder relevance judgments. We implement these features into a dual-interface system that allows users to choose between an active or passive information seeking process depending on the amount of time available. PMID:21347115

  11. Evidence-based medicine meets goal-directed health care.

    PubMed

    Mold, James W; Hamm, Robert; Scheid, Dewey

    2003-05-01

    Evidence-based medicine and goal-directed, patient-centered health care seem, at times, like parallel universes, though, at a conceptual level, they are perfectly compatible. Part of the problem is that many of the kinds of information required for decision making in primary care are often unavailable or difficult to find. Several case examples are used to illustrate this problem, and reasons and solutions are suggested. The goal-directed health care model could be helpful for directing the search for evidence that is relevant to the decisions that patients and their primary care physicians must make on a regular basis. PMID:12772939

  12. Evidence-based clinical practice for the neurointerventionalist.

    PubMed

    Hirsch, Joshua A; Turk, Aquilla S; Mocco, J; Fiorella, David J; Jayaraman, Mahesh V; Meyers, Phillip M; Yoo, Albert J; Manchikanti, Laxmaiah

    2015-03-01

    The field of neurointerventional (NI) surgery has developed in the context of technologic innovation. Many treatments readily provided in 2014 would have been hard to imagine as recently as 10 years ago. The reality of present day NI care is that, while providers, payors, policy makers and patients rely on evidence to guide NI decision-making, the available data are often less robust than participants might desire. In this paper we will explore the fundamentals of evidence-based clinical practice. PMID:24578482

  13. Evidence-based management of developmental dysplasia of the hip.

    PubMed

    Cooper, Anthony Philip; Doddabasappa, Siddesh Nandi; Mulpuri, Kishore

    2014-07-01

    Developmental Dysplasia of the Hip (DDH) refers to a spectrum of abnormalities involving the developing hip. These abnormalities range from mild instability to frank dislocation of the joint. It is important to treat the condition effectively in order to encourage the hip to develop normally and produce good long-term results. This article reviews the evidence related to the treatment of DDH. The quality of evidence for DDH management remains low, with little uniformity in terminology and most studies being retrospective in nature. Given this, it is not possible to recommend or reject most treatment modalities based on existing studies. PMID:24975762

  14. Batch and fixed-bed assessment of sulphate removal by the weak base ion exchange resin Amberlyst A21.

    PubMed

    Guimarães, Damaris; Leão, Versiane A

    2014-09-15

    This paper investigated sulphate removal from aqueous solutions by Amberlyst A21, a polystyrene weak base ion exchange resin. Both the pH and initial sulphate concentration were observed to strongly affect sorption yields, which were largest in acidic environments. Working under optimum operational conditions, sulphate sorption by Amberlyst A21 was relatively fast and reached equilibrium after 45 min of contact between the solid and liquid phases. Sorption kinetics could be described by either the pseudo-first order (k1=3.05 × 10(-5)s(-1)) or pseudo-second order model (k2=1.67 × 10(-4)s(-1)), and both the Freundlich and Langmuir models successfully fitted the equilibrium data. Sulphate uptake by Amberlyst A21 was a physisorption process (ΔH=-25.06 kJ mol(-1)) that occurred with entropy reduction (ΔS=-0.042 kJ mol(-1)K(-1)). Elution experiments showed that sulphate is easily desorbed (∼ 100%) from the resin by sodium hydroxide solutions at pH 10 or pH 12. Fixed-bed experiments assessed the effects of the initial sulphate concentration, bed height and flow rate on the breakthrough curves and the efficiency of the Amberlyst A21 in the treatment of a real effluent. In all studied conditions, the maximum sulphate loading resin varied between 8 and 40 mg(SO4(2-))mL(resin)(-1). PMID:25151243

  15. pH-dependent drug-drug interactions for weak base drugs: potential implications for new drug development.

    PubMed

    Zhang, L; Wu, F; Lee, S C; Zhao, H; Zhang, L

    2014-08-01

    Absorption of an orally administered drug with pH-dependent solubility may be altered when it is coadministered with a gastric acid-reducing agent (ARA). Assessing a drug's potential for pH-dependent drug-drug interactions (DDIs), considering study design elements for such DDI studies, and interpreting and communicating study results in the drug labeling to guide drug dosing are important for drug development. We collected pertinent information related to new molecular entities approved from January 2003 to May 2013 by the US Food and Drug Administration for which clinical DDI studies with ARAs were performed. On the basis of assessments of data on pH solubility and in vivo DDIs with ARAs, we proposed a conceptual framework for assessing the need for clinical pH-dependent DDI studies for weak base drugs (WBDs). Important study design considerations include selection of ARAs and timing of dosing of an ARA relative to the WBD in a DDI study. Labeling implications for drugs having DDIs with ARAs are also illustrated. PMID:24733008

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

    PubMed

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

    2016-02-01

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

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

    PubMed Central

    Bracke, Paul J.; Howse, David K.; Keim, Samuel M.

    2008-01-01

    Purpose: 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. Brief Description: 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. Outcomes/Conclusion: 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. PMID:18379665

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

    PubMed

    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. PMID:27584696

  19. Evidence-based treatment of patients with rectal cancer

    PubMed Central

    ZHANG, QIANG; YANG, JIE; QIAN, QUN

    2016-01-01

    Rectal cancer is a worldwide disease whose incidence has increased significantly. Evidence-based medicine is a category of medicine that optimizes decision making by using evidence from well-designed and conducted research. Evidence-based medicine can be used to formulate a reasonable treatment plan for newly diagnosed rectal cancer patients. The current review focuses on the application of evidence-based treatment on patients with rectal cancer. The relationship between perioperative blood transfusion and recurrence of rectal cancer after surgery, the selection between minimally invasive laparoscopic surgery and traditional laparotomy, choice of chemotherapy for patients with rectal cancer prior to surgery, selection between stapled and hand-sewn methods for colorectal anastomosis during rectal cancer resection, and selection between temporary ileostomy and colostomy during the surgery were addressed. Laparoscopy is considered to have more advantages but is time-consuming and has high medical costs. In addition, laparoscopic rectal cancer radical resection is preferred to open surgery. In radical resection surgery, use of a stapling device for anastomosis can reduce postoperative anastomotic fistula, although patients should be informed of possible anastomotic stenosis. PMID:26998054

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  1. Developing evidence-based immunization recommendations and GRADE.

    PubMed

    Duclos, P; Durrheim, D N; Reingold, A L; Bhutta, Z A; Vannice, K; Rees, H

    2012-12-17

    The Strategic Group of Advisory Experts (SAGE) on immunization is an independent advisory committee with a mandate to advise the World Health Organization (WHO) on the development of vaccine and immunization related policies. SAGE working groups are established on a time-limited basis to review and provide evidence-based recommendations, together with their implications, for open deliberation and decision-making by SAGE. In making its recommendations, SAGE takes into consideration: the epidemiologic and clinical characteristics of the disease; vaccine and immunization characteristics; economic analysis; health system considerations; the existence of and interaction with other intervention and control strategies; costing and social impacts; and legal and ethical concerns. Since 1998, WHO has produced evidence-based vaccine position papers for use primarily by national public health officials and immunization programme managers. Since April 2006 all new or updated position papers have been based on SAGE recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by WHO and, since 2008, GRADE tables that rate the quality of evidence have been produced in support of key recommendations. SAGE previously expressed concern that GRADE was not ideally suited to many immunization-specific issues such as the vaccine population level effect and the inclusion of surveillance system data, particularly for vaccine safety. Extensive productive interactions with various advisory groups including the US Advisory Committee on Immunization Practices, the European Centres for Disease Control, the German Standing Committee on Vaccination (STIKO), WHO's Global Advisory Committee on Vaccine Safety and the GRADE working group resulted in key enhancements to accommodate vaccine-relevant evidence. This facilitated integration and acceptability of the GRADE approach in the development of immunization related SAGE and WHO

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

    PubMed

    Owens, Barry M; Phebus, Jeffrey G

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  4. Evidence-Based Assessment of Obsessive–Compulsive Disorder

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2010-04-01

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

  6. Evidence-based health information and risk competence

    PubMed Central

    Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke

    2015-01-01

    Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions. PMID:26195924

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

    PubMed

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

    2012-01-01

    The debate around the role of the work at personal computer as cause of De Quervain's Tenosynovitis was developed partially, without considering multidisciplinary available data. A systematic review of the literature, using an evidence-based approach, was performed. In disorders associated with the use of VDU, we must distinguish those at the upper limbs and among them those related to an overload. Experimental studies on the occurrence of De Quervain's Tenosynovitis are quite limited, as well as clinically are quite difficult to prove the professional etiology, considering the interference due to other activities of daily living or to the biological susceptibility (i.e. anatomical variability, sex, age, exercise). At present there is no evidence of any connection between De Quervain syndrome and time of use of the personal computer or keyboard, limited evidence of correlation is found with time using a mouse. No data are available regarding the use exclusively or predominantly for personal laptops or mobile "smart phone". PMID:23405595

  8. Strengths and limitations of evidence-based dermatology.

    PubMed

    Williams, Hywel C

    2014-03-01

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

  9. Weak bond screening system

    NASA Astrophysics Data System (ADS)

    Chuang, S. Y.; Chang, F. H.; Bell, J. R.

    Consideration is given to the development of a weak bond screening system which is based on the utilization of a high power ultrasonic (HPU) technique. The instrumentation of the prototype bond strength screening system is described, and the adhesively bonded specimens used in the system developmental effort are detailed. Test results obtained from these specimens are presented in terms of bond strength and level of high power ultrasound irradiation. The following observations were made: (1) for Al/Al specimens, 2.6 sec of HPU irradiation will screen weak bond conditions due to improper preparation of bonding surfaces; (2) for composite/composite specimens, 2.0 sec of HPU irradiation will disrupt weak bonds due to under-cured conditions; (3) for Al honeycomb core with composite skin structure, 3.5 sec of HPU irradiation will disrupt weak bonds due to bad adhesive or oils contamination of bonding surfaces; and (4) for Nomex honeycomb with Al skin structure, 1.3 sec of HPU irradiation will disrupt weak bonds due to bad adhesive.

