Science.gov

Sample records for weak evidence base

  1. Weak mutually unbiased bases

    E-print Network

    M. Shalaby; A. Vourdas

    2012-03-05

    Quantum systems with variables in ${\\mathbb Z}(d)$ are considered. The properties of lines in the ${\\mathbb Z}(d)\\times {\\mathbb Z}(d)$ phase space of these systems, are studied. Weak mutually unbiased bases in these systems are defined as bases for which the overlap of any two vectors in two different bases, is equal to $d^{-1/2}$ or alternatively to one of the $d_i^{-1/2},0$ (where $d_i$ is a divisor of $d$ apart from $d,1$). They are designed for the geometry of the ${\\mathbb Z}(d)\\times {\\mathbb Z}(d)$ phase space, in the sense that there is a duality between the weak mutually unbiased bases and the maximal lines through the origin. In the special case of prime $d$, there are no divisors of $d$ apart from $1,d$ and the weak mutually unbiased bases are mutually unbiased bases.

  2. 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

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

    PubMed

    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

  4. 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.

  5. The expression and interpretation of uncertain forensic science evidence: verbal equivalence, evidence strength, and the weak evidence effect.

    PubMed

    Martire, Kristy A; Kemp, Richard I; Watkins, Ian; Sayle, Malindi A; Newell, Ben R

    2013-06-01

    Standards published by the Association of Forensic Science Providers (2009, Standards for the formulation of evaluative forensic science expert opinion, Science & Justice, Vol. 49, pp. 161-164) encourage forensic scientists to express their conclusions in the form of a likelihood ratio (LR), in which the value of the evidence is conveyed verbally or numerically. In this article, we report two experiments (using undergraduates and Mechanical Turk recruits) designed to investigate how much decision makers change their beliefs when presented with evidence in the form of verbal or numeric LRs. In Experiment 1 (N = 494), participants read a summary of a larceny trial containing inculpatory expert testimony in which evidence strength (low, moderate, high) and presentation method (verbal, numerical) varied. In Experiment 2 (N = 411), participants read the same larceny trial, this time including either exculpatory or inculpatory expert evidence that varied in strength (low, high) and presentation method (verbal, numerical). Both studies found a reasonable degree of correspondence in observed belief change resulting from verbal and numeric formats. However, belief change was considerably smaller than Bayesian calculations would predict. In addition, participants presented with evidence weakly supporting guilt tended to "invert" the evidence, thereby counterintuitively reducing their belief in the guilt of the accused. This "weak evidence effect" was most apparent in the verbal presentation conditions of both experiments, but only when the evidence was inculpatory. These findings raise questions about the interpretability of LRs by jurors and appear to support an expectancy-based account of the weak evidence effect. PMID:23750600

  6. [Evidence-based physiotherapy].

    PubMed

    Bender, Tamás

    2013-12-01

    This article on physiotherapy presents some current evidence stating the strengths and weaknesses of the physiotherapeutic procedures. In the area of physiotherapy empirical data obtained during decades were overtaken by evidence from current studies. The author points out the great problem of physiotherapy, namely the heterogeneity of the applied parameters. Knowledge of current evidence may be very important and helpful for the physicians, but the author proposes, from the practical point of view, that physiotherapeutical procedures based on exprience and used for many years should not be entirely neglected. Nowadays physiotherapy plays an important role in the treament of locomotor diseases but its use is increasing in other fields of medicine, as well. PMID:24273287

  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. Evidence based? Caveat emptor!

    PubMed

    Steinberg, Earl P; Luce, Bryan R

    2005-01-01

    Medical practices, clinical practice guidelines, clinical performance measures and measurements, and a variety of health care-related administrative decisions, such as insurance coverage decisions, are claiming to be "evidence based" with increasing frequency. In this paper we examine the "evidence based" label; discuss how evidence ought to have been assembled, evaluated, and synthesized; and when evidence is sufficient for the "evidence-based" moniker to rightfully apply. We also highlight several considerations other than the strength of evidence that are relevant to several common types of health care-related administrative decisions and that influence the extent to which the resulting decisions are truly evidence based. PMID:15647218

  9. Evidence-Based Anatomy

    PubMed Central

    Yammine, Kaissar

    2014-01-01

    Anatomy is a descriptive basic medical science that is no longer considered a research-led discipline. Many publications in clinical anatomy are prevalence studies treating clinically relevant anatomical variations and reporting their frequencies and/or associations with variables such as age, sex, side, laterality, and ancestry. This article discusses the need to make sense of the available literature. A new concept, evidence-based anatomy (EBA), is proposed to find, appraise, and synthetize the results reported in such publications. It consists in applying evidence-based principles to the field of epidemiological anatomy research through evidence synthesis using systematic reviews and meta-analyses to generate weighted pooled results. Pooled frequencies and associations based on large pooled sample size are likely to be more accurate and to reflect true population statistics and associations more closely. A checklist of a typical systematic review in anatomy is suggested and the implications of EBA for practice and future research, along with its scope, are discussed. The EBA approach would have positive implications for the future preservation of anatomy as a keystone basic science, for sound knowledge of anatomical variants, and for the safety of medical practice. Clin. Anat. 27:847–852, 2014. PMID:24797314

  10. 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

  11. Maximal Holevo Quantity Based on Weak Measurements.

    PubMed

    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

  12. 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

  13. 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

  14. 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…

  15. Quantum trajectories based on the weak value

    NASA Astrophysics Data System (ADS)

    Mori, Takuya; Tsutsui, Izumi

    2015-04-01

    The notion of the trajectory of an individual particle is strictly inhibited in quantum mechanics because of the uncertainty principle. Nonetheless, the weak value, which has been proposed as a novel and measurable quantity definable to any quantum observable, can offer a possible description of trajectory on account of its statistical nature. In this paper, we explore the physical significance provided by this "weak trajectory" by considering various situations where interference takes place simultaneously with the observation of particles, that is, in prototypical quantum situations for which no classical treatment is available. These include the double slit experiment and Lloyd's mirror, where in the former case it is argued that the real part of the weak trajectory describes an average over the possible classical trajectories involved in the process, and that the imaginary part is related to the variation of interference. It is shown that this average interpretation of the weak trajectory holds universally under the complex probability defined from the given transition process. These features remain essentially unaltered in the case of Lloyd's mirror where interference occurs with a single slit.

  16. 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.; Brada?, 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 ?CDM cosmology, including the full cross-correlations between different redshift bins. Assuming a flat ?CDM cosmology, we measure ?_8(?_m/0.3)0.51 = 0.75±0.08 from lensing, in perfect agreement with WMAP-5, yielding joint constraints ?_m = 0.266+0.025-0.023, ?_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 constraints are still relatively weak solely due to the limited area of COSMOS. However, they provide an important demonstration of the usefulness of tomographic weak lensing measurements from space. Based on observations made with the NASA/ESA Hubble Space Telescope, obtained from the data archives at the Space Telescope European Coordinating Facility and the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555.

  17. Evidence-Based Management of

    E-print Network

    Shen, Jun

    #12;#12;Evidence-Based Management of Sickle Cell Disease Expert Panel Report, 2014 #12;#12;EVIDENCE-BASED MANAGEMENT OF SICKLE CELL DISEASE: EXPERT PANEL REPORT, 2014 iii Contents Foreword ...................................................10 Chapter 2: Health Maintenance for People With Sickle Cell Disease

  18. Evidence for a weak angiogenic response to human colorectal cancers.

    PubMed Central

    Pritchard, A. J.; Chatterjee, T.; Wilkinson, M.; Powe, D. G.; Gray, T.; Hewitt, R. E.

    1995-01-01

    Many previous qualitative studies have shown that tumours are less vascular in the centre, and that host tissues become more vascular in close proximity to tumours. However, quantitative findings presented here for human colorectal cancer reveal some significant differences. Sections from 20 colorectal carcinomas (ten moderately and ten poorly differentiated) were immunostained with the QB/end/10 monoclonal to demonstrate blood vessels. These were measured by interactive morphometry and vascular volume density, surface density (Sv) and length density were recorded. In poorly differentiated carcinomas, the tumour centre was significantly less vascular than the periphery for all three parameters (P = 0.008 for Sv). However, no significant difference was seen for moderately differentiated tumours, which constitute the majority of colorectal cancers. Surrounding host tissues did not show a general increase in vascular density close to tumours. Furthermore, when total viable tissue was considered, the vascular density of carcinomas was not markedly different from normal mucosa. In the centre of moderately differentiated carcinomas for example, the mean value for Sv was only 1.4 times higher than the mean value for normal mucosa. These findings suggest that colorectal cancers may elicit a relatively weak angiogenic response, consistent with their exceptionally slow growth rate. Images Figure 1 Figure 2 Figure 3 PMID:7537517

  19. Evidence for weak coupling in sup 145 Pm

    SciTech Connect

    Glasmacher, T.; Caussyn, D.D.; Cottle, P.D.; Johnson, T.D.; Kemper, K.W.; Womble, P.C. )

    1992-04-01

    States in {sup 145}Pm were studied in the reaction {sup 130}Te({sup 19}F,4{ital n}) at a beam energy of 75 MeV using techniques of in-beam {gamma}-ray and conversion electron spectroscopy. Measurements were made of {gamma}-{gamma} coincidences, {gamma}-ray angular distributions, conversion electrons, and excitation functions between 70 and 85 MeV. The reduced {ital B}({ital E}3) transition strength for the 795 keV (11/2{sup {minus}}{r arrow}5/2{sub g.s.}{sup +}) transition was determined to be 7.8(18) Weisskopf units, supporting the interpretation of the 11/2{sup {minus}} state as a {ital h}{sub 11/2} proton state. A negative-parity sequence built on the 11/2{sup {minus}} state as well as eleven new states above the 1503 keV 15/2{sup +} state were found. A weak coupling model can explain the structure of the deduced decay scheme up to an energy of 2.5 MeV.

  20. Observational Evidence for Small-Scale Mixture of Weak and Strong Fields in the Quiet Sun

    NASA Astrophysics Data System (ADS)

    Socas-Navarro, H.; Lites, B. W.

    2004-11-01

    Three different maps of the quiet Sun, observed with the Advanced Stokes Polarimeter (ASP) and the Diffraction-Limited Stokes Polarimeter (DLSP), show evidence of strong (~=1700 G) and weak (<500 G) fields coexisting within the resolution element at both network and internetwork locations. The angular resolution of the observations is of 1" (ASP) and 0.6" (DLSP). Even at the higher DLSP resolution, a significant fraction of the network magnetic patches harbor a mixture of strong and weak fields. Internetwork elements that exhibit kG fields when analyzed with a single-component atmosphere are also shown to harbor considerable amounts of weak fields. Only those patches for which a single-component analysis yields weak fields do not show this mixture of field strengths. Finally, there is a larger fractional area of weak fields in the convective upflows than in the downflows.

  1. 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.

  2. Power-recycled weak-value-based metrology.

    PubMed

    Lyons, Kevin; Dressel, Justin; Jordan, Andrew N; Howell, John C; Kwiat, Paul G

    2015-05-01

    We improve the precision of the interferometric weak-value-based beam deflection measurement by introducing a power recycling mirror, creating a resonant cavity. This results in all the light exiting to the detector with a large deflection, thus eliminating the inefficiency of the rare postselection. The signal-to-noise ratio of the deflection is itself magnified by the weak value. We discuss ways to realize this proposal, using a transverse beam filter and different cavity designs. PMID:25978218

  3. Power-Recycled Weak-Value-Based Metrology

    NASA Astrophysics Data System (ADS)

    Lyons, Kevin; Dressel, Justin; Jordan, Andrew N.; Howell, John C.; Kwiat, Paul G.

    2015-05-01

    We improve the precision of the interferometric weak-value-based beam deflection measurement by introducing a power recycling mirror, creating a resonant cavity. This results in all the light exiting to the detector with a large deflection, thus eliminating the inefficiency of the rare postselection. The signal-to-noise ratio of the deflection is itself magnified by the weak value. We discuss ways to realize this proposal, using a transverse beam filter and different cavity designs.

  4. Power-recycled weak-value-based metrology

    E-print Network

    Kevin Lyons; Justin Dressel; Andrew N. Jordan; John C. Howell; Paul G. Kwiat

    2015-04-30

    We improve the precision of the interferometric weak-value-based beam deflection measurement by introducing a power recycling mirror, creating a resonant cavity. This results in \\emph{all} the light exiting to the detector with a large deflection, thus eliminating the inefficiency of the rare postselection. The signal-to-noise ratio of the deflection is itself magnified by the weak value. We discuss ways to realize this proposal, using a transverse beam filter and different cavity designs.

  5. 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

  6. Experimentally quantifying the advantages of weak-value-based metrology

    NASA Astrophysics Data System (ADS)

    Viza, Gerardo I.; Martínez-Rincón, Julián; Alves, Gabriel B.; Jordan, Andrew N.; Howell, John C.

    2015-09-01

    We experimentally investigate the relative advantages of implementing weak-value-based metrology versus standard methods. While the techniques outlined herein apply more generally, we measure small optical beam deflections both using a Sagnac interferometer with a monitored dark port (the weak-value-based technique), and by focusing the entire beam to a split detector (the standard technique). By introducing controlled external transverse detector modulations and transverse beam deflection momentum modulations, we quantify the mitigation of these sources in the weak-value-based experiment versus the standard focusing experiment. The experiments are compared using a combination of deterministic and stochastic methods. In all cases, the weak-value technique performs the same or better than the standard technique by up to two orders of magnitude in precision for our parameters. We further measure the statistical efficiency of the weak-value-based technique. By postselecting on 1 % of the photons, we obtain 99 % of the available Fisher information of the beam deflection parameter.

  7. 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…

  8. 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.

  9. 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 (?{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.

  10. 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.

  11. Epistemology of evidence based medicine.

    PubMed

    Michel, Luc

    2006-01-01

    Clinically relevant attitudes and guidelines issued by a rational evidence based medicine (EBM) approach integrate individual clinical expertise with the best available external clinical evidence from systematic research. However, many physicians, while considering the ultraliberal world they are practising in and fearing that the primary goal of managed care in a market environment is reducing cost in order to make profit or decrease spending, remain suspicious of this kind of tentative protocol driven medicine when applied to medical and surgical practice. If physicians want to develop a health policy agenda that emphasises patient care issues above providers' or payers' interests, they should share a common semantics (i.e. understand the words and the numbers), enhance education programmes, improve continuing objective assessment of the way medicine and surgery are performed, face moral issues raised by innovation, and assume an increased leadership role in sound critical evaluation of non-validated new techniques. They should no longer consider EBM as a weapon turned against the medical profession, but rather see it as a tool that may provide some answers to chronically unresolved questions in the evolving art of Medicine and Surgery. PMID:16929624

  12. 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.

  13. A weak blind signature scheme based on quantum cryptography

    NASA Astrophysics Data System (ADS)

    Wen, Xiaojun; Niu, Xiamu; Ji, Liping; Tian, Yuan

    2009-02-01

    In this paper, we present a weak blind signature scheme based on the correlation of EPR (Einstein-Padolsky-Rosen) pairs. Different from classical blind signature schemes and current quantum signature schemes, our quantum blind signature scheme could guarantee not only the unconditionally security but also the anonymity of the message owner. To achieve that, quantum key distribution and one-time pad are adopted in our scheme. Experimental analysis proved that our scheme have the characteristics of non-counterfeit, non-disavowal, blindness and traceability. It has a wide application to E-payment system, E-government, E-business, and etc.

  14. Direct Evidence of the Transition from Weak to Strong MHD Turbulence

    E-print Network

    Romain Meyrand; Sebastien Galtier; Khurom H. Kiyani

    2015-09-21

    One of the most important predictions in magnetohydrodynamics (MHD) is that in the presence of a uniform magnetic field $\\textbf{b}_{0}$ 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 thanks to a three-dimensional direct numerical simulation of incompressible balanced MHD turbulence with a grid resolution of $3072^2 \\times 256$. 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 $\\chi_{c}\\sim0.35$; iii) an absence followed by a dramatic increase of the communication between Alfv\\'en modes; and iv) a modification of the iso-contours of energy revealing a transition from a purely perpendicular cascade to a cascade compatible with the critical balance type phenomenology. All these changes happen at approximately the same transition scale and therefore can be seen as manifest signatures of the transition from weak to strong wave turbulence.

  15. 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…

  16. Several Weak Bit-Commitments Using Seal-Once Tamper-Evident Ioana Boureanu and Serge Vaudenay

    E-print Network

    International Association for Cryptologic Research (IACR)

    Several Weak Bit-Commitments Using Seal-Once Tamper-Evident Devices Ioana Boureanu and Serge.g., a type of distin- guishable, sealed envelopes. We show that by using a second formalisation of tamper our first functionality of distinguishable envelopes (FDE OneSeal), the standard UC

  17. 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

  18. 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

  19. Infantile spasms--evidence based medical management.

    PubMed

    Sahu, Jitendra Kumar

    2014-10-01

    Infantile spasms constitute significant burden of refractory epilepsy in children. The first line treatment choice varies at different centres. The author presents concise evidence based update on medical management of infantile spasms. PMID:24986193

  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. Evidence-Based ACL Reconstruction

    PubMed Central

    Rodriguez-Merchan, E. Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 2) Double bundle or single bundle; 3) Allograft or authograft; 4) Early or late reconstruction; 5) Rate of return to sports after ACL reconstruction; 6) Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE) search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analyses focused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II) of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years. PMID:25692162

  2. 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

  3. What's new about evidence-based assessment?

    PubMed

    Barlow, David H

    2005-09-01

    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 psychometric approach to the development of assessment procedures. Nevertheless, the era of evidence-based assessment highlights 2 somewhat different issues. First, sophisticated assessment is closely integrated with our emerging conceptions of psychopathology, rather than standing separate from these conceptions. Second, broad-based ongoing outcomes assessment systems are increasingly required for EBP on the part of governments and health care policymakers. This article summarizes these developments and looks to the future. PMID:16262456

  4. 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 identi- fied 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

  5. Evidence-based management of recurrent miscarriages

    PubMed Central

    Jeve, Yadava B.; Davies, William

    2014-01-01

    Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

  6. 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 1990s, evidence-based medicine was defined as the integration of current best evidence with clinical expertise and patient values. When these methods are applied outside internal medicine, the process is called evidence-based practice (EBP). EBP facilitates understanding, interpretation, and application of the best current evidence into radiology practice, which optimizes patient care. It has been incorporated into "Practice-based Learning and Improvement" and "Systems-based Practice," which are two of the six core resident competencies of the Accreditation Council for Graduate Medical Education and two of the 12 American Board of Radiology milestones for diagnostic radiology. Noninterpretive skills, such as systems-based practice, are also formally assessed in the "Quality and Safety" section of the American Board of Radiology Core and Certifying examinations. This article describes (a) the EBP framework, with particular focus on its relevance to the American Board of Radiology certification and maintenance of certification curricula; (b) how EBP can be integrated into a residency program; and (c) the current value and likely place of EBP in the radiology information technology infrastructure. Online supplemental material is available for this article. (©)RSNA, 2015. PMID:26466187

  7. [Evidence based chemotherapy for lung cancer].

    PubMed

    Watanabe, H; Saijo, N

    2000-01-01

    There is often little foundation for decisions in experience-based or impression-based medicine. Therapy, however, should be based on the highest level of available evidence. In many clinical cancer practices, "uncertainty" exists. When no evidence is available, it is important that we perform clinical trials to generate new evidence. Organizing multi-institutional clinical trials in Japan is an urgent necessity. Limited disease SCLC Concurrent radiotherapy in combination with cisplatin and etoposide is considered to be a standard treatment in limited disease SCLC. Extensive disease SCLC Chemotherapy regiments such as PE or CAV/PE are standard therapy for ED SCLC. There is no current evidence for alternating chemotherapy, dose intensive chemotherapy, high dose chemotherapy, late intensification chemotherapy or maintenance chemotherapy in extensive disease SCLC. New drugs in combination with cisplatin have been reported to show promising antitumor activity in extensive disease SCLC. The impact of CPT-11 + CDDP on survival may be discussed at the 2000 ASCO meeting. Surgically unresectable stage III NSCLC In a recent meta-analysis, cisplatin-based chemotherapy plus radiotherapy was compared with radiotherapy alone in prolonging survival. Cisplatin-based chemotherapy with or followed by radiation was proven to enhance survival. However, the optimal sequencing of chemotherapy and radiation has not been definitively established. Chemoradiotherapy with new drugs (paclitaxel, docetaxel, vinorelbine, gemicitabine, CPT-11) has been evaluated for activity and efficacy. Metastatic stage IV NSCLC Compared with the best supportive care alone, cisplatin-based chemotherapy yields an absolute improvement in survival. New drugs in combination with cisplatin or carboplatin have been reported to show promising antitumor activity. There is no combination therapy including a new anti-cancer agent which can be recommended as a "gold standard". There is no current evidence that either confirms or refutes non-platinum-based combination chemotherapy. Second line chemotherapy Second line chemotherapy (docetaxel 75 mg/m2) improves survival in patients previously treated with platinum-based chemotherapy. PMID:10660731

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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

  14. Evidence-based practice in action.

    PubMed

    MacPhee, Maura

    2002-08-01

    As Associate Editor for Journal of Pediatric Nursing (JPN), I will be assisting with evidence-based practice (EBP) submissions or other clinically based articles. I welcome questions, works-in-progress for constructive criticism, and finished submissions for review. This article comprises an overview of the EBP process, an EBP submission format for JPN, and 4 examples of EBP in a variety of pediatric clinical settings. PMID:12219333

  15. 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.

  16. 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

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

    PubMed

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

    2011-11-01

    Through extensive survey analysis, we investigated expert opinion in sports medicine. The study had 3 purposes: to provide clinical guidance for cases in which the correct action is not necessarily apparent, to examine expert opinion itself, and to delineate areas of future study. A total of 500 members of the American Medical Society for Sports Medicine and the American Orthopaedic Society for Sports Medicine evaluated a set of 25 statements on unresolved issues in sports medicine. The following 10 statements were deemed false: "It's okay for 12-year-old pitchers to throw curve balls; it's the pitch count that matters"; "Resistance training ('weight lifting') should be avoided until physeal closure"; "Jogging during pregnancy is to be avoided"; "At an athletic event, if sideline coverage is offered by an emergency medical technician and athletic trainer, there is little additional benefit from having a physician present"; "Contact sport athletes who sustain a second concussion should be excluded from contact sports permanently"; "The utility of pre-season medical screening is derived from the history; as such, student-athletes should complete a questionnaire, with physical examination reserved for only those with a positive relevant history"; "Femoroacetabular impingement is a myth-the designation of anatomic variation as disease"; "An AC (acromioclavicular) separation in a contact athlete should not be treated surgically if the athlete won't give up the sport; it will fail"; "Ankle taping induces weakness and atrophy of the dynamic stabilizers of the ankle"; "Only autografts should be used in ACL (anterior cruciate ligament) surgery, as allografts have an unnecessary high failure rate in clinical practice." One statement was accepted as true: "Surgery to treat anterior (patello-femoral) knee pain in a patient with normal patellar mechanics and stability is contraindicated." In short, expert opinion may be a helpful adjunct to clinical practice. Expert opinion cannot replace individual judgment and certainly does not trump the primary medical literature. Yet when better evidence is lacking, expert opinion is valuable for even the staunchest practitioner of evidence-based medicine. PMID:22293774

  18. Color-weak compensation using local affine isometry based on discrimination threshold matching.

    PubMed

    Mochizuki, Rika; Kojima, Takanori; Lenz, Reiner; Chao, Jinhui

    2015-11-01

    We develop algorithms for color-weak compensation and color-weak simulation based on Riemannian geometry models of color spaces. The objective function introduced measures the match of color discrimination thresholds of average normal observers and a color-weak observer. The developed matching process makes use of local affine maps between color spaces of color-normal and color-weak observers. The method can be used to generate displays of images that provide color-normal and color-weak observers with a similar color difference experience. It can also be used to simulate the perception of a color-weak observer for color-normal observers. We also introduce a new database of measurements of color discrimination threshold data for color-normal and color-weak observers obtained at different lightness levels in CIELUV space. The compensation methods include compensations of chromaticity using local affine maps between chromaticity planes of color-normal and color-weak observers, and one-dimensional (1D) compensation on lightness. We describe how to determine correspondences between the origins of local coordinates in color spaces of color-normal and color-weak observers using a neighborhood expansion method. After matching the origins of the two coordinate systems, a local affine map is estimated by solving a nonlinear equation, or singular-value-decomposition (SVD). We apply the methods to natural images and evaluate their performance using the semantic differential (SD) method. PMID:26560924

  19. OPTIMAL CONFIGURATION OF HASH TABLE BASED MULTIMEDIA FINGERPRINT DATABASES USING WEAK BITS

    E-print Network

    Bauer, Claus

    OPTIMAL CONFIGURATION OF HASH TABLE BASED MULTIMEDIA FINGERPRINT DATABASES USING WEAK BITS Claus fingerprinting has been widely researched and successfully commercialized as a technology to trace and recognize both audio and video content. Most published research on multimedia fingerprinting focuses

  20. 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…

  1. Combining large number of weak biomarkers based on AUC.

    PubMed

    Yan, Li; Tian, Lili; Liu, Song

    2015-12-20

    Combining multiple biomarkers to improve diagnosis and/or prognosis accuracy is a common practice in clinical medicine. Both parametric and non-parametric methods have been developed for finding the optimal linear combination of biomarkers to maximize the area under the receiver operating characteristic curve (AUC), primarily focusing on the setting with a small number of well-defined biomarkers. This problem becomes more challenging when the number of observations is not order of magnitude greater than the number of variables, especially when the involved biomarkers are relatively weak. Such settings are not uncommon in certain applied fields. The first aim of this paper is to empirically evaluate the performance of existing linear combination methods under such settings. The second aim is to propose a new combination method, namely, the pairwise approach, to maximize AUC. Our simulation studies demonstrated that the performance of several existing methods can become unsatisfactory as the number of markers becomes large, while the newly proposed pairwise method performs reasonably well. Furthermore, we apply all the combination methods to real datasets used for the development and validation of MammaPrint. The implication of our study for the design of optimal linear combination methods is discussed. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26227901

  2. Evidence-based hypnotherapy for depression.

    PubMed

    Alladin, Assen

    2010-04-01

    Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy. PMID:20390689

  3. 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 reconsideration of the methods used for moral evaluation and resolution, however the options should not include obscuring normative content by seemingly neutral technical measure. PMID:16277663

  4. 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.

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

    E-print Network

    E. V. Gotthelf; J. P. Halpern

    2007-11-10

    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, 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 B_s 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.

  6. Evidence Based Psychosocial Interventions in Substance Use

    PubMed Central

    Jhanjee, Sonali

    2014-01-01

    In recent years, there has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence. A literature review was undertaken using the several electronic databases (PubMed, Cochrane Database of systemic reviews and specific journals, which pertain to psychosocial issues in addictive disorders and guidelines on this topic). Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users. The evidence base for psychological treatment needs to be expanded and should also include research on optimal combinations of psychological therapies and any particular matching effects, if any. Psychological interventions are an essential part of the treatment regimen and efforts should be made to integrate evidence-based interventions in all substance use disorder treatment programs. PMID:24860208

  7. Biometric Face Authentication using Pixel-based Weak Classifiers

    E-print Network

    of pa- rameters that are difficult to store on a smart-card for instance. Re- cently, boosting classifiers based sim- ply on pixel values. The proposed approach is tested on a benchmark database, namely XM-life applications such as access control, transaction authentication (in telephone banking or remote credit card

  8. 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…

  9. 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…

  10. Evidence for the Strangeness-Changing Weak Decay ?_{b}^{-}??_{b}^{0}?^{-}.

    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 ?_{b}^{-}??_{b}^{0}?^{-}. 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_{?_{b}^{-}}/f_{?_{b}^{0}}B(?_{b}^{-}??_{b}^{0}?^{-})=(5.7±1.8_{-0.9}^{+0.8})×10^{-4},where f_{?_{b}^{-}} and f_{?_{b}^{0}} are the b??_{b}^{-} and b??_{b}^{0} fragmentation fractions, and B(?_{b}^{-}??_{b}^{0}?^{-}) is the branching fraction. Assuming f_{?_{b}^{-}}/f_{?_{b}^{0}} is bounded between 0.1 and 0.3, the branching fraction B(?_{b}^{-}??_{b}^{0}?^{-}) would lie in the range from (0.57±0.21)% to (0.19±0.07)%. PMID:26705625

  11. Evidence for a Weak Galactic Center Magnetic Field from Diffuse Low Frequency Nonthermal Radio Emission

    E-print Network

    T. N. LaRosa; C. L. Brogan; S. N. Shore; T. J. Lazio; N. E. Kassim; M. E. Nord

    2005-06-24

    New low-frequency 74 and 330 MHz observations of the Galactic center (GC) region reveal the presence of a large-scale ($6\\arcdeg\\times 2\\arcdeg$) diffuse source of nonthermal synchrotron emission. A minimum energy analysis of this emission yields a total energy of $\\sim (\\phi^{4/7}f^{3/7})\\times 10^{52}$ ergs and a magnetic field strength of $\\sim 6(\\phi/f)^{2/7}$ \\muG (where $\\phi$ is the proton to electron energy ratio and $f$ is the filling factor of the synchrotron emitting gas). The equipartition particle energy density is $1.2(\\phi/f)^{2/7}$ \\evcm, a value consistent with cosmic-ray data. However, the derived magnetic field is several orders of magnitude below the 1 mG field commonly invoked for the GC. With this field the source can be maintained with the SN rate inferred from the GC star formation. Furthermore, a strong magnetic field implies an abnormally low GC cosmic-ray energy density. We conclude that the mean magnetic field in the GC region must be weak, of order 10 \\muG (at least on size scales $\\ga 125\\arcsec$).

  12. Evidence-based ventilator weaning and discontinuation.

    PubMed

    MacIntyre, Neil R

    2004-07-01

    Ventilator management of a patient who is recovering from acute respiratory failure must balance competing objectives. Discontinuing mechanical ventilation and removing the artificial airway as soon as possible reduces the risk of ventilator-induced lung injury, nosocomial pneumonia, airway trauma from the endotracheal tube, and unnecessary sedation, but premature ventilator-discontinuation or extubation can cause ventilatory muscle fatigue, gas exchange failure, and loss of airway protection. In 1999 the McMaster University Outcomes Research Unit conducted a comprehensive evidence-based review of the literature on ventilator-discontinuation. Using that literature review, the American College of Chest Physicians, the Society of Critical Care Medicine, and the American Association for Respiratory Care created evidence-based guidelines, which include the following principles: 1. Frequent assessment is required to determine whether ventilatory support and the artificial airway are still needed. 2. Patients who continue to require support should be continually re-evaluated to assure that all factors contributing to ventilator dependence are addressed. 3. With patients who continue to require support, the support strategy should maximize patient comfort and provide muscle unloading. 4. Patients who require prolonged ventilatory support beyond the intensive care unit should go to specialized facilities that can provide more gradual support reduction strategies. 5. Ventilator-discontinuation and weaning protocols can be effectively carried out by nonphysician clinicians. PMID:15222913

  13. Towards evidence?based medicine for paediatricians

    PubMed Central

    2006-01-01

    To give the best care to patients and families, paediatricians need to integrate the highest?quality scientific evidence with clinical expertise and the opinions of the family.1Archimedes seeks to assist practising clinicians by providing “evidence?based” answers to common questions which are not at the forefront of research but are at the core of practice. In doing this, we are adapting a format that has been successfully developed by Kevin Macaway?Jones and the group at the Emergency Medicine Journal—“BestBets”. A word of warning. The topic summaries are not systematic reviews, although they are as exhaustive as a practising clinician can produce. They make no attempt to statistically aggregate the data, nor search the grey, unpublished literature. What Archimedes offers are practical, best evidence?based answers to practical, clinical questions. The format of Archimedes may be familiar. A description of the clinical setting is followed by a structured clinical question. (These aid in focusing the mind, assisting searching2 and gaining answers.3) A brief report of the search used follows—this has been carried out in a hierarchical way, to search for the best?quality evidence to answer the question (http://www.cebm.net/levels_of_evidence.asp). A table provides a summary of the evidence and key points of the critical appraisal. For further information on critical appraisal and the measures of effect (such as number needed to treat), books by Sackett et al4 and Moyer et al5 may help. To pull the information together, a commentary is provided. But to make it all much more accessible, a box provides the clinical bottom lines. Electronic?only topics that have been published on the BestBets site (www.bestbets.org) and may be of interest to paediatricians include: Are meningeal irritation signs reliable in diagnosing meningitis in children? Is immobilisation effective in Osgood?Schlatter's disease? Do all children presenting to the emergency department with a needlestick injury require PEP for HIV to reduce HIV transmission? Readers wishing to submit their own questions—with best evidence answers—are encouraged to review those already proposed at www.bestbets.org. If your question still has not been answered, feel free to submit your summary according to the Instructions for Authors at www.archdischild.com. Three topics are covered in this issue of the journal. Is lumbar puncture necessary for evaluation of early neonatal sepsis? Does the use of calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection? Is supplementary iron useful when preterm infants are treated with erythropoietin? Is more research needed? “More research is needed” is a phrase you might have read before. But is more research really needed? Two situations are offered to us in Archimedes this month where clinical questions are, as yet, unanswered. Is iron supplementation really necessary for premature infants treated with erythropoietin, and do antihistamines and calamine lotion help in children with chicken pox? How can we decide if these questions really do “need” research? It may be worth thinking of how likely benefits and harms may be, what the importance of these outcomes are and finally, how much would you consider reasonable to pay for the answer? For example, what chance is there that antihistamines work in chickenpox? What is the chance that side effects will occur? What is the relative severity of side effects versus the delight of being itch free? If we pay for research and spend hours and hours of time pressing through the increasing regulatory frameworks for clinical trials to define the answer to this question, what will be the opportunity cost? What would we fail to do by looking at this? The same questions can be asked of iron supplementation in premature infants, the salvage treatment of relapsing systemic histocytosis or the promotion of car?seat use

  14. 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.

