Content Integrity, Conflict of Interest, and Commercial Support: Defining and Operationalizing the Terms.

PubMed

Dickerson, Pam; Chappell, Kathy

2015-01-01

One of the hallmarks of quality continuing education developed using accreditation criteria is content integrity. Components of content integrity include identifying, resolving, and disclosing conflict of interest; ensuring content is based on the best available evidence; managing commercial support (if applicable); and presenting the educational activity free of promotion or bias. This article explores content integrity, conflict of interest, and commercial support. Understanding and being able to operationalize these concepts will enable providers to offer high-quality educational activities that promote the professional development of nurses and/or improve the quality of patient care.

Quality of Web-based information on cocaine addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-08-01

To evaluate the quality of web-based information on cocaine use and addiction and to investigate potential content quality indicators. Three keywords: cocaine, cocaine addiction and cocaine dependence were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. Of the 120 websites identified, 61 were included. Most were commercial sites. The results of the study indicate low scores on each of the measures including content quality. A global score (the sum of accountability, interactivity, content quality and aesthetic criteria) appeared as a good content quality indicator. While cocaine education websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cocaine use and addiction on the web. The poor and variable quality of web-based information and its possible impact on physician-patient relationship argue for a serious provider for patient talk about the health information found on Internet. Internet sites could improve their content using the global score as a quality indicator.

Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management.

PubMed

Scotto Rosato, Nancy; Correll, Christoph U; Pappadopulos, Elizabeth; Chait, Alanna; Crystal, Stephen; Jensen, Peter S

2012-06-01

To develop guidelines for management and treatment of maladaptive aggression in youth in the areas of psychosocial interventions, medication treatments, and side-effect management. Evidence was assembled and evaluated in a multistep process, including systematic reviews of published literature; an expert survey of recommended practices; a consensus conference of researchers, policymakers, clinicians, and family advocates; and review by the steering committee of successive drafts of the recommendations. The Center for Education and Research on Mental Health Therapeutics Treatment of Maladaptive Aggression in Youth guidelines reflect a synthesis of the available evidence, based on this multistep process. This article describes the content, rationale, and evidence for 11 recommendations. Key treatment principles include considering psychosocial interventions, such as evidence-based parent and child skills training as the first line of treatment; targeting the underlying disorder first following evidence-based guidelines; considering individual psychosocial and medical factors, including cardiovascular risk in the selection of agents if medication treatment (ideally with the best evidence base) is initiated; avoiding the use of multiple psychotropic medications simultaneously; and careful monitoring of treatment response, by using structured rating scales, as well as close medical monitoring for side effects, including metabolic changes. Treatment of children with maladaptive aggression is a "moving target" requiring ongoing assimilation of new evidence as it emerges. Based on the existing evidence, the Treatment of Maladaptive Aggression in Youth guidelines provide a framework for management of maladaptive aggression in youth, appropriate for use by primary care clinicians and mental health providers.

45 CFR 508.6 - Résumé of hearing, preparation of.

Code of Federal Regulations, 2010 CFR

2010-10-01

... which the hearing was based, and including a list of documents and contents and other items relative to the issues that were introduced as evidence. A brief analysis of oral testimony will also be prepared...

A review of guidance on fish consumption in pregnancy: is it fit for purpose?

PubMed

Taylor, Caroline M; Emmett, Pauline M; Emond, Alan M; Golding, Jean

2018-03-26

Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption. We searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed. We identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all. Guidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps

PubMed Central

Silfee, Valerie J; Waring, Molly E; Boudreaux, Edwin D; Sadasivam, Rajani S; Mullen, Sean P; Carey, Jennifer L; Hayes, Rashelle B; Ding, Eric Y; Bennett, Gary G; Pagoto, Sherry L

2017-01-01

Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps. PMID:29254914

Danish first aid books compliance with the new evidence-based non-resuscitative first aid guidelines.

PubMed

Jensen, Theo Walther; Møller, Thea Palsgaard; Viereck, Søren; Roland, Jens; Pedersen, Thomas Egesborg; Lippert, Freddy K

2018-01-10

The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. We identified first aid books from all the first aid courses offered by major Danish suppliers. Based on the new ERC first aid guidelines, we developed a checklist of 26 items within 16 different categories to assess the content; this checklist was adapted following the principle of mutually exclusive and collectively exhaustive questioning. To assess the agreement between four raters, Fleiss' kappa test was used. Items that did not reach an acceptable kappa score were excluded. We evaluated 10 first aid books used for first aid courses and published between 2009 and 2015. The content of the books complied with the new in 38% of the answers. In 12 of the 26 items, there was less than 50% consistency. These items include proximal pressure points and elevation of extremities for the control of bleeding, use of cervical collars, treatment for an open chest wound, burn dressing, dental avulsion, passive leg raising, administration of bronchodilators, adrenaline, and aspirin. Danish course material showed significant inconsistencies with the new evidence-based first aid guidelines. The new knowledge from the evidence-based guidelines should be incorporated into revised and updated first aid course material.

Toward a Transdisciplinary Model of Evidence-Based Practice

PubMed Central

Satterfield, Jason M; Spring, Bonnie; Brownson, Ross C; Mullen, Edward J; Newhouse, Robin P; Walker, Barbara B; Whitlock, Evelyn P

2009-01-01

Context This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed. PMID:19523122

Quality of web-based information on cannabis addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-01-01

This study evaluated the quality of Web-based information on cannabis use and addiction and investigated particular content quality indicators. Three keywords ("cannabis addiction," "cannabis dependence," and "cannabis abuse") were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of the 94 Websites identified, 57 were included. Most were commercial sites. Based on outcome measures, the overall quality of the sites turned out to be poor. A global score (the sum of accountability, interactivity, content quality and esthetic criteria) appeared as a good content quality indicator. While cannabis education Websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cannabis use and addiction on the Web.

Support Systems for Treatment Integrity

ERIC Educational Resources Information Center

Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

2016-01-01

Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

The omnivorous Tyrolean Iceman: colon contents (meat, cereals, pollen, moss and whipworm) and stable isotope analyses.

PubMed Central

Dickson, J H; Oeggl, K; Holden, T G; Handley, L L; O'Connell, T C; Preston, T

2000-01-01

The contents of the colon of the Tyrolean Iceman who lived ca. 5300 years ago include muscle fibres, cereal remains, a diversity of pollen, and most notably that of the hop hornbeam (Ostrya carpinifolia) retaining cellular contents, as well as a moss leaf (Neckera complanata) and eggs of the parasitic whipworm (Trichuris trichiura). Based almost solely on stable isotope analyses and ignoring the work on the colon contents, two recently published papers on the Iceman's diet draw ill-founded conclusions about vegetarianism and even veganism. Neither the pollen nor the moss is likely to have been deliberately consumed as food by the Iceman. All the available evidence concerning the Iceman's broad-based diet is reviewed and the significance of the colon contents for matters other than assessment of food intake is outlined. PMID:11205345

Development and clinical application of an evidence-based pharmaceutical care service algorithm in acute coronary syndrome.

PubMed

Kang, J E; Yu, J M; Choi, J H; Chung, I-M; Pyun, W B; Kim, S A; Lee, E K; Han, N Y; Yoon, J-H; Oh, J M; Rhie, S J

2018-06-01

Drug therapies are critical for preventing secondary complications in acute coronary syndrome (ACS). The purpose of this study was to develop and apply a pharmaceutical care service (PCS) algorithm for ACS and confirm that it is applicable through a prospective clinical trial. The ACS-PCS algorithm was developed according to extant evidence-based treatment and pharmaceutical care guidelines. Quality assurance was conducted through two methods: literature comparison and expert panel evaluation. The literature comparison was used to compare the content of the algorithm with the referenced guidelines. Expert evaluations were conducted by nine experts for 75 questionnaire items. A trial was conducted to confirm its effectiveness. Seventy-nine patients were assigned to either the pharmacist-included multidisciplinary team care (MTC) group or the usual care (UC) group. The endpoints of the trial were the prescription rate of two important drugs, readmission, emergency room (ER) visit and mortality. The main frame of the algorithm was structured with three tasks: medication reconciliation, medication optimization and transition of care. The contents and context of the algorithm were compliant with class I recommendations and the main service items from the evidence-based guidelines. Opinions from the expert panel were mostly positive. There were significant differences in beta-blocker prescription rates in the overall period (P = .013) and ER visits (four cases, 9.76%, P = .016) in the MTC group compared to the UC group, respectively. We developed a PCS algorithm for ACS based on the contents of evidence-based drug therapy and the core concept of pharmacist services. © 2018 John Wiley & Sons Ltd.

Science-based occupations and the science curriculum: Concepts of evidence

NASA Astrophysics Data System (ADS)

Aikenhead, Glen S.

2005-03-01

What science-related knowledge is actually used by nurses in their day-to-day clinical reasoning when attending patients? The study investigated the knowledge-in-use of six acute-care nurses in a hospital surgical unit. It was found that the nurses mainly drew upon their professional knowledge of nursing and upon their procedural understanding that included a common core of concepts of evidence (concepts implicitly applied to the evaluation of data and the evaluation of evidence - the focus of this research). This core included validity triangulation, normalcy range, accuracy, and a general predilection for direct sensual access to a phenomenon over indirect machine-managed access. A cluster of emotion-related concepts of evidence (e.g. cultural sensitivity) was also discovered. These results add to a compendium of concepts of evidence published in the literature. Only a small proportion of nurses (one of the six nurses in the study) used canonical science content in their clinical reasoning, a result consistent with other research. This study also confirms earlier research on employees in science-rich workplaces in general, and on professional development programs for nurses specifically: canonical science content found in a typical science curriculum (e.g. high school physics) does not appear relevant to many nurses' knowledge-in-use. These findings support a curriculum policy that gives emphasis to students learning how to learn science content as required by an authentic everyday or workplace context, and to students learning concepts of evidence.

Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis

PubMed Central

Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping

2015-01-01

Background Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. Objective To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. Methods All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association. TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. Results A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Conclusions Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. PMID:26041487

Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis.

PubMed

Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping

2015-06-03

Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors' Association.TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

PubMed Central

von Karsa, L.; Patnick, J.; Segnan, N.; Atkin, W.; Halloran, S.; Lansdorp-Vogelaar, I.; Malila, N.; Minozzi, S.; Moss, S.; Quirke, P.; Steele, R. J.; Vieth, M.; Aabakken, L.; Altenhofen, L.; Ancelle-Park, R.; Antoljak, N.; Anttila, A.; Armaroli, P.; Arrossi, S.; Austoker, J.; Banzi, R.; Bellisario, C.; Blom, J.; Brenner, H.; Bretthauer, M.; Camargo Cancela, M.; Costamagna, G.; Cuzick, J.; Dai, M.; Daniel, J.; Dekker, E.; Delicata, N.; Ducarroz, S.; Erfkamp, H.; Espinàs, J. A.; Faivre, J.; Faulds Wood, L.; Flugelman, A.; Frkovic-Grazio, S.; Geller, B.; Giordano, L.; Grazzini, G.; Green, J.; Hamashima, C.; Herrmann, C.; Hewitson, P.; Hoff, G.; Holten, I.; Jover, R.; Kaminski, M. F.; Kuipers, E. J.; Kurtinaitis, J.; Lambert, R.; Launoy, G.; Lee, W.; Leicester, R.; Leja, M.; Lieberman, D.; Lignini, T.; Lucas, E.; Lynge, E.; Mádai, S.; Marinho, J.; Maučec Zakotnik, J.; Minoli, G.; Monk, C.; Morais, A.; Muwonge, R.; Nadel, M.; Neamtiu, L.; Peris Tuser, M.; Pignone, M.; Pox, C.; Primic-Zakelj, M.; Psaila, J.; Rabeneck, L.; Ransohoff, D.; Rasmussen, M.; Regula, J.; Ren, J.; Rennert, G.; Rey, J.; Riddell, R. H.; Risio, M.; Rodrigues, V.; Saito, H.; Sauvaget, C.; Scharpantgen, A.; Schmiegel, W.; Senore, C.; Siddiqi, M.; Sighoko, D.; Smith, R.; Smith, S.; Suchanek, S.; Suonio, E.; Tong, W.; Törnberg, S.; Van Cutsem, E.; Vignatelli, L.; Villain, P.; Voti, L.; Watanabe, H.; Watson, J.; Winawer, S.; Young, G.; Zaksas, V.; Zappa, M.; Valori, R.

2015-01-01

Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. PMID:23212726

Pharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes: a systematic review on content and adherence to guidelines.

PubMed

Vegter, Stefan; Boersma, Cornelis; Rozenbaum, Mark; Wilffert, Bob; Navis, Gerjan; Postma, Maarten J

2008-01-01

The fields of pharmacogenetics and pharmacogenomics have become important practical tools to progress goals in medical and pharmaceutical research and development. As more screening tests are being developed, with some already used in clinical practice, consideration of cost-effectiveness implications is important. A systematic review was performed on the content of and adherence to pharmacoeconomic guidelines of recent pharmacoeconomic analyses performed in the field of pharmacogenetics and pharmacogenomics. Economic analyses of screening strategies for genetic variations, which were evidence-based and assumed to be associated with drug efficacy or safety, were included in the review. The 20 papers included cover a variety of healthcare issues, including screening tests on several cytochrome P450 (CYP) enzyme genes, thiopurine S-methyltransferase (TMPT) and angiotensin-converting enzyme (ACE) insertion deletion (ACE I/D) polymorphisms. Most economic analyses reported that genetic screening was cost effective and often even clearly dominated existing non-screening strategies. However, we found a lack of standardization regarding aspects such as the perspective of the analysis, factors included in the sensitivity analysis and the applied discount rates. In particular, an important limitation of several studies related to the failure to provide a sufficient evidence-based rationale for an association between genotype and phenotype. Future economic analyses should be conducted utilizing correct methods, with adherence to guidelines and including extensive sensitivity analyses. Most importantly, genetic screening strategies should be based on good evidence-based rationales. For these goals, we provide a list of recommendations for good pharmacoeconomic practice deemed useful in the fields of pharmacogenetics and pharmacogenomics, regardless of country and origin of the economic analysis.

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

PubMed

Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J

2014-07-29

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

Linking simulation-based educational assessments and patient-related outcomes: a systematic review and meta-analysis.

PubMed

Brydges, Ryan; Hatala, Rose; Zendejas, Benjamin; Erwin, Patricia J; Cook, David A

2015-02-01

To examine the evidence supporting the use of simulation-based assessments as surrogates for patient-related outcomes assessed in the workplace. The authors systematically searched MEDLINE, EMBASE, Scopus, and key journals through February 26, 2013. They included original studies that assessed health professionals and trainees using simulation and then linked those scores with patient-related outcomes assessed in the workplace. Two reviewers independently extracted information on participants, tasks, validity evidence, study quality, patient-related and simulation-based outcomes, and magnitude of correlation. All correlations were pooled using random-effects meta-analysis. Of 11,628 potentially relevant articles, the 33 included studies enrolled 1,203 participants, including postgraduate physicians (n = 24 studies), practicing physicians (n = 8), medical students (n = 6), dentists (n = 2), and nurses (n = 1). The pooled correlation for provider behaviors was 0.51 (95% confidence interval [CI], 0.38 to 0.62; n = 27 studies); for time behaviors, 0.44 (95% CI, 0.15 to 0.66; n = 7); and for patient outcomes, 0.24 (95% CI, -0.02 to 0.47; n = 5). Most reported validity evidence was favorable, though studies often included only correlational evidence. Validity evidence of internal structure (n = 13 studies), content (n = 12), response process (n = 2), and consequences (n = 1) were reported less often. Three tools showed large pooled correlations and favorable (albeit incomplete) validity evidence. Simulation-based assessments often correlate positively with patient-related outcomes. Although these surrogates are imperfect, tools with established validity evidence may replace workplace-based assessments for evaluating select procedural skills.

Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

PubMed Central

Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

2014-01-01

Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

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.

Brainstorming for breakthrough thinking.

PubMed

Shirey, Maria R

2011-12-01

This department highlights change management strategies that may be used in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses brainstorming as a viable innovation technique and goal-based change intervention.

Screening tool for oropharyngeal dysphagia in stroke - Part I: evidence of validity based on the content and response processes.

PubMed

Almeida, Tatiana Magalhães de; Cola, Paula Cristina; Pernambuco, Leandro de Araújo; Magalhães, Hipólito Virgílio; Magnoni, Carlos Daniel; Silva, Roberta Gonçalves da

2017-08-17

The aim of the present study was to identify the evidence of validity based on the content and response process of the Rastreamento de Disfagia Orofaríngea no Acidente Vascular Encefálico (RADAVE; "Screening Tool for Oropharyngeal Dysphagia in Stroke"). The criteria used to elaborate the questions were based on a literature review. A group of judges consisting of 19 different health professionals evaluated the relevance and representativeness of the questions, and the results were analyzed using the Content Validity Index. In order to evidence validity based on the response processes, 23 health professionals administered the screening tool and analyzed the questions using a structured scale and cognitive interview. The RADAVE structured to be applied in two stages. The first version consisted of 18 questions in stage I and 11 questions in stage II. Eight questions in stage I and four in stage II did not reach the minimum Content Validity Index, requiring reformulation by the authors. The cognitive interview demonstrated some misconceptions. New adjustments were made and the final version was produced with 12 questions in stage I and six questions in stage II. It was possible to develop a screening tool for dysphagia in stroke with adequate evidence of validity based on content and response processes. Both validity evidences obtained so far allowed to adjust the screening tool in relation to its construct. The next studies will analyze the other evidences of validity and the measures of accuracy.

Instruction, Rationality and Learning to be Moral.

ERIC Educational Resources Information Center

Hyland, J. T.

1986-01-01

Defines rationality and morality and contends that learning to be moral must be based on more than value-neutral approaches which stress process over content. Argues that instruction in moral principles need not be simple bald exposition, but must include proofs, evidences, and arguments, making it nondogmatic and fully compatible with the…

Evidence-Based Assessment of Child Obsessive Compulsive Disorder: Recommendations for Clinical Practice and Treatment Research

ERIC Educational Resources Information Center

Lewin, Adam B.; Piacentini, John

2010-01-01

Obsessive-compulsive disorder (OCD) presents heterogeneously and can be difficult to assess in youth. This review focuses on research-supported assessment approaches for OCD in childhood. Content areas include pre-visit screening, diagnostic establishment, differential diagnosis, assessment of comorbid psychiatric conditions, tracking symptom…

Eight-step method to build the clinical content of an evidence-based care pathway: the case for COPD exacerbation

PubMed Central

2012-01-01

Background Optimization of the clinical care process by integration of evidence-based knowledge is one of the active components in care pathways. When studying the impact of a care pathway by using a cluster-randomized design, standardization of the care pathway intervention is crucial. This methodology paper describes the development of the clinical content of an evidence-based care pathway for in-hospital management of chronic obstructive pulmonary disease (COPD) exacerbation in the context of a cluster-randomized controlled trial (cRCT) on care pathway effectiveness. Methods The clinical content of a care pathway for COPD exacerbation was developed based on recognized process design and guideline development methods. Subsequently, based on the COPD case study, a generalized eight-step method was designed to support the development of the clinical content of an evidence-based care pathway. Results A set of 38 evidence-based key interventions and a set of 24 process and 15 outcome indicators were developed in eight different steps. Nine Belgian multidisciplinary teams piloted both the set of key interventions and indicators. The key intervention set was judged by the teams as being valid and clinically applicable. In addition, the pilot study showed that the indicators were feasible for the involved clinicians and patients. Conclusions The set of 38 key interventions and the set of process and outcome indicators were found to be appropriate for the development and standardization of the clinical content of the COPD care pathway in the context of a cRCT on pathway effectiveness. The developed eight-step method may facilitate multidisciplinary teams caring for other patient populations in designing the clinical content of their future care pathways. PMID:23190552

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

PubMed

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

2016-02-01

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

A Review of Online Evidence-based Practice Point-of-Care Information Summary Providers

PubMed Central

Liberati, Alessandro; Moschetti, Ivan; Tagliabue, Ludovica; Moja, Lorenzo

2010-01-01

Background Busy clinicians need easy access to evidence-based information to inform their clinical practice. Publishers and organizations have designed specific tools to meet doctors’ needs at the point of care. Objective The aim of this study was to describe online point-of-care summaries and evaluate their breadth, content development, and editorial policy against their claims of being “evidence-based.” Methods We searched Medline, Google, librarian association websites, and information conference proceedings from January to December 2008. We included English Web-based point-of-care summaries designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, evidence-based information to clinicians. Two investigators independently extracted data on the general characteristics and content presentation of summaries. We assessed and ranked point-of-care products according to: (1) coverage (volume) of medical conditions, (2) editorial quality, and (3) evidence-based methodology. We explored how these factors were associated. Results We retrieved 30 eligible summaries. Of these products, 18 met our inclusion criteria and were qualitatively described, and 16 provided sufficient data for quantitative evaluation. The median volume of medical conditions covered was 80.6% (interquartile range, 68.9% - 84.2%) and varied for the different products. Similarly, differences emerged for editorial policy (median 8.0, interquartile range 5.8 - 10.3) and evidence-based methodology scores (median 10.0, interquartile range 1.0 - 12.8) on a 15-point scale. None of these dimensions turned out to be significantly associated with the other dimensions (editorial quality and volume, Spearman rank correlation r = -0.001, P = .99; evidence-based methodology and volume, r = -0.19, P = .48; editorial and evidence-based methodology, r = 0.43, P =.09). Conclusions Publishers are moving to develop point-of-care summary products. Some of these have better profiles than others, and there is room for improved reporting of the strengths and weaknesses of these products. PMID:20610379

How to Define the Content of a Job-Specific Worker's Health Surveillance for Hospital Physicians?

PubMed

Ruitenburg, Martijn M; Frings-Dresen, Monique H W; Sluiter, Judith K

2016-03-01

A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content. Based on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications. Information from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness. The process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.

Synthesising quantitative and qualitative research in evidence-based patient information.

PubMed

Goldsmith, Megan R; Bankhead, Clare R; Austoker, Joan

2007-03-01

Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence-based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge. This paper describes the review methods developed and the difficulties encountered during the process of updating a systematic review of evidence to inform guidelines for the content of patient information related to cervical screening. Systematic searches of 12 electronic databases (January 1996 to July 2004) were conducted. Studies that evaluated the content of information provided to women about cervical screening or that addressed women's information needs were assessed for inclusion. A data extraction form and quality assessment criteria were developed from published resources. A non-quantitative synthesis was conducted and a tabular evidence profile for each important outcome (eg "explain what the test involves") was prepared. The overall quality of evidence for each outcome was then assessed using an approach published by the GRADE working group, which was adapted to suit the review questions and modified to include qualitative research evidence. Quantitative and qualitative studies were considered separately for every outcome. 32 papers were included in the systematic review following data extraction and assessment of methodological quality. The review questions were best answered by evidence from a range of data sources. The inclusion of qualitative research, which was often highly relevant and specific to many components of the screening information materials, enabled the production of a set of recommendations that will directly affect policy within the NHS Cervical Screening Programme. A practical example is provided of how quantitative and qualitative data sources might successfully be brought together and considered in one review.

Motivating Students to Read in the Content Classroom: Six Evidence-Based Principles

ERIC Educational Resources Information Center

Brozo, William G.; Flynt, E. Sutton

2008-01-01

Teachers who plan content area instruction with evidence-based principles of reading engagement in mind will seek ways of making learning interesting and worthwhile; will create learning contexts that maximize participation in reading, writing, and thinking; and will always account for motivation and engagement when considering students' classroom…

Clinician Resources to Improve Evidence-Based Sexual Healthcare: Does Content and Design Matter?

ERIC Educational Resources Information Center

Hosseinzadeh, Hassan; Dadich, Ann; Bourne, Chris; Murray, Carolyn

2014-01-01

This study examines how the design and content of printed educational materials (PEMs) influence clinician capacity to deliver evidence-based sexual healthcare. General practitioners in New South Wales, Australia (n = 214), completed a survey about their use and perceptions of PEMs - a clinical aide, sexual health articles, and an educational…

Using Video Modeling and Video Prompting to Teach Core Academic Content to Students with Learning Disabilities

ERIC Educational Resources Information Center

Kellems, Ryan O.; Edwards, Sean

2016-01-01

Practitioners are constantly searching for evidence-based practices that are effective in teaching academic skills to students with learning disabilities (LD). Video modeling (VM) and video prompting have become popular instructional interventions for many students across a wide range of different disability classifications, including those with…

[Conception and implementation of a novel E-learning module with EbM learning contents in operative dentistry].

PubMed

Gerhardt-Szép, Susanne; Dreher, Stefanie; Rüttermann, Stefan; Weberschock, Tobias

2017-11-01

Computer-assisted learning (CAL) programs are becoming more widely used in medical and dental training. However, the combination of CAL programs and evidence-based education in dentistry has not been described previously. The aim was to determine the acceptance and user-friendliness of a CAL program combined with evidence-based training. The didactic concept of the module includes the case-oriented, problem-based embedding of a total of 32 EbM learning assignments, which can be completed interactively and self-determinedly in an interdisciplinary context using focus patients with different diseases. The present study was conducted at the Dental School of the Goethe University in Frankfurt/Main. Data on acceptance and user-friendliness were collected from three consecutive cohorts of 114 dental students attending their first clinical semester. They used the "Toothache Walk-in Clinic: FOCUS" CAL, which can be downloaded via the Internet. The instrument consisted of 64 statements. The first part addressed general information about the user. The second part contained 43 specific statements on the CAL program. These included factors A (handling and technical aspects), B (content and functional range), and C (didactics and suitability for education). Possible responses ranged from 0 to 3 (0 = strongly disagree, 3 = strongly agree). All of the 114 questionnaires distributed were returned (response rate 100%). Most users (90.1%) considered the topics of evidence-based dentistry important for their training. They rated the program by using German school grades, and the overall rating was 2.26 (SD = 0.64). Most students (88.6%) considered the program useful for their clinical training in the treatment of patients. The mean scores for the 43 specific items amounted to 1.90 (factor A, SD = 0.63), 1.55 (factor B, SD = 1.93), and 2.23 (factor C, SD = 0.79). The CAL program with dental medicine vignettes and learning elements for evidence-based medicine received a primarily positive assessment. Students welcome that EbM contents are offered as part of their dental studies curriculum. Copyright © 2017. Published by Elsevier GmbH.

Balancing health care evidence and art to meet clinical needs: policymakers' perspectives.

PubMed

Parker, Louise E; Ritchie, Mona J; Kirchner, Joann E; Owen, Richard R

2009-12-01

Rationale, aims and objectives Although many believe that evidence-based practice (EBP) has great potential, critics have identified limitations including a focus on randomized clinical trial (RCT) evidence to the exclusion of other evidence types and a disregard for the art of medicine. Others have argued, however, that proper application of EBP involves reasoned consideration of a wide variety of information; thus, the dichotomy between medical science and art may be false. We explore the views of executive-level policymakers from the Veterans Health Administration, a leader in the EBP movement, regarding what constitutes evidence and the relative importance of evidence versus practical needs when determining clinical policy. Method We conducted 26 semi-structured qualitative interviews and performed a content analysis. Results Although informants generally believed in the value of EBP and the role of RCTs within it, they also valued other types of evidence. Further, they had concerns that were sometimes antithetical with strict adherence to an evidence-based approach. These included practical concerns, fit with organizational values and with local circumstances, resources, political pressures and patient needs. They were especially concerned about how to address medical conditions that affect many individuals or high-risk populations that have no evidence-based treatment. Conclusion When possible, health care practice should be evidence-based. When this is not possible, health care providers must turn to the art of medicine by using consensus-based best practices. Further, it is important for policymakers and researchers to work in concert to develop EBPs that are practical and meet needs.

Evaluating Evidence-Based Practice in Teaching Science Content to Students with Severe Developmental Disabilities

ERIC Educational Resources Information Center

Spooner, Fred; Knight, Vicki; Browder, Diane; Jimenez, Bree; DiBiase, Warren

2011-01-01

A comprehensive review of the literature was conducted for articles published between 1985 and May 2009 to (a) examine the degree to which science content was taught to students with severe developmental disabilities and (b) and evaluate instructional procedures in science as evidence-based practices. The review was organized by a conceptual model…

Establishing Computer-Assisted Instruction to Teach Academics to Students with Autism as an Evidence-Based Practice.

PubMed

Root, Jenny R; Stevenson, Bradley S; Davis, Luann Ley; Geddes-Hall, Jennifer; Test, David W

2017-02-01

Computer-assisted instruction (CAI) is growing in popularity and has demonstrated positive effects for students with disabilities, including those with autism spectrum disorder (ASD). In this review, criteria for group experimental and single case studies were used to determine quality (Horner et al., Exceptional Children 71:165-179, 2005; Gersten et al., Exceptional Children 71:149-164, 2005; National Technical Assistance Center on Transition Center 2015). Included studies of high and adequate quality were further analyzed in terms of content, context, and specific instructional practices. Based on the NTACT criteria, this systematic review has established CAI as an evidence-based practice for teaching academics to students with ASD with support from 10 single-case and two group design studies of high or adequate quality. Suggestions for future research and implications for practice are discussed.

A mapping review of international guidance on the management and care of amyotrophic lateral sclerosis (ALS).

PubMed

Janssens, Astrid I W A; Ruytings, Marijke; Al-Chalabi, Ammar; Chio, Adriano; Hardiman, Orla; Mcdermott, Christopher J; Meyer, Thomas; Mora, Gabriele; Van Damme, Philip; Van Den Berg, Leonard H; Vanhaecht, Kris; Winkler, Andrea S; Sermeus, Walter

2016-01-01

Management of ALS is suboptimal. Consequently, quality improvement interventions are needed to improve ALS care. An evidence-based insight into how patients should be managed is essential when developing quality improvement interventions. Therefore, this study aimed to map, categorize and summarize international guidance on the management and care of ALS and to identify gaps in this guidance by means of a mapping review. Literature was searched for clinical practice guidelines, quality indicators and evidence-based clinical summaries. A content analysis and meta-synthesis of the included literature was performed. Interventions and outcomes used in the management and care of ALS were identified and categorized. Furthermore, the amount of guidance underpinning these interventions and outcomes was analysed. Six clinical practice guidelines, one set of quality indicators and three evidence-based clinical summaries were identified. The results demonstrated that certain domains in ALS care, mainly disease-specific domains such as breathing and swallowing, are extensively addressed in the literature whereas other subjects, such as care coordination, receive little attention. In conclusion, this mapping review provides a scientific basis for targeting and developing the clinical content of a quality improvement intervention for the management of ALS.

Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence.

PubMed

Chatterji, Madhabi; Graham, Mark J; Wyer, Peter C

2009-12-01

The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a "PBLI-EBM" domain for assessing resident physician competence. The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments.

Mapping Cognitive Overlaps Between Practice-Based Learning and Improvement and Evidence-Based Medicine: An Operational Definition for Assessing Resident Physician Competence

PubMed Central

Chatterji, Madhabi; Graham, Mark J.; Wyer, Peter C.

2009-01-01

Purpose The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a “PBLI-EBM” domain for assessing resident physician competence. Method The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. Results The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. Conclusions The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments. PMID:21975994

Students' attitudes and perceptions of teaching and assessment of evidence-based practice in an occupational therapy professional Master's curriculum: a mixed methods study.

PubMed

Thomas, Aliki; Han, Lu; Osler, Brittony P; Turnbull, Emily A; Douglas, Erin

2017-03-27

Most health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students' attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students' perceptions towards the teaching and assessment of evidence-based practice within a professional master's curriculum and their self-efficacy for evidence-based practice. The study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings. All student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous education had less favourable perceptions. Students' self-efficacy for evidence-based practice was significantly higher across cohorts. Four main themes emerged from the focus group data: (a) Having mixed feelings about the value of evidence-based practice (b) Barriers to the application of evidence-based practice; (c) Opposing worlds and (d) Vital and imperfect role of the curriculum. This study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

PubMed

MacIntosh-Murray, Anu; Perrier, Laure; Davis, David

2006-01-01

Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Development and implementation of a mobile device-based pediatric electronic decision support tool as part of a national practice standardization project.

PubMed

McCulloh, Russell J; Fouquet, Sarah D; Herigon, Joshua; Biondi, Eric A; Kennedy, Brandan; Kerns, Ellen; DePorre, Adrienne; Markham, Jessica L; Chan, Y Raymond; Nelson, Krista; Newland, Jason G

2018-06-07

Implementing evidence-based practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may encourage evidence-based practice adoption. However, data regarding the role of mobile ECDS tools in pediatrics is scant. Our objective is to describe the development, distribution, and usage patterns of a smartphone-based ECDS tool within a national practice standardization project. We developed a smartphone-based ECDS tool for use in the American Academy of Pediatrics, Value in Inpatient Pediatrics Network project entitled "Reducing Excessive Variation in the Infant Sepsis Evaluation (REVISE)." The mobile application (app), PedsGuide, was developed using evidence-based recommendations created by an interdisciplinary panel. App workflow and content were aligned with clinical benchmarks; app interface was adjusted after usability heuristic review. Usage patterns were measured using Google Analytics. Overall, 3805 users across the United States downloaded PedsGuide from December 1, 2016, to July 31, 2017, leading to 14 256 use sessions (average 3.75 sessions per user). Users engaged in 60 442 screen views, including 37 424 (61.8%) screen views that displayed content related to the REVISE clinical practice benchmarks, including hospital admission appropriateness (26.8%), length of hospitalization (14.6%), and diagnostic testing recommendations (17.0%). Median user touch depth was 5 [IQR 5]. We observed rapid dissemination and in-depth engagement with PedsGuide, demonstrating feasibility for using smartphone-based ECDS tools within national practice improvement projects. ECDS tools may prove valuable in future national practice standardization initiatives. Work should next focus on developing robust analytics to determine ECDS tools' impact on medical decision making, clinical practice, and health outcomes.

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

PubMed Central

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

2016-01-01

Background: Evidence based practice is an effective strategy to improve the quality of obstetric care. Identification of barriers to adaptation of evidence-based intrapartum care is necessary and crucial to deliver high quality care to parturient women. Objectives: The current study aimed to explore barriers to adaptation of evidence-based intrapartum care from the perspective of clinical groups that provide obstetric care in Iran. Materials and Methods: This descriptive exploratory qualitative research was conducted from 2013 to 2014 in fourteen state medical training centers in Iran. Participants were selected from midwives, specialists, and residents of obstetrics and gynecology, with a purposive sample and snowball method. Data were collected through face-to-face semi-structured in-depth interviews and analyzed according to conventional content analysis. Results: Data analysis identified twenty subcategories and four main categories. Main categories included barriers were related to laboring women, persons providing care, the organization environment and health system. Conclusions: The adoption of evidence based intrapartum care is a complex process. In this regard, identifying potential barriers is the first step to determine and apply effective strategies to encourage the compliance evidence based obstetric care and improves maternity care quality. PMID:27175303

Validity evidence as a key marker of quality of technical skill assessment in OTL-HNS.

PubMed

Labbé, Mathilde; Young, Meredith; Nguyen, Lily H P

2018-01-13

Quality monitoring of assessment practices should be a priority in all residency programs. Validity evidence is one of the main hallmarks of assessment quality and should be collected to support the interpretation and use of assessment data. Our objective was to identify, synthesize, and present the validity evidence reported supporting different technical skill assessment tools in otolaryngology-head and neck surgery (OTL-HNS). We performed a secondary analysis of data generated through a systematic review of all published tools for assessing technical skills in OTL-HNS (n = 16). For each tool, we coded validity evidence according to the five types of evidence described by the American Educational Research Association's interpretation of Messick's validity framework. Descriptive statistical analyses were conducted. All 16 tools included in our analysis were supported by internal structure and relationship to variables validity evidence. Eleven articles presented evidence supporting content. Response process was discussed only in one article, and no study reported on evidence exploring consequences. We present the validity evidence reported for 16 rater-based tools that could be used for work-based assessment of OTL-HNS residents in the operating room. The articles included in our review were consistently deficient in evidence for response process and consequences. Rater-based assessment tools that support high-stakes decisions that impact the learner and programs should include several sources of validity evidence. Thus, use of any assessment should be done with careful consideration of the context-specific validity evidence supporting score interpretation, and we encourage deliberate continual assessment quality-monitoring. NA. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

34 CFR 34.17 - Content of decision.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Content of decision. 34.17 Section 34.17 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.17 Content of decision. (a) The written decision is based on the evidence contained in the hearing record. The decision includes— (1) A description of the evidence...