  10. Meta-Analyses and Orthodontic Evidence-Based Clinical Practice in the 21st Century

    PubMed Central

    Papadopoulos, Moschos A.

    2010-01-01

    Introduction: Aim of this systematic review was to assess the orthodontic related issues which currently provide the best evidence as documented by meta-analyses, by critically evaluating and discussing the methodology used in these studies. Material and Methods: Several electronic databases were searched and handsearching was also performed in order to identify the corresponding meta-analyses investigating orthodontic related subjects. In total, 197 studies were retrieved initially. After applying specific inclusion and exclusion criteria, 27 articles were identified as meta-analyses treating orthodontic-related subjects. Results: Many of these 27 papers presented sufficient quality and followed appropriate meta-analytic approaches to quantitatively synthesize data and presented adequately supported evidence. However, the methodology used in some of them presented weaknesses, limitations or deficiencies. Consequently, the topics in orthodontics which currently provide the best evidence, include some issues related to Class II or Class III treatment, treatment of transverse problems, external apical root resorption, dental anomalies, such as congenital missing teeth and tooth transposition, frequency of severe occlusal problems, nickel hypersensitivity, obstructive sleep apnea syndrome, and computer-assisted learning in orthodontic education. Conclusions: Only a few orthodontic related issues have been so far investigated by means of MAs. In addition, for some of these issues investigated in the corresponding MAs no definite conclusions could be drawn, due to significant methodological deficiencies of these studies. According to this investigation, it can be concluded that at the begin of the 21st century there is evidence for only a few orthodontic related issues as documented by meta-analyses, and more well-conducted high quality research studies are needed to produce strong evidence in order to support evidence-based clinical practice in orthodontics. PMID

  11. Study of atmospheric pressure weakly ionized plasma as surface compatibilization technique for improved plastic composites loaded with cellulose based fillers

    NASA Astrophysics Data System (ADS)

    Lekobou, William Pimakouon

    Atmospheric pressure plasmas have gained considerable interest from researchers recently for their unique prospective of engineering surfaces with plasma without the need of vacuum systems. They offer the advantage of low energy consumption, minimal capital cost and their simplicity as compared to conventional low pressure plasmas make them easy to upscale from laboratory to industry size. The present dissertation summarizes results of our attempt at applying atmospheric pressure weakly ionized plasma (APWIP) to the engineering of plastic composites filled with cellulose based substrates. An APWIP reactor was designed and built based on a multipoint-to-grounded ring and screen configurations. The carrier gas was argon and acetylene serves as the precursor molecule. The APWIP reactors showed capability of depositing plasma polymerized coating rich in carbon on substrates positioned within the electrode gap as well as downstream of the plasma discharge into the afterglow region. Our findings show that films grow by forming islands which for prolonged deposition time grow into thin films showing nodules, aggregates of nodules and microspheres. They also show chemical structure similar to films deposited from hydrocarbons with other conventional plasma techniques. The plasma polymerized deposits were used on substrates to modify their surface properties. Results show the surface of wood veneer and wood flour can be finely tuned from hydrophilic to hydrophobic. It was achieved by altering the topography of the surfaces along with their chemical composition. The wettability of wood veneer was investigated with contact angle measurements on capacitive drops and the capillary effect was utilized to assess surface properties of wood flour exposed to the discharges.

  12. Evidence-based volcanology: application to eruption crises

    NASA Astrophysics Data System (ADS)

    Aspinall, W. P.; Woo, G.; Voight, B.; Baxter, P. J.

    2003-11-01

    The way in which strands of uncertain volcanological evidence can be used for decision-making, and the weight that should be given them, is a problem requiring formulation in terms of the logical principles of Evidence Science. The basic ideas are outlined using the explosion at Galeras volcano in Colombia in January 1993 as an example. Our retrospective analysis suggests that if a robust precautionary appraisal had been made of the circumstances in which distinctive tornillo signals were detected at Galeras, those events might have been construed as stronger precursory evidence for imminent explosive activity than were the indications for quiescence, given by the absence of other warning traits. However, whilst visits to the crater might have been recognised as involving elevated risk if this form of analysis had been applied to the situation in January 1993, a traditional scientific consideration of the available information was likely to have provided a neutral assessment of short-term risk levels. We use these inferences not to criticise interpretations or decisions made at the time, but to illustrate how a structured, evidence-based analysis procedure might have provided a different perspective to that derived from the conventional scientific standpoint. We advocate a formalism that may aid such decision-making in future: graphical Bayesian Belief Networks are introduced as a tool for performing the necessary numerical procedures. With this approach, Evidence Science concepts can be incorporated rationally, efficiently and reliably into decision support during volcanic crises.

  13. Age and response bias: evidence from the strength-based mirror effect.

    PubMed

    Criss, Amy H; Aue, William; Kılıç, Aslı

    2014-10-01

    Performance in episodic memory is determined both by accurate retrieval from memory and by decision processes. A substantial body of literature suggests slightly poorer episodic memory accuracy for older than younger adults; however, age-related changes in the decision mechanisms in memory have received much less attention. Response bias, the willingness to endorse an item as remembered, is an important decision factor that contributes to episodic memory performance, and therefore understanding age-related changes in response bias is critical to theoretical development. We manipulate list strength in order to investigate two aspects of response bias. First, we evaluate whether criterion placement in episodic memory differs for older and younger adults. Second, we ask whether older adults have the same degree of flexibility to adjust the criterion in response to task demands as younger adults. Participants were tested on weakly and strongly encoded lists where word frequency (Experiment 1) or similarity between targets and foils (Experiment 2) was manipulated. Both older and younger adults had higher hit rates and lower false-alarm rates for strong lists than for weak lists (i.e., a strength-based mirror effect). Older adults were more conservative (less likely to endorse an item as studied) than younger adults, and we found no evidence that older and younger adults differ in their ability to flexibly adjust their criterion based on the demands of the task. PMID:24386987

  14. Evidence-based surgery – evidence from survey and citation analysis in orthopaedic surgery

    PubMed Central

    Kumar, Malhar; Gopalakrishna, Chethan; Swaminath, Pazhayannur V; Mysore, Sanjay S

    2010-01-01

    INTRODUCTION The results of a survey on evidence-based surgery (EBS) among members of the American Academy of Orthopedic Surgeons (AAOS) and the British Orthopaedic Association (BOA) are presented. The study also analyzes the citations earned by articles with different levels of evidence (LOE) to see if LOE have any bearing on the importance attached to the articles by authors and contributors to the journals. SUBJECTS AND METHODS The questionnaire was e-mailed to 1000 randomly chosen consultant orthopaedic surgeons who were members of either the AAOS or the BOA. Participants were provided with the option of responding through web-based entry. For citation analysis, citation data were gathered from the Journal of Bone and Joint Surgery (American volume) between the years 2003 and 2007 (5-year period). RESULTS The survey showed that awareness and access to EBS have improved greatly over the years. At the present time, these factors are not important barriers to the implementation of EBS in clinical practice in developed countries. There was a statistically significant difference in those with and without additional qualifications with regard to the approach to EBS. However, an equal percentage of surgeons with and without additional qualifications felt that it was difficult to adhere to EBS guidelines in daily clinical practice. Citation analysis showed that readers of professional journals attach importance to LOE category of the article and tend to cite level-I evidence articles more than other articles. PMID:21073824

  15. Evidence-based health care management: what is the research evidence available for health care managers?

    PubMed

    Jaana, Mirou; Vartak, Smruti; Ward, Marcia M

    2014-09-01

    In light of increasing interest in evidence-based management, we conducted a scoping review of systematic reviews (SRs) and meta-analyses (MAs) to determine the availability and accessibility of evidence for health care managers; 14 MAs and 61 SRs met the inclusion criteria. Most reviews appeared in medical journals (53%), originated in the United States (29%) or United Kingdom (22%), were hospital-based (55%), and targeted clinical providers (55%). Topics included health services organization (34%), quality/patient safety (17%), information technology (15%), organization/workplace management (13%), and health care workforce (12%). Most reviews addressed clinical topics of relevance to managers; management-related interventions were rare. The management issues were mostly classified as operational (65%). Surprisingly, 96.5% of search results were not on target. A better classification within PubMed is needed to increase the accessibility of meaningful resources and facilitate evidence retrieval. Health care journals should take initiatives encouraging the publication of reviews in relevant management areas. PMID:24296471

  16. Therapeutic management of anal eczema: an evidence-based review

    PubMed Central

    Havlickova, B; Weyandt, G H

    2014-01-01

    Aim To conduct a systematic review of treatments for anal eczema (AE). Methods We conducted a Medline search for clinical trial data for the treatment of perianal diseases including AE, including papers not published in the English language. We assessed the study reports using the system recommended by the Oxford Centre for Evidence-based Medicine. No meta-analysis was attempted. Results The evidence base for topical treatments used to treat AE is very poor: there are very few studies and many of those that exist are of poor quality. The best evidence was found for medications that are yet to be licensed for AE. Among products with existing licences for the treatment of eczema, our assessment found some evidence to support the continued use of mild-to-moderate corticosteroids first line in most patients. Discussion Features of the perianal region, and the fact that it is almost always occluded, mean that not all medications recommended in the general treatment guidelines for eczema are appropriate for AE. However, there are no specific treatment guidelines for these patients. This may in part be because of the lack of high-quality evidence-based medicine in this therapy area. Many frequently prescribed medications were developed and licensed many years ago, in an era when clinical trial design was not expected to be as rigorous as it is today. Conclusion This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared. PMID:24898365

  17. Evidence-based guideline update: Plasmapheresis in neurologic disorders

    PubMed Central

    Cortese, I.; Chaudhry, V.; So, Y.T.; Cantor, F.; Cornblath, D.R.; Rae-Grant, A.