  15. 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

  16. 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…

  17. 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…

  18. 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…

  19. 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

  20. Specialized Community-Based Care: An Evidence-Based Analysis

    PubMed Central

    2012-01-01

    Background Specialized community-based care (SCBC) refers to services that manage chronic illness through formalized links between primary and specialized care. Objectives The objectives of this evidence-based analysis (EBA) were as follows: to summarize the literature on SCBC, also known as intermediate care to synthesize the evidence from previous Medical Advisory Secretariat (now Health Quality Ontario) EBAs on SCBC for heart failure, diabetes, chronic obstructive pulmonary disease (COPD), and chronic wounds to examine the role of SCBC in family practice Results Part 1: Systematic Review of Intermediate Care Seven systematic reviews on intermediate care since 2008 were identified. The literature base is complex and difficult to define. There is evidence to suggest that intermediate care is effective in improving outcomes; however, the effective interventions are still uncertain. Part 2: Synthesis of Evidence in Intermediate Care Mortality • Heart failure Significant reduction in patients receiving SCBC • COPD Nonsignificant reduction in patients receiving SCBC Hospitalization • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Emergency Department Visits • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Disease-Specific Patient Outcomes • COPD Nonsignificant improvement in lung function in patients receiving SCBC • Diabetes Significant reduction in hemoglobin A1c (HbA1c) and systolic blood pressure in patients receiving SCBC • Chronic wounds Significant increase in the proportion of healed wounds in patients receiving SCBC Quality of Life • Heart failure Trend toward improvement in patients receiving SCBC • COPD Significant improvement in patients receiving SCBC Part 3: Intermediate Care in Family Practice—Evidence-Based Analysis Five randomized controlled trials were identified comparing SCBC to usual care in family practice. Inclusion criteria were 1) the presence of multiple chronic conditions, and 2) interventions that included 2 or more health care professions. The GRADE quality of the evidence was assessed as low for all outcomes due to the inconsistency and indirectness of the results. Limitations This review did not look at disease-specific studies on intermediate care in family practice. Conclusions Specialized community-based care effectively improves outcomes in patients with heart failure, COPD, and diabetes. The effectiveness of SCBC in family practice is unclear. PMID:23226812

  1. 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…

  2. Evidence-Based Medicine, the Essential Role of Systematic Reviews,

    E-print Network

    Meng, Weiyi

    Storage and Retrieval, Text-Mining, Evidence-Based Medicine. 1. Introduction The practice of Evidence in information processing technologies that have assisted other textual domains. We propose a specific text-miningEvidence-Based Medicine, the Essential Role of Systematic Reviews, and the Need for Automated Text

  3. 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…

  4. Weakly Supervised Automatic Transcription of Mouthings for Gloss-Based Sign Language Corpora

    E-print Network

    Bowden, Richard

    Weakly Supervised Automatic Transcription of Mouthings for Gloss-Based Sign Language Corpora Oscar a method to automatically annotate mouthings in sign language corpora, requiring no more than a simple understanding of sign language is not possible without exploring its remaining parameters. Mouthings provide

  5. Using Standards-Based Grading to Address Students' Strengths and Weaknesses

    ERIC Educational Resources Information Center

    Knaack, Susan; Kreuz, Allie; Zawlocki, Erin

    2012-01-01

    This action research project report uses standard-based grading to address the problem of traditional grades not adequately assessing student content mastery and students' lack of awareness regarding their strengths and weaknesses. Research was conducted by one elementary and two middle school teachers with 158 students between the dates of…

  6. An advanced educational program promoting evidence-based practice.

    PubMed

    Cullen, Laura; Titler, Marita G; Rempel, Grace

    2011-04-01

    Evidence-based practice has led to improved health care quality and safety; greater patient, family, and staff satisfaction; and reduced costs. Despite these promising outcomes, use of evidence-based practice is inconsistent. The purpose of this article is to describe an advanced educational program for nurses in leadership roles responsible for guiding teams and mentoring colleagues through the challenges inherent in the evidence-based practice process. The Advanced Practice Institute: Promoting Adoption of Evidence-Based Practice is an innovative program designed to develop advanced skills essential for completing evidence-based practice projects and building organizational capacity for evidence-based practice programs. Learning is facilitated through group discussion, facilitated work time, networking, and consultation. Content includes finding and synthesizing evidence, learning effective strategies for implementation and evaluation, and discussing techniques for building an EBP program in the nurses' organization. Program evaluations are extremely positive, and the long-term impact is described. PMID:20705775

  7. 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 to systematic, but in general small, corrections to earlier theoretical predictions describing the behavior of weak polyelectrolyte layers. However, polyelectrolyte uncharging results in a decrease in the concentration of counterions and inclusion of the Born Energy can result in a substantial decrease of the counterion concentration. The effect of considering the Born energy contribution is explored for end-grafted weak polyelectrolyte layers by calculating experimental observables which are known to depend on the presence of charges within the polyelectrolyte layer: inclusion of the Born energy contribution leads to a decrease in the capacitance of polyelectrolyte-modified electrodes, a decrease of conductivity of polyelectrolyte-modified nanopores and an increase in the repulsion exerted by a planar polyelectrolyte layer confined by an opposing wall.

  8. 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 to systematic, but in general small, corrections to earlier theoretical predictions describing the behavior of weak polyelectrolyte layers. However, polyelectrolyte uncharging results in a decrease in the concentration of counterions and inclusion of the Born Energy can result in a substantial decrease of the counterion concentration. The effect of considering the Born energy contribution is explored for end-grafted weak polyelectrolyte layers by calculating experimental observables which are known to depend on the presence of charges within the polyelectrolyte layer: inclusion of the Born energy contribution leads to a decrease in the capacitance of polyelectrolyte-modified electrodes, a decrease of conductivity of polyelectrolyte-modified nanopores and an increase in the repulsion exerted by a planar polyelectrolyte layer confined by an opposing wall. PMID:24437914

  9. 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 to systematic, but in general small, corrections to earlier theoretical predictions describing the behavior of weak polyelectrolyte layers. However, polyelectrolyte uncharging results in a decrease in the concentration of counterions and inclusion of the Born Energy can result in a substantial decrease of the counterion concentration. The effect of considering the Born energy contribution is explored for end-grafted weak polyelectrolyte layers by calculating experimental observables which are known to depend on the presence of charges within the polyelectrolyte layer: inclusion of the Born energy contribution leads to a decrease in the capacitance of polyelectrolyte-modified electrodes, a decrease of conductivity of polyelectrolyte-modified nanopores and an increase in the repulsion exerted by a planar polyelectrolyte layer confined by an opposing wall.

  10. 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.

  11. Quantum sensors based on weak-value amplification cannot overcome decoherence

    E-print Network

    George C. Knee; G. Andrew D. Briggs; Simon C. Benjamin; Erik M. Gauger

    2013-01-17

    Sensors that harness exclusively quantum phenomena (such as entanglement) can achieve superior performance compared to those employing only classical principles. Recently, a technique based on postselected, weakly-performed measurements has emerged as a method of overcoming technical noise in the detection and estimation of small interaction parameters, particularly in optical systems. The question of which other types of noise may be combatted remains open. We here analyze whether the effect can overcome decoherence in a typical field sensing scenario. Benchmarking a weak, postselected measurement strategy against a strong, direct strategy we conclude that no advantage is achievable, and that even a small amount of decoherence proves catastrophic to the weak-value amplification technique.

  12. Study of weak vibrating signal detection based on chaotic oscillator in MEMS resonant beam sensor

    NASA Astrophysics Data System (ADS)

    Shi, Huichao; Fan, Shangchun; Xing, Weiwei; Sun, Jinhao

    2015-01-01

    In this paper, the application of weak signal detection based on chaotic oscillator is studied in a MEMS resonant beam sensor. Chaotic oscillator can detect weak signal which is submerged in the background of large noise. According to the frequency and phase characteristic of the output vibrating signal, reference current signal with fixed frequency difference and same phase to the output signal is set. Frequency and phase of the signal are fixed by detection resistor which works as a multiplier. By calculating the maximum Lyapunov exponent, detection threshold is obtained, and motion change of detection system is monitored. The results of numerical simulation and experiment show that this method can effectively detect the weak resonant signal and find the resonant frequency accurately by setting the threshold of the chaotic oscillator, and it is immune to the noise.

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

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  14. 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

  15. [Evidence Based Medicine: shadows and lights].

    PubMed

    Kopitowski, Karin

    2010-01-01

    When taking decisions as regards patient care, based on the evidence (MBE) medicine is the conscious, wise and explicit utilization of the best available tests. The utilization of this strategy involves the recognition of the patches in the knowledge, the realization of a precise research in primary information sources, the analysis of the validity of the discoveries and their utilization in problem solving. The MBE has emerged in a frame of explosion regarding clinical research and access to the information. It has also been a response to the difficulty of keeping up-dated, to the increasing variability in the clinical practice, and to the non-application of measures with checked security and effectiveness. However, it is worrying the fact that a great part of the investigation tests are designed, conducted and analyzed by the pharmaceutical industry. This phenomenon has introduced a worrying distortion because it investigates what it is interesting for the pharmaceutical companies. On the other hand, financial sources mainly achieve results which are favourable to their interests, which are more spread and communicated through different mechanisms. PMID:21218208

  16. 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).

  17. Evidence-Based Elections Philip B. Stark

    E-print Network

    Stark, Philip B.

    Independence = VVPR + Compliance Audit Evidence = Strong Software Independence + Risk-Limiting Audit since? Risk-limiting Audit To pass, need convincing evidence that full hand count would find the same, no matter why. Risk is biggest chance of not correcting a wrong outcome. #12;Risk-Limiting Audits Required

  18. Merging Evidence-Based Psychosocial Interventions in Schizophrenia

    PubMed Central

    Lecomte, Tania; Corbière, Marc; Simard, Stéphanie; Leclerc, Claude

    2014-01-01

    Psychosocial interventions are an essential part of the treatment for people with severe mental illness such as schizophrenia. The criteria regarding what makes an intervention “evidence-based” along with a current list of evidence-based interventions are presented. Although many evidence-based interventions exist, implementation studies reveal that few, if any, are ever implemented in a given setting. Various theories and approaches have been developed to better understand and overcome implementation obstacles. Among these, merging two evidence-based interventions, or offering an evidence-based intervention within an evidence-based service, are increasingly being reported and studied in the literature. Five such merges are presented, along with their empirical support: cognitive behavior therapy (CBT) with skills training; CBT and family psychoeducation; supported employment (SE) and skills training; SE and cognitive remediation; and SE and CBT. PMID:25431447

  19. 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

  20. 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…

  1. 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

  2. Weak bases affect late stages of Mayaro virus replication cycle in vertebrate cells.

    PubMed

    Ferreira, D F; Santo, M P; Rebello, M A; Rebello, M C

    2000-04-01

    This paper describes the effect of two weak bases (ammonium chloride and chloroquine) on the morphogenesis of Mayaro virus. When Mayaro virus-infected TC7 (monkey kidney) cells were treated with these agents it was observed that weak bases caused a significant reduction in virus yield. Also, cellular protein synthesis, which is inhibited by Mayaro virus infection, recovered to nearly normal levels. However, the synthesis of Mayaro virus proteins was affected. These phenomena were dose-dependent. The process of Mayaro virus infection in vertebrate cells is very rapid. Virus precursors are not observed in cell cytoplasm and budding through the plasma membrane seems to be the only way of virus release. Electron microscopy of cells infected with Mayaro virus and treated with weak bases revealed an accumulation of virus structures in cell cytoplasm. The study also noted an inhibition of budding through the plasma membrane and the appearance of virus particles inside intracytoplasmic vacuoles. These observations indicate an impairment at the final stages of the virus replication cycle. PMID:10755624

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Evidence-Based Assessment of Anxiety Disorders in Adults

    ERIC Educational Resources Information Center

    Antony, Martin M.; Rowa, Karen

    2005-01-01

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

  10. Evidence-Based Practice in Education. Conducting Educational Research

    ERIC Educational Resources Information Center

    Pring, Richard; Thomas, Gary

    2004-01-01

    The book begins with an explication of evidence-based practice. Some of the ideas of its proponents are discussed, including the Campbell Collaboration, and the application to education of Cochrane-style reviews and meta-analyses. The thinking behind evidence-based practice has been the subject of much criticism, particularly in education, and…

  11. 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…

  12. 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…

  13. Predicting the precipitation of poorly soluble weak bases upon entry in the small intestine.

    PubMed

    Kostewicz, Edmund S; Wunderlich, Martin; Brauns, Ulrich; Becker, Robert; Bock, Thomas; Dressman, Jennifer B

    2004-01-01

    Solubility and dissolution relationships in the gastrointestinal tract can be critical for the oral bioavailability of poorly soluble drugs. In the case of poorly soluble weak bases, the possibility of drug precipitation upon entry into the small intestine may also affect the amount of drug available for uptake through the intestinal mucosa. To simulate the transfer out of the stomach into the intestine, a transfer model was devised, in which a solution of the drug in simulated gastric fluid is continuously pumped into a simulated intestinal fluid, and drug precipitation in the acceptor medium is examined via concentration-time measurements. The in-vitro precipitation of three poorly soluble weakly basic drugs, dipyridamole, BIBU 104 XX and BIMT 17 BS, was investigated. For all three, extensive supersaturation was achieved in the acceptor medium. Under simulated fasted-state conditions, precipitation occurred for all three compounds whereas under simulated fed-state conditions, the higher concentrations of bile components and the lower pH value in the acceptor medium inhibited precipitation at concentrations corresponding to usual doses in all cases. Comparison with pharmacokinetic data indicated that a combination of transfer model data with solubility and dissolution profiles should lead to better predictions of in-vivo behaviour of poorly soluble weak bases. PMID:14980000

  14. 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…

  15. Evidence-Based Elections Philip B. Stark

    E-print Network

    Stark, Philip B.

    audit to ensure the integrity of those records. Risk-limiting audit of the records to verify generated, and curated adequately since? Risk-limiting Audit To pass, need convincing evidence that full Certification vs Risk-Limiting Audits Question 1 In the lab, can the vote-tabulation system--as delivered from

  16. Implementing Evidence-Based Practice to Reduce Infections Following Arthroplasty.

    PubMed

    Mori, Candy

    2015-01-01

    Surgical site infections can have a devastating effect on a patient's morbidity impacting their quality of life and productivity in society. Financial burdens are placed on healthcare organizations because of surgical site infections as well. Evidence has shown that it is a worthwhile endeavor to implement a practice to screen and treat patients who are nasal carriers of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus. Implementing evidence-based practices to combat surgical site infections can help ensure quality healthcare, while producing best possible patient outcomes; however, getting evidence to the bedside can be a challenge. The Johns Hopkins nursing evidence-based practice model is designed to help nurses translate evidence into practice. This article describes the steps one community hospital took to implement an evidence-based practice using the Johns Hopkins model to decrease the likelihood of methicillin-resistant Staphylococcus aureus surgical site infections in patients undergoing total knee arthroplasty and total hip arthroplasty. PMID:26213870

  17. Archie Cochrane and his vision for evidence-based medicine

    PubMed Central

    Shah, Hriday M.; Chung, Kevin C.

    2009-01-01

    Archibald (Archie) Cochrane's most influential mark on healthcare was his 1971 publication, “Effectiveness and Efficiency.” This book strongly criticized the lack of reliable evidence behind many of the commonly accepted healthcare interventions at the time. His criticisms spurred rigorous evaluations of healthcare interventions and highlighted the need for evidence in medicine. His call for a collection of systematic reviews led to the creation of The Cochrane Collaboration. Archie Cochrane was a visionary person who helped lay down much of the foundation for evidence-based medicine. This paper will introduce evidence-based medicine to Plastic Surgery by tracing its history to the seminal efforts by Archie Cochrane. PMID:19730323

  18. 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

  19. 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

  20. 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

  1. Discrimination of enantiomers based on LSPR biosensors fabricated with weak enantioselective and nonselective receptors.

    PubMed

    Guo, Longhua; Wang, Daifang; Xu, Yang; Qiu, Bin; Lin, Zhenyu; Dai, Hong; Yang, Huang-Hao; Chen, Guonan

    2013-09-15

    Chiral recognition based on enantioselective sensors is superior to conventional chromatographic enantioseparation techniques in terms of simplicity and rapidity. Normally, highly specific enantioselective receptors are used for the fabrication of enantioselective sensors. However, to date there only limited number of highly specific chiral selectors are reported, which greatly confines the development of enantioselective sensors. Herein, we demonstrate the feasibility of using relatively weak chiral selectors to construct an enantioselective biosensor for accurate chiral discrimination of enantiomers. The detection of racemic mixture of (R)- and (S)-1,2,3,4-Tetrahydro-1-naphthylamine (TNA) was demonstrated as an example. The sensor was made up of a dual-channel microfluidic chip. One channel of the chip was modified with human serum albumin (HSA), which was reported to be a weak chiral selector for TNA; while the other channel was modified with a monoclonal anti-TNA antibody, which was a non-enantioselective TNA receptor. A portable localized surface plasmon resonance (LSPR) detection system was integrated with the microfluidic chip to accomplish the signal collection. Our investigation revealed that the combination of LSPR responses obtained from the two channels can be used for quantitative discrimination of the (R)- and (S)-TNA. The limit of detection was found to be 150nM for (R)-TNA and 100nM for (S)-TNA. The feasibility of use relatively weak chiral selectors could potentially promote the development of various enantioselective sensors. PMID:23578974

  2. 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.

  3. 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

  4. 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.

  5. 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

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

    PubMed

    Aravamudhan, K; Frantsve-Hawley, Julie

    2009-09-01

    Time and access have often been cited as barriers to implementing Evidence-Based Dentistry (EBD). This paper describes a new web-based resource launched by the American Dental Association to enable practitioners to incorporate evidence into treatment planning. The website offers a database of systematic reviews, critical summaries of systematic reviews, evidence-based clinical recommendations and links to external resources to enable practitioners to access evidence at the point of care. In addition the site offers an online space for clinicians to suggest clinical scenarios where evidence is lacking. This could potentially be a source of topics to drive future research. With the explosion in the use of information technology within a dental office, this web-site will serve as the one-stop resource for credible scientific information for practitioners. PMID:19737668

  7. Implementing Evidence-Based Practices for People With Schizophrenia

    PubMed Central

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

    2009-01-01

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

  8. 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.

  9. Basing Cryptographic Protocols on TamperEvident Seals #

    E-print Network

    Naor, Moni

    Basing Cryptographic Protocols on Tamper­Evident Seals # Tal Moran and Moni Naor ## Department. In this paper we attempt to formally study two very intu­ itive physical models: sealed envelopes and locked are called ``tamper­evident seals''. Another physical object with this property is the ``scratch­o# card

  10. 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…

  11. Toward Evidence-Based End-of-Life Care.

    PubMed

    Halpern, Scott D

    2015-11-19

    No current policy or practice designed to improve care for dying Americans is backed by a fraction of the evidence that the FDA would require to approve even a relatively innocuous drug. Achieving evidence-based end-of-life care will require several key developments. PMID:26465826

  12. 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…

  13. 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

  14. 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.

  15. [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

  16. 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

  17. 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.

  18. Rotator cuff tears: An evidence based approach.

    PubMed

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

    2015-12-18

    Lesions of the rotator cuff (RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an age-dependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears (PTT) can be bursal-sided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears (FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations - cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, anti-inflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being cost-effective, this helps in providing a functional shoulder with a stable cuff. An easily reproducible technique of maximal strength and 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. Rotator cuff tears: An evidence based approach

    PubMed Central

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

    2015-01-01

    Lesions of the rotator cuff (RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an age-dependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears (PTT) can be bursal-sided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears (FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations - cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, anti-inflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being cost-effective, this helps in providing a functional shoulder with a stable cuff. An easily reproducible technique of maximal strength and 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

  20. Traits-based approaches in bioassessment and ecological risk assessment: strengths, weaknesses, opportunities and threats.

    PubMed

    Van den Brink, Paul J; Alexander, Alexa C; Desrosiers, Mélanie; Goedkoop, Willem; Goethals, Peter L M; Liess, Matthias; Dyer, Scott D

    2011-04-01

    We discuss the application of traits-based bioassessment approaches in retrospective bioassessment as well as in prospective ecological risk assessments in regulatory frameworks. Both approaches address the interaction between species and stressors and their consequences at different levels of biological organization, but the fact that a specific species may be less abundant in a potentially impacted site compared with a reference site is, regrettably, insufficient to provide diagnostic information. Species traits may, however, overcome the problems associated with taxonomy-based bioassessment. Trait-based approaches could provide signals regarding what environmental factors may be responsible for the impairment and, thereby, provide causal insight into the interaction between species and stressors. For development of traits-based (TBA), traits should correspond to specific types of stressors or suites of stressors. In this paper, a strengths, weaknesses, opportunities, and threats (SWOT) analysis of TBA in both applications was used to identify challenges and potentials. This paper is part of a series describing the output of the TERA (Traits-based ecological risk assessment: Realising the potential of ecoinformatics approaches in ecotoxicology) Workshop held between 7 and 11 September, 2009, in Burlington, Ontario, Canada. The recognized strengths were that traits are transferrable across geographies, add mechanistic and diagnostic knowledge, require no new sampling methodology, have an old tradition, and can supplement taxonomic analysis. Weaknesses include autocorrelation, redundancy, and inability to protect biodiversity directly. Automated image analysis, combined with genetic and biotechnology tools and improved data analysis to solve autocorrelation problems were identified as opportunities, whereas low availability of trait data, their transferability, their quantitative interpretation, the risk of developing nonrelevant traits, low quality of historic databases, and their standardization were listed as threats. PMID:20981837

  1. Organizational change strategies for evidence-based practice.

    PubMed

    Newhouse, Robin P; Dearholt, Sandi; Poe, Stephanie; Pugh, Linda C; White, Kathleen M

    2007-12-01

    Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university. PMID:18090518

  2. 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.

  3. Ab initio molecular dynamics study of the mechanism of proton recombination with a weak base.

    PubMed

    Cuny, Jérôme; Hassanali, Ali A

    2014-12-01

    Despite its fundamental nature, many of the microscopic features of acid–base recombination remain poorly understood. In this work, we use ab initio molecular dynamics simulations to study the recombination of the proton with a weak base, the carbonate ion CO3(2–). Our simulations elucidate the network structure around CO3(2–) that provides a distribution of pathways over which recombination can occur. We observe that the penultimate neutralization step involves a correlated behavior of the transferred protons that is mediated by the water wires decorating the carbonate. These concerted proton transfers are coupled to collective compressions of these water wires. We show further that these processes are dynamically coupled to the reorganization of the water molecules hydrating the CO3(2–) ion. The insights from these simulations help to bridge the structural and dynamical complexity of the microscopic mechanisms with those of phenomenological models invoked by experiments in this field. PMID:25415885

  4. Towards a spectrum-based bar code for identification of weakly fluorescent microparticles

    NASA Astrophysics Data System (ADS)

    Petrášek, Zden?k; Wiedemann, Jens; Schwille, Petra

    2014-03-01

    Spectrally resolved detection of fluorescent probes can be used to identify multiple labeled target molecules in an unknown mixture. We study how the spectral shape, the experimental noise, and the number of spectral detection channels affect the success of identification of weakly fluorescent beads on basis of their emission spectra. The proposed formalism allows to estimate the performance of the spectral identification procedure with a given set of spectral codes on the basis of the reference spectra only. We constructed a simple prism-based setup for spectral detection and demonstrate that seven distinct but overlapping spectral codes realized by combining up to three fluorescent dyes bound to a single bead in a barcode-based manner can be reliably identified. The procedure allows correct identification even in the presence of known autofluorescence background stronger than the actual signal.

  5. Assessment of tailor-made HPMC-based matrix minitablets comprising a weakly basic drug compound.

    PubMed

    Siepe, Stefanie; Lueckel, Barbara; Kramer, Andrea; Ries, Angelika; Gurny, Robert

    2008-01-01

    Tailor-made, pH-controlled matrix minitablets based on different HPMC types were developed comprising the weakly basic drug dipyridamole. The incorporation of pH modifiers, i.e., fumaric and succinic acid, enhanced the drug release at pH 6.8. Assessing the drug release, acid release, and the microenvironmental pH (pHM) provided detailed understanding of pH-controlled mini-matrices. The extent and duration of pHM alteration was more pronounced in presence of fumaric acid. Minitablets based on the fast dissolving Methocel K100LV (< or = 100 cps) showed simultaneous release rates of dipyridamole and fumaric acid with a constant low average pHM. PMID:18214754

  6. 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…

  7. 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.

  8. Evidence-based pharmacotherapy of eating disorders.

    PubMed

    Flament, Martine F; Bissada, Hany; Spettigue, Wendy

    2012-03-01

    The objective was to review scientific evidence for efficacy and safety of pharmacotherapy in adults or children with an eating disorder (ED). We conducted a computer search for all randomized controlled trials (RCTs) published between 1960 and May 2010 for treatment of anorexia nervosa (AN), bulimia nervosa (BN) or binge-eating disorder (BED). For drugs for which no RCT was found, open trials or case reports were retrieved. Clinically relevant RCTs in the treatment of AN have used atypical antipsychotics, selective serotonin reuptake inhibitors (SSRIs), and zinc supplementation. Olanzapine demonstrated an adjunctive effect for in-patient treatment of underweight AN patients, and fluoxetine helped prevent relapse in weight-restored AN patients in 1/2 studies. For treatment of BN, controlled studies have used SSRIs, other antidepressants, and mood stabilizers. In 9/11 studies, pharmacotherapy yielded a statistically significant although moderate reduction in binge/purge frequency, and some additional benefits. For BED, RCTs have been conducted using SSRIs and one serotonin norepinephrine reuptake inhibitor (SNRI), mood stabilizers, and anti-obesity medications. In 11/12 studies, there was a statistically significant albeit limited effect of medication. Meta-analyses on efficacy of pharmacotherapy for BN and BED support moderate effect sizes for medication, but generally low recovery rates. Treatment resistance is an inherent feature of AN, where treatment should focus on renourishment plus psychotherapy. For BN and BED, combined treatment with pharmacotherapy and cognitive behaviour therapy has been more effective than either alone. Data on the long-term efficacy of pharmacotherapy for EDs are scarce. Short- and long-term pharmacotherapy of EDs still remains a challenge for the clinician. PMID:21414249

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

    PubMed

    Crowther, Helen; Lipworth, Wendy; Kerridge, Ian

    2011-10-01

    Evidence-based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine. PMID:21815969

  10. 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.; Gago?, M.; Kornarzy?ski, 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.

  11. Core structure re-examined using new teleseismic data recorded in Antarctica: evidence for, at most, weak cylindrical seismic anisotropy in the inner core

    NASA Astrophysics Data System (ADS)

    Leykam, Daniel; Tkal?i?, Hrvoje; Reading, Anya M.

    2010-03-01

    We present a significant addition to the data set of traveltimes of seismic PKP waves that sample the Earth's lowermost mantle and core along the Earth's rotation axis. Recorded at permanent Global Seismic Network (GSN) and temporary SSCUA deployment broad-band seismographic stations in Antarctica, the new data improve the previously poor and biased coverage that underlies the seismic constraints on recent models of inner core structure and anisotropy. On the one hand, new differential PKP traveltime measurements improve the sampling of predominantly the eastern inner core hemisphere. PKPab-df and PKPbc-df differential traveltime residuals, with respect to the spherically symmetric model ak135, are consistently smaller than two seconds along the north-south paths sampled. Axially symmetric models of inner core seismic anisotropy with fast axis parallel to the Earth's rotation axis require a weak anisotropy of (0.7 +/- 0.1) per cent to be consistent with our PKPbc-df observations. PKPbc-df residuals from the quasi-eastern hemisphere indicate (0.4 +/- 0.1) per cent anisotropy. If only PKPbc-df observations from the top 200 km of this hemisphere are considered, this is reduced to (0.1 +/- 0.2) per cent, consistent with an isotropic layer. On the other hand, new absolute PKP traveltime measurements add to the sampling of both hemispheres of the inner core, but it is difficult to use them with more confidence to assess structure of the core since they are affected by crustal and mantle structure and source uncertainties. The newly collected data set also increases constraints on D" structure beneath the South Pole. In contrast to previous inferences based on data from northern stations, we find no evidence of a velocity heterogeneity in the outer core near the inner core boundary associated with the cylinder tangent to the inner core in the southern hemisphere.

  12. 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

  13. Evidence-Based Cardiology in Hemodialysis Patients

    PubMed Central

    2013-01-01

    Cardiac events are the major cause of death in hemodialysis patients. Because of the paucity of randomized clinical trials (RCTs) in hemodialysis patients, most cardiovascular therapies in this population are based on observational studies or results extrapolated from studies that excluded hemodialysis patients. However, associations discovered in observational studies do not prove causality, and these studies often report surrogate outcomes rather than clinical end points. Furthermore, interventions that show effectiveness in the general population may have drastically different outcomes and side effect profiles in hemodialysis patients. This review discusses the results of RCTs undertaken recently to evaluate cardiovascular therapies in hemodialysis patients and emphasizes clinically relevant outcomes. Although some interventions have produced similar outcomes in hemodialysis patients and the general population, others have not, suggesting that the management of cardiovascular disease in hemodialysis patients may require strategies that differ from the best practice guidelines applied to general population. PMID:24136920

  14. Evidence-based dentistry: a model for clinical practice.

    PubMed

    Faggion, Clóvis M; Tu, Yu-Kang

    2007-06-01

    Making decisions in dentistry should be based on the best evidence available. The objective of this study was to demonstrate a practical procedure and model that clinicians can use to apply the results of well-conducted studies to patient care by critically appraising the evidence with checklists and letter grade scales. To demonstrate application of this model for critically appraising the quality of research evidence, a hypothetical case involving an adult male with chronic periodontitis is used as an example. To determine the best clinical approach for this patient, a four-step, evidence-based model is demonstrated, consisting of the following: definition of a research question using the PICO format, search and selection of relevant literature, critical appraisal of identified research reports using checklists, and the application of evidence. In this model, the quality of research evidence was assessed quantitatively based on different levels of quality that are assigned letter grades of A, B, and C by evaluating the studies against the QUOROM (Quality of Reporting Meta-Analyses) and CONSORT (Consolidated Standards of Reporting Trials) checklists in a tabular format. For this hypothetical periodontics case, application of the model identified the best available evidence for clinical decision making, i.e., one randomized controlled trial and one systematic review of randomized controlled trials. Both studies showed similar answers for the research question. The use of a letter grade scale allowed an objective analysis of the quality of evidence. A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists' decision making skill. PMID:17554100

  15. 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.

  16. 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

  17. Rejection Properties of Stochastic-Resonance-Based Detectors of Weak Harmonic Signals

    E-print Network

    R. P. Croce; Th. Demma; V. Galdi; V. Pierro; I. M. Pinto; F. Postiglione

    2004-06-16

    In (V. Galdi et al., Phys. Rev. E57, 6470, 1998) a thorough characterization in terms of receiver operating characteristics (ROCs) of stochastic-resonance (SR) detectors of weak harmonic signals of known frequency in additive gaussian noise was given. It was shown that strobed sign-counting based strategies can be used to achieve a nice trade-off between performance and cost, by comparison with non-coherent correlators. Here we discuss the more realistic case where besides the sought signal (whose frequency is assumed known) further unwanted spectrally nearby signals with comparable amplitude are present. Rejection properties are discussed in terms of suitably defined false-alarm and false-dismissal probabilities for various values of interfering signal(s) strength and spectral separation.