A ubiquitous but ineffective intervention: Signs do not increase hand hygiene compliance.

PubMed

Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Everett-Thomas, Ruth; Arheart, Kristopher L

Proper hand hygiene is critical for preventing healthcare-associated infection, but provider compliance remains suboptimal. While signs are commonly used to remind physicians and nurses to perform hand hygiene, the content of these signs is rarely based on specific, validated health behavior theories. This observational study assessed the efficacy of a hand hygiene sign disseminated by the Centers for Disease Control and Prevention in an intensive care unit compared to an optimized evidence-based sign designed by a team of patient safety experts. The optimized sign was developed by four patient safety experts to include known evidence-based components and was subsequently validated by surveying ten physicians and ten nurses using a 10 point Likert scale. Eighty-two physicians and 98 nurses (102 females; 78 males) were observed for hand hygiene (HH) compliance, and the total HH compliance rate was 16%. HH compliance was not significantly different among the signs (Baseline 10% vs. CDC 18% vs. OIS 20%; p=0.280). The findings of this study suggest that even when the content and design of a hand hygiene reminder sign incorporates evidence-based constructs, healthcare providers comply only a fraction of the time. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Developing a Master's Student's Research and Practitioner Skills through Collaboration with a Doctoral Researcher

ERIC Educational Resources Information Center

Abrams, Rachel; Nolan, Emily

2016-01-01

Art therapy master's programs are required to include research coursework in their curriculum; however, they differ in content and types of required projects. Students encouraged to conduct studies that increase the evidence base of art therapy may struggle to do so. This article describes a research collaboration that allowed a master's level…

Development of a tailored strategy to improve postpartum hemorrhage guideline adherence.

PubMed

de Visser, Suzan M; Woiski, Mallory D; Grol, Richard P; Vandenbussche, Frank P H A; Hulscher, Marlies E J L; Scheepers, Hubertina C J; Hermens, Rosella P M G

2018-02-08

Despite the introduction of evidence based guidelines and practical courses, the incidence of postpartum hemorrhage shows an increasing trend in developed countries. Substandard care is often found, which implies an inadequate implementation in high resource countries. We aimed to reduce the gap between evidence-based guidelines and clinical application, by developing a strategy, tailored to current barriers for implementation. The development of the implementation strategy consisted of three phases, supervised by a multidisciplinary expert panel. In the first phase a framework of the strategy was created, based on barriers to optimal adherence identified among professionals and patients together with evidence on effectiveness of strategies found in literature. In the second phase, the tools within the framework were developed, leading to a first draft. In the third phase the strategy was evaluated among professionals and patients. The professionals were asked to give written feedback on tool contents, clinical usability and inconsistencies with current evidence care. Patients evaluated the tools on content and usability. Based on the feedback of both professionals and patients the tools were adjusted. We developed a tailored strategy to improve guideline adherence, covering the trajectory of the third trimester of pregnancy till the end of the delivery. The strategy, directed at professionals, comprehending three stop moments includes a risk assessment checklist, care bundle and time-out procedure. As patient empowerment tools, a patient passport and a website with patient information was developed. The evaluation among the expert panel showed all professionals to be satisfied with the content and usability and no discrepancies or inconsistencies with current evidence was found. Patients' evaluation revealed that the information they received through the tools was incomplete. The tools were adjusted accordingly to the missing information. A usable, tailored strategy to implement PPH guidelines and practical courses was developed. The next step is the evaluation of the strategy in a feasibility trial. Clinical trial registration: The Fluxim study, registration number: NCT00928863 .

McMaster Optimal Aging Portal: an evidence-based database for geriatrics-focused health professionals.

PubMed

Barbara, Angela M; Dobbins, Maureen; Brian Haynes, R; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

2017-07-11

The objective of this work was to provide easy access to reliable health information based on good quality research that will help health care professionals to learn what works best for seniors to stay as healthy as possible, manage health conditions and build supportive health systems. This will help meet the demands of our aging population that clinicians provide high quality care for older adults, that public health professionals deliver disease prevention and health promotion strategies across the life span, and that policymakers address the economic and social need to create a robust health system and a healthy society for all ages. The McMaster Optimal Aging Portal's (Portal) professional bibliographic database contains high quality scientific evidence about optimal aging specifically targeted to clinicians, public health professionals and policymakers. The database content comes from three information services: McMaster Premium LiteratUre Service (MacPLUS™), Health Evidence™ and Health Systems Evidence. The Portal is continually updated, freely accessible online, easily searchable, and provides email-based alerts when new records are added. The database is being continually assessed for value, usability and use. A number of improvements are planned, including French language translation of content, increased linkages between related records within the Portal database, and inclusion of additional types of content. While this article focuses on the professional database, the Portal also houses resources for patients, caregivers and the general public, which may also be of interest to geriatric practitioners and researchers.

Informing Patients About Placebo Effects: Using Evidence, Theory, and Qualitative Methods to Develop a New Website.

PubMed

Greville-Harris, Maddy; Bostock, Jennifer; Din, Amy; Graham, Cynthia A; Lewith, George; Liossi, Christina; O'Riordan, Tim; White, Peter; Yardley, Lucy; Bishop, Felicity L

2016-06-10

According to established ethical principles and guidelines, patients in clinical trials should be fully informed about the interventions they might receive. However, information about placebo-controlled clinical trials typically focuses on the new intervention being tested and provides limited and at times misleading information about placebos. We aimed to create an informative, scientifically accurate, and engaging website that could be used to improve understanding of placebo effects among patients who might be considering taking part in a placebo-controlled clinical trial. Our approach drew on evidence-, theory-, and person-based intervention development. We used existing evidence and theory about placebo effects to develop content that was scientifically accurate. We used existing evidence and theory of health behavior to ensure our content would be communicated persuasively, to an audience who might currently be ignorant or misinformed about placebo effects. A qualitative 'think aloud' study was conducted in which 10 participants viewed prototypes of the website and spoke their thoughts out loud in the presence of a researcher. The website provides information about 10 key topics and uses text, evidence summaries, quizzes, audio clips of patients' stories, and a short film to convey key messages. Comments from participants in the think aloud study highlighted occasional misunderstandings and off-putting/confusing features. These were addressed by modifying elements of content, style, and navigation to improve participants' experiences of using the website. We have developed an evidence-based website that incorporates theory-based techniques to inform members of the public about placebos and placebo effects. Qualitative research ensured our website was engaging and convincing for our target audience who might not perceive a need to learn about placebo effects. Before using the website in clinical trials, it is necessary to test its effects on key outcomes including patients' knowledge and capacity for making informed choices about placebos.

Informing Patients About Placebo Effects: Using Evidence, Theory, and Qualitative Methods to Develop a New Website

PubMed Central

Greville-Harris, Maddy; Bostock, Jennifer; Din, Amy; Graham, Cynthia A; Lewith, George; Liossi, Christina; O’Riordan, Tim; White, Peter; Yardley, Lucy

2016-01-01

Background According to established ethical principles and guidelines, patients in clinical trials should be fully informed about the interventions they might receive. However, information about placebo-controlled clinical trials typically focuses on the new intervention being tested and provides limited and at times misleading information about placebos. Objective We aimed to create an informative, scientifically accurate, and engaging website that could be used to improve understanding of placebo effects among patients who might be considering taking part in a placebo-controlled clinical trial. Methods Our approach drew on evidence-, theory-, and person-based intervention development. We used existing evidence and theory about placebo effects to develop content that was scientifically accurate. We used existing evidence and theory of health behavior to ensure our content would be communicated persuasively, to an audience who might currently be ignorant or misinformed about placebo effects. A qualitative ‘think aloud’ study was conducted in which 10 participants viewed prototypes of the website and spoke their thoughts out loud in the presence of a researcher. Results The website provides information about 10 key topics and uses text, evidence summaries, quizzes, audio clips of patients’ stories, and a short film to convey key messages. Comments from participants in the think aloud study highlighted occasional misunderstandings and off-putting/confusing features. These were addressed by modifying elements of content, style, and navigation to improve participants’ experiences of using the website. Conclusions We have developed an evidence-based website that incorporates theory-based techniques to inform members of the public about placebos and placebo effects. Qualitative research ensured our website was engaging and convincing for our target audience who might not perceive a need to learn about placebo effects. Before using the website in clinical trials, it is necessary to test its effects on key outcomes including patients’ knowledge and capacity for making informed choices about placebos. PMID:27288271

Type, Content, and Source of Social Support Perceived by Women during Pregnancy: Evidence from Matlab, Bangladesh

PubMed Central

Paul, Moni; Sibley, Lynn M.

2011-01-01

Specific and contextualized data on social support during distinct health events are needed to improve social support interventions. This study identified the type, content, and source of social support perceived by women during pregnancy. In-depth interviews with 25 women, aged 18-49 years, living in Matlab, Bangladesh, were conducted. The findings demonstrated that women perceived, the receipt of eight distinct types of support. The four most frequently-mentioned types included: practical help with routine activities, information/advice, emotional support and assurance, as well as the provision of resources and material goods. Sources varied by type of support and most frequently included-—mothers, mothers-in-law, sisters-in-law, and husbands. Examples depicting the content of each type of support revealed culturally-specific issues that can inform community-based social support interventions. PMID:21608426

User experiences of evidence-based online resources for health professionals: User testing of The Cochrane Library

PubMed Central

Rosenbaum, Sarah E; Glenton, Claire; Cracknell, Jane

2008-01-01

Background Evidence-based decision making relies on easy access to trustworthy research results. The Cochrane Library is a key source of evidence about the effect of interventions and aims to "promote the accessibility of systematic reviews to anyone wanting to make a decision about health care". We explored how health professionals found, used and experienced The Library, looking at facets of user experience including findability, usability, usefulness, credibility, desirability and value. Methods We carried out 32 one-hour usability tests on participants from Norway and the UK. Participants both browsed freely and attempted to perform individually tailored tasks while "thinking aloud". Sessions were recorded and viewed in real time by researchers. Transcriptions and videos were reviewed by one researcher and one designer. Findings reported here reflect issues receiving a high degree of saturation and that we judge to be critical to the user experience of evidence-based web sites, based on principles for usability heuristics, web guidelines and evidence-based practice. Results Participants had much difficulty locating both the site and its contents. Non-native English speakers were at an extra disadvantage when retrieving relevant documents despite high levels of English-language skills. Many participants displayed feelings of ineptitude, alienation and frustration. Some made serious mistakes in correctly distinguishing between different information types, for instance reviews, review protocols, and individual studies. Although most expressed a high regard for the site's credibility, some later displayed a mistrust of the independence of the information. Others were overconfident, thinking everything on The Cochrane Library site shared the same level of quality approval. Conclusion Paradoxically, The Cochrane Library, established to support easy access to research evidence, has its own problems of accessibility. Health professionals' experiences of this and other evidence-based online resources can be improved by applying existing principles for web usability, prioritizing the development of simple search functionality, emitting "researcher" jargon, consistent marking of site ownership, and clear signposting of different document types and different content quality. PMID:18662382

Evaluating the quality of perinatal anxiety information available online.

PubMed

Kirby, Paige L; Reynolds, Kristin A; Walker, John R; Furer, Patricia; Pryor, Teaghan A M

2018-06-22

The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.

Public health guidelines for physical activity: is there an app for that? A review of android and apple app stores.

PubMed

Knight, Emily; Stuckey, Melanie I; Prapavessis, Harry; Petrella, Robert J

2015-05-21

Physical activity participation is an important behavior for modifying lifestyle-related disease risk. Mobile health apps for chronic disease management and prevention are being developed at a rapid rate. However, it is unclear whether these apps are evidence-based. Current public health recommendations for physical activity participation for adults highlight the importance of engaging in 150 minutes weekly of purposeful exercise, and muscle strengthening activities on at least 2 days of the week. The aims of the present review were to (1) identify available evidence-based physical activity apps, and (2) identify technological features that could be leveraged to improve health outcomes. iTunes and Google Play mobile app stores were searched using keyword and category searching during a single day (February 18, 2014) for physical activity apps available in English. The description pages of eligible apps were reviewed by 4 independent reviewers for evidence-based content, technological, and descriptive features. An a priori subset of apps was downloaded for further review (n=6 affiliated with a non-commercial agency; n=10 top rated; n=10 random selection), and developers were contacted for information regarding evidence-informed content. The initial search yielded 2400 apps, of which 379 apps (n=206 iTunes; n=173 Google Play) were eligible. Primary results demonstrated no apps (n=0) adhering to evidence-based guidelines for aerobic physical activity, and 7 out of 379 implementing evidence-based guidelines for resistance training physical activity. Technological features of apps included social networking (n=207), pairing with a peripheral health device (n=61), and measuring additional health parameters (n=139). Secondary results revealed 1 app that referenced physical activity guidelines (150 minutes/weekly of exercise), and demonstrated that apps were based on various physical activity reports (n=4) or personal expertise (n=2). The present study demonstrated a shortage of evidence-based physical activity apps. This gap underscores the need for development of evidence-informed mobile apps. Results highlight the opportunity to develop evidence-informed mobile apps that can be used clinically to enhance health outcomes.

What information is used in treatment decision aids? A systematic review of the types of evidence populating health decision aids.

PubMed

Clifford, Amanda M; Ryan, Jean; Walsh, Cathal; McCurtin, Arlene

2017-02-23

Patient decision aids (DAs) are support tools designed to provide patients with relevant information to help them make informed decisions about their healthcare. While DAs can be effective in improving patient knowledge and decision quality, it is unknown what types of information and evidence are used to populate such decision tools. Systematic methods were used to identify and appraise the relevant literature and patient DAs published between 2006 and 2015. Six databases (Academic Search Complete, AMED, CINAHL, Biomedical Reference Collection, General Sciences and MEDLINE) and reference list searching were used. Articles evaluating the effectiveness of the DAs were appraised using the Cochrane Risk of Bias tool. The content, quality and sources of evidence in the decision aids were evaluated using the IPDASi-SF and a novel classification system. Findings were synthesised and a narrative analysis was performed on the results. Thirteen studies representing ten DAs met the inclusion criteria. The IPDASI-SF score ranged from 9 to 16 indicating many of the studies met the majority of quality criteria. Sources of evidence were described but reports were sometimes generic or missing important information. The majority of DAs incorporated high quality research evidence including systematic reviews and meta-analyses. Patient and practice evidence was less commonly employed, with only a third of included DAs using these to populate decision aid content. The quality of practice and patient evidence ranged from high to low. Contextual factors were addressed across all DAs to varying degrees and covered a range of factors. This is an initial study examining the information and evidence used to populate DAs. While research evidence and contextual factors are well represented in included DAs, consideration should be given to incorporating high quality information representing all four pillars of evidence based practice when developing DAs. Further, patient and expert practice evidence should be acquired rigorously and DAs should report the means by which such evidence is obtained with citations clearly provided.

Knowledge-based approach to video content classification

NASA Astrophysics Data System (ADS)

Chen, Yu; Wong, Edward K.

2001-01-01

A framework for video content classification using a knowledge-based approach is herein proposed. This approach is motivated by the fact that videos are rich in semantic contents, which can best be interpreted and analyzed by human experts. We demonstrate the concept by implementing a prototype video classification system using the rule-based programming language CLIPS 6.05. Knowledge for video classification is encoded as a set of rules in the rule base. The left-hand-sides of rules contain high level and low level features, while the right-hand-sides of rules contain intermediate results or conclusions. Our current implementation includes features computed from motion, color, and text extracted from video frames. Our current rule set allows us to classify input video into one of five classes: news, weather, reporting, commercial, basketball and football. We use MYCIN's inexact reasoning method for combining evidences, and to handle the uncertainties in the features and in the classification results. We obtained good results in a preliminary experiment, and it demonstrated the validity of the proposed approach.

Knowledge-based approach to video content classification

NASA Astrophysics Data System (ADS)

Chen, Yu; Wong, Edward K.

2000-12-01

A framework for video content classification using a knowledge-based approach is herein proposed. This approach is motivated by the fact that videos are rich in semantic contents, which can best be interpreted and analyzed by human experts. We demonstrate the concept by implementing a prototype video classification system using the rule-based programming language CLIPS 6.05. Knowledge for video classification is encoded as a set of rules in the rule base. The left-hand-sides of rules contain high level and low level features, while the right-hand-sides of rules contain intermediate results or conclusions. Our current implementation includes features computed from motion, color, and text extracted from video frames. Our current rule set allows us to classify input video into one of five classes: news, weather, reporting, commercial, basketball and football. We use MYCIN's inexact reasoning method for combining evidences, and to handle the uncertainties in the features and in the classification results. We obtained good results in a preliminary experiment, and it demonstrated the validity of the proposed approach.

Validating NO2 measurements in the vertical atmospheric column with the OMI instrument aboard the EOS Aura satellite against ground-based measurements at the Zvenigorod Scientific Station

NASA Astrophysics Data System (ADS)

Gruzdev, A. N.; Elokhov, A. S.

2009-08-01

Data on the NO2 content in the vertical column of the atmosphere obtained with the Ozone Monitoring Instrument (OMI) aboard the EOS Aura satellite (United States) in the period from October 2004 to October 2007 are compared with the results of ground-based measurements at the Zvenigorod Scientific Station (55.7° N, 36.8° E). The “unpolluted”; part of the total NO2 content in the atmospheric column, which mostly represents the stratosphere, and the NO2 contents in the vertical column of the troposphere, including the lower layer, which is subject to pollution, are included in the comparison. The correlation coefficient between the results of ground-based and satellite measurements of the “unpolluted” total NO2 content is ˜0.9. The content values measured with the OMI instrument are smaller than the results of ground-based measurements (on average, by (0.30 ± 0.03) × 1015 cm-2 or by (11 ± 1)%). Therms discrepancy between the satellite and ground-based data is 0.6 × 1015 cm-2. The NO2 content in the vertical column of the troposphere from the results of satellite measurements is, on average, (1.4 ± 0.5) × 1015 cm-2, (or about 35%) smaller than from the results of ground-based measurements, and the rms discrepancy between them is about 200%. The correlation coefficient between these data is ˜0.4. This considerable discrepancy is evidently caused by the strong spatial (horizontal) inhomogeneity and the temporal variability of the NO2 field during episodes of pollution, which leads to different (and often uncorrelated) estimates of the NO2 content in the lower troposphere due to different spatial resolutions of ground-based and satellite measurements.

Parental Involvement and Child and Adolescent Eating Disorders: Perspectives from Residents in Psychiatry, Pediatrics, and Family Medicine

PubMed Central

Marcon, Tamara Davidson; Girz, Laura; Stillar, Amanda; Tessier, Carole; Lafrance, Adele

2017-01-01

Objectives Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents’ perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. Method Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey. Questions pertained to assessment and treatment practices for child/adolescent ED. Analyses included ANOVAs, paired t-tests, and, for residents who endorsed family involvement (N = 444), qualitative content analysis. Results Overall, residents reported that they “mostly” agreed with the involvement of family in the assessment and treatment of ED. Residents’ endorsement of family involvement in both domains increased according to the extent of ED training received. Four major themes emerged from the content analysis of family involvement and included recommendations in line with evidence-based models and unspecified, passive involvement in the assessment and recovery process. Conclusions Many residents endorse family involvement in both assessment and treatment; however, understanding of the nature of such involvement is often vague. Training in evidence-based protocols is necessary for residents planning to engage in multi-disciplinary assessment, referral, and/or treatment in their future practice. PMID:28747930

Evidence-based Frameworks for Teaching and Learning in Classical Singing Training: A Systematic Review.

PubMed

Crocco, Laura; Madill, Catherine J; McCabe, Patricia

2017-01-01

The study systematically reviews evidence-based frameworks for teaching and learning of classical singing training. This is a systematic review. A systematic literature search of 15 electronic databases following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines was conducted. Eligibility criteria included type of publication, participant characteristics, intervention, and report of outcomes. Quality rating scales were applied to support assessment of the included literature. Data analysis was conducted using meta-aggregation. Nine papers met the inclusion criteria. No complete evidence-based teaching and learning framework was found. Thematic content analysis showed that studies either (1) identified teaching practices in one-to-one lessons, (2) identified student learning strategies in one-to-one lessons or personal practice sessions, and (3) implemented a tool to enhance one specific area of teaching and learning in lessons. The included studies showed that research in music education is not always specific to musical genre or instrumental group, with four of the nine studies including participant teachers and students of classical voice training only. The overall methodological quality ratings were low. Research in classical singing training has not yet developed an evidence-based framework for classical singing training. This review has found that introductory information on teaching and learning practices has been provided, and tools have been suggested for use in the evaluation of the teaching-learning process. High-quality methodological research designs are needed. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines].

PubMed

Martínez-Nicolás, I; Ángel-García, D; Saturno, P J; López-Soriano, F

2016-01-01

Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

HIV prevention for South African youth: which interventions work? A systematic review of current evidence

PubMed Central

2010-01-01

Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning. PMID:20187957

Funding big research with small money.

PubMed

Hickey, Joanne V; Koithan, Mary; Unruh, Lynn; Lundmark, Vicki

2014-06-01

This department highlights change management strategies that maybe successful in strategically planning and executing organizational change initiatives.With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools,and resources that mobilize and sustain organizational change initiatives.In this article, the guest authors introduce crowd sourcing asa strategy for funding big research with small money.

Evaluating the Content of Individualized Education Programs and 504 Plans of Young Adolescents with Attention Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Spiel, Craig F.; Evans, Steven W.; Langberg, Joshua M.

2014-01-01

The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with attention deficit/hyperactivity disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of…

Cultivating strategic thinking skills.

PubMed

Shirey, Maria R

2012-06-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author presents an overview of strategic leadership and offers approaches for cultivating strategic thinking skills.

Interactive Electronic Decision Trees for the Integrated Primary Care Management of Febrile Children in Low Resource Settings - Review of existing tools.

PubMed

Keitel, Kristina; D'Acremont, Valérie

2018-04-20

The lack of effective, integrated diagnostic tools pose a major challenge to the primary care management of febrile childhood illnesses. These limitations are especially evident in low-resource settings and are often inappropriately compensated by antimicrobial over-prescription. Interactive electronic decision trees (IEDTs) have the potential to close these gaps: guiding antibiotic use and better identifying serious disease. This narrative review summarizes existing IEDTs, to provide an overview of their degree of validation, as well as to identify gaps in current knowledge and prospects for future innovation. Structured literature review in PubMed and Embase complemented by google search and contact with developers. Six integrated IEDTs were identified: three (eIMCI, REC, and Bangladesh digital IMCI) based on Integrated Management of Childhood Illnesses (IMCI); four (SL eCCM, MEDSINC, e-iCCM, and D-Tree eCCM) on Integrated Community Case Management (iCCM); two (ALMANACH, MSFeCARE) with a modified IMCI content; and one (ePOCT) that integrates novel content with biomarker testing. The types of publications and evaluation studies varied greatly: the content and evidence-base was published for two (ALMANACH and ePOCT), ALMANACH and ePOCT were validated in efficacy studies. Other types of evaluations, such as compliance, acceptability were available for D-Tree eCCM, eIMCI, ALMANACH. Several evaluations are still ongoing. Future prospects include conducting effectiveness and impact studies using data gathered through larger studies to adapt the medical content to local epidemiology, improving the software and sensors, and Assessing factors that influence compliance and scale-up. IEDTs are valuable tools that have the potential to improve management of febrile children in primary care and increase the rational use of diagnostics and antimicrobials. Next steps in the evidence pathway should be larger effectiveness and impact studies (including cost analysis) and continuous integration of clinically useful diagnostic and treatment innovations. Copyright © 2018. Published by Elsevier Ltd.

Practice-Based Measures of Elementary Science Teachers' Content Knowledge for Teaching: Initial Item Development and Validity Evidence. Research Report. ETS RR-17-43

ERIC Educational Resources Information Center

Mikeska, Jamie N.; Phelps, Geoffrey; Croft, Andrew J.

2017-01-01

This report describes efforts by a group of science teachers, teacher educators, researchers, and content specialists to conceptualize, develop, and pilot practice-based assessment items designed to measure elementary science teachers' content knowledge for teaching (CKT). The report documents the framework used to specify the content-specific…

Evidence-based guidelines for the wise use of computers by children: physical development guidelines.

PubMed

Straker, L; Maslen, B; Burgess-Limerick, R; Johnson, P; Dennerlein, J

2010-04-01

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

Evidence-based first aid advice for paediatric burns in the United Kingdom.

PubMed

Varley, Alice; Sarginson, Julia; Young, Amber

2016-05-01

Burn and scald injuries are common in children. First aid advice for paediatric burns is offered by a range of health organisations and charities in the UK. Despite this, children still present to emergency departments and burn services having received little or inadequate first aid. A survey was undertaken regarding the content and consistency of the advice given by a cross-section of UK health organisations involved in first aid prevention and education. The advice was subsequently examined to determine if it was evidence-based. Our study has demonstrated inconsistencies in the content of the first aid advice provided by the 21 organisations included in the study. Seventy-one percent of the information was only available online. The temperature, method and duration of cooling varied substantially, as did the advice recommended for the removal of clothing and jewellery and methods for covering the burn immediately after injury. Results from the literature review concluded the following based on available evidence; cool the burn with running tap water for 20min, remove clothing and jewellery and cover the burn with cling film or a clean non-adhesive dressing. This study highlights the lack of consistency between first aid guidance provided by health organisations and charities in the UK. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Using health communication best practices to develop a web-based provider-patient communication aid: the CONNECT study.

PubMed

Fleisher, Linda; Buzaglo, Joanne; Collins, Michael; Millard, Jennifer; Miller, Suzanne M; Egleston, Brian L; Solarino, Nicholas; Trinastic, Jonathan; Cegala, Donald J; Benson, Al B; Schulman, Kevin A; Weinfurt, Kevin P; Sulmasy, Daniel; Diefenbach, Michael A; Meropol, Neal J

2008-06-01

Although there is broad consensus that careful content vetting and user testing is important in the development of technology-based educational interventions, often these steps are overlooked. This paper highlights the development of a theory-guided, web-based communication aid (CONNECT), designed to facilitate treatment decision-making among patients with advanced cancer. The communication aid included an on-line survey, patient skills training module and an automated physician report. Development steps included: (1) evidence-based content development; (2) usability testing; (3) pilot testing; and (4) patient utilization and satisfaction. Usability testing identified some confusing directions and navigation for the on-line survey and validated the relevance of the "patient testimonials" in the skills module. Preliminary satisfaction from the implementation of the communication aid showed that 66% found the survey length reasonable and 70% found it helpful in talking with the physician. Seventy percent reported the skills module helpful and about half found it affected the consultation. Designing patient education interventions for translation into practice requires the integration of health communication best practice including user feedback along the developmental process. This developmental process can be translated to a broad array of community-based patient and provider educational interventions.

Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

PubMed

Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

2013-07-01

Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

Project power: Adapting an evidence-based HIV/STI prevention intervention for incarcerated women.

PubMed

Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah; Carry, Monique; Gaiter, Juarlyn; Parker, Sharon

2013-06-01

Incarcerated women are a critical population for targeted HIV/STI prevention programming; however, there is a dearth of evidence-based, genderspecific behavioral interventions for this population. Systematically adapting existing evidence-based interventions (EBIs) can help fill this gap. We illustrate the adaptation of the HIV/STI prevention EBI, Project Safe, for use among incarcerated women and delivery in prisons. Project POWER, the final adapted intervention, was developed using formative research with prison staff and administration, incarcerated and previously incarcerated women, and input of community advisory boards. Intervention delivery adaptations included: shorter, more frequent intervention sessions; booster sessions prior to and just after release; facilitator experience in prisons and counseling; and new videos. Intervention content adaptations addressed issues of empowerment, substance use, gender and power inequity in relationships, interpersonal violence, mental health, reentry, and social support. This illustration of the adaption process provides information to inform additional efforts to adapt EBIs for this underserved population.

Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

PubMed

Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

2006-01-01

At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

Consumer perception versus scientific evidence about health benefits and safety risks from fish consumption.

PubMed

Verbeke, Wim; Sioen, Isabelle; Pieniak, Zuzanna; Van Camp, John; De Henauw, Stefaan

2005-06-01

To investigate the gap between consumer perception and scientific evidence related to health benefits and safety risks from fish consumption. Consumer perceptions from a cross-sectional survey in March 2003 in Belgium were compared with scientific evidence based on a literature review. A quota sampling procedure was used with age as quota control variable. Subjects completed a self-administered questionnaire including health benefit beliefs from fish, fish content and effect beliefs for nutrients and harmful substances. Adults (n=429), who were the main person responsible for food purchasing in the household (284 women; 145 men), aged 18-83 years, from different regional, education, family size and income groups. Fish is predominantly perceived as a healthy food that reduces risk for coronary heart disease, which corroborates scientific evidence. This perception is stronger among women than among men. In contrast with scientific evidence, 46% of the consumers believe that fish contains dietary fibre, whereas less than one-third is aware that fish contains omega-3 fatty acids and that this nutrient has a positive impact on human health. The gap between perception and evidence is larger among consumers with lower education. In general, consumers are better aware of the content and effect of harmful substances than of nutrients in fish. Despite conclusive evidence about the content and positive effect of omega-3 fatty acids in fish, related consumer awareness and beliefs are poor and often wrong. This study exemplifies the need for nutrition education and more effective communication about the health benefits of fish consumption.

Improving care transitions through meaningful use stage 2: continuity of care document.

PubMed

Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

2013-02-01

In this department, Drs Murphy, Wilson, and Newhouse 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 demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

Impact of Chemistry Teachers' Knowledge and Practices on Student Achievement

NASA Astrophysics Data System (ADS)

Scantlebury, Kathryn

2008-10-01

Professional development programs promoting inquiry-based teaching are challenged with providing teachers content knowledge and using pedagogical approaches that model standards based instruction. Inquiry practices are also important for undergraduate students. This paper focuses on the evaluation of an extensive professional development program for chemistry teachers that included chemistry content tests for students and the teachers and the impact of undergraduate research experiences on college students' attitudes towards chemistry. Baseline results for the students showed that there were no gender differences on the achievement test but white students scored significantly higher than non-white students. However, parent/adult involvement with chemistry homework and projects, was a significant negative predictor of 11th grade students' test chemistry achievement score. This paper will focus on students' achievement and attitude results for teachers who are mid-way through the program providing evidence that on-going, sustained professional development in content and pedagogy is critical for improving students' science achievement.

DynaMed Plus®: An Evidence-Based Clinical Reference Resource.

PubMed

Charbonneau, Deborah H; James, LaTeesa N

2018-01-01

DynaMed Plus ® from EBSCO Health is an evidence-based tool that health professionals can use to inform clinical care. DynaMed Plus content undergoes a review process, and the evidence is synthesized in detailed topic overviews. A unique three-level rating scale is used to assess the quality of available evidence. Topic overviews summarize current evidence and provide recommendations to support health providers at the point-of-care. Additionally, DynaMed Plus content can be accessed via a desktop computer or mobile platforms. Given this, DynaMed Plus can be a time-saving resource for health providers. Overall, DynaMed Plus provides evidence summaries using an easy-to-read bullet format, and the resource incorporates images, clinical calculators, patient handouts, and practice guidelines in one place.

Towards effective outcomes in teaching, learning and assessment of law in medical education.

PubMed

Preston-Shoot, Michael; McKimm, Judy

2011-04-01

Law is slowly emerging as a core subject area in medical education, alongside content on the ethical responsibilities of doctors to protect and promote patient health and well-being. Curriculum statements have begun to advise on core content and methods for organising teaching and assessment. However, no comprehensive overview of approaches to the delivery of this law curriculum has been undertaken. This paper reports an assessment of the nature and strength of the published evidence base for the teaching, learning and assessment of law in medical education. It also provides a thematic content overview from the best available literature on the teaching of law to medical students and on the assessment of their legal knowledge and skills. A systematic review of the evidence base was completed. Detailed scrutiny resulted in the inclusion of 31 empirical sources and 11 conceptual papers. The quality of the included material was assessed. Significant gaps exist in the evidence base. Empirical studies of the teaching of law are characterised by insufficient sample sizes and a focus on individual study programmes. They rely on measures of student satisfaction and on evaluating short-term outcomes rather than assessing whether knowledge is retained and whether learning impacts on patient outcomes. Studies reveal a lack of coordination between pre- or non-clinical and clinical medico-legal education. Although evidence on the development of students' knowledge is available, much learning is distant from the practice in which its application would be tested. Law learning in clinical placements appears to be opportunistic rather than structured. The place of law in the curriculum remains uncertain and should be more clearly identified. A more robust knowledge base is needed to realise the aspirations behind curriculum statements on law and to enable medical students to develop sufficient legal literacy to manage challenging practice encounters. Further research is needed into effective methods of teaching, learning and assessing legal knowledge and skills during and following initial medical education. © Blackwell Publishing Ltd 2011.

Using an iPad2® with Systematic Instruction to Teach Shared Stories for Elementary-Aged Students with Autism

ERIC Educational Resources Information Center

Spooner, Fred; Ahlgrim-Delzell, Lynn; Kemp-Inman, Amy; Wood, Leah A.

2014-01-01

Literacy skills are important for accessing all areas of academic content as well as for increasing quality of life. The use of shared stories to teach early literacy skills to students with extensive support needs, including students with autism, is an evidence-based practice. This project extends the research by examining the effects of…

Establishing a sense of urgency for leading transformational change.

PubMed

Shirey, Maria R

2011-04-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses successful tactics for establishing a sense of urgency to facilitate organizational change.

Addressing strategy execution challenges to lead sustainable change.

PubMed

Shirey, Maria R

2011-01-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategy execution challenges that must be addressed to lead sustainable change.

Leaning in: lessons for leadership career development.

PubMed

Shirey, Maria R

2013-11-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author introduces the book Lean In and presents applicable lessons for nursing leadership career development.

The Impact of Electronic Knowledge-Based Nursing Content and Decision-Support on Nursing-Sensitive Patient Outcomes

DTIC Science & Technology

2015-02-01

with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1...the impact of an electronic innovation must include a description of the sociotechnical context as well as the process and outcome metrics for...dissemination, will have a positive effect on nursing knowledge, use of evidence-based practices, and the achievement of nurse-sensitive patient outcomes

Mindfulness-Based Symptom and Stress Management Apps for Adults With Chronic Lung Disease: Systematic Search in App Stores

PubMed Central

2018-01-01

Background Up to 70% of lung cancer survivors are affected by chronic obstructive pulmonary disease (COPD), a common, debilitating, comorbid disease. Lung cancer and COPD are both characterized by symptoms such as breathlessness, fatigue, and psychological distress. These distressing chronic symptoms are exacerbated by stress and detract from an individual’s quality of life. Objective The aim of this study was to identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history (ie, chronic lung disease). Methods For this review, an interdisciplinary research team used 19 keyword combinations in the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on the apps’ (1) content, (2) usability heuristics, (3) grade-level readability, and (4) cultural sensitivity. Results The search resulted in 768 apps (508 in iOS and 260 in Google stores). A total of 9 apps met the inclusion criteria and received further evaluation. Only 1 app had below an eighth-grade reading level; the ninth one did not have enough text to calculate a readability score. None of the 9 apps met the cultural sensitivity evaluation criteria. Conclusions This systematic review identified critical design flaws that may affect the ease of using the apps in this study. Few mobile apps promote mindfulness-based strategies among adults with chronic lung disease (ie, COPD or lung cancer or both), but those that exist, overall, do not meet the latest scientific evidence. Recommendations include more stringent regulation of health-related apps, use of evidence-based frameworks and participatory design processes, following evidence-based usability practices, use of culturally sensitive language and images, and ensuring that content is written in plain language. PMID:29764800

A content review of online naloxone Continuing Education courses for pharmacists in states with standing orders.