    2011-01-01

    Objective: To reassess the role of plasmapheresis in the treatment of neurologic disorders. Methods: We evaluated the available evidence based on a structured literature review for relevant articles from 1995 through September 2009. In addition, due to revision of the definitions of classification of evidence since the publication of the previous American Academy of Neurology assessment in 1996, the evidence cited in that manuscript was reviewed and reclassified. Results and Recommendations: Plasmapheresis is established as effective and should be offered in severe acute inflammatory demyelinating polyneuropathy (AIDP)/Guillain-Barré syndrome (GBS) and in the short-term management of chronic inflammatory demyelinating polyneuropathy (Class I studies, Level A). Plasmapheresis is established as ineffective and should not be offered for chronic or secondary progressive multiple sclerosis (MS) (Class I studies, Level A). Plasmapheresis is probably effective and should be considered for mild AIDP/GBS, as second-line treatment of steroid-resistant exacerbations in relapsing forms of MS, and for neuropathy associated with immunoglobulin A or immunoglobulin G gammopathy, based on at least one Class I or 2 Class II studies (Level B). Plasmapheresis is probably not effective and should not be considered for neuropathy associated with immunoglobulin M gammopathy, based on one Class I study (Level B). Plasmapheresis is possibly effective and may be considered for acute fulminant demyelinating CNS disease (Level C). There is insufficient evidence to support or refute the use of plasmapheresis for myasthenia gravis, pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection, and Sydenham chorea (Class III evidence, Level U). PMID:21242498

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

    PubMed

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

    2007-11-01

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

  19. Bowel anastomoses: The theory, the practice and the evidence base

    PubMed Central

    Goulder, Frances

    2012-01-01

    Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions. PMID:23293735

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

    PubMed

    Atiya, A S

    2002-12-01

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

  1. Continuing to challenge practice to be evidence based.

    PubMed

    Makic, Mary Beth Flynn; Rauen, Carol; Jones, Kimmith; Fisk, Anna C

    2015-04-01

    Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient's actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice. PMID:25834007

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

    PubMed Central

    Devnani, Preeti; Fernandes, Racheal

    2015-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG) while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms. PMID:25745301

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

    PubMed

    Devnani, Preeti; Fernandes, Racheal

    2015-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG) while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms. PMID:25745301

  4. Evidence-based medicine: what is the evidence that it has made a difference?

    PubMed

    McQuay, Henry

    2011-07-01

    Evidence-based medicine (EBM) has, over the past 20 years, made us all more critical in our thinking about the efficacy and safety of interventions. This is evident in the higher standards of our spoken and written work, formal and informal, and in our approach to the subject. The downside has been the coincidence of the squeeze on healthcare funding with the emergence of the EBM ideas - it has been all too easy to misuse the tools of EBM to deny patients access to treatment, and this, together with the off-putting political correctness of the EBM approach in some quarters, has made clinicians uneasy. Clinicians have to make decisions about therapy for the individual patient. Ideally this is guided by the best available evidence and their experience. EBM can guide one as to the population efficacy and safety of a particular intervention, but as we all know few patients are average. That guidance can only be given if there is adequate evidence, and the difficulty with guidance about symptom control is often the paucity of evidence of sufficient quality to yield credible guidance. Palliative care is often a 'complex intervention', and here EBM struggles to untangle which components, if any, of the complex interventions are important. The trial and review methodologies for complex intervention are wanting. Tom Chalmers, a grandfather of the EBM movement, argued late in his career that the most important function of the EBM approach was to frame the research agenda. This we think is correct. The process of systematic review of a topic throws up the deficits in trial methods and the lacunae in the data, and this then can show the way forward. PMID:21708846

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

    PubMed

    Weaver, Robert R

    2015-12-01

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

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

    PubMed

    Mykkänen, Minna; Miettinen, Merja; Saranto, Kaija

    2016-01-01

    Nursing documentation is crucial to high quality, effective and safe nursing care. According to earlier studies nursing documentation practices vary and nursing classifications used in electronic patient records (EPR) are not yet standardized internationally nor nationally. A unified national model for documenting patient care improves information flow in nursing practice, management, research and development toward evidence-based nursing care. Nursing documentation quality, accuracy and development requires follow-up and evaluation. An audit instrument is used in the Kuopio University Hospital (KUH) when evaluating nursing documentation. The results of the auditing process suggest that the national nursing documentation model fulfills nurses' expectations of electronic tools, facilitating their important documentation duty. This paper discusses the importance of using information about nursing documentation and how we can take advantage of structural information in evidence-based nursing management. PMID:27332244

  7. Using motivational interviewing: through evidence-based health coaching.

    PubMed

    Huffman, Melinda

    2014-10-01

    To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short. PMID:25268529

  8. Meniere's disease: an evidence based approach to assessment and management.

    PubMed

    Syed, I; Aldren, C

    2012-02-01

    Menière's disease (MD) is frequently over-diagnosed in both primary and secondary care. This is unfortunate given the significant medical and social implications of such a diagnosis. Difficulties may arise in differentiating the patient with true MD from those individuals with less clearly defined disorders of cochleo-vestibular function. In this review, we suggest a practical evidence based approach to assessment and management of the patient with MD. PMID:22257041

  9. The Four Cornerstones of Evidence-Based Practice in Social Work

    ERIC Educational Resources Information Center

    Gilgun, Jane F.

    2005-01-01

    The purpose of this article is to place evidence-based practice within its wider scholarly contexts and draw lessons from the experiences of other professions that are engaged in implementing it. The analysis is based primarily on evidence-based medicine, the parent discipline of evidence-based practice, but the author also draws on evidence-based…

  10. Evidence-Based Special Education and Professional Wisdom: Putting It All Together

    ERIC Educational Resources Information Center

    Cook, Bryan G.; Tankersley, Melody; Harjusola-Webb, Sanna

    2008-01-01

    There has been an increasing focus on evidence-based practices in special education with efforts underway to authoritatively identify those practices that are evidence based. However, the identification of evidence-based practices is only the beginning of the process of implementing evidence-based special education. The professional wisdom of…

  11. Evaluating the effect of stellar multiplicity on the point spread function of space-based weak lensing surveys

    NASA Astrophysics Data System (ADS)

    Kuntzer, T.; Courbin, F.; Meylan, G.

    2016-02-01

    The next generation of space-based telescopes used for weak lensing surveys will require exquisite point spread function (PSF) determination. Previously negligible effects may become important in the reconstruction of the PSF, in part because of the improved spatial resolution. In this paper, we show that unresolved multiple star systems can affect the ellipticity and size of the PSF and that this effect is not cancelled even when using many stars in the reconstruction process. We estimate the error in the reconstruction of the PSF due to the binaries in the star sample both analytically and with image simulations for different PSFs and stellar populations. The simulations support our analytical finding that the error on the size of the PSF is a function of the multiple stars distribution and of the intrinsic value of the size of the PSF, i.e. if all stars were single. Similarly, the modification of each of the complex ellipticity components (e1,e2) depends on the distribution of multiple stars and on the intrinsic complex ellipticity. Using image simulations, we also show that the predicted error in the PSF shape is a theoretical limit that can be reached only if large number of stars (up to thousands) are used together to build the PSF at any desired spatial position. For a lower number of stars, the PSF reconstruction is worse. Finally, we compute the effect of binarity for different stellar magnitudes and show that bright stars alter the PSF size and ellipticity more than faint stars. This may affect the design of PSF calibration strategies and the choice of the related calibration fields.

  12. Detection of planets in extremely weak central perturbation microlensing events via next-generation ground-based surveys

    SciTech Connect

    Chung, Sun-Ju; Lee, Chung-Uk; Koo, Jae-Rim E-mail: leecu@kasi.re.kr

    2014-04-20

    Even though the recently discovered high-magnification event MOA-2010-BLG-311 had complete coverage over its peak, confident planet detection did not happen due to extremely weak central perturbations (EWCPs, fractional deviations of ≲ 2%). For confident detection of planets in EWCP events, it is necessary to have both high cadence monitoring and high photometric accuracy better than those of current follow-up observation systems. The next-generation ground-based observation project, Korea Microlensing Telescope Network (KMTNet), satisfies these conditions. We estimate the probability of occurrence of EWCP events with fractional deviations of ≤2% in high-magnification events and the efficiency of detecting planets in the EWCP events using the KMTNet. From this study, we find that the EWCP events occur with a frequency of >50% in the case of ≲ 100 M {sub E} planets with separations of 0.2 AU ≲ d ≲ 20 AU. We find that for main-sequence and sub-giant source stars, ≳ 1 M {sub E} planets in EWCP events with deviations ≤2% can be detected with frequency >50% in a certain range that changes with the planet mass. However, it is difficult to detect planets in EWCP events of bright stars like giant stars because it is easy for KMTNet to be saturated around the peak of the events because of its constant exposure time. EWCP events are caused by close, intermediate, and wide planetary systems with low-mass planets and close and wide planetary systems with massive planets. Therefore, we expect that a much greater variety of planetary systems than those already detected, which are mostly intermediate planetary systems, regardless of the planet mass, will be significantly detected in the near future.

  13. Competing weak localization and weak antilocalization in ultrathin topological insulators

    NASA Astrophysics Data System (ADS)

    Lang, Murong; He, Liang; Kou, Xufeng; Upadhyaya, Pramey; Fan, Yabin; Chu, Hao; Yeh, Nai-Chang; Wang, Kang

    2013-03-01

    We demonstrate the evidences of a surface gap opening in (Bi0.57Sb0.43)2 Te3 samples for film thickness below 6 quintuple layers, through magnetotransport and scanning tunneling spectroscopy measurements. By tuning Fermi level position relative to the gap, the striking crossover between weak antilocalization and weak localization is observed in nonmagnetic 4 and 5 QL films at low field region, a characteristic feature of quantum interferences competition, possibly owing to the change of net Berry phase. Furthermore, when the Fermi level is swept into the surface gap, the overall unitary behaviors are revealed at higher magnetic field, which are in contrast to the pure WAL signals obtained in thicker films. Besides, the surface bandgap of ultrathin film is also determined by low temperature STS measurements. Our findings show an exotic phenomenon characterizing the gapped TI surface states and point to the future realization of quantum spin Hall effect and dissipationless TI-based applications. This work was in part supported by Defense Advanced Research Projects Agency (DARPA), Focus Center Research Program-Center on Functional Engineered Nano Architectonics (FENA).