  18. 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…

  19. 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…

  20. 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

  1. Evidence-based history taking under “time constraint”

    PubMed Central

    Moayyeri, Alireza; Soltani, Akbar; Moosapour, Hamideh; Raza, Mohsin

    2011-01-01

    Physicians all through the world visit patients under time limitations. The most important troubled clinical skill under “time constraint” is the diagnostic approach. In this situation, clinicians need some diagnostic approaches to reduce both diagnostic time and errors. It seems that highly experienced physicians utilize some special tactics in this regard. Evidence-based medicine (EBM) as a relatively new paradigm for clinical practice stresses on using research evidences in diagnostic evaluations. The authors aimed to evaluate experts’ strategies and assess what EBM can add to these tactics. They reviewed diagnostic strategies of some veteran internists in their busy outpatient clinics and proposed an evidence-based diagnostic model engaging clinical experience and research evidence. It appears that every clinician utilizes a set of “key pointer” questions for decision-making. In addition to use of evidence-based resources for making differential diagnosis and estimating utility of various diseases, clinicians should use “key pointers” with significant likelihood ratios and from independent systems to reduce time and errors of history taking. Clinical trainees can improve their practice by constructing their own set of pointers from valid research evidences. Using this diagnostic model, EBM can help physicians to struggle against their “time constraint”. PMID:22091274

  2. 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

  3. The weak helps the strong: sigma-holes and the stability of MF(4)·base complexes.

    PubMed

    Donald, Kelling J; Tawfik, Marina

    2013-12-27

    Bonding interactions between an electron-deficient region (a sigma-hole) on M and electron donors in MF4-Base complexes, where M = C, Si, Ge, Sn, and Pb, are examined and rationalized. These interactions are seen to transition from weak primarily noncovalent interactions for all bases when M = C to stronger primarily covalent bonds in adducts as the valence shell expands for the heavier M atoms. For M = Ge, Sn, and Pb, the complexes are particularly stable. The consistent axial preference in these systems is anticipated by previous studies and is readily explained from the vantage point of sigma-hole interactions. A series of bound complexes of common bases such as pyridine, tetrahydrofuran, and water are identified, some of which are even more stable than the SiF4·NH3 and SiF4·N(CH3)3 complexes that have already been identified experimentally. Sigma-hole bonding to di- and poly-substituted central atoms, perhaps on par with halogen bonding, is expected to become increasingly important as an ordering interaction in materials science and engineering. Group 14 compounds have distinct advantages in this respect. PMID:24147896

  4. Creating the evidence base for quality improvement collaboratives.

    PubMed

    Mittman, Brian S

    2004-06-01

    Intensive efforts are under way to improve health care quality and safety throughout the United States and abroad. Many of these efforts use the quality improvement collaborative method, an approach emphasizing collaborative learning and exchange of insights and support among a set of health care organizations. Unfortunately, the widespread acceptance and reliance on this approach are based not on solid evidence but on shared beliefs and anecdotal affirmations that may overstate the actual effectiveness of the method. More effective use of the collaborative method will require a commitment by users, researchers, and other stakeholders to rigorous, objective evaluation and the creation of a valid, useful knowledge and evidence base. Development of this evidence base will require improved conceptions of the nature of quality problems, quality improvement processes, and the types of research needed to elucidate these processes. Researchers, journal editors, and funding agencies must also cooperate to ensure that published evaluations are relevant, comprehensive, and cumulative. PMID:15172904

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

    PubMed

    Patwardhan, Bhushan

    2014-01-01

    This article reviews contemporary approaches for bridging Ayurveda with evidence-based medicine. In doing so, the author presents a pragmatic assessment of quality, methodology and extent of scientific research in Ayurvedic medicine. The article discusses the meaning of evidence and indicates the need to adopt epistemologically sensitive methods and rigorous experimentation using modern science. The author critically analyzes the status of Ayurvedic medicine based on personal observations, peer interactions and published research. This review article concludes that traditional knowledge systems like Ayurveda and modern scientific evidence-based medicine should be integrated. The author advocates that Ayurvedic researchers should develop strategic collaborations with innovative initiatives like 'Horizon 2020' involving predictive, preventive and personalized medicine (PPPM). PMID:25395997

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

    PubMed

    Kuijpers-Jagtman, A M

    2003-01-01

    Clinical performance can be kept up to date by learning how to practice evidence-based orthodontics, by seeking and appraising evidence-based summaries from the literature and by applying evidence-based strategies to change clinical behaviour. A MEDLINE search over the period 1990-2000 identified 8345 publications on clinical orthodontic subjects. Of these articles 49.5% was published in five specific orthodontic journals, while the others were published in about seventy other journals making it difficult for the clinician to stay current easily. Systematic reviews are an efficient and reliable source of information, but due to a lack of well-designed randomised clinical trials systematic reviews in orthodontics are still rare. PMID:15004985

  7. Practice parameter: laryngeal electromyography (an evidence-based review).

    PubMed

    Sataloff, Robert T; Mandel, Steven; Mann, Eric A; Ludlow, Christy L

    2004-06-01

    This paper reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders, including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performed a systematic review of the medical literature from 1944 through 2001 on the clinical application of EMG to laryngeal disorders. Thirty-three of the 584 articles met the predefined inclusion criteria. The evidence demonstrated that in a double-blind treatment trial of botulinum toxin versus saline, laryngeal EMG used to guide injections into the thyroarytenoid muscle in persons with adductor spasmodic dysphonia was beneficial. A cross-over comparison between laryngeal EMG-guided injection and endoscopic injection of botulinum toxin into the posterior cricoarytenoid muscle in abductor spasmodic dysphonia found no significant difference between the two techniques and no significant treatment benefit. Based on the evidence, laryngeal EMG is possibly useful for the injection of botulinum toxin into the thyroarytenoid muscle in the treatment of adductor spasmodic dysphonia. There were no evidence-based data sufficient to support or refute the value of laryngeal EMG for the other uses investigated, although there is extensive anecdotal literature suggesting that it is useful for each of them. There is an urgent need for evidence-based research addressing other applications in the use of laryngeal EMG for other applications. PMID:15193662

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

    PubMed

    Cobban, Sandra J

    2004-11-01

    The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research-practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice. PMID:16451489

  9. 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…

  10. 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…

  11. 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,…

  12. 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.

  13. Evidence-based gene predictions in plant genomes

    PubMed Central

    Liang, Chengzhi; Mao, Long; Ware, Doreen; Stein, Lincoln

    2009-01-01

    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 transcriptional evidence—known proteins, full-length cDNAs, or expressed sequence tags (ESTs)—in the species of interest. This limitation is of particular concern for plant genomes, where the rate of genome sequencing is greatly outpacing the rate of EST- and cDNA-sequencing projects. To overcome this limitation, we have developed an evidence-based gene build system (the Gramene pipeline) that can use transcriptional evidence across related species. The Gramene pipeline uses the Ensembl computing infrastructure with a novel data processing scheme. Using the previously annotated plant genomes, the dicot Arabidopsis thaliana and the monocot Oryza sativa, we show that the cross-species ESTs from within monocot or dicot class are a valuable source of evidence for gene predictions. We also find that, using only EST and cross-species evidence, the Gramene pipeline can generate a plant gene set that is comparable in quality to the human genes based on known proteins and full-length cDNAs. We compare the Gramene pipeline to several widely used ab initio gene prediction programs in rice; this comparison shows the pipeline performs favorably at both the gene and exon levels with cross-species gene products only. We discuss the results of testing the pipeline on a 22-Mb region of the newly sequenced maize genome and discuss potential application of the pipeline to other genomes. PMID:19541913

  14. 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

  15. 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

  16. Evidence integration in model-based tree search.

    PubMed

    Solway, Alec; Botvinick, Matthew M

    2015-09-15

    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

  17. Voltage Stability and Frequency Synchronization of Weak Power Distribution Networks with Inverter-Based

    E-print Network

    Lemmon, Michael

    between a bus' short-circuit power and its coupled generator's power rating. As a consequence this perspective, a network weakness parameter called short-circuit ra- tio (SCR) is defined in [18], as the ratioVoltage Stability and Frequency Synchronization of Weak Power Distribution Networks with Inverter

  18. 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

  19. 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

  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. An Evidence-Based Protocol for Protecting Newborns From Pertussis.

    PubMed

    Stinson, Cynthia F; Hooper, Gwendolyn; Oliver, JoAnn S

    2015-10-01

    Pertussis, also known as whooping cough, is a vaccine-preventable disease most commonly affecting infants and young children. This article describes a project to develop an evidence-based protocol for implementing prenatal vaccination and cocooning in a major medical center in Georgia. PMID:26460912

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. Evidence-Based Practice for Conduct Disorder Symptoms

    ERIC Educational Resources Information Center

    Thomas, Christopher R.

    2006-01-01

    Patients exhibiting symptoms associated with conduct disorder present challenges in assessment and treatment. The difficulties are not only the complexities of correct identification and appropriate intervention, but also that the knowledge is rapidly growing. Evidence-based practice (EBP) provides a useful framework for dealing with these issues.…

  7. 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.…

  8. 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…

  9. 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…

  10. 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…

  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. 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. 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…

  14. 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…

  15. 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

  16. Expanding Minds: A Commitment to Research-Based Evidence

    ERIC Educational Resources Information Center

    All Kinds of Minds, 2005

    2005-01-01

    In 2004, the Research, Program Evaluation and Information Department of "All Kinds of Minds" guided a research initiative designed to advance evidence-based scholarship about the impact of the Schools Attuned[R] Program to demonstrate the impact of Schools Attuned[R] on student outcomes; on special education; and on teacher knowledge and…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  18. Translational Medicine/ Evidence Based Practice Translational Medicine 2

    E-print Network

    Finley Jr., Russell L.

    Translational Medicine/ Evidence Based Practice Years I-IV 2014-2015 Year II Translational Medicine 2 Year 2 students practice the Translational Medicine skills learned in first year in small group journal discussions with clinical research faculty. Objectives of Translational Medicine 2: · Assess

  19. 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…

  20. 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

  1. 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…

  2. 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,…

  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. Integrating Evidence-Based Practices in Middle Science Reading

    ERIC Educational Resources Information Center

    Kroeger, Stephen D.; Burton, Cathy; Preston, Christopher

    2009-01-01

    The purpose of this study was to examine the effectiveness of an evidence-based practice that addresses the learning needs of middle school students who have difficulty comprehending science texts. The teachers used a single-subject reversal design to implement peer-mediated instruction while asking to what degree the use of peer-mediated…

  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. 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

  7. 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.

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

    PubMed

    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

  9. 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

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

    PubMed

    Sato, Takeshi; Nakai, Hiromi

    2009-12-14

    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. PMID:20001021

  12. Improving sublingual delivery of weak base compounds using pH(max) concept: application to propranolol.

    PubMed

    Wang, Yanfeng; Zuo, Zhong; Chen, Xiao; Tomlinson, Brian; Chow, Moses S S

    2010-02-19

    The purpose of the present work was to provide theoretical and experimental support in generating an optimal pH (pH(max)) for a representative weak base compound (propranolol), that can lead to enhanced sublingual absorption. Initially equations for pH-solubility and pH-permeability profiles were derived and compared to the profiles obtained experimentally. Excellent correlation (R(2)=0.999) of solubility profiles was obtained using non-linear regression, and the permeability profiles further predicted that at certain pH (pH(max)), optimal mucosal permeation could be achieved. Subsequently, in a pharmacokinetics study, a buffered sublingual propranolol tablet, designed to achieve its pH(max) (when dissolved in saliva), were compared to that from a marketed product (Inderal) which could not achieve pH(max)) in 8 healthy subjects. Each subject received the products sublingually for 15 min followed by swallowing the remaining drug-saliva. The plasma propranolol concentrations of AUC during first 30 min from the buffered tablet were significantly higher than that from the Inderal tablet (p<0.05), and no significant differences in the remaining AUC were observed. These in vitro and in vivo results on propranolol provided experimental confirmation of the pH(max) concept as well as its utility in sublingual drug delivery. Such an approach may be applicable to other similar compounds to improve sublingual drug delivery. PMID:20060467

  13. 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.

  14. Cross-correlation measurement techniques for cavity-based axion and weakly interacting slim particle searches

    E-print Network

    Stephen R. Parker; Ben McAllister; Eugene N. Ivanov; Michael E. Tobar

    2015-10-20

    Weakly Interacting Slim Particles (WISPs), such as axions, are highly motivated dark matter candidates. The most sensitive experimental searches for these particles exploit WISP-to-photon conversion mechanisms and use resonant cavity structures to enhance the resulting power signal. For WISPs to constitute Cold Dark Matter their required masses correspond to photons in the microwave spectrum. As such, searches for these types of WISPs are primarily limited by the thermal cavity noise and the broadband first-stage amplifier noise. In this work we propose and then verify two cross-correlation measurement techniques for cavity-based WISP searches. These are two channel measurement schemes where the cross-spectrum is computed, rejecting uncorrelated noise sources while still retaining correlated signals such as those generated by WISPs. The first technique allows for the cavity thermal spectrum to be observed with an enhanced resolution. The second technique cross-correlates two individual cavity/amplifier systems that can be spatially well-separated, thereby opening up opportunities for characterizing candidate dark matter WISP signals.

  15. 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

  16. [Evidence-based practice: Part 2: Steps in the process].

    PubMed

    Goulet, Céline; Lampron, Annie; Morin, Diane; Héon, Marjolaine

    2004-03-01

    Evidence-based (EBP) aims for a new distribution of power centered on scientific evidence rather than clinical expertise. The present article describes the operational process of EBP by describing the implementation stages of this type of practise. This stage presentation is essential given that there are many conceptions end models of EBP and that some nurses have a limited knowledge of its rules ans implications. Given that number and formulation of the stages varies by author, the process presented here attempts to integrate the different stages reviewed. PMID:15085565

  17. Improving Search for Evidence-based Practice using Information Extraction

    PubMed Central

    Zhao, Jin; Kan, Min-Yen; Procter, Paula M.; Zubaidah, Siti; Yip, Wai Kin; Li, Goh Mien

    2010-01-01

    The search for applicable and valid research evidence-based practice articles is not supported well in common EBP resources, as some crucial study data, such as patient details, study design and results, are not available or presented explicitly. We propose to extract these data from research articles using a two-step supervised soft classification method. Compared to manual annotation, our approach is less labor-intensive and more flexible, hence opening up the possibility of utilizing these data to facilitate the evidence selection process in information seeking support systems. PMID:21347116

  18. 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

  19. 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

  20. [Synopsis on clinical practice guideline of 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

    2014-02-01

    Although, gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to that of Western countries. However, there is no Korean multidisciplinary guideline for gastric cancer and thus, a guideline adequate for domestic circumstances is required. Experts from related societies developed 22 recommendation statements for the diagnosis (n=9) and treatment (n=13) based on relevant key questions. Evidence levels based on systematic review of literatures were classified as five levels from A to E, and recommendation grades were classified as either strong or weak. The topics of this guideline cover diagnostic modalities (endoscopy, endoscopic ultrasound, radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, radiotherapy) and pathologic evaluation. External review of the guideline was conducted at the finalization phase. PMID:24561693

  1. 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

  2. Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology. WCER Working Paper No. 2003-13

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.; Shernoff, Elisa Steele

    2003-01-01

    The Evidence-Based Intervention (EBI) movement has gained tremendous momentum in the past few years with developments in psychology, medicine (e.g., psychiatry), education, and prevention science. The purpose of this paper is to present some of the issues relating to the adoption of EBIs in practice and, specifically, the multiple roles…

  3. Evidence-Based Behavioral Interventions for Repetitive Behaviors in Autism

    PubMed Central

    McDonough, Stephen G.; Bodfish, James W.

    2013-01-01

    Restricted and repetitive behaviors (RRBs) are a core symptom of autism spectrum disorders (ASD). There has been an increased research emphasis on repetitive behaviors; however, this research primarily has focused on phenomenology and mechanisms. Thus, the knowledge base on interventions is lagging behind other areas of research. The literature suggests there are evidence-based practices to treat “lower order” RRBs in ASD (e.g., stereotypies); yet, there is a lack of a focused program of intervention research for “higher order” behaviors (e.g., insistence on sameness). This paper will (a) discuss barriers to intervention development for RRBs; (b) review evidence-based interventions to treat RRBs in ASD, with a focus on higher order behaviors; and (c) conclude with recommendations for practice and research. PMID:21584849

  4. 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

  5. Evidence based medicine and extradigestive manifestations of Helicobacter pylori.

    PubMed

    De Koster, E; De Bruyne, I; Langlet, P; Deltenre, M

    2000-01-01

    A putative pathogenetic role has been ascribed to Helicobacter pylori in several extradigestive diseases, including vascular (atherosclerosis and ischaemic heart disease, primary Raynaud phenomenon, primary headache), autoimmune (Sjögren's syndrome, Henoch-Schönlein purpura, autoimmune thyroiditis, idiopathic arrythmias, Parkinson's disease, nonarterial anterior optic ischemic neuropathy), and skin diseases (chronic idiopathic urticaria, rosacea, alopecia areata), sideropenic anemia, growth retardation, late menarche, extragastric MALT lymphoma, diabetes mellitus, hepatic encephalopathy, sudden infant death syndrome, and anorexia of aging. We examine critically the strength of the evidence linking these diseases to Helicobacter pylori, using ischaemic heart disease as an example of epidemiological techniques, and skin diseases as an example of treatment studies. By the standards of evidence-based medicine, studies have been often of low quality. The best evidence usually is not indicative of a role for Helicobacter pylori in these diseases. PMID:11233523

  6. Antidotes and treatments for chemical warfare/terrorism agents: an evidence-based review.

    PubMed

    Rodgers, G C; Condurache, C T

    2010-09-01

    This article reviews the evidence supporting the efficacy of antidotes used or recommended for the potential chemical warfare agents of most concern. Chemical warfare agents considered include cyanide, vesicants, pulmonary irritants such as chlorine and phosgene, and nerve agents. The strength of evidence for most antidotes is weak, highlighting the need for additional research in this area. PMID:20686476

  7. 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.

  8. 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:21673839

  9. 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

  10. 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

  11. 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

  12. [Evidence-based aspects of clinical mastitis treatment].

    PubMed

    Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

    2015-10-14

    Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.???e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents. PMID:26365364

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

    PubMed Central

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

    2014-01-01

    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 discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout. Conclusion SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders. PMID:23071200

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

    PubMed

    Djuricich, Alexander M

    2014-01-01

    Medical practice and medical journals must adapt to a constantly changing environment, in which social media plays an ever-increasing role. Social media platforms such as Twitter can provide an opportunity to disseminate information in innovative ways. The concept of evidence-based tweeting is introduced, especially as "tweeting the meeting" continues to expand within medical conferences and other venues important for continuing education for health care providers. Future social media strategies for the journal are outlined. PMID:25530289

  15. Evidence-Based Care of Acute Wounds: A Perspective

    PubMed Central

    Ubbink, Dirk T.; Brölmann, Fleur E.; Go, Peter M. N. Y. H.; Vermeulen, Hester

    2015-01-01

    Significance: Large variation and many controversies exist regarding the treatment of, and care for, acute wounds, especially regarding wound cleansing, pain relief, dressing choice, patient instructions, and organizational aspects. Recent Advances: A multidisciplinary team developed evidence-based guidelines for the Netherlands using the AGREE-II and GRADE instruments. A working group, consisting of 17 representatives from all professional societies involved in wound care, tackled five controversial issues in acute-wound care, as provided by any caregiver throughout the whole chain of care. Critical Issues: The guidelines contain 38 recommendations, based on best available evidence, additional expert considerations, and patient experiences. In summary, primarily closed wounds need no cleansing; acute open wounds are best cleansed with lukewarm (drinkable) water; apply the WHO pain ladder to choose analgesics against continuous wound pain; use lidocaine or prilocaine infiltration anesthesia for wound manipulations or closure; primarily closed wounds may not require coverage with a dressing; use simple dressings for open wounds; and give your patient clear instructions about how to handle the wound. Future Directions: These evidence-based guidelines on acute wound care may help achieve a more uniform policy to treat acute wounds in all settings and an improved effectiveness and quality of wound care. PMID:26005594

  16. Evidence-based development in nurse-led interprofessional teams.

    PubMed

    Pilon, Bonita; Ketel, Christian; Davidson, Heather

    2015-06-01

    Team-based care is often described as the best way to provide health care. However the effective use of teams in primary care is not yet prevalent in the US and nurse-led interprofessional collaborative teams are rare. Over the past three years the US Department of Health and Human Services has put great emphasis on the development of nurse-led interprofessional teams and this article describes the development of one such team in a primary care setting and the evidence base behind it. PMID:26014794

  17. 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

  18. The Development of a Research Template to Assist Music Therapy Clinicians in Evidence-Based Practice

    E-print Network

    Edwards, Robin

    2009-04-23

    One of the most prevalent trends in healthcare today is the movement toward evidence-based practice. Evidence-based practice requires that health care providers base their treatment decisions not only on their own professional ...

  19. 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. CONCLUSION: The IMM Database in junction with the IMM is helping NASA aerospace program improve the health care and reduce risk for the astronauts crew. Both the database and model will continue to expand to meet customer needs through its multi-disciplinary evidence based approach to managing data. Future expansion could serve as a platform for a Space Medicine Wiki of medical conditions.

  20. 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…

  1. Nonconvulsive seizures in patients presenting with altered mental status: an evidence-based review.

    PubMed

    Zehtabchi, Shahriar; Abdel Baki, Samah G; Malhotra, Shweta; Grant, Arthur C

    2011-10-01

    Definitive diagnosis of nonconvulsive seizures (NCS) can be made only by electroencephalography, and delay in diagnosis can increase morbidity, resource utilization, and length of hospitalization. We performed an evidence-based literature review to estimate the prevalence of NCS in patients with altered mental status (AMS) of unknown cause. PUBMED, EMBASE, the Cochrane Library, and other resources were searched for studies that included AMS and seizure as topics. The resulting 276 articles were screened for predetermined inclusion and exclusion criteria, leaving 5 studies enrolling 478 patients for review. The prevalence of NCS in patients with AMS ranged from 8 to 30% (overall prevalence of 21.5%, 95% CI: 18-25%), suggesting that the prevalence of NCS is sufficiently high to consider routine use of urgent electroencephalography in such patients. However, methodological weaknesses limit the generalizability of the results. A large, prospective study enrolling and screening for NCS in all patients who present with acute AMS is needed. PMID:21784709

  2. 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…

  3. 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;…

  4. 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

  5. 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

  6. 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

  7. Evidence Based Conservative Management of Patello-femoral Syndrome

    PubMed Central

    Rodriguez-Merchan, E. Carlos

    2014-01-01

    Patellofemoral pain syndrome (PFPS) is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or athletic activities. Patella dislocation is not included in PFPS. This review analyzes the evidence based conservative management of PFPS. A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because they were focused on the topic of the article. Overall ten articles were analyzed. Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces. Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed. PMID:25207305

  8. Evidence Based Conservative Management of Patello-femoral Syndrome.

    PubMed

    Rodriguez-Merchan, E Carlos

    2014-03-01

    Patellofemoral pain syndrome (PFPS) is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or athletic activities. Patella dislocation is not included in PFPS. This review analyzes the evidence based conservative management of PFPS. A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because they were focused on the topic of the article. Overall ten articles were analyzed. Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces. Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed. PMID:25207305

  9. 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

  10. Explanation-based learning with weak domain theories Michael J. Pazzani (pazzani@ics.uci.edu)

    E-print Network

    Pazzani, Michael J.

    , the softness of the surface of impact affects the stopping distance and hence the impact force..... And third, foiling large animals ore in general more injury prone than small ones, os they s&r greater impact stress knowledge to propose hypotheses that are then teste.d against further data. PostHoc utilizes a weak domain

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

    PubMed

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

    2014-02-01

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

  12. 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

  13. Strategies for advancing evidence-based practice in clinical settings.

    PubMed

    Fineout-Overholt, Ellen; Levin, Rona F; Melnyk, Bernadette Mazurek

    Evidence-based practice (EBP) is a problem-solving approach that incorporates the best available scientific evidence, clinicians' expertise, and patients' preferences and values. Melnyk and Fineout-Overholt have developed the ARCC (Advancing Research and Clinical practice through close Collaboration) model for the purpose of implementing EBP. A pilot study was conducted to test the ARCC model at two acute-care sites. This article shares information learned from the pilot study about what is necessary for successful implementation of EBP in the acute-care setting. These essentials include identifying EBP champions, redefining nurses' roles to include EBP activities, allocating time and money to the EBP process, and creating an organizational culture that fosters EBP. In addition, practical strategies for implementing EBP are presented to encourage implementation of EBP. PMID:15884483

  14. 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

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

    PubMed

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

    2005-01-01

    This article describes one step in the process that was undertaken to prepare for the introduction of evidence-based practice (EBP) into the curriculum across the Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Philosophy programs, as well as the programs that were under development, Clinical Nurse Leader and Doctor of Nursing Practice, at the University of Pittsburgh School of Nursing. Expected research competencies were identified for each level or academic year within each program. Based on these competencies, recommendations on how to modify the curriculum into one that would support students' acquisition and development of the skills necessary to be successful in matriculating through an EBP curriculum were developed. Evaluation mechanisms for the achievement of these competencies vary across the academic programs and will include performance on capstone projects, comprehensive examinations, and program milestones for doctoral students. The establishment of evidence-based competencies provided a foundation for the development of new teaching approaches and the curricular revisions across the three academic programs. Thus, the University of Pittsburgh model of educating for EBP is based on a sequential layering of research competencies throughout the curriculum. PMID:16311231

  16. Management of fibromyalgia syndrome – an interdisciplinary evidence-based guideline

    PubMed Central

    Häuser, Winfried; Arnold, Bernhard; Eich, Wolfgang; Felde, Eva; Flügge, Christl; Henningsen, Peter; Herrmann, Markus; Köllner, Volker; Kühn, Edeltraud; Nutzinger, Detlev; Offenbächer, Martin; Schiltenwolf, Marcus; Sommer, Claudia; Thieme, Kati; Kopp, Ina

    2008-01-01

    The prevalence of fibromyalgia syndrome (FMS) of 1–2% in the general population associated with high disease-related costs and the conflicting data on treatment effectiveness had led to the development of evidence-based guidelines designed to provide patients and physicians guidance in selecting among the alternatives. Until now no evidence-based interdisciplinary (including patients) guideline for the management of FMS was available in Europe. Therefore a guideline for the management of fibromyalgia syndrome (FMS) was developed by 13 German medical and psychological associations and two patient self-help organisations. The task was coordinated by two German scientific umbrella organisations, the Association of the Scientific Medical Societies in Germany AWMF and the German Interdisciplinary Association of Pain Therapy DIVS. A systematic search of the literature including all controlled studies, systematic reviews and meta-analyses of pharmacological and non-pharmacological treatments of FMS was performed in the Cochrane Library (1993–12/2006), Medline (1980–12/2006), PsychInfo (1966–12/2006) and Scopus (1980–12/ 2006). Levels of evidence were assigned according to the classification system of the Oxford-Centre for Evidence Based Medicine. Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures were used to reach a consensus on recommendations. The guideline was reviewed and finally approved by the boards of the societies involved and published online by the AWMF on april 25, 2008: http://www.uni-duesseldorf.de/AWMF/ll/041-004.htm. A short version of the guideline for patients is available as well: http://www.uni-duesseldorf.de/AWMF/ll/041-004p.htm. The following procedures in the management of FMS were strongly recommended: information on diagnosis and therapeutic options and patient-centered communication, aerobic exercise, cognitive and operant behavioural therapy, multicomponent treatment and amitriptyline. Based on expert opinion, a stepwise FMS-management was proposed. Step 1 comprises confirming the diagnosis and patient education and treatment of physical or mental comorbidities or aerobic exercise or cognitive behavioural therapy or amitriptyline. Step 2 includes multicomponent treatment. Step 3 comprises no further treatment or self-management (aerobic exercise, stress management) and/or booster multicomponent therapy and/or pharmacological therapy (duloxetine or fluoxetine or paroxetine or pregabalin or tramadol/aminoacetophen) and/or psychotherapy (hypnotherapy or written emotional disclosure) and/or physical therapy (balneotherapy or whole body heat therapy) and/or complementary therapies (homoeopathy or vegetarian diet). The choice of treatment options should be based on informed decision-making and respect of the patients’ preferences. PMID:19675740

  17. 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

  18. 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

  19. From randomized controlled trials to evidence grading schemes: current state of evidence-based practice in social sciences.

    PubMed

    Boruch, Robert; Rui, Ning

    2008-11-01

    With the advance of web search and navigation technology, enormous amount of information, non-information, and misinformation may be obtained in milliseconds in response to questions about 'what works' in social sciences. Today, policy makers in non-medical public service arenas are under increasing pressure to make sound decisions based on scientific evidence. Some of these decisions are a matter of legal requirement. This paper shows how such movements are closely aligned with the evolution of organizations that develop and apply evidence standards and evidence grading schemes within the social science communities. The current state of evidence-based practice in social sciences is examined by reviewing the latest development of randomized trials and evidence grading schemes in the fields of education, criminal justice, and social welfare. Studies conducted under the auspices of the Campbell Collaboration and What Works Clearinghouse are used to illustrate ingredients of evidence grading schemes, graphic display of results of systematic reviews, and discrepancies of evidence derived from randomized trials and non-experimental trials. Furthermore, it is argued that the use of evidence on 'what works' depends on the potential users' awareness, understanding of the evidence, as well as their capacity and willingness to use it. Awareness and understanding depends on the world wide web and its augmentations, while capacity and willingness depends more on incentives to use good evidence and on political and ethical values. Implications for the future development of evidence grading organizations are discussed. PMID:21348975

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  1. eSocial Science and Evidence-Based Policy Assessment: Challenges and

    E-print Network

    Edwards, Pete

    that is grounded in evidence and subject to rigorous evaluation. Evidence is used at various stages of policy making, from the design of new policies to the evaluation and review of existing policy. An evidence base a notable contribution to the evidence base for many areas of public policy: they produce `new' knowledge

  2. 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.

  3. Interdisciplinary Evidence-based Practice: Moving from Silos to Synergy

    PubMed Central

    Newhouse, Robin P.; Spring, Bonnie

    2010-01-01

    Despite the assumption that health care providers work synergistically in practice, professions have tended to be more exclusive than inclusive when it comes to educating students in a collaborative approach to interdisciplinary evidence-based practice (EBP). This article explores the state of academic and clinical training regarding interdisciplinary EBP, describes efforts to foster interdisciplinary EBP, and suggests strategies to accelerate the translation of EBP across disciplines. Moving from silos to synergy in interdisciplinary EBP will require a paradigm shift. Changes can be leveraged professionally and politically using national initiatives currently in place on improving quality and health care reform. PMID:21074648

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

    PubMed

    Shoemaker, Lorie K; Fischer, Brenda

    2011-03-01

    This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article. PMID:21320657

  5. Evidence-based guideline update: Medical treatment of infantile spasms

    PubMed Central

    Go, C.Y.; Mackay, M.T.; Weiss, S.K.; Stephens, D.; Adams-Webber, T.; Ashwal, S.; Snead, O.C.

    2012-01-01

    Objective: To update the 2004 American Academy of Neurology/Child Neurology Society practice parameter on treatment of infantile spasms in children. Methods: MEDLINE and EMBASE were searched from 2002 to 2011 and searches of reference lists of retrieved articles were performed. Sixty-eight articles were selected for detailed review; 26 were included in the analysis. Recommendations were based on a 4-tiered classification scheme combining pre-2002 evidence and more recent evidence. Results: There is insufficient evidence to determine whether other forms of corticosteroids are as effective as adrenocorticotropic hormone (ACTH) for short-term treatment of infantile spasms. However, low-dose ACTH is probably as effective as high-dose ACTH. ACTH is more effective than vigabatrin (VGB) for short-term treatment of children with infantile spasms (excluding those with tuberous sclerosis complex). There is insufficient evidence to show that other agents and combination therapy are effective for short-term treatment of infantile spasms. Short lag time to treatment leads to better long-term developmental outcome. Successful short-term treatment of cryptogenic infantile spasms with ACTH or prednisolone leads to better long-term developmental outcome than treatment with VGB. Recommendations: Low-dose ACTH should be considered for treatment of infantile spasms. ACTH or VGB may be useful for short-term treatment of infantile spasms, with ACTH considered preferentially over VGB. Hormonal therapy (ACTH or prednisolone) may be considered for use in preference to VGB in infants with cryptogenic infantile spasms, to possibly improve developmental outcome. A shorter lag time to treatment of infantile spasms with either hormonal therapy or VGB possibly improves long-term developmental outcomes. PMID:22689735

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

    PubMed

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

    2013-01-01

    Evidence-based veterinary medicine (EBVM) is of interest and relevance to veterinary practitioners. Consequently, veterinary schools take responsibility for teaching students how to appraise scientific articles and for equipping them with the skills needed to obtain and evaluate the best evidence and to apply this approach to their own cases. As part of our farm animal clinical rotation, we train students in qualitative and quantitative EBVM methods using an e-learning environment, online teaching materials, a wiki (a Web site that allows its users to edit its content via a Web browser), and face-to-face tutorials that support learning. Students working in small groups use a wiki to record details of the history, clinical presentation, diagnostic tests, herd data, and management plans for their chosen farm animal clinical cases. Using a standardized patient, intervention, comparison, and outcome (PICO) format, each group formulates a patient question based on either a proposed intervention or diagnostic procedure for the case and conducts an online scientific literature database search. The students appraise the articles retrieved using EBVM approaches and record the information in the wiki. The summation of this body of work, the group's critically appraised topic (CAT), includes the original PICO, a standardized table of the scientific evidence for the effectiveness of the intervention or diagnostic procedure, a summary statement in the form of a clinical bottom line, and their reflections upon the CAT. At the end of the rotation, students take part in a structured "CAT Club" where they present and discuss their findings with fellow students and clinicians. PMID:23975071

  7. Toward an improved understanding of the precipitation behavior of weakly basic drugs from oral lipid-based formulations.