PubMed

Carpenter, Delesha M; Roberts, Courtney A; Westrick, Salisa C; Ferreri, Stefanie P; Kennelty, Korey A; Look, Kevin A; Abraham, Olufunmilola; Wilson, Courtenay

2017-11-21

Many community pharmacists are uncomfortable educating patients about naloxone, an opioid reversal agent. To examine whether training materials prepare pharmacists to counsel patients and caregivers about naloxone, online naloxone education materials for pharmacists in the 13 states with standing orders were analyzed. Two coders reviewed 12 naloxone training programs and extracted data for 15 topics that were clustered in four categories: background/importance, naloxone products, business/operations, and communication. Programs that included communication content were coded for whether they: 1) suggested specific verbiage for naloxone counseling; 2) recommended evidence-based communication practices; and 3) included example naloxone conversations. Most programs covered the majority of topics, with the exception of extended treatment for individuals who overdose and naloxone storage/expiration information. Eleven programs addressed pharmacist-patient communication, although information on communication was often limited. Only one program included an example pharmacist-patient naloxone conversation, but the conversation was 10 min long and occurred in a private room, limiting its applicability to most community pharmacies. Online naloxone training materials for pharmacists include limited content on how to communicate with patients and caregivers. Training materials that include more in-depth content on communication may increase pharmacists' confidence to discuss the topics of overdose and naloxone. Copyright © 2017 Elsevier Inc. All rights reserved.

Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries

PubMed Central

Kwag, Koren Hyogene; González-Lorenzo, Marien; Banzi, Rita; Bonovas, Stefanos

2016-01-01

Background The complexity of modern practice requires health professionals to be active information-seekers. Objective Our aim was to review the quality and progress of point-of-care information summaries—Web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. We aimed to evaluate product claims of being evidence-based. Methods We updated our previous evaluations by searching Medline, Google, librarian association websites, and conference proceedings from August 2012 to December 2014. We included Web-based, regularly updated point-of-care information summaries with claims of being evidence-based. We extracted data on the general characteristics and content presentation of products, and we quantitatively assessed their breadth of disease coverage, editorial quality, and evidence-based methodology. We assessed potential relationships between these dimensions and compared them with our 2008 assessment. Results We screened 58 products; 26 met our inclusion criteria. Nearly a quarter (6/26, 23%) were newly identified in 2014. We accessed and analyzed 23 products for content presentation and quantitative dimensions. Most summaries were developed by major publishers in the United States and the United Kingdom; no products derived from low- and middle-income countries. The main target audience remained physicians, although nurses and physiotherapists were increasingly represented. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions. The majority of products did not excel across all dimensions: we found only a moderate positive correlation between editorial quality and evidence-based methodology (r=.41, P=.0496). However, all dimensions improved from 2008: editorial quality (P=.01), evidence-based methodology (P=.015), and volume of diseases and medical conditions (P<.001). Conclusions Medical and scientific publishers are investing substantial resources towards the development and maintenance of point-of-care summaries. The number of these products has increased since 2008 along with their quality. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions, while others that were marketed as evidence-based were less reliable. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time. PMID:26786976

Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries.

PubMed

Kwag, Koren Hyogene; González-Lorenzo, Marien; Banzi, Rita; Bonovas, Stefanos; Moja, Lorenzo

2016-01-19

The complexity of modern practice requires health professionals to be active information-seekers. Our aim was to review the quality and progress of point-of-care information summaries-Web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. We aimed to evaluate product claims of being evidence-based. We updated our previous evaluations by searching Medline, Google, librarian association websites, and conference proceedings from August 2012 to December 2014. We included Web-based, regularly updated point-of-care information summaries with claims of being evidence-based. We extracted data on the general characteristics and content presentation of products, and we quantitatively assessed their breadth of disease coverage, editorial quality, and evidence-based methodology. We assessed potential relationships between these dimensions and compared them with our 2008 assessment. We screened 58 products; 26 met our inclusion criteria. Nearly a quarter (6/26, 23%) were newly identified in 2014. We accessed and analyzed 23 products for content presentation and quantitative dimensions. Most summaries were developed by major publishers in the United States and the United Kingdom; no products derived from low- and middle-income countries. The main target audience remained physicians, although nurses and physiotherapists were increasingly represented. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions. The majority of products did not excel across all dimensions: we found only a moderate positive correlation between editorial quality and evidence-based methodology (r=.41, P=.0496). However, all dimensions improved from 2008: editorial quality (P=.01), evidence-based methodology (P=.015), and volume of diseases and medical conditions (P<.001). Medical and scientific publishers are investing substantial resources towards the development and maintenance of point-of-care summaries. The number of these products has increased since 2008 along with their quality. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions, while others that were marketed as evidence-based were less reliable. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

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

PubMed

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

2011-05-01

To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor treatment, nursing, health economic and management, and medical education. Internationally, EBM research topics have begun to shift, from drug treatment to surgery or other non-pharmacological treatments; from therapy to diagnosis, rehabilitation, and prevention; from evidence based clinical practice to evidence based management and policymaking. The philosophy and method of EBM, evidence production and translation are also shifting from well resourced settings to low- and middle-income countries, especially those in which English is not a major language. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

Need to Address Evidence-Based Practice in Educational Administration

ERIC Educational Resources Information Center

Kowalski, Theodore

2009-01-01

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

"If it's worth my time, i will make the time": school-based providers' decision-making about participating in an evidence-based psychotherapy consultation program.

PubMed

Lyon, Aaron R; Ludwig, Kristy; Romano, Evalynn; Leonard, Skyler; Stoep, Ann Vander; McCauley, Elizabeth

2013-11-01

This study evaluated influences on school-based clinicians' decision-making surrounding participation in a modular psychotherapy training and consultation program lasting one academic year. Clinicians were recruited from three participation groups: those who never engaged, those who engaged and then discontinued, and those who participated fully. Qualitative interviews explored influences on initial and continued participation, as well as differences in decision-making by participation group, knowledge about evidence-based practices, and attitudes toward evidence-based practices. Eight major themes were identified: time, practice utility, intervention/training content, training process, attitudes toward training, social influences, commitment to training, and expectations. Some themes were discussed universally across all comparison groups, while others varied in frequency or content. Recommendations for increasing participation are presented, based on the findings.

The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study.

PubMed

Eardley, Debra L; Krumwiede, Kelly A; Secginli, Selda; Garner, Linda; DeBlieck, Conni; Cosansu, Gulhan; Nahcivan, Nursen O

2018-06-01

Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

Prevalence of behavior changing strategies in fitness video games: theory-based content analysis.

PubMed

Lyons, Elizabeth Jane; Hatkevich, Claire

2013-05-07

Fitness video games are popular, but little is known about their content. Because many contain interactive tools that mimic behavioral strategies from weight loss intervention programs, it is possible that differences in content could affect player physical activity and/or weight outcomes. There is a need for a better understanding of what behavioral strategies are currently available in fitness games and how they are implemented. The purpose of this study was to investigate the prevalence of evidence-based behavioral strategies across fitness video games available for home use. Games available for consoles that used camera-based controllers were also contrasted with games available for a console that used handheld motion controllers. Fitness games (N=18) available for three home consoles were systematically identified and play-tested by 2 trained coders for at least 3 hours each. In cases of multiple games from one series, only the most recently released game was included. The Sony PlayStation 3 and Microsoft Xbox360 were the two camera-based consoles, and the Nintendo Wii was the handheld motion controller console. A coding list based on a taxonomy of behavioral strategies was used to begin coding. Codes were refined in an iterative process based on data found during play-testing. The most prevalent behavioral strategies were modeling (17/18), specific performance feedback (17/18), reinforcement (16/18), caloric expenditure feedback (15/18), and guided practice (15/18). All games included some kind of feedback on performance accuracy, exercise frequency, and/or fitness progress. Action planning (scheduling future workouts) was the least prevalent of the included strategies (4/18). Twelve games included some kind of social integration, with nine of them providing options for real-time multiplayer sessions. Only two games did not feature any kind of reward. Games for the camera-based consoles (mean 12.89, SD 2.71) included a greater number of strategies than those for the handheld motion controller console (mean 10.00, SD 2.74, P=.04). Behavioral strategies for increasing self-efficacy and self-regulation are common in home console fitness video games. Social support and reinforcement occurred in approximately half of the studied games. Strategy prevalence varies by console type, partially due to greater feedback afforded by camera-based controllers. Experimental studies are required to test the effects of these strategies when delivered as interactive tools, as this medium may represent an innovative platform for disseminating evidence-based behavioral weight loss intervention components.

Prevalence of Behavior Changing Strategies in Fitness Video Games: Theory-Based Content Analysis

PubMed Central

Hatkevich, Claire

2013-01-01

Background Fitness video games are popular, but little is known about their content. Because many contain interactive tools that mimic behavioral strategies from weight loss intervention programs, it is possible that differences in content could affect player physical activity and/or weight outcomes. There is a need for a better understanding of what behavioral strategies are currently available in fitness games and how they are implemented. Objective The purpose of this study was to investigate the prevalence of evidence-based behavioral strategies across fitness video games available for home use. Games available for consoles that used camera-based controllers were also contrasted with games available for a console that used handheld motion controllers. Methods Fitness games (N=18) available for three home consoles were systematically identified and play-tested by 2 trained coders for at least 3 hours each. In cases of multiple games from one series, only the most recently released game was included. The Sony PlayStation 3 and Microsoft Xbox360 were the two camera-based consoles, and the Nintendo Wii was the handheld motion controller console. A coding list based on a taxonomy of behavioral strategies was used to begin coding. Codes were refined in an iterative process based on data found during play-testing. Results The most prevalent behavioral strategies were modeling (17/18), specific performance feedback (17/18), reinforcement (16/18), caloric expenditure feedback (15/18), and guided practice (15/18). All games included some kind of feedback on performance accuracy, exercise frequency, and/or fitness progress. Action planning (scheduling future workouts) was the least prevalent of the included strategies (4/18). Twelve games included some kind of social integration, with nine of them providing options for real-time multiplayer sessions. Only two games did not feature any kind of reward. Games for the camera-based consoles (mean 12.89, SD 2.71) included a greater number of strategies than those for the handheld motion controller console (mean 10.00, SD 2.74, P=.04). Conclusions Behavioral strategies for increasing self-efficacy and self-regulation are common in home console fitness video games. Social support and reinforcement occurred in approximately half of the studied games. Strategy prevalence varies by console type, partially due to greater feedback afforded by camera-based controllers. Experimental studies are required to test the effects of these strategies when delivered as interactive tools, as this medium may represent an innovative platform for disseminating evidence-based behavioral weight loss intervention components. PMID:23651701

Pediatric obsessive-compulsive disorder: an update for advanced practice psychiatric nurses.

PubMed

Kameg, Kirstyn Marie; Richardson, Luann; Szpak, Janene Luther

2015-05-01

Obsessive-compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence-based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence-based treatment options. © 2015 Wiley Periodicals, Inc.

Middle-school children's understanding of physical activity: "if you're moving, you're doing physical activity".

PubMed

Pearce, Patricia F; Harrell, Joanne S; McMurray, Robert G

2008-06-01

This qualitative descriptive study explored the understanding of physical activity from the perspectives of middle-school children (n = 12; ages 11-15 years) who participated in 15 collaborative exploratory meetings (approximately 1.5 hours/meeting) that were audiorecorded. Content analysis was completed; a pediatric nurse specialist and the participating children validated the findings. The children understood physical activity concretely, considering everything they did as physical activity based on their primary criterion of body movement. The children adeptly recalled activities and activity time duration, but struggled with categorizing the intensity of their activities. Domains of activity included home and school; social activities crossed both arenas. The study contributes to our knowledge of children's understanding of physical activity, highlighting the concreteness of the children's thinking, including their perspectives on evidence and conclusions based on their notions of evidence. Implications for nursing are discussed.

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

PubMed

Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2018-03-07

To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Paediatric musculoskeletal matters (pmm)--collaborative development of an online evidence based interactive learning tool and information resource for education in paediatric musculoskeletal medicine.

PubMed

Smith, Nicola; Rapley, Tim; Jandial, Sharmila; English, Christine; Davies, Barbara; Wyllie, Ruth; Foster, Helen E

2016-01-05

We describe the collaborative development of an evidence based, free online resource namely 'paediatric musculoskeletal matters' (pmm). This resource was developed with the aim of reaching a wide range of health professionals to increase awareness, knowledge and skills within paediatric musculoskeletal medicine, thereby facilitating early diagnosis and referral to specialist care. Engagement with stakeholder groups (primary care, paediatrics, musculoskeletal specialties and medical students) informed the essential 'core' learning outcomes to derive content of pmm. Representatives from stakeholder groups, social science and web development experts transformed the learning outcomes into a suitable framework. Target audience representatives reviewed the framework and their opinion was gathered using an online survey (n = 74) and focus groups (n = 2). Experts in paediatric musculoskeletal medicine peer reviewed the content and design. User preferences informed design with mobile, tablet and web compatible versions to facilitate access, various media and formats to engage users and the content presented in module format (i.e. Clinical assessment, Investigations and management, Limping child, Joint pain by site, Swollen joint(s) and Resources). We propose that our collaborative and evidence-based approach has ensured that pmm is user-friendly, with readily accessible, suitable content, and will help to improve access to paediatric musculoskeletal medicine education. The content is evidence-based with the design and functionality of pmm to facilitate optimal and 'real life' access to information. pmm is targeted at medical students and the primary care environment although messages are transferable to all health care professionals involved in the care of children and young people.

Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50.

PubMed

Aarons, Gregory A; Cafri, Guy; Lugo, Lindsay; Sawitzky, Angelina

2012-09-01

Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61-74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.

Evidence-Based Practice Point-of-Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content.

PubMed

Campbell, Jared M; Umapathysivam, Kandiah; Xue, Yifan; Lockwood, Craig

2015-12-01

Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources. A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians." A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume. Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+. The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options. © 2015 Sigma Theta Tau International.

A Systematic Assessment of Smartphone Tools for Suicide Prevention

PubMed Central

Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen

2016-01-01

Background Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Methods Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. Results One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Discussion Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence-based support. Apps with potentially harmful content were also identified. Despite the number of apps available, and their varied purposes, there is a clear need to develop useful, pragmatic, and multifaceted mobile resources for this population. Clinicians should be wary in recommending apps, especially as potentially harmful content can be presented as helpful. Currently safety plan apps are the most comprehensive and evidence-informed, for example, “Safety Net” and “MoodTools—Depression Aid”. PMID:27073900

A Systematic Assessment of Smartphone Tools for Suicide Prevention.

PubMed

Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen

2016-01-01

Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence-based support. Apps with potentially harmful content were also identified. Despite the number of apps available, and their varied purposes, there is a clear need to develop useful, pragmatic, and multifaceted mobile resources for this population. Clinicians should be wary in recommending apps, especially as potentially harmful content can be presented as helpful. Currently safety plan apps are the most comprehensive and evidence-informed, for example, "Safety Net" and "Mood-Tools--Depression Aid".

Are the Public Health Responsibility Deal alcohol pledges likely to improve public health? An evidence synthesis.

PubMed

Knai, Cécile; Petticrew, Mark; Durand, Mary Alison; Eastmure, Elizabeth; Mays, Nicholas

2015-08-01

The English Public Health Responsibility Deal (RD) is a public-private partnership involving voluntary pledges between industry, government and other actors in various areas including alcohol, and designed to improve public health. This paper reviews systematically the evidence underpinning four RD alcohol pledges. We conducted a systematic review of reviews of the evidence underpinning interventions proposed in four RD alcohol pledges, namely alcohol labelling, tackling underage alcohol sales, advertising and marketing alcohol, and alcohol unit reduction. In addition, we included relevant studies of interventions where these had not been covered by a recent review. We synthesized the evidence from 14 reviews published between 2002 and 2013. Overall, alcohol labelling is likely to be of limited effect on consumption: alcohol unit content labels can help consumers assess the alcohol content of drinks; however, labels promoting drinking guidelines and pregnancy warning labels are unlikely to influence drinking behaviour. Responsible drinking messages are found to be ambiguous, and industry-funded alcohol prevention campaigns can promote drinking instead of dissuading consumption. Removing advertising near schools can contribute to reducing underage drinking; however, community mobilization and law enforcement are most effective. Finally, reducing alcohol consumption is more likely to occur if there are incentives such as making lower-strength alcohol products cheaper. The most effective evidence-based strategies to reduce alcohol-related harm are not reflected consistently in the RD alcohol pledges. The evidence is clear that an alcohol control strategy should support effective interventions to make alcohol less available and more expensive. © 2015 Society for the Study of Addiction.

A New Method for Analyzing Content Validity Data Using Multidimensional Scaling

ERIC Educational Resources Information Center

Li, Xueming; Sireci, Stephen G.

2013-01-01

Validity evidence based on test content is of essential importance in educational testing. One source for such evidence is an alignment study, which helps evaluate the congruence between tested objectives and those specified in the curriculum. However, the results of an alignment study do not always sufficiently capture the degree to which a test…

Use of a business case model for organizational change.

PubMed

Shirey, Maria R

2011-01-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses the concept of a business case and introduces a 3-phase business case model for organizational change.

Synthesising quantitative and qualitative research in evidence‐based patient information

PubMed Central

Goldsmith, Megan R; Bankhead, Clare R; Austoker, Joan

2007-01-01

Background Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence‐based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge. Aims This paper describes the review methods developed and the difficulties encountered during the process of updating a systematic review of evidence to inform guidelines for the content of patient information related to cervical screening. Methods Systematic searches of 12 electronic databases (January 1996 to July 2004) were conducted. Studies that evaluated the content of information provided to women about cervical screening or that addressed women's information needs were assessed for inclusion. A data extraction form and quality assessment criteria were developed from published resources. A non‐quantitative synthesis was conducted and a tabular evidence profile for each important outcome (eg “explain what the test involves”) was prepared. The overall quality of evidence for each outcome was then assessed using an approach published by the GRADE working group, which was adapted to suit the review questions and modified to include qualitative research evidence. Quantitative and qualitative studies were considered separately for every outcome. Results 32 papers were included in the systematic review following data extraction and assessment of methodological quality. The review questions were best answered by evidence from a range of data sources. The inclusion of qualitative research, which was often highly relevant and specific to many components of the screening information materials, enabled the production of a set of recommendations that will directly affect policy within the NHS Cervical Screening Programme. Conclusions A practical example is provided of how quantitative and qualitative data sources might successfully be brought together and considered in one review. PMID:17325406

What should students learn about complementary and alternative medicine?

PubMed

Gaster, Barak; Unterborn, John N; Scott, Richard B; Schneeweiss, Ronald

2007-10-01

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Using Health Communication Best Practices to Develop a Web-Based Provider-Patient Communication Aid: The CONNECT™ Study

PubMed Central

Fleisher, Linda; Buzaglo, Joanne; Collins, Michael; Millard, Jennifer; Miller, Suzanne M.; Egleston, Brian L.; Solarino, Nicholas; Trinastic, Jonathan; Cegala, Donald J.; Benson, Al B.; Schulman, Kevin A.; Weinfurt, Kevin P.; Sulmasy, Daniel; Diefenbach, Michael A.; Meropol, Neal J.

2008-01-01

Objective Although there is broad consensus that careful content vetting and user testing is important in the development of technology-based educational interventions, often these steps are overlooked. This paper highlights the development of a theory-guided, web-based communication aid (CONNECT™), designed to facilitate treatment decision making among patients with advanced cancer. Methods The communication aid included an online survey, patient skills training module and an automated physician report. Development steps included: 1) evidence-based content development, 2) usability testing, 3) pilot testing, and 4) patient utilization and satisfaction. Results Usability testing identified some confusing directions and navigation for the on-line survey and validated the relevance of the “patient testimonials” in the skills module. Preliminary satisfaction from the implementation of the communication aid showed that 66% found the survey length reasonable and 70% found it helpful in talking with the physician. Seventy percent reported the skills module helpful and about half found it affected the consultation. Conclusion Designing patient education interventions for translation into practice requires the integration of health communication best practice including user feedback along the developmental process. Practice Implications This developmental process can be translated to a broad array of community based patient and provider educational interventions. PMID:18417312

The New Parent Checklist: A Tool to Promote Parental Reflection.

PubMed

Keys, Elizabeth M; McNeil, Deborah A; Wallace, Donna A; Bostick, Jason; Churchill, A Jocelyn; Dodd, Maureen M

To design and establish content and face validity of an evidence-informed tool that promotes parental self-reflection during the transition to parenthood. The New Parent Checklist was developed using a three-phase sequential approach: Phase 1 a scoping review and expert consultation to develop and refine a prototype tool; Phase 2 content analysis of parent focus groups; and Phase 3 assessment of utility in a cross-sectional sample of parents completing the New Parent Checklist and a questionnaire. The initial version of the checklist was considered by experts to contain key information. Focus group participants found it useful, appropriate, and nonjudgmental, and offered suggestions to enhance readability, utility, as well as face and content validity. In the cross-sectional survey, 83% of the participants rated the New Parent Checklist as "helpful" or "very helpful" and 90% found the New Parent Checklist "very easy" to use. Open-ended survey responses included predominantly positive feedback. Notable differences existed for some items based on respondents' first language, age, and sex. Results and feedback from all three phases informed the current version, available for download online. The New Parent Checklist is a comprehensive evidence-informed self-reflective tool with promising content and face validity. Depending on parental characteristics and infant age, certain items of the New Parent Checklist have particular utility but may also require further adaptation and testing. Local resources for information and/or support are included in the tool and could be easily adapted by other regions to incorporate their own local resources.

Integrating Information Literacy and Evidence-Based Medicine Content within a New School of Medicine Curriculum: Process and Outcome.

PubMed

Muellenbach, Joanne M; Houk, Kathryn M; E Thimons, Dana; Rodriguez, Bredny

2018-01-01

This column describes a process for integrating information literacy (IL) and evidence-based medicine (EBM) content within a new school of medicine curriculum. The project was a collaborative effort among health sciences librarians, curriculum deans, directors, and faculty. The health sciences librarians became members of the curriculum committees, developed a successful proposal for IL and EBM content within the curriculum, and were invited to become course instructors for Analytics in Medicine. As course instructors, the librarians worked with the other faculty instructors to design and deliver active learning class sessions based on a flipped classroom approach using a proprietary Information Mastery curriculum. Results of this collaboration may add to the knowledge base of attitudes and skills needed to practice as full faculty partners in curricular design and instruction.

Making generic tutorials content specific: recycling evidence-based practice (EBP) tutorials for two disciplines.

PubMed

Jeffery, Keven M; Maggio, Lauren; Blanchard, Mary

2009-01-01

Librarians at the Boston University Medical Center constructed two interactive online tutorials, "Introduction to EBM" and "Formulating a Clinical Question (PICO)," for a Family Medicine Clerkship and then quickly repurposed the existing tutorials to support an Evidence-based Dentistry course. Adobe's ColdFusion software was used to populate the tutorials with course-specific content based on the URL used to enter each tutorial, and a MySQL database was used to collect student input. Student responses were viewable immediately by course faculty on a password-protected Web site. The tutorials ensured that all students received the same baseline training and allowed librarians to tailor a subsequent library skills workshop to student tutorial answers. The tutorials were well-received by the medical and dental schools and have been added to mandatory first-year Evidence-based Medicine (EBM) and Evidence-based Dentistry (EBD) courses, meaning that every medical and dental student at BUMC will be expected to complete these tutorials.

Investigating Climate Change Issues With Web-Based Geospatial Inquiry Activities

NASA Astrophysics Data System (ADS)

Dempsey, C.; Bodzin, A. M.; Sahagian, D. L.; Anastasio, D. J.; Peffer, T.; Cirucci, L.

2011-12-01

In the Environmental Literacy and Inquiry middle school Climate Change curriculum we focus on essential climate literacy principles with an emphasis on weather and climate, Earth system energy balance, greenhouse gases, paleoclimatology, and how human activities influence climate change (http://www.ei.lehigh.edu/eli/cc/). It incorporates a related set of a framework and design principles to provide guidance for the development of the geospatial technology-integrated Earth and environmental science curriculum materials. Students use virtual globes, Web-based tools including an interactive carbon calculator and geologic timeline, and inquiry-based lab activities to investigate climate change topics. The curriculum includes educative curriculum materials that are designed to promote and support teachers' learning of important climate change content and issues, geospatial pedagogical content knowledge, and geographic spatial thinking. The curriculum includes baseline instructional guidance for teachers and provides implementation and adaptation guidance for teaching with diverse learners including low-level readers, English language learners and students with disabilities. In the curriculum, students use geospatial technology tools including Google Earth with embedded spatial data to investigate global temperature changes, areas affected by climate change, evidence of climate change, and the effects of sea level rise on the existing landscape. We conducted a designed-based research implementation study with urban middle school students. Findings showed that the use of the Climate Change curriculum showed significant improvement in urban middle school students' understanding of climate change concepts.

How equity is addressed in clinical practice guidelines: a content analysis

PubMed Central

Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang

2014-01-01

Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795

Design Considerations in Developing a Text Messaging Program Aimed at Smoking Cessation

PubMed Central

Holtrop, Jodi Summers; Bağci Bosi, A Tülay; Emri, Salih

2012-01-01

Background Cell phone text messaging is gaining increasing recognition as an important tool that can be harnessed for prevention and intervention programs across a wide variety of health research applications. Despite the growing body of literature reporting positive outcomes, very little is available about the design decisions that scaffold the development of text messaging-based health interventions. What seems to be missing is documentation of the thought process of investigators in the initial stages of protocol and content development. This omission is of particular concern because many researchers seem to view text messaging as the intervention itself instead of simply a delivery mechanism. Certainly, aspects of this technology may increase participant engagement. Like other interventions, however, the content is a central driver of the behavior change. Objective To address this noted gap in the literature, we discuss the protocol decisions and content development for SMS Turkey (or Cebiniz birakin diyor in Turkish), a smoking cessation text messaging program for adult smokers in Turkey. Methods Content was developed in English and translated into Turkish. Efforts were made to ensure that the protocol and content were grounded in evidence-based smoking cessation theory, while also reflective of the cultural aspects of smoking and quitting in Turkey. Results Methodological considerations included whether to provide cell phones and whether to reimburse participants for texting costs; whether to include supplementary intervention resources (eg, personal contact); and whether to utilize unidirectional versus bidirectional messaging. Program design considerations included how messages were tailored to the quitting curve and one’s smoking status after one’s quit date, the number of messages participants received per day, and over what period of time the intervention lasted. Conclusion The content and methods of effective smoking cessation quitline programs were a useful guide in developing SMS Turkey. Proposed guidelines in developing text messaging-based behavior change programs are offered. PMID:22832182

Evidentiary Pluralism as a Strategy for Research and Evidence-Based Practice in Rehabilitation Psychology

PubMed Central

Tucker, Jalie A.; Reed, Geoffrey M.

2008-01-01

This paper examines the utility of evidentiary pluralism, a research strategy that selects methods in service of content questions, in the context of rehabilitation psychology. Hierarchical views that favor randomized controlled clinical trials (RCTs) over other evidence are discussed, and RCTs are considered as they intersect with issues in the field. RCTs are vital for establishing treatment efficacy, but whether they are uniformly the best evidence to inform practice is critically evaluated. We argue that because treatment is only one of several variables that influence functioning, disability, and participation over time, an expanded set of conceptual and data analytic approaches should be selected in an informed way to support an expanded research agenda that investigates therapeutic and extra-therapeutic influences on rehabilitation processes and outcomes. The benefits of evidentiary pluralism are considered, including helping close the gap between the narrower clinical rehabilitation model and a public health disability model. KEY WORDS: evidence-based practice, evidentiary pluralism, rehabilitation psychology, randomized controlled trials PMID:19649150

Development of a web-based, work-related asthma educational tool for patients with asthma.

PubMed

Ghajar-Khosravi, Shadi; Tarlo, Susan M; Liss, Gary M; Chignell, Mark; Ribeiro, Marcos; Levinson, Anthony J; Gupta, Samir

2013-01-01

Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists. To develop a WRA educational website for adults with asthma. An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website prototype. This was subsequently tested and serially revised according to patient feedback in three moderated phases (one focus group and two interview phases), followed by face validation by asthma educators. Patients (n=10) were 20 to 28 years of age; seven (70%) were female, three (30%) were in university, two (20%) were in college and five (50%) were currently employed. Key format preferences included: well-spaced, bulleted text; movies (as opposed to animations); photos (as opposed to cartoons); an explicit listing of website aims on the home page; and an exploding tab structure. Participants disliked integrated games and knowledge quizzes. Desired informational content included a list of triggers, prevention⁄control methods, currently available tools and resources, a self-test for WRA, real-life scenario presentations, compensation information, information for colleagues on how to react during an asthma attack and a WRA discussion forum. The website met the perceived needs of young asthmatic patients. This resource could be disseminated widely and should be tested for its effects on patient behaviour, including job choice, workplace irritant⁄allergen avoidance and⁄or protective equipment, asthma medication use and physician prompting for management of WRA symptoms.

The quality of instruments to assess the process of shared decision making: A systematic review.

PubMed

Gärtner, Fania R; Bomhof-Roordink, Hanna; Smith, Ian P; Scholl, Isabelle; Stiggelbout, Anne M; Pieterse, Arwen H

2018-01-01

To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.

Creation of a Tool for Assessing Knowledge in Evidence-Based Decision-Making in Practicing Health Care Providers.

PubMed

Spurr, Kathy; Dechman, Gail; Lackie, Kelly; Gilbert, Robert

2016-01-01

Evidence-based decision-making (EBDM) is the process health care providers (HCPs) use to identify and appraise potential evidence. It supports the integration of best research evidence with clinical expertise and patient values into the decision-making process for patient care. Competence in this process is essential to delivery of optimal care. There is no objective tool that assesses EBDM across HCP groups. This research aimed to develop a content valid tool to assess knowledge of the principles of evidence-based medicine and the EBDM process, for use with all HCPs. A Delphi process was used in the creation of the tool. Pilot testing established its content validity with the added benefit of evaluating HCPs' knowledge of EBDM. Descriptive statistics and multivariate mixed models were used to evaluate individual survey responses in total, as well as within each EBDM component. The tool consisted of 26 multiple-choice questions. A total of 12,884 HCPs in Nova Scotia were invited to participate in the web-based validation study, yielding 818 (6.3%) participants, 471 of whom completed all questions. The mean overall score was 68%. Knowledge in one component, integration of evidence with clinical expertise and patient preferences, was identified as needing development across all HCPs surveyed. A content valid tool for assessing HCP EBDM knowledge was created and can be used to support the development of continuing education programs to enhance EBDM competency.

40 CFR 80.1508 - What evidence may be used to determine compliance with the requirements of this subpart and...

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Additional Requirements for Gasoline-Ethanol Blends § 80... the ethanol content of gasoline shall be determined based on the ethanol level of the gasoline... exclusive use of such evidence or information, may be used to establish the ethanol content of gasoline if...

40 CFR 80.1508 - What evidence may be used to determine compliance with the requirements of this subpart and...

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Additional Requirements for Gasoline-Ethanol Blends § 80... the ethanol content of gasoline shall be determined based on the ethanol level of the gasoline... exclusive use of such evidence or information, may be used to establish the ethanol content of gasoline if...

40 CFR 80.1508 - What evidence may be used to determine compliance with the requirements of this subpart and...

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Additional Requirements for Gasoline-Ethanol Blends § 80... the ethanol content of gasoline shall be determined based on the ethanol level of the gasoline... exclusive use of such evidence or information, may be used to establish the ethanol content of gasoline if...

Development of an evidence-informed leisure time physical activity resource for adults with spinal cord injury: the SCI Get Fit Toolkit.

PubMed

Arbour-Nicitopoulos, K P; Martin Ginis, K A; Latimer-Cheung, A E; Bourne, C; Campbell, D; Cappe, S; Ginis, S; Hicks, A L; Pomerleau, P; Smith, K

2013-06-01

To systematically develop an evidence-informed leisure time physical activity (LTPA) resource for adults with spinal cord injury (SCI). Canada. The Appraisal of Guidelines, Research and Evaluation (AGREE) II protocol was used to develop a toolkit to teach and encourage adults with SCI how to make smart and informed choices about being physically active. A multidisciplinary expert panel appraised the evidence and generated specific recommendations for the content of the toolkit. Pilot testing was conducted to refine the toolkit's presentation. Recommendations emanating from the consultation process were that the toolkit be a brief, evidence-based resource that contains images of adults with tetraplegia and paraplegia, and links to more detailed online information. The content of the toolkit should include the physical activity guidelines (PAGs) for adults with SCI, activities tailored to manual and power chair users, the benefits of LTPA, and strategies to overcome common LTPA barriers for adults with SCI. The inclusion of action plans and safety tips was also recommended. These recommendations have resulted in the development of an evidence-informed LTPA resource to assist adults with SCI in meeting the PAGs. This toolkit will have important implications for consumers, health care professionals and policy makers for encouraging LTPA in the SCI community.

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence. PMID:20181270

Transcriptome Analyses Reveal Lipid Metabolic Process in Liver Related to the Difference of Carcass Fat Content in Rainbow Trout (Oncorhynchus mykiss)

PubMed Central

Hu, Guo; Gu, Wei; Sun, Peng; Bai, Qingli

2016-01-01

Excessive accumulation of carcass fat in farm animals, including fish, has a significant impact on meat quality and on the cost of feeding. Similar to farmed animals and humans, the liver can be considered one of the most important organs involved in lipid metabolism in rainbow trout (Oncorhynchus mykiss). RNA-seq based whole transcriptome sequencing was performed to liver tissue of rainbow trout with high and low carcass fat content in this study. In total 1,694 differentially expressed transcripts were identified, including many genes involved in lipid metabolism, such as L-FABP, adiponectin, PPAR-α, PPAR-β, and IGFBP1a. Evidence presented in this study indicated that lipid metabolic process in liver may be related to the difference of carcass fat content. The relevance of PPAR-α and PPAR-β as molecular markers for fat storage in liver should be worthy of further investigation. PMID:27652256

Smoking cessation support for pregnant women: role of mobile technology

PubMed Central

Heminger, Christina L; Schindler-Ruwisch, Jennifer M; Abroms, Lorien C

2016-01-01

Background Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscape of mHealth cessation programs aimed at pregnant smokers and where available reviews evidence to support their use. Methods A search strategy was conducted in June–August 2015 to identify mHealth programs with at least one component or activity that was explicitly directed at smoking cessation assistance for pregnant women. The search for text messaging programs and applications included keyword searches within public health and medical databases of peer-reviewed literature, Google Play/iTunes stores, and gray literature via Google. Results Five unique short message service programs and two mobile applications were identified and reviewed. Little evidence was identified to support their use. Common tools and features identified included the ability to set your quit date, ability to track smoking status, ability to get help during cravings, referral to quitline, and tailored content for the individual participant. The theoretical approach utilized was varied, and approximately half of the programs included pregnancy-related content, in addition to cessation content. With one exception, the mHealth programs identified were found to have low enrollment. Conclusion Globally, there are a handful of applications and text-based mHealth programs available for pregnant smokers. Future studies are needed that examine the efficacy of such programs, as well as strategies to best promote enrollment. PMID:27110146

An evidence-based guide to clinical instruction in audiology.

PubMed

Mormer, Elaine; Palmer, Catherine; Messick, Cheryl; Jorgensen, Lindsey

2013-05-01

A significant portion of the AuD curriculum occurs in clinical settings outside the classroom. Expert clinicians, employed within and outside of the university, are called upon to provide this clinical education. Most have had little or no formal training in clinical teaching yet face pedagogical and logistical challenges when simultaneously providing clinical service and teaching. Training to provide optimal methods and approaches to clinical instruction should be based on research evidence; however, there is a paucity of research in this area within the audiology discipline. This article provides a review of literature supplying evidence for important concepts, elements, and approaches to the clinical instruction process. Additionally, we provide readers with some practical tools with which to facilitate application of optimal clinical teaching principles. We conducted a systematic review of literature on clinical education in audiology and across a wide array of health professions. Through the use of content analysis we identified four elements of the clinical teaching process most critical in examining optimal practices. The elements identified as critical to positive clinical learning outcomes include the establishment of mutual expectations and goals; structured content and delivery of feedback; establishment of a positive instructor/student relationship; and questioning strategies that lead to the development of critical thinking skills. Many disciplines outside of audiology demonstrate robust research activity related to understanding and optimizing the clinical education process. The application of a number of evidence-based clinical teaching principles should allow us to improve student outcomes in audiology. Researchers in our field might consider if and how we should develop our own research literature in clinical education. American Academy of Audiology.

Polycyclic Aromatic Hydrocarbons Content in Contaminated Forest Soils with Different Humus Types.