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

    PubMed

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

    2016-01-01

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

  15. Social construction and the evidence-based drug policy endeavour.

    PubMed

    Lancaster, Kari

    2014-09-01

    'Evidence-based policy' has become the catch-cry of the drug policy field. A growing literature has been dedicated to better realising the goal of evidence-based drug policy: to maximise the use of the best quality research to inform policy decision-making and help answer the question of 'what works'. Alternative accounts in the policy processes literature conceptualise policy activity as an ambiguous and contested process, and the role of evidence as being only marginally influential. Multiple participants jostle for influence and seek to define what may be regarded as a policy problem, how it may be appropriately addressed, which participants may speak authoritatively, and what knowledge(s) may be brought to bear. The question posited in this article is whether the conceptual shift offered by thinking about policy activity as a process of social construction may be valuable for beginning to explore different perspectives of the evidence-based drug policy endeavour. Within a constructionist account of policy, what counts as valid 'evidence' will always be a constructed notion within a dynamic system, based on the privileging and silencing of participants and discourse, and the contestation of those many positions and perspectives. The social construction account shifts our focus from the inherent value of 'evidence' for addressing 'problems' to the ways in which policy knowledge is made valid, by whom and in what contexts. As such, social construction provides a framework for critically analysing the ways in which 'policy-relevant knowledge' may not be a stable concept but rather one which is constructed through the policy process, and, through a process of validation, is rendered useful. We have limited knowledge in the drug policy field about how this happens; how ambiguity about the problems to be addressed, which voices should be heard, and what activities may be appropriate is contested and managed. By unpicking the values and assumptions which underlie drug

  16. Evidence-based Assessment in Pediatric Psychology: Family Measures

    PubMed Central

    Fiese, Barbara H.; Gold, Jeffrey I.; Cutuli, J. J.; Holmbeck, Grayson N.; Goldbeck, Lutz; Chambers, Christine T.; Abad, Mona; Spetter, Dante; Patterson, Joän

    2008-01-01

    Objective To provide a review of the evidence base of family measures relevant to pediatric psychology. Method Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: “Well-established”, “Approaching well-established”, or “Promising.” Results Nineteen measures met “well-established” criteria and the remaining ten were “approaching well-established.” “Well-established” measures were documented for each of the broad assessment categories named above. Conclusions Many measures deemed “well-established” in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures. PMID:17905801

  17. Evidence for a pairing anti-halo effect in the odd-even staggering in reaction cross sections of weakly bound nuclei

    SciTech Connect

    Hagino, K.; Sagawa, H.

    2011-07-15

    We investigate the spatial extension of weakly bound Ne and C isotopes by taking into account the pairing correlation with the Hartree-Fock-Bogoliubov (HFB) method and a three-body model, respectively. We show that the odd-even staggering in the reaction cross sections of {sup 30,31,32}Ne and {sup 14,15,16}C are successfully reproduced, and thus the staggering can be attributed to the pairing anti-halo effect. A correlation between a one-neutron separation energy and the anti-halo effect is demonstrated for s and p waves using the HFB wave functions.

  18. Resisting Weakness of the Will

    PubMed Central

    Levy, Neil

    2012-01-01

    I develop an account of weakness of the will that is driven by experimental evidence from cognitive and social psychology. I will argue that this account demonstrates that there is no such thing as weakness of the will: no psychological kind corresponds to it. Instead, weakness of the will ought to be understood as depletion of System II resources. Neither the explanatory purposes of psychology nor our practical purposes as agents are well-served by retaining the concept. I therefore suggest that we ought to jettison it, in favour of the vocabulary and concepts of cognitive psychology. PMID:22984298

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

    PubMed Central

    Hart, J T

    1997-01-01

    As presently understood, evidence based medicine aims to advance practice from its traditional unverifiable mix of art and science to rational use of measurable inputs and outputs. In practice, however, its advocates accept uncritically a desocialised definition of science, assume that major clinical decisions are taken at the level of secondary specialist rather than primary generalist care, and ignore the multiple nature of most clinical problems, as well as the complexity of social problems within which clinical problems arise and have to be solved. These reductionist assumptions derive from the use of evidence based medicine as a tool for managed care in a transactional model for consultations. If these assumptions persist, they will strengthen reification of disease and promote the episodic output of process regardless of health outcome. We need to work within a different paradigm based on development of patients as co-producers rather than consumers, promoting continuing output of health gain through shared decisions using all relevant evidence, within a broader, socialised definition of science. Adoption of this model would require a major social and cultural shift for health professionals. This shift has already begun, promoted by changes in public attitudes to professional authority, changes in the relation of professionals to managers, and pressures for improved effectiveness and efficiency which, contrary to received wisdom, seem more likely to endorse cooperative than transactional clinical production. Progress on these lines is resisted by rapidly growing and extremely powerful economic and political interests. Health professionals and strategists have yet to recognise and admit the existence of this choice. PMID:9519124

  20. Tactics for teaching evidence-based practice: improving self-efficacy in finding and appraising evidence in a master's evidence-based practice unit.

    PubMed

    Chang, Anne; Levin, Rona F

    2014-08-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787. PMID:25131896

  1. An Evidence-Based Videotaped Running Biomechanics Analysis.

    PubMed

    Souza, Richard B

    2016-02-01

    Running biomechanics play an important role in the development of injuries. Performing a running biomechanics analysis on injured runners can help to develop treatment strategies. This article provides a framework for a systematic video-based running biomechanics analysis plan based on the current evidence on running injuries, using 2-dimensional (2D) video and readily available tools. Fourteen measurements are proposed in this analysis plan from lateral and posterior video. Identifying simple 2D surrogates for 3D biomechanic variables of interest allows for widespread translation of best practices, and have the best opportunity to impact the highly prevalent problem of the injured runner. PMID:26616185

  2. Neuropsychology 3.0: Evidence-Based Science and Practice

    PubMed Central

    Bilder, Robert M.

    2011-01-01

    Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift towards evidence-based science and practice can be enabled by innovations, including: (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress towards these goals. PMID:21092355

  3. A new application of high-efficient silver salts-based photocatalyst under natural indoor weak light for wastewater cleaning.

    PubMed

    Hua, Xia; Teng, Fei; Zhao, Yunxuan; Xu, Juan; Xu, Chuangye; Yang, Yang; Zhang, Qiqi; Paul, Shashi; Zhang, Yi; Chen, Mindong; Zhao, Xudong

    2015-09-15

    As a high-quantum-efficiency photocatalyst, the serious photo-corrosion of silver phosphate (Ag3PO4), limits the practical applications in water purification and challenges us. Herein, Ag3PO4 is found to have a high stability under natural indoor weak light irradiation, suggesting that we can employ it by adopting a new application strategy. In our studies, rhodamine B (RhB, cationic dye), methyl orange (MO, anionic dye) and RhB-MO mixture aqueous solutions are used as the probing reaction for the degradation of organic wastewater. It is found that RhB, MO and RhB-MO can be completely degraded after 28 h under natural indoor weak light irradiation, indicating that multi-component organic contaminants can be efficiently degraded by Ag3PO4 under natural indoor weak light irradiation. The density of natural indoor weak light is measured to be 72cd, which is merely one-thousandth of 300 W xenon lamp (68.2 × 10(3)cd). Most importantly, Ag3PO4 shows a high stability under natural indoor weak light irradiation, demonstrated by the formation of fairly rare Ag. Furthermore, we also investigate the influence of inorganic ions on organic dyes degradation. It shows that the Cl(-) and Cr(6+) ions with high concentrations in wastewater have significantly decreased the degradation rate. From the viewpoint of energy saving and stability, this study shows us that we can utilize the Ag-containing photocatalysts under natural indoor weak light, which could be extended to indoor air cleaning process. PMID:26107659

  4. Utilization of evidence-based practice by registered occupational therapists.

    PubMed

    Cameron, Karen Ann V; Ballantyne, Scott; Kulbitsky, Autumnrose; Margolis-Gal, Michelle; Daugherty, Timothy; Ludwig, Ferol

    2005-01-01

    Although the use of evidence-based practice (EBP) is presently on the rise, there have been limited studies examining its use by occupational therapists within the US. The purpose of this study was to examine the use of EBP among registered occupational therapists in the occupational therapy intervention planning process. This descriptive study surveyed 500 members of the American Occupational Therapy Association (AOTA), of which 131 participants responded (26%). The results of the study supported the hypothesis that, within the sample studied, a minority of registered occupational therapists in the US utilize EBP in the intervention planning process. Other results included: (1) As level of academic education increased, the view of the importance of research to occupational therapy decreased. (2) As the years of practice increased, the use of research evidence in making clinical decisions decreased. As the occupational therapy profession moves towards utilization of EBP as a professional standard, it is imperative that the profession examines specific strategies to promote the adoption of such practice by its members, including the promotion of competency in evidence utilization, and the valuing of the established clinical reasoning skills of the practitioner while integrating research evidence into intervention planning to support professional practice. PMID:16398202

  5. Inversion of calcite twin data, paleostress reconstruction and multiphase weak deformation in cratonic interior - Evidence from the Proterozoic Cuddapah basin, India

    NASA Astrophysics Data System (ADS)

    Tripathy, Vikash; Saha, Dilip

    2015-08-01

    Paleostress orientations from mechanically twinned calcite in carbonate rocks and veins in the neighborhood of large faults were investigated to comment on the nature of weak upper crustal stresses affecting sedimentary successions within the Proterozoic Cuddapah basin, India. Application of Turner's P-B-T method and Spang's Numerical dynamic analysis on Cuddapah samples provided paleostress orientations comparable to those derived from fault-slip inversion. Results from the neighborhood of E-W faults cutting through the Paleoproterozoic Papaghni and Chitravati groups and the Neoproterozoic Kurnool Group in the western Cuddapah basin, reveal existence of multiple deformation events - (1) NE-SW σ3 in strike-slip to extensional regime along with an additional event having NW-SE σ3, for lower Cuddapah samples; (2) compressional/transpressional event with ESE-WNW or NNE-SSW σ1 mainly from younger Kurnool samples. Integrating results from calcite twin data inversion, fault-slip analysis and regional geology we propose that late Mesoproterozoic crustal extension led to initial opening of the Kurnool sub-basin, subsequently influenced by weak compressional deformation. The dynamic analysis of calcite twins thus constrains the stress regimes influencing basin initiation in the southern Indian cratonic interior and subsequent basin inversion in relation to craton margin mobile belts and plausible global tectonic events in the Proterozoic.