    PubMed

    Stillhart, Cordula; Dürr, Désirée; Kuentz, Martin

    2014-04-01

    The aim of the present study was to analyze the impact of lipid-based formulation (LBF) dispersion and digestion on the precipitation behavior of weakly basic drugs. Loratadine and carvedilol were formulated in a range of LBFs and drug solubilization was analyzed under simulated dispersive and digestive conditions (fasted state). The extent of supersaturation and drug precipitation as well as the solid-state properties and redissolution behavior of precipitated drugs were assessed. X-ray powder diffraction indicated that carvedilol precipitated in a crystalline form upon dispersion, but interestingly, this drug gave an amorphous precipitate during lipolysis. In contrast, loratadine precipitated as crystalline material during both formulation dispersion and digestion. No influence of the formulation composition on the type of precipitation was observed. These results suggested that in vitro conditions (dispersive versus digestive) largely influenced the solid-state properties of precipitating weak bases. Solid-state characterization of precipitated drugs under different experimental conditions should be routinely performed in formulation screening to better understand the biopharmaceutical behavior of LBFs. Hence, these findings are of high practical importance for the pharmaceutical development and in vitro assessment of LBFs using weakly basic drugs. PMID:24515977

  8. Reality of evidence-based practice in palliative care

    PubMed Central

    Visser, Claire; Hadley, Gina; Wee, Bee

    2015-01-01

    There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard’ randomised controlled trials (RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient’s physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle (noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach’ are likely to pose the correct clinical questions and derive evidence-based yet clinically relevant outcomes. PMID:26487964

  9. Reality of evidence-based practice in palliative care.

    PubMed

    Visser, Claire; Hadley, Gina; Wee, Bee

    2015-09-01

    There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by 'gold standard' randomised controlled trials (RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient's physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle (noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a 'mixed methods approach' are likely to pose the correct clinical questions and derive evidence-based yet clinically relevant outcomes. PMID:26487964

  10. 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

  11. Frequency of Testing for Dyslipidemia: An Evidence-Based Analysis

    PubMed Central

    2014-01-01

    Background Dyslipidemias include high levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides and low levels of high-density lipoprotein (HDL) cholesterol. Dyslipidemia is a risk factor for cardiovascular disease, which is a major contributor to mortality in Canada. Approximately 23% of the 2009/11 Canadian Health Measures Survey (CHMS) participants had a high level of LDL cholesterol, with prevalence increasing with age, and approximately 15% had a total cholesterol to HDL ratio above the threshold. Objectives To evaluate the frequency of lipid testing in adults not diagnosed with dyslipidemia and in adults on treatment for dyslipidemia. Research Methods A systematic review of the literature set out to identify randomized controlled trials (RCTs), systematic reviews, health technology assessments (HTAs), and observational studies published between January 1, 2000, and November 29, 2012, that evaluated the frequency of testing for dyslipidemia in the 2 populations. Results Two observational studies assessed the frequency of lipid testing, 1 in individuals not on lipid-lowering medications and 1 in treated individuals. Both studies were based on previously collected data intended for a different objective and, therefore, no conclusions could be reached about the frequency of testing at intervals other than the ones used in the original studies. Given this limitation and generalizability issues, the quality of evidence was considered very low. No evidence for the frequency of lipid testing was identified in the 2 HTAs included. Canadian and international guidelines recommend testing for dyslipidemia in individuals at an increased risk for cardiovascular disease. The frequency of testing recommended is based on expert consensus. Conclusions Conclusions on the frequency of lipid testing could not be made based on the 2 observational studies. Current guidelines recommend lipid testing in adults with increased cardiovascular risk, with the frequency of testing based on individual cardiovascular risk. PMID:26316920

  12. 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

    SciTech Connect

    Aaltonen, T.; Abazov, V.M.; Abbott, B.; Acharya, B.S.; Adams, M.; Adams, T.; Alexeev, G.D.; Alkhazov, G.; Alton, A.; Alvarez Gonzalez, B.; Alverson, G.; /Northeastern U. /INFN, Padua

    2012-07-01

    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 p{bar p} collisions at {radical}s=1.96 TeV, correspond to integrated luminosities of up to 9.7 fb{sup -1}. The searches are conducted for a Higgs boson with mass in the range 100-150 GeV/c{sup 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{sup 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.

  13. 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

    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

  14. Atmospheric Pressure Weakly Ionized Plasma Reactor Based on the Corona Discharge

    NASA Astrophysics Data System (ADS)

    Wemlinger, Erik

    Atmospheric pressure weakly ionized plasma (APWIP) is being used to treat or process goods and materials because it only activates the surface without modification of the bulk material. This work describes research into the synchronicity of corona discharges and some applications of APWIP. A reactor was built to generate corona discharges using an array of needles, the geometry of each needle being consistent with point-to-plane configuration. The interaction between corona discharges in the needle array was studied. The reactor was then used to decontaminate fresh produce inoculated with E. coli ATCC 1177 and to deposit films via plasma polymerization of acetylene.

  15. Revitalising the evidence base for public health: an assets model.

    PubMed

    Morgan, Antony; Ziglio, Erio

    2007-01-01

    Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective action on health inequities. This re-balancing would help in better understanding the factors that influence health and what can be done about them. It would promote a positive and inclusive approach to action. PMID:17685075

  16. The Benefits of Breakfast Cereal Consumption: A Systematic Review of the Evidence Base1234

    PubMed Central

    Williams, Peter G.

    2014-01-01

    There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A (can be trusted to guide practice) to D (weak and must be applied with caution). Breakfast cereal consumption is associated with diets higher in vitamins and minerals and lower in fat (grade B) but is not associated with increased intakes of total energy or sodium (grade C) or risk of dental caries (grade B). Most studies on the nutritional impact are cross-sectional, with very few intervention studies, so breakfast cereal consumption may be a marker of an overall healthy lifestyle. Oat-, barley-, or psyllium-based cereals can help lower cholesterol concentrations (grade A), and high-fiber, wheat-based cereals can improve bowel function (grade A). Regular breakfast cereal consumption is associated with a lower body mass index and less risk of being overweight or obese (grade B). Presweetened breakfast cereals do not increase the risk of overweight and obesity in children (grade C). Whole-grain or high-fiber breakfast cereals are associated with a lower risk of diabetes (grade B) and cardiovascular disease (grade C). There is emerging evidence of associations with feelings of greater well-being and a lower risk of hypertension (grade D), but more research is required. PMID:25225349

  17. Final Evidence-based Decision Making (EBDM) documentation Division of Student Affairs and Enrollment Management

    E-print Network

    Hutcheon, James M.

    Final Evidence-based Decision Making (EBDM) documentation for the Division of Student Affairs and Enrollment Management FY12 Plans and Outcomes - Worksheet on Evidence-Based Decision Making (EBDM) Campus ­ May 2, 2013 R:\\Common\\SACS\\EBDM Evidence-based Decision-making\\EBDM Reports_FY12_SAEM 1 Table

  18. Final Evidence-based Decision Making documentation Division of Student Affairs and Enrollment Management

    E-print Network

    Hutcheon, James M.

    Final Evidence-based Decision Making documentation for the Division of Student Affairs on Evidence-Based Decision Making (EBDM) (Initial plan provided by Department Head in FY07 Annual Report to VP Research and Analysis, SACS Leadership Team & SAEM EBDM Lead U:\\SACS\\EBDM Evidence-based Decision-making

  19. Final Evidence-based Decision Making (EBDM) documentation Division of Student Affairs and Enrollment Management

    E-print Network

    Hutcheon, James M.

    Final Evidence-based Decision Making (EBDM) documentation for the Division of Student Affairs - Worksheet on Evidence-Based Decision Making (EBDM) Campus SAEM Coordinator: Dr. R. Jayne Perkins Brown:\\SACS\\EBDM Evidence-based Decision-making\\EBDM Reports_FY11_SAEM 1 Table of Contents Abstract

  20. Evidence-Based Practice: What Does It Really Mean for the Early Childhood Field?

    ERIC Educational Resources Information Center

    Buysse, Virginia; Wesley, Patricia W.; Snyder, Patricia; Winton, Pamela

    2006-01-01

    The growing use of the term "evidence-based" in conference presentations, web sites, journal articles and grants announcements suggest definitive answers to a host of practice-related issues. The purpose of this paper is to address the questions of: (1) defining evidence-based practice; (2) how evidence-based practice differs from other practices;…

  1. Disruptive Innovations for Designing and Diffusing Evidence-based Interventions

    PubMed Central

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F.

    2013-01-01

    The numbers of evidence-based interventions (EBIs) have been growing exponentially, both therapeutic and prevention programs. Yet, EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically re-examine our scientific conventions and norms. Innovation may be spurred by re-examining the biomedical model for validating EBIs and the compartmentalization of EBIs as disease-specific, institutionally-based, counseling programs. The model of Disruptive Innovations suggests that we re-engineer EBIs based on their most robust features in order to reach more people in less time and at lower cost. Four new research agendas will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. PMID:22545596

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

    PubMed Central

    2011-01-01

    Background Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. Methods The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. Results 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. Conclusion Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively. PMID:21269446

  3. Pharmacological management of tetanus: an evidence-based review

    PubMed Central

    2014-01-01

    Tetanus is becoming rarer in both industrialized and developing nations due to an effective vaccination program. In 2010, the World Health Organization estimated there was a 93% reduction in newborns dying from tetanus worldwide, compared to the situation in the late 1980s. Due to its rarity, many diagnostic delays occur as physicians may not consider the diagnosis until the manifestations become overt. Without timely diagnosis and proper treatment, severe tetanus is fatal (mortality is also influenced by the comorbidities of the patient). The principles of treating tetanus are: reducing muscle spasms, rigidity and autonomic instability (with ventilatory support when necessary); neutralization of tetanus toxin with human antitetanus immunoglobulin or equine antitetanus sera; wound debridement; and administration of antibiotics to eradicate locally proliferating bacteria at the wound site. It is difficult to conduct trials on different treatment modalities in tetanus due to both logistical and ethical reasons. However, it is imperative that physicians are aware of the best evidence-based treatment strategies currently available to improve the outcome of patients. This review concentrates on analyzing the current evidence on the pharmacological management of tetanus. PMID:25029486

  4. Eating Disorder Prevention: Current Evidence-Base and Future Directions

    PubMed Central

    Stice, Eric; Becker, Carolyn Black; Yokum, Sonja

    2014-01-01

    Objective This narrative review sought to (a) characterize prevention programs that have produced reliable, reproducible, and clinically meaningful effects in efficacy trials, (b) discuss effectiveness trials that have tested whether prevention programs produce intervention effects under ecologically valid real-world conditions, (c) discuss dissemination efforts and research on dissemination, and (d) offer suggestions regarding directions for future research in this field. Conclusion A literature revealed that 6 prevention programs have produced significant reductions in eating disorder symptoms through at least 6-month follow-up and that 2 have significantly reduced future eating disorder onset. Effectiveness trials indicate that 2 prevention programs have produced effects under ecologically valid conditions that are only slightly attenuated. Although there have been few dissemination efforts, evidence suggests that a community participatory approach is most effective. Lastly, it would be useful to develop programs that produce larger and more persistent reductions in eating disorder symptoms and eating disorder onset, focus more on effectiveness trials that confirm that prevention programs produce clinically meaningful effects under real-world conditions, conduct meditational, mechanisms of action, and moderator research that provides stronger support for the intervention theory of prevention programs, and investigate the optimal methods of disseminating and implementing evidence-based prevention programs. PMID:23658095

  5. 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.

  6. Nutrition in the ICU: an evidence-based approach.

    PubMed

    Desai, Svetang V; McClave, Stephen A; Rice, Todd W

    2014-05-01

    Providing artificial nutrition is an important part of caring for critically ill patients. However, because of a paucity of robust data, the practice has been highly variable and often based more on dogma than evidence. A number of studies have been published investigating many different aspects of critical care nutrition. Although the influx of data has better informed the practice, the results have often been conflicting or counter to prevailing thought, resulting in discordant opinions and different interpretations by experts in the field. In this article, we review and summarize the data from a number of the published studies, including studies investigating enteral vs parenteral nutrition, supplementing enteral with parenteral nutrition, and use of immunonutrition. In addition, published studies informing the practice of how best to provide enteral nutrition will be reviewed, including the use of trophic feedings, gastric residual volumes, and gastric vs postpyloric tube placement. PMID:24798840

  7. Introducing Evidence-based Medicine to Plastic and Reconstructive Surgery

    PubMed Central

    Chung, Kevin C.; Swanson, Jennifer A.; Schmitz, DeLaine; Sullivan, Daniel; Rohrich, Rod J.

    2009-01-01

    An effective healthcare system is one in which healthcare spending provides acceptable returns in terms of health outcomes and broad coverage for its citizens. By this measure, the United States healthcare system unfortunately falls short. Tremendous pressure for improvement has given rise to several initiatives designed to decrease healthcare expenditure and improve outcomes, access, and quality of care. The outcomes movement, which is revolutionary in American medicine, has heightened awareness about the need to critically examine our treatment outcomes. However, the early euphoria surrounding the outcomes movement was met with restraint at the realization of its limitations. Although the outcomes movement has verified the effectiveness of many existing treatments in plastic surgery, most of the investments in these projects unfortunately have resulted in few, if any, positive changes for the patient, physician or healthcare system (1). US healthcare is now moving towards the adoption of evidence-based medicine (EBM), which may potentially be another revolution in American healthcare (2). PMID:19337107

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

    PubMed

    Frith, Lucy

    2015-03-01

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

  9. Picture Exchange Communication System (PECS) or Sign Language: An Evidence-Based Decision-Making Example

    ERIC Educational Resources Information Center

    Spencer, Trina D.; Petersen, Douglas B.; Gillam, Sandra L.

    2008-01-01

    Evidence-based practice (EBP) refers to clinical decisions as a result of the careful integration of research evidence and student needs. Legal mandates such as No Child Left Behind require teachers to employ evidence-based practices in their classrooms, yet teachers receive little guidance regarding how to determine which practices are…

  10. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus.

    PubMed

    Birke-Sorensen, H; Malmsjo, M; Rome, P; Hudson, D; Krug, E; Berg, L; Bruhin, A; Caravaggi, C; Chariker, M; Depoorter, M; Dowsett, C; Dunn, R; Duteille, F; Ferreira, F; Francos Martínez, J M; Grudzien, G; Ichioka, S; Ingemansson, R; Jeffery, S; Lee, C; Vig, S; Runkel, N; Martin, R; Smith, J

    2011-09-01

    Negative pressure wound therapy (NPWT) is becoming a commonplace treatment in many clinical settings. New devices and dressings are being introduced. Despite widespread adoption, there remains uncertainty regarding several aspects of NPWT use. To respond to these gaps, a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In a previous communication, we have reviewed the evidence base for the use of NPWT within trauma and reconstructive surgery. In this communication, we present results of the assessment of evidence relating to the different NPWT treatment variables: different wound fillers (principally foam and gauze); when to use a wound contact layer; different pressure settings; and the impact of NPWT on bacterial bioburden. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence and drafting of the recommendations by a global expert panel. Evidence and recommendations were graded according to the Scottish Intercollegiate Guidelines Network (SIGN) classification system. In general, there is relatively weak evidence on which to base recommendations for any one NPWT treatment variable over another. Overall, 14 recommendations were developed: five for the choice of wound filler and wound contact layer, four for choice of pressure setting and five for use of NPWT in infected wounds. With respect to bioburden, evidence suggests that reduction of bacteria in wounds is not a major mode of action of NPWT. PMID:21868296

  11. Evidence-Based Phytotherapy in Europe: Where Do We Stand?

    PubMed

    Fürst, Robert; Zündorf, Ilse

    2015-08-01

    Medicinal plants represent the oldest source of pharmacotherapy used by mankind. A considerable number of traditional systems of medicine (folk medicine) have emerged over the last millennia under different cultural conditions. Even nowadays, the majority of people in less developed countries have to rely on herbal remedies as primary health care. Based on scientific and technical progress, the options to produce high quality herbal medicinal products have been largely improved in the last decades. The acceptance of phytotherapy as a "natural and mild alternative" to synthetic drugs is very high within the general public in developed countries and, from a global perspective, sales figures of herbal medicines are constantly rising. However, we still face many issues in this field. In contrast to the popularity of herbal medicinal products, physicians and their respective societies often have a very critical view of them. Besides dogmatic obstacles, this is based on the frequently missing clinical trials that clearly demonstrate their efficacy and/or safety. This perspective discusses the reasons and implications of the lack of scientific evidence and also of the wrong understanding of the principles of rational phytotherapy. PMID:25922913

  12. Population-Based Provider Engagement in Delivery of Evidence-Based Parenting Interventions: Challenges and Solutions

    ERIC Educational Resources Information Center

    Shapiro, Cheri J.; Prinz, Ronald J.; Sanders, Matthew R.

    2010-01-01

    Population-wide interventions do not often address parenting, and relatively little is known about large scale dissemination of evidence-based parenting interventions. Most parenting interventions are not designed to reach the majority of parents in a geographic area or to influence prevalence rates for a problem, nor do they take full advantage…

  13. Evidence based practice beliefs and implementation among nurses: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Having a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses. The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation. Method We carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used. Results In total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r?=?0.59, p?=?0.001). There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r?=?0.38, p?evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups. Conclusion This study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between beliefs about evidence-based practice and implementation of evidence-based practice. Beliefs related to knowledge appear to have the greatest effect on implementation of evidence-based practice. Having knowledge and taking part in evidence-based practice working groups seem important. PMID:24661602

  14. Hypothesis-based weight-of-evidence evaluation and risk assessment for naphthalene carcinogenesis.

    PubMed

    Bailey, Lisa A; Nascarella, Marc A; Kerper, Laura E; Rhomberg, Lorenz R

    2016-01-01

    Inhalation of naphthalene causes olfactory epithelial nasal tumors in rats (but not in mice) and benign lung adenomas in mice (but not in rats). The limited available human data have not identified an association between naphthalene exposure and increased respiratory cancer risk. Assessing naphthalene's carcinogenicity in humans, therefore, depends entirely on experimental evidence from rodents. We evaluated the respiratory carcinogenicity of naphthalene in rodents, and its potential relevance to humans, using our Hypothesis-Based Weight-of-Evidence (HBWoE) approach. We systematically and comparatively reviewed data relevant to key elements in the hypothesized modes of action (MoA) to determine which is best supported by the available data, allowing all of the data from each realm of investigation to inform interpretation of one another. Our analysis supports a mechanism that involves initial metabolism of naphthalene to the epoxide, followed by GSH depletion, cytotoxicity, chronic inflammation, regenerative hyperplasia, and tumor formation, with possible weak genotoxicity from downstream metabolites occurring only at high cytotoxic doses, strongly supporting a non-mutagenic threshold MoA in the rat nose. We also conducted a dose-response analysis, based on the likely MoA, which suggests that the rat nasal MoA is not relevant in human respiratory tissues at typical environmental exposures. Our analysis illustrates how a thorough WoE evaluation can be used to support a MoA, even when a mechanism of action cannot be fully elucidated. A non-mutagenic threshold MoA for naphthalene-induced rat nasal tumors should be considered as a basis to determine human relevance and to guide regulatory and risk-management decisions. PMID:26202831

  15. The Ozone Trends Panel - CFCs and evidence-based policymaking

    NASA Astrophysics Data System (ADS)

    Watson, R.

    2012-12-01

    My involvement with the issue of stratospheric ozone depletion started with my Ph.D studies, which predated the seminal paper of Rowland and Molina in 1974, and focussed on understanding how chlorine and bromine atoms and free radicals interacted with atmospheric constituents (e.g., ozone, oxygen atoms, nitric oxide, nitrogen oxide, methane, etc). My post-doctoral studies and work at the Jet Propulsion laboratory continued my gas-phase kinetic studies into reactions of both stratospheric and tropospheric importance, including understanding the rates of reactions between the hydroxyl radical and HCFCs. This work, along with the results of other laboratory studies, provided a major input to the theoretical modelling work which was projecting significant ozone losses from continued use of chlorofluorocarbons and halons. In 1980 I became the program manager for stratospheric ozone depletion at NASA and provided funding for some ground-breaking laboratory studies, field measurements and theoretical modelling, some in collaboration with NOAA, the fluorocarbon industry and international partners. Highlights included the Antarctic and Arctic aircraft campaigns, which demonstrated beyond doubt that chlorinated and brominated species were the cause of the significant losses of ozone in the polar spring, initiated through novel heterogeneous chemical reactions in the lower stratosphere - the most dramatic observation being the so-called Antarctic Ozone hole. These findings played a critical role in strengthening the Montreal Protocol. In 1980, after joining NASA, I initiated the first International Stratospheric Ozone Assessment, which provided much of the scientific evidence used to develop the 1985 Convention to protect stratospheric ozone. Subsequent international assessments provided the scientific basis for the 1987 Montreal Protocol and the following adjustments and amendments. Key among these assessments was the International Ozone Trends Panel where Sherry Rowland played a pivotal role by chairing the chapter which demonstrated, using ground-based Dobson measurements and satellite observations, significant ozone losses in mid- and high latitudes in both hemispheres, especially in winter. These findings that basically validated the models focussed the attention of Governments that it was not only polar ozone that was being depleted, but ozone over heavily inhabited areas. This provided a stimulus for even stronger regulations to protect the ozone layer. Another facet of my career was to be the technical advisor to the US Government as the Ozone Convention and Montreal Protocol were negotiated. It was a pleasure to see that Governments recognized the importance of world-class research and the international assessments, in developing the Montreal Protocol and the subsequent amendments and adjustments. It is possibly the best example to date of evidence-based policymaking at the global scale.

  16. 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.

  17. EXPERIMENTAL STUDY ON TRIANGULAR APERTURE GEOGRID-REINFORCED BASES OVER WEAK SUBGRADE UNDER CYCLIC LOADING

    E-print Network

    Qian, Yu

    2009-12-09

    of resilient displacement, stress distribution, and modulus variation were investigated. Nineteen large-scale laboratory cyclic plate loading tests were conducted on unpaved sections with three different base course thicknesses. Three types of triangular...

  18. Studer Group® ' s evidence-based leadership initiatives.

    PubMed

    Schuller, Kristin A; Kash, Bita A; Gamm, Larry D

    2015-09-21

    Purpose - The purpose of this paper is to analyze the implementation of an organizational change initiative - Studer Group®'s Evidence-Based Leadership (EBL) - in two large, US health systems by comparing and contrasting the factors associated with successful implementation and sustainability of the EBL initiative. Design/methodology/approach - This comparative case study assesses the responses to two pairs of open-ended questions during in-depth qualitative interviews of leaders and managers at both health systems. Qualitative content analysis was employed to identify major themes. Findings - Three themes associated with success and sustainability of EBL emerged at both health systems: leadership; culture; and organizational processes. The theme most frequently identified for both success and sustainability of EBL was culture. In contrast, there was a significant decline in salience of the leadership theme as attention shifts from success in implementation of EBL to sustaining EBL long term. Within the culture theme, accountability, and buy-in were most often cited by interviewees as success factors, while sense of accountability, buy-in, and communication were the most reported factors for sustainability. Originality/value - Cultural factors, such as accountability, staff support, and communication are driving forces of success and sustainability of EBL across both health systems. Leadership, a critical factor in several stages of implementation, appears to be less salient as among factors identified as important to longer term sustainability of EBL. PMID:26394252

  19. Navigating the Application of Evidence-Based Science Communication

    NASA Astrophysics Data System (ADS)

    Downs, M. R.

    2014-12-01

    Science communications professionals not only come from varied backgrounds, but also have different goals and institutional contexts — as do the scientists with which they work. An approach that succeeds at information dissemination may be ineffective or even counterproductive for improving institutional reputation, achieving behavior change, or fostering use-inspired research. Thus, the application of communications research cannot be one-size fits most. One role for the science communications professional is as a "navigator," matching evidence-based communications practice with the goals and contexts of scientists. The Nature Conservancy's Science Impact Project establishes a continuing partnership between the organization's science communication leadership and a select group of Conservancy scientists with strong interest in effective communication. Working closely together over a 30-month program, scientists gain grounding in communications research and practice, while communications professionals gain a thorough understanding of the scientists' specific communication goals, opportunities, and research-appropriate questions. Program scientists are performing experiments at the intersection of conservation science and communications. Topics include: municipal decision making on green infrastructure, uptake of conservation innovations, and the effect of injecting new voices into frozen debates. Additional opportunities for active collaboration with communications researchers are emerging from the program's first 3 years.

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

    PubMed

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

    2015-10-01

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

  1. Evidence-based medicine and progress in the medical sciences.

    PubMed

    De Vreese, Leen

    2011-10-01

    The question what scientific progress means for a particular domain such as medicine seems importantly different from the question what scientific progress is in general. While the latter question received ample treatment in the philosophical literature, the former question is hardly discussed. I argue that it is nonetheless important to think about this question in view of the methodological choices we make. I raise specific questions that should be tackled regarding scientific progress in the medical sciences and demonstrate their importance by means of an analysis of what evidence-based medicine (EBM) has, and has not, to offer in terms of progress. I show how critically thinking about EBM from the point of view of progress can help us in putting EBM and its favoured methodologies in the right perspective. My conclusion will be that blindly favouring certain methods because of their immediately tangible short-term benefits implies that we parry the important question of how best to advance progress in the long run. This leads us to losing sight of our general goals in doing research in the medical sciences. PMID:21848941

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

    PubMed

    Schmidt, Timothy H; Shinkai, Kanade

    2015-10-01

    Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA. PMID:26138647

  3. Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

    PubMed Central

    Huey, Stanley J.; 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 youth with anxiety-related problems, attention-deficit/hyperactivity disorder, depression, conduct problems, substance use problems, trauma-related syndromes, and other clinical problems. In addition, all studies met either Nathan and Gorman's (2002) Type 1 or Type 2 methodological criteria. A brief meta-analysis showed overall treatment effects of medium magnitude (d = .44). Effects were larger when EBTs were compared to no treatment (d = .58) or psychological placebos (d = .51) versus treatment as usual (d = .22). Youth ethnicity (African American, Latino, mixed/other minority), problem type, clinical severity, diagnostic status, and culture-responsive treatment status did not moderate treatment outcome. Most studies had low statistical power and poor representation of less acculturated youth. Few tests of cultural adaptation effects have been conducted in the literature and culturally validated outcome measures are mostly lacking. Recommendations for clinical practice and future research directions are provided. PMID:18444061

  4. Caesarean Delivery Rate Review: An Evidence-Based Analysis

    PubMed Central

    Degani, N; Sikich, N

    2015-01-01

    Background In 2007, caesarean deliveries comprised 28% of all hospital deliveries in Ontario. Provincial caesarean delivery rates increased with maternal age and varied by Local Health Integration Network. However, the accepted rate of caesarean delivery in a low-risk maternal population remains unclear. Objectives To review the literature to assess factors that affect the likelihood of experiencing a caesarean delivery, and to examine Ontario caesarean delivery rates to determine whether there is rate variation across the province. Data Sources Data sources included publications from OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, as well as data from the Canadian Institute for Health Information Discharge Abstracts Database and the Better Outcomes and Registry Network. Review Methods A mixed-methods approach was used, which included a systematic review of the literature to delineate factors associated with the likelihood of caesarean delivery and an analysis of administrative and clinical data on hospital deliveries in Ontario to determine provincial caesarean delivery rates, variation in rates, and reasons for variation. Results Fourteen systematic reviews assessed 14 factors affecting the likelihood of caesarean delivery; 7 factors were associated with an increased likelihood of caesarean delivery, and 2 factors were associated with a decreased likelihood. Five factors had no influence. One factor provided moderate-quality evidence supporting elective induction policies in low-risk women. The overall Ontario caesarean delivery rate in a very-low-risk population was 17%, but varied significantly across Ontario hospitals. Limitations The literature review included a 5–year period and used only systematic reviews. The determination of Robson class for women is based on care received in hospital only, and the low-risk population may have included data from women with obstetrical conditions that warranted a caesarean delivery. Conclusions There is moderate-quality evidence that—compared with expectant management—an induction policy is associated with a decrease in caesarean delivery rates in low-risk women. There is significant caesarean delivery rate variation among Ontario hospitals. PMID:26366243

  5. Evidence-Based Medicine and the Practicing Clinician

    PubMed Central

    McAlister, Finlay A; Graham, Ian; Karr, Gerald W; Laupacis, Andreas

    1999-01-01

    OBJECTIVE To assess the attitudes of practicing general internists toward evidence-based medicine (EBM—defined as the process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions) and their perceived barriers to its use. DESIGN Cross-sectional, self-administered mail questionnaire conducted between June and October 1997. SETTING Canada. PARTICIPANTS Questionnaires were sent to all 521 physician members of the Canadian Society of Internal Medicine with Canadian mailing addresses; 296 (60%) of 495 eligible physicians responded. Exclusion of two incomplete surveys resulted in a final sample size of 294. MAIN RESULTS Mean age of respondents was 46 years, 80% were male, and 52% worked in large urban medical centers. Participants reported using EBM in their clinical practice always (33, 11%), often (173, 59%), sometimes (80, 27%), or rarely/never (8, 3%). There were no significant differences in demographics, training, or practice types or locales on univariate or multivariate analyses between those who reported using EBM often or always and those who did not. Both groups reported high usage of traditional (non-EBM) information sources: clinical experience (93%), review articles (73%), the opinion of colleagues (61%), and textbooks (45%). Only a minority used EBM-related information sources such as primary research studies (45%), clinical practice guidelines (27%), or Cochrane Collaboration Reviews (5%) on a regular basis. Barriers to the use of EBM cited by respondents included lack of relevant evidence (26%), newness of the concept (25%), impracticality for use in day-to-day practice (14%), and negative impact on traditional medical skills and “the art of medicine” (11%). Less than half of respondents were confident in basic skills of EBM such as conducting a literature search (46%) or evaluating the methodology of published studies (34%). However, respondents demonstrated a high level of interest in further education about these tasks. CONCLUSIONS The likelihood that physicians will incorporate EBM into their practice cannot be predicted by any demographic or practice-related factors. Even those physicians who are most enthusiastic about EBM rely more on traditional information sources than EBM-related sources. The most important barriers to increased use of EBM by practicing clinicians appear to be lack of knowledge and familiarity with the basic skills, rather than skepticism about the concept. PMID:10203636

  6. Pluronic-Functionalized Silica-Lipid Hybrid Microparticles: Improving the Oral Delivery of Poorly Water-Soluble Weak Bases.

    PubMed

    Rao, Shasha; Richter, Katharina; Nguyen, Tri-Hung; Boyd, Ben J; Porter, Christopher J H; Tan, Angel; Prestidge, Clive A

    2015-12-01

    A Pluronic-functionalized silica-lipid hybrid (Plu-SLH) microparticle system for the oral delivery of poorly water-soluble, weak base drugs is reported for the first time. A highly effective Plu-SLH microparticle system was composed of Labrasol as the lipid phase, Pluronic F127 as the polymeric precipitation inhibitor (PPI), and silica nanoparticles as the solid carrier. For the model drug cinnarizine (CIN), the Plu-SLH delivery system was shown to offer significant biopharmaceutical advantages in comparison with unformulated drug and drug in the silica-lipid hybrid (SLH) system. In vitro two-phase dissolution studies illustrated significantly reduced pH provoked CIN precipitation and an 8- to 14-fold improvement in the extent of dissolution in intestinal conditions. In addition, under simulated intestinal digesting conditions, the Plu-SLH provided approximately three times more drug solubilization than the SLH. Oral administration in rats resulted in superior bioavailability for Plu-SLH microparticles, i.e., 1.6- and 2.1-fold greater than the SLH and the unformulated CIN, respectively. A physical mixture of Pluronic and SLH (Plu&SLH), having the same composition as Plu-SLH, was also evaluated, but showed no significant increase in CIN absorption when compared to unmodified CIN or SLH. This work represents the first study where different methods of incorporating PPI to formulate solid-state lipid-based formulations were compared for the impact on the biopharmaceutical performance. The data suggest that the novel physicochemical properties and structure of the fabricated Plu-SLH microparticle delivery system play an important role in facilitating the synergistic advantage of Labrasol and Pluronic F127 in preventing drug precipitation, and the Plu-SLH provides efficient oral delivery of poorly water-soluble weak bases. PMID:26523928

  7. A Review of the Evidence Base of Functional Assessment-Based Interventions for Young Students Using One Systematic Approach

    ERIC Educational Resources Information Center

    Wood, Brenna K.; Oakes, Wendy Peia; Fettig, Angel; Lane, Kathleen Lynne

    2015-01-01

    This review of the literature was conducted to explore the evidence base for functional assessment-based interventions (FABIs) for one systematic approach developed by Umbreit, Ferro, Liaupsin, and Lane (2007). Specifically, this review examined the evidence base for this systematic approach to FABI for young students by applying quality…

  8. Security weaknesses in two multi-server password based authentication protocols

    E-print Network

    International Association for Cryptologic Research (IACR)

    . proposed a smart card based password authentication schemes for multi-server environments, respectively flaws in these two protocols. Keywords: multi-server, remote password authenticationl, smart card, key circuits card (IC card or smart card). At that time, it was used as the debit card by the bank. Recenlly

  9. Knowledge-Based Weak Supervision for Information Extraction of Overlapping Relations

    E-print Network

    Zettlemoyer, Luke

    Hoffmann, Congle Zhang, Xiao Ling, Luke Zettlemoyer, Daniel S. Weld Computer Science & Engineering University of Washington Seattle, WA 98195, USA {raphaelh,clzhang,xiaoling,lsz,weld a large repository of high-quality extracted tuples, arguing that such a knowledge base could benefit many

  10. 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...