PubMed

Lasota, Jarosław; Błońska, Ewa

2018-01-01

The aim of the study was to determine polycyclic aromatic hydrocarbon (PAH) content in different forest humus types. The investigation was carried out in Chrzanów Forest District in southern Poland. Twenty research plots with different humus types (mor and mull) were selected. The samples for analysis were taken after litter horizons removing from a depth of 0-10 cm (from the Of- and Oh-horizon total or A-horizon). pH, organic carbon and total nitrogen content, base cations, acidity, and heavy metal content were determined. In the natural moisture state, the activity of dehydrogenase was determined. The study included the determination of PAH content. The conducted research confirms strong contamination of study soil by PAHs and heavy metals. Our experiment provided evidence that different forest humus types accumulate different PAH amounts. The highest content of PAHs and heavy metals was recorded in mor humus type. The content of PAHs in forest humus horizon depends on the content and quality of soil organic matter. Weaker degradation of hydrocarbons is associated with lower biological activity of soils. The mull humus type showed lower content of PAHs and at the same time the highest biological activity confirmed by high dehydrogenase activity.

Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review

PubMed Central

Shah, Ushma; Birnie, Kathryn A; Davies-Chalmers, Cleo; Rivera, Jordan; Stinson, Jennifer; Campbell, Fiona

2017-01-01

Background Recently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning. Smartphone apps that provide remote real-time monitoring and symptom management have the potential to improve self-management skills in patients experiencing postoperative pain. Increased confidence and practice of self-management skills could contribute to decreased postoperative pain and reduce risk of developing persistent pain. Published reviews of general pain self-management apps demonstrate a lack of evidence-based content, theoretical grounding, and health care professional involvement. However, no review to date has focused on the app marketplace specific for individuals with postoperative pain. Objective The aim of this study was to characterize and critically appraise the content and functionality of commercially available postoperative pain self-management apps. Methods An electronic search and extraction was conducted between December 2016 and March 2017 of the official Canadian app stores for the three major smartphone operating systems (iPhone operating system [iOS], Android, and Windows). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the public app description. Metadata from all included apps were abstracted into a standard spreadsheet. Two authors verified the data with reference to the apps and downloaded apps themselves. The content and functionality of each app as it pertained to postoperative pain self-management was rated. Results A total of 10 apps met the inclusion criteria. All included apps were designed exclusively for the Android platform. Education was the most common self-management feature offered (8/10, 80%), with none of the apps offering features related to goal setting or social support. Overall, no single app was comprehensive in terms of pain self-management content. Five (50%) apps reported the involvement of a health care provider in their development. However, not a single app involved end users in their development, and none of the apps underwent scientific evaluation. Additionally, none of the apps were designed for use in pediatric patients. Conclusions Currently available postoperative pain apps for patients lack evidence-based content, goal setting, and social support functions. There is a need to develop and test comprehensive theory-based apps to support patients with pain self-management care following surgery. PMID:29061558

Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review.

PubMed

Lalloo, Chitra; Shah, Ushma; Birnie, Kathryn A; Davies-Chalmers, Cleo; Rivera, Jordan; Stinson, Jennifer; Campbell, Fiona

2017-10-23

Recently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning. Smartphone apps that provide remote real-time monitoring and symptom management have the potential to improve self-management skills in patients experiencing postoperative pain. Increased confidence and practice of self-management skills could contribute to decreased postoperative pain and reduce risk of developing persistent pain. Published reviews of general pain self-management apps demonstrate a lack of evidence-based content, theoretical grounding, and health care professional involvement. However, no review to date has focused on the app marketplace specific for individuals with postoperative pain. The aim of this study was to characterize and critically appraise the content and functionality of commercially available postoperative pain self-management apps. An electronic search and extraction was conducted between December 2016 and March 2017 of the official Canadian app stores for the three major smartphone operating systems (iPhone operating system [iOS], Android, and Windows). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the public app description. Metadata from all included apps were abstracted into a standard spreadsheet. Two authors verified the data with reference to the apps and downloaded apps themselves. The content and functionality of each app as it pertained to postoperative pain self-management was rated. A total of 10 apps met the inclusion criteria. All included apps were designed exclusively for the Android platform. Education was the most common self-management feature offered (8/10, 80%), with none of the apps offering features related to goal setting or social support. Overall, no single app was comprehensive in terms of pain self-management content. Five (50%) apps reported the involvement of a health care provider in their development. However, not a single app involved end users in their development, and none of the apps underwent scientific evaluation. Additionally, none of the apps were designed for use in pediatric patients. Currently available postoperative pain apps for patients lack evidence-based content, goal setting, and social support functions. There is a need to develop and test comprehensive theory-based apps to support patients with pain self-management care following surgery. ©Chitra Lalloo, Ushma Shah, Kathryn A Birnie, Cleo Davies-Chalmers, Jordan Rivera, Jennifer Stinson, Fiona Campbell. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.10.2017.

Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community.

PubMed

McCambridge, Jim; Mialon, Melissa

2018-06-13

Alcohol companies have recently invested large sums of money in answering research questions to which they have clear vested interests in the outcomes. There have been extensive concerns about corporate influence on public health sciences, following the experience with the tobacco industry. This systematic review aims to investigate the perspectives of researchers on the activities of alcohol industry actors in relation to science, in order to guide future research. All data published in peer-reviewed journals (including commentaries, opinion pieces, editorials and letters as well as research reports) were eligible for inclusion. This analysis focuses on the manifest rather than latent content of the articulated views, and accordingly adopts a thematic analysis using an inductive approach to the generation of themes. There are serious concerns identified in three main areas, principally defined by where the impacts of industry scientific activities occur; on evidence informed policy making (instrumental uses of research by industry actors), on the content of the scientific evidence base itself (industry funding as a source of bias); and on the processes of undertaking research (transgressions of basic scientific norms). There are also opposing views which provide a useful critique. The evidence-base on the validity of all concerns has been slow to develop. The concerns are extensive, longstanding and unresolved and high quality investigations are needed. This study informs the detailed content of the research needed to address the concerns identified here. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Development and evaluation of brochures for fall prevention education created to empower nursing home residents and family members.

PubMed

Schoberer, Daniela; Eglseer, Doris; Halfens, Ruud J G; Lohrmann, Christa

2018-06-01

In this study, we describe the development of evidence- and theory-based fall prevention educational material and its evaluation from the users' perspectives. To reduce risk factors for falling in nursing homes, nursing staff must enact multifactorial fall prevention intervention programmes. A core component of these programmes is to educate residents and their family members, both verbally and in a written form. However, users can only benefit from educational material if it is based on current scientific evidence, easy to understand and process and customised. We followed a structured procedure during the development process, while considering various aspect of quality. To assess the understandability and usefulness of the resulting educational materials, we conducted a qualitative content analysis study. The educational materials development process incorporated several iterative steps including a systematic literature search and the application of frameworks for designing and writing the materials. To evaluate the material, we performed six focus group discussions separately with residents, family members and nursing staff from two nursing homes (total of 32 participants). Residents' brochures included clear information on avoiding external risks as well as coping strategies after a fall event. Family members' brochures were more comprehensive, including both concrete tips and outlining the advantages and disadvantages of interventions. Residents and family members had no difficulties understanding the material and tried to apply the content to their individual situations. Nursing staff commented on some ambiguities and incongruities relating to current nursing care practice. By involving users in the development of evidence-based educational materials, nursing staff can achieve a high acceptance rate for the materials and motivate users to address the topic. The involvement of users is essential for developing educational material that meets users' needs. Educational material should be used as part of an overall strategy to educate residents and family members in nursing homes. © 2018 John Wiley & Sons Ltd.

Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers

PubMed Central

Sivyer, Katy; Vedhara, Kavita; Yardley, Lucy; Game, Frances; Chalder, Trudie; Richards, Gayle; Drake, Nikki; Gray, Katie; Weinman, John; Bradbury, Katherine

2018-01-01

Objectives To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. Methods Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20). This was used to identify the psychosocial needs and challenges of this population and barriers and facilitators to the intervention’s target behaviours: regular foot checking, rapid self-referral in the event of changes in foot health, graded and regular physical activity and emotional management. In phase II, this evidence was combined with expert consultation to develop the intervention plan. Brief ‘guiding principles’ for shaping intervention development were created. ‘Behavioural analysis’ and ‘logic modelling’ were used to map intervention content onto behaviour change theory to comprehensively describe the intervention and its hypothesised mechanisms. Results Key challenges to the intervention’s target behaviours included patients’ uncertainty regarding when to self-refer, physical limitations affecting foot checking and physical activity and, for some, difficulties managing negative emotions. Important considerations for the intervention design included a need to increase patients’ confidence in making a self-referral and in using the maintenance intervention and a need to acknowledge that some intervention content might be relevant to only some patients (emotional management, physical activity). The behavioural analysis identified the following processes hypothesised to facilitate long-term behaviour maintenance including increasing patients’ skills, self-efficacy, knowledge, positive outcome expectancies, sense of personal control, social support and physical opportunity. Conclusions This research provides a transparent description of the intervention planning for the REDUCE maintenance intervention. It provides insights into potential barriers and facilitators to the target behaviours and potentially useful behaviour change techniques to use in clinical practice. PMID:29779008

The quality of the evidence base for clinical pathway effectiveness: room for improvement in the design of evaluation trials.

PubMed

Rotter, Thomas; Kinsman, Leigh; James, Erica; Machotta, Andreas; Steyerberg, Ewout W

2012-06-18

The purpose of this article is to report on the quality of the existing evidence base regarding the effectiveness of clinical pathway (CPW) research in the hospital setting. The analysis is based on a recently published Cochrane review of the effectiveness of CPWs. An integral component of the review process was a rigorous appraisal of the methodological quality of published CPW evaluations. This allowed the identification of strengths and limitations of the evidence base for CPW effectiveness. We followed the validated Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria for randomized and non-randomized clinical pathway evaluations. In addition, we tested the hypotheses that simple pre-post studies tend to overestimate CPW effects reported. Out of the 260 primary studies meeting CPW content criteria, only 27 studies met the EPOC study design criteria, with the majority of CPW studies (more than 70 %) excluded from the review on the basis that they were simple pre-post evaluations, mostly comparing two or more annual patient cohorts. Methodologically poor study designs are often used to evaluate CPWs and this compromises the quality of the existing evidence base. Cochrane EPOC methodological criteria, including the selection of rigorous study designs along with detailed descriptions of CPW development and implementation processes, are recommended for quantitative evaluations to improve the evidence base for the use of CPWs in hospitals.

Implementation plans included in World Health Organisation guidelines.

PubMed

Wang, Zhicheng; Norris, Susan L; Bero, Lisa

2016-05-20

The implementation of high-quality guidelines is essential to improve clinical practice and public health. The World Health Organisation (WHO) develops evidence-based public health and other guidelines that are used or adapted by countries around the world. Detailed implementation plans are often necessary for local policymakers to properly use the guidelines developed by WHO. This paper describes the plans for guideline implementation reported in WHO guidelines and indicates which of these plans are evidence-based. We conducted a content analysis of the implementation sections of WHO guidelines approved by the WHO guideline review committee between December 2007 and May 2015. The implementation techniques reported in each guideline were coded according to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) taxonomy and classified as passive, active or policy strategies. The frequencies of implementation techniques are reported. The WHO guidelines (n = 123) analysed mentioned implementation techniques 800 times, although most mentioned implementation techniques very briefly, if at all. Passive strategies (21 %, 167/800) and general policy strategies (62 %, 496/800) occurred most often. Evidence-based active implementation methods were generally neglected with no guideline mentioning reminders (computerised or paper) and only one mentioning a multifaceted approach. Many guidelines contained implementation sections that were identical to those used in older guidelines produced by the same WHO technical unit. The prevalence of passive and policy-based implementation techniques as opposed to evidence-based active techniques suggests that WHO guidelines should contain stronger guidance for implementation. This could include structured and increased detail on implementation considerations, accompanying or linked documents that provide information on what is needed to contextualise or adapt a guideline and specific options from among evidence-based implementation strategies.

Assessing the Viability of Social Media for Disseminating Evidence-Based Nutrition Practice Guideline Through Content Analysis of Twitter Messages and Health Professional Interviews: An Observational Study

PubMed Central

Kenne, Deric; Wolfram, Taylor M; Abram, Jenica K; Fleming, Michael

2016-01-01

Background Given the high penetration of social media use, social media has been proposed as a method for the dissemination of information to health professionals and patients. This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). Objectives The objectives were to (1) describe the existing social media content on HF, including message content, source, and target audience, and (2) describe the attitude of physicians and registered dietitian nutritionists (RDNs) who care for outpatient HF patients toward the use of social media as a method to obtain information for themselves and to share this information with patients. Methods The methods were divided into 2 parts. Part 1 involved conducting a content analysis of tweets related to HF, which were downloaded from Twitonomy and assigned codes for message content (19 codes), source (9 codes), and target audience (9 codes); code frequency was described. A comparison in the popularity of tweets (those marked as favorites or retweeted) based on applied codes was made using t tests. Part 2 involved conducting phone interviews with RDNs and physicians to describe health professionals’ attitude toward the use of social media to communicate general health information and information specifically related to the HF EBNPG. Interviews were transcribed and coded; exemplar quotes representing frequent themes are presented. Results The sample included 294 original tweets with the hashtag “#heartfailure.” The most frequent message content codes were “HF awareness” (166/294, 56.5%) and “patient support” (97/294, 33.0%). The most frequent source codes were “professional, government, patient advocacy organization, or charity” (112/277, 40.4%) and “patient or family” (105/277, 37.9%). The most frequent target audience codes were “unable to identify” (111/277, 40.1%) and “other” (55/277, 19.9%). Significant differences were found in the popularity of tweets with (mean 1, SD 1.3 favorites) or without (mean 0.7, SD 1.3 favorites), the content code being “HF research” (P=.049). Tweets with the source code “professional, government, patient advocacy organizations, or charities” were significantly more likely to be marked as a favorite and retweeted than those without this source code (mean 1.2, SD 1.4 vs mean 0.8, SD 1.2, P=.03) and (mean 1.5, SD 1.8 vs mean 0.9, SD 2.0, P=.03). Interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients due to privacy concerns and the fact that the information had to be kept general rather than be tailored for a specific patient and the belief that their patients did not use social media or technology. Conclusions Existing Twitter content related to HF comes from a combination of patients and evidence-based organizations; however, there is little nutrition content. That gap may present an opportunity for EBNPG dissemination. Health professionals use social media to gather information for themselves but are skeptical of its value when communicating with patients, particularly due to privacy concerns and misconceptions about the characteristics of social media users. PMID:27847349

Assessing the Viability of Social Media for Disseminating Evidence-Based Nutrition Practice Guideline Through Content Analysis of Twitter Messages and Health Professional Interviews: An Observational Study.

PubMed

Hand, Rosa K; Kenne, Deric; Wolfram, Taylor M; Abram, Jenica K; Fleming, Michael

2016-11-15

Given the high penetration of social media use, social media has been proposed as a method for the dissemination of information to health professionals and patients. This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). The objectives were to (1) describe the existing social media content on HF, including message content, source, and target audience, and (2) describe the attitude of physicians and registered dietitian nutritionists (RDNs) who care for outpatient HF patients toward the use of social media as a method to obtain information for themselves and to share this information with patients. The methods were divided into 2 parts. Part 1 involved conducting a content analysis of tweets related to HF, which were downloaded from Twitonomy and assigned codes for message content (19 codes), source (9 codes), and target audience (9 codes); code frequency was described. A comparison in the popularity of tweets (those marked as favorites or retweeted) based on applied codes was made using t tests. Part 2 involved conducting phone interviews with RDNs and physicians to describe health professionals' attitude toward the use of social media to communicate general health information and information specifically related to the HF EBNPG. Interviews were transcribed and coded; exemplar quotes representing frequent themes are presented. The sample included 294 original tweets with the hashtag "#heartfailure." The most frequent message content codes were "HF awareness" (166/294, 56.5%) and "patient support" (97/294, 33.0%). The most frequent source codes were "professional, government, patient advocacy organization, or charity" (112/277, 40.4%) and "patient or family" (105/277, 37.9%). The most frequent target audience codes were "unable to identify" (111/277, 40.1%) and "other" (55/277, 19.9%). Significant differences were found in the popularity of tweets with (mean 1, SD 1.3 favorites) or without (mean 0.7, SD 1.3 favorites), the content code being "HF research" (P=.049). Tweets with the source code "professional, government, patient advocacy organizations, or charities" were significantly more likely to be marked as a favorite and retweeted than those without this source code (mean 1.2, SD 1.4 vs mean 0.8, SD 1.2, P=.03) and (mean 1.5, SD 1.8 vs mean 0.9, SD 2.0, P=.03). Interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients due to privacy concerns and the fact that the information had to be kept general rather than be tailored for a specific patient and the belief that their patients did not use social media or technology. Existing Twitter content related to HF comes from a combination of patients and evidence-based organizations; however, there is little nutrition content. That gap may present an opportunity for EBNPG dissemination. Health professionals use social media to gather information for themselves but are skeptical of its value when communicating with patients, particularly due to privacy concerns and misconceptions about the characteristics of social media users. ©Rosa K Hand, Deric Kenne, Taylor M Wolfram, Jenica K Abram, Michael Fleming. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.11.2016.

Content Representation in the Human Medial Temporal Lobe

PubMed Central

Liang, Jackson C.; Wagner, Anthony D.

2013-01-01

Current theories of medial temporal lobe (MTL) function focus on event content as an important organizational principle that differentiates MTL subregions. Perirhinal and parahippocampal cortices may play content-specific roles in memory, whereas hippocampal processing is alternately hypothesized to be content specific or content general. Despite anatomical evidence for content-specific MTL pathways, empirical data for content-based MTL subregional dissociations are mixed. Here, we combined functional magnetic resonance imaging with multiple statistical approaches to characterize MTL subregional responses to different classes of novel event content (faces, scenes, spoken words, sounds, visual words). Univariate analyses revealed that responses to novel faces and scenes were distributed across the anterior–posterior axis of MTL cortex, with face responses distributed more anteriorly than scene responses. Moreover, multivariate pattern analyses of perirhinal and parahippocampal data revealed spatially organized representational codes for multiple content classes, including nonpreferred visual and auditory stimuli. In contrast, anterior hippocampal responses were content general, with less accurate overall pattern classification relative to MTL cortex. Finally, posterior hippocampal activation patterns consistently discriminated scenes more accurately than other forms of content. Collectively, our findings indicate differential contributions of MTL subregions to event representation via a distributed code along the anterior–posterior axis of MTL that depends on the nature of event content. PMID:22275474

Prospective content in the friendship conversations of young adults.

PubMed

Young, Richard A; Marshall, Sheila K; Murray, John

2017-01-01

Prospection is cognitive processes that involve constructing, encoding, and remembering the future. Less is known about the how these processes are evident in the prospective content of conversations. This study sought to identify and describe evidence of the prospective content in the conversations of friends as they transition to adulthood. The present secondary content analysis of the videotaped conversations of 15 young adult friendship dyads (n = 30, 16 females, 14 males, mean age = 21.3 years) in Canada examined these conversations based the following characteristics of prospection: simulation, reasoning about counterfactuals, constructing multiple possible futures, and episodic memory of the past. Four categories of prospective content were evident in these conversations, these processes were used sparingly in all but one conversation, and relatively few of them were collaborative in that dyad partners did not appear to serve to augment, clarify, or disconfirm prospective content. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Health information in Vietnamese-American print media: results of a content analysis.

PubMed

Nguyen, Giang T; Ashfaq, Hera; Pham, Tuong Vi H

2010-01-01

Vietnamese-Americans (VA) constitute a large minority community that is mostly foreign born with limited English proficiency. This article compares the health content of free print media targeting VA with that of free English-language print media. Content analysis. All free print media available at the three largest VA-serving supermarkets in Philadelphia, Pennsylvania, were reviewed. Comparison English-language periodicals included free and purchased publications. We identified and coded 254 health content-containing articles from 22 issues of six periodicals (four free Vietnamese, one free English language, and one purchased English language) collected over a 4-week period. Chi-square and t-tests for independent samples were used to compare free Vietnamese- and free English-language periodicals. Additional analyses included all English-language periodicals as the comparison group. Higher proportions of advertisements and "pseudonews" articles (ads formatted like news stories) were found in free Vietnamese- vs. free English-language publications (overt ads, 61% vs. 28%; pseudonews, 18% vs. 0%). Moreover, Vietnamese-language publications did not contain many articles addressing diseases most commonly found in Asian-Americans. The significant proportion made up by profit-motivated health content in VA print media points to an untapped opportunity to provide evidence-based information about health topics of interest to this community. Future studies should examine secular trends, assess multiple communities, and develop community-based participatory approaches to improving access to quality health information among minorities with limited English proficiency.

Medial temporal lobe reinstatement of content-specific details predicts source memory

PubMed Central

Liang, Jackson C.; Preston, Alison R.

2016-01-01

Leading theories propose that when remembering past events, medial temporal lobe (MTL) structures reinstate the neural patterns that were active when those events were initially encoded. Accurate reinstatement is hypothesized to support detailed recollection of memories, including their source. While several studies have linked cortical reinstatement to successful retrieval, indexing reinstatement within the MTL network and its relationship to memory performance has proved challenging. Here, we addressed this gap in knowledge by having participants perform an incidental encoding task, during which they visualized people, places, and objects in response to adjective cues. During a surprise memory test, participants saw studied and novel adjectives and indicated the imagery task they performed for each adjective. A multivariate pattern classifier was trained to discriminate the imagery tasks based on functional magnetic resonance imaging (fMRI) responses from hippocampus and MTL cortex at encoding. The classifier was then tested on MTL patterns during the source memory task. We found that MTL encoding patterns were reinstated during successful source retrieval. Moreover, when participants made source misattributions, errors were predicted by reinstatement of incorrect source content in MTL cortex. We further observed a gradient of content-specific reinstatement along the anterior-posterior axis of hippocampus and MTL cortex. Within anterior hippocampus, we found that reinstatement of person content was related to source memory accuracy, whereas reinstatement of place information across the entire hippocampal axis predicted correct source judgments. Content-specific reinstatement was also graded across MTL cortex, with PRc patterns evincing reactivation of people and more posterior regions, including PHc, showing evidence for reinstatement of places and objects. Collectively, these findings provide key evidence that source recollection relies on reinstatement of past experience within the MTL network. PMID:28029355

Medial temporal lobe reinstatement of content-specific details predicts source memory.

PubMed

Liang, Jackson C; Preston, Alison R

2017-06-01

Leading theories propose that when remembering past events, medial temporal lobe (MTL) structures reinstate the neural patterns that were active when those events were initially encoded. Accurate reinstatement is hypothesized to support detailed recollection of memories, including their source. While several studies have linked cortical reinstatement to successful retrieval, indexing reinstatement within the MTL network and its relationship to memory performance has proved challenging. Here, we addressed this gap in knowledge by having participants perform an incidental encoding task, during which they visualized people, places, and objects in response to adjective cues. During a surprise memory test, participants saw studied and novel adjectives and indicated the imagery task they performed for each adjective. A multivariate pattern classifier was trained to discriminate the imagery tasks based on functional magnetic resonance imaging (fMRI) responses from hippocampus and MTL cortex at encoding. The classifier was then tested on MTL patterns during the source memory task. We found that MTL encoding patterns were reinstated during successful source retrieval. Moreover, when participants made source misattributions, errors were predicted by reinstatement of incorrect source content in MTL cortex. We further observed a gradient of content-specific reinstatement along the anterior-posterior axis of hippocampus and MTL cortex. Within anterior hippocampus, we found that reinstatement of person content was related to source memory accuracy, whereas reinstatement of place information across the entire hippocampal axis predicted correct source judgments. Content-specific reinstatement was also graded across MTL cortex, with PRc patterns evincing reactivation of people and more posterior regions, including PHc, showing evidence for reinstatement of places and objects. Collectively, these findings provide key evidence that source recollection relies on reinstatement of past experience within the MTL network. Copyright © 2016 Elsevier Ltd. All rights reserved.

A prototype for evidence-based pharmaceutical opinions to promote physician-pharmacist communication around deprescribing

PubMed Central

Tannenbaum, Cara

2018-01-01

Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians’ views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada. Participants were asked to comment on the need for clarifying treatment goals, including personalized patient data and biomarkers, highlighting evidence about drug harms, listing the credibility and source of the recommendations, providing therapeutic alternatives and formalizing official documentation of decision making. The content and format of the prototype underwent revision by community physicians and pharmacists until consensus was reached on a final recommended template. Results: The majority of physicians (84%-97%) requested that the source of the deprescribing recommendations be cited, that alternative management options be provided and that the information be tailored to the patient. Sixteen percent of physicians expressed concern about the information in the opinions being too dense. Pharmacists also questioned the length of the opinion and asked that additional space be provided for the physician’s response. A statement was added making the opinion a valid prescription upon receipt of a signature from physicians. Compared to a nonstandardized opinion, the majority of pharmacists believed the template was easier to use, more evidence based, more time efficient and more likely to lead to deprescribing. Conclusion: Physicians and pharmacists endorsed a standardized template that promotes interprofessional communication for deprescribing (available at https://www.deprescribingnetwork.ca/pharmaceutical-opinions). The outcome of the D-Prescribe trial will determine the effectiveness of these evidence-based pharmaceutical opinions on deprescribing processes and outcomes. Can Pharm J (Ott) 2018;151:xx-xx. PMID:29531631

A Portal of Educational Resources: Providing Evidence for Matching Pedagogy with Technology

ERIC Educational Resources Information Center

Di Blas, Nicoletta; Fiore, Alessandro; Mainetti, Luca; Vergallo, Roberto; Paolini, Paolo

2014-01-01

The TPACK (Technology, Pedagogy and Content Knowledge) model presents the three types of knowledge that are necessary to implement a successful technology-based educational activity. It highlights how the intersections between TPK (Technological Pedagogical Knowledge), PCK (Pedagogical Content Knowledge) and TCK (Technological Content Knowledge)…

Typology of Delivery Quality: Latent Profile Analysis of Teacher Engagement and Delivery Techniques in a School-Based Prevention Intervention, "Keepin' It REAL" Curriculum

ERIC Educational Resources Information Center

Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.

2014-01-01

Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may…

Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

PubMed

Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

2014-01-01

In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

Environmental pediatrics: an introduction and evaluation of online resources.

PubMed

Weinstangel, Hannah; Buka, Irena; Campbell, Sandra

2016-12-01

The World Health Organization (WHO) estimates that three million children under the age of 5 die annually from environmentally related disease. In the United States, the cost of environmentally related public health concerns is estimated as greater than $55 billion. Environmental exposure is among parents' top health concerns for children. Yet, the study of the effects of environmental exposure on health outcomes is a developing field, and clinicians feel inadequately prepared to address these concerns. The Children's Environmental Health Clinic (ChEHC) is the first clinic of its kind in Canada. Their website includes a list of online resources on major topics related to child health and the environment. There has not yet been an objective evaluation of the comprehensiveness of the topics or scientific quality of the information on the website. This study seeks to offer an accessible introduction to the field of environmental pediatrics, including an online resource for evidence-based information on key topics in the field. These resources assist in disease prevention, health promotion, education, and the increasing need to balance environmental health risks. A scoping review of scientific and gray literature in the field of environmental pediatrics was performed to inform a written introduction to the field and to identify gaps in the content of the ChEHC website. The content of the ChEHC website was then objectively evaluated using the National Network of Libraries of Medicine checklist for health websites. Ten categories within the field of environmental pediatrics emerged from the literature review. A small number of gaps were identified on the website and in the literature. The content of the ChEHC website was found to be of high quality. The website will be updated using the results of the study as a guide, to make it as relevant, complete, and evidence-based as possible. Environmental pediatrics is an important, emerging topic. There is a need for accessible, evidence-based pediatric environmental health resources for clinicians and the general public. The products of this study (a publication and website) respond to that need and thus assist in disease prevention and health promotion.

Guidelines for children's work in agriculture: implications for the future.

PubMed

Marlenga, Barbara; Lee, Barbara C; Pickett, William

2012-01-01

The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to assist parents in assigning developmentally appropriate and safe farm work to their children aged 7-16 years. Since their release in 1999, a growing body of evidence has accumulated regarding the content and application of these guidelines to populations of working children on farms. The purpose of this paper is to review the scientific and programmatic evidence about the content, efficacy, application, and uptake of NAGCAT and propose key recommendations for the future. The methods for this review included a synthesis of the peer-reviewed literature and programmatic evidence gathered from safety professionals. From the review, it is clear that the NAGCAT tractor guidelines and the manual material handling guidelines need to be updated based upon the latest empirical evidence. While NAGCAT do have the potential to prevent serious injuries to working children in the correct age range (7-16 years), the highest incidence of farm related injuries and fatalities occur to children aged 1-6 years and NAGCAT are unlikely to have any direct effect on this leading injury problem. It is also clear that NAGCAT, as a voluntary educational strategy, is not sufficient by itself to protect children working on farms. Uptake of NAGCAT has been sporadic, despite being geographically widespread and has depended, almost solely, on a few interested and committed professionals. Key recommendations for the future are provided based upon this review.

Mindfulness-Based Symptom and Stress Management Apps for Adults With Chronic Lung Disease: Systematic Search in App Stores.

PubMed

Owens, Otis L; Beer, Jenay M; Reyes, Ligia I; Gallerani, David G; Myhren-Bennett, Amanda R; McDonnell, Karen K

2018-05-15

Up to 70% of lung cancer survivors are affected by chronic obstructive pulmonary disease (COPD), a common, debilitating, comorbid disease. Lung cancer and COPD are both characterized by symptoms such as breathlessness, fatigue, and psychological distress. These distressing chronic symptoms are exacerbated by stress and detract from an individual's quality of life. The aim of this study was to identify and evaluate evidence-based, commercially available apps for promoting mindfulness-based strategies among adults with a COPD or lung cancer history (ie, chronic lung disease). For this review, an interdisciplinary research team used 19 keyword combinations in the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on the apps' (1) content, (2) usability heuristics, (3) grade-level readability, and (4) cultural sensitivity. The search resulted in 768 apps (508 in iOS and 260 in Google stores). A total of 9 apps met the inclusion criteria and received further evaluation. Only 1 app had below an eighth-grade reading level; the ninth one did not have enough text to calculate a readability score. None of the 9 apps met the cultural sensitivity evaluation criteria. This systematic review identified critical design flaws that may affect the ease of using the apps in this study. Few mobile apps promote mindfulness-based strategies among adults with chronic lung disease (ie, COPD or lung cancer or both), but those that exist, overall, do not meet the latest scientific evidence. Recommendations include more stringent regulation of health-related apps, use of evidence-based frameworks and participatory design processes, following evidence-based usability practices, use of culturally sensitive language and images, and ensuring that content is written in plain language. ©Otis L Owens, Jenay M Beer, Ligia I Reyes, David G Gallerani, Amanda R Myhren-Bennett, Karen K McDonnell. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.05.2018.

Physical activity and cognitive-health content in top-circulating magazines, 2006-2008.

PubMed

Price, Anna E; Corwin, Sara J; Friedman, Daniela B; Laditka, Sarah B; Colabianchi, Natalie; Montgomery, Kara M

2011-04-01

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.

Communication: essential strategies for success.

PubMed

O'Connor, Mary

2013-06-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advance organizational change, content includes evidence-based projects, tool, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategies for communication for change processes, whether large or small. Intentional planning and development of a communication strategy alongside, not as an afterthought, to change initiatives are essential.

[Obstacles perceived by nurses for evidence-based practice: a qualitative study].

PubMed

Sánchez-García, Inmaculada; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L

2013-01-01

To examine the obstacles perceived by nurses to implement an evidence-based clinical practice. A qualitative study through semi-structured interviews conducted in 2010-2011 including 11 nurses purposively selected from public hospitals and community centres in Jaén and Córdoba (Spain). A content analysis was performed, using Miles and Huberman as a reference and comprising the following steps: data reduction, data presentation, and data conclusion/verification. Data saturation was reached in these categories (obstacles). The obstacles perceived by nurses to introduce an evidence-based clinical practice (EBCP) were grouped into 3 major categories: obstacles related with professionals (routine-based practice, unwilling and stagnant attitudes, and lack of training in EBCP), obstacles related to the social context (reluctance from other professionals and from patients or families), and obstacles related to the organization (obsolete cultures that do not promote innovation in nursing care). This study highlights the persistence of various factors that hinder the use of research findings in clinical practice. The results underline the need to change the culture of healthcare organizations, to motivate professionals, and to break some of the resistance attitudes that hinder the implementation of evidence-based practice. Copyright © 2012 Elsevier España, S.L. All rights reserved.

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

The undergraduate research fellows program: a unique model to promote engagement in research.

PubMed

Vessey, Judith A; DeMarco, Rosanna F

2008-01-01

Well-educated nurses with research expertise are needed to advance evidence-based nursing practice. A primary goal of undergraduate nursing curricula is to create meaningful participatory experiences to help students develop a research skill set that articulates with rapid career advancement of gifted, young graduates interested in nursing research and faculty careers. Three research enrichment models-undergraduate honors programs, research assistant work-for-hire programs, and research work/mentorship programs-to be in conjunction with standard research content are reviewed. The development and implementation of one research work/mentorship program, the Boston College undergraduate research fellows program (UGRF), is explicated. This process included surveying previous UGRFs followed by creating a retreat and seminars to address specific research skill sets. The research skill sets included (a) how to develop a research team, (b) accurate data retrieval, (c) ethical considerations, (d) the research process, (e) data management, (f) successful writing of abstracts, and (g) creating effective poster presentations. Outcomes include evidence of involvement in research productivity and valuing of evidenced-based practice through the UGRF mentorship process with faculty partners.

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

PubMed

Eldredge, J D

2000-01-01

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

Directing the public to evidence-based online content

PubMed Central

Cooper, Crystale Purvis; Gelb, Cynthia A; Vaughn, Alexandra N; Smuland, Jenny; Hughes, Alexandra G; Hawkins, Nikki A

2015-01-01

To direct online users searching for gynecologic cancer information to accurate content, the Centers for Disease Control and Prevention’s (CDC) ‘Inside Knowledge: Get the Facts About Gynecologic Cancer’ campaign sponsored search engine advertisements in English and Spanish. From June 2012 to August 2013, advertisements appeared when US Google users entered search terms related to gynecologic cancer. Users who clicked on the advertisements were directed to relevant content on the CDC website. Compared with the 3 months before the initiative (March–May 2012), visits to the CDC web pages linked to the advertisements were 26 times higher after the initiative began (June–August 2012) (p<0.01), and 65 times higher when the search engine advertisements were supplemented with promotion on television and additional websites (September 2012–August 2013) (p<0.01). Search engine advertisements can direct users to evidence-based content at a highly teachable moment—when they are seeking relevant information. PMID:25053580

Evidence-based clinical practice guidelines for chronic pancreatitis 2015.

PubMed

Ito, Tetsuhide; Ishiguro, Hiroshi; Ohara, Hirotaka; Kamisawa, Terumi; Sakagami, Junichi; Sata, Naohiro; Takeyama, Yoshifumi; Hirota, Morihisa; Miyakawa, Hiroyuki; Igarashi, Hisato; Lee, Lingaku; Fujiyama, Takashi; Hijioka, Masayuki; Ueda, Keijiro; Tachibana, Yuichi; Sogame, Yoshio; Yasuda, Hiroaki; Kato, Ryusuke; Kataoka, Keisho; Shiratori, Keiko; Sugiyama, Masanori; Okazaki, Kazuichi; Kawa, Shigeyuki; Tando, Yusuke; Kinoshita, Yoshikazu; Watanabe, Mamoru; Shimosegawa, Tooru

2016-02-01

Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

Clinician Documentation on Receipt of Trauma-Focused Evidence-Based Psychotherapies in a VA PTSD Clinic.