  6. Acute Stroke: Current Evidence-based Recommendations for Prehospital Care

    PubMed Central

    Glober, Nancy K.; Sporer, Karl A.; Guluma, Kama Z.; Serra, John P.; Barger, Joe A.; Brown, John F.; Gilbert, Gregory H.; Koenig, Kristi L.; Rudnick, Eric M.; Salvucci, Angelo A.

    2016-01-01

    Introduction In the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with a suspected stroke and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods We performed a literature review of the current evidence in the prehospital treatment of a patient with a suspected stroke and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the stroke protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were the use of a stroke scale, blood glucose evaluation, use of supplemental oxygen, patient positioning, 12-lead electrocardiogram (ECG) and cardiac monitoring, fluid assessment and intravenous access, and stroke regionalization. Results Protocols across EMS agencies in California varied widely. Most used some sort of stroke scale with the majority using the Cincinnati Prehospital Stroke Scale (CPSS). All recommended the evaluation of blood glucose with the level for action ranging from 60 to 80mg/dL. Cardiac monitoring was recommended in 58% and 33% recommended an ECG. More than half required the direct transport to a primary stroke center and 88% recommended hospital notification. Conclusion Protocols for a patient with a suspected stroke vary widely across the state of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols. PMID:26973735

  7. Integration of Evidence Base into a Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    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

  8. Efficiencies and Optimization of Weak Base Anion Ion-Exchange Resin for Groundwater Hexavalent Chromium Removal at Hanford

    SciTech Connect

    Nesham, Dean O.; Ivarson, Kristine A.; Hanson, James P.; Miller, Charles W.; Meyers, P.; Jaschke, Naomi M.

    2014-02-03

    The U.S. Department of Energy’s (DOE’s) contractor, CH2M HILL Plateau Remediation Company, has successfully converted a series of groundwater treatment facilities to use a new treatment resin that is delivering more than $3 million in annual cost savings and efficiency in treating groundwater contamination at the DOE Hanford Site in southeastern Washington State. During the production era, the nuclear reactors at the Hanford Site required a continuous supply of high-quality cooling water during operations. Cooling water consumption ranged from about 151,417 to 378,541 L/min (40,000 to 100,000 gal/min) per reactor, depending on specific operating conditions. Water from the Columbia River was filtered and treated chemically prior to use as cooling water, including the addition of sodium dichromate as a corrosion inhibitor. Hexavalent chromium was the primary component of the sodium dichromate and was introduced into the groundwater at the Hanford Site as a result of planned and unplanned discharges from the reactors starting in 1944. Groundwater contamination by hexavalent chromium and other contaminants related to nuclear reactor operations resulted in the need for groundwater remedial actions within the Hanford Site reactor areas. Beginning in 1995, groundwater treatment methods were evaluated, leading to the use of pump-and-treat facilities with ion exchange using Dowex™ 21K, a regenerable, strong-base anion exchange resin. This required regeneration of the resin, which was performed offsite. In 2008, DOE recognized that regulatory agreements would require significant expansion for the groundwater chromium treatment capacity. As a result, CH2M HILL performed testing at the Hanford Site in 2009 and 2010 to demonstrate resin performance in the specific groundwater chemistry at different waste sites. The testing demonstrated that a weak-base anion, single-use resin, specifically ResinTech SIR-700 ®, was effective at removing chromium, had a significantly

  9. Practice-Based Evidence to Evidence-Based Practice: Building the National Radiation Oncology Registry

    PubMed Central

    Efstathiou, Jason A.; Nassif, Deborah S.; McNutt, Todd R.; Bogardus, C. Bob; Bosch, Walter; Carlin, Jeffrey; Chen, Ronald C.; Chou, Henry; Eggert, Dave; Fraass, Benedick A.; Goldwein, Joel; Hoffman, Karen E.; Hotz, Ken; Hunt, Margie; Kessler, Marc; Lawton, Colleen A.F.; Mayo, Charles; Michalski, Jeff M.; Mutic, Sasa; Potters, Louis; Rose, Christopher M.; Sandler, Howard M.; Sharp, Gregory; Tomé, Wolfgang; Tran, Phuoc T.; Wall, Terry; Zietman, Anthony L.; Gabriel, Peter E.; Bekelman, Justin E.

    2013-01-01

    The National Radiation Oncology Registry (NROR), sponsored by the Radiation Oncology Institute and the American Society for Radiation Oncology, is designed to collect standardized information on cancer care delivery among patients treated with radiotherapy in the United States and will focus on patients with prostate cancer. Stakeholders were engaged through a forum that emphasized the need for patient-centered outcomes, minimal data burden, and maximal connectivity to existing registries and databases. An electronic infrastructure is under development to provide connectivity across radiation oncology and hospital information systems. The NROR Gateway features automatic abstraction as well as aggregation of treatment and outcome data. The prostate cancer data dictionary provides standardized elements in four domains: facility, physician, patient, and treatment. The pilot phase will consist of clinical centers chosen to provide a representative mix of radiation treatment modalities, facility types, population-based settings, and regional locations. The initial set of radiation practice metrics includes physician board certification and maintenance, ordering of staging scans, active surveillance discussion, dose prescriptions for low-risk/high-risk disease, radiation fields for low-risk/high-risk disease, image-guided radiation therapy use, androgen deprivation therapy use, post-brachytherapy implant computed tomography dosimetry, collection of toxicity assessments, and longitudinal patient follow-up. The NROR pilot study will provide the framework for expansion to a nationwide electronic registry for radiation oncology. PMID:23942508

  10. Information systems: the key to evidence-based health practice.

    PubMed Central

    Rodrigues, R. J.

    2000-01-01

    Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

  11. Telemedicine framework using case-based reasoning with evidences.

    PubMed

    Sene, A; Kamsu-Foguem, B; Rumeau, P

    2015-08-01

    Telemedicine is the medical practice of information exchanged from one location to another through electronic communications to improve the delivery of health care services. This research article describes a telemedicine framework with knowledge engineering using taxonomic reasoning of ontology modeling and semantic similarity. In addition to being a precious support in the procedure of medical decision-making, this framework can be used to strengthen significant collaborations and traceability that are important for the development of official deployment of telemedicine applications. Adequate mechanisms for information management with traceability of the reasoning process are also essential in the fields of epidemiology and public health. In this paper we enrich the case-based reasoning process by taking into account former evidence-based knowledge. We use the regular four steps approach and implement an additional (iii) step: (i) establish diagnosis, (ii) retrieve treatment, (iii) apply evidence, (iv) adaptation, (v) retain. Each step is performed using tools from knowledge engineering and information processing (natural language processing, ontology, indexation, algorithm, etc.). The case representation is done by the taxonomy component of a medical ontology model. The proposed approach is illustrated with an example from the oncology domain. Medical ontology allows a good and efficient modeling of the patient and his treatment. We are pointing up the role of evidences and specialist's opinions in effectiveness and safety of care. PMID:26001421

  12. Evidence-based patient education: knowledge transfer to endodontic patients.

    PubMed

    Sorrell, John T; McNeil, Daniel W; Gochenour, Lori L; Jackson, C Russell

    2009-11-01

    Evidence-based treatment is emphasized in oral health care, but there has been less focus on empirically demonstrating the effects of patient education. Attempts to educate patients must be empirically demonstrated in order to provide evidence-based guidance to practitioners and educators. We conducted two studies that assessed information acquisition during five-minute audiovisual films on oral hygiene procedures, endodontic procedures, and fear about pain during root canal therapy. A fifteen-item Dental Knowledge Questionnaire (DKQ), with three subscales each focusing on the content of one of the films, was developed and psychometrically evaluated. Study 1 included 268 undergraduates; study 2 involved 104 endodontic patients. Participants completed the DKQ, viewed one of the three films, and repeated the questionnaire. The effects of information on knowledge were assessed using 3 (film group) X 3 (subscale of the DKQ) X 2 (time) repeated measures ANOVAs. Scores improved in a content-specific fashion relevant to the film viewed among undergraduates, F(4, 263)=211.33, p<.001, partial eta(2)=.62 and endodontic patients, F(4, 99)=87.22, p<.001, partial eta(2)=.63. The results provide evidence for using brief informational film as an efficacious method to increase patient knowledge, at least in the short term. The DKQ is proposed as a tool to assess patient knowledge in the arenas of oral hygiene and endodontics. PMID:19910479

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

    PubMed

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

    2016-07-01

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

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

    PubMed Central

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

    2016-01-01

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

  15. The Care and Feeding of Evidence Based Medicine

    PubMed Central

    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. Published EBM data vary in quality for reasons that have been the subject of many perceptive literature reviews. Study design can be faulted, and conflicts of interest, personal and economic, can potentially bias study results and their publication. Practical guides for data evaluation are presented here, with discussion of technical and sociological issues that affect information quality and its clinical application. Clinical practice often appears to resist good evidence in making clinical choices. Personal views of some practicing physicians about EBM are presented that underlie the occasional difficulties in applying valid research information in patient care. Improvements in study design and publication standards may enhance the clinical application of evidence-based information. EBM guided practice holds promise to improve outcomes and expense, to standardize and streamline process in ways that make for much safer patient care. PMID:22532934