  11. Strengths and Weaknesses of Elementary and Secondary Education in Uganda: Evaluation Based on a Teachers' Survey

    ERIC Educational Resources Information Center

    Walugembe, Frederick

    2009-01-01

    This study intends to identify the aspects of the Ugandan teachers' jobs and work environment perceived by selective participants as satisfactory, as well as those perceived as less satisfactory or unsatisfactory. The study is based on the assumption that teachers, being directly involved in the current activities of educational institutions, have…

  12. Evolution of evidence-based guidelines for home care: Wisconsin's experience.

    PubMed

    Spitz, Bobbie; Fraker, Cindy; Meyer, Cheryl P; Peterson, Terri

    2007-05-01

    In a pay-for-performance home health system, achieving superior patient outcomes becomes the key to agency success. Evidence-based guidelines help in the achievement of exceptional patient outcomes. In this article, the Wisconsin Homecare Organization (WHO) describes its journey toward basing its home health practice on evidence-based guidelines. PMID:17495563

  13. Towards Evidence-Based Practice in Language Intervention for Bilingual Children

    ERIC Educational Resources Information Center

    Thordardottir, Elin

    2010-01-01

    Evidence-based practice requires that clinical decisions be based on evidence from rigorously controlled research studies. At this time, very few studies have directly examined the efficacy of clinical intervention methods for bilingual children. Clinical decisions for this population cannot, therefore, be based on the strongest forms of research…

  14. Factors influencing the development of evidence-based practice among nurses: a self-report survey

    PubMed Central

    2012-01-01

    Background Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP). The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice. PMID:23092366

  15. Librarian involvement in a nutrition undergraduate research course: preparing nutrition students for evidence-based practice.

    PubMed

    Smith, Susan C; Penumetcha, Meera

    2010-01-01

    Given the foundational importance of literature searching skills to later stages of research and, ultimately, evidence-based practice, the authors wanted to assess a unique strategy for teaching such skills. This pilot study describes the results of an undergraduate nutrition research course in which a librarian lead several class sessions. The goal of this study was to assess students' perceptions, attitudes and use of research literature and resources before and after a course partially taught by a librarian. Twenty-seven students enrolled in an undergraduate Introduction to Research course at Georgia State University were given pre- and post-test questionnaires at the beginning and end of a course that included three librarian-led class sessions. Most of the results indicate that the repeated involvement of a librarian enriched this particular undergraduate research course. By the end of the course, students were more comfortable in libraries and with using library resources; they used the campus library more frequently; they were more confident in their ability to find high-quality information on nutrition-related topics and identify strengths and weaknesses of different information sources; and they felt they gained skills that will help them achieve their educational and career goals. PMID:20539924

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

    ERIC Educational Resources Information Center

    Mattox, Teryn; Kilburn, M. Rebecca

    2012-01-01

    With the growing and diverse use of the term "evidence-based practice" it can be difficult for policymakers, funders, program officers, and other professionals to separate the good evidence from the flawed. Furthermore, once good evidence has been identified, it can be difficult to know how to use it. This article discusses key issues to consider…

  17. Impact of an evidence-based practice course on occupational therapist's confidence levels and goals.

    PubMed

    Brangan, Joan; Quinn, Sarah; Spirtos, Michelle

    2015-01-01

    Confidence levels of 136 Irish occupational therapists were measured before and after an evidence based practice training course. Ranked scores on the evidence based practice confidence scale showed statistically significant improvement in all areas between pre and post course. Goals set by therapists to integrate EBP into their practice following the course were analysed and grouped into categories which included: 1) getting ready to use evidence based practice, 2) examining current and best practices, and 3) promoting a culture of evidence based practice in the workplace. Course feedback using Likert scales identified satisfaction with course content and delivery method. PMID:25337671

  18. Evidence based practice in clinical physiotherapy education: a qualitative interpretive description

    PubMed Central

    2013-01-01

    Background Health care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students’ use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers. Methods In total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process. Results Four integrative themes emerged from the analysis: “attempt to apply evidence-based practice”, “novices in clinical practice”, “prioritize practice experience over evidence-based practice” and “lack role models in evidence-based practice”. Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice. Conclusions Clinical instructors are in a position to influence students during clinical education, and thus, important potential role models in evidence-based practice. Actions from academic and clinical settings are needed to improve competence in evidence-based practice among clinical instructors, and future research is needed to investigate the effect of such efforts on students’ behaviour. PMID:23578211

  19. Evidence-based nutritional support of the elderly cancer patient.

    PubMed

    Bozzetti, Federico

    2015-04-01

    The papers included in this section represent the effort of the Task Force on Nutrition of the International Society of Geriatric Oncology to synthetize the evidence-based concepts on nutritional support of the elderly cancer patients. In the attempt of presenting a comprehensive overview of the topic, the panel included experts from different specialties: basic researchers, nutritionists, geriatricians, nurses, dieticians, gastroenterologists, oncologists. Cancer in elderly people is a growing problem. Not only in almost every country, the proportion of people aged over 60 years is growing faster than any other age group, but cancer per se is also a disease of old adult-elderly people, hence the oncologists face an increasing number of these patients both now and in the next years. The are several studies on nutrition of elderly subjects and many other on nutrition of cancer patients but relatively few specifically devoted to the nutritional support of the elderly cancer patients. However, the awareness that elderly subjects account for a high proportion of the mixed cancer patients population, in some way legitimates us to extend some conclusions of the literature also to the elderly cancer patients. Although the topics of this Experts' Consensus have been written by specialists in different areas of nutrition, the final message is addressed to the oncologists. Not only they should be more directly involved in the simplest steps of the nutritional care (recognition of the potential existence of a "nutritional risk" which can compromise the planned oncologic program, use of some oral supplements, etc.) but, as the true experts of the natural history of their cancer patient, they should also coordinate the process of the nutritional support, integrating this approach in the overall multidisciplinary cancer care. PMID:25770321

  20. Incorporating patient and family preferences into evidence-based medicine

    PubMed Central

    2013-01-01

    Background Clinicians are encouraged to practice evidence-based medicine (EBM) as well as patient-centered medicine. At times, these paradigms seem to be mutually exclusive and difficult to reconcile. It can become even more challenging when trying to include the preferences of the patient’s family members. This paper discusses the basis for this quandary, providing examples of the real-world impact it has on diagnosis-seeking and treatment decision-making behaviors and how it might inform implementation of EBM practices. Analysis To further explore the role of friends and family in health-care decision making and to understand how patients and families introduce other considerations that may or may not be congruent with a strictly EBM approach, data from two research studies that examined healthcare–seeking behaviors are presented. Both studies explore how family and friends not only can influence health-care decisions but also may be a source of conflict for the patient and/or clinician. Conclusions Illness is a biological and social process. Clinicians who engage in EBM need to acknowledge the social and cultural factors that affect the health-care encounter, understand the important role of those factors in health-care decision making, and expand the paradigm of EBM to incorporate sociocultural influences more explicitly. Moreover, recognition of the influences family members and other caregivers have within the clinical encounter—by offering opinions and participating in treatment-related decision making—is needed and could lead to more efficient and effective health care. PMID:24565268

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

    PubMed

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

    2009-05-01

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

  2. Evidence-Based Comprehensive Treatments for Early Autism

    PubMed Central

    Rogers, Sally J.; Vismara, Laurie A.

    2010-01-01

    Early intervention for children with autism is currently a politically and scientifically complex topic. Randomized controlled trials have demonstrated positive effects in both short-term and longer term studies. The evidence suggests that early intervention programs are indeed beneficial for children with autism, often improving developmental functioning and decreasing maladaptive behaviors and symptom severity at the level of group analysis. Whether such changes lead to significant improvements in terms of greater independence and vocational and social functioning in adulthood is also unknown. Given the few randomized controlled treatment trials that have been carried out, the few models that have been tested, and the large differences in interventions that are being published, it is clear that the field is still very early in the process of determining (a) what kinds of interventions are most efficacious in early autism, (b) what variables moderate and mediate treatment gains and improved outcomes following intervention, and (c) the degree of both short-term and long-term improvements that can reasonably be expected. To examine these current research needs, the empirical studies of comprehensive treatments for young children with autism published since 1998 were reviewed. Lovaas's treatment meet Chambless and colleague's (Chambless et al., 1998; Chambless et al., 1996) criteria for “well-established” and no treatment meets the “probably efficacious” criteria, though three treatments meet criteria for “possibly efficacious” (Chambless & Hollon, 1998). Most studies were either Type 2 or 3 in terms of their methodological rigor based on Nathan and Gorman's (2002) criteria. Implications of these findings are also discussed in relation to practice guidelines as well as critical areas of research that have yet to be answered PMID:18444052

  3. Regulation of intracellular pH in sea urchin eggs by medium containing both weak acid and base.

    PubMed

    Hamaguchi, M S; Watanabe, K; Hamaguchi, Y

    1997-08-01

    To establish a method of pHi regulation and to understand the pH regulation mechanism in the cell, we investigated the pHi response of unfertilized or fertilized eggs of sea urchin, applying sea water containing both weak permeant acid, acetic acid and/or base, ammonia, to eggs. Pyranine was employed as a pH indicator to measure intracellular pH (pHi) by microfluorometry. The unfertilized/fertilized eggs had a pHi of 6.80/7.34 and 6.81/7.32 for Schaphechinus mirabilis and Hemicentrotus pulcherrimus, respectively. With the addition of both acetic acid and ammonia to the media, pHi changed linearly against extracellular pH (pHo) between 6-8 and was almost equal to pHo at the concentration of 20 mM acetate and ammonia. This mixed application was proved to be available for regulating pHi at the desired value within a wide range involving the original pHi by a single solution system. pHi after the treatment was dependent on various factors, such as the concentration of the weak acid and base, the pHi before the treatment, and pH buffering power in the cytoplasm. The latter was estimated to be 43 mM and 58 mM in unfertilized and fertilized eggs, respectively, from the measurement of pHi change induced by microinjecting a HEPES solution, assuming that the pH buffering power is caused by phosphate. PMID:9368712

  4. New gel-like polymers as selective weak-base anion exchangers.

    PubMed

    Gierczyk, B?a?ej; Ceg?owski, Micha?; 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

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

    PubMed Central

    Gierczyk, B?a?ej; Ceg?owski, Micha?; 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

  6. [Adjuvant chemotherapy based on evidence-based medicine for breast cancer patients].

    PubMed

    Tokudome, Nahomi; Ito, Yoshinori

    2006-03-01

    Adjuvant chemotherapy for breast cancer patients has been derived from the results of various clinical studies and metaanalysis. Currently, an anthracycline-containing regimen is a standard chemotherapy for node-negative breast cancer patients with any risk of recurrence. Node-positive breast cancer patients employ AC followed by taxane. The concept of dose-dense therapy or adjuvant trastuzumab for HER 2-positive breast cancer patients will be introduced in the near future. We have to catch the procedures of standard treatments and treat our patients with the latest knowledge. Therefore, we can refer to any guidelines based on evidence-based medicine. PMID:16531711

  7. 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.

  8. Treatment of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines with Special Emphasis on Complementary and Alternative Therapies

    PubMed Central

    Fitzcharles, Mary-Ann; Buskila, Dan; Shir, Yoram; Sommer, Claudia

    2013-01-01

    Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS). First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin) and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran) were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques). PMID:24348701

  9. Preparing Facilitators From Community-Based Organizations for Evidence-Based Intervention Training in Second Life

    PubMed Central

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

    2014-01-01

    Background A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. Objective The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. Methods We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Results Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Conclusions Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost-effective and accessible training options for evidence-based interventions. PMID:25270991

  10. Implementing evidence-based medicine in general practice: a focus group based study

    PubMed Central

    Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

    2005-01-01

    Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

  11. Parallel inhibition of active force and relaxed fiber stiffness by caldesmon fragments at physiological ionic strength and temperature conditions: additional evidence that weak cross-bridge binding to actin is an essential intermediate for force generation.

    PubMed Central

    Kraft, T; Chalovich, J M; Yu, L C; Brenner, B

    1995-01-01

    Previously we showed that stiffness of relaxed fibers and active force generated in single skinned fibers of rabbit psoas muscle are inhibited in parallel by actin-binding fragments of caldesmon, an actin-associated protein of smooth muscle, under conditions in which a large fraction of cross-bridges is weakly attached to actin (ionic strength of 50 mM and temperature of 5 degrees C). These results suggested that weak cross-bridge attachment to actin is essential for force generation. The present study provides evidence that this is also true for physiological ionic strength (170 mM) at temperatures up to 30 degrees C, suggesting that weak cross-bridge binding to actin is generally required for force generation. In addition, we show that the inhibition of active force is not a result of changes in cross-bridge cycling kinetics but apparently results from selective inhibition of weak cross-bridge binding to actin. Together with our previous biochemical, mechanical, and structural studies, these findings support the proposal that weak cross-bridge attachment to actin is an essential intermediate on the path to force generation and are consistent with the concept that isometric force mainly results from an increase in strain of the attached cross-bridge as a result of a structural change associated with the transition from a weakly bound to a strongly bound actomyosin complex. This mechanism is different from the processes responsible for quick tension recovery that were proposed by Huxley and Simmons (Proposed mechanism of force generation in striated muscle. Nature. 233:533-538.) to represent the elementary mechanism of force generation. Images FIGURE 1 PMID:7647245

  12. Evidence-Based Management of Common Gallstone-Related Emergencies.

    PubMed

    Demehri, Farokh R; Alam, Hasan B

    2016-01-01

    Gallstone-related disease is among the most common clinical problems encountered worldwide. The manifestations of cholelithiasis vary greatly, ranging from mild biliary colic to life-threatening gallstone pancreatitis and cholangitis. The vast majority of gallstone-related diseases encountered in an acute setting can be categorized as biliary colic, cholecystitis, choledocholithiasis, and pancreatitis, although these diagnoses can overlap. The management of these diseases is uniquely multidisciplinary, involving many specialties and treatment options. Thus, care may be compromised due to redundant tests, treatment delays, or inconsistent management. This review outlines the evidence for initial evaluation, diagnostic workup, and treatment for the most common gallstone-related emergencies. Key principles include initial risk stratification of patients to aid in triage and timing of interventions, early initiation of appropriate antibiotics for patients with evidence of cholecystitis or cholangitis, patient selection for endoscopic biliary decompression, and growing evidence in favor of early laparoscopic cholecystectomy for clinically stable patients. PMID:25320159

  13. An evidence-based evaluation of endometriosis-associated infertility.

    PubMed

    Pritts, Elizabeth A; Taylor, Robert N

    2003-09-01

    Although endometriosis is associated with infertility, a clear causal relationship has yet to be established, unless adhesive disease is found. Despite this indirect association, multiple theories have been promulgated and studies are currently underway to investigate theoretic pathogenetic mechanisms. The data regarding the treatment of endometriosis-associated infertility are limited and conflicting; however, some general preliminary conclusions can be drawn. It seems that, with early-stage disease, surgical treatment increases pregnancy rates. Using the US Preventive Services Task Force classification scheme, the evidence in support of this finding is of the highest quality, or level I. Surgical treatment for moderate and severe disease also confers benefit, although the evidence in support of this treatment is of lesser quality, level II-3 by the scheme. Medical treatment, particularly if it induces an anovulatory state, has no benefit and may delay fertility. This evidence is again of the highest quality, with a classification of level I. Although assisted reproductive technologies are of benefit regarding fertility for women with endometriosis, the IVF evidence is inconclusive, with both treatments being evaluated by at least one randomized, controlled trial conferring a level I classification to the evidence. It is unclear at this time whether endometriomas have an impact on IVF outcome. The evidence consists of only a few lower-quality studies, with a classification level of II-2. Despite the haziness of current insight into the treatment of endometriosis-associated infertility, well-designed clinical trials and basic mechanistic investigations are underway in many reproductive medicine centers. As the data from these scientific inquiries emerge, clinicians will have a clearer view of effective treatment regimens for endometriosis. PMID:14560892

  14. Evidence-based diuretics: focus on chlorthalidone and indapamide.

    PubMed

    DiNicolantonio, James J; Bhutani, Jaikrit; Lavie, Carl J; O'Keefe, James H

    2015-03-01

    Thiazide and thiazide-like diuretics are cornerstone treatments for hypertension. However, unlike chlorthalidone (CTD) and indapamide (IDP), hydrochlorothiazide (HCTZ) lacks evidence for reducing morbidity and mortality as monotherapy compared with placebo or control. Despite this fact, HCTZ is prescribed much more frequently than CTD or IDP. We believe that all hypertension guidelines should follow the National Institute for Health and Excellence (NICE) and make IDP and CTD first choice 'thiazide-like diuretics.' This article will focus on the available evidence pertaining to HCTZ versus CTD and IDP. We will review the pharmacological differences between these three diuretics, as well as the clinical trial data and important side effects. PMID:25760879

  15. Evaluating the Properties of the Evidence-Based Practice Attitude Scale (EBPAS) in Health Care

    ERIC Educational Resources Information Center

    Melas, Christos D.; Zampetakis, Leonidas A.; Dimopoulou, Anastasia; Moustakis, Vassilis

    2012-01-01

    The Evidence-Based Practice Attitude Scale (EBPAS; Aarons, 2004) is a relatively new construct for the study of attitudes toward the adoption of innovation and evidence-based practices (EBPs) in mental health service settings. Despite widespread interest in measuring the attitudes of health care providers in conjunction with the adoption of EBPs,…

  16. Evidence-Based Practice and Research: A Challenge to the Development of Adapted Physical Activity

    ERIC Educational Resources Information Center

    Hutzler, Yeshayahu Shayke

    2011-01-01

    Evidence-based practice (EBP) is a growing movement in the health and educational disciplines that recommends emphasis on research outcomes during decision making in practice. EBP is made possible through evidence based research (EBR), which attempts to synthesize the volume and scientific rigor of intervention effectiveness. With the purpose of…

  17. Evidence-Based Practice for Teachers of Children with Autism: A Dynamic Approach

    ERIC Educational Resources Information Center

    Lubas, Margaret; Mitchell, Jennifer; De Leo, Gianluca

    2016-01-01

    Evidence-based practice related to autism research is a controversial topic. Governmental entities and national agencies are defining evidence-based practice as a specific set of interventions that educators should implement; however, large-scale efforts to generalize autism research, which are often single-subject case designs, may be a setback…

  18. Scaffolding Preservice Science Teachers' Evidence-Based Arguments during an Investigation of Natural Selection.

    ERIC Educational Resources Information Center

    Zembal-Saul, Carla; Munford, Danusa; Crawford, Barbara; Friedrichsen, Patricia; Land, Susan

    2002-01-01

    Reports on a qualitative study in which preservice science teachers (PSTs) enrolled in an advanced methods course participated in a complex, data-rich investigation based on an adapted version of the "Struggle for Survival" curriculum. Uses the Galapagos Finches software and emphasizes giving priority to evidence and constructing evidence-based

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

    ERIC Educational Resources Information Center

    Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth

    2015-01-01

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

  20. CEC's Standards for Classifying the Evidence Base of Practices in Special Education

    ERIC Educational Resources Information Center

    Cook, Bryan G.; Buysse, Virginia; Klingner, Janette; Landrum, Timothy J.; McWilliam, R. A.; Tankersley, Melody; Test, David W.

    2015-01-01

    As an initial step toward improving the outcomes of learners with disabilities, special educators have formulated guidelines for identifying evidence-based practices. We describe the Council of Exceptional Children's new set of standards for identifying evidence-based practices in special education and how they (a) were systematically vetted by…

  1. Key Implementation Considerations for Executing Evidence-Based Programs: Project Overview. ASPE Research Brief

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2013

    2013-01-01

    In April 2011, the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) hosted a Forum, Emphasizing Evidence-Based Programs for Children and Youth, to convene the nation's leading practitioners and researchers with experience using and evaluating an array of evidence-based

  2. MedView: A Declarative Approach to Evidence-Based Medicine

    E-print Network

    Torgersson, Olof

    MedView: A Declarative Approach to Evidence-Based Medicine Göran Falkman Department of Computer Abstract. MedView is a project that meets the challenges of evidence-based oral medicine by providing", John Naisbitt exclaimed in 1982 [1]. This is perhaps particularly true for clinical medicine

  3. Network Influences on Dissemination of Evidence-Based Guidelines in State Tobacco Control Programs

    ERIC Educational Resources Information Center

    Luke, Douglas A.; Wald, Lana M.; Carothers, Bobbi J.; Bach, Laura E.; Harris, Jenine K.

    2013-01-01

    Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's "Best Practices for Comprehensive Tobacco Control Programs," are…

  4. Portable Data Assistants: Potential in Evidence-Based Practice Autism Treatment

    ERIC Educational Resources Information Center

    Dunkel-Jackson, Sarah M.; Dixon, Mark R.; Szekely, Susan

    2012-01-01

    The emerging era of "evidence-based practice" emphasizes that human service agencies need to find effective and efficient means of training staff and implementing systems change based on scientific evidence. Additional advancements in technology use across populations and settings within the field have also served as a catalyst for the development…

  5. Teaching Master's and Doctoral Social Work Students to Systematically Evaluate Evidence-Based Interventions

    ERIC Educational Resources Information Center

    Auslander, Wendy; Fisher, Colleen; Ollie, Marcia; Yu, ManSoo

    2012-01-01

    Evidence-based research relevant to social work practice has grown dramatically. This article describes a method that was implemented to teach master's and doctoral social work students how to synthesize and evaluate evidence-based interventions for social work-related problems and populations. The method includes eight steps: conceptualize the…

  6. Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up

    ERIC Educational Resources Information Center

    Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

    2005-01-01

    The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented…

  7. Creating Synergy in Practice: Promoting Complementarity between Evidence-Based and Postmodern Approaches

    ERIC Educational Resources Information Center

    Jacobs, Stephanie; Kissil, Karni; Scott, Dalesa; Davey, Maureen

    2010-01-01

    Postmodern and evidence-based practice (EBP) are compared and contrasted with the primary aim of adapting evidence-based practice with a more flexible epistemological lens. We begin by reviewing the epistemological underpinnings of postmodern and EBP within the field of marriage and family therapy (MFT). We next discuss how these contrasting…

  8. Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

    ERIC Educational Resources Information Center

    DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

    2012-01-01

    Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

  9. No evidence for survival selection on carotenoid-based nestling coloration in great tits (Parus major)

    E-print Network

    Richner, Heinz

    No evidence for survival selection on carotenoid-based nestling coloration in great tits (Parus be the reason for its evolution. Here we test whether the carotenoid-based nestling coloration of great tits

  10. Putting evidence into practice: an update of evidence-based interventions for cancer-related fatigue during and following treatment.

    PubMed

    Mitchell, Sandra A; Hoffman, Amy J; Clark, Jane C; DeGennaro, Regina M; Poirier, Patricia; Robinson, Carolene B; Weisbrod, Breanna L

    2014-01-01

    Cancer-related fatigue (CRF) has deleterious effects on physical, social, cognitive, and vocational functioning, and causes emotional and spiritual distress for patients and their families; however, it remains under-recognized and undertreated. This article critically reviews and integrates the available empirical evidence supporting the efficacy of pharmacologic and nonpharmacologic treatment approaches to CRF, highlighting new evidence since 2007 and 2009 Putting Evidence Into Practice publications. Interventions that are recommended for practice or likely to be effective in improving fatigue outcomes include exercise; screening for treatable risk factors; management of concurrent symptoms; yoga; structured rehabilitation; Wisconsin ginseng; cognitive-behavioral therapies for insomnia, pain, and depression; mindfulness-based stress reduction; and psychoeducational interventions such as anticipatory guidance, psychosocial support, and energy conservation and activity management. This information can be applied to improve the management of CRF, inform health policy and program development, shape the design of clinical trials of new therapies for CRF, and drive basic and translational research. PMID:25427608

  11. Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

    PubMed

    Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

    2014-01-01

    Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare. PMID:24943520

  12. Mixing Strong and Weak Targets Provides No Evidence against the Unequal-Variance Explanation of zRoc Slope: A Comment on Koen and Yonelinas (2010)

    ERIC Educational Resources Information Center

    Starns, Jeffrey J.; Rotello, Caren M.; Ratcliff, Roger

    2012-01-01

    Koen and Yonelinas (2010; K&Y) reported that mixing classes of targets that had short (weak) or long (strong) study times had no impact on zROC slope, contradicting the predictions of the encoding variability hypothesis. We show that they actually derived their predictions from a mixture unequal-variance signal detection (UVSD) model, which…

  13. Evidence-Based Approaches to Improving Chemical Equilibrium Instruction

    ERIC Educational Resources Information Center

    Davenport, Jodi L.; Leinhardt, Gaea; Greeno, James; Koedinger, Kenneth; Klahr, David; Karabinos, Michael; Yaron, David J.

    2014-01-01

    Two suggestions for instruction in chemical equilibrium are presented, along with the evidence that supports these suggestions. The first is to use diagrams to connect chemical reactions to the effects of reactions on concentrations. The second is the use of the majority and minority species (M&M) strategy to analyze chemical equilibrium…

  14. Heritability in Cognitive Performance: Evidence Using Computer-Based Testing

    ERIC Educational Resources Information Center

    Hervey, Aaron S.; Greenfield, Kathryn; Gualtieri, C. Thomas

    2012-01-01

    There is overwhelming evidence of genetic influence on cognition. The effect is seen in general cognitive ability, as well as in specific cognitive domains. A conventional assessment approach using face-to-face paper and pencil testing is difficult for large-scale studies. Computerized neurocognitive testing is a suitable alternative. A total of…

  15. Reconstructing sickle cell disease: a data-based analysis of the "hyperhemolysis paradigm" for pulmonary hypertension from the perspective of evidence-based medicine.

    PubMed

    Hebbel, Robert P

    2011-02-01

    The "hyperhemolytic paradigm" (HHP) posits that hemolysis in sickle disease sequentially and causally establishes increased cell-free plasma Hb, consumption of NO, a state of NO biodeficiency, endothelial dysfunction, and a high prevalence of pulmonary hypertension. The basic science underpinning this concept has added an important facet to the complexity of vascular pathobiology in sickle disease, and clinical research has identified worrisome clinical issues. However, this critique identifies and explains a number of significant concerns about the various HHP component tenets. In addressing these issues, this report presents: a very brief history of the HHP, an integrated synthesis of mechanisms underlying sickle hemolysis, a review of the evidentiary value of hemolysis biomarkers, an examination of evidence bearing on existence of a hyperhemolytic subgroup, and a series of questions that should naturally be applied to the HHP if it is examined using critical thinking skills, the fundamental basis of evidence-based medicine. The veracity of different HHP tenets is found to vary from true, to weakly supported, to demonstrably false. The thesis is developed that the HHP has misidentified the mechanism and clinical significance of its findings. The extant research questions identified by these analyses are delineated, and a conservative, evidence-based approach is suggested for application in clinical medicine. PMID:21264896

  16. Use of Web 2.0 Technologies in K-12 and Higher Education: The Search for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Hew, Khe Foon; Cheung, Wing Sum

    2013-01-01

    Evidence-based practice in education entails making pedagogical decisions that are informed by relevant empirical research evidence. The main purpose of this paper is to discuss evidence-based pedagogical approaches related to the use of Web 2.0 technologies in both K-12 and higher education settings. The use of such evidence-based practice would…

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

    PubMed

    Archibald, Thomas

    2015-02-01

    Community education and outreach programs should be evidence-based. This dictum seems at once warranted, welcome, and slightly platitudinous. However, the "evidence-based" movement's more narrow definition of evidence--privileging randomized controlled trials as the "gold standard"--has fomented much debate. Such debate, though insightful, often lacks grounding in actual practice. To address that lack, the purpose of the study presented in this paper was to examine what actually happens, in practice, when people support the implementation of evidence-based programs (EBPs) or engage in related efforts to make non-formal education more "evidence-based." Focusing on three cases--two adolescent sexual health projects (one in the United States and one in Kenya) and one more general youth development organization--I used qualitative methods to address the questions: (1) How is evidence-based program and evidence-based practice work actually practiced? (2) What perspectives and assumptions about what non-formal education is are manifested through that work? and (3) What conflicts and tensions emerge through that work related to those perspectives and assumptions? Informed by theoretical perspectives on the intersection of science, expertise, and democracy, I conclude that the current dominant approach to making non-formal education more evidence-based by way of EBPs is seriously flawed. PMID:25204228

  18. Theory- and Evidence- Based Intervention: Practice-Based Evidence--Integrating Positive Psychology into a Clinical Psychological Assessment and Intervention Model and How to Measure Outcome

    ERIC Educational Resources Information Center

    Nissen, Poul

    2011-01-01

    In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence- based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning, which includes recognition of the influence of community, school, peers, family and the…

  19. An 'adjustable' calculator program to determine fraction of species versus pH profiles for mono-, di- or triprotic weak acids or bases.

    PubMed

    Hajratwala, B R

    1985-09-01

    A calculator program for TI-58/59 is presented which determines the fraction of dissociated and undissociated species of weak acids and bases, provided values for dissociation constants and pH are known. The answers are displayed in exponential notation. The calculations can be repeated at as many pH-values as required to obtain a satisfactory fraction of species versus pH profile. The program is made 'adjustable' by deleting selected program steps to accommodate calculations for mono-, di- or triprotic weak acids or bases. PMID:3840462

  20. Evidence-Based of Nonoperative Treatment in Adolescent Idiopathic Scoliosis

    PubMed Central

    2014-01-01

    Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence. PMID:25346826

  1. Pattern search in multi-structure data: a framework for the next-generation evidence-based medicine

    NASA Astrophysics Data System (ADS)

    Sukumar, Sreenivas R.; Ainsworth, Keela C.

    2014-03-01

    With the impetus towards personalized and evidence-based medicine, the need for a framework to analyze/interpret quantitative measurements (blood work, toxicology, etc.) with qualitative descriptions (specialist reports after reading images, bio-medical knowledgebase, etc.) to predict diagnostic risks is fast emerging. Addressing this need, we pose and answer the following questions: (i) How can we jointly analyze and explore measurement data in context with qualitative domain knowledge? (ii) How can we search and hypothesize patterns (not known apriori) from such multi-structure data? (iii) How can we build predictive models by integrating weakly-associated multi-relational multi-structure data? We propose a framework towards answering these questions. We describe a software solution that leverages hardware for scalable in-memory analytics and applies next-generation semantic query tools on medical data.

  2. The dark side of cognitive illusions: When an illusory belief interferes with the acquisition of evidence-based knowledge.

    PubMed

    Yarritu, Ion; Matute, Helena; Luque, David

    2015-11-01

    Cognitive illusions are often associated with mental health and well-being. However, they are not without risk. This research shows they can interfere with the acquisition of evidence-based knowledge. During the first phase of the experiment, one group of participants was induced to develop a strong illusion that a placebo medicine was effective to treat a fictitious disease, whereas another group was induced to develop a weak illusion. Then, in Phase 2, both groups observed fictitious patients who always took the bogus treatment simultaneously with a second treatment which was effective. Our results showed that the group who developed the strong illusion about the effectiveness of the bogus treatment during Phase 1 had more difficulties in learning during Phase 2 that the added treatment was effective. PMID:25641547

  3. Evidence based knee injections for the management of arthritis

    PubMed Central

    Cheng, Olivia T.; Souzdalnitski, Dmitri; Vrooman, Bruce; Cheng, Jianguo

    2012-01-01

    Objective Arthritis of the knee affects 46 million Americans. We aimed to determine the level of evidence of intraarticular knee injections in the management of arthritic knee pain. Methods We systematically searched PUBMED/MEDLINE and the Cochrane databases for articles published on knee injections and evaluated their level of evidence and recommendations according to established criteria. Results The evidence supports the use of intraarticular corticosteroid injections for rheumatoid arthritis (1A+ level), osteoarthritis (1A+ level), and juvenile idiopathic arthritis (2C+ level). Pain relief and functional improvement are significant for months up to one year after the injection. Triamcinolone hexacetonide offers an advantage over triamcinolone acetonide and should be the intraarticular steroid of choice (2B+ level). Intraarticular injection of hyaluronate may provide longer pain relief than steroid injection in osteoarthritis (2B+ level). It can also be effective for rheumatoid arthritis knee pain (1A+ level). However, it is only recommended for patients with significant surgical risk factors and for patients with mild radiographic disease in whom conservative treatment has failed (2B± level). Botulinum toxin Type A injection is effective in reducing arthritic knee pain (2B+ level) and so is tropisetron (2B+ level) and tanezumab (2B+ level). The new agents, such as rAAV2-TNFR:Fc, SB-210396/CE 9.1, and various radioisotopes have provided various degrees of success, but their long-term safety and efficacy remains to be determined. Conclusions We conclude that strong evidence supports the use of intraarticular knee injection as a valuable intervention in the continuum of management of arthritis between conservative treatment and knee surgeries. PMID:22621287

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

    PubMed Central

    Aarons, Gregory A.

    2006-01-01

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

  5. Vacancy ion-exclusion/adsorption chromatography of aliphatic amines on a polymethacrylate-based weakly basic anion-exchange column.