PubMed

Lu, Mary W; Plagge, Jane M; Marsiglio, Mary C; Dobscha, Steven K

2016-01-01

The U.S. Department of Veterans Affairs (VA) is implementing two trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD): cognitive processing therapy and prolonged exposure therapy (PE). Veterans with PTSD often do not receive these treatments, and little is known about the reasons veterans may not receive TF-EBPs. The aim of this qualitative study was to summarize clinician-reported reasons in medical records for nonreceipt of TF-EBPs. All veterans (N = 63) identified through PTSD screening who were newly engaged in mental health care and received individual evaluations in a PTSD specialty clinic in fiscal year 2008 were included in the sample. Content analysis of electronic medical records revealed multiple potential reasons for nonreceipt of TF-EBPs including referral to other PTSD treatments, other clinical priorities, poor engagement in care, practical barriers, negative beliefs, and receipt of care in other settings. Eight veterans (13%) initiated TF-EBPs. Further interventions to promote engagement in PTSD treatment are warranted.

Formalizing Evidence Type Definitions for Drug-Drug Interaction Studies to Improve Evidence Base Curation.

PubMed

Utecht, Joseph; Brochhausen, Mathias; Judkins, John; Schneider, Jodi; Boyce, Richard D

2017-01-01

In this research we aim to demonstrate that an ontology-based system can categorize potential drug-drug interaction (PDDI) evidence items into complex types based on a small set of simple questions. Such a method could increase the transparency and reliability of PDDI evidence evaluation, while also reducing the variations in content and seriousness ratings present in PDDI knowledge bases. We extended the DIDEO ontology with 44 formal evidence type definitions. We then manually annotated the evidence types of 30 evidence items. We tested an RDF/OWL representation of answers to a small number of simple questions about each of these 30 evidence items and showed that automatic inference can determine the detailed evidence types based on this small number of simpler questions. These results show proof-of-concept for a decision support infrastructure that frees the evidence evaluator from mastering relatively complex written evidence type definitions.

Experiences of nursing students of Evidence-Based Practice Education according to Rogers' Diffusion of Innovation Model: A Directed Content Analysis.

PubMed

Pashaeypoor, Shahzad; Ashktorab, Tahereh; Rassouli, Maryam; Alavi Majd, Hamid

2017-10-01

Evidence based practice (EBP) education is essential in promoting of clinical care, but an effective educational strategy for teaching EBP in nursing faculties is not available. The aim of this study was to explore the experiences of nursing students of EBP Education according to Rogers' Diffusion of Innovation Model. This qualitative study was carried out using a directed content analysis method and purposeful sampling. Data were collected until saturation by fourteen semi-structured face-to-face individual interviews and two focus group discussions with nursing students from two nursing faculties in Tehran, Iran. Rogers' Model was used in this study. Data were classified into five themes and 11 categories according to the Rogers's Model. Themes and main categories were knowledge (educational enrichment, new strategy for education), persuasion (internalization of education, improvement of motivation), decision (acceptance, use in the future), implementation (objectivity, consolidation of learning) and confirmation (learning and teaching, achieving a goal, self-confidence). EBP Education, based on the teaching strategy of Rogers's Model, leads to an improved EBP learning. All the necessary steps for a better education of it are included in this educational approach which can be used to teach any new subject like EBP.

The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

PubMed

Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

2012-08-01

This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

PubMed Central

Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

2012-01-01

Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

Information literacy: using LISTEN project strategies to equip nurses worldwide.

PubMed

Patterson, Ramona; Carter-Templeton, Heather; Russell, Cynthia

2009-01-01

The 21st century presents a major challenge in the form of information overload. In a profession where new knowledge is ever expanding, nurse educators must equip nurses to find the information they need to provide safe evidence-based care. Information literacy and information technology competencies have become a priority in nursing education, but inconsistencies in definitions, frameworks, content, and design, combined with ill-equipped faculty have hindered the development of a transferable model geared toward improving nurses' information literacy. Challenges are compounded for nurses in developing nations, where access to information and training for information literacy are both problematic. This paper describes experiences from the LISTEN project, during the 1st year of a 3-year funded Nurse Education Practice and Retention grant. Designed to improve information literacy competencies of student and workforce nurses, using individualized learning via interactive web-based modules, LISTEN provides on its' website a Did You Know video dramatizing the importance of information literacy to nurses, and offers resources for information literacy, information technology, and evidence-based nursing practice. Preliminary findings from beta testing reveal the module content is realistic, complete, and logical. The website and video have generated worldwide interest. Future possibilities include nationwide implementation and adaptation for the international arena.

Using Content Acquisition Podcasts to Deliver Core Content to Preservice Teacher Candidates

ERIC Educational Resources Information Center

Kennedy, Michael J.; Kellems, Ryan O.; Thomas, Cathy Newman; Newton, Jennifer R.

2015-01-01

Teacher educators are always looking for instructional strategies that are easy to create and use but are powerful for promoting learning among preservice teacher candidates. Content acquisition podcasts (CAPs) is an example of an instructional strategy that embeds evidence-based instructional design principles to package and deliver critical…

Evaluating the Content Validity of Multistage-Adaptive Tests

ERIC Educational Resources Information Center

Crotts, Katrina; Sireci, Stephen G.; Zenisky, April

2012-01-01

Validity evidence based on test content is important for educational tests to demonstrate the degree to which they fulfill their purposes. Most content validity studies involve subject matter experts (SMEs) who rate items that comprise a test form. In computerized-adaptive testing, examinees take different sets of items and test "forms"…

ESCAPE: database for integrating high-content published data collected from human and mouse embryonic stem cells.

PubMed

Xu, Huilei; Baroukh, Caroline; Dannenfelser, Ruth; Chen, Edward Y; Tan, Christopher M; Kou, Yan; Kim, Yujin E; Lemischka, Ihor R; Ma'ayan, Avi

2013-01-01

High content studies that profile mouse and human embryonic stem cells (m/hESCs) using various genome-wide technologies such as transcriptomics and proteomics are constantly being published. However, efforts to integrate such data to obtain a global view of the molecular circuitry in m/hESCs are lagging behind. Here, we present an m/hESC-centered database called Embryonic Stem Cell Atlas from Pluripotency Evidence integrating data from many recent diverse high-throughput studies including chromatin immunoprecipitation followed by deep sequencing, genome-wide inhibitory RNA screens, gene expression microarrays or RNA-seq after knockdown (KD) or overexpression of critical factors, immunoprecipitation followed by mass spectrometry proteomics and phosphoproteomics. The database provides web-based interactive search and visualization tools that can be used to build subnetworks and to identify known and novel regulatory interactions across various regulatory layers. The web-interface also includes tools to predict the effects of combinatorial KDs by additive effects controlled by sliders, or through simulation software implemented in MATLAB. Overall, the Embryonic Stem Cell Atlas from Pluripotency Evidence database is a comprehensive resource for the stem cell systems biology community. Database URL: http://www.maayanlab.net/ESCAPE

Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review.

PubMed

Li, Shelly-Anne; Jeffs, Lianne; Barwick, Melanie; Stevens, Bonnie

2018-05-05

Organizational contextual features have been recognized as important determinants for implementing evidence-based practices across healthcare settings for over a decade. However, implementation scientists have not reached consensus on which features are most important for implementing evidence-based practices. The aims of this review were to identify the most commonly reported organizational contextual features that influence the implementation of evidence-based practices across healthcare settings, and to describe how these features affect implementation. An integrative review was undertaken following literature searches in CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane databases from January 2005 to June 2017. English language, peer-reviewed empirical studies exploring organizational context in at least one implementation initiative within a healthcare setting were included. Quality appraisal of the included studies was performed using the Mixed Methods Appraisal Tool. Inductive content analysis informed data extraction and reduction. The search generated 5152 citations. After removing duplicates and applying eligibility criteria, 36 journal articles were included. The majority (n = 20) of the study designs were qualitative, 11 were quantitative, and 5 used a mixed methods approach. Six main organizational contextual features (organizational culture; leadership; networks and communication; resources; evaluation, monitoring and feedback; and champions) were most commonly reported to influence implementation outcomes in the selected studies across a wide range of healthcare settings. We identified six organizational contextual features that appear to be interrelated and work synergistically to influence the implementation of evidence-based practices within an organization. Organizational contextual features did not influence implementation efforts independently from other features. Rather, features were interrelated and often influenced each other in complex, dynamic ways to effect change. These features corresponded to the constructs in the Consolidated Framework for Implementation Research (CFIR), which supports the use of CFIR as a guiding framework for studies that explore the relationship between organizational context and implementation. Organizational culture was most commonly reported to affect implementation. Leadership exerted influence on the five other features, indicating it may be a moderator or mediator that enhances or impedes the implementation of evidence-based practices. Future research should focus on how organizational features interact to influence implementation effectiveness.

Improved statistical signal detection in pharmacovigilance by combining multiple strength-of-evidence aspects in vigiRank.

PubMed

Caster, Ola; Juhlin, Kristina; Watson, Sarah; Norén, G Niklas

2014-08-01

Detection of unknown risks with marketed medicines is key to securing the optimal care of individual patients and to reducing the societal burden from adverse drug reactions. Large collections of individual case reports remain the primary source of information and require effective analytics to guide clinical assessors towards likely drug safety signals. Disproportionality analysis is based solely on aggregate numbers of reports and naively disregards report quality and content. However, these latter features are the very fundament of the ensuing clinical assessment. Our objective was to develop and evaluate a data-driven screening algorithm for emerging drug safety signals that accounts for report quality and content. vigiRank is a predictive model for emerging safety signals, here implemented with shrinkage logistic regression to identify predictive variables and estimate their respective contributions. The variables considered for inclusion capture different aspects of strength of evidence, including quality and clinical content of individual reports, as well as trends in time and geographic spread. A reference set of 264 positive controls (historical safety signals from 2003 to 2007) and 5,280 negative controls (pairs of drugs and adverse events not listed in the Summary of Product Characteristics of that drug in 2012) was used for model fitting and evaluation; the latter used fivefold cross-validation to protect against over-fitting. All analyses were performed on a reconstructed version of VigiBase(®) as of 31 December 2004, at around which time most safety signals in our reference set were emerging. The following aspects of strength of evidence were selected for inclusion into vigiRank: the numbers of informative and recent reports, respectively; disproportional reporting; the number of reports with free-text descriptions of the case; and the geographic spread of reporting. vigiRank offered a statistically significant improvement in area under the receiver operating characteristics curve (AUC) over screening based on the Information Component (IC) and raw numbers of reports, respectively (0.775 vs. 0.736 and 0.707, cross-validated). Accounting for multiple aspects of strength of evidence has clear conceptual and empirical advantages over disproportionality analysis. vigiRank is a first-of-its-kind predictive model to factor in report quality and content in first-pass screening to better meet tomorrow's post-marketing drug safety surveillance needs.

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

PubMed

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Is a Picture Worth a Thousand Words? Few Evidence-Based Features of Dietary Interventions Included in Photo Diet Tracking Mobile Apps for Weight Loss.

PubMed

Hales, Sarah; Dunn, Caroline; Wilcox, Sara; Turner-McGrievy, Gabrielle M

2016-11-01

Apps using digital photos to track dietary intake and provide feedback are common, but currently there has been no research examining what evidence-based strategies are included in these apps. A content analysis of mobile apps for photo diet tracking was conducted, including whether effective techniques for interventions promoting behavior change, including self-regulation, for healthy eating (HE) are targeted. An initial search of app stores yielded 34 apps (n = 8 Android and Apple; n = 11 Android; n = 15 Apple). One app was removed (unable to download), and other apps (n = 4) were unable to be rated (no longer available). Remaining apps (n = 29) were downloaded, reviewed, and coded by 2 independent reviewers to determine the number of known effective self-regulation and other behavior change techniques included. The raters met to compare their coding of the apps, calculate interrater agreement, resolve any discrepancies, and come to a consensus. Six apps (21%) did not utilize any of the behavior change techniques examined. Three apps (10%) provided feedback to users via crowdsourcing or collective feedback from other users and professionals, 7 apps (24%) used crowdsourcing or collective feedback, 1 app (3%) used professionals, and 18 apps (62%) did not provide any dietary feedback to users. Few photo diet-tracking apps include evidence-based strategies to improve dietary intake. Use of photos to self-monitor dietary intake and receive feedback has the potential to reduce user burden for self-monitoring, yet photo diet tracking apps need to incorporate known effective behavior strategies for HE, including self-regulation. © 2016 Diabetes Technology Society.

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

"People power" or "pester power"? YouTube as a forum for the generation of evidence and patient advocacy.

PubMed

Mazanderani, Fadhila; O'Neill, Braden; Powell, John

2013-12-01

Venoplasty has been proposed, alongside the theory of chronic cerebrospinal venous insufficiency (CCSVI), as a treatment for multiple sclerosis (MS). Despite concerns about its efficacy and safety, thousands of patients have undergone the procedure. This paper analyses YouTube videos where patients have shared their treatment experiences. Content analysis on the 100 most viewed videos from over 4000 identified in a search for 'CCSVI', and qualitative thematic analysis on popular 'channels' demonstrating patients' experiences. Videos adopt an overwhelmingly positive stance towards CCSVI; many were uploaded by patients and present pre- and/or post-treatment experiences. Patients demonstrate rather than merely describe their symptoms, performing tests on themselves before and after treatment to quantify improvement. Videos combine medical terminology and tests with personal experiences of living with MS. Social media technologies provide patients with novel opportunities for advocating for particular treatments; generating alternative forms of 'evidence' built on a hybrid of personal experience and medical knowledge. Healthcare practitioners need to engage with new digital forms of content, including online social media. Instead of disregarding sources not considered 'evidence-based', practitioners should enhance their understanding of what 'experiential-evidence' is deemed significant to patients, particularly in contested areas of healthcare. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Type of Evidence Behind Point-of-Care Clinical Information Products: A Bibliometric Analysis

PubMed Central

2011-01-01

Background Point-of-care (POC) products are widely used as information reference tools in the clinical setting. Although usability, scope of coverage, ability to answer clinical questions, and impact on health outcomes have been studied, no comparative analysis of the characteristics of the references, the evidence for the content, in POC products is available. Objective The objective of this study was to compare the type of evidence behind five POC clinical information products. Methods This study is a comparative bibliometric analysis of references cited in monographs in POC products. Five commonly used products served as subjects for the study: ACP PIER, Clinical Evidence, DynaMed, FirstCONSULT, and UpToDate. The four clinical topics examined to identify content in the products were asthma, hypertension, hyperlipidemia, and carbon monoxide poisoning. Four indicators were measured: distribution of citations, type of evidence, product currency, and citation overlap. The type of evidence was determined based primarily on the publication type found in the MEDLINE bibliographic record, as well as the Medical Subject Headings (MeSH), both assigned by the US National Library of Medicine. MeSH is the controlled vocabulary used for indexing articles in MEDLINE/PubMed. Results FirstCONSULT had the greatest proportion of references with higher levels of evidence publication types such as systematic review and randomized controlled trial (137/153, 89.5%), although it contained the lowest total number of references (153/2330, 6.6%). DynaMed had the largest total number of references (1131/2330, 48.5%) and the largest proportion of current (2007-2009) references (170/1131, 15%). The distribution of references cited for each topic varied between products. For example, asthma had the most references listed in DynaMed, Clinical Evidence, and FirstCONSULT, while hypertension had the most references in UpToDate and ACP PIER. An unexpected finding was that the rate of citation overlap was less than 1% for each topic across all five products. Conclusions Differences between POC products are revealed by examining the references cited in the monographs themselves. Citation analysis extended to include key content indicators can be used to compare the evidence levels of the literature supporting the content found in POC products. PMID:21335319

Construction of technological artifacts and teaching strategies to promote flexible scientific understanding

NASA Astrophysics Data System (ADS)

Spitulnik, Michele Wisnudel

Science education reforms advocate inquiry as a way to build explanations and make informed decisions. Based on this call this dissertation (1) defines flexible scientific understanding by elaborating on content, inquiry and epistemic understandings; (2) describes an inquiry based unit that integrates dynamic modeling software; (3) examines students' understandings as they construct models; and (4) identifies instructional strategies that support inquiry and model building. A curriculum unit was designed to engage students in inquiry by identifying problems and constructing models to represent, explain and predict phenomena. Ninth grade students in a public mid-western high school worked in teams of 2-3 to ask questions, find information and reflect on the purposes of models. Data sources including classroom video, observations, interviews, student models and handouts were used to formulate cases that examine how two groups construct understanding. A teacher case study identifies the teaching strategies that support understanding. Categories within content, inquiry and epistemic understandings were used to analyze student understandings and teaching supports. The findings demonstrate that students can build flexible understanding by constructing models. Students built: (1) content understanding by identifying key ideas and building relationships and explanations of phenomena; (2) inquiry understanding by defining problems, constructing models and developing positions; and (3) epistemic understanding by describing the purposes of models as generalizing phenomena, testing hypotheses and making predictions. However, students demonstrated difficulty in using evidence to defend scientific arguments. Strategies that support flexible understanding were also identified. Content supports include: setting expectations for explanations; using examples to illustrate explanations; modeling questions; and providing feedback that prompts detailed explanations. Supports for inquiry are setting expectations for data gathering; using examples that illustrate model building; modeling the development of an argument; and providing feedback to promote coherent models. Epistemic supports include: using examples to illustrate purposes and assumptions within models, and providing feedback as students evaluate their models. The dissertation demonstrates that teaching strategies impact student understanding but are challenging to implement. When strategies are not used, students do not necessarily construct desired outcomes such as, using evidence to support arguments.

Assessing child and adolescent pragmatic language competencies: toward evidence-based assessments.

PubMed

Russell, Robert L; Grizzle, Kenneth L

2008-06-01

Using language appropriately and effectively in social contexts requires pragmatic language competencies (PLCs). Increasingly, deficits in PLCs are linked to child and adolescent disorders, including autism spectrum, externalizing, and internalizing disorders. As the role of PLCs expands in diagnosis and treatment of developmental psychopathology, psychologists and educators will need to appraise and select clinical and research PLC instruments for use in assessments and/or studies. To assist in this appraisal, 24 PLC instruments, containing 1,082 items, are assessed by addressing four questions: (1) Can PLC domains targeted by assessment items be reliably identified?, (2) What are the core PLC domains that emerge across the 24 instruments?, (3) Do PLC questionnaires and tests assess similar PLC domains?, and (4) Do the instruments achieve content, structural, diagnostic, and ecological validity? Results indicate that test and questionnaire items can be reliably categorized into PLC domains, that PLC domains featured in questionnaires and tests significantly differ, and that PLC instruments need empirical confirmation of their dimensional structure, content validity across all developmental age bands, and ecological validity. Progress in building a better evidence base for PLC assessments should be a priority in future research.

Improving Chronic Diseases Management Through the Development of an Evidence-Based Resource.

PubMed

Khalil, Hanan; Chambers, Helen; Munn, Zachary; Porritt, Kylie

2015-06-01

There is a large gap between evidence and practice within health care, particularly within the field of chronic disease. To reduce this gap and improve the management of chronic disease, a collaborative partnership between two schools within a large university and two industry partners (a large regional rural hospital and a rural community health center) in rural Victoria, Australia, was developed. The aim of the collaboration was to promote the development of translation science and the implementation of evidence-based health care in chronic disease with a specific focus on developing evidence-based resources that are easily accessed by clinicians. A working group consisting of members of the collaborating organizations and an internationally renowned expert reference group was formed. The group acted as a steering committee and was tasked with developing a taxonomy of the resources. In addition, a peer review process of all resources was established. A corresponding reference group consisting of researchers and clinicians who are clinical experts in various fields was involved in the review process. The resources developed by the group include evidence summaries and recommended practices made available on a web-based database, which can be accessed via subscription by clinicians and researchers worldwide. As of mid-2014, there were 109 new evidence summaries and 25 recommended practices detailing the best available evidence on topics related to chronic disease management including asthma, diabetes, heart failure, dementia, and others. Training sessions and a newsletter were developed for clinicians within the node to enable them to use the content effectively. This paper describes the processes involved in the successful development of the collaborative partnership and its evolution into producing a valuable resource for the translation of evidence into practice in the areas of chronic disease management. The resource developed is being used by clinicians to inform practice and support their clinical decision making. © 2015 Sigma Theta Tau International.

Evidence-Based Exercise Recommendations to Reduce Hepatic Fat Content in Youth- a Systematic Review and Meta-Analysis.

PubMed

Medrano, María; Cadenas-Sanchez, Cristina; Álvarez-Bueno, Celia; Cavero-Redondo, Iván; Ruiz, Jonatan R; Ortega, Francisco B; Labayen, Idoia

2018-02-13

The main purposes of this study were to elucidate the effects of supervised-exercise training (ET) interventions on hepatic fat content and on non-alcoholic fatty liver disease (NAFLD) prevalence in children and adolescents and to provide information about the optimal ET prescription (type, intensity, volume, and frequency) needed to reduce hepatic fat content in youths. Supervised-ET interventions performed in children and adolescents (6-19 years) that provided results of exercise effects on hepatic fat content or NAFLD prevalence were included. Supervised-exercise significantly reduced hepatic fat content compared to the control groups. Lifestyle interventions that included supervised-ET significantly reduced the prevalence of NAFLD. This systematic review and meta-analysis shows that supervised-ET could be an effective strategy in the management and prevention of NAFLD in children and adolescents. Both aerobic and resistance ET, at vigorous or moderate-to-vigorous intensities, with a volume ≥60 min/session and a frequency ≥3 sessions/week, aiming to improve cardiorespiratory fitness and muscular strength, had benefits on hepatic fat content reduction in youth. These data concur with the international recommendations of physical activity for health promotion in youth and may be useful when designing ET programs to improve and prevent hepatic steatosis in the pediatric population. Copyright © 2017 Elsevier Inc. All rights reserved.

Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

PubMed

Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

2017-10-01

Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

The 2002 NIMH Provisional Diagnostic Criteria for Depression of Alzheimer's Disease (PDC-dAD): Gauging their Validity over a Decade Later.

PubMed

Sepehry, Amir A; Lee, Philip E; Hsiung, Ging-Yuek R; Beattie, B Lynn; Feldman, Howard H; Jacova, Claudia

2017-01-01

Presented herein is evidence for criterion, content, and convergent/discriminant validity of the NIMH-Provisional Diagnostic Criteria for depression of Alzheimer's Disease (PDC-dAD) that were formulated to address depression in Alzheimer's disease (AD). Using meta-analytic and systematic review methods, we examined criterion validity evidence in epidemiological and clinical studies comparing the PDC-dAD to Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV), and International Classification of Disease (ICD 9) depression diagnostic criteria. We estimated prevalence of depression by PDC, DSM, and ICD with an omnibus event rate effect-size. We also examined diagnostic agreement between PDC and DSM. To gauge content validity, we reviewed rates of symptom endorsement for each diagnostic approach. Finally, we examined the PDC's relationship with assessment scales (global cognition, neuropsychiatric, and depression definition) for convergent validity evidence. The aggregate evidence supports the validity of the PDC-dAD. Our findings suggest that depression in AD differs from other depressive disorders including Major Depressive Disorder (MDD) in that dAD is more prevalent, with generally a milder presentation and with unique features not captured by the DSM. Although the PDC are the current standard for diagnosis of depression in AD, we identified the need for their further optimization based on predictive validity evidence.

Pivot Points: Direct Measures of the Content and Process of Community-Based Learning

ERIC Educational Resources Information Center

Wickersham, Carol; Westerberg, Charles; Jones, Karen; Cress, Margaret

2016-01-01

This research is an initial investigation into the ways community-based learning increase the cognitive skills central to the exercise of the sociological imagination. In addition to identifying a means to reveal that learning had occurred, we looked for evidence that the students were mastering sociological content, especially the concepts and…

Declarative and Dynamic Pedagogical Content Knowledge as Elicited through Two Video-Based Interview Methods

ERIC Educational Resources Information Center

Alonzo, Alicia C.; Kim, Jiwon

2016-01-01

Although pedagogical content knowledge (PCK) has become widely recognized as an essential part of the knowledge base for teaching, empirical evidence demonstrating a connection between PCK and teaching practice or student learning outcomes is mixed. In response, we argue for further attention to the measurement of dynamic (spontaneous or flexible,…

Children and Adolescents and Digital Media.

PubMed

Reid Chassiakos, Yolanda Linda; Radesky, Jenny; Christakis, Dimitri; Moreno, Megan A; Cross, Corinn

2016-11-01

Today's children and adolescents are immersed in both traditional and new forms of digital media. Research on traditional media, such as television, has identified health concerns and negative outcomes that correlate with the duration and content of viewing. Over the past decade, the use of digital media, including interactive and social media, has grown, and research evidence suggests that these newer media offer both benefits and risks to the health of children and teenagers. Evidence-based benefits identified from the use of digital and social media include early learning, exposure to new ideas and knowledge, increased opportunities for social contact and support, and new opportunities to access health promotion messages and information. Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. This technical report reviews the literature regarding these opportunities and risks, framed around clinical questions, for children from birth to adulthood. To promote health and wellness in children and adolescents, it is important to maintain adequate physical activity, healthy nutrition, good sleep hygiene, and a nurturing social environment. A healthy Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that is individualized for a specific child, teenager, or family can identify an appropriate balance between screen time/online time and other activities, set boundaries for accessing content, guide displays of personal information, encourage age-appropriate critical thinking and digital literacy, and support open family communication and implementation of consistent rules about media use. Copyright © 2016 by the American Academy of Pediatrics.

Elementary teachers' perceptions of science inquiry and professional development challenges and opportunities

NASA Astrophysics Data System (ADS)

Jones, Kathleen M.

Inquiry science, including a focus on evidence-based discourse, is essential to spark interest in science education in the early grades and maintain that interest throughout children's schooling. The researcher was interested in two broad areas: inquiry science in the elementary classroom and the need/desire for professional development opportunities for elementary teachers related to science education, and specifically professional development focused on inquiry science. A cross sectional survey design was prepared and distributed in May 2005 and usable responses were received from 228 elementary teachers from the south-central area of Pennsylvania which was a representative sample of socio-economical and geographical factors. Areas of particular interest in the results section include: (1) The use of Science Kits which is popular, but may not have the desired impact since they are "adjusted" by teachers often removing the opportunity for evidence-based discourse by the students. This may be partly based on the lack of time dedicated to science instruction and, secondly, the teachers' lack of comfort with the science topics. Another issue arising from science kits is the amount of preparation time required to utilize them. (2) Teachers demonstrated understanding of the high qualities of professional development but, when it came to science content professional development, they were more inclined to opt for short-term opportunities as opposed to long-term learning opportunities. Since elementary teachers are generalists and most schools are not focusing on science, the lack of attention to a subject where they are least comfortable is understandable, but disappointing. (3) There is a great need for more training in evidence--based discourse so teachers can implement this needed skill and increase students' understanding of science content so they are more able to compete in the international science and math measurements. (4) Professional development, especially in the science area, needs to be a long-term, grass-roots effort in all schools. We need to dedicate funding, and make time available for teachers to participate in long-term collaborative learning opportunities. Teachers want to observe each other and collaborate on lessons but, unless it becomes a priority of the school, it will not happen. Time must be dedicated throughout the day that allows small groups of teachers across the board to get together and share, learn, attempt new approaches, reflect and revise. Various forms of professional learning are available, and each school must choose the one that works for them. (5) The principal as the educational leader in the school needs to be more fully engaged with the learning process of the teachers and the students. The principal should not be viewed only as the evaluator of teachers, but as a collaborator of learning and teaching. Suggestions for further research include longitudinal studies of the impact on students of long term professional development of the teachers that specifically targets science content, inquiry and evidence--based discourse.

Investigation Organizer

NASA Technical Reports Server (NTRS)

Panontin, Tina; Carvalho, Robert; Keller, Richard

2004-01-01

Contents include the folloving:Overview of the Application; Input Data; Analytical Process; Tool's Output; and Application of the Results of the Analysis.The tool enables the first element through a Web-based application that can be accessed by distributed teams to store and retrieve any type of digital investigation material in a secure environment. The second is accomplished by making the relationships between information explicit through the use of a semantic network-a structure that literally allows an investigator or team to "connect -the-dots." The third element, the significance of the correlated information, is established through causality and consistency tests using a number of different methods embedded within the tool, including fault trees, event sequences, and other accident models. And finally, the evidence gathered and structured within the tool can be directly, electronically archived to preserve the evidence and investigative reasoning.

Overt attention in natural scenes: objects dominate features.

PubMed

Stoll, Josef; Thrun, Michael; Nuthmann, Antje; Einhäuser, Wolfgang

2015-02-01

Whether overt attention in natural scenes is guided by object content or by low-level stimulus features has become a matter of intense debate. Experimental evidence seemed to indicate that once object locations in a scene are known, salience models provide little extra explanatory power. This approach has recently been criticized for using inadequate models of early salience; and indeed, state-of-the-art salience models outperform trivial object-based models that assume a uniform distribution of fixations on objects. Here we propose to use object-based models that take a preferred viewing location (PVL) close to the centre of objects into account. In experiment 1, we demonstrate that, when including this comparably subtle modification, object-based models again are at par with state-of-the-art salience models in predicting fixations in natural scenes. One possible interpretation of these results is that objects rather than early salience dominate attentional guidance. In this view, early-salience models predict fixations through the correlation of their features with object locations. To test this hypothesis directly, in two additional experiments we reduced low-level salience in image areas of high object content. For these modified stimuli, the object-based model predicted fixations significantly better than early salience. This finding held in an object-naming task (experiment 2) and a free-viewing task (experiment 3). These results provide further evidence for object-based fixation selection--and by inference object-based attentional guidance--in natural scenes. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dietary composition and nutrient content of the New Nordic Diet.

PubMed

Mithril, Charlotte; Dragsted, Lars Ove; Meyer, Claus; Tetens, Inge; Biltoft-Jensen, Anja; Astrup, Arne

2013-05-01

To describe the dietary composition of the New Nordic Diet (NND) and to compare it with the Nordic Nutrition Recommendations (NNR)/Danish Food-based Dietary Guidelines (DFDG) and with the average Danish diet. Dietary components with clear health-promoting properties included in the DFDG were included in the NND in amounts at least equivalent to those prescribed by the DFDG. The quantities of the other dietary components in the NND were based on scientific arguments for their potential health-promoting properties together with considerations of acceptability, toxicological concerns, availability and the environment. Calculations were conducted for quantifying the dietary and nutrient composition of the NND. Denmark. None. The NND is characterized by a high content of fruits and vegetables (especially berries, cabbages, root vegetables and legumes), fresh herbs, potatoes, plants and mushrooms from the wild countryside, whole grains, nuts, fish and shellfish, seaweed, free-range livestock (including pigs and poultry) and game. Overall, the average daily intakes of macro- and micronutrients in the NND meet the NNR with small adjustments based on evidence of their health-promoting properties. The NND is a prototype regional diet that takes palatability, health, food culture and the environment into consideration. Regionally appropriate healthy diets could be created on similar principles anywhere in the world.

Evaluating the Content of Individualized Education Programs and 504 Plans of Young Adolescents with Attention Deficit/Hyperactivity Disorder

PubMed Central

Spiel, Craig F.; Evans, Steven W.; Langberg, Joshua M.

2014-01-01

The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with Attention Deficit/Hyperactivity Disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of students’ present level of academic achievement and functional performance (PLAAFP) and targeted in the students’ measurable annual goals and objectives (MAGOs). In addition, we compared services to lists of recommended services provided by the U.S. Department of Education (ED) and reviews of evidence-based practices. Participants were 97 middle school students with ADHD, 61.9% with an IEP and 38.1% with a 504 Plan. Most (85%) IEP PLAAFP statements described nonacademic/behavior problems, but less than half had MAGOs targeting these areas of need. Services listed on IEPs and Section 504 Plans were frequently consistent with ED recommendations, but had little to no research supporting their effectiveness. In addition, services with evidence supporting benefit to students with ADHD were rarely included on IEPs or 504 Plans. Implications for special education policy and future directions are discussed. PMID:25485467

Arizona Registered Dietitians Show Gaps in Knowledge of Bean Health Benefits

PubMed Central

Thompson, Sharon V.; Dougherty, Mariah K.

2018-01-01

Registered Dietitians (RDs) promote nutrition practices and policies and can influence food consumption patterns to include nutrient dense foods such as beans. Although many evidence-based health benefits of bean consumption (e.g., cholesterol reduction, glycemic control) have been demonstrated, there is limited research on the knowledge, attitudes, and perceptions of RDs regarding the inclusion of beans in a healthy diet. To fill this existing research gap, this cross-sectional survey explored the perceptions, knowledge, and attitudes of 296 RDs in Arizona, USA, toward beans. The RDs largely held positive attitudes toward the healthfulness of beans and were aware of many health benefits. Some gaps in awareness were evident, including effect on cancer risk, intestinal health benefits, folate content, and application with celiac disease patients. RDs with greater personal bean consumption had significantly higher bean health benefit knowledge. Twenty-nine percent of the RDs did not know the meaning of ‘legume’, and over two-thirds could not define the term ‘pulse’. It is essential that RDs have up-to-date, evidence-based information regarding bean benefits to provide appropriate education to patients, clients, and the public. PMID:29316699

Dietary Interventions in Multiple Sclerosis: Development and Pilot-Testing of an Evidence Based Patient Education Program

PubMed Central

Riemann-Lorenz, Karin; Eilers, Marlene; von Geldern, Gloria; Schulz, Karl-Heinz; Köpke, Sascha; Heesen, Christoph

2016-01-01

Background Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS). Specific diets are widely used among patients with MS. Objective To design and pilot-test an evidence based patient education program on dietary factors in MS. Methods We performed a systematic literature search on the effectiveness of dietary interventions in MS. A web-based survey among 337 patients with MS and 136 healthy controls assessed knowledge, dietary habits and information needs. An interactive group education program was developed and pilot-tested. Results Fifteen randomised-controlled trials (RCTs) were included in the systematic review. Quality of evidence was low and no clear benefit could be seen. Patients with MS significantly more often adhered to a `Mediterranean Diet`(29.7% versus 14.0%, p<0.001) compared to controls. 143 (42%) of the patients with MS had tried special MS diets. Important information needs addressed effectiveness of MS diets (44%) and relation between nutrition and MS (43%). A pilot test of our newly developed patient education program with 13 participants showed excellent comprehensibility and the MS-specific content was judged as very important. However, the poor evidence base for dietary approaches in MS was perceived disappointing. Conclusions Development and pilot-testing of an evidence-based patient education program on nutrition and MS is feasible. Patient satisfaction with the program suffers from the lack of evidence. Further research should focus on generating evidence for the potential influence of lifestyle habits (diet, physical activity) on MS disease course thus meeting the needs of patients with MS. PMID:27764237

Dietary Interventions in Multiple Sclerosis: Development and Pilot-Testing of an Evidence Based Patient Education Program.

PubMed

Riemann-Lorenz, Karin; Eilers, Marlene; von Geldern, Gloria; Schulz, Karl-Heinz; Köpke, Sascha; Heesen, Christoph

2016-01-01

Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS). Specific diets are widely used among patients with MS. To design and pilot-test an evidence based patient education program on dietary factors in MS. We performed a systematic literature search on the effectiveness of dietary interventions in MS. A web-based survey among 337 patients with MS and 136 healthy controls assessed knowledge, dietary habits and information needs. An interactive group education program was developed and pilot-tested. Fifteen randomised-controlled trials (RCTs) were included in the systematic review. Quality of evidence was low and no clear benefit could be seen. Patients with MS significantly more often adhered to a `Mediterranean Diet`(29.7% versus 14.0%, p<0.001) compared to controls. 143 (42%) of the patients with MS had tried special MS diets. Important information needs addressed effectiveness of MS diets (44%) and relation between nutrition and MS (43%). A pilot test of our newly developed patient education program with 13 participants showed excellent comprehensibility and the MS-specific content was judged as very important. However, the poor evidence base for dietary approaches in MS was perceived disappointing. Development and pilot-testing of an evidence-based patient education program on nutrition and MS is feasible. Patient satisfaction with the program suffers from the lack of evidence. Further research should focus on generating evidence for the potential influence of lifestyle habits (diet, physical activity) on MS disease course thus meeting the needs of patients with MS.

Systematic review: reliability of compendia methods for off-label oncology indications.