  16. Evidence-based Kernels: Fundamental Units of Behavioral Influence

    PubMed Central

    Biglan, Anthony

    2008-01-01

    This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior–influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of its components would render it inert. Existing evidence shows that a variety of kernels can influence behavior in context, and some evidence suggests that frequent use or sufficient use of some kernels may produce longer lasting behavioral shifts. The analysis of kernels could contribute to an empirically based theory of behavioral influence, augment existing prevention or treatment efforts, facilitate the dissemination of effective prevention and treatment practices, clarify the active ingredients in existing interventions, and contribute to efficiently developing interventions that are more effective. Kernels involve one or more of the following mechanisms of behavior influence: reinforcement, altering antecedents, changing verbal relational responding, or changing physiological states directly. The paper describes 52 of these kernels, and details practical, theoretical, and research implications, including calling for a national database of kernels that influence human behavior. PMID:18712600

  17. Feature extraction of rolling bearing’s early weak fault based on EEMD and tunable Q-factor wavelet transform

    NASA Astrophysics Data System (ADS)

    Wang, Hongchao; Chen, Jin; Dong, Guangming

    2014-10-01

    When early weak fault emerges in rolling bearing the fault feature is too weak to extract using the traditional fault diagnosis methods such as Fast Fourier Transform (FFT) and envelope demodulation. The tunable Q-factor wavelet transform (TQWT) is the improvement of traditional one single Q-factor wavelet transform, and it is very fit for separating the low Q-factor transient impact component from the high Q-factor sustained oscillation components when fault emerges in rolling bearing. However, it is hard to extract the rolling bearing’ early weak fault feature perfectly using the TQWT directly. Ensemble empirical mode decomposition (EEMD) is the improvement of empirical mode decomposition (EMD) which not only has the virtue of self-adaptability of EMD but also overcomes the mode mixing problem of EMD. The original signal of rolling bearing’ early weak fault is decomposed by EEMD and several intrinsic mode functions (IMFs) are obtained. Then the IMF with biggest kurtosis index value is selected and handled by the TQWT subsequently. At last, the envelope demodulation method is applied on the low Q-factor transient impact component and satisfactory extraction result is obtained.

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

    ERIC Educational Resources Information Center

    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.…

  19. Evidence-based practice: a practical approach to implementation.

    PubMed

    Newhouse, Robin; Dearholt, Sandra; Poe, Stephanie; Pugh, Linda C; White, Kathleen M

    2005-01-01

    Organizations often do not have processes in place to support nurses through a systematic approach for developing and evaluating nursing interventions, protocols, critical pathways, and policies that are derived from scientific evidence. The development of a framework to guide inquiry will have a positive impact on patients. This process may foster a higher level of professional engagement by nurses that may, in the long-term, help improve nurse retention and recruitment. The authors discuss a nursing evidence-based practice model and guidelines that were developed by a team of hospital and academic nurse leaders and is practical and easy to use. This model has been successfully implemented across the department of nursing as a strategic initiative. Results of the implementation have shown that staff nurses can effectively use this model with the help of knowledgeable mentors. PMID:15647668

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

    PubMed

    Gődény, Sándor; Csenteri, Orsolya Karola

    2015-11-01

    Polycystic ovary syndrome is recognized as the most common hormonal and metabolic disorder likely to affect women. The heterogeneous endocrinopathy is characterized by clinical and/or biochemical hyperandrogenism, oligo- or amenorrhoea, anovulatory infertility, and polycystic ovarian morphology. The syndrome is often associated with obesity, hyperinsulinemia and adversely affects endocrine, metabolic, and cardiovascular health. The symptoms and complaint of the patients vary with age. To maximise health gain of the syndrome, adequate, evidence based effective, efficient and safe treatment is necessary. This article summarises the highest available evidence provided by studies, meta-analysis and systematic reviews about the therapeutical possibilities for treating obesity, hyperandrogenism, menstrual abnormalities, infertility and psychological problems related to polycystic ovary syndrome. PMID:26551444

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

    PubMed

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

    2015-12-01

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

  2. The deconstructing angel: nursing, reflection and evidence-based practice.

    PubMed

    Rolfe, Gary

    2005-06-01

    This paper explores Jacques Derrida's strategy of deconstruction as a way of understanding and critiquing nursing theory and practice. Deconstruction has its origins in philosophy, but I argue that it is useful and relevant as a way of challenging the dominant paradigm of any discipline, including nursing. Because deconstruction is notoriously difficult to define, I offer a number of examples of deconstruction in action. In particular, I focus on three critiques of reflective practice by the meta-narrative of evidence-based practice (EBP) and attempt to show how those critiques can be directed back at EBP itself. I conclude with the observation that EBP is open to many of the criticisms that it directs at other discourses, including problems of a lack of empirical evidence, of distortions due to memory, and of falsification of the 'facts'. PMID:15892723

  3. Strengthening the evidence base for health programming in humanitarian crises.

    PubMed

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. PMID:25214616

  4. Health technology assessment: an evidence-based medicine perspective.

    PubMed

    Glasziou, Paul

    2012-01-01

    A challenge of health technology assessment is integrating the information from different disciplines. This talk focuses on the evidence-based medicine perspective and challenges 3 assumptions of health technology assessment: assumptions about effectiveness, assumptions about coverage by health technology assessment, and assumptions about costs being immutable. Challenging these assumptions has several implications. First is the need for better evidence on effects: both low-volume, high-cost technologies and low-cost, high-volume technologies that are ineffective drains on health care systems' resources. Second, cheap but effective technologies should be better promoted, as they can displace high-cost technologies. Finally, for effective but expensive technologies, we should work to lower the price and/or costs. PMID:22040831

  5. Evidence-Based Parenting Interventions to Promote Secure Attachment

    PubMed Central

    Wright, Barry; Edginton, Elizabeth

    2016-01-01

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

  6. Selective neurotoxic effects of nicotine on axons in fasciculus retroflexus further support evidence that this a weak link in brain across multiple drugs of abuse.

    PubMed

    Carlson, J; Armstrong, B; Switzer, R C; Ellison, G

    2000-10-01

    When administered continuously for several days at relatively low plasma levels, a variety of drugs of abuse with strong dopaminergic actions induce degeneration in axons traveling from the lateral habenula through the sheath of fasciculus retroflexus to midbrain monoaminergic nuclei. With some of these drugs, such as cocaine, this is virtually the only degeneration induced in brain. Nicotine given continuously also selectively induces degeneration in fasciculus retroflexus, but in the other half of the tract: the cholinergic axons running from medial habenula in the core of the tract to the interpeduncular nucleus. Fasciculus retroflexus appears to be a weak link in brain for diverse drugs of abuse when administered incessantly for several days. Alterations in this tract would be predicted to be especially important for the genesis of the symptomatology which develops during drug binges, residual effects of such binges, and the processes underlying relapse. PMID:11044749

  7. Identifying Educational Practices Supported by Rigorous Evidence: A Guide to the Selection of Evidence-Based Practices

    ERIC Educational Resources Information Center

    Regional Resource Center Program, 2014

    2014-01-01

    One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…

  8. Evidence-Based Practice in Mental Health Care to Ethnic Minority Communities: Has Its Practice Fallen Short of Its Evidence?

    ERIC Educational Resources Information Center

    Aisenberg, Eugene

    2008-01-01

    Evidence-based practice (EBP) has contributed substantially to the advancement of knowledge in the treatment and prevention of adult mental health disorders. A fundamental assumption, based on documented evidence of effectiveness with certain populations, is that EBP is equally effective and applicable to all populations. However, small sample…

  9. Opportunities and Challenges in Evidence-Based Social Policy. Social Policy Report. Volume 28, Number 4

    ERIC Educational Resources Information Center

    Supplee, Lauren H.; Metz, Allison

    2014-01-01

    Despite a robust body of evidence of effectiveness of social programs, few evidence-based programs have been scaled for population-level improvement in social problems. Since 2010 the federal government has invested in evidence-based social policy by supporting a number of new evidence-based programs and grant initiatives. These initiatives…

  10. Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence.

    PubMed

    Morcke, Anne Mette; Dornan, Tim; Eika, Berit

    2013-10-01

    Outcome based or competency based education (OBE) is so firmly established in undergraduate medical education that it might not seem necessary to ask why it was included in recommendations for the future, like the Flexner centenary report. Uncritical acceptance may not, however, deliver its greatest benefits. Our aim was to explore the underpinnings of OBE: its historical origins, theoretical basis, and empirical evidence of its effects in order to answer the question: How can predetermined learning outcomes influence undergraduate medical education? This literature review had three components: A review of historical landmarks in the evolution of OBE; a review of conceptual frameworks and theories; and a systematic review of empirical publications from 1999 to 2010 that reported data concerning the effects of learning outcomes on undergraduate medical education. OBE had its origins in behaviourist theories of learning. It is tightly linked to the assessment and regulation of proficiency, but less clearly linked to teaching and learning activities. Over time, there have been cycles of advocacy for, then criticism of, OBE. A recurring critique concerns the place of complex personal and professional attributes as "competencies". OBE has been adopted by consensus in the face of weak empirical evidence. OBE, which has been advocated for over 50 years, can contribute usefully to defining requisite knowledge and skills, and blueprinting assessments. Its applicability to more complex aspects of clinical performance is not clear. OBE, we conclude, provides a valuable approach to some, but not all, important aspects of undergraduate medical education. PMID:22987194

  11. Perspectives--A Problem in Our Field: Making Distinctions between Evidence-Based Treatment and Evidence-Based Practice as a Decision-Making Process