    PubMed

    Mori, Masanobu; Helaleh, Murad I H; Xu, Qun; Hu, Wenzhi; Ikedo, Mikaru; Ding, Ming-Yu; Taoda, Hiroshi; Tanaka, Kazuhiko

    2004-06-11

    Vacancy ion-exclusion/adsorption chromatography has been applied to investigate the separation behavior of five aliphatic amines (ethylamine, propylamine, butylamine, pentylamine and hexylamine) on a polymethacrylate-based weakly basic anion-exchange column (Tosoh TSKgel DEAE-5PW). This system is consisted of analytes as a mobile phase and water as an injected sample. In the vacancy ion-exclusion/adsorption chromatography, the elution order was as follows: ethylamine < propylamine < butylamine < pentylamine < hexylamine, depending on their hydrophobicity. The retention times of the amines were decreased with decreasing their concentrations in the mobile phase. The retention times and resolutions of the amines were increased by adding a basic compound (e.g., lithium hydroxide or heptylamine) and by increasing the pH of mobile phase (pH > 11). This was because the dissociations of amine samples in the mobile phase were suppressed and thus the hydrophobic adsorption effects were enhanced. The linearity of calibration graphs could be obtained from the peak areas of the amine samples injected to the 0.05, 0.5 and 5 mM of amine mobile phase at pH 11 by heptylamine. The detection limits of aliphatic amines as injected samples were around 1 microM for five aliphatic amines at three different amine mobile phases. From these results, the retention behaviors of aliphatic amines on vacancy ion-exclusion/adsorption chromatography were concluded to be governed by the hydrophobic adsorption effect. PMID:15250414

  6. Systemic treatments in paediatric psoriasis: a systematic evidence-based update.

    PubMed

    van Geel, M J; Mul, K; de Jager, M E A; van de Kerkhof, P C M; de Jong, E M G J; Seyger, M M B

    2015-03-01

    In 2008, a systematic review revealed that evidence-based data on efficacy and safety of treatments in paediatric psoriasis are scarce and with low level of evidence. In recent years, publications on this topic have increased exponentially. To present a systematic, evidence-based update on the efficacy and safety of systemic treatments in paediatric psoriasis and to provide treatment recommendations, an update of the previous review was performed. PubMed, EMBASE and the Cochrane Controlled Clinical Trial Register were searched between January 2007 and March 2014 for all available literature on efficacy and safety of all systemic treatments in paediatric psoriasis. The levels of evidence were determined on the Oxford Centre for Evidence-based Medicine Levels of Evidence. The newly retrieved evidence was combined with the evidence available in the former review. Fifty-two studies were included: 36 from the former review, plus 16 new articles. New evidence on induction therapy was mainly available on fumaric acid esters (FAEs), which are shown to be effective in a subgroup of patients. Long-term (96 weeks) safety and efficacy data on etanercept were found. Prospective studies are scarce. Most conclusions are formulated on studies with low level of evidence. Of the conventional systemic treatments, methotrexate still has the most evidence albeit in a low number of patients and with a low level of evidence. FAEs seem to be effective in a subgroup of patients, with gastro-intestinal complaints, flushes and temporary shifts in leucocyte counts and liver enzymes being the main side-effects. Etanercept has still accumulated most evidence of the available systematic treatments, with a large efficacy and reassuring safety profile in a 96-week follow-up. PMID:25346019

  7. Can evidence-based medicine change toilet-training practice?

    PubMed Central

    Wu, Hsi-Yang

    2012-01-01

    Objectives To assess the evidence showing that a specific method of toilet training (TT) is more effective than others, as any method of TT recommended by a physician faces obstacles because parents rarely request advice on TT from physicians, and TT practices vary tremendously across cultures and socioeconomic levels. Methods Reports on the natural course of urinary incontinence in children and different methods of TT, published in English between 1946 and 2012, were reviewed. Specifically investigated were historical recommendations on TT, the prevalence of urinary incontinence during childhood, the outcome of TT methods, and the effect of culture and socioeconomic status on the choice of TT method and timing. Results TT now occurs at later ages than it did previously. This progression reflects changing ideas about normal childhood physiology and psychology. The prevalence of urinary incontinence in European countries progressively decreased in children aged between 6–7 years and 16–17 years old. TT methods change with increasing socioeconomic levels to ‘child-centred’ techniques applied at older ages, but the prevalence of urinary incontinence after ‘parent-centred’ techniques of TT at younger ages has not been studied. There is currently no evidence that a specific timing or method of TT is more effective or prevents voiding dysfunction. Conclusions Follow-up studies of urinary continence in children toilet trained at 6–12 months of age might provide evidence for whether a given method or timing of TT is beneficial to prevent voiding dysfunction. The recommendations of physicians might be more readily adopted if they fit culturally accepted ideas of good parenting techniques.

  8. Surgical Management of Adrenocortical Carcinoma: An Evidence-Based Approach.

    PubMed

    Datta, Jashodeep; Roses, Robert E

    2016-01-01

    Adrenocortical carcinoma frequently presents with sequelae of steroid precursor overproduction and has a proclivity for aggressive local growth, early metastasis, and recurrence. En bloc surgical resection with negative margins is the cornerstone of therapy for localized disease, and re-resection has a role in selected recurrent cases. Presence of occult micrometastatic disease at the time of presentation is confirmed by frequent distant failure after apparent negative margin resection. Data for many aspects of therapy are limited or nonexistent. This review critically considers existing evidence with a particular focus on surgical management. PMID:26610780

  9. Acupuncture for Pain Management in Evidence-based Medicine.

    PubMed

    Ning, Zhipeng; Lao, Lixing

    2015-10-01

    Pain is an enormous and prevalent problem that troubles people of all ages worldwide. The effectiveness of acupuncture for pain management has been strongly verified by large randomized controlled trials (RCTs) and meta-analyses. Increasing numbers of patients with pain have accepted acupuncture treatment worldwide. However, some challenges exist in establishing evidence for the efficacy of acupuncture. A more applicable and innovative research methodology that can reflect the effect of acupuncture in the settings of daily clinical practice needs to be developed. PMID:26433806

  10. Why evidence-based medicine is a good approach in physical and rehabilitation medicine. Thesis.

    PubMed

    Negrini, S

    2014-10-01

    According to a good definition, evidence-based medicine (EBM) is: "The explicit, conscientious, and judicious use of the current best evidence in making decisions about the care of individual patients (and populations)". More appropriate in a clinical context like that of physical and rehabilitation medicine (PRM) is looking at evidence based clinical practice (EBCP), whose definition is: "The integration of best research evidence with clinical expertise and patient values". In the past the term evidence-based physical and rehabilitation medicine (EBPRM) was also proposed. In this thesis, after some historical notes on EBM and on PRM, we will discuss why in our view EBPRM must be the real foundation of our everyday PRM clinical practice. PMID:25201616

  11. Acute Management of Open Fractures: An Evidence-Based Review.

    PubMed

    Halawi, Mohamad J; Morwood, Michael P

    2015-11-01

    Open fractures are complex injuries associated with high morbidity and mortality. Despite advances made in fracture care and infection prevention, open fractures remain a therapeutic challenge with varying levels of evidence to support some of the most commonly used practices. Additionally, a significant number of studies on this topic have focused on open tibial fractures. A systematic approach to evaluation and management should begin as soon as immediate life-threatening conditions have been stabilized. The Gustilo classification is arguably the most widely used method for characterizing open fractures. A first-generation cephalosporin should be administered as soon as possible. The optimal duration of antibiotics has not been well defined, but they should be continued for 24 hours. There is inconclusive evidence to support either extending the duration or broadening the antibiotic prophylaxis for type Gustilo type III wounds. Urgent surgical irrigation and debridement remains the mainstay of infection eradication, although questions persist regarding the optimal irrigation solution, volume, and delivery pressure. Wound sampling has a poor predictive value in determining subsequent infections. Early wound closure is recommended to minimize the risk of infection and cannot be substituted by negative-pressure wound therapy. Antibiotic-impregnated devices can be important adjuncts to systemic antibiotics in highly contaminated or comminuted injuries. Multiple fixation techniques are available, each having advantages and disadvantages. It is extremely important to maintain a high index of suspicion for compartment syndrome, especially in the setting of high-energy trauma. [Orthopedics. 2015; 38(11):e1025-e1033.]. PMID:26558667

  12. Cystatin C–A Paradigm of Evidence Based Laboratory Medicine

    PubMed Central

    Chew, Janice SC; Saleem, Mohammed; Florkowski, Christopher M; George, Peter M

    2008-01-01

    Cystatin C is a 13-kDa protein, of the cysteine proteinase inhibitor superfamily, produced by all nucleated cells. Its production rate is constant throughout the ages of 1 to 50 years. It is freely filtered at the glomerulus and then resorbed and fully catabolised by proximal renal tubules, making it an ideal marker of glomerular filtration rate (GFR). Serum creatinine, the most established marker of renal function, is affected by age, gender, muscle mass, nutritional status and analytical interference. The abbreviated Modifiation of Diet in Renal Diseases (MDRD) equation has recently been introduced in an attempt to overcome these shortcomings, but still has many limitations. Cystatin C is not affected by gender, muscle mass, malignancy, its production rate is usually constant and its plasma concentration therefore is dependent only on GFR. Cystatin C has been demonstrated to be more accurate than serum creatinine in the detection of early renal impairment and in specific populations may allow for early detection of renal disease. Cystatin C has also been found to be a strong predictor of long-term clinical outcomes in patients with cardiovascular diseases. Although cystatin C may have advantages in detection of early renal impairment there is a paucity of evidence that it significantly improves clinical decision making over creatinine. This coupled with assay cost may be the reason why cystatin C, although well recognised, has not been introduced into routine operational use, although that may eventuate with emerging evidence. PMID:18787643

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

    PubMed

    Tsai, Jung-Mei

    2014-12-01

    Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application. PMID:25464952

  14. Statistical Cognition: Towards Evidence-Based Practice in Statistics and Statistics Education

    ERIC Educational Resources Information Center

    Beyth-Marom, Ruth; Fidler, Fiona; Cumming, Geoff

    2008-01-01

    Practitioners and teachers should be able to justify their chosen techniques by taking into account research results: This is evidence-based practice (EBP). We argue that, specifically, statistical practice and statistics education should be guided by evidence, and we propose statistical cognition (SC) as an integration of theory, research, and…

  15. Commissioning Pharmacological Treatments for Drug Users: A Brief Review of the Evidence Base

    ERIC Educational Resources Information Center

    Keen, Jenny; Oliver, Philip

    2004-01-01

    Aims: To provide a brief review of relevant existing evidence regarding pharmacological treatment for drug users, in order to enable commissioners and service providers to make informed decisions that are evidence based wherever possible. Methods: The review process involved an examination of key reference texts and literature derived from…

  16. Student Success Skills: An Evidence-Based School Counseling Program Grounded in Humanistic Theory

    ERIC Educational Resources Information Center

    Villares, Elizabeth; Lemberger, Matthew; Brigman, Greg; Webb, Linda

    2011-01-01

    The Student Success Skills program is an evidence-based, counselor-led intervention founded on a variety of humanistic principles. Five studies and a recent meta-analysis provide evidence that integrating human potential practices into the school by teaching students foundational learning skills strengthens the link between school counseling…

  17. Migration, Race and Education: Evidence-Based Policy or Institutional Racism?

    ERIC Educational Resources Information Center

    Warren, Simon

    2007-01-01

    The promise of evidence-based policy is that social scientific research can lead to rational planning that will lead to improved outcomes and life chances for people across the whole spectrum of social provision. This article argues that evidence is politically mobilised to legitimise the reproduction of racial and social advantage and construct…

  18. Methods for Evidence-Based Practice: Quantitative Synthesis of Single-Subject Designs

    ERIC Educational Resources Information Center

    Shadish, William R.; Rindskopf, David M.

    2007-01-01

    Good quantitative evidence does not require large, aggregate group designs. The authors describe ground-breaking work in managing the conceptual and practical demands in developing meta-analytic strategies for single subject designs in an effort to add to evidence-based practice. (Contains 2 figures.)

  19. Evidence-Based Practice at a Crossroads: The Timely Emergence of Common Elements and Common Factors

    ERIC Educational Resources Information Center

    Barth, Richard P.; Lee, Bethany R.; Lindsey, Michael A.; Collins, Kathryn S.; Strieder, Frederick; Chorpita, Bruce F.; Becker, Kimberly D.; Sparks, Jacqueline A.

    2012-01-01

    Social work is increasingly embracing evidence-based practice (EBP) as a decision-making process that incorporates the best available evidence about effective treatments given client values and preferences, in addition to social worker expertise. Yet, social work practitioners have typically encountered challenges with the application of…

  20. Understanding the Evolution of NSAID: A Knowledge Domain Visualization Approach to Evidence-Based Medicine

    E-print Network

    Chen, Chaomei

    Understanding the Evolution of NSAID: A Knowledge Domain Visualization Approach to Evidence after a three-year colon cancer clinical trial revealed an increased risk of heart attacks 18 months the evolution of a pharmacological field, which is intrinsically evidence-based medicine. The goal of the study

  1. Evidence-based Audit Jeffrey A. Vaughan Limin Jia Karl Mazurak Steve Zdancewic

    E-print Network

    Zdancewic, Steve

    Evidence-based Audit Jeffrey A. Vaughan Limin Jia Karl Mazurak Steve Zdancewic University-control decision has been made in accor- dance with policy. Using such proofs for auditing purposes is implicit ramifications of adopting this "proofs as log entries" approach to auditing. Two benefits of evidence

  2. Sight Word Instruction for Students with Autism: An Evaluation of the Evidence Base

    ERIC Educational Resources Information Center

    Spector, Janet E.

    2011-01-01

    This paper reviews the evidence on sight word instruction as a method of teaching students with autism and significant cognitive and verbal limitations to read printed words. Nine single-subject studies were rated using Reichow et al.'s ("J Autism Dev Disord" 38:1311-1319, 2008) evaluative method for identifying evidence-based practice, and…

  3. Evidence-Based Systematic Review: Effects of Nonspeech Oral Motor Exercises on Speech

    ERIC Educational Resources Information Center

    McCauley, Rebecca J.; Strand, Edythe; Lof, Gregory L.; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: The purpose of this systematic review was to examine the current evidence for the use of oral motor exercises (OMEs) on speech (i.e., speech physiology, speech production, and functional speech outcomes) as a means of supporting further research and clinicians' use of evidence-based practice. Method: The peer-reviewed literature from 1960…

  4. Current Status of Evidence-Based Practice for Students with Intellectual Disability and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    West, Elizabeth A.; McCollow, Meaghan; Umbarger, Gardner; Kidwell, James; Cote, Debra L.

    2013-01-01

    The purpose of this paper is to provide a current look at the status of evidence-based practice (EBP) for students with intellectual disability and autism spectrum disorders. Specifically, this paper will (1) provide an introduction to the history and evolution of the use of levels of evidence, (2) discuss the importance of EBPs, (3) identify…

  5. Known Knowns, Known Unknowns, Unknown Unknowns: The Predicament of Evidence-Based Policy

    ERIC Educational Resources Information Center

    Pawson, Ray; Wong, Geoff; Owen, Lesley

    2011-01-01

    The authors present a case study examining the potential for policies to be "evidence-based." To what extent is it possible to say that a decision to implement a complex social intervention is warranted on the basis of available empirical data? The case chosen is whether there is sufficient evidence to justify banning smoking in cars carrying…

  6. Evidence-Based Medicine in Managed Care: A Survey of Current and Emerging Strategies

    PubMed Central

    Keckley, Paul H

    2004-01-01

    Background Evidence-based medicine is the “conscientious application of scientific best practice by clinicians in concert with patient understanding and values.”[1] Recent studies by the Institute of Medicine, RAND, and others have called attention to the gap between scientifically supported approaches to care and day-to-day practice by clinicians. Compounding the problem of non-adherence by providers, researchers have observed that patient compliance also falls short. As a result, avoidable costs from inappropriate variability in practice patterns coupled with patient noncompliance are a significant focus of managed care. Managed care plans play a key role in the selection of providers by consumers and in the design of benefits programs by employers. Avoidable costs from misuse, overuse, and under-use of care from clinicians is a strategic focus for health plans. The evidence upon which a plan makes coverage decisions and the incorporation of evidence in programs targeting providers, employers, and consumers was a focus of this study. Methodology A Delphi survey and 2-day interactive sessions with 128 clinical program directors and medical officers from 89 health plans were the primary methods used in this descriptive analysis. To test participant applications of evidence-based medicine in health plan medical management strategy, 3 conditions were used for illustrative purpose: managing rheumatoid arthritis, increasing remission in depression, and reducing heart disease among diabetics. Each provided a unique challenge to plans in terms of condition prevalence, strength of evidence, and cost. Key Findings Health plans incorporate evidence-based medicine in 5 areas overseen by medical management: (1) coverage decisions wherein improvements in pharmaceutical and therapeutic review processes are sought, (2) disease management efforts wherein increased attention to secondary prevention is desirable, (3) provider profiling wherein increased use of adherence measures comparing practices is a focus, (4) pay-for-performance programs linking physician adherence to financial incentives, and (5) consumer-directed care programs wherein patient compliance to evidence-based treatment directives is the focus. Factors that influence a plan's approach to a patient population include prevalence of the condition, the strength of evidence about a particular diagnostic or prognostic strategy, costs associated with the condition, and the influence of employers in coverage decisions. Conclusion Evidence-based medicine is the foundation for significant activity among plans to increase physician and patient adherence. There remain significant challenges in the implementation of evidence-based care management by plans, including the willingness of plans to agree on evidence-based guidelines, the willingness of employers to pay for evidence-based interventions, the balance of short- and long-term benefits for evidence-based interventions where secondary prevention is a consideration, and substantial distrust among providers. PMID:15266281

  7. Problem-Based Learning: Outcomes Evidence from the Health Professions

    ERIC Educational Resources Information Center

    Albanese, Mark A.; Dast, Laura

    2014-01-01

    Over the past 30 years, problem-based learning (PBL) has become a major force in health professions education and even in the broader educational world. This article focuses on the outcomes that have been found from using PBL in the health professions based on at least 20 reviews done since 1990. The outcomes identified in these reviews are…

  8. 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.

  9. Being baby friendly: evidence-based breastfeeding support.

    PubMed

    Cleminson, J; Oddie, S; Renfrew, M J; McGuire, W

    2015-03-01

    Breast feeding improves important outcomes for mothers and infants. In the UK, breastfeeding rates have historically been low, particularly among socially disadvantaged young women. Although there have been gradual increases in breastfeeding initiation rates since 2000, rates of exclusive breast feeding and continuation until 6?months remain lower than those in similar countries. This review summarises the evidence for effective and cost-effective strategies to help women, particularly those in low income groups, make informed choices, overcome barriers and establish and maintain breast feeding. We describe the development and impact of the Unicef Baby Friendly Initiative, and the roles and responsibilities, and challenges and opportunities that clinicians have in promoting breast feeding and maintaining a baby-friendly culture and environment. PMID:25293712

  10. Risk assessment in offenders with intellectual disability: the evidence base.

    PubMed

    Johnston, S J

    2002-05-01

    A review of the current literature on risk assessment and management in offenders with intellectual disability (ID) revealed little direct evidence for the specific population. Theoretical models and non-ID populations have been abstracted and adapted, but not validated, for those with ID. The varying conceptual frameworks of risk, and its assessment and management, must be considered in context. Difficulties remain with the consideration of offences versus offence-like behaviour, offender versus those with similar needs, and indeed, what is regarded as 'intellectual disability'. Mainstream forensic assessment has moved towards a more dynamic appreciation of risk and risk management, as opposed to risk elimination. This development is more in line with the normalization principles of 'risk-taking' in ID. Consideration is given to future research and development priorities. PMID:12031017

  11. An Evidence-Based Public Health Approach to Climate Change Adaptation

    PubMed Central

    Eidson, Millicent; Tlumak, Jennifer E.; Raab, Kristin K.; Luber, George

    2014-01-01

    Background: Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Objectives: Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. Methods: We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. Discussion: A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. Conclusions: The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders. Citation: Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G. 2014. An evidence-based public health approach to climate change adaptation. Environ Health Perspect 122:1177–1186; http://dx.doi.org/10.1289/ehp.1307396 PMID:25003495

  12. Empirically Supported Treatments in Psychotherapy: Towards an Evidence-Based or Evidence-Biased Psychology in Clinical Settings?

    PubMed Central

    Castelnuovo, Gianluca

    2010-01-01

    The field of research and practice in psychotherapy has been deeply influenced by two different approaches: the empirically supported treatments (ESTs) movement, linked with the evidence-based medicine (EBM) perspective and the “Common Factors” approach, typically connected with the “Dodo Bird Verdict”. About the first perspective, since 1998 a list of ESTs has been established in mental health field. Criterions for “well-established” and “probably efficacious” treatments have arisen. The development of these kinds of paradigms was motivated by the emergence of a “managerial” approach and related systems for remuneration also for mental health providers and for insurance companies. In this article ESTs will be presented underlining also some possible criticisms. Finally complementary approaches, that could add different evidence in the psychotherapy research in comparison with traditional EBM approach, are presented. PMID:21833197

  13. "Evidence-based dentistry in oral surgery: could we do better?".

    PubMed

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

    2010-01-01

    Evidence-based Dentistry (EBD), like Evidence-based Medicine (EBM), was born in order to seek the "best available research evidence" in the field of dentistry both in research and clinical routine.BUT EVIDENCE IS NOT CLEARLY MEASURABLE IN ALL FIELDS OF HEALTHCARE: in particular, while drug effect is rather independent from clinician's characteristics, the effectiveness of surgical procedures is strictly related to surgeon's expertise, which is difficult to quantify. The research problems of dentistry have a lot in common with other surgical fields, where at the moment the best therapeutic recommendations and guidelines originates from an integration of evidence-based medicine and data from consensus conferences.To cope with these problems, new instruments have been developed, aimed at standardizing clinical procedures (CAD-CAM technology) and at integrating EBM achievements with the opinions of expert clinicians (GRADE System).ONE THING WE HAVE TO REMEMBER HOWEVER: it is necessary to use the instruments developed by evidence-based medicine but is impossible to produce sound knowledge without considering clinical expertise and quality of surgical procedures simultaneously. Only in this way we will obtain an evidence-based dentistry both in dental research and clinical practice, which is up to third millennium standards. PMID:20871758

  14. Description of a Standardized Treatment Center that Utilizes Evidence-Based Clinic Operations to Facilitate Implementation of an Evidence-Based Treatment

    ERIC Educational Resources Information Center

    Donohue, Brad; Allen, Daniel N.; Romero, Valerie; Hill, Heather H.; Vasaeli, Kathryn; Lapota, Holly; Tracy, Kendra; Gorney, Suzanne; Abdel-al, Ruweida; Caldas, Diana; Herdzik, Karen; Bradshaw, Kelsey; Valdez, Robby; Van Hasselt, Vincent B.

    2009-01-01

    Developers of evidence-based therapies are enhancing methods of teaching therapists to implement "best practices" with integrity. However, there is a relative dearth of information available as to clinic operations and related contextual factors necessary to sustain successful implementation of these treatments. This article describes various…

  15. The semantic origin of unconscious priming: Behavioral and event-related potential evidence during category congruency priming from strongly and weakly related masked words.

    PubMed

    Ortells, Juan J; Kiefer, Markus; Castillo, Alejandro; Megías, Montserrat; Morillas, Alejandro

    2016-01-01

    The mechanisms underlying masked congruency priming, semantic mechanisms such as semantic activation or non-semantic mechanisms, for example response activation, remain a matter of debate. In order to decide between these alternatives, reaction times (RTs) and event-related potentials (ERPs) were recorded in the present study, while participants performed a semantic categorization task on visible word targets that were preceded either 167ms (Experiment 1) or 34ms before (Experiment 2) by briefly presented (33ms) novel (unpracticed) masked prime words. The primes and targets belonged to different categories (unrelated), or they were either strongly or weakly semantically related category co-exemplars. Behavioral (RT) and electrophysiological masked congruency priming effects were significantly greater for strongly related pairs than for weakly related pairs, indicating a semantic origin of effects. Priming in the latter condition was not statistically reliable. Furthermore, priming effects modulated the N400 event-related potential (ERP) component, an electrophysiological index of semantic processing, but not ERPs in the time range of the N200 component, associated with response conflict and visuo-motor response priming. The present results demonstrate that masked congruency priming from novel prime words also depends on semantic processing of the primes and is not exclusively driven by non-semantic mechanisms such as response activation. PMID:26412392

  16. 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 ?3 in strike-slip to extensional regime along with an additional event having NW-SE ?3, for lower Cuddapah samples; (2) compressional/transpressional event with ESE-WNW or NNE-SSW ?1 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.

  17. Evidence-based treatment for mental disorders in children and adolescents.

    PubMed

    Fabiano, Gregory A; Pelham, William E

    2002-04-01

    In the past decade, increased emphasis has been placed on identifying treatments for childhood disorders that are supported by empirical evidence of their effectiveness. This process was spearheaded by an American Psychological Association division 12 task force that identified evidence-based treatments--mostly for disorders of adulthood. Because of the publication of the task force results, other studies have been published that contribute to the knowledge base of evidence-based treatment, and these studies are briefly reviewed. Across evidence-based treatments, common features of effective treatments, such as parent involvement, use of a treatment manual, and the emphasis on generalization of treatment effects to natural settings, are also identified and reviewed.Introduction PMID:11914169

  18. Banaba (Lagerstroemia speciosa L.): an evidence-based systematic review by the Natural Standard research collaboration.

    PubMed

    Ulbricht, Catherine; Dam, Chi; Milkin, Tamara; Seamon, Erica; Weissner, Wendy; Woods, Jen

    2007-01-01

    This study is an evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing. PMID:17594991

  19. Training Teachers to use Evidence-Based Practices for Autism: Examining Procedural Implementation fidelity

    PubMed Central

    Stahmer, Aubyn C.; Reed, Sarah; Lee, Ember; Reisinger, Erica M.; Connell, James E.; Mandell, David S.

    2014-01-01

    The purpose of this study was to examine the extent to which public school teachers implemented evidence-based interventions for students with autism in the way these practices were designed. Evidence-based practices for students with autism are rarely incorporated into community settings, and little is known about the quality of implementation. An indicator of intervention quality is procedural implementation fidelity (the degree to which a treatment is implemented as prescribed). Procedural fidelity likely affects student outcomes. This project examined procedural implementation fidelity of three evidence-based practices used in a randomized trial of a comprehensive program for students with autism in partnership with a large, urban school district. Results indicate that teachers in public school special education classrooms can learn to implement evidence-based strategies; however they require extensive training, coaching, and time to reach and maintain moderate procedural implementation fidelity. Procedural fidelity over time, and across intervention strategies is examined. PMID:25593374

  20. Evidence-Based Interventions in School Psychology: State of the Art and Directions for the Future.

    ERIC Educational Resources Information Center

    Gutkin, Terry B.

    2002-01-01

    Presents an overview of this special journal issue, designed to provide a current snapshot of the accomplishments and controversies pertaining to evidence-based intervention in school psychology. (GCP)

  1. Columbia University's Competency and Evidence-based Acute Care Nurse Practitioner Program.

    ERIC Educational Resources Information Center

    Curran, Christine R.; Roberts, W. Dan

    2002-01-01

    Columbia University's acute care nurse practitioner curriculum incorporates evaluation strategies and standards to assess clinical competence and foster evidence-based practice. The curriculum consists of four core courses, supporting sciences, and specialty courses. (Contains 17 references.) (SK)

  2. NLM Evidence-based Information At Your Fingertips - NMA

    SciTech Connect

    McMurray, L.

    2010-08-02

    The National Library of Medicine: Evidenced-Based Information at Your Fingertips workshop is designed specifically for physicians attending the Community Medicine and Public Health Section portion of the National Medical Association 2010 Annual Convention and Scientific Assembly. This course seeks to address the digital divide issue by teaching participants to use the NLM resources and to improve their ability to use health information echnology to treat their patients and develop strategies to eliminate race-based disparities in health.

  3. 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.

  4. How evidence-based medicine is failing due to biased trials and selective publication.

    PubMed

    Every-Palmer, Susanna; Howick, Jeremy

    2014-12-01

    Evidence-based medicine (EBM) was announced in the early 1990s as a 'new paradigm' for improving patient care. Yet there is currently little evidence that EBM has achieved its aim. Since its introduction, health care costs have increased while there remains a lack of high-quality evidence suggesting EBM has resulted in substantial population-level health gains. In this paper we suggest that EBM's potential for improving patients' health care has been thwarted by bias in the choice of hypotheses tested, manipulation of study design and selective publication. Evidence for these flaws is clearest in industry-funded studies. We argue EBM's indiscriminate acceptance of industry-generated 'evidence' is akin to letting politicians count their own votes. Given that most intervention studies are industry funded, this is a serious problem for the overall evidence base. Clinical decisions based on such evidence are likely to be misinformed, with patients given less effective, harmful or more expensive treatments. More investment in independent research is urgently required. Independent bodies, informed democratically, need to set research priorities. We also propose that evidence rating schemes are formally modified so research with conflict of interest bias is explicitly downgraded in value. PMID:24819404

  5. Clinical expert facilitators of evidence-based practice: a community hospital program.

    PubMed

    Rutledge, Dana N; Skelton, Katie

    2011-01-01

    A 1-year program for select clinical nurse experts led to increased comfort in using evidence-based practice strategies. Nurses identified specific barriers and facilitators for evidence-based practice efforts, accomplished individual goals, and saw changes in their practice roles. Results from the program and its evaluation are that staff can benefit from such an effort (4-day course with specific follow-up activities). PMID:21946793

  6. Kawasaki disease: an evidence based approach to diagnosis, treatment, and proposals for future research

    PubMed Central

    Brogan, P; Bose, A; Burgner, D; Shingadia, D; Tulloh, R; Michie, C; Klein, N; Booy, R; Levin, M; Dillon, M

    2002-01-01

    This article proposes a clinical guideline for the diagnosis and treatment of Kawasaki disease in the UK based on the best available evidence to date, and highlights areas of practice where evidence is anecdotal or based on retrospective data. Future research as proposed by the London Kawasaki Disease Research Group is outlined, and clinicians are invited to prospectively enrol their suspected cases into this collaborative research project. PMID:11919108

  7. A critique of the evidence base for non-pharmacological sleep interventions for persons with dementia.

    PubMed

    Brown, Cary A; Berry, Robyn; Tan, Maria C; Khoshia, Anjalee; Turlapati, Lakshmi; Swedlove, Fern

    2013-03-01

    Disordered sleep in persons with dementia is a contributing factor for a range of health problems. The evidence base for non-pharmacological interventions has not been evaluated and clearly presented in the literature. This paper provides a structured Critical Literature Review of the evidence for non-pharmacological interventions to reduce disordered sleep in persons with dementia. The systematic search retrieved 29 studies that were evaluated for methodological quality. The quality of evidence ranged from conclusive for light therapy and activity to inconclusive for most other interventions. There is a paucity of conclusive research for non-pharmacological sleep interventions for persons with dementia. Most of the evidence about effective interventions is anecdotal and untested. There is a need for rigorous scientific inquiry, coupled with tacit knowledge to build a strong evidence base on non-pharmacological interventions for disordered sleep for persons with dementia. PMID:24336770

  8. Outreach Science Education: Evidence-Based Studies in a Gene Technology Lab

    ERIC Educational Resources Information Center

    Scharfenberg, Franz-Josef; Bogner, Franz X.