PubMed

Abernethy, Amy P; Raman, Gowri; Balk, Ethan M; Hammond, Julia M; Orlando, Lori A; Wheeler, Jane L; Lau, Joseph; McCrory, Douglas C

2009-03-03

The Centers for Medicare & Medicaid Services limit coverage of cancer drugs for off-label indications to indications listed in specified compendia. To assess whether compendia provide comprehensive, research-based, and timely information for off-label prescribing in oncology. 6 drug compendia, English-language literature searches of MEDLINE and the Cochrane Central Register of Controlled Trials from 2006 and 2008, and American Society of Clinical Oncology annual meeting abstracts from 2004 to 2007. Data Assessment: The compendia's stated methods, literature related to off-label indications of 14 cancer drugs in 2006, updated literature related to 1 off-label indication between 2006 and 2008, and completeness of compendia content and citations were assessed. The compendia's stated methods varied greatly from their actual practices. Compendia cited little of the available evidence, often neither the most recent nor that of highest methodological quality. Compendia differed in evidence cited, terminology, detail, presentation, and referencing. For the 14 off-label indications studied, the compendia differed in the indications included and whether and how they recommended particular agents for particular types of cancer. Update schedules varied, and documentation practices made it difficult to determine whether and when compendia content was updated. For 1 indication, compendia citations did not increase between 2006 and 2008 despite newly published articles. The 2006 analysis was limited to 14 off-label indications; the 2008 update examined 1 indication. Only off-label indications for cancer drugs were included, and results cannot be generalized to noncancer drugs or indications. Oncologists rely on compendia for up-to-date access to evidence and reimbursement information for off-label indications. Current compendia lack transparency, cite little current evidence, and lack systematic methods to review or update evidence.

Constraints on vertical transport near the polar summer mesopause from PMC observations and modelling

NASA Astrophysics Data System (ADS)

Wilms, H.; Rapp, M.; Kirsch, A.

2016-12-01

The comparison of microphysical simulations of polar mesospheric cloud properties with ground based and satellite borne observations suggests that vertical wind variance imposed by gravity waves is an important prerequisite to realistically model PMC properties. This paper reviews the available observational evidence of vertical wind measurements at the polar summer mesopause (including their frequency content). Corresponding results are compared to vertical wind variance from several global models and implications for the transport of trace constituents in this altitude region are discussed.

Studies of Brazilian meteorites. XIV - Mineralogy, petrology, and chemistry of the Conquista, Minas Gerais, chondrite

NASA Technical Reports Server (NTRS)

Keil, K.; Kirchner, E.; Gomes, C. B.; Jarosewich, E.; Murta, R. L. L.

1978-01-01

The Conquista chondrite is described and classified as an H4. The mineral composition is reported. H-group classification is based on described microscopic, electron microprobe, and bulk chemical studies. The evidence for petrologic type 4 classification includes the pronounced well-developed chondritic texture; the slight compositional variations in constituent phases; the high Ca contents of pyroxene and the presence of pigeonite; glassy to microcrystalline interstitial material rich in alkalis and SiO2; and twinned low-Ca clinopyroxene.

The Impact of Project-Based Climate Change Learning Experiences on Students' Broad Climate Literacy

NASA Astrophysics Data System (ADS)

DeWaters, J.; Powers, S. E.; Dhaniyala, S.

2014-12-01

Evidence-based pedagogical approaches such as project- and inquiry-based techniques have been shown to promote effective learning in science and engineering. The impact of project-based learning experiences on middle school (MS), high school (HS), and undergraduate (UG) students' climate literacy was investigated as part of a NASA Innovations in Climate Education (NICE) project. Project-based modules were developed and taught by MS and HS teachers who participated in climate change education workshops. UG students enrolled in a climate science course completed independent research projects that provided the basis for several of the HS/MS modules. All modules required students to acquire and analyze historical temperature data and future climate predictions, and apply their analysis to the solution of a societal or environmental problem related to our changing climate. Three versions of a quantitative survey were developed and used in a pre-test/post-test research design to help evaluate the project's impact on MS, HS, and UG students' climate literacy, which includes broad climate knowledge as well as affective and behavioral aspects. Content objectives were guided primarily by the 2009 document, Climate Literacy: The Essential Principles of Climate Sciences. All three groups of students made modest but statistically significant cognitive (p<<0.001) and affective (p<0.01) gains; UG students also showed an increase in behavior scores (p=0.001). Results of an ANCOVA showed significant differences in students' cognitive (p<0.001), behavioral (p=0.005) and self-efficacy (p=0.012) outcomes among the 9 participating MS and HS classrooms, where both teacher and module content varied. The presentation will include a description of some key aspects of the project-based curricula developed and used in this research, the development and content of the climate literacy survey, and the interpretation of specific pre/post changes in participating students relative to the content of and approach used in the project-based modules.

Health information for young people where and when they most want it: a case study of www.teenagehealthfreak.org.

PubMed

McPherson, Ann; Macfarlane, Aidan

2007-08-01

The Internet is an exciting resource for providing immediately available, evidence-based, health information for young people in an age-appropriate form on a 24 hours/day, 7 days/week basis. www.teenagehealthfreak.org is a United Kingdom-based Web site designed to take advantage of this. The content of the site, which is the leading teenage health Web site on a Google search, contains both the diary of a hypochondriac 15-year-old boy and a virtual doctor's surgery. It also allows for young people to e-mail health-related questions and receive relevant answers from a health expert. Analysis of the content of these e-mails indicates the unmet health needs and concerns of young people. Future developments of the site include linking the site www.youthhealthtalk.org, a Web site that contains videotaped interviews with young people who have a variety other health concerns.

The Use of Protein Markers to Pinpoint Predation Events

USDA-ARS?s Scientific Manuscript database

Identifying the feeding choices and amount of prey consumed by generalist predators is difficult. Often the only evidence of arthropod predation is in the stomach contents of predators. Currently, the state-of-the-art predator stomach content assays include prey-specific enzyme-linked immunosorbent...

Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang).

PubMed

Yang, Yingxin; Ma, Qiu-Yan; Yang, Yue; He, Yu-Peng; Ma, Chao-Ting; Li, Qiang; Jin, Ming; Chen, Wei

2018-03-01

Primary open angle glaucoma (POAG) is a chronic, progressive optic neuropathy. The aim was to develop an evidence-based clinical practice guideline of Chinese herbal medicine (CHM) for POAG with focus on Chinese medicine pattern differentiation and treatment as well as approved herbal proprietary medicine. The guideline development group involved in various pieces of expertise in contents and methods. Authors searched electronic databases include CNKI, VIP, Sino-Med, Wanfang data, PubMed, the Cochrane Library, EMBASE, as well as checked China State Food and Drug Administration (SFDA) from the inception of these databases to June 30, 2015. Systematic reviews and randomized controlled trials of Chinese herbal medicine treating adults with POAG were evaluated. Risk of bias tool in the Cochrane Handbook and evidence strength developed by the GRADE group were applied for the evaluation, and recommendations were based on the findings incorporating evidence strength. After several rounds of Expert consensus, the final guideline was endorsed by relevant professional committees. CHM treatment principle and formulae based on pattern differentiation together with approved patent herbal medicines are the main treatments for POAG, and the diagnosis and treatment focusing on blood related patterns is the major domain. CHM therapy alone or combined with other conventional treatment reported in clinical studies together with Expert consensus were recommended for clinical practice.

Executive summary: evaluating the evidence base to support the inclusion of infants and children from birth to 24 mo of age in the Dietary Guidelines for Americans—“the B-24 Project”123

PubMed Central

Raghavan, Ramkripa; Porter, Alexandra; Obbagy, Julie E; Spahn, Joanne M

2014-01-01

The Dietary Guidelines for Americans (DGA) are the cornerstone of US government efforts to promote health and prevent disease through diet and nutrition. The DGA currently provides guidelines for ages ≥2 y. In an effort to determine the strength of the evidence to support the inclusion of infants and children from birth to age 24 mo, the partner agencies led by the Department of Health and Human Services Office of Disease Prevention and Health Promotion and the USDA Center for Nutrition Program and Policy initiated the project entitled “Evaluating the evidence base to support the inclusion of infants and children from birth to 24 months of age in the Dietary Guidelines for Americans—the B-24 Project.” This project represents the first step in the process of applying systematic reviews to the process of deciding whether the evidence is sufficient to include this age group in future editions of the DGA. This supplement includes the B-24 Executive Summary, which describes the B-24 Project and the deliberations of the 4 working groups during the process of developing priority topics for the systematic review, and a research agenda to address the critical gaps. Also included in this supplement issue is an article on the Nutrition Evidence Library methodology for developing systematic review questions and articles from the invited content presenters at the B-24 Prime meeting. PMID:24500158

Evaluation of the Evidence Base for the Alcohol Industry's Actions to Reduce Drink Driving Globally.

PubMed

Esser, Marissa B; Bao, James; Jernigan, David H; Hyder, Adnan A

2016-04-01

To evaluate the evidence base for the content of initiatives that the alcohol industry implemented to reduce drink driving from 1982 to May 2015. We systematically analyzed the content of 266 global initiatives that the alcohol industry has categorized as actions to reduce drink driving. Social aspects public relations organizations (i.e., organizations funded by the alcohol industry to handle issues that may be damaging to the business) sponsored the greatest proportion of the actions. Only 0.8% (n = 2) of the sampled industry actions were consistent with public health evidence of effectiveness for reducing drink driving. The vast majority of the alcohol industry's actions to reduce drink driving does not reflect public health evidenced-based recommendations, even though effective drink-driving countermeasures exist, such as a maximum blood alcohol concentration limit of 0.05 grams per deciliter for drivers and widespread use of sobriety checkpoints.

Position of the American Dietetic Association: functional foods.

PubMed

Hasler, Clare M; Brown, Amy C

2009-04-01

All foods are functional at some physiological level, but it is the position of the American Dietetic Association (ADA) that functional foods that include whole foods and fortified, enriched, or enhanced foods have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. ADA supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Health claims on food products, including functional foods, should be based on the significant scientific agreement standard of evidence and ADA supports label claims based on such strong scientific substantiation. Food and nutrition professionals will continue to work with the food industry, allied health professionals, the government, the scientific community, and the media to ensure that the public has accurate information regarding functional foods and thus should continue to educate themselves on this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from plant, animal, and microbial food sources, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk and health promotion. This position paper reviews the definition of functional foods, their regulation, and the scientific evidence supporting this evolving area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.

Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline.

PubMed

Lyman, Gary H; Greenlee, Heather; Bohlke, Kari; Bao, Ting; DeMichele, Angela M; Deng, Gary E; Fouladbakhsh, Judith M; Gil, Brigitte; Hershman, Dawn L; Mansfield, Sami; Mussallem, Dawn M; Mustian, Karen M; Price, Erin; Rafte, Susan; Cohen, Lorenzo

2018-06-11

Purpose The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement. Methods The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. Results The ASCO Expert Panel determined that the recommendations in the SIO guideline-published in 2017-are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points. Recommendations Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .

Comparative experimental investigation on the actuation mechanisms of ionic polymer–metal composites with different backbones and water contents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, Zicai; Chang, Longfei; Wang, Yanjie

2014-03-28

Water-based ionic polymer–metal composites (IPMCs) exhibit complex deformation properties, especially when the water content changes. To explore the general actuation mechanisms, both Nafion and Flemion membranes are used as the polymer backbones. IPMC deformation includes three stages: fast anode deformation, relaxation deformation, and slow anode deformation, which is mainly dependent on the water content and the backbone. When the water content decreases from 21 to 14 wt. %, Nafion–IPMC exhibits a large negative relaxation deformation, zero deformation, a positive relaxation deformation, and a positive steady deformation without relaxation in sequence. Despite the slow anode deformation, Flemion–IPMC also shows a slight relaxation deformation,more » which disappears when the water content is less than 13 wt. %. The different water states are investigated at different water contents using nuclear magnetic resonance spectroscopy. The free water, which decreases rapidly at the beginning through evaporation, is proven to be critical for relaxation deformation. For the backbone, indirect evidence from the steady current response is correlated with the slow anode deformation of Flemion-IPMC. The latter is explained by the secondary dissociation of the weak acid group –COOH. Finally, we thoroughly explain not only the three deformations by swelling but also their evolvement with decreasing water content. A fitting model is also presented based on a multi-diffusion equation to reveal the deformation processes more clearly, the results from which are in good agreement with the experimental results.« less

Development of a Guided Internet-based Psycho-education Intervention Using Cognitive Behavioral Therapy and Self-Management for Individuals with Chronic Pain.

PubMed

Perry, Jennifer; VanDenKerkhof, Elizabeth G; Wilson, Rosemary; Tripp, Dean A

2017-04-01

Evidence-based chronic pain treatment includes nonpharmacologic therapies. When addressing barriers to treatment, there is a need to deliver these therapies in a way that is accessible to all individuals who may benefit. To develop a guided Internet-based intervention for individuals with chronic pain, program content and sequence of evidence-based treatments for chronic pain, traditionally delivered via in-person sessions, were identified to be adapted for Internet delivery. With consideration to historical barriers to treatment, and through use of a concept map, therapeutic components and educational material were situated, in an ordered sequence, into six modules. An Internet-based chronic pain intervention was constructed to improve access to evidence-based chronic pain therapies. Research using this intervention, in the form of a pilot study for intervention refinement, was conducted, and a large-scale study to assess effectiveness is necessary prior to implementation. As clients may face barriers to multimodal treatment for chronic pain, nurses could introduce components of education, cognitive behavioral therapy and self-management to clients and prepare them for the "work" of managing chronic pain, through use of this Internet-based intervention. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

"People Can Go against the Government": Risk-Based Decision Making and High School Students' Concepts of Society

ERIC Educational Resources Information Center

Radakovic, Nenad

2015-01-01

Research in mathematics education stresses the importance of content knowledge in solving authentic tasks in statistics and in risk-based decision making. Existing research supports the claim that students rely on content knowledge and context expertise to make sense of data. In this article, however, I present evidence that the relationship…

Safety of soya-based infant formulas in children.

PubMed

Vandenplas, Yvan; Castrellon, Pedro Gutierrez; Rivas, Rodolfo; Gutiérrez, Carlos Jimenez; Garcia, Luisa Diaz; Jimenez, Juliana Estevez; Anzo, Anahi; Hegar, Badriul; Alarcon, Pedro

2014-04-28

Soya-based infant formulas (SIF) containing soya flour were introduced almost 100 years ago. Modern soya formulas are used in allergy/intolerance to cows' milk-based formulas (CMF), post-infectious diarrhoea, lactose intolerance and galactosaemia, as a vegan human milk (HM) substitute, etc. The safety of SIF is still debated. In the present study, we reviewed the safety of SIF in relation to anthropometric growth, bone health (bone mineral content), immunity, cognition, and reproductive and endocrine functions. The present review includes cross-sectional, case-control, cohort studies or clinical trials that were carried out in children fed SIF compared with those fed other types of infant formulas and that measured safety. The databases that were searched included PubMed (1909 to July 2013), Embase (1988 to May 2013), LILACS (1990 to May 2011), ARTEMISA (13th edition, December 2012), Cochrane controlled trials register, Bandolier and DARE using the Cochrane methodology. Wherever possible, a meta-analysis was carried out. We found that the anthropometric patterns of children fed SIF were similar to those of children fed CMF or HM. Despite the high levels of phytates and aluminium in SIF, Hb, serum protein, Zn and Ca concentrations and bone mineral content were found to be similar to those of children fed CMF or HM. We also found the levels of genistein and daidzein to be higher in children fed SIF; however, we did not find strong evidence of a negative effect on reproductive and endocrine functions. Immune measurements and neurocognitive parameters were similar in all the feeding groups. In conclusion, modern SIF are evidence-based safety options to feed children requiring them. The patterns of growth, bone health and metabolic, reproductive, endocrine, immune and neurological functions are similar to those observed in children fed CMF or HM.

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review1234

PubMed Central

Brimblecombe, Julie; Wycherley, Thomas Philip

2017-01-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. PMID:28298274

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review.

PubMed

Tonkin, Emma; Brimblecombe, Julie; Wycherley, Thomas Philip

2017-03-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. © 2017 American Society for Nutrition.

A Statistical Analysis of the PPII Propensity of Amino Acid Guests in Proline-Rich Peptides

PubMed Central

Moradi, Mahmoud; Babin, Volodymyr; Sagui, Celeste; Roland, Christopher

2011-01-01

There has been considerable debate about the intrinsic PPII propensity of amino-acid residues in denatured polypeptides. Experimentally, the propensity scale is based on the behavior of guest amino-acid residues placed in the middle of polyproline hosts. We have used classical molecular dynamics simulations, with state-of-the-art force fields to carry out a comprehensive analysis of the conformational equilibria of the proline-based host oligopeptides with single guests. The tracked structural characteristics include the PPII content, the cis/trans isomerization of the prolyl bonds, the puckering of the pyrrolidine rings of the proline residues, and the secondary structural motifs. We find no evidence for an intrinsic PPII propensity in any of the guest amino acids other than proline. Instead, the PPII content as derived from experiments may be explained in terms of: 1), a local correlation between the dihedral angles of the guest amino acid and the proline residue immediately preceding it; and 2), a nonlocal correlation between the cis/trans states of the peptide bonds. In terms of the latter, we find that the presence of a guest (other than proline, tyrosine, or tryptophan) increases the trans content of most of the prolyl bonds, which results in an effective increase of the peptide PPII content. With respect to the local dihedral correlations, we find that these are well described in terms of the so-called odds-ratio statistic. Expressed in terms of free energy language, the PPII content based on the odds-ratio of the relevant residues correlate well with the experimentally measured PPII content. PMID:21320454

The quality of instruments to assess the process of shared decision making: A systematic review

PubMed Central

Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

2018-01-01

Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations. PMID:29447193

A multidimensional approach to assessing intervention fidelity in a process evaluation of audit and feedback interventions to reduce unnecessary blood transfusions: a study protocol.

PubMed

Lorencatto, Fabiana; Gould, Natalie J; McIntyre, Stephen A; During, Camilla; Bird, Jon; Walwyn, Rebecca; Cicero, Robert; Glidewell, Liz; Hartley, Suzanne; Stanworth, Simon J; Foy, Robbie; Grimshaw, Jeremy M; Michie, Susan; Francis, Jill J

2016-12-12

In England, NHS Blood and Transplant conducts national audits of transfusion and provides feedback to hospitals to promote evidence-based practice. Audits demonstrate 20% of transfusions fall outside guidelines. The AFFINITIE programme (Development & Evaluation of Audit and Feedback INterventions to Increase evidence-based Transfusion practIcE) involves two linked, 2×2 factorial, cluster-randomised trials, each evaluating two theoretically-enhanced audit and feedback interventions to reduce unnecessary blood transfusions in UK hospitals. The first intervention concerns the content/format of feedback reports. The second aims to support hospital transfusion staff to plan their response to feedback and includes a web-based toolkit and telephone support. Interpretation of trials is enhanced by comprehensively assessing intervention fidelity. However, reviews demonstrate fidelity evaluations are often limited, typically only assessing whether interventions were delivered as intended. This protocol presents methods for assessing fidelity across five dimensions proposed by the Behaviour Change Consortium fidelity framework, including intervention designer-, provider- and recipient-levels. (1) Design: Intervention content will be specified in intervention manuals in terms of component behaviour change techniques (BCTs). Treatment differentiation will be examined by comparing BCTs across intervention/standard practice, noting the proportion of unique/convergent BCTs. (2) Training: draft feedback reports and audio-recorded role-play telephone support scenarios will be content analysed to assess intervention providers' competence to deliver manual-specified BCTs. (3) Delivery: intervention materials (feedback reports, toolkit) and audio-recorded telephone support session transcripts will be content analysed to assess actual delivery of manual-specified BCTs during the intervention period. (4) Receipt and (5) enactment: questionnaires, semi-structured interviews based on the Theoretical Domains Framework, and objective web-analytics data (report downloads, toolkit usage patterns) will be analysed to assess hospital transfusion staff exposure to, understanding and enactment of the interventions, and to identify contextual barriers/enablers to implementation. Associations between observed fidelity and trial outcomes (% unnecessary transfusions) will be examined using mediation analyses. If the interventions have acceptable fidelity, then results of the AFFINITIE trials can be attributed to effectiveness, or lack of effectiveness, of the interventions. Hence, this comprehensive assessment of fidelity will be used to interpret trial findings. These methods may inform fidelity assessments in future trials. ISRCTN 15490813 . Registered 11/03/2015.

Quality of web-based information on social phobia: a cross-sectional study.

PubMed

Khazaal, Yasser; Fernandez, Sebastien; Cochand, Sophie; Reboh, Isabel; Zullino, Daniele

2008-01-01

The objective of the study is to evaluate the quality of web-based information on social phobia and to investigate particular quality indicators. Two keywords, "Social phobia" and "Social Anxiety Disorder", were entered into five popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. "Health On the Net" (HON) quality label and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. This study evaluates the quality of web-based information on social phobia. On the 200 identified links, 58 were included. On the basis of outcome measures, the overall quality of the sites turned out to be poor. DISCERN and HON label were indicators of good quality indicators. Accountability criteria were poor indicators of site quality. Although social phobia education Websites for patients are common, educational material highly varies in quality and content. There is a need for better evidence-based information about social phobia on the Web and a need to reconsider the role of accountability criteria as indicators of site quality. Clinicians should advise patients of the HON label and DISCERN as useful indicators of site quality. (c) 2007 Wiley-Liss, Inc.

Stress Management Apps With Regard to Emotion-Focused Coping and Behavior Change Techniques: A Content Analysis

PubMed Central

Hoffmann, Alexandra; Bleser, Gabriele

2017-01-01

Background Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. Objective The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Methods Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. Results The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). Conclusions The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. PMID:28232299

Cover-Copy-Compare: A Method for Enhancing Evidence-Based Instruction

ERIC Educational Resources Information Center

Konrad, Moira; Joseph, Laurice M.

2014-01-01

Cover-copy-compare is a practical, low-cost, effective strategy for teachers to add to their repertoires of evidence-based practices. This article describes the cover-copy-compare strategy and how it can be applied to teach both self-management and basic academic skills. A variety of ways this strategy can be used across content areas are…

Through the looking glass of a chemistry video game: Evaluating the effects of different MLEs presenting identical content material

NASA Astrophysics Data System (ADS)

Hillman, Dustin S.

The primary goal of this study is to evaluate the effects of different media-based learning environments (MLEs) that present identical chemistry content material. This is done with four different MLEs that utilize some or all components of a chemistry-based media-based prototype video game. Examination of general chemistry student volunteers purposefully randomized to one of four different MLEs did not provide evidence that the higher the level of interactivity resulted in a more effective MLE for the chemistry content. Data suggested that the cognitive load to play the chemistry-based video game may impaired the chemistry content being presented and recalled by the students while the students watching the movie of the chemistry-based video game were able to recall the chemistry content more efficiently. Further studies in this area need to address the overall cognitive load of the different MLEs to potentially better determine what the most effective MLE may be for this chemistry content.

EBMPracticeNet: A Bilingual National Electronic Point-Of-Care Project for Retrieval of Evidence-Based Clinical Guideline Information and Decision Support

PubMed Central

2013-01-01

Background In Belgium, the construction of a national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, health care providers, evidence-based medicine (EBM) partners, and vendors of electronic health records (EHR) is unique to this project. All Belgian health care professionals get free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides EBM information from other sources than guidelines, including computerized clinical decision support that is integrated in the EHRs. Objective The objective of this paper was to describe the development strategy, the overall content, and the management of EBMPracticeNet which may be of relevance to other health organizations creating national or regional electronic point-of-care information services. Methods Several candidate providers of comprehensive guideline solutions were evaluated and one database was selected. Translation of the guidelines to Dutch and French was done with translation software, post-editing by translators and medical proofreading. A strategy is determined to adapt the guideline content to the Belgian context. Acceptance of the computerized clinical decision support tool has been tested and a randomized controlled trial is planned to evaluate the effect on process and patient outcomes. Results Currently, EBMPracticeNet is in "work in progress" state. Reference is made to the results of a pilot study and to further planned research including a randomized controlled trial. Conclusions The collaboration of government, health care providers, EBM partners, and vendors of EHRs is unique. The potential value of the project is great. The link between all the EHRs from different vendors and a national database held on a single platform that is controlled by all EBM organizations in Belgium are the strengths of EBMPracticeNet. PMID:23842038

‘Toning’ up hypotonia assessment: A proposal and critique

PubMed Central

Joubert, Robin W.E.

2016-01-01

Background Clinical assessment of hypotonia is challenging due to the subjective nature of the initial clinical evaluation. This poses dilemmas for practitioners in gaining accuracy, given that the presentation of hypotonia can be either a non-threatening or malevolent sign. The research question posed was how clinical assessment can be improved, given the current contentions expressed in the scientific literature. Objectives This paper describes the development and critique of a clinical algorithm to aid the assessment of hypotonia. Methods An initial exploratory sequential phase, consisting of a systematic review, a survey amongst clinicians and a Delphi process, assisted in the development of the algorithm, which is presented within the framework of the International Classification of Functioning, Disability and Health. The ensuing critique followed a qualitative emergent–systematic focus group design with a purposive sample of 59 clinicians. Data were analysed using semantical content analysis and are presented thematically with analytical considerations. Results This study culminated in the development of an evidence-based clinical algorithm for practice. The qualitative critique of the algorithm considered aspects such as inadequacies, misconceptions and omissions; strengths; clinical use; resource implications; and recommendations. Conclusions The first prototype and critique of a clinical algorithm to assist the clinical assessment of hypotonia in children has been described. Barriers highlighted include aspects related to knowledge gaps of clinicians, issues around user-friendliness and formatting concerns. Strengths identified by the critique included aspects related to the evidence-based nature of the criteria within the algorithm, the suitability of the algorithm in being merged or extending current practice, the potential of the algorithm in aiding more accurate decision-making, the suitability of the algorithm across age groups and the logical flow. These findings provide a starting point towards ascertaining the clinical utility of the algorithm as an essential step towards evidence-based praxis. PMID:28730054

Chemistry Vocabulary Attainment among Higher Secondary Students

ERIC Educational Resources Information Center

Gafoor, K. Abdul; Greeshma, K.

2014-01-01

In the context of growing empirical evidence to lack of clear understanding of the language of the science content, undesirable student outcomes including difficulty in learning science and a lack of interest with their science content area, and chemistry being particularly loaded with specialized terminology of its own, this study analyzed the…

Comparison of child obesity prevention and control content in mainstream and Spanish-language US parenting magazines.

PubMed

Kalin, Sari R; Fung, Teresa T

2013-01-01

Mass media coverage of child obesity is rising, paralleling the child obesity epidemic's growth, and there is evidence that parents seek parenting advice from media sources. Yet little to no research has examined the coverage of child obesity in parenting magazines or Spanish-language media. The purpose of this study was to use qualitative and quantitative content analysis methods to identify, quantify, and compare strategies for child obesity prevention and control presented in mainstream and Spanish-language US parenting magazines. Child obesity-related editorial content in 68 mainstream and 20 Spanish-language magazine issues published over 32 months was gathered. Magazine content was coded with a manual developed by refining themes from the sample and from an evidence-based child obesity prevention action plan. Seventy-three articles related to child obesity prevention and control were identified. Most focused on parental behavior change rather than environmental change, and only 3 in 10 articles referred to the social context in which parental behavior change takes place. Child obesity-focused articles were not given high prominence; only one in four articles in the entire sample referred to child obesity as a growing problem or epidemic. Key differences between genres reflect culturally important Latino themes, including family focus and changing health beliefs around child weight status. Given mass media's potential influence on parenting practices and public perceptions, nutrition communication professionals and registered dietitians need to work to reframe media coverage of childhood obesity as an environmental problem that requires broad-based policy solutions. Spanish-speaking media can be an ally in helping Latina women change cultural health beliefs around child weight status. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study.

PubMed

Jack, Susan M; Dobbins, Maureen; Sword, Wendy; Novotna, Gabriela; Brooks, Sandy; Lipman, Ellen L; Niccols, Alison

2011-11-07

Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions.

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

PubMed Central

2011-01-01

Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions. PMID:22059528

[Approach to Evidence-based Medicine Exercises Using Flipped Teaching: Introductory Education for Clinical Practice for 4th-Year Pharmacy Students].

PubMed

Onda, Mitsuko; Takagaki, Nobumasa

2018-01-01

　Osaka University of Pharmaceutical Sciences has included an evidence-based medicine (EBM) exercise in the introductory education for clinical practice for 4th-year pharmacy students since 2015. The purpose of this exercise is to learn the process of practice and basic concepts of EBM, especially to cultivate the practical ability to solve patients' problems and answer their questions. Additionally, in 2016, we have attempted flipped teaching. The students are instructed to review the basic knowledge necessary for active learning in this exercise by watching video teaching materials and to bring reports summarizing the contents on the flipped teaching days. The program includes short lectures [overview of EBM, document retrieval, randomized controlled trials (RCTs), and systematic review], exercises [patient, intervention, comparison, outcome (PICO) structuring, critical appraisal of papers in small groups with tutors], and presentations. The program includes: step 1, PICO structuring based on scenarios; step 2, critical appraisal of English-language papers on RCTs using evaluation worksheets; and step 3, reviewing the results of the PICO exercise with patients. The results of the review are shared among groups through general discussion. In this symposium, I discuss students' attitudes, the effectiveness of small group discussions using flipped teaching, and future challenges to be addressed in this program.

Increase in the Stratospheric NO2 Content Derived from Results of Ground-Based Observations after the October 2003 Solar Proton Event

NASA Astrophysics Data System (ADS)

Ageyeva, V. Yu.; Gruzdev, A. N.; Elokhov, A. S.

2018-04-01

This paper reports on the first experimental evidence of the impact of a solar proton event on the stratospheric NO2 content derived from ground-based spectrometric measurements at middle and high latitudes of the Northern Hemisphere. In October 2003, a solar proton event caused an increase in the NO2 content in the upper stratosphere by 0.6 × 1015 cm-2, which accounted for about one-third of the increase in the column NO2 content. Solar proton events may be an essential factor for variability of the column NO2 content in the atmosphere of the high and middle latitudes.

Is Project Based Learning More Effective than Direct Instruction in School Science Classrooms? An Analysis of the Empirical Research Evidence

NASA Astrophysics Data System (ADS)

Dann, Clifford

An increasingly loud call by parents, school administrators, teachers, and even business leaders for "authentic learning", emphasizing both group-work and problem solving, has led to growing enthusiasm for inquiry-based learning over the past decade. Although "inquiry" can be defined in many ways, a curriculum called "project-based learning" has recently emerged as the inquiry practice-of-choice with roots in the educational constructivism that emerged in the mid-twentieth century. Often, project-based learning is framed as an alternative instructional strategy to direct instruction for maximizing student content knowledge. This study investigates the empirical evidence for such a comparison while also evaluating the overall quality of the available studies in the light of accepted standards for educational research. Specifically, this thesis investigates what the body of quantitative research says about the efficacy of project-based learning vs. direct instruction when considering student acquisition of content knowledge in science classrooms. Further, existing limitations of the research pertaining to project based learning and secondary school education are explored. The thesis concludes with a discussion of where and how we should focus our empirical efforts in the future. The research revealed that the available empirical research contains flaws in both design and instrumentation. In particular, randomization is poor amongst all the studies considered. The empirical evidence indicates that project-based learning curricula improved student content knowledge but that, while the results were statistically significant, increases in raw test scores were marginal.

Learning About Semi Conductors for Teaching—the Role Played by Content Knowledge in Pedagogical Content Knowledge (PCK) Development

NASA Astrophysics Data System (ADS)

Rollnick, Marissa

2017-08-01

This study focuses on how teachers learn to teach a new topic and the role played by their developing content knowledge as they teach. The paper is based on seven high school science teachers' studies on the teaching of semiconductors, at the time a new topic in the curriculum. Analysis of artefacts such as teacher concept maps, video recordings of lessons, journals and other classroom-based evidence shows how the extent and type of teachers' content knowledge informed their choice of teaching approaches and how their learning of content took place alongside the development of teaching strategies. The development of content knowledge was combined with increased understanding of how to teach the topic in almost all cases. Evidence of development of teachers' PCK was found in their increased ability to design teaching strategies, and their use of representations and suitable assessment tasks for their lessons. Some specific common teaching strategies were identified across the teachers. These strategies could add to the canon of teachers' topic - specific professional knowledge for semiconductors. The study provides increased understanding of how teachers simultaneously master content and its teaching and how mediated self-reflection is a fruitful approach for assisting teachers to learn to teach a new topic.

Infant teething information on the world wide web: taking a byte out of the search.

PubMed

Kozuch, Mary; Peacock, Erica; D'Auria, Jennifer P

2015-01-01

The purpose of this study was to describe and evaluate the quality of infant teething information on selected popular parenting Web sites. Two checklists were used to evaluate the quality of the 16 parenting sites and infant teething-specific content included on each site. Three of the 16 parenting sites did not contain teething-specific articles. Teething-specific content found on 13 of the 16 sites supported a connection between the process of teething and nonspecific symptoms with a perception that management is required. Popular management strategies included chewing on chilled objects, gingival massage, and the use of over-the-counter medications. Information about possible adverse effects of administering medications for infant teething was not found on the majority of sites. Eleven of the 16 sites advised parents to contact their primary care provider if they were uncertain about management for infant teething or whether the symptoms were related to illness. Although infant teething has an evidence base from which parents and professionals can make safe decisions about symptoms and treatment, translating the evidence into professional practice and health-related information on the Internet remains a challenge. Parents and pediatric health providers would benefit greatly from the development of clinical practice guidelines summarizing our present-day understanding of teething symptoms and the limited evidence supporting the use of over-the-counter medications. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

The development and validation of the core competencies scale (CCS) for the college and university students.

PubMed

Ruan, Bin; Mok, Magdalena Mo Ching; Edginton, Christopher R; Chin, Ming Kai

2012-01-01

This article describes the development and validation of the Core Competencies Scale (CCS) using Bok's (2006) competency framework for undergraduate education. The framework included: communication, critical thinking, character development, citizenship, diversity, global understanding, widening of interest, and career and vocational development. The sample comprised 70 college and university students. Results of analysis using Rasch rating scale modelling showed that there was strong empirical evidence on the validity of the measures in contents, structure, interpretation, generalizability, and response options of the CCS scale. The implication of having developed Rasch-based valid and dependable measures in this study for gauging the value added of college and university education to their students is that the feedback generated from CCS will enable evidence-based decision and policy making to be implemented and strategized. Further, program effectiveness can be measured and thus accountability on the achievement of the program objectives.

Smoking and Male Infertility: An Evidence-Based Review

PubMed Central

Harlev, Avi; Gunes, Sezgin Ozgur; Shetty, Amit; du Plessis, Stefan Simon

2015-01-01

Many studies have reported that the contents of cigarette smoke negatively affect sperm parameters, seminal plasma, and various other fertility factors. Nevertheless, the actual effect of smoking on male fertility is not clear. The effect of smoking on semen parameters is based on the well-established biological finding that smoking increases the presence of reactive oxygen species, thereby resulting in oxidative stress (OS). OS has devastating effects on sperm parameters, such as viability and morphology, and impairs sperm function, hence reducing male fertility. However, not all studies have come to the same conclusions. This review sheds light upon the arguable association between smoking and male fertility and also assesses the impact of non-smoking routes of tobacco consumption on male infertility. It also highlights the evidence that links smoking with male infertility, including newly emerging genetic and epigenetic data, and discusses the clinical implications thereof. PMID:26770934

Content validation of terms and definitions in a wound glossary.

PubMed

Milne, Catherine T; Paine, Tim; Sullivan, Valerie; Sawyer, Allen

2011-12-01

A common language and lexicon provide the easiest means of mutual understanding. Inconsistency in terminology makes effective information exchange difficult. Previous studies identified the need to determine standard, accepted definitions for the vocabulary frequently used in wound care. The objective of this study was to establish content validation for these terms and develop an evidence-based glossary for this specialty. Members of the Association for the Advancement of Wound Care Quality of Care Task Force reviewed literature to determine glossary content generation and the associated literature-based definitions. Thirty-nine wound care professionals from wound care stakeholder professional organizations in the United States and Canada participated in the content validation process. Participants were asked to quantify the degree of validity using a 367-item, 4-point Likert-type scale. On a scale of 1 to 4, the mean score of the entire instrument was 3.84. The instrument's overall scale content validity index was 0.96. Terms with an item content validity index of less than 0.70 were removed from the glossary, leaving 365 items with established content validity. Qualitative data analysis revealed themes suggesting that enhanced communication between providers improves patient outcomes. The need for ongoing updates of the glossary was also identified. The wound care glossary in its finalized form proved valid. An evidence-based glossary bridges the chasm of miscommunication and nonstandardization so that wound care, as an emerging specialized medical science field, can move forward to optimize both process and clinical outcomes.