    ERIC Educational Resources Information Center

    Brandt, Kristie; Diel, James; Feder, Joshua; Lillas, Connie

    2012-01-01

    The authors contend that the term "evidence-based treatment" (EBT) is often used synonymously with the term "evidence-based practice" (EBP) without making an important distinction. If a practitioner is applying an EBT, it should not be assumed that one is "practicing" the evidence. Within the infant-family and early childhood field, this confusion…

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

    PubMed

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

    2005-04-01

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

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

    PubMed

    Vanherweghem, J-L

    2015-09-01

    The contrast between the efficiency of Evidence-Based Medicine (EBM), a scientific fact, and the popularity of Complementary and Alternative Medicines (CAM) is a paradox of the art of healing. EBM is based on the paradigm of positivism and materialism while CAM are based on those of relativism and vitalism. These paradigms are diametrically opposed and the aim of an integrative medicine is aporetic. However, EBM is today in a dead end. The objective proof of a disease according to the rules of EBM is often lacking face to the expectations of patients demanding their illness to be taken into account. EBM and CAM have thus to coexist. Lessons can be drawn from CAM : patient expectations should be given a meaning and be integrated in his or her psychosocial context. PMID:26591330

  14. Evidence-Based Practice in Group Care: The Effects of Policy, Research, and Organizational Practices

    ERIC Educational Resources Information Center

    Stuart, Carol; Sanders, Larry; Gurevich, Maria; Fulton, Robert

    2011-01-01

    This article describes the effect of a province-wide vision of evidence-based and outcome-based services for children and youth and the challenges of implementing evidence-based practice (EBP) and evidence-based treatment (EBT) approaches within group care settings. The paper is based on the results of a survey of group care settings in the…

  15. A Conditional Model of Evidence-Based Decision Making

    PubMed Central

    Falzer, Paul R.; Garman, D. Melissa

    2009-01-01

    Rationale Efforts to describe how individual treatment decisions are informed by systematic knowledge have been hindered by a standard that gauges the quality of clinical decisions by their adherence to guidelines and evidence-based practices. This paper tests a new contextual standard that gauges the incorporation of knowledge into practice and develops a model of evidence-based decision making. Aims and objectives Previous work found that the forecasted outcome of a treatment guideline exerts a highly significant influence on how it is used in making decisions. This study proposed that forecasted outcomes affect the recognition of a treatment scenario, and this recognition triggers distinct contextual decision strategies. Method N=21 volunteers from a psychiatric residency program responded to 64 case vignettes, 16 in each of four treatment scenarios. The vignettes represented a fully balanced within-subjects design that included guideline switching criteria and patient-specific factors. For each vignette, participants indicated whether they endorsed the guideline’s recommendation. Results Clinicians employed consistent contextual decision strategies in responding to clearly positive or negative forecasts. When forecasts were more ambiguous or risky, their strategies became complex and relatively inconsistent. Conclusion The results support a three step model of evidence-based decision making, in which clinicians recognize a decision scenario, apply a simple contextual strategy, then if necessary engage a more complex strategy to resolve discrepancies between general guidelines and specific cases. The paper concludes by noting study limitations and discussing implications of the model for future research in clinical and shared decision making, training, and guideline development. PMID:20367718

  16. Evidence-based Management Strategies for Treatment of Chronic Wounds

    PubMed Central

    Werdin, Frank; Tennenhaus, Mayer; Schaller, Hans-Eberhardt; Rennekampff, Hans-Oliver

    2009-01-01

    The care and management of patients with chronic wounds and their far-reaching effects challenge both the patient and the practitioner. Further complicating this situation is the paucity of evidence-based treatment strategies for chronic wound care. After searching both MEDLINE and Cochrane databases, we reviewed currently available articles concerning chronic wound care. Utilizing this information, we have outlined a review of current, evidence-based concepts as they pertain to the treatment of chronic wounds, focusing on fundamental treatment principles for the management of venous, arterial, diabetic, and pressure ulcers. Individualized treatment options as well as general wound management principles applicable to all varieties of chronic wounds are described. Classification and treatment guidelines as well as the adoption of the TIME acronym facilitate an organized conceptional approach to wound care. In so doing, individual aspects of generalized wound care such as debridement, infection, and moisture control as well as attention to the qualities of the wound edge are comprehensively evaluated, communicated, and addressed. Effective adjuvant agents for the therapy of chronic wounds including nutritional and social support measures are listed, as is a brief review of strategies helpful for preventing recurrence. An appreciation of evidence-based treatment pathways and an understanding of the pathophysiology of chronic wounds are important elements in the management of patients with chronic wounds. To achieve effective and long-lasting results, a multidisciplinary approach to patient care, focused on the education and coordination of patient, family as well as medical and support staff can prove invaluable. PMID:19578487

  17. Evidence-based practice, research, peer review, and publication.

    PubMed

    Gunn, I P

    1998-11-01

    For about a quarter of a century, concerns have been expressed about published biomedical research. It became more acute after some published research and broad dissemination was found fraudulent. With the emphasis now being placed on scientifically validated or evidence-based practice, it has become more imperative that clinical guidelines be based on credible information in our textbooks and research literature. Since the early 1990s, it has been found that much of the research in our electronic databases does not meet quality standards and often is irrelevant, calling into questions problems with peer review, including the selection and publication process of our journals. This column is devoted to calling attention to these problems not only to CRNAs and other researchers, but also to the consumers of research who often use it to make changes in their practice. It also calls attention to the CRNA community about the movement toward calls for greater accountability in practice, both as to quality and cost, from which the movement toward evidence-based practice, the identification and benchmarking of best practices, and the development and implementation of clinical practice guideline has evolved. To feel ownership in anesthesia-related clinical practice guidelines, CRNAs must become involved in their development and implementation. PMID:9866493

  18. [Health economics, medical ethics, and evidence-based medicine].

    PubMed

    Stelmach, Włodzimierz; Bryła, Marek; Stelmach, Iwona; Denys, Andrzej

    2002-12-01

    The paper is based on the assumption that the management on different levels of decision-making requires not only strictly medical knowledge, but also the competence to make use of the acquisitions of health economics as well as certain knowledge of the principles of medical ethics and research methods applied in the evidence-based medicine. So far the relevant scientific literature lacks any attempts to analyse the common and separate features of the three fields mentioned above. Therefore, this paper aims at filling this gap. The objective is going to be met by acquainting the reader with the historical development of the three disciplines. Emphasis will be put on the existing definitions and scope of the health economics, medical ethics and evidence-based medicine. The concluding remarks contain the authors' conviction that this paper will contribute to make the medical environment more interested in the presented issues and thus constitute the first step to work out solutions which could be applied in clinical practice in the future. PMID:12666439

  19. Perfectionism in Anorexia Nervosa: Novel Performance Based Evidence

    PubMed Central

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

    2014-01-01

    Existing research into perfectionism in Anorexia Nervosa (AN) is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study – 81 with a diagnosis of AN and 72 healthy controls (HCs). Participants completed two performance based tasks assessing perfectionism – a text replication task and a bead sorting task – along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36) and produced significantly higher quality copies (p = <0.01, d = 0.45). In the bead sorting task, there was a trend towards more participants in the AN group choosing to check their work compared with the HC group (p = 0.07, d = 0.30) and the AN group took significantly longer checking than those in the HC group (p = <0.01, d = 0.45). Only copy quality uniquely predicted scores on self report measures of perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group. PMID:25360690

  20. Dental education and evidence-based educational best practices: bridging the great divide.

    PubMed

    Masella, Richard S; Thompson, Thomas J

    2004-12-01

    Research about educational best practices is negatively perceived by many dental faculty. Separation between teaching and learning strategies commonly employed in dental education and evidence-based educational techniques is real and caused by a variety of factors: the often incomprehensible jargon of educational specialists; traditional academic dominance of research, publication, and grantsmanship in faculty promotions; institutional undervaluing of teaching and the educational process; and departmentalization of dental school governance with resultant narrowness of academic vision. Clinician-dentists hired as dental school faculty may model teaching activities on decades-old personal experiences, ignoring recent educational evidence and the academic culture. Dentistry's twin internal weaknesses--factionalism and parochialism--contribute to academic resistance to change and unwillingness to share power. Dental accreditation is a powerful impetus toward inclusion of best teaching and learning evidence in dental education. This article will describe how the gap between traditional educational strategies and research-based practices can be reduced by several approaches including dental schools' promotion of learning cultures that encourage and reward faculty who earn advanced degrees in education, regular evaluation of teaching by peers and educational consultants with inclusion of the results of these evaluations in promotion and tenure committee deliberations, creating tangible reward systems to recognize and encourage teaching excellence, and basing faculty development programs on adult learning principles. Leadership development should be part of faculty enrichment, as effective administration is essential to dental school mission fulfillment. Finally, faculty who investigate the effectiveness of educational techniques need to make their research more available by publishing it, more understandable by reducing educational jargon, and more relevant to the day

  1. Evidence-based practice: how nurse leaders can facilitate innovation.

    PubMed

    Shirey, Maria R

    2006-01-01

    Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action. PMID:16878011

  2. Evidence base for pre-employment medical screening.

    PubMed

    Pachman, Joseph

    2009-07-01

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

  3. The early history of evidence-based reproductive medicine.

    PubMed

    Johnson, Martin H

    2013-03-01

    The origins of evidence-based medicine as understood today are traceable to 1972 and the publication of Archie Cochrane’s book Effectiveness and Efficiency: Random Reflections on Health Services. This book attempted to bridge the divide between scientific medicine and clinical judgment that had developed since the mid-19th century. Its genesis was stimulated by Cochrane’s experiences as a prisoner-of-war medical officer and of the demands placed after the 1939-1945 war on the UK National Health Service. In the 1960s, reproductive medicine was considered by the UK Medical Research Council to be relatively ‘unscientific’ in its approach to care delivery and was described as such by Cochrane in the 1970s. Evidence is presented here that reproductive medicine responded, becoming by 1989 a pioneering clinical discipline in the application of evidence to practice. This was achieved largely through the efforts of Iain Chalmers, who was a key player in the development of the systematic review and in the foundation of the Cochrane collection. PMID:23273757