    2014-01-01

    Nowadays, outreach labs are important informal learning environments in science education. After summarizing research to goals outreach labs focus on, we describe our evidence-based gene technology lab as a model of a research-driven outreach program. Evaluation-based optimizations of hands-on teaching based on cognitive load theory (additional…

  9. An Evidence-Based Approach To Exercise Prescriptions on ISS

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, Lori

    2009-01-01

    This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

  10. Anemia, Heart Failure and Evidence-Based Clinical management

    PubMed Central

    Pereira, Camila Alves; Roscani, Meliza Goi; Zanati, Silméia Garcia; Matsubara, Beatriz Bojikian

    2013-01-01

    Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with heart failure (HF). Its clinical relevance, as well as its pathophysiology and the clinical management of these patients are important subjects in the specialized literature. In the present review, we describe the current concepts on the pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for iron supplementation. Also, we make a critical analysis of the major studies showing evidences on the benefits of this supplementation. The four main components of anemia are addressed: chronic disease, dilutional, "renal" and malabsorption. In patients with HF, the diagnostic criteria are the same as those used in the general population: serum ferritin levels lower than 30 mcg/L in patients without kidney diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with transferring saturation lower than 20% in patients with chronic kidney diseases. Finally, the therapeutic possibilities for anemia in this specific patient population are discussed. PMID:23917508

  11. Treatment of meniscal tears: An evidence based approach

    PubMed Central

    Mordecai, Simon C; Al-Hadithy, Nawfal; Ware, Howard E; Gupte, Chinmay M

    2014-01-01

    Treatment options for meniscal tears fall into three broad categories; non-operative, meniscectomy or meniscal repair. Selecting the most appropriate treatment for a given patient involves both patient factors (e.g., age, co-morbidities and compliance) and tear characteristics (e.g., location of tear/age/reducibility of tear). There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line. Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically. Partial meniscectomy is suitable for symptomatic tears not amenable to repair, and can still preserve meniscal function especially when the peripheral meniscal rim is intact. Meniscal repair shows 80% success at 2 years and is more suitable in younger patients with reducible tears that are peripheral (e.g., nearer the capsular attachment) and horizontal or longitudinal in nature. However, careful patient selection and repair technique is required with good compliance to post-operative rehabilitation, which often consists of bracing and non-weight bearing for 4-6 wk. PMID:25035825

  12. Strawberry as a functional food: an evidence-based review.

    PubMed

    Basu, Arpita; Nguyen, Angel; Betts, Nancy M; Lyons, Timothy J

    2014-01-01

    Emerging research provides substantial evidence to classify strawberries as a functional food with several preventive and therapeutic health benefits. Strawberries, a rich source of phytochemicals (ellagic acid, anthocyanins, quercetin, and catechin) and vitamins (ascorbic acid and folic acid), have been highly ranked among dietary sources of polyphenols and antioxidant capacity. It should however be noted that these bioactive factors can be significantly affected by differences in strawberry cultivars, agricultural practices, storage, and processing methods: freezing versus dry heat has been associated with maximum retention of strawberry bioactives in several studies. Nutritional epidemiology shows inverse association between strawberry consumption and incidence of hypertension or serum C-reactive protein; controlled feeding studies have identified the ability of strawberries to attenuate high-fat diet induced postprandial oxidative stress and inflammation, or postprandial hyperglycemia, or hyperlipidemia in subjects with cardiovascular risk factors. Mechanistic studies have elucidated specific biochemical pathways that might confer these protective effects of strawberries: upregulation of endothelial nitric oxide synthase (eNOS) activity, downregulation of NF-kB activity and subsequent inflammation, or inhibitions of carbohydrate digestive enzymes. These health effects may be attributed to the synergistic effects of nutrients and phytochemicals in strawberries. Further studies are needed to define the optimal dose and duration of strawberry intake in affecting levels of biomarkers or pathways related to chronic diseases. PMID:24345049

  13. Analyzing forensic evidence based on density with magnetic levitation.

    PubMed

    Lockett, Matthew R; Mirica, Katherine A; Mace, Charles R; Blackledge, Robert D; Whitesides, George M

    2013-01-01

    This paper describes a method for determining the density of contact trace objects with magnetic levitation (MagLev). MagLev measurements accurately determine the density (± 0.0002 g/cm(3) ) of a diamagnetic object and are compatible with objects that are nonuniform in shape and size. The MagLev device (composed of two permanent magnets with like poles facing) and the method described provide a means of accurately determining the density of trace objects. This method is inexpensive, rapid, and verifiable and provides numerical values--independent of the specific apparatus or analyst--that correspond to the absolute density of the sample that may be entered into a searchable database. We discuss the feasibility of MagLev as a possible means of characterizing forensic-related evidence and demonstrate the ability of MagLev to (i) determine the density of samples of glitter and gunpowder, (ii) separate glitter particles of different densities, and (iii) determine the density of a glitter sample that was removed from a complex sample matrix. PMID:22804094

  14. Tobacco plain packaging: Evidence based policy or public health advocacy?

    PubMed

    McKeganey, Neil; Russell, Christopher

    2015-06-01

    In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters. PMID:26041731

  15. Team-Based Models for End-of-Life Care: An Evidence-Based Analysis

    PubMed Central

    2014-01-01

    Background End of life refers to the period when people are living with advanced illness that will not stabilize and from which they will not recover and will eventually die. It is not limited to the period immediately before death. Multiple services are required to support people and their families during this time period. The model of care used to deliver these services can affect the quality of the care they receive. Objectives Our objective was to determine whether an optimal team-based model of care exists for service delivery at end of life. In systematically reviewing such models, we considered their core components: team membership, services offered, modes of patient contact, and setting. Data Sources A literature search was performed on October 14, 2013, using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, for studies published from January 1, 2000, to October 14, 2013. Review Methods Abstracts were reviewed by a single reviewer and full-text articles were obtained that met the inclusion criteria. Studies were included if they evaluated a team model of care compared with usual care in an end-of-life adult population. A team was defined as having at least 2 health care disciplines represented. Studies were limited to English publications. A meta-analysis was completed to obtain pooled effect estimates where data permitted. The GRADE quality of the evidence was evaluated. Results Our literature search located 10 randomized controlled trials which, among them, evaluated the following 6 team-based models of care: hospital, direct contact home, direct contact home, indirect contact comprehensive, indirect contact comprehensive, direct contact comprehensive, direct, and early contact Direct contact is when team members see the patient; indirect contact is when they advise another health care practitioner (e.g., a family doctor) who sees the patient. A “comprehensive” model is one that provides continuity of service across inpatient and outpatient settings, e.g., in hospital and then at home. All teams consisted of a nurse and physician at minimum, at least one of whom had a specialty in end-of-life health care. More than 50% of the teams offered services that included symptom management, psychosocial care, development of patient care plans, end-of-life care planning, and coordination of care. We found moderate-quality evidence that the use of a comprehensive direct contact model initiated up to 9 months before death improved informal caregiver satisfaction and the odds of having a home death, and decreased the odds of dying in a nursing home. We found moderate-quality evidence that the use of a comprehensive, direct, and early (up to 24 months before death) contact model improved patient quality of life, symptom management, and patient satisfaction. We did not find that using a comprehensive team-based model had an impact on hospital admissions or length of stay. We found low-quality evidence that the use of a home team-based model increased the odds of having a home death. Limitations Heterogeneity in data reporting across studies limited the ability to complete a meta-analysis on many of the outcome measures. Missing data was not managed well within the studies. Conclusions Moderate-quality evidence shows that a comprehensive, direct-contact, team-based model of care provides the following benefits for end-of-life patients with an estimated survival of up to 9 months: it improves caregiver satisfaction and increases the odds of dying at home while decreasing the odds of dying in a nursing home. Moderate-quality evidence also shows that improvement in patient quality of life, symptom management, and patient satisfaction occur when end-of-life care via this model is provided early (up to 24 months before death). However, using this model to deliver end-of-life care does not impact hospital admissions or hospital length of stay. Team membership includes at minimum a physician and nu

  16. 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 higher capacity, could be disposed of efficiently onsite, and would eliminate the complexities and programmatic risks from sampling, packaging, transportation, and return of resin for regeneration.

  17. An Evidence-Based Approach to Introductory Chemistry

    ERIC Educational Resources Information Center

    Johnson, Philip

    2014-01-01

    Drawing on research into students' understanding, this article argues that the customary approach to introductory chemistry has created difficulties for students. Instead of being based on the notion of "solids, liquids and gases", introductory chemistry should be structured to develop the concept of a substance. The concept of a…

  18. School-Based Management Developments and Partnership: Evidence from Indonesia

    ERIC Educational Resources Information Center

    Bandur, Agustinus

    2012-01-01

    School-based management (SBM) with devolution of authority and responsibility to school level decision-makers has become the most prominent feature of public school management systems in most countries around the world. This article provides the global trends and current developments in SBM in Indonesia with an emphasis on how SBM has created…

  19. Treatment in the pediatric emergency department is evidence based: a retrospective analysis

    PubMed Central

    Waters, Kellie L; Wiebe, Natasha; Cramer, Kristie; Hartling, Lisa; Klassen, Terry P

    2006-01-01

    Background Our goal was to quantify the evidence that is available to the physicians of a pediatric emergency department (PED) in making treatment decisions. Further, we wished to ascertain what percentage of evidence for treatment provided in the PED comes from pediatric studies. Methods We conducted a retrospective chart review of randomly selected patients seen in the PED between January 1 and December 31, 2002. The principal investigator identified a primary diagnosis and primary intervention for each chart. A thorough literature search was then undertaken with respect to the primary intervention. If a randomized control trial (RCT) or a systematic review was found, the intervention was classified as level I evidence. If no RCT was found, the intervention was assessed by an expert committee who determined its appropriateness based on face validity (RCTs were unanimously judged to be both unnecessary and, if a placebo would have been involved, unethical). These interventions were classified as level II evidence. Interventions that did not fall into either above category were classified as level III evidence. Results Two hundred and sixty-two patient charts were reviewed. Of these, 35.9% did not receive a primary intervention. Of the 168 interventions assessed, 80.4% were evidence-based (level I), 7.1% had face validity (level II) and 12.5% had no supporting evidence (level III). Of the evidence-based interventions, 83.7% were supported by studies with mostly pediatric patients. Conclusion Our study demonstrates that a substantial proportion of PED treatment decisions are evidence-based, with most based on studies in pediatric patients. Also, a large number of patients seen in the PED receive no intervention. PMID:17022829

  20. 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

  1. Evidence-Based Practice: SLTs under Siege or Opportunity for Growth? The Use and Nature of Research Evidence in the Profession

    ERIC Educational Resources Information Center

    McCurtin, Arlene; Roddam, Hazel

    2012-01-01

    Background: Speech and language therapists are encouraged to be evidence-based practitioners in contemporary clinical practice. This apparently signifies their commitment to "good" practice. An examination of evidence-based practice (EBP) and its adoption in clinical practice is therefore warranted. Aims: This paper aims to explore EBP,…

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

    PubMed

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

    2013-01-01

    Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will never have enough suitable evidence for all and every aspects of health provision in every locality. Innovation signifies a substantial positive change compared to gradual or incremental changes. Innovation using inductive reasoning has to play a major role within health care system and it is applicable to all three level of service provision: clinical practice, policy and organisation structure. The aim of this paper is to examine critically the above concepts and their complimentary role in supporting provision of health care systems which are suitable for the requirements of the population, affordable, deliverable, flexible and adaptable to social changes. PMID:23603268

  3. Nonequilibrium Steady-State Differences in Partial Pressure of CO2 and in Concentration of Weak Acids and Bases between Blood and Tissue

    PubMed Central

    Gurtner, Gail H.

    1972-01-01

    Several investigators have demonstrated that under conditions where little or no gas exchange occurs across the alveolar capillary membrane the PCO2 is higher in the alveolus than in the mixed venous blood, whereas there are no PO2 differences. Gurtner et al. have explained the ?PCO2 by a model in which H+ dissociation of proteins due to an electrical field caused by a negatively charged capillary wall (Wien effect) sets up an intracapillary PCO2 difference between wall and bulk phase which is maintained by blood flow. The model is not specific for CO2 and predicts that weak acids should be concentrated in a manner similar to CO2 whereas weak bases should be relatively excluded from the alveolar space. Measurements of the steady-state distribution of the uncharged forms of the weak acids 5,5-dimethyloxyazoladinedione (DMO) and barbital and of the weak base tris(hydroxymethyl)aminomethane (THAM) between mixed venous blood and a fluid-filled lobe of lung were made in living dogs. The results agree fairly well with the predicted values. PMID:5029430

  4. New directions in evidence-based policy research: a critical analysis of the literature

    PubMed Central

    2014-01-01

    Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence – whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of ‘evidence’, methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics’ research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence – meaning research evidence – use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of ‘getting evidence into policy’ has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy. PMID:25023520

  5. Late pleistocene ice age scenarios based on observational evidence

    SciTech Connect

    DeBlonde, G. ); Peltier, W.R. )

    1993-04-01

    Ice age scenarios for the last glacial interglacial cycle, based on observations of Boyle and Keigwin concerning the North Atlantic thermohaline circulation and of Barnola et al. concerning atmospheric CO[sub 2] variations derived from the Vostok ice cores, are herein analyzed. Northern Hemisphere continental ice sheets are simulated with an energy balance model (EBM) that is asynchronously coupled to vertically integrated ice sheets models based on the Glen flow law. The EBM includes both a realistic land-sea distribution and temperature-albedo feedback and is driven with orbital variations of effective solar insolation. With the addition of atmospheric CO[sub 2] and ocean heat flux variations, but not in their absence, a complete collapse is obtained for the Eurasian ice sheet but not for the North American ice sheet. We therefore suggest that further feedback mechanisms, perhaps involving more accurate modeling of the dynamics of the mostly marine-based Laurentide complex appears necessary to explain termination I. 96 refs., 12 figs., 2 tabs.

  6. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    PubMed Central

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be improved. PMID:20504357

  7. Strategies to promote practice nurse capacity to deliver evidence-based care.

    PubMed

    Dadich, Ann; Abbott, Penny; Hosseinzadeh, Hassan

    2015-11-16

    Purpose - Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice. Design/methodology/approach - A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare - namely, a clinical aide and online training. Findings - The perceived impact of both resources was determined by views on relevance and design - particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues. Research limitations/implications - This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare. Practical implications - Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited. Originality/value - Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace. PMID:26556164

  8. Developing practice-based evidence: benefits, challenges, and tensions.

    PubMed

    Holmqvist, Rolf; Philips, Björn; Barkham, Michael

    2015-01-01

    Attempts to regulate service delivery in line with results from randomized trials have been vigorously debated. In this paper, results from practice-based studies using the CORE System illustrate the potential to enrich knowledge about the actual outcome of psychological therapy in routine care. These studies also provide data for important questions in psychotherapy research, like orientation differences, the importance of the therapist factor, number of sessions needed for clinical effect, and the alliance-outcome question. Obstacles and challenges in making such studies are illustrated. In conclusion, arguments are put forward for introducing a common measurement system that strikes a balance between clinicians' questions and the need for comparable data, and that encompasses the complexities of patients' reasons for seeking psychological help. PMID:24283264

  9. The evolving evidence base for child protection in Chinese societies.

    PubMed

    Dunne, Michael P; Chen, Jing Qi; Wan Yuen Choo

    2008-01-01

    Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives. PMID:19124321

  10. Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future.

    PubMed

    O'Hara, Kate; Wright, Ian M R; Schneider, Jennifer J; Jones, Alison L; Martin, Jennifer H

    2015-12-01

    Paediatric patients, particularly preterm neonates, present many pharmacological challenges. Due to the difficulty in conducting clinical trials in these populations dosing information is often extrapolated from adult populations. As the processes of absorption, distribution, metabolism and excretion of drugs change throughout growth and development extrapolation presents risk of over or underestimating the doses required. Information about the development these processes, particularly drug metabolism pathways, is still limited with weight based dose adjustment presenting the best method of estimating pharmacokinetic changes due to growth and development. New innovations in pharmacokinetic research, such as population pharmacokinetic modelling, present unique opportunities to conduct clinical trials in these populations improving the safety and effectiveness of the drugs used. More research is required into this area to ensure the best outcomes for our most vulnerable patients. PMID:26256466

  11. Evidence of the weakness of the O?H⋯F hydrogen bond from a conformational study of 3-fluoro-1-propanol by microwave spectroscopy

    NASA Astrophysics Data System (ADS)

    Caminati, Walther

    1982-03-01

    The rotational spectra of the OH and OD isotopic species have been observed for three rotamers of 3-fluoro-1-propanol. One of them (HBC form) displays an internal hydrogen bond with a distorted chair conformation of the six-membered ring. The other two rotamers have the oxygen atom gauche with respect to the C 2?C 3 bond, the hydroxyl hydrogen trans with respect to the C 1?C 2 bond and the fluorine atom gauche (GGT form) and trans (TGT form), respectively, with respect to the C 2?C 1 bond. The energies of the vibrational ground states of the HBC and TGT forms are ˜0.4 and 1.0 kcal/mole higher than that of the GGT form, respectively (from relative intensity measurements). The hydrogen bond is therefore rather weak in this compound. With compounds capable of forming O?H⋯O or O?H⋯N bonds, the conformation appropriate for hydrogen bonding is normally the most stable form. Several excited states have been analyzed for the TGT and GGT rotamers in order to have additional data with respect to the potential function for the internal rotation about the C 3?C 2 bond.

  12. Influence of a weak dc electric field on tricritical phase transition in TGSe: evidence of different specific heat behaviour on cooling and heating runs

    NASA Astrophysics Data System (ADS)

    Romero, F. J.; Gallardo, M. C.; Jiménez, J.; del Cerro, J.

    2006-11-01

    The para-ferroelectric tricritical phase transition of a single crystal of triglycine selenate (TGSe) has been studied in the neighbourhood of the transition temperature, under weak electric fields, E, using a highly sensitive calorimetric technique. The specific heat, cE, under fields in the range between 5 and 175 V cm-1 and close to transition temperature (0.2 K), shows different behaviour on cooling and on heating at a temperature variation rate of ± 0.03 K h-1 for T

  13. Translation to practice: developing an evidence-based practice nurse internship program.

    PubMed

    Selig, Patricia M; Lewanowicz, Walter

    2008-01-01

    Creating a culture of inquiry in which nurses are engaged in the pursuit of the best evidence to support nursing practice ultimately improves patient care and clinical outcomes. So, how do we do that? Implementation of an evidence-based practice nurse internship program has proven to be a key ingredient for success in stimulating critical thinking and subsequent analysis of the evidence behind nursing practice. A pragmatic approach to developing and sustaining an evidence-based practice nurse internship program can be a helpful guide for those who are considering a similar proposition. The recruitment process, education, clinical projects, and lessons learned are detailed in this article as a resource to nursing colleagues in the spirit of professional growth. PMID:18670208

  14. Electronic health record: integrating evidence-based information at the point of clinical decision making.

    PubMed

    Fowler, Susan A; Yaeger, Lauren H; Yu, Feliciano; Doerhoff, Dwight; Schoening, Paul; Kelly, Betsy

    2014-01-01

    The authors created two tools to achieve the goals of providing physicians with a way to review alternative diagnoses and improving access to relevant evidence-based library resources without disrupting established workflows. The “diagnostic decision support tool” lifted terms from standard, coded fields in the electronic health record and sent them to Isabel, which produced a list of possible diagnoses. The physicians chose their diagnoses and were presented with the “knowledge page,” a collection of evidence-based library resources. Each resource was automatically populated with search results based on the chosen diagnosis. Physicians responded positively to the “knowledge page.” PMID:24415920

  15. Multidisciplinary and Evidence-based Method for Prioritizing Diseases of Food-producing Animals and Zoonoses

    PubMed Central

    Humblet, Marie-France; Vandeputte, Sébastien; Albert, Adelin; Gosset, Christiane; Kirschvink, Nathalie; Haubruge, Eric; Fecher-Bourgeois, Fabienne; Pastoret, Paul-Pierre

    2012-01-01

    To prioritize 100 animal diseases and zoonoses in Europe, we used a multicriteria decision-making procedure based on opinions of experts and evidence-based data. Forty international experts performed intracategory and intercategory weighting of 57 prioritization criteria. Two methods (deterministic with mean of each weight and probabilistic with distribution functions of weights by using Monte Carlo simulation) were used to calculate a score for each disease. Consecutive ranking was established. Few differences were observed between each method. Compared with previous prioritization methods, our procedure is evidence based, includes a range of fields and criteria while considering uncertainty, and will be useful for analyzing diseases that affect public health. PMID:22469519

  16. Long-term sustainability of evidence-based practices in community mental health agencies.

    PubMed

    Bond, Gary R; Drake, Robert E; McHugo, Gregory J; Peterson, Alison E; Jones, Amanda M; Williams, Jessica

    2014-03-01

    This study examined rates of sustainability, defined as program continuation, and factors associated with sustainability 6 years after full implementation of five evidence-based practices in 49 sites in the National Implementing Evidence-Based Practices Project. Based on interviews with agency leaders and state leaders, 47 % of sites sustained the practice for 6 years, 16 % restarted the practice after a period of discontinuation, and 37 % discontinued the practice permanently. Agency leaders from discontinuing sites identified inadequate financial support, lack of prioritization, and workforce issues as barriers to continuation. Adequate financing, ongoing supervision, and monitoring of fidelity and outcome may promote long-term sustainability. PMID:23266661

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

  18. Developing an evidence-based, multimedia group counseling curriculum toolkit

    PubMed Central

    Brooks, Adam C.; DiGuiseppi, Graham; Laudet, Alexandre; Rosenwasser, Beth; Knoblach, Dan; Carpenedo, Carolyn M.; Carise, Deni; Kirby, Kimberly C.

    2013-01-01

    Training community-based addiction counselors in empirically supported treatments (ESTs) far exceeds the ever-decreasing resources of publicly funded treatment agencies. This feasibility study describes the development and pilot testing of a group counseling toolkit (an approach adapted from the education field) focused on relapse prevention (RP). When counselors (N = 17) used the RP toolkit after 3 hours of training, their content adherence scores on “coping with craving” and “drug refusal skills” showed significant improvement, as indicated by very large effect sizes (Cohen’s d = 1.49 and 1.34, respectively). Counselor skillfulness, in the “adequate-to-average” range at baseline, did not change. Although this feasibility study indicates some benefit to counselor EST acquisition, it is important to note that the impact of the curriculum on client outcomes is unknown. Because a majority of addiction treatment is delivered in group format, a multimedia curriculum approach may assist counselors in applying ESTs in the context of actual service delivery. PMID:22301082

  19. Is Oxytocin Application for Autism Spectrum Disorder Evidence-Based?

    PubMed Central

    Lee, Seung Yup; Lee, Ah Rah; Hwangbo, Ram; Han, Juhee; Hong, Minha

    2015-01-01

    Autism spectrum disorder (ASD) is characterized by persistent deficits within two core symptom domains: social communication and restricted, repetitive behaviors. Although numerous studies have reported psychopharmacological treatment outcomes for the core symptom domains of ASD, there are not enough studies on fundamental treatments based on the etiological pathology of ASD. Studies on candidate medications related to the pathogenesis of ASD, such as naltrexone and secretin, were conducted, but the results were inconclusive. Oxytocin has been identified as having an important role in maternal behavior and attachment, and it has been recognized as a key factor in the social developmental deficit seen in ASD. Genetic studies have also identified associations between ASD and the oxytocin pathway. As ASD has its onset in infancy, parents are willing to try even experimental or unapproved treatments in an effort to avoid missing the critical period for diagnosis and treatment, which can place their child in an irreversible state. While therapeutic application of oxytocin for ASD is in its early stages, we have concluded that oxytocin would be a promising therapeutic substance via a thorough literature review focusing on the following: the relationship between oxytocin and sociality; single nucleotide polymorphisms as a biological marker of ASD; and validity verification of oxytocin treatment in humans. We also reviewed materials related to the mechanism of oxytocin action that may support its potential application in treating ASD. PMID:26713079

  20. Transtheoretical Model-Based Dietary Interventions in Primary Care: A Review of the Evidence in Diabetes

    ERIC Educational Resources Information Center

    Salmela, Sanna; Poskiparta, Marita; Kasila, Kirsti; Vahasarja, Kati; Vanhala, Mauno

    2009-01-01

    The objective of this study was to review the evidence concerning stage-based dietary interventions in primary care among persons with diabetes or an elevated diabetes risk. Search strategies were electronic databases and manual search. Selection criteria were randomized controlled studies with stage-based dietary intervention, conducted in…

  1. Supporting Evidence-Based Practice in Schools with an Online Database of Best Practices

    ERIC Educational Resources Information Center

    Powers, Joelle D.; Bowen, Natasha K.; Bowen, Gary L.

    2011-01-01

    In spite of multidisciplinary recommendations to use evidence-based interventions in schools and a growing knowledge base of such practices, most schools are not using empirically supported interventions. On the basis of a careful analysis of barriers to the implementation of the best researched programs, an online, free, and publicly available…

  2. Are Online Sources for Identifying Evidence-Based Practices Trustworthy? An Evaluation

    ERIC Educational Resources Information Center

    Test, David W.; Kemp-Inman, Amy; Diegelmann, Karen; Hitt, Sara Beth; Bethune, Lauren

    2015-01-01

    The use of evidence-based practices has become a focus in education since the No Child Left Behind Act of 2001 and the Individuals with Disabilities Education Act reauthorization of 2004 required using practices based on scientific research to improve student outcomes. Although many teachers may not have the time or expertise to evaluate the…

  3. Implementation of Evidence-Based Adolescent Literacy Practices by Select Secondary Teachers

    ERIC Educational Resources Information Center

    Mergele, Catherine E.

    2013-01-01

    The purpose of this mixed methods research study was to investigate how evidence-based adolescent literacy practices are implemented by secondary teachers in the classroom or what the reasons might be for these practices not being implemented. Three secondary English teachers of three different types of classes, comprising Intensive, Project-based

  4. Evidence-based Decision Making: Influences on Central-Office Administrators' Decision-Making Practices 

    E-print Network

    Haecker, Bonnie Minnia

    2013-12-05

    of this quantitative non-experimental study was to identify the evidence-based decision-making practices of central office administrators (n = 268) and the factors that influence them. Based on the findings in the literature, a survey was developed to collect data...

  5. ORNL/TM-2013/107 Evidence-Based Background Material

    E-print Network

    ORNL/TM-2013/107 Evidence-Based Background Material Underlying Guidance for Federal Agencies-Based Background Material Underlying Guidance for Federal Agencies in Implementing Strategic Sustainability effort to assist federal agencies in taking action and changing their institutions to achieve

  6. Evidence-Based Problem Solving: Liberal Education and Preparation for the Health Professions

    ERIC Educational Resources Information Center

    Riegelman, Richard

    2012-01-01

    In recent years, the health professions have moved from "eminence-based" solutions to "evidence-based" problem solving. This evolution provides new opportunities to implement integrative curricula for those preparing for the health professions. These new curricula can be built on the Essential Learning Outcomes identified through the Association…

  7. A Critical Quest: Confirming Physical Therapists' Attitudes and Knowledge toward Evidence-Based Practice

    ERIC Educational Resources Information Center

    Newman, Beverly Cumberland

    2013-01-01

    The overall purpose of this study was to investigate physical therapists attitudes and knowledge toward research and evidence-based practice (EBP). The research design was based on a realist theoretical framework. Twenty-five interviews were conducted asking standardized open-end questions which allowed the participants to relate their real world…

  8. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  9. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  10. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist...

  11. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist...

  12. 20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on...

  13. Tourette's Disorder: Genetic Update, Neurological Correlates, and Evidence-Based Interventions

    ERIC Educational Resources Information Center

    Phelps, LeAdelle

    2008-01-01

    This article provides an update of the search for genetic markers related to Tourette's Disorder. The probable neurophysiology of the disorder is reviewed. Frequently prescribed medications are related to the probable biological bases of the disorder. Behavioral interventions and assessment tools are examined. It is concluded that evidence based

  14. 77 FR 40634 - Solicitation for a Cooperative Agreement: Pretrial Technical Assistance for Evidence-Based...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ...will be targeted toward expanding the knowledge and use of legal and evidence-based...reduction outcomes; and (3) Change in knowledge, skills, and abilities regarding research-based...request for proposal is to expand the knowledge and use of legal and...

  15. The evidence-based principles of negative pressure wound therapy in trauma & orthopedics.

    PubMed

    A, Novak; Khan, Wasim S; J, Palmer

    2014-01-01

    Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice. PMID:25067971

  16. Demonstration of a highly-sensitive tunable beam displacer with no movable elements based on the concept of weak value amplification

    E-print Network

    Luis José Salazar-Serrano; David Guzmán; Alejandra Valencia; Juan P. Torres

    2015-02-19

    We report the implementation of a highly sensitive beam displacer based on the concept of weak value amplification that allows to displace the centroid of a Gaussian beam a distance much smaller than its beam width without the need to use movable optical elements. The beam's centroid position can be displaced by controlling the linear polarization of the output beam, and the dependence between the centroid's position and the angle of polarization is linear.

  17. Systematic review and its relationship with evidence-based practice in health.

    PubMed

    Urra Medina, Eugenia; Barría Pailaquilén, René Mauricio

    2010-01-01

    Systematic reviews (SR) have gained relevance in the world and Latin America because of their credibility in the search, compilation, arranging and analysis of the information obtained from research about health interventions, during a period of time. Consequently, evidence-based practice uses SR as a way to capture the best evidence of clinical effectiveness. This article reviews SR methodology, process, and its usefulness in health professions like nursing and medicine. PMID:20922332

  18. Using a Mock Trial Method to Enhance Effectiveness of Teaching Evidence-Based Practice in Nursing.

    PubMed

    White, Cindy T

    2015-01-01

    Traditional teaching methodologies may deter adult learning because of passive the exchange of knowledge. Teaching to the "evidence" substantiating best practice requires a systematic approach to transfer knowledge into clinical inquiry. A mock trial simulated role-play activity was selected to show the value of learning through active engagement. The nurse "defendant" was challenged to substantiate practice based on the evidence. Seminar participants (the jury) scrutinized testimony through deliberation before delivering the final verdict. PMID:26580469

  19. How Current Are Leading Evidence-Based Medical Textbooks? An Analytic Survey of Four Online Textbooks

    PubMed Central

    2012-01-01

    Background The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. Objective To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Methods Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks–UpToDate, Physicians’ Information Education Resource (PIER), DynaMed, and Best Practice–were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. Results 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks’ treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice (? 2 3=65.3, P<.001). The time since the last update for each textbook averaged from 170 days (range 131-209) for DynaMed, to 488 days (range 423-554) for PIER (P<.001 across all textbooks). Conclusions In online evidence-based textbooks, the proportion of topics with potentially outdated treatment recommendations varies substantially. PMID:23220465

  20. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity.

    PubMed

    Panossian, Alexander; Wikman, Georg

    2009-09-01

    The aim of this review article is to assess the level of scientific evidence presented by clinical trials of adaptogens in fatigue, and to provide a rationale at the molecular level for verified effects. Strong scientific evidence is available for Rhodiola rosea SHR-5 extract, which improved attention, cognitive function and mental performance in fatigue and in chronic fatigue syndrome. Good scientific evidence has been documented in trails in which Schisandra chinensis and Eleutherococcus senticosus increased endurance and mental performance in patients with mild fatigue and weakness. Based on their efficacy in clinical studies, adaptogens can be defined as a pharmacological group of herbal preparations that increase tolerance to mental exhaustion and enhance attention and mental endurance in situations of decreased performance. The beneficial stress-protective effect of adaptogens is related to regulation of homeostasis via several mechanisms of action associated with the hypothalamic-pituitary-adrenal axis and the control of key mediators of stress response such as molecular chaperons (e.g. Hsp70), stress-activated c-Jun N-terminal protein kinase (JNK1), Forkhead Box O transcription factor DAF-16, cortisol and nitric oxide (NO). The key point of action of phytoadaptogens appears to be their up-regulating and stress-mimetic effects on the "stress-sensor" protein Hsp70, which plays an important role in cell survival and apoptosis. Hsp70 inhibits the expression of NO synthase II gene and interacts with glucocorticoid receptors directly and via the JNK pathway, thus affecting the levels of circulating cortisol and NO. Prevention of stress-induced increase in NO, and the associated decrease in ATP production, results in increased performance and endurance. Adaptogen-induced up-regulation of Hsp70 triggers stress-induced JNK-1 and DAF-16-mediated pathways regulating the resistance to stress and resulting in enhanced mental and physical performance and, possibly, increased longevity. PMID:19500070

  1. The implementation road: engaging community partnerships in evidence-based cancer control interventions.

    PubMed

    Breslau, Erica S; Weiss, Elisa S; Williams, Abigail; Burness, Allison; Kepka, Deanna

    2015-01-01

    Southern rural and underserved counties have high proportions of individuals with increased mortality for cervical and breast cancers. To improve the integration of behavioral research into practice, the dissemination and implementation of efficacious interventions to encourage the use of screening have increased in recent years. This study addressed gaps in the dissemination and implementation of evidence-based interventions with a pilot called Team Up. Qualitative interviews with 24 key individuals in six state-level partnerships explored partnership characteristics that influenced selection and use of evidence-based interventions among low-income, rarely or never screened women. Guided by diffusion of innovations theory and the Lasker and Weiss partnership functioning model, interviews about the intervention centered on (a) knowledge surrounding evidence base; (b) identification, selection, and adoption; (c) planning and adaptation; (d) implementation; and (e) partnership reflections and impact. Using grounded theory and content analysis, data revealed that lack of communication and high partner turnover hindered adoption and adaptation, whereas failure of partnership leaders to engage local stakeholders and lack of sufficient funds hampered implementation. Delivery of evidence-based interventions was more effective when partnerships included local partners in early decision making and when coaches were introduced to facilitate strategic thinking about translating evidence-based interventions into practice. A challenge for public health partnerships was the translation of interventions into successful programs, such that underserved communities benefited from early detection intervention research. PMID:24700166

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

    PubMed Central

    Aravind, Maya; Chung, Kevin C.

    2015-01-01

    The use of reliable evidence to evaluate health care interventions has gained strong support within the medical community and in the field of plastic surgery in particular. Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn’t know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for health care reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improving the quality and effectiveness of patient care today. PMID:19910854

  3. Improving the Evidence Base for Treating Older Adults With Cancer: American Society of Clinical Oncology Statement.

    PubMed

    Hurria, Arti; Levit, Laura A; Dale, William; Mohile, Supriya G; Muss, Hyman B; Fehrenbacher, Louis; Magnuson, Allison; Lichtman, Stuart M; Bruinooge, Suanna S; Soto-Perez-de-Celis, Enrique; Tew, William P; Postow, Michael A; Cohen, Harvey J

    2015-11-10

    The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response to a critical need identified by the Institute of Medicine. Older adults experience the majority of cancer diagnoses and deaths and make up the majority of cancer survivors. Older adults are also the fastest growing segment of the US population. However, the evidence base for treating this population is sparse, because older adults are underrepresented in clinical trials, and trials designed specifically for older adults are rare. The result is that clinicians have less evidence on how to treat older adults, who represent the majority of patients with cancer. Clinicians and patients are forced to extrapolate from trials conducted in younger, healthier populations when developing treatment plans. This has created a dearth of knowledge regarding the risk of toxicity in the average older patient and about key end points of importance to older adults. ASCO makes five recommendations to improve evidence generation in this population: (1) Use clinical trials to improve the evidence base for treating older adults with cancer, (2) leverage research designs and infrastructure for generating evidence on older adults with cancer, (3) increase US Food and Drug Administration authority to incentivize and require research involving older adults with cancer, (4) increase clinicians' recruitment of older adults with cancer to clinical trials, and (5) use journal policies to improve researchers' reporting on the age distribution and health risk profiles of research participants. PMID:26195697

  4. Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

    PubMed

    Asokan, G V

    2012-11-01

    Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. PMID:23557503

  5. 17 CFR 240.6h-2 - Security future based on note, bond, debenture, or evidence of indebtedness.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., bond, debenture, or evidence of indebtedness. 240.6h-2 Section 240.6h-2 Commodity and Securities... of Exchanges § 240.6h-2 Security future based on note, bond, debenture, or evidence of indebtedness. A security future may be based upon a security that is a note, bond, debenture, or evidence...