A systematic review of three approaches for constructing physical activity messages: What messages work and what improvements are needed?

PubMed Central

2010-01-01

Background To motivate individuals to adhere to a regular physical activity regime, guidelines must be supplemented with persuasive messages that are disseminated widely. While substantial research has examined effective strategies for disseminating physical activity messages, there has been no systematic effort to examine optimal message content. This paper reviews studies that evaluate the effectiveness of three approaches for constructing physical activity messages including tailoring messages to suit individual characteristics of message recipients (message tailoring), framing messages in terms of gains versus losses (message framing), and targeting messages to affect change in self-efficacy (i.e., a theoretical determinant of behavior change). Methods We searched the MEDLINE, PsycINFO, EMBASE and CINAHL databases up to July 2008. Relevant reference lists also were searched. We included intervention trials, field experiments, and laboratory-based studies that aimed to test the efficacy or effectiveness of tailored messages, framed messages and self-efficacy change messages among healthy adults. We used a descriptive approach to analyze emerging patterns in research findings. Based on this evidence we made recommendations for practice and future research. Results Twenty-two studies were identified. Twelve studies evaluated message tailoring. In 10 of these studies, tailored messages resulted in greater physical activity than a control message. Six studies evaluated framed messages. Five of these studies demonstrated that gain-framed messages lead to stronger intentions to be active compared to a control message. Moreover, a gain-frame advantage was evident in three of the four studies that assessed physical activity. Four studies evaluated self-efficacy change messages. The two studies that used an experimental design provide a clear indication that individuals' beliefs can be affected by messages that incorporate types of information known to be determinants of self-efficacy. Overall, strong evidence to support definitive recommendations for optimal message content and structure was lacking. Conclusions Additional research testing the optimal content of messages used to supplement physical activity guidelines is needed. Tailored messages, gain-framed messages, and self-efficacy change messages hold promise as strategies for constructing physical activity messages and should be a focus of future research. PMID:20459779

Connecting Education to Quality: Engaging Medical Students in the Development of Evidence-Based Clinical Decision Support Tools.

PubMed

Crabtree, Elizabeth A; Brennan, Emily; Davis, Amanda; Squires, Jerry E

2017-01-01

Evidence-based practice (EBP) skills are crucial for delivering high-quality patient care. It is essential that medical students learn EBP concepts through a practical, in-depth research project. To date, literature on preparing students in this manner is limited. In academic year 2014-2015, the Medical University of South Carolina's (MUSC's) Center for Evidence-Based Practice (now known as the Value Institute) partnered with College of Medicine faculty to revitalize the undergraduate medical student EBP curriculum. Without adding to the number of the lecture hours, the curriculum was restructured to be more process driven, project based, and clinically relevant. The resulting yearlong EBP course partnered small teams of medical students with interprofessional clinical teams to engage the students in developing evidence-based clinical decision support tools. The content developed during the EBP projects is currently being used to develop evidence-based clinical practice guidelines and accompanying order sets. It is likely that this model will serve as a new framework for guideline development and will greatly expand the breadth of evidence-based content currently produced and available for clinicians at the MUSC. It would be feasible to offer a similar course within the MUSC to other disciplines and colleges, or at other institutions, if there were support from administration, interest on the part of clinicians and medical faculty, and individuals with the required expertise available to develop the curriculum and facilitate the course. It is worth considering how to improve the course and evaluating opportunities to implement it within other settings.

Process-oriented guided-inquiry learning: a natural fit for occupational therapy education.

PubMed

Jaffe, Lynn; Gibson, Robert; D'Amico, Mariana

2015-04-01

After a brief review of the major group cooperative learning strategies, this article presents the format and use of Process-Oriented Guided-Inquiry Learning (POGIL) as a recommended teaching strategy for occupational therapy classes. This recommendation is based upon evidence of effectiveness of this strategy for enhancing critical thinking, content retention, and teamwork. Strategies for learning the process and suggestions for its use are based upon literature evidence and the authors' experiences with this strategy over 4 years in a class on evidence-based practice.

Developing and using a rubric for evaluating evidence-based medicine point-of-care tools.

PubMed

Shurtz, Suzanne; Foster, Margaret J

2011-07-01

The research sought to establish a rubric for evaluating evidence-based medicine (EBM) point-of-care tools in a health sciences library. The authors searched the literature for EBM tool evaluations and found that most previous reviews were designed to evaluate the ability of an EBM tool to answer a clinical question. The researchers' goal was to develop and complete rubrics for assessing these tools based on criteria for a general evaluation of tools (reviewing content, search options, quality control, and grading) and criteria for an evaluation of clinical summaries (searching tools for treatments of common diagnoses and evaluating summaries for quality control). Differences between EBM tools' options, content coverage, and usability were minimal. However, the products' methods for locating and grading evidence varied widely in transparency and process. As EBM tools are constantly updating and evolving, evaluation of these tools needs to be conducted frequently. Standards for evaluating EBM tools need to be established, with one method being the use of objective rubrics. In addition, EBM tools need to provide more information about authorship, reviewers, methods for evidence collection, and grading system employed.

Examining the use of evidence-based and social media supported tools in freely accessible physical activity intervention websites.

PubMed

Vandelanotte, Corneel; Kirwan, Morwenna; Rebar, Amanda; Alley, Stephanie; Short, Camille; Fallon, Luke; Buzza, Gavin; Schoeppe, Stephanie; Maher, Carol; Duncan, Mitch J

2014-08-17

It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evidence-based behavior change techniques and provide social media applications. In 2013, a systematic search strategy examined 750 websites. Data was extracted on a wide range of variables (e.g. self-monitoring, goal setting, and social media applications). To evaluate website quality a new tool, comprising three sub-scores (Behavioral Components, Interactivity and User Generated Content), was developed to assess implementation of behavior change techniques and social media applications. An overall website quality scored was obtained by summing the three sub-scores. Forty-six publicly available websites were included in the study. The use of self-monitoring (54.3%), goal setting (41.3%) and provision of feedback (46%) was relatively low given the amount of evidence supporting these features. Whereas the presence of features allowing users to generate content (73.9%), and social media components (Facebook (65.2%), Twitter (47.8%), YouTube (48.7%), smartphone applications (34.8%)) was relatively high considering their innovative and untested nature. Nearly all websites applied some behavioral and social media applications. The average Behavioral Components score was 3.45 (±2.53) out of 10. The average Interactivity score was 3.57 (±2.16) out of 10. The average User Generated Content Score was 4.02 (±2.77) out of 10. The average overall website quality score was 11.04 (±6.92) out of 30. Four websites (8.7%) were classified as high quality, 12 websites (26.1%) were classified as moderate quality, and 30 websites (65.2%) were classified as low quality. Despite large developments in Internet technology and growth in the knowledge of how to develop more effective web-based interventions, overall website quality was low and the majority of freely available physical activity websites lack the components associated with behavior change. However, the results show that website quality can be improved by taking a number of simple steps, and the presence of social media applications in most websites is encouraging.

Clinical effectiveness of garlic (Allium sativum).

PubMed

Pittler, Max H; Ernst, Edzard

2007-11-01

The objective of this review is to update and assess the clinical evidence based on rigorous trials of the effectiveness of garlic (A. sativum). Systematic searches were carried out in Medline, Embase, Amed, the Cochrane Database of Systematic Reviews, Natural Standard, and the Natural Medicines Comprehensive Database (search date December 2006). Our own files, the bibliographies of relevant papers and the contents pages of all issues of the review journal FACT were searched for further studies. No language restrictions were imposed. To be included, trials were required to state that they were randomized and double blind. Systematic reviews and meta-analyses of garlic were included if based on the results of randomized, double-blind trials. The literature searches identified six relevant systematic reviews and meta-analysis and double-blind randomized trials (RCT) that were published subsequently. These relate to cancer, common cold, hypercholesterolemia, hypertension, peripheral arterial disease and pre-eclampsia. The evidence based on rigorous clinical trials of garlic is not convincing. For hypercholesterolemia, the reported effects are small and may therefore not be of clinical relevance. For reducing blood pressure, few studies are available and the reported effects are too small to be clinically meaningful. For all other conditions not enough data are available for clinical recommendations.

Translation of an Evidence-Based Tailored Childhood Injury Prevention Program

PubMed Central

Weaver, Nancy L.; Williams, Janice; Jacobsen, Heather A.; Botello-Harbaum, Maria; Glasheen, Cristie; Noelcke, Elizabeth; Nansel, Tonja R.

2008-01-01

This article describes the process of translating Safe n’ Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n’ Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n’ Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n’ Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed. PMID:18287925

The Impact of Electronic Knowledge-Based Nursing Content and Decision-Support on Nursing-Sensitive Patient Outcomes

DTIC Science & Technology

2016-02-01

other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a ...Based Nursing (KBN) innovation, a customized design featuring actionable EB recommendations embedded into policy and the content and CDS tools in the...will have a positive effect on nursing knowledge, use of evidence-based practices, and the achievement of nurse-sensitive patient outcomes at

Improving Student Learning via Mobile Phone Video Content: Evidence from the BridgeIT India Project

ERIC Educational Resources Information Center

Wennersten, Matthew; Quraishy, Zubeeda Banu; Velamuri, Malathi

2015-01-01

Past efforts invested in computer-based education technology interventions have generated little evidence of affordable success at scale. This paper presents the results of a mobile phone-based intervention conducted in the Indian states of Andhra Pradesh and Tamil Nadu in 2012-13. The BridgeIT project provided a pool of audio-visual learning…

Systematic reviews of physical and rehabilitation medicine Cochrane contents. Part 1. Disabilities due to spinal disorders and pain syndromes in adults.

PubMed

Negrini, S; Imperio, G; Villafañe, J H; Negrini, F; Zaina, F

2013-08-01

This article is the first in a series presenting the strongest published evidence for physical and rehabilitation medicine (PRM) to date coming from the Cochrane Collaboration. The intent of the series is to stimulate ideas for reviews and research in neglected areas of PRM. To systematically review the rehabilitation contents of the Cochrane Collaboration on disabilities due to spinal disorders or pain syndromes in adults. The Cochrane Database of Systematic Reviews was searched at the end of June 2013 for articles relevant for PRM about disabilities resulting from spinal disorders or pain syndromes in adults. Retrieved papers were classified according to the PRM approach: active therapies, which require active participation by patients to achieve treatment goals, and passive treatments, which rely on the application of external forces. The quality of the reviews was checked against the AMSTAR checklist. Reviews on spinal disorders or pain syndromes were found in the Cochrane Back Group (CBG) and in the Pain, Palliative and Supportive Care Group (CPPSCG). Thirty-eight (42.8%) of 89 Cochrane reviews in the CBG and 7 (2.4%) of 293 Cochrane reviews in the CPPSCG were included. All were of high quality (range, 8-11 points out of 11 on the AMSTAR checklist). The contents of the reviews are given in detail. This review presents an overview of the current evidence for PRM in the treatment of disabilities due to spinal disorders or pain syndromes in adults. Within PRM there is ample space for research in the Cochrane Collaboration and for producing original studies (randomized controlled trials [RCTs]). To apply evidence-based clinical practice, clinicians must be familiar with the current best evidence.

Community-Based Participatory Research in an Obesity Prevention Media Campaign for Mexican Americans: Tu Salud ¡Si Cuenta!

PubMed Central

Reininger, Belinda M.; Barroso, Cristina S.; Mitchell-Bennett, Lisa; Cantu, Ethel; Fernandez, Maria E.; Gonzalez, Dora Alicia; Chavez, Marge; Freeberg, Diamantina; McAlister, Alfred

2009-01-01

Background and Methods To address obesity and related morbidities, community-based participatory research (CBPR) strategies were employed to design / evaluate a Spanish language media campaign promoting physical activity and healthful food choices among Mexican Americans. Qualitative evaluation strategies including content analyses on types and focus of media messages were conducted. Focus groups assessed appeal and trustworthiness of messages. Results All media campaign products feature role models and experts. Campaign messages primarily (98%) appear in TV morning show segments. Newsletters present individual and family role model stories. Majority of newsletters (68%) are distributed through churches and “promotora” outreach efforts. Conclusions CBPR lends itself to the selection and tailoring of evidence-based media campaigns. Moreover, CBPR guidance resulted in media messages that are credible and appealing to audience. Process evaluation strategies that gather information from the community provide solid evidence for how to modify the campaign to best meet audience expectations. PMID:19131541

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

PubMed

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

2017-06-01

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

[The added value of information summaries supporting clinical decisions at the point-of-care.

PubMed

Banzi, Rita; González-Lorenzo, Marien; Kwag, Koren Hyogene; Bonovas, Stefanos; Moja, Lorenzo

2016-11-01

Evidence-based healthcare requires the integration of the best research evidence with clinical expertise and patients' values. International publishers are developing evidence-based information services and resources designed to overcome the difficulties in retrieving, assessing and updating medical information as well as to facilitate a rapid access to valid clinical knowledge. Point-of-care information summaries are defined as web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. Their validity must be assessed against marketing claims that they are evidence-based. We periodically evaluate the content development processes of several international point-of-care information summaries. The number of these products has increased along with their quality. The last analysis done in 2014 identified 26 products and found that three of them (Best Practice, Dynamed e Uptodate) scored the highest across all evaluated dimensions (volume, quality of the editorial process and evidence-based methodology). Point-of-care information summaries as stand-alone products or integrated with other systems, are gaining ground to support clinical decisions. The choice of one product over another depends both on the properties of the service and the preference of users. However, even the most innovative information system must rely on transparent and valid contents. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

Social media use by patients with glaucoma: what can we learn?

PubMed

McGregor, Freia; Somner, John E A; Bourne, Rupert R; Munn-Giddings, Carol; Shah, Peter; Cross, Vinette

2014-01-01

Much health-related information is available on the internet but its quality is known to be variable. This research aimed to analyse the ophthalmic content of social media platforms which has yet to be formally assessed. Five online social media platforms were selected, the International Glaucoma Association (IGA) forum, Facebook, Twitter, YouTube and Patient Opinion.org.uk. A total of 3785 items were scraped from the sites, collated and analysed using simple thematic analysis by two coders. Fourteen themes were identified. The most commonly discussed topics included treatments, care experiences, promotions and support. Un-moderated sites contain more misleading information. Complementary therapies and treatments with a poor evidence base are presented more positively than established, evidence-based treatments. Online forums give patients a space to air questions, grievances, suggestions and to provide mutual support. The information they contain may be of use to physicians by flagging adverse drug reactions, areas for service improvement or topics about which patients require more information. There is a risk of exposure to misleading content which is heightened in un-moderated sites. Social media platforms may be an adjunct to current care models by providing a supportive and educational online community if these risks are understood. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

Use of clinical guidelines in remote Australia: A realist evaluation.

PubMed

Reddy, Sandeep; Orpin, Victoria; Herring, Sally; Mackie-Schneider, Stephanie; Struber, Janet

2018-02-01

The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory. Many remote health practitioners have adopted standardized, evidence-based practice because of the use of the RPHCM. The mechanisms that led to the use of the manuals include acceptance of the worth of the protocols to their clinical practice, reliance on manual content to guide their practice, the perception of credibility, the applicability of RPHCM content to the context, and a fear of the consequences of not using the RPHCMs. Some remote health practitioners are less inclined to use the RPHCM regularly because of a perception that the content is less suited to their needs and daily practice or it is hard to navigate or understand. The evaluation concluded that there is work to be done to widen the RPHCM user base, and organizations need to increase support for their staff to use the RPHCM protocols better. These measures are expected to enable standardized clinical practice in the remote context. © 2017 John Wiley & Sons, Ltd.

Evaluating the content of Individualized Education Programs and 504 Plans of young adolescents with attention deficit/hyperactivity disorder.

PubMed

Spiel, Craig F; Evans, Steven W; Langberg, Joshua M

2014-12-01

The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with attention deficit/hyperactivity disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of students' present level of academic achievement and functional performance (PLAAFP) and targeted in the students' measurable annual goals and objectives (MAGOs). In addition, we compared services with lists of recommended services provided by the U.S. Department of Education (ED) and reviews of evidence-based practices. Participants were 97 middle school students with ADHD, 61.9% with an IEP, and 38.1% with a 504 Plan. Most (85%) IEP PLAAFP statements described nonacademic/behavior problems, but fewer than half had MAGOs targeting these areas of need. Services listed on IEPs and Section 504 Plans were frequently consistent with ED recommendations, but had little to no research supporting their effectiveness. In addition, services with evidence supporting benefit to students with ADHD were rarely included on IEPs or 504 Plans. Implications for special education policy and future directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Lewin's Theory of Planned Change as a strategic resource.

PubMed

Shirey, Maria R

2013-02-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author explores the use of the Lewin's Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with a discussion of its strengths, limitations, and targeted application.

Stakeholder analysis and mapping as targeted communication strategy.

PubMed

Shirey, Maria R

2012-09-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author highlights the importance of stakeholder theory and discusses how to apply the theory to conduct a stakeholder analysis. This article also provides an explanation of how to use related stakeholder mapping techniques with targeted communication strategies.

Developing an interministerial substance use response strategy for Lebanon: process, content and lessons learned.

PubMed

Hajal, Sandra; Kik, Nour; El Chammay, Rabih; Ammar, Walid

2017-05-01

Evidence on substance use in Lebanon shows an increase in usage, limited availability and accessibility to evidence-based services, and high level of stigma and discrimination. In line with the "Mental Health and Substance Use Strategy for Lebanon 2015-2020", the Ministry of Public Health initiated the process of developing a strategy focused on substance use response to address these challenges in collaboration with the Ministries of Education and Higher Education, Interior and Municipalities, Justice and Social Affairs. The result of this process was a strategy launched jointly by the ministries including six domains of action covering the whole spectrum of substance use response with strategic objectives addressing the challenges identified through stakeholders' consultations. The following key principles adopted throughout the process contributed to the successful development of the strategy: building on evidence and international frameworks, maximizing the participation of all stakeholders, prioritising national consensus, maintaining flexibility and maximizing transparency.

Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang)

PubMed Central

Yang, Yingxin; Ma, Qiu-yan; Yang, Yue; He, Yu-peng; Ma, Chao-ting; Li, Qiang; Jin, Ming; Chen, Wei

2018-01-01

Abstract Background: Primary open angle glaucoma (POAG) is a chronic, progressive optic neuropathy. The aim was to develop an evidence-based clinical practice guideline of Chinese herbal medicine (CHM) for POAG with focus on Chinese medicine pattern differentiation and treatment as well as approved herbal proprietary medicine. Methods: The guideline development group involved in various pieces of expertise in contents and methods. Authors searched electronic databases include CNKI, VIP, Sino-Med, Wanfang data, PubMed, the Cochrane Library, EMBASE, as well as checked China State Food and Drug Administration (SFDA) from the inception of these databases to June 30, 2015. Systematic reviews and randomized controlled trials of Chinese herbal medicine treating adults with POAG were evaluated. Risk of bias tool in the Cochrane Handbook and evidence strength developed by the GRADE group were applied for the evaluation, and recommendations were based on the findings incorporating evidence strength. After several rounds of Expert consensus, the final guideline was endorsed by relevant professional committees. Results: CHM treatment principle and formulae based on pattern differentiation together with approved patent herbal medicines are the main treatments for POAG, and the diagnosis and treatment focusing on blood related patterns is the major domain. Conclusion: CHM therapy alone or combined with other conventional treatment reported in clinical studies together with Expert consensus were recommended for clinical practice. PMID:29595636

Behavior change techniques in popular alcohol reduction apps: content analysis.

PubMed

Crane, David; Garnett, Claire; Brown, James; West, Robert; Michie, Susan

2015-05-14

Mobile phone apps have the potential to reduce excessive alcohol consumption cost-effectively. Although hundreds of alcohol-related apps are available, there is little information about the behavior change techniques (BCTs) they contain, or the extent to which they are based on evidence or theory and how this relates to their popularity and user ratings. Our aim was to assess the proportion of popular alcohol-related apps available in the United Kingdom that focus on alcohol reduction, identify the BCTs they contain, and explore whether BCTs or the mention of theory or evidence is associated with app popularity and user ratings. We searched the iTunes and Google Play stores with the terms "alcohol" and "drink", and the first 800 results were classified into alcohol reduction, entertainment, or blood alcohol content measurement. Of those classified as alcohol reduction, all free apps and the top 10 paid apps were coded for BCTs and for reference to evidence or theory. Measures of popularity and user ratings were extracted. Of the 800 apps identified, 662 were unique. Of these, 13.7% (91/662) were classified as alcohol reduction (95% CI 11.3-16.6), 53.9% (357/662) entertainment (95% CI 50.1-57.7), 18.9% (125/662) blood alcohol content measurement (95% CI 16.1-22.0) and 13.4% (89/662) other (95% CI 11.1-16.3). The 51 free alcohol reduction apps and the top 10 paid apps contained a mean of 3.6 BCTs (SD 3.4), with approximately 12% (7/61) not including any BCTs. The BCTs used most often were "facilitate self-recording" (54%, 33/61), "provide information on consequences of excessive alcohol use and drinking cessation" (43%, 26/61), "provide feedback on performance" (41%, 25/61), "give options for additional and later support" (25%, 15/61) and "offer/direct towards appropriate written materials" (23%, 14/61). These apps also rarely included any of the 22 BCTs frequently used in other health behavior change interventions (mean 2.46, SD 2.06). Evidence was mentioned by 16.4% of apps, and theory was not mentioned by any app. Multivariable regression showed that apps including advice on environmental restructuring were associated with lower user ratings (Β=-46.61, P=.04, 95% CI -91.77 to -1.45) and that both the techniques of "advise on/facilitate the use of social support" (Β=2549.21, P=.04, 95% CI 96.75-5001.67) and the mention of evidence (Β=1376.74, P=.02, 95%, CI 208.62-2544.86) were associated with the popularity of the app. Only a minority of alcohol-related apps promoted health while the majority implicitly or explicitly promoted the use of alcohol. Alcohol-related apps that promoted health contained few BCTs and none referred to theory. The mention of evidence was associated with more popular apps, but popularity and user ratings were only weakly associated with the BCT content.

A quantitative analysis of the quality and content of the health advice in popular Australian magazines.

PubMed

Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros

2017-06-01

To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews

PubMed Central

Young, Taryn; Rohwer, Anke; Volmink, Jimmy; Clarke, Mike

2014-01-01

Background An evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC). Methods/Findings We searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem-based approaches, compared to no intervention, increased knowledge but not appraisal skills. Conclusions EBHC teaching and learning strategies should focus on implementing multifaceted, clinically integrated approaches with assessment. Future rigorous research should evaluate minimum components for multifaceted interventions, assessment of medium to long-term outcomes, and implementation of these interventions. PMID:24489771

Bridging the gap between content and context: establishing expert consensus on the content of an exercise training program to prevent lower-limb injuries.

PubMed

Donaldson, Alex; Cook, Jill; Gabbe, Belinda; Lloyd, David G; Young, Warren; Finch, Caroline F

2015-05-01

To achieve expert consensus on the content of an exercise training program (known as FootyFirst) to prevent lower-limb injuries. Three-round online Delphi consultation process. Community Australian Football (AF). Members of the Australian Football Leagues' Medical Officers (n = 94), physiotherapists (n = 50), and Sports Science (n = 19) Associations were invited to participate through e-mail. Five people with more general expertise in sports-related lower-limb injury prevention were also invited to participate. The primary outcome measure was the level of agreement on the appropriateness of the proposed exercises and progressions for inclusion in FootyFirst. Consensus was reached when ≥75% of experts who responded to each item agreed and strongly agreed, or disagreed and strongly disagreed, that an exercise or its progressions were appropriate to include in FootyFirst. Fifty-five experts participated in at least 1 Delphi round. In round 1, consensus was achieved that the proposed warm-up (run through and dynamic stretches) and the exercises and progressions for hamstring strength and for balance, landing, and changing direction were appropriate to include in FootyFirst. There was also consensus in round 1 that progressions for hip/core strength should be included in FootyFirst. Consensus was reached in round 2 that the revised groin strength and hip strength exercises should be included in FootyFirst. Consensus was reached for the progression of the groin strength exercises in round 3. The formal consensus development process has resulted in an evidence-informed, researcher-developed, exercise-based sports injury prevention program that is expert endorsed and specific to the context of AF. Lower-limb injuries are common in running, kicking, and contact sports like AF. These injuries are often costly to treat, and many have high rates of recurrence, making them challenging to treat clinically. Reducing these injuries is a high priority for players, teams, and medical staff. Exercise programs provide a method for primary prevention of lower-limb injuries, but they have to be evidence based, have currency with sports practitioners/clinicians, and utility for the context in which they are to be used. However, the comprehensive methods and clinical engagement processes used to develop injury prevention exercise programs have not previously been described in detail. This study describes the results of engaging clinicians and sport scientists in the development of a lower-limb sports injury prevention program for community AF, enabling the development of a program that is both evidence informed and considerate of expert clinical opinion.

Smartphone apps for the self-management of low back pain: A systematic review.

PubMed

Machado, Gustavo C; Pinheiro, Marina B; Lee, Hopin; Ahmed, Osman H; Hendrick, Paul; Williams, Chris; Kamper, Steven J

2016-12-01

Guidelines for low back pain (LBP) often recommend the use of self-management such as unsupervised exercise, booklets, and online education. Another potentially useful way for patients to self-manage LBP is by using smartphone applications (apps). However, to date, there has been no rigorous evaluation of LBP apps and no guidance for consumers on how to select high-quality, evidence-based apps. This chapter reviews smartphone apps for the self-management of LBP and evaluates their content quality and whether they recommend evidence-based interventions. This chapter shows that generally app developers are selecting interventions that are endorsed by guidelines, although their quality is low. There are many apps available for the self-management of LBP, but their effectiveness in improving patient outcomes has not been rigorously assessed. App developers need to work closely with healthcare professionals, researchers, and patients to ensure app content is accurate, evidence based, and engaging. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of the Evidence Base for the Alcohol Industry’s Actions to Reduce Drink Driving Globally

PubMed Central

Esser, Marissa B.; Bao, James; Jernigan, David H.

2016-01-01

Objectives. To evaluate the evidence base for the content of initiatives that the alcohol industry implemented to reduce drink driving from 1982 to May 2015. Methods. We systematically analyzed the content of 266 global initiatives that the alcohol industry has categorized as actions to reduce drink driving. Results. Social aspects public relations organizations (i.e., organizations funded by the alcohol industry to handle issues that may be damaging to the business) sponsored the greatest proportion of the actions. Only 0.8% (n = 2) of the sampled industry actions were consistent with public health evidence of effectiveness for reducing drink driving. Conclusions. The vast majority of the alcohol industry’s actions to reduce drink driving does not reflect public health evidenced–based recommendations, even though effective drink-driving countermeasures exist, such as a maximum blood alcohol concentration limit of 0.05 grams per deciliter for drivers and widespread use of sobriety checkpoints. PMID:26890181

Economic content in medical journal advertisements for medical devices and prescription drugs.

PubMed

Ackerly, D Clay; Glickman, Seth W; Schulman, Kevin A

2010-01-01

Previous studies of economic content in medical journal advertisements have not examined all types of economic content and have not included advertisements for medical devices. To examine trends in the economic content of medical device and pharmaceutical advertisements in medical journals. Three reviewers examined pharmaceutical and medical device advertisements in six leading medical journals from 1997 through 2006. Product characteristics, economic claims and evidence to support those claims were evaluated. Economic content appeared in 23.5% (561/2389) of pharmaceutical and device advertisements; 11.9% made market share claims and 12.7% made other economic claims. From 1997 through 2006, the percentage of medical device advertisements containing economic content declined from 26.7% to 6.7% (p = 0.02), whereas the percentage of pharmaceutical advertisements containing economic content remained stable (21.6-22.0%; p = 0.99). For pharmaceuticals, price claims declined significantly (15.7-4.2%; p < 0.01) and market share claims increased (2.8-11.5%; p = 0.09), and both consistently presented evidence (83% and 98%, respectively) while other types did not (e.g. 13.5% of formulary claims). Medical device economic claims differed from pharmaceutical economic claims; they made fewer market share claims (1.1% vs 12.8%) but more cost-effectiveness (6.5% vs 0.6%) and reimbursement (4.9% vs 0.8%) claims. Fewer than 2% of device advertisements with economic claims provided supporting evidence. The prevalence and type of economic content in pharmaceutical and device advertisements changed between 1997 and 2006, which may reflect evolving market dynamics, such as changes in reimbursement systems. Furthermore, the lack of supporting evidence in medical device advertisements and pharmaceutical formulary claims are potential areas of concern that require additional scrutiny by regulators and journal editors.

Barriers to Primary Care Clinician Adherence to Clinical Guidelines for the Management of Low Back Pain: A Systematic Review and Metasynthesis of Qualitative Studies.

PubMed

Slade, Susan C; Kent, Peter; Patel, Shilpa; Bucknall, Tracey; Buchbinder, Rachelle

2016-09-01

Despite the availability of evidence-based guidelines for the management of low back pain (LBP) that contain consistent messages, large evidence-practice gaps in primary care remain. To perform a systematic review and metasynthesis of qualitative studies that have explored primary care clinicians' perceptions and beliefs about guidelines for LBP, including perceived enablers and barriers to guideline adherence. Studies investigating perceptions and beliefs about LBP guidelines were included if participants were primary care clinicians and qualitative methods had been used for both data collection and analysis. We searched major databases up to July 2014. Pairs of reviewers independently screened titles and abstracts, extracted data, appraised method quality using the CASP checklist, conducted thematic analysis, and synthesized the results in narrative format. Seventeen studies, with a total of 705 participants, were included. We identified 3 key emergent themes and 8 subthemes: (1) guideline implementation and adherence beliefs and perceptions; (2) maintaining the patient-clinician relationship with imaging referrals; and (3) barriers to guideline implementation. Clinicians believed that guidelines were categorical, prescriptive, and constrained professional practice; however, popular clinical practices superseded the guidelines. Imaging referrals were used to manage consultations and to obtain definitive diagnoses. Clinicians' perceptions reflected a lack of content knowledge and understanding of how guidelines are developed. Addressing misconceptions and other barriers to uptake of evidence-based guidelines for managing LBP is needed to improve knowledge transfer and close the evidence-practice gap in the treatment of this common condition.

A method for co-creation of an evidence-based patient workbook to address alcohol use when quitting smoking in primary care: a case study.

PubMed

Minian, Nadia; Noormohamed, Aliya; Zawertailo, Laurie; Baliunas, Dolly; Giesbrecht, Norman; Le Foll, Bernard; Rehm, Jürgen; Samokhvalov, Andriy; Selby, Peter L

2018-01-01

The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients' values, preferences, and needs. Fourteen adult smokers who drink alcohol were invited to the Centre for Addiction and Mental Health (CAMH) to take part in a four-hour event to help design the workbook with the CAMH research team. Participants provided their opinions and ideas to create an outline for the workbook, including activities, images, and titles. The workbook - called Self-Awareness - is currently being offered in a smoking cessation program in 221 primary care clinics across Ontario to help smokers quit or reduce their harmful alcohol use. The patient engagement event was a useful way to co-create educational materials that incorporate both scientific research and patient needs. Background Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values. There are few methodologies on how to design evidence-based programs and resources to include patient values. The latter is an important aspect of patient-centered care, and is essential for patients to trust the recommendations and empower them as consumers to make informed choices. This manuscript describes a participatory research approach to design patient-facing educational materials that incorporate both evidence-based and community-sensitive principles. These materials are intended to support smokers to reduce or stop harmful alcohol consumption. Methods Adult smokers who report consuming alcohol were invited to a co-creation meeting at the Centre for Addiction and Mental Health's Nicotine Dependence Service to guide the adaptation of evidence-based materials. The four-hour event consisted of individual reflections, group discussions, and consensus-building interactions. Detailed notes were taken and then incorporated into the material. Results Fourteen individuals participated in the event. The end product was a descriptive outline of an educational resource - entitled Self-Awareness - incorporating material from evidence-based workbooks and patient-driven features. Participants collaboratively selected the resource's content, structure, and titles. Conclusions This model describes a participatory research method that emphasizes the value of the patient perspective; preliminary evidence finds this adaptation approach can increase the adoption of resources. The process described in this article could be replicated in other settings to co-create evidence-based resources, interventions, and programs that reflect the needs of the community. Trial registration ClinicalTrials.gov NCT03108144. Retrospectively registered 11 April 2017.

A statistical analysis of the PPII propensity of amino acid guests in proline-rich peptides.

PubMed

Moradi, Mahmoud; Babin, Volodymyr; Sagui, Celeste; Roland, Christopher

2011-02-16

There has been considerable debate about the intrinsic PPII propensity of amino-acid residues in denatured polypeptides. Experimentally, the propensity scale is based on the behavior of guest amino-acid residues placed in the middle of polyproline hosts. We have used classical molecular dynamics simulations, with state-of-the-art force fields to carry out a comprehensive analysis of the conformational equilibria of the proline-based host oligopeptides with single guests. The tracked structural characteristics include the PPII content, the cis/trans isomerization of the prolyl bonds, the puckering of the pyrrolidine rings of the proline residues, and the secondary structural motifs. We find no evidence for an intrinsic PPII propensity in any of the guest amino acids other than proline. Instead, the PPII content as derived from experiments may be explained in terms of: 1), a local correlation between the dihedral angles of the guest amino acid and the proline residue immediately preceding it; and 2), a nonlocal correlation between the cis/trans states of the peptide bonds. In terms of the latter, we find that the presence of a guest (other than proline, tyrosine, or tryptophan) increases the trans content of most of the prolyl bonds, which results in an effective increase of the peptide PPII content. With respect to the local dihedral correlations, we find that these are well described in terms of the so-called odds-ratio statistic. Expressed in terms of free energy language, the PPII content based on the odds-ratio of the relevant residues correlate well with the experimentally measured PPII content. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Guidelines and Value-Based Decision Making: An Evolving Role for Payers.

PubMed

McCauley, Janet L

2015-01-01

Payers use evidence-based guidelines to promote effective health diagnoses and treatments for their members and to ensure that members are not subject to harmful or wasteful care. Payer guidelines inform coverage, but the content of these guidelines relies on the same evidentiary base as clinical treatment guidelines. Recent strategies to foster value through benefit design and alternative reimbursement methodologies illustrate emerging applications for evidence-based guidelines. The current focus on cost effectiveness within health technology assessment, comparative effectiveness research in collaboration with payers, and transparency around payer evidence assessment could better align payers' interests in evidence-based care with those of other stakeholders. The move to value in health care will depend upon credible clinical evidence to enable informed decision making. ©2015 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Development and evaluation of online evidence based guideline bank system.

PubMed

Park, Myonghwa

2006-01-01

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

Effective communication network structures for hospital infection prevention: a study protocol.

PubMed

Rangachari, Pavani

2013-01-01

Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implementation failure" in health care organizations. Several studies have used retrospective designs to examine the problem; however, there are few prospective studies examining communication dynamics underlying successful implementation of change (eg, evidence-based practices). This prospective study will be set in 2 intensive care units at an academic medical center. At baseline, both units have low compliance with CLB and higher-than-expected CRBSIs. Periodic quality improvement (QI) interventions will be conducted over a 52-week period to promote implementation of CLB in both units. Simultaneously, the following parameters will be examined: (1) Structure and content of communication related to CLB in both units through "communication logs" completed weekly by nurses, physicians, and managers; and (2) outcomes, that is, CLB adherence in both units through weekly chart review. Catheter utilization and CRBSI (infection) rates will serve as additional unit-level outcome measures. The aim is 2-fold: (1) to examine associations between QI interventions and structure and content of communication at the unit level; and (2) to examine associations between structure and content of communication and outcomes at the unit level. The periodic QI interventions are expected to increase CLB adherence and reduce CRBSIs through their influence on structure and content of communication. The prospective design would help examine dynamics in unit-level communication structure and content related to CLB, as well as unit-level outcomes. The study has potential to make significant contributions to theory and practice, particularly if interventions are found to be effective in enabling successful practice change at the unit level. To this effect, the study has potential to provide insights into communication structure and content associated with collective learning and culture change at the unit level. Results and insights are expected to lay a foundation for generating context-sensitive "evidence-based management" strategies for successful practice change at the unit level. An ultimate expected deliverable is the development of an "action-learning framework" for successful implementation of evidence-based practices in health care organizations.