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

    PubMed

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

    2009-02-01

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

  5. Laparoscopic urinary stone surgery: an updated evidence-based review.

    PubMed

    Skolarikos, Andreas; Papatsoris, Athanasios G; Albanis, Stefanos; Assimos, Dean

    2010-10-01

    The treatment of urinary lithiasis has been revolutionized during the last three decades. Minimally invasive therapies in the form of endoscopic surgery in companion with the advent of shock wave lithotripsy have diminished the role of open stone surgery. Laparoscopy, another minimally invasive treatment, is continuously gaining place in the treatment of urinary stones, mainly replacing open surgery. We have tried to identify the level of the evidence and grade of recommendation, according to the evidence-based medicine criteria, in studies supporting the laparoscopic approach to stone extraction. The highest level of evidence (IIa) was found for laparoscopic ureterolithotomy. It is technically feasible with the advantage of being minimally invasive and having lower postoperative morbidity compared to open ureterolithotomy. It is mostly recommended (grade B) for large impacted stones or when endoscopic ureterolithotripsy or shock wave stone disintegration have failed. Laparoscopic pyelolithotomy is feasible but rarely indicated in the present era (III/B). Laparoscopic nephrolithotomy may be indicated to remove a stone from an anterior diverticulum or when PNL or flexible ureteroscopy have failed (III/B). PMID:20396871

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

    PubMed Central

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

    2014-01-01

    The Nursing and Allied Health Resources Section (NAHRS) of the Medical Library Association created the 2012 NAHRS Selected List of Nursing Journals to assist librarians with collection development and to provide nurses and librarians with data on nursing and interdisciplinary journals to assist their decisions about where to submit articles for publication. This list is a continuation and expansion of a list initially known as the Key Nursing Journals list. It compares database coverage and full-text options for each title and includes an analysis of the number of evidence-based, research, and continuing education articles. PMID:24860267

  7. Score-based likelihood ratios for handwriting evidence.

    PubMed

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

    2012-06-10

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

  8. Identifying influential nodes in weighted networks based on evidence theory

    NASA Astrophysics Data System (ADS)

    Wei, Daijun; Deng, Xinyang; Zhang, Xiaoge; Deng, Yong; Mahadevan, Sankaran

    2013-05-01

    The design of an effective ranking method to identify influential nodes is an important problem in the study of complex networks. In this paper, a new centrality measure is proposed based on the Dempster-Shafer evidence theory. The proposed measure trades off between the degree and strength of every node in a weighted network. The influences of both the degree and the strength of each node are represented by basic probability assignment (BPA). The proposed centrality measure is determined by the combination of these BPAs. Numerical examples are used to illustrate the effectiveness of the proposed method.

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

    SciTech Connect

    Womble, R.

    2010-08-06

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

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

    PubMed

    Raditic, Donna M; Bartges, Joseph W

    2014-09-01

    Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology. PMID:25174902

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Hempel, Eliana V; Bollard, Edward R

    2016-09-01

    Anemia is a prevalent disease with multiple possible etiologies and resultant complications. Iron deficiency anemia is a common cause of anemia and is typically due to insufficient intake, poor absorption, or overt or occult blood loss. Distinguishing iron deficiency from other causes of anemia is integral to initiating the appropriate treatment. In addition, identifying the underlying cause of iron deficiency is also necessary to help guide management of these patients. We review the key components to an evidence-based, cost-conscious evaluation of suspected iron deficiency anemia. PMID:27542426

  13. Controversial ultrasound findings in mid trimester pregnancy. Evidence based approach.

    PubMed

    Ebrashy, Alaa; Kurjak, Asim; Adra, Abdallah; Aliyu, Labaran Dayyabu; Wataganara, Tuangsit; de Sá, Renato Augusto Moreira; Pooh, Ritsuko; Sen, Cihat; Stanojevic, Milan

    2016-03-01

    Mid trimester fetal anatomy scan is a fundamental part of routine antenatal care. Some U/S soft markers or controversial U/S signs are seen during the scan and create some confusion regarding their relation to fetal chromosomal abnormalities. Example of these signs: echogenic focus in the heart, echogenic bowel, renal pyelectasis, ventriculomegaly, polydactely, club foot, choroid plexus cyst, single umbilical artery. We are presenting an evidence based approach from the literature for management of these controversial U/S signs. PMID:26506099

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

    PubMed

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

    2014-04-01

    The Nursing and Allied Health Resources Section (NAHRS) of the Medical Library Association created the 2012 NAHRS Selected List of Nursing Journals to assist librarians with collection development and to provide nurses and librarians with data on nursing and interdisciplinary journals to assist their decisions about where to submit articles for publication. This list is a continuation and expansion of a list initially known as the Key Nursing Journals list. It compares database coverage and full-text options for each title and includes an analysis of the number of evidence-based, research, and continuing education articles. PMID:24860267

  15. Factors influencing evidence-based practice for community nurses.

    PubMed

    Baird, Lisa M Garland; Miller, Tess

    2015-05-01

    Factors influencing the development of evidence-based nursing practice (EBNP) were examined in Prince Edward Island, Canada. An adapted electronic questionnaire was distributed to practicing registered nurses and nurse practitioners (n=68). An analysis of variance revealed a significant difference between nurses' clinical practice setting and the EBNP scale. Significant differences were also found between age and education level when compared with the EBNP subscales where novice nurses were less likely to rely on experience and intuition, and expert nurses with a higher level of education reported being more skilful at synthesising and applying information from research findings into their nursing practice. PMID:25993372

  16. Strategies for Training Counselors in Evidence-Based Treatments

    PubMed Central

    Martino, Steve

    2010-01-01

    Evidence-based treatments (EBTs) for substance abuse and dependence have demonstrated superiority over treatment as usual when applied with strict fidelity in controlled clinical trials. Effective counselor training is critical if substance abuse programs are to realize these interventions’ full potential to enhance client outcomes in community practice. Although few empirical evaluations of training in EBTs have been conducted to date, the existing data warrant tentative conclusions concerning the appropriate roles and effectiveness of workshops, clinical supervision, distance learning, and blended learning. Among several outstanding research issues are questions of benchmarks for counselors’ performance in training and the relationships between such performance and clients’ substance abuse outcomes. PMID:22002451

  17. Synchrotron-radiation study of weak fluorescence from neat liquids of simple alkenes: Anomalous excitation spectra as evidence for wavelength-dependent photochemistry

    SciTech Connect

    Inoue, Yoshihisa; Daino, Yoshihiko; Tai, Akira; Hakushi, Tadao ); Okada, Tadashi )

    1989-07-19

    Fluorescence excitation spectra of trans-2-octene, trans-cyclooctene, 2-methyl-2-butene, and 2,3-dimethyl-2-butene were measured by using synchrotron radiation as a tunable light source in the vacuum UV and UV region. The wavelength dependence of the fluorescence yields provides direct evidence for the long-proposed assignment that the emissive state is the {pi},R(3s) Rydberg state, which in turn gives the carbene-derived photoproducts.

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

    PubMed

    Afzal, Muhammad; Hussain, Maqbool; Ali, Taqdir; Hussain, Jamil; Khan, Wajahat Ali; Lee, Sungyoung; Kang, Byeong Ho

    2015-01-01

    Finding appropriate evidence to support clinical practices is always challenging, and the construction of a query to retrieve such evidence is a fundamental step. Typically, evidence is found using manual or semi-automatic methods, which are time-consuming and sometimes make it difficult to construct knowledge-based complex queries. To overcome the difficulty in constructing knowledge-based complex queries, we utilized the knowledge base (KB) of the clinical decision support system (CDSS), which has the potential to provide sufficient contextual information. To automatically construct knowledge-based complex queries, we designed methods to parse rule structure in KB of CDSS in order to determine an executable path and extract the terms by parsing the control structures and logic connectives used in the logic. The automatically constructed knowledge-based complex queries were executed on the PubMed search service to evaluate the results on the reduction of retrieved citations with high relevance. The average number of citations was reduced from 56,249 citations to 330 citations with the knowledge-based query construction approach, and relevance increased from 1 term to 6 terms on average. The ability to automatically retrieve relevant evidence maximizes efficiency for clinicians in terms of time, based on feedback collected from clinicians. This approach is generally useful in evidence-based medicine, especially in ambient assisted living environments where automation is highly important. PMID:26343669

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

    PubMed Central

    Afzal, Muhammad; Hussain, Maqbool; Ali, Taqdir; Hussain, Jamil; Khan, Wajahat Ali; Lee, Sungyoung; Kang, Byeong Ho

    2015-01-01

    Finding appropriate evidence to support clinical practices is always challenging, and the construction of a query to retrieve such evidence is a fundamental step. Typically, evidence is found using manual or semi-automatic methods, which are time-consuming and sometimes make it difficult to construct knowledge-based complex queries. To overcome the difficulty in constructing knowledge-based complex queries, we utilized the knowledge base (KB) of the clinical decision support system (CDSS), which has the potential to provide sufficient contextual information. To automatically construct knowledge-based complex queries, we designed methods to parse rule structure in KB of CDSS in order to determine an executable path and extract the terms by parsing the control structures and logic connectives used in the logic. The automatically constructed knowledge-based complex queries were executed on the PubMed search service to evaluate the results on the reduction of retrieved citations with high relevance. The average number of citations was reduced from 56,249 citations to 330 citations with the knowledge-based query construction approach, and relevance increased from 1 term to 6 terms on average. The ability to automatically retrieve relevant evidence maximizes efficiency for clinicians in terms of time, based on feedback collected from clinicians. This approach is generally useful in evidence-based medicine, especially in ambient assisted living environments where automation is highly important. PMID:26343669

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

    ERIC Educational Resources Information Center

    Jones, Elizabeth

    2013-01-01

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