  6. Translating evidence-based interventions for implementation: Experiences from Project HEAL in African American churches

    PubMed Central

    2014-01-01

    Background Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations. Method This article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support). Results We describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations. Conclusions Project HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control. PMID:24885069

  7. The intersection of evidence-based practice with 5 quality improvement methodologies.

    PubMed

    Seidl, Kristin L; Newhouse, Robin P

    2012-06-01

    In this department, the authors highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demonstrate innovative approaches to organizational problems. In this article, the authors describe the intersection of various quality improvement methodologies with the evidence-based practice process. Five quality improvement approaches, plan-do-check-act, Six Sigma, Lean, root cause analysis, and failure mode effects analysis, are described and are used to frame examples. PMID:22617691

  8. Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings.

    PubMed

    Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton

    2015-09-01

    Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context. PMID:25217100

  9. [Use of PubMed to improve evidence-based medicine in routine urological practice].

    PubMed

    Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

    2013-03-01

    Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment. PMID:23503794

  10. Physiatrists as expert decision makers or understanding the efficiency bashing mismanagement of evidence-based medicine.

    PubMed

    King, John C

    2009-10-01

    The practice of inpatient rehabilitation addresses the extensive and complex needs of a very small but needy percent of the overall population. This uniqueness makes most physiatric inpatients outliers relative to the best evidence-based medicine practices. Evidence-based medicine studies focus on simple one problem issues averaged statistically over the entire population or a representative sample. Our inpatients rarely have one problem, and often the multiplicity of problems means contradictory guidance to care. To care for these patients efficiently, feedback to optimize and individualize care is necessary. To try to make all patients fit simplistic evidence-based medicine care paths without individualization leads to less cost-efficient and at times harmful care. PMID:21119309

  11. Using evidence-based leadership initiatives to create a healthy nursing work environment.

    PubMed

    Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela

    2013-01-01

    In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care. PMID:23759905

  12. Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings

    PubMed Central

    Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P.; Kravitz, Richard L.; Owen, Richard R.; Sullivan, Greer; Wu, Albert W.; Di Capua, Paul; Hoagwood, Kimberly Eaton

    2015-01-01

    Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context. PMID:25217100

  13. Implementing Evidence-based Psychosocial Treatment in Specialty Substance Use Disorder Care

    PubMed Central

    Manuel, Jennifer K.; Hagedorn, Hildi J.; Finney, John W.

    2011-01-01

    Implementing evidence-based psychosocial or behavioral treatments for clients with substance use disorders (SUDs) presents significant challenges. In this article, we first identify the treatments for which there is some consensus that sufficient empirical support exists to designate them as “evidence-based,” and then briefly consider the nature of that evidence. Following that, we review data from a Substance Abuse and Mental Health Services Administration survey on the extent to which these evidence-based treatments (EBTs) are used in SUD treatment in the United States. The main focus of the article is a review of 21 studies attempting to implement EBTs from which we glean information on factors associated with more and less successful implementation. We conclude that more conceptually-driven, organizationally-focused (not just individual-provider-focused) approaches to implementation are needed and that, at least with some providers in some organizational contexts, it may be more effective to implement evidence-based practices or processes (EBPs) rather than EBTs. PMID:21668085

  14. Physician Perspectives on Comparative Effectiveness Research: Implications for Practice-based Evidence

    PubMed Central

    Chesney, Margaret A.; Witt, Claudia M.; Berman, Brian M.

    2012-01-01

    Comparative effectiveness research (CER) is defined by the Institute of Medicine as “the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care.” The goal of CER is to provide timely, useful evidence to healthcare decision makers including physicians, patients, policymakers, and payers. A prime focus for the use of CER evidence is the interaction between physician and patient. Physicians in primary practice are critical to the success of the CER enterprise. A 2009 survey suggests, however, that physician attitudes toward CER may be mixed—somewhat positive toward the potential for patient care improvement, yet negative toward potential restriction on physician freedom of practice. CER methods and goals closely parallel those of practice-based research, an important movement in family medicine in the United States since the 1970s. This article addresses apparent physician ambivalence toward CER and makes a case for family medicine engagement in CER to produce useful practice-based evidence. Such an effort has potential to expand care options through personalized medicine, individualized guidelines, focus on patient preferences and patient-reported outcomes, and study of complex therapeutic interventions, such as integrative care. Academic medical researchers will need to collaborate with experienced family physicians to identify significant practice-based research questions and design meaningful studies. Such collaborations would shape CER to produce high-quality practice-based evidence to inform family and community medicine. PMID:24278829

  15. Using evidence-based internet interventions to reduce health disparities worldwide.

    PubMed

    Muñoz, Ricardo F

    2010-01-01

    Health disparities are a persistent problem worldwide. A major obstacle to reducing health disparities is reliance on "consumable interventions," that is, interventions that, once used, cannot be used again. To reduce health disparities, interventions are required that can be used again and again without losing their therapeutic power, that can reach people even if local health care systems do not provide them with needed health care, and that can be shared globally without taking resources away from the populations where the interventions were developed. This paper presents the argument that automated self-help evidence-based Internet interventions meet the above criteria and can contribute to the reduction of health disparities worldwide. Proof-of-concept studies show that evidence-based Internet interventions can reach hundreds of thousands of people worldwide and could be used in public sector settings to augment existing offerings and provide services not currently available (such as prevention interventions). This paper presents a framework for systematically filling in a matrix composed of columns representing common health problems and rows representing languages. To bring the benefits of evidence-based Internet interventions to the underserved, public sector clinics should establish eHealth resource centers, through which patients could be screened online for common disorders and provided with evidence-based Internet intervention services not currently available at the clinics. These resources should be available in the patients' languages, in formats that do not require literacy, and that can be accessed with mobile devices. Such evidence-based Internet interventions should then be shared with public sector clinics as well as individuals anywhere in the world. Finally, this paper addresses sustainability and describes a continuum of evidence-based Internet interventions to share nationally and across the world. This approach to expanding health service delivery will significantly contribute to a reduction of health disparities worldwide, adding to the often-quoted slogan, "Think globally, act locally," a third line: "Share globally." PMID:21169162

  16. Evidence based guidelines for the prevention, identification, and management of occupational asthma

    PubMed Central

    Nicholson, P; Cullinan, P; Newman, T; Burge, P; Boyle, C

    2005-01-01

    Background: Occupational asthma is the most frequently reported work related respiratory disease in many countries. This work was commissioned by the British Occupational Health Research Foundation to assist the Health and Safety Executive in achieving its target of reducing the incidence of occupational asthma in Great Britain by 30% by 2010. Aim: The guidelines aim to improve the prevention, identification, and management of occupational asthma by providing evidence based recommendations on which future practice can be based. Methods: The literature was searched systematically using Medline and Embase for articles published in all languages up to the end of June 2004. Evidence based statements and recommendations were graded according to the Royal College of General Practitioner's star system and the revised Scottish Intercollegiate Guidelines Network grading system. Results: A total of 474 original studies were selected for appraisal from over 2500 abstracts. The systematic review produced 52 graded evidence statements and 22 recommendations based on 223 studies. Discussion: Evidence based guidelines have become benchmarks for practice in healthcare and the process used to prepare them is well established. This evidence review and its recommendations focus on interventions and outcomes to provide a robust approach to the prevention, identification, and management of occupational asthma, based on and using the best available medical evidence. The most important action to prevent cases of occupational asthma is to reduce exposure at source. Thereafter surveillance should be performed for the early identification of symptoms, including occupational rhinitis, with additional functional and immunological tests where appropriate. Effective management of workers suspected to have occupational asthma involves the identification and investigation of symptoms suggestive of asthma immediately they occur. Those workers who are confirmed to have occupational asthma should be advised to avoid further exposure completely and early in the course of their disease to offer the best chance of recovery. PMID:15837849

  17. The relationship between office system tools and evidence-based care in primary care physician practice.

    PubMed

    Davis, Mark A; Pavur, Robert J

    2011-08-01

    A number of office system tools have been developed to improve the rates of preventive services and enhance the quality of medical care in practice settings. New approaches to measuring physician adherence to evidence-based standards of treatment, offer a unique opportunity to examine the link between the use of office system tools and evidence-based practices in primary care. Using episode-based profiling measures of adherence as the criterion, results from this investigation suggest that the application of simple physician reminders can be an effective technique for promoting evidence-based treatment. The data also reveal that the influence of health information technology (HIT) resources on adherence was not exclusively positive. Specifically, adherence to evidence-based standards was higher for primary care practices that employed HIT resources judiciously. In contrast, extensive use of personal digital assistants was negatively associated with adherence. Despite concerns directed towards the new generation of episode-based profiling measures, results from this research indicate that the measures behave similarly to traditional measures of quality. PMID:21840895

  18. Risks, Outcomes, and Evidence-Based Interventions for Girls in the US Juvenile Justice System.

    PubMed

    Leve, Leslie D; Chamberlain, Patricia; Kim, Hyoun K

    2015-09-01

    The proportion of the juvenile justice population that comprises females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls' involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice-involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched and underserved population of highly vulnerable youths. PMID:26119215

  19. Nursing culture: An enemy of evidence-based practice? A focus group exploration.

    PubMed

    Henderson, Ellen M; Fletcher, Margaret

    2015-12-01

    Evidence-based practice (EBP) is challenging for most nurses due to the time constraints of caring for patients and the emerging pressures of a changing health service. To explore these challenges, and thus to establish possible means of overcoming them, three focus groups (n = 17) with children's nurses were conducted. Participants were asked how they would define EBP, what the barriers to EBP were, what skills they needed to help access evidence and how they could integrate evidence into everyday practice. Data were analysed thematically and the anticipated themes of definitions of EBP, barriers, education and nursing culture were determined. Important subthemes were personal and employer disengagement, passivity and lack of resource utilisation. Passive use of evidence readily available in patient folders and on the wards was common. It seemed that little consideration was given to how often this evidence was updated. Nurses define their access to evidence as primarily passive in nature. This is reinforced by a lack of ready access to ongoing education and a perceived lack of investment at institutional level in their continued engagement with evidence. Promoting EBP needs to engage more with those ritual and traditional aspects of nursing culture to challenge these perceptions. PMID:24812063

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

    PubMed

    Olano-Marin, Juanita; Plis, Kamila; Sönnichsen, Leif; Borowik, Tomasz; Niedzia?kowska, Magdalena; J?drzejewska, Bogumi?a

    2014-01-01

    We investigated contemporary and historical influences on the pattern of genetic diversity of European roe deer (Capreolus capreolus). The study was conducted in northeastern Poland, a zone where vast areas of primeval forests are conserved and where the European roe deer was never driven to extinction. A total of 319 unique samples collected in three sampling areas were genotyped at 16 microsatellites and one fragment (610 bp) of mitochondrial DNA (mtDNA) control region. Genetic diversity was high, and a low degree of genetic differentiation among sampling areas was observed with both microsatellites and mtDNA. No evidence of genetic differentiation between roe deer inhabiting open fields and forested areas was found, indicating that the ability of the species to exploit these contrasting environments might be the result of its phenotypic plasticity. Half of the studied individuals carried an mtDNA haplotype that did not belong to C. capreolus, but to a related species that does not occur naturally in the area, the Siberian roe deer (C. pygargus). No differentiation between individuals with Siberian and European mtDNA haplotypes was detected at microsatellite loci. Introgression of mtDNA of Siberian roe deer into the genome of European roe deer has recently been detected in eastern Europe. Such introgression might be caused by human-mediated translocations of Siberian roe deer within the range of European roe deer or by natural hybridization between these species in the past. PMID:25271423

  1. Weak Population Structure in European Roe Deer (Capreolus capreolus) and Evidence of Introgressive Hybridization with Siberian Roe Deer (C. pygargus) in Northeastern Poland

    PubMed Central

    Olano-Marin, Juanita; Plis, Kamila; Sönnichsen, Leif; Borowik, Tomasz; Niedzia?kowska, Magdalena; J?drzejewska, Bogumi?a

    2014-01-01

    We investigated contemporary and historical influences on the pattern of genetic diversity of European roe deer (Capreolus capreolus). The study was conducted in northeastern Poland, a zone where vast areas of primeval forests are conserved and where the European roe deer was never driven to extinction. A total of 319 unique samples collected in three sampling areas were genotyped at 16 microsatellites and one fragment (610 bp) of mitochondrial DNA (mtDNA) control region. Genetic diversity was high, and a low degree of genetic differentiation among sampling areas was observed with both microsatellites and mtDNA. No evidence of genetic differentiation between roe deer inhabiting open fields and forested areas was found, indicating that the ability of the species to exploit these contrasting environments might be the result of its phenotypic plasticity. Half of the studied individuals carried an mtDNA haplotype that did not belong to C. capreolus, but to a related species that does not occur naturally in the area, the Siberian roe deer (C. pygargus). No differentiation between individuals with Siberian and European mtDNA haplotypes was detected at microsatellite loci. Introgression of mtDNA of Siberian roe deer into the genome of European roe deer has recently been detected in eastern Europe. Such introgression might be caused by human-mediated translocations of Siberian roe deer within the range of European roe deer or by natural hybridization between these species in the past. PMID:25271423

  2. Evidence-based review of safety and efficacy in cerebral palsy.

    PubMed

    Tilton, Ann Henderson

    2015-12-01

    The introduction of botulinum toxin has been a major advance in the care of children with cerebral palsy. Clinically the positive effects of treatment with botulinum toxin are seen in patients with all levels of GMFCS. Botulinum toxin has been established in multiple studies to reduce spasticity in the upper and lower extremities, although there is some conflicting evidence regarding function. The medication is felt to be generally safe with a low incidence of adverse events which are temporary and self-limited. However there is the recognition that severe weakness may rarely occur. Ultimately it is incumbent upon the physician to consider both risks and benefits in determining the best treatment plan for the individual patient. PMID:26403867

  3. Adapting Evidence-based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

    PubMed Central

    Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B.

    2009-01-01

    This paper describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for using partnerships as a basis for conducting mental health treatment research is presented. Finally, an ongoing partnership research project concerned with the adaptation of evidence-based mental health treatments for childhood internalizing problems in community settings is presented, with preliminary results of the ongoing effort discussed. PMID:18697917

  4. Fresh Frozen Plasma Administration in the Neonatal Intensive Care Unit: Evidence-Based Guidelines.

    PubMed

    Motta, Mario; Del Vecchio, Antonio; Chirico, Gaetano

    2015-09-01

    Neonates receiving fresh frozen plasma (FFP) should do so according to evidence-based guidelines so as to reduce inappropriate use of this life-saving and costly blood product and to minimize associated adverse effects. The consensus-based uses of FFP in neonatology involve neonates with active bleeding and associated coagulopathy. However, because of limited and poor-quality evidence, considerable FFP utilization occurs outside these recommendations. In this review, we describe what we conclude are currently the best practices for the use of FFP in neonates, including interpreting neonatal coagulation tests and strategies for reducing unnecessary FFP transfusions. PMID:26250923

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

    PubMed Central

    Canetta, Pietro A. A.; Radhakrishnan, Jai

    2015-01-01

    Adult-onset nephrotic syndrome (NS) differs from its pediatric counterpart in several important ways. Most importantly, NS in adults is more etiologically heterogeneous compared to children, and thus treatment approaches rely heavily on the histological diagnosis provided by renal biopsy. The evidence-based approach to treatment of adult NS has been critically examined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in glomerulonephritis, published in 2012. Here, we examine the strengths and limits of those guidelines and review recent work that expands the evidence-based approach. PMID:26442238

  6. Evidence-based early clinical detection of emerging diseases in food animals and zoonoses: two cases.

    PubMed

    Saegerman, Claude; Humblet, Marie-France; Porter, Sarah Rebecca; Zanella, Gina; Martinelle, Ludovic

    2012-03-01

    If diseases of food-producing animals or zoonoses (re-)emerge, early clinical decision making is of major importance. In this particular condition, it is difficult to apply a classic evidence-based veterinary medicine process, because of a lack of available published data. A method based on the partition of field clinical observations (evidences) could be developed as an interesting alternative approach. The classification and regression tree (CART) analysis was used to improve the early clinical detection in two cases of emerging diseases: bovine spongiform encephalopathy (mad cow disease) and bluetongue due to the serotype 8-virus in cattle. PMID:22374122

  7. An evidence-based approach to evaluating and improving clinical practice: guideline development.

    PubMed

    Handley, M R; Stuart, M E

    1994-03-01

    Group Health Cooperative of Puget Sound has developed a model for evaluating and improving clinical practice based on an explicit, evidence-based approach. It is designed to identify gaps between current and optimal practices, and to bring about changes in physician behavior so that health care outcomes (health status, patient satisfaction, provider satisfaction, cost/utilization) are maximized. This model stresses the importance of a rigorous process in looking objectively at evidence in working to improve outcomes. Discrete tools have been developed which help teams move successfully from problem identification to the ongoing evaluation and improvement of a new clinical practice. PMID:10132936

  8. A restatement of the natural science evidence base concerning neonicotinoid insecticides and insect pollinators

    PubMed Central

    Godfray, H. Charles J.; Blacquière, Tjeerd; Field, Linda M.; Hails, Rosemary S.; Petrokofsky, Gillian; Potts, Simon G.; Raine, Nigel E.; Vanbergen, Adam J.; McLean, Angela R.

    2014-01-01

    There is evidence that in Europe and North America many species of pollinators are in decline, both in abundance and distribution. Although there is a long list of potential causes of this decline, there is concern that neonicotinoid insecticides, in particular through their use as seed treatments are, at least in part, responsible. This paper describes a project that set out to summarize the natural science evidence base relevant to neonicotinoid insecticides and insect pollinators in as policy-neutral terms as possible. A series of evidence statements are listed and categorized according to the nature of the underlying information. The evidence summary forms the appendix to this paper and an annotated bibliography is provided in the electronic supplementary material. PMID:24850927

  9. A restatement of the natural science evidence base concerning neonicotinoid insecticides and insect pollinators.

    PubMed

    Godfray, H Charles J; Blacquière, Tjeerd; Field, Linda M; Hails, Rosemary S; Petrokofsky, Gillian; Potts, Simon G; Raine, Nigel E; Vanbergen, Adam J; McLean, Angela R

    2014-07-01

    There is evidence that in Europe and North America many species of pollinators are in decline, both in abundance and distribution. Although there is a long list of potential causes of this decline, there is concern that neonicotinoid insecticides, in particular through their use as seed treatments are, at least in part, responsible. This paper describes a project that set out to summarize the natural science evidence base relevant to neonicotinoid insecticides and insect pollinators in as policy-neutral terms as possible. A series of evidence statements are listed and categorized according to the nature of the underlying information. The evidence summary forms the appendix to this paper and an annotated bibliography is provided in the electronic supplementary material. PMID:24850927

  10. Comments on the manuscript: ``The weak absorbing outflow in AGN Mrk 279: evidence of super-solar metal abundances'' astro-ph/0611578 by Fields et al

    E-print Network

    Nahum Arav; Jelle Kaastra; Elisa Costantini

    2006-11-28

    A recent manuscript posted on astro-ph (astro-ph/0611578) by Fields et al. (hereafter F06) reports evidence of supersolar metal abundances in Mrk 279 by analyzing its Chandra LETGS X-ray spectrum. We point out that it is impossible in principle to obtain direct metal abundances from these X-ray data, since there is no handle on the amount of hydrogen column density. If F06 would have lowered their C, N, O and Fe abundance by a factor of ten and increased the hydrogen column density by a factor of ten, they would have obtained an almost identical fit with subsolar metalicity. F06 find support for their supersolar metal abundances from a cursory analysis of the UV data from the same Mrk 279 campaign. We point out that F06 included in that analysis portions of the UV trough that are known to arise from gas unrelated to the outflow, which weakens the support from the UV data. A detailed analysis of the Chandra LETGS X-ray spectrum was accepted for publication in A&A on Sept 14 2006 (Costantini et al 2006; hereafter C06) and posted on astro-ph on the same date. F06 ignore most of this published analysis while duplicating the finding of two ionization components with similar parameters to the ones found by C06. Finally, we note that it is possible to derive accurate abundances from the UV data set of this object. We already published these findings in a conference precedings and have submitted the relevant manuscript to ApJ. We find that relative to solar the abundances in the Mrk 279 outflow are (linear scaling): carbon 2.2 +/- 0.7, nitrogen 3.5 +/- 1.1 and oxygen 1.6 +/- 0.8.

  11. Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain

    PubMed Central

    Dunsford, Angela; Kumar, Saravana; Clarke, Sarah

    2011-01-01

    Low back pain (LBP) is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP) exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies) and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas), which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. PMID:22135496

  12. Radiologists’ perspectives about evidence-based medicine and their clinical practice: a semistructured interview study

    PubMed Central

    Tong, Allison; Mahady, Suzanne E; Craig, Jonathan C; Lau, Gabes; Peduto, Anthony J; Loy, Clement

    2014-01-01

    Objectives To describe radiologist's attitudes and perspectives on evidence-based medicine (EBM) and their practice. Design Face-to-face semistructured interviews, thematic analysis. Setting 24 institutions across six Australian states and New Zealand. Transcripts were imported into HyperRESEARCH software and thematically analysed. Participants 25 radiologists. Results Six themes were identified: legitimising decisions (validated justification, prioritising patient preferences, reinforcing protocols), optimising outcomes (ensuring patient safety, maximising efficiency), availability of access (requiring immediacy, inadequacy of evidence, time constraints, proximity of peer networks, grasping information dispersion), over-riding pragmatism (perceptibly applicability, preserving the art of medicine, technical demands), limited confidence (conceptual obscurity, reputation-based trust, demands constant practice, suspicion and cynicism), and competing powers (hierarchical conflict, prevailing commercial interests). Conclusions Radiologists believe EBM can support clinical decision-making for optimal patient outcomes and service efficiency but feel limited in their capacities to assimilate and apply EBM in practice. Improving access to evidence, providing ongoing education and training supplemented with practical tools for appraising evidence; and developing evidence-based guidelines and protocols may enhance feasibility and promote the confidence and skills among radiologists in applying EBM in radiology practice for better patient care. PMID:25500161

  13. [Online information service: the library support for evidence-based practice].

    PubMed

    Markulin, Helena; Petrak, Jelka

    2014-01-01

    It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice. PMID:24720156

  14. Evidence-based reproductive health care in Cameroon: population-based study of awareness, use and barriers.

    PubMed Central

    Tita, Alan T. N.; Selwyn, Beatrice J.; Waller, D. Kim; Kapadia, Asha S.; Dongmo, Sylvestre

    2005-01-01

    OBJECTIVE: To estimate the prevalence of awareness and use of evidence-based reproductive health interventions and to describe the barriers associated with the use of evidence-based interventions among health providers in north-west Cameroon. METHODS: In February 2004, a population-based descriptive study of the awareness and use of 13 evidence-based interventions targeted health workers providing reproductive health care. Their awareness and use of a composite of four vital interventions was also evaluated. These were peripartum use of antiretrovirals to prevent transmission of HIV, antenatal corticosteroid administration, magnesium sulfate prophylaxis and active management of placental delivery with uterotonics. In-depth interviews with key informants were conducted as part of a qualitative substudy to discover the barriers to the use of evidence-based interventions. FINDINGS: Overall, 91.4% (328/359) of reproductive health workers were surveyed. Their awareness of evidence-based interventions varied from 29% for the use of antenatal corticosteroids to 97% for the use of iron and folic acid supplementation during pregnancy. Their use of these interventions ranged from 10.2% for antenatal corticosteroids to 94.8% for iron and folic acid supplementation. Only 50/322 (15.5%; 95% confidence interval (CI)=11.8-20.0) of health workers were aware of all four vital interventions, and only 12/312 (3.8%; 95% CI=2.0- 6.6) reported using all of them regularly. A total of 26 key informants participated in the qualitative substudy. A deficiency in the education and training of health workers, especially a lack of continuing education, was commonly identified as the most important barrier to their awareness of evidence-based practices. A lack of awareness and a lack of supplies and materials were the main barriers to practice. CONCLUSION: The awareness and practice of important evidence-based reproductive health interventions were less than optimal. To improve maternal and perinatal outcomes both remedial programmes to enhance awareness, including continuing education for health workers, and the provision of necessary supplies are needed. PMID:16462981

  15. In vitro dissolution methodology, mini-Gastrointestinal Simulator (mGIS), predicts better in vivo dissolution of a weak base drug, dasatinib.

    PubMed

    Tsume, Yasuhiro; Takeuchi, Susumu; Matsui, Kazuki; Amidon, Gregory E; Amidon, Gordon L

    2015-08-30

    USP apparatus I and II are gold standard methodologies for determining the in vitro dissolution profiles of test drugs. However, it is difficult to use in vitro dissolution results to predict in vivo dissolution, particularly the pH-dependent solubility of weak acid and base drugs, because the USP apparatus contains one vessel with a fixed pH for the test drug, limiting insight into in vivo drug dissolution of weak acid and weak base drugs. This discrepancy underscores the need to develop new in vitro dissolution methodology that better predicts in vivo response to assure the therapeutic efficacy and safety of oral drug products. Thus, the development of the in vivo predictive dissolution (IPD) methodology is necessitated. The major goals of in vitro dissolution are to ensure the performance of oral drug products and the support of drug formulation design, including bioequivalence (BE). Orally administered anticancer drugs, such as dasatinib and erlotinib (tyrosine kinase inhibitors), are used to treat various types of cancer. These drugs are weak bases that exhibit pH-dependent and high solubility in the acidic stomach and low solubility in the small intestine (>pH 6.0). Therefore, these drugs supersaturate and/or precipitate when they move from the stomach to the small intestine. Also of importance, gastric acidity for cancer patients may be altered with aging (reduction of gastric fluid secretion) and/or co-administration of acid-reducing agents. These may result in changes to the dissolution profiles of weak base and the reduction of drug absorption and efficacy. In vitro dissolution methodologies that assess the impact of these physiological changes in the GI condition are expected to better predict in vivo dissolution of oral medications for patients and, hence, better assess efficacy, toxicity and safety concerns. The objective of this present study is to determine the initial conditions for a mini-Gastrointestinal Simulator (mGIS) to assess in vivo dissolution of BCS class IIb drugs, dasatinib as a model drug, including the different gastric condition. The maximum dissolution of dasatinib with USP dissolution apparatus II was less than 1% in pH 6.5 SIF, while the one with mGIS (pH 1.2 SGF/pH 6.5 SIF) reached almost 100%. The supersaturation and precipitation of dasatinib were observed in the in vitro dissolution studies with mGIS but not with USP apparatus II. Additionally, dasatinib dissolution with mGIS was reduced to less than 10% when the gastric pH was elevated, suggesting the co-administration of acid reducing agents will decrease the oral bioavailability of dasatinib. Accurate prediction of in vivo drug dissolution would be beneficial for assuring product safety and efficacy for patients. To this end, we have created a new in vitro dissolution system, mGIS, to predict the in vivo dissolution phenomena of a weak base drug, dasatinib. The experimental results when combined with in silico simulation suggest that the mGIS predicted the in vivo dissolution well due to the elevation of gastric pH. Thus, mGIS might be suitable to predict in vivo dissolution of weak basic drugs. This mGIS methodology is expected to significantly advance the prediction of in vivo drug dissolution. It is also expected to assist in optimizing product development and drug formulation design in support of Quality by Design (QbD) initiatives. PMID:25978875

  16. Evidence-based Research in Complementary and Alternative Medicine I: History

    PubMed Central

    2005-01-01

    Contemporary Western medicine has witnessed a fragmentation of our conceptualization of the medical endeavor into ‘traditional medicine’ and ‘non-traditional medicine’. The former is meant to refer to the Western medical tradition, the latter encompasses both ‘complementary’ and ‘alternative’ medical practices. Complementary medicine complements conventional medical treatments, and alternative modes of medical interventions are meant to replace traditional Western medicine. Evidence-based research must be directed at establishing the best available evidence in complementary and alternative medicine. This paper is the first of a set of four ‘lectures’ that reviews the process of evidence-based research, and discusses its implications and applications for the early decades of the 21st century. The purpose of this paper is to introduce the series by examining some of the historical and philosophical foundations of this research endeavor. PMID:16322801

  17. An evidence-based diagnostic classification system for low back pain

    PubMed Central

    Vining, Robert; Potocki, Eric; Seidman, Michael; Morgenthal, A. Paige

    2013-01-01

    Introduction: While clinicians generally accept that musculoskeletal low back pain (LBP) can arise from specific tissues, it remains difficult to confirm specific sources. Methods: Based on evidence supported by diagnostic utility studies, doctors of chiropractic functioning as members of a research clinic created a diagnostic classification system, corresponding exam and checklist based on strength of evidence, and in-office efficiency. Results: The diagnostic classification system contains one screening category, two pain categories: Nociceptive, Neuropathic, one functional evaluation category, and one category for unknown or poorly defined diagnoses. Nociceptive and neuropathic pain categories are each divided into 4 subcategories. Conclusion: This article describes and discusses the strength of evidence surrounding diagnostic categories for an in-office, clinical exam and checklist tool for LBP diagnosis. The use of a standardized tool for diagnosing low back pain in clinical and research settings is encouraged. PMID:23997245

  18. Message generalizations that support evidence-based persuasive message design: specifying the evidentiary requirements.

    PubMed

    O'Keefe, Daniel J

    2015-01-01

    Evidence-based persuasive message design can be informed by dependable research-based generalizations about the relative persuasiveness of alternative message-design options. Five propositions are offered as specifying what constitutes the best evidence to underwrite such generalizations: (1) The evidence should take the form of replicated randomized trials in which message features are varied. (2) Results should be described in terms of effect sizes and confidence intervals, not statistical significance. (3) The results should be synthesized using random-effects meta-analytic procedures. (4) The analysis should treat attitudinal, intention, and behavioral assessments as yielding equivalent indices of relative persuasiveness. (5) The replications included in research syntheses should not be limited to published studies or to English-language studies. PMID:25470435

  19. Novel Ultra Stable Silica-Based Stationary Phases for Reversed Phase Liquid Chromatography-Study of a Hydrophobically Assisted Weak Acid Cation Exchange Phase

    PubMed Central

    Zhang, Yu; Carr, Peter W.

    2010-01-01

    A mixed-mode reversed-phase/weak cation exchange (RP/WCX) phase has been developed by introducing a small amount of carboxylate functionality into a hydrophobic hyper-crosslinked (HC) platform. This silica based HC-platform was designed to form an extensive polystyrene network completely confined to the particle's surface. The fully connected polymer network prevents the loss of bonded phase, which leads to superior hydrolytic stability of the new phase when compared to conventional silica based phases. Compared to previously introduced HC phases the added carboxylic groups impart a new weak cation exchange selectivity to the base hydrophobic HC platform. The phase thus prepared shows a mixed-mode retention mechanism, allowing for both neutral organic compounds and bases of a wide polarity range to be simultaneously separated on the same phase under the same conditions. In addition, the new phase offers the flexibility that gradients in organic modifier, pH or ionic competitors can be used to affect the separation of a wide range of solutes. Moreover, the inherent weak acid cation exchange groups allow formic and acetic acid buffers to be used as eluents thereby avoiding the mass spectrometric ionization suppression problems concomitant to the use of non-volatile additives such as strong amine modifiers (e.g. triethylamine) or salts (e.g. NaCl) to elute basic solutes from the strong cation exchange phase which was previously developed in this lab. The use of the new phase for achieving strong retention of rather hydrophilic neurotransmitters and drugs of abuse without the need for ion pairing agents is demonstrated. PMID:21227426

  20. Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?

    PubMed Central

    Agarwal, Koki; Askew, Ian; Iriarte, Emma; Morgan, Lindsay; Watson, Julia

    2013-01-01

    Performance-based incentives (PBIs) aim to counteract weak providers’ performance in health systems of many developing countries by providing rewards that are directly linked to better health outcomes for mothers and their newborns. Translating funding into better health requires many actions by a large number of people. The actions span from community to the national level. While different forms of PBIs are being implemented in a number of countries to improve health outcomes, there has not been a systematic review of the evidence of their impact on the health of mothers and newborns. This paper analyzes and synthesizes the available evidence from published studies on the impact of supply-side PBIs on the quantity and quality of health services for mothers and newborns. This paper reviews evidence from published and grey literature that spans PBI for public-sector facilities, PBI in social insurance reforms, and PBI in NGO contracting. Some initiatives focus on safe deliveries, and others reward a broader package of results that include deliveries. The Evidence Review Team that focused on supply-side incentives for the US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives, reviewed published research reports and papers and added studies from additional grey literature that were deemed relevant. After collecting and reviewing 17 documents, nine studies were included in this review, three of which used before-after designs; four included comparison or control groups; one applied econometric methods to a five-year time series; and one reported results from a large-scale impact evaluation with randomly-assigned intervention and control facilities. The available evidence suggests that incentives that reward providers for institutional deliveries result in an increase in the number of institutional deliveries. There is some evidence that the content of antenatal care can improve with PBI. We found no direct evidence on the impact of PBI on neonatal health services or on mortality of mothers and newborns, although intention of the study was not to document impact on mortality. A number of studies describe approaches to rewarding quality as well as increases in the quantities of services provided, although how quality is defined and monitored is not always clear. Because incentives exist in all health systems, considering how to align the incentives of the many health workers and their supervisors so that they focus efforts on achieving health goals for mothers and newborns is critical if the health system is to perform more effectively and efficiently. A wide range of PBI models is being developed and tested, and there is still much to learn about what works best. Future studies should include a larger focus on rewarding quality and measuring its impact. Finally, more qualitative research to better understand PBI implementation and how various incentive models function in different settings is needed to help practitioners refine and improve their programmes.