Enhancing meaningful learning and self-efficacy through collaboration between dental hygienist and physiotherapist students - a scholarship project.

PubMed

Johannsen, A; Bolander-Laksov, K; Bjurshammar, N; Nordgren, B; Fridén, C; Hagströmer, M

2012-11-01

Within the field of Dental Hygiene (DH) and Physiotherapy (PT), students are taught to use an evidence-based approach. Educators need to consider the nature of evidence-based practice from the perspective of content knowledge and learning strategies. Such effort to seek best available evidence and to apply a systematic and scholarly approach to teaching and learning is called scholarship of teaching and learning. To evaluate the application of the scholarship model including an evidence-based approach to enhance meaningful learning and self-efficacy among DH and PT students. Based on the research on student learning, three central theories were identified (constructivism, meaningful learning and self-efficacy). These were applied in our context to support learner engagement and the application of prior knowledge in a new situation. The DH students performed an oral health examination on the PT students, and the PT students performed an individual health test on the DH students; both groups used motivational interviewing. Documentation of student's learning experience was carried out through seminars and questionnaires. The students were overall satisfied with the learning experience. Most appreciated are that it reflected a 'real' professional situation and that it also reinforced important learning from their seminars. The scholarship model made the teachers aware of the importance of evidence-based teaching. Furthermore, the indicators for meaningful learning and increased self-efficacy were high, and the students became more engaged by practising in a real situation, more aware of other health professions and reflected about tacit knowledge. © 2012 John Wiley & Sons A/S.

Why are some evidence-based care recommendations in chronic obstructive pulmonary disease better implemented than others? Perspectives of medical practitioners

PubMed Central

Johnston, Kylie N; Young, Mary; Grimmer-Somers, Karen A; Antic, Ral; Frith, Peter A

2011-01-01

Background Clinical guidelines for management of patients with chronic obstructive pulmonary disease (COPD) include recommendations based on high levels of evidence, but gaps exist in their implementation. The aim of this study was to examine the perspectives of medical practitioners regarding implementation of six high-evidence recommendations for the management of people with COPD. Methods Semi-structured interviews were conducted with medical practitioners involved with care of COPD patients in hospital and general practice. Interviews sought medical practitioners’ experience regarding implementation of smoking cessation, influenza vaccination, pulmonary rehabilitation, guideline-based medications, long-term oxygen therapy for hypoxemia and plan and advice for future exacerbations. Interviews were audiotaped, transcribed verbatim and analyzed using content analysis. Results Nine hospital-based medical practitioners and seven general practitioners participated. Four major categories were identified which impacted on implementation of the target recommendations in the care of patients with COPD: (1) role clarity of the medical practitioner; (2) persuasive communication with the patient; (3) complexity of behavioral change required; (4) awareness and support available at multiple levels. For some recommendations, strength in all four categories provided significant enablers supporting implementation. However, with regard to pulmonary rehabilitation and plans and advice for future exacerbations, all identified categories that presented barriers to implementation. Conclusion This study of medical practitioner perspectives has indicated areas where significant barriers to the implementation of key evidence-based recommendations in COPD management persist. Developing strategies to target the identified categories provides an opportunity to achieve greater implementation of those high-evidence recommendations in the care of people with COPD. PMID:22259242

Pressure ulcer prevention algorithm content validation: a mixed-methods, quantitative study.

PubMed

van Rijswijk, Lia; Beitz, Janice M

2015-04-01

Translating pressure ulcer prevention (PUP) evidence-based recommendations into practice remains challenging for a variety of reasons, including the perceived quality, validity, and usability of the research or the guideline itself. Following the development and face validation testing of an evidence-based PUP algorithm, additional stakeholder input and testing were needed. Using convenience sampling methods, wound care experts attending a national wound care conference and a regional wound ostomy continence nursing (WOCN) conference and/or graduates of a WOCN program were invited to participate in an Internal Review Board-approved, mixed-methods quantitative survey with qualitative components to examine algorithm content validity. After participants provided written informed consent, demographic variables were collected and participants were asked to comment on and rate the relevance and appropriateness of each of the 26 algorithm decision points/steps using standard content validation study procedures. All responses were anonymous. Descriptive summary statistics, mean relevance/appropriateness scores, and the content validity index (CVI) were calculated. Qualitative comments were transcribed and thematically analyzed. Of the 553 wound care experts invited, 79 (average age 52.9 years, SD 10.1; range 23-73) consented to participate and completed the study (a response rate of 14%). Most (67, 85%) were female, registered (49, 62%) or advanced practice (12, 15%) nurses, and had > 10 years of health care experience (88, 92%). Other health disciplines included medical doctors, physical therapists, nurse practitioners, and certified nurse specialists. Almost all had received formal wound care education (75, 95%). On a Likert-type scale of 1 (not relevant/appropriate) to 4 (very relevant and appropriate), the average score for the entire algorithm/all decision points (N = 1,912) was 3.72 with an overall CVI of 0.94 (out of 1). The only decision point/step recommendation with a CVI of ≤ 0.70 was the recommendation to provide medical-grade sheepskin for patients at high risk for friction/shear. Many positive and substantive suggestions for minor modifications including color, flow, and algorithm orientation were received. The high overall and individual item rating scores and CVI further support the validity and appropriateness of the PUP algorithm with the addition of the minor modifications. The generic recommendations facilitate individualization, and future research should focus on construct validation testing.

Development and testing of an audio forensic software for enhancing speech signals masked by loud music

NASA Astrophysics Data System (ADS)

Dobre, Robert A.; Negrescu, Cristian; Stanomir, Dumitru

2016-12-01

In many situations audio recordings can decide the fate of a trial when accepted as evidence. But until they can be taken into account they must be authenticated at first, but also the quality of the targeted content (speech in most cases) must be good enough to remove any doubt. In this scope two main directions of multimedia forensics come into play: content authentication and noise reduction. This paper presents an application that is included in the latter. If someone would like to conceal their conversation, the easiest way to do it would be to turn loud the nearest audio system. In this situation, if a microphone was placed close by, the recorded signal would be apparently useless because the speech signal would be masked by the loud music signal. The paper proposes an adaptive filters based solution to remove the musical content from a previously described signal mixture in order to recover the masked vocal signal. Two adaptive filtering algorithms were tested in the proposed solution: the Normalised Least Mean Squares (NLMS) and Recursive Least Squares (RLS). Their performances in the described situation were evaluated using Simulink, compared and included in the paper.

Sex Ed to Go: A Content Analysis of Comprehensive Sexual Education Apps.

PubMed

Kalke, Kerstin M; Ginossar, Tamar; Shah, Sayyed Fawad Ali; West, Andrew J

2017-12-01

Mobile applications ("apps") designed for sexual health education have the potential to reach teens and young adults that are hard to reach through traditional platforms; however, little is known about availability of these apps and their adherence to existing guidelines. Following a search on the two major app stores, data from 2,693 apps were analyzed. Only 697 (25%) addressed sexual health, and only 15 (1%) of apps met inclusion criteria for comprehensive programs and their content was further analyzed. The content of most of these apps narrowly focused on sexually transmitted infections and pregnancy prevention and lacked information on puberty, sexual identity, and personal safety. Theoretically grounded strategies including self-efficacy and modeling behavior to strengthen behavior change efforts were largely absent. Last, we identified significant shortcomings in the literate design of these apps, including limited use of interactive features, such as videos, quizzes, or games. These findings indicate that the potential of apps as sexual health promotion tools has not yet been fully realized. We outline recommendations for developing theory- and evidence-based sexual education apps and provide suggestions for health educators on how to select relevant apps when working for youth.

Evidence for Natural Selection in Nucleotide Content Relationships Based on Complete Mitochondrial Genomes: Strong Effect of Guanine Content on Separation between Terrestrial and Aquatic Vertebrates.

PubMed

Sorimachi, Kenji; Okayasu, Teiji

2015-01-01

The complete vertebrate mitochondrial genome consists of 13 coding genes. We used this genome to investigate the existence of natural selection in vertebrate evolution. From the complete mitochondrial genomes, we predicted nucleotide contents and then separated these values into coding and non-coding regions. When nucleotide contents of a coding or non-coding region were plotted against the nucleotide content of the complete mitochondrial genomes, we obtained linear regression lines only between homonucleotides and their analogs. On every plot using G or A content purine, G content in aquatic vertebrates was higher than that in terrestrial vertebrates, while A content in aquatic vertebrates was lower than that in terrestrial vertebrates. Based on these relationships, vertebrates were separated into two groups, terrestrial and aquatic. However, using C or T content pyrimidine, clear separation between these two groups was not obtained. The hagfish (Eptatretus burgeri) was further separated from both terrestrial and aquatic vertebrates. Based on these results, nucleotide content relationships predicted from the complete vertebrate mitochondrial genomes reveal the existence of natural selection based on evolutionary separation between terrestrial and aquatic vertebrate groups. In addition, we propose that separation of the two groups might be linked to ammonia detoxification based on high G and low A contents, which encode Glu rich and Lys poor proteins.

Teaching scientific literacy in an introductory women's studies course: a case study in interdisciplinary collaboration

NASA Astrophysics Data System (ADS)

Fuselier, Linda; Murphy, Claudia; Bender, Anita; Creel Falcón, Kandace

2015-01-01

Background and purpose:The purpose of this exploratory case study is to describe how scholars negotiated disciplinary divides to develop and communicate to their students an understanding of the basic features of scientific knowledge. Our goals were to examine boundary crossing in interdisciplinary collaboration and to assess the efficacy of adding science content to an introductory Women's Studies course. Sample:We studied a collaboration between faculty in Biology and Women's Studies and evaluated science modules in a Women's Studies course at a regional four-year university in the Midwestern USA. The study included 186 student participants over three semesters and four faculty from Philosophy, Women's Studies and Biology. Design and method:Women's Studies and Biology faculty collaborated to design and implement science content learning modules that included the case of women and science in an introductory Women's Studies course. Qualitative data collected from faculty participants in the form of peer debrief sessions and narrative reflections were used to examine the process of interdisciplinary collaboration. Students exposed to curriculum changes were administered pre- and post-lesson surveys to evaluate their understanding of issues faced by women in science careers, the nature of science, and interest in science studies. Data from collaborators, student journal reflections, and pre-/post-lesson surveys were considered together in an evaluation of how knowledge of science was understood and taught in a Women's Studies course over a longitudinal study of three semesters. Results:We found evidence of discipline-based challenges to interdisciplinarity and disciplinary boundary crossing among collaborators. Three themes emerged from our collaboration: challenges posed by disciplinary differences, creation of a space for interdisciplinary work, and evidence of boundary crossing. Student participants exhibited more prior knowledge of Women's Studies content than nature of science but showed learning in the areas of scientific literacy and the understanding of issues related to women in science careers. Student understanding of science content was enhanced by the participation of a woman scientist in the learning module. Conclusion:This case study illustrates how creating an inclusive space for interdisciplinary collaboration led to successful curriculum transformation and academic boundary crossing by faculty participants. Success is evident in the legacy of interdisciplinarity in the curriculum and learning gains by students. Use of a feminist science studies framework was successful at helping students learn about the influence of values on science and the tentative nature of scientific conclusions. It was less successful in teaching the distinction between science and other ways of knowing and the conception that science is an evidence-based approach to understanding the natural world. This study highlights the importance of interdisciplinary teams of faculty members collaborating to help students learn about science by modeling that there are multiple ways of knowing.

How prevention curricula are taught under real-world conditions

PubMed Central

Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Shin, YoungJu; Graham, John; Krieger, Janice

2015-01-01

Purpose As interventions are disseminated widely, issues of fidelity and adaptation become increasingly critical to understand. This study aims to describe the types of adaptations made by teachers delivering a school-based substance use prevention curriculum and their reasons for adapting program content. Design/methodology/approach To determine the degree to which implementers adhere to a prevention curriculum, naturally adapt the curriculum, and the reasons implementers give for making adaptations, the study examined lesson adaptations made by the 31 teachers who implemented the keepin' it REAL drug prevention curriculum in 7th grade classrooms (n = 25 schools). Data were collected from teacher self-reports after each lesson and observer coding of videotaped lessons. From the total sample, 276 lesson videos were randomly selected for observational analysis. Findings Teachers self-reported adapting more than 68 percent of prevention lessons, while independent observers reported more than 97 percent of the observed lessons were adapted in some way. Types of adaptations included: altering the delivery of the lesson by revising the delivery timetable or delivery context; changing content of the lesson by removing, partially covering, revising, or adding content; and altering the designated format of the lesson (such as assigning small group activities to students as individual work). Reasons for adaptation included responding to constraints (time, institutional, personal, and technical), and responding to student needs (students' abilities to process curriculum content, to enhance student engagement with material). Research limitations/implications The study sample was limited to rural schools in the US mid-Atlantic; however, the results suggest that if programs are to be effectively implemented, program developers need a better understanding of the types of adaptations and reasons implementers provide for adapting curricula. Practical implications These descriptive data suggest that prevention curricula be developed in shorter teaching modules, developers reconsider the usefulness of homework, and implementer training and ongoing support might benefit from more attention to different implementation styles. Originality/value With nearly half of US public schools implementing some form of evidence-based substance use prevention program, issues of implementation fidelity and adaptation have become paramount in the field of prevention. The findings from this study reveal the complexity of the types of adaptations teachers make naturally in the classroom to evidence-based curricula and provide reasons for these adaptations. This information should prove useful for prevention researchers, program developers, and health educators alike. PMID:26290626

Not another boring lecture: engaging learners with active learning techniques.

PubMed

Wolff, Margaret; Wagner, Mary Jo; Poznanski, Stacey; Schiller, Jocelyn; Santen, Sally

2015-01-01

Core content in Emergency Medicine Residency Programs is traditionally covered in didactic sessions, despite evidence suggesting that learners do not retain a significant portion of what is taught during lectures. We describe techniques that medical educators can use when leading teaching sessions to foster engagement and encourage self-directed learning, based on current literature and evidence about learning. When these techniques are incorporated, sessions can be effective in delivering core knowledge, contextualizing content, and explaining difficult concepts, leading to increased learning. Copyright © 2015 Elsevier Inc. All rights reserved.

Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and 'grey' literature.

PubMed

Van Cauwenberghe, Eveline; Maes, Lea; Spittaels, Heleen; van Lenthe, Frank J; Brug, Johannes; Oppert, Jean-Michel; De Bourdeaudhuij, Ilse

2010-03-01

The objective of the present review was to summarise the existing European published and 'grey' literature on the effectiveness of school-based interventions to promote a healthy diet in children (6-12 years old) and adolescents (13-18 years old). Eight electronic databases, websites and contents of key journals were systematically searched, reference lists were screened, and authors and experts in the field were contacted for studies evaluating school-based interventions promoting a healthy diet and aiming at primary prevention of obesity. The studies were included if they were published between 1 January 1990 and 31 December 2007 and reported effects on dietary behaviour or on anthropometrics. Finally, forty-two studies met the inclusion criteria: twenty-nine in children and thirteen in adolescents. In children, strong evidence of effect was found for multicomponent interventions on fruit and vegetable intakes. Limited evidence of effect was found for educational interventions on behaviour, and for environmental interventions on fruit and vegetable intakes. Interventions that specifically targeted children from lower socio-economic status groups showed limited evidence of effect on behaviour. In adolescents, moderate evidence of effect was found for educational interventions on behaviour and limited evidence of effect for multicomponent programmes on behaviour. In children and adolescents, effects on anthropometrics were often not measured, and therefore evidence was lacking or delivered inconclusive evidence. To conclude, evidence was found for the effectiveness of especially multicomponent interventions promoting a healthy diet in school-aged children in European Union countries on self-reported dietary behaviour. Evidence for effectiveness on anthropometrical obesity-related measures is lacking.

Stress Management Apps With Regard to Emotion-Focused Coping and Behavior Change Techniques: A Content Analysis.

PubMed

Christmann, Corinna Anna; Hoffmann, Alexandra; Bleser, Gabriele

2017-02-23

Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. ©Corinna Anna Christmann, Alexandra Hoffmann, Gabriele Bleser. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.02.2017.

Content-Based Networking: DTN, AMS, Sharednet

NASA Technical Reports Server (NTRS)

Burleigh, Scott

2006-01-01

A detailed viewgraph presentation on DTN, AMS, and Sharednet content-based networking is shown. The contents include: 1) DARPA Content-Based Networking Summary of Requirements; 2) Concept; 3) Key Features of AMS; 4) Overview of Sharednet; 5) SharedNet Deployment History; 6) SharedNet AMS DTN; 7) Detailed Structure; and 8) Bottom line.

Usability and Navigability of an HIV/AIDS Internet Intervention for Adolescents in a Resource Limited Setting

PubMed Central

Ybarra, Michele; Biringi, Ruth; Prescott, Tonya; Bull, Sheana S.

2012-01-01

Use of Internet is growing in Sub Saharan Africa. Evidence of computer and Internet effectiveness for reduction in risk behaviors associated with HIV shown in U.S. settings has yet to be replicated in Africa. We describe the development, usability and navigability testing of an Internet-based HIV prevention program for secondary school students in Uganda, called CyberSenga. For this work, we used four data collection activities, including observation of (a) computer skills and (b) navigation, (c) focus group discussions, and (d) field assessments to document comprehension and usability of program content. We document limited skills among students, but youth with basic computers skills were able to navigate the program after instruction. Youth were most interested in activities with more interaction. Field-testing illustrated the importance of using a stand-alone electrical source during program delivery. This work suggests delivery of Internet-based health promotion content in Africa requires attention to user preparedness and literacy, bandwidth, Internet connection, and electricity. PMID:22918136

Developing Academic Language and Content for Emergent Bilinguals through a Science Inquiry Unit

ERIC Educational Resources Information Center

Mercuri, Sandra; Ebe, Ann E.

2011-01-01

There is growing evidence that schools are not meeting the needs of emergent bilinguals who are falling behind in both academic language development and content knowledge learning. In response to this concern, this article proposes five research-based guidelines for promoting effective instruction for emergent bilinguals. In order to connect…

Directing the public to evidence-based online content.

PubMed

Cooper, Crystale Purvis; Gelb, Cynthia A; Vaughn, Alexandra N; Smuland, Jenny; Hughes, Alexandra G; Hawkins, Nikki A

2015-04-01

To direct online users searching for gynecologic cancer information to accurate content, the Centers for Disease Control and Prevention's (CDC) 'Inside Knowledge: Get the Facts About Gynecologic Cancer' campaign sponsored search engine advertisements in English and Spanish. From June 2012 to August 2013, advertisements appeared when US Google users entered search terms related to gynecologic cancer. Users who clicked on the advertisements were directed to relevant content on the CDC website. Compared with the 3 months before the initiative (March-May 2012), visits to the CDC web pages linked to the advertisements were 26 times higher after the initiative began (June-August 2012) (p<0.01), and 65 times higher when the search engine advertisements were supplemented with promotion on television and additional websites (September 2012-August 2013) (p<0.01). Search engine advertisements can direct users to evidence-based content at a highly teachable moment--when they are seeking relevant information. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

fMRI-based Multivariate Pattern Analyses Reveal Imagery Modality and Imagery Content Specific Representations in Primary Somatosensory, Motor and Auditory Cortices.

PubMed

de Borst, Aline W; de Gelder, Beatrice

2017-08-01

Previous studies have shown that the early visual cortex contains content-specific representations of stimuli during visual imagery, and that these representational patterns of imagery content have a perceptual basis. To date, there is little evidence for the presence of a similar organization in the auditory and tactile domains. Using fMRI-based multivariate pattern analyses we showed that primary somatosensory, auditory, motor, and visual cortices are discriminative for imagery of touch versus sound. In the somatosensory, motor and visual cortices the imagery modality discriminative patterns were similar to perception modality discriminative patterns, suggesting that top-down modulations in these regions rely on similar neural representations as bottom-up perceptual processes. Moreover, we found evidence for content-specific representations of the stimuli during auditory imagery in the primary somatosensory and primary motor cortices. Both the imagined emotions and the imagined identities of the auditory stimuli could be successfully classified in these regions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Evidence-based guidelines for the informal use of computers by children to promote the development of academic, cognitive and social skills.

PubMed

Tran, Phuoc; Subrahmanyam, Kaveri

2013-01-01

The use of computers in the home has become very common among young children. This paper reviews research on the effects of informal computer use and identifies potential pathways through which computers may impact children's development. Based on the evidence reviewed, we present the following guidelines to arrange informal computer experiences that will promote the development of children's academic, cognitive and social skills: (1) children should be encouraged to use computers for moderate amounts of time (2-3 days a week for an hour or two per day) and (2) children's use of computers should (a) include non-violent action-based computer games as well as educational games, (b) not displace social activities but should instead be arranged to provide opportunities for social engagement with peers and family members and (c) involve content with pro-social and non-violent themes. We conclude the paper with questions that must be addressed in future research. This paper reviews research on the effects of informal computer use on children's academic, cognitive and social skills. Based on the evidence presented, we have presented guidelines to enable parents, teachers and other adults to arrange informal computer experiences so as to maximise their potential benefit for children's development.

Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

PubMed Central

2012-01-01

Background Continuous quality improvement (CQI) methods are widely used in healthcare; however, the effectiveness of the methods is variable, and evidence about the extent to which contextual and other factors modify effects is limited. Investigating the relationship between these factors and CQI outcomes poses challenges for those evaluating CQI, among the most complex of which relate to the measurement of modifying factors. We aimed to provide guidance to support the selection of measurement instruments by systematically collating, categorising, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments, reference lists of systematic reviews, and citations and references of the main report of instruments. Study selection: The scope of the review was determined by a conceptual framework developed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). Papers reporting development or use of an instrument measuring a construct encompassed by the framework were included. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarising and comparing instruments. Instrument content was categorised using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 186 potentially relevant instruments, 152 of which were analysed to develop the taxonomy. Eighty-four instruments measured constructs relevant to primary care, with content measuring CQI implementation and use (19 instruments), organizational context (51 instruments), and individual factors (21 instruments). Forty-one instruments were included for full review. Development methods were often pragmatic, rather than systematic and theory-based, and evidence supporting measurement properties was limited. Conclusions Many instruments are available for evaluating CQI, but most require further use and testing to establish their measurement properties. Further development and use of these measures in evaluations should increase the contribution made by individual studies to our understanding of CQI and enhance our ability to synthesise evidence for informing policy and practice. PMID:23241168

Filling the treatment gap: developing a task sharing counselling intervention for perinatal depression in Khayelitsha, South Africa.

PubMed

Nyatsanza, Memory; Schneider, Marguerite; Davies, Thandi; Lund, Crick

2016-05-26

Perinatal depression is a major public health issue especially in low income settings in South Africa, where there is a shortage of mental health professionals. New psychological interventions delivered by non-specialists are needed to fill the treatment gap. This paper describes the process of developing a manual based task sharing counselling intervention for perinatal depression in Khayelitsha, Cape Town. Qualitative semi-structured interviews were conducted with 26 participants, including service providers and service users at a clinic in Khayelitsha in order to explore the feasibility, acceptability and content of a task sharing counselling intervention. The interviews were recorded, translated and transcribed. Themes were identified using the framework analysis approach and were coded and analysed using NVivo v10. After the semi-structured interviews, a workshop was conducted with mental health experts on evidence-based psychological interventions for depression, together with a document review of counselling manuals for community health workers in South Africa. The findings indicate that a task sharing counselling intervention was acceptable and feasible for depressed women in Khayelitsha, under the following conditions: (1) respondents preferred a female counsellor and felt that clinic based individual sessions should be provided at least once a month by an experienced Xhosa speaking counsellor from the community; and (2) the content of a counselling intervention should include psycho-education on cognitive and behavioural effects of depression, how to cope with interpersonal problems, and financial stressors. Based on these conditions, the review of manuals and expert consultation, key components of the counselling intervention were identified as: psycho-education, problem solving, healthy thinking and behaviour activation. These were included in the final counselling manual. The development of task sharing counselling interventions for perinatal depression should be informed by the views and needs of local service users and service providers. The study illustrates the manner in which these views can be incorporated for the development of evidence-based psychological interventions, within a task sharing framework in low and middle-income countries.

The research evidence published in high impact nursing journals between 2000 and 2006: a quantitative content analysis.

PubMed

Mantzoukas, Stefanos

2009-04-01

Evidence-based practice has become an imperative for efficient, effective and safe practice. Furthermore, evidences emerging from published research are considered as valid knowledge sources to guiding practice. The aim of this paper is to review all research articles published in the top 10 general nursing journals for the years 2000-2006 to identify the methodologies used, the types of evidence these studies produced and the issues upon which they endeavored. Quantitative content analysis was implemented to study all published research papers of the top 10 general nursing journals for the years 2000-2006. The top 10 general nursing journals were included in the study. The abstracts of all research articles were analysed with regards the methodologies of enquiry, the types of evidence produced and the issues of study they endeavored upon. Percentages were developed as to enable conclusions to be drawn. The results for the category methodologies used were 7% experimental, 6% quasi-experimental, 39% non-experimental, 2% ethnographical studies, 7% phenomenological, 4% grounded theory, 1% action research, 1% case study, 15% unspecified, 5.5% other, 0.5% meta-synthesis, 2% meta-analysis, 5% literature reviews and 3% secondary analysis. For the category types of evidence were 4% hypothesis/theory testing, 11% evaluative, 5% comparative, 2% correlational, 46% descriptive, 5% interpretative and 27% exploratory. For the category issues of study were 45% practice/clinical, 8% educational, 11% professional, 3% spiritual/ethical/metaphysical, 26% health promotion and 7% managerial/policy. Published studies can provide adequate evidences for practice if nursing journals conceptualise evidence emerging from non-experimental and qualitative studies as relevant types of evidences for practice and develop appropriate mechanisms for assessing their validity. Also, nursing journals need to increase and encourage the publication of studies that implement RCT methodology, systematic reviews, meta-synthesis and meta-analysis methodologies. Finally, nursing journals need to encourage more high quality research evidence that derive from interpretative, theory testing and evaluative types of studies that are practice relevant.

Building capacity in implementation science research training at the University of Nairobi.

PubMed

Osanjo, George O; Oyugi, Julius O; Kibwage, Isaac O; Mwanda, Walter O; Ngugi, Elizabeth N; Otieno, Fredrick C; Ndege, Wycliffe; Child, Mara; Farquhar, Carey; Penner, Jeremy; Talib, Zohray; Kiarie, James N

2016-03-08

Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science. This paper describes how the University of Nairobi leveraged resources from the Medical Education Partnership to develop an institutional program that provides training and mentoring in implementation science, builds relationships between researchers and implementers, and identifies local research priorities for implementation science. The curriculum content includes core material in implementation science theory, methods, and experiences. The program adopts a team mentoring and supervision approach, in which fellows are matched with mentors at the University of Nairobi and partnering institutions: University of Washington, Seattle, and University of Maryland, Baltimore. A survey of program participants showed a high degree satisfaction with most aspects of the program, including the content, duration, and attachment sites. A key strength of the fellowship program is the partnership approach, which leverages innovative use of information technology to offer diverse perspectives, and a team model for mentorship and supervision. As health care systems and training institutions seek new approaches to increase capacity in implementation science, the University of Nairobi Implementation Science Fellowship program can be a model for health educators and administrators who wish to develop their program and curricula.

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

PubMed

Prinja, S

2010-01-01

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

What Counts as Validity Evidence? Examples and Prevalence in a Systematic Review of Simulation-Based Assessment

ERIC Educational Resources Information Center

Cook, David A.; Zendejas, Benjamin; Hamstra, Stanley J.; Hatala, Rose; Brydges, Ryan

2014-01-01

Ongoing transformations in health professions education underscore the need for valid and reliable assessment. The current standard for assessment validation requires evidence from five sources: content, response process, internal structure, relations with other variables, and consequences. However, researchers remain uncertain regarding the types…

34 CFR 34.17 - Content of decision.

Code of Federal Regulations, 2013 CFR

2013-07-01

... decision. (a) The written decision is based on the evidence contained in the hearing record. The decision includes— (1) A description of the evidence considered by the hearing official; (2) The hearing official's... rights under this part for reconsideration of the decision. (b) The hearing official's decision is the...

Social networking profiles and professionalism issues in residency applicants: an original study-cohort study.

PubMed

Ponce, Brent A; Determann, Jason R; Boohaker, Hikel A; Sheppard, Evan; McGwin, Gerald; Theiss, Steven

2013-01-01

To determine the frequency of social networking, the degree of information publicly disclosed, and whether unprofessional content was identified in applicants from the 2010 Residency Match. Medical professionalism is an essential competency for physicians to learn, and information found on social networking sites may be hazardous to the doctor-patient relationship and an institution's public perception. No study has analyzed the social network content of applicants applying for residency. Online review of social networking Facebook profiles of graduating medical students applying for a residency in orthopedic surgery. Evidence of unprofessional content was based upon Accreditation Council for Graduate Medical Education guidelines. Additional recorded applicant data included as follows: age, United States Medical Licensing Examination part I score, and residency composite score. Relationship between professionalism score and recorded data points was evaluated using an analysis of variance. Nearly half of all applicants, 46% (200/431), had a Facebook profile. The majority of profiles (85%) did not restrict online access to their profile. Unprofessional content was identified in 16% of resident applicant profiles. Variables associated with lower professionalism scores included unmarried relationship status and lower residency composite scores. It is critical for healthcare professionals to recognize both the benefits and risks present with electronic communication and to vigorously protect the content of material allowed to be publically accessed through the Internet. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Developing and using a rubric for evaluating evidence-based medicine point-of-care tools

PubMed Central

Foster, Margaret J

2011-01-01

Objective: The research sought to establish a rubric for evaluating evidence-based medicine (EBM) point-of-care tools in a health sciences library. Methods: The authors searched the literature for EBM tool evaluations and found that most previous reviews were designed to evaluate the ability of an EBM tool to answer a clinical question. The researchers' goal was to develop and complete rubrics for assessing these tools based on criteria for a general evaluation of tools (reviewing content, search options, quality control, and grading) and criteria for an evaluation of clinical summaries (searching tools for treatments of common diagnoses and evaluating summaries for quality control). Results: Differences between EBM tools' options, content coverage, and usability were minimal. However, the products' methods for locating and grading evidence varied widely in transparency and process. Conclusions: As EBM tools are constantly updating and evolving, evaluation of these tools needs to be conducted frequently. Standards for evaluating EBM tools need to be established, with one method being the use of objective rubrics. In addition, EBM tools need to provide more information about authorship, reviewers, methods for evidence collection, and grading system employed. PMID:21753917

Evidence-Based Design of Fixed-Dose Combinations: Principles and Application to Pediatric Anti-Tuberculosis Therapy.

PubMed

Svensson, Elin M; Yngman, Gunnar; Denti, Paolo; McIlleron, Helen; Kjellsson, Maria C; Karlsson, Mats O

2018-05-01

Fixed-dose combination formulations where several drugs are included in one tablet are important for the implementation of many long-term multidrug therapies. The selection of optimal dose ratios and tablet content of a fixed-dose combination and the design of individualized dosing regimens is a complex task, requiring multiple simultaneous considerations. In this work, a methodology for the rational design of a fixed-dose combination was developed and applied to the case of a three-drug pediatric anti-tuberculosis formulation individualized on body weight. The optimization methodology synthesizes information about the intended use population, the pharmacokinetic properties of the drugs, therapeutic targets, and practical constraints. A utility function is included to penalize deviations from the targets; a sequential estimation procedure was developed for stable estimation of break-points for individualized dosing. The suggested optimized pediatric anti-tuberculosis fixed-dose combination was compared with the recently launched World Health Organization-endorsed formulation. The optimized fixed-dose combination included 15, 36, and 16% higher amounts of rifampicin, isoniazid, and pyrazinamide, respectively. The optimized fixed-dose combination is expected to result in overall less deviation from the therapeutic targets based on adult exposure and substantially fewer children with underexposure (below half the target). The development of this design tool can aid the implementation of evidence-based formulations, integrating available knowledge and practical considerations, to optimize drug exposures and thereby treatment outcomes.

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

PubMed

Canada, Amanda N

2016-04-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based practice and critical thinking. • Identify the relationship between evidence-based practice and critical thinking. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Evidence-based practice is not a new concept to the profession of nursing, yet its application and sustainability is inconsistent in nursing practice. Despite the expansion of efforts to teach evidence-based practice and practically apply evidence at the bedside, a research-practice gap still exists. Several critical factors contribute to the successful application of evidence into practice, including critical thinking. The purpose of this article is to discuss the relationship between critical thinking and the current evidence-based practice implementation models. Understanding this relationship will help nurse educators and clinicians in cultivating critical thinking skills in nursing staff to most effectively apply evidence at the bedside. Critical thinking is a key element and is essential to the learning and implementation of evidence-based practice, as demonstrated by its integration into evidence-based practice implementation models. Copyright 2016, SLACK Incorporated.

National preceptor development program (PDP): Influential evidence and theory. The first of a 3-part series.

PubMed

Mulherin, Katrina; Walter, Sheila; Cox, Craig D

2018-03-01

Priority #3 of the Canadian Experiential Education Project for Pharmacy provided evidence-based guidance for the design and implementation of a national approach to preceptor development. In this first article (of three), findings from the project and recommendations to achieve a high-quality preceptor development program (PDP) are presented. A multi-method approach including detailed semi-structured interviews, classic literature review, and advisory committee feedback was employed. The research team performed an integrated analysis of all data to achieve the objectives of Priority #3. Fifteen formal interviews, 167 articles and two stakeholder meetings informed findings. Experiential Education programs exhibited commonality in content and usually delivered programs online using modules or live lectures. Not all programs required preceptor education despite it being mandated by academic accreditors. Academics' perceptions varied regarding pharmacists' baseline knowledge, skills and attitudes prior to engaging in the preceptor role. A national approach to a PDP was desired if jurisdictional content was accommodated. Copious interprofessional literature of generally fair quality did not identify superior preceptor development approaches although there were numerous descriptions of interventions. Only 29 articles measured educational outcomes. Outcomes included satisfaction rates, self-efficacy and perceived knowledge, skill retention, skill implementation and participation rates. Twelve recommendations were identified to guide successful development of a national PDP. In the absence of good evidence, adult educational theory provided a basis for an effective PDP. Findings from Priority #3 may be relevant not only to pharmacy in Canada but other health professions and counterparts in other western nations with similar approaches to professional education. Copyright © 2017 Elsevier Inc. All rights reserved.

IVIG Versus PLEX in the Treatment of Worsening Myasthenia Gravis: What is the Evidence?: A Critically Appraised Topic.

PubMed

Dhawan, Priya S; Goodman, Brent P; Harper, Charles M; Bosch, Peter E; Hoffman-Snyder, Charlene R; Wellik, Kay E; Wingerchuk, Dean M; Demaerschalk, Bart M

2015-05-01

Immune therapies such as intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) are first line in the treatment of worsening myasthenia gravis. Although PLEX is favored in myasthenic crisis, IVIG is increasingly used in exacerbations due to cost and ease of administration. To review and critically assess current evidence on the effects of IVIG and PLEX on functional outcomes in patients with worsening myasthenia gravis. A structured critical appraisal was conducted on the objective topic. This included a creation of a structured question based on a clinical scenario, comprehensive literature search, selection of evidence for review, and critical appraisal of selected evidence. Evidence was summarized and commentary provided. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and content experts in the field of neuromuscular neurology. A single-blinded, randomized-controlled trial that compared IVIG and PLEX in 84 patients with worsening myasthenia gravis was selected for review. Primary outcome measure was functional status at 14 days after treatment, as assessed by the Quantitative Myasthenia Gravis Score. Change in Quantitative Myasthenia Gravis Score at day 14 for all subjects was 4.0, without statistically significant differences between IVIG and PLEX groups. IVIG and PLEX are equally effective in worsening myasthenia gravis. Treatment decisions may depend on several variables, including presence of respiratory distress, medical comorbidities, access to medication, and cost. PLEX will likely remain the treatment of choice in true myasthenic crisis.

The Integration of Language and Content: Form-Focused Instruction in a Content-Based Language Program

ERIC Educational Resources Information Center

Valeo, Antonella

2013-01-01

This comparative, classroom-based study investigated the effect and effectiveness of introducing a focus on form approach to a content-based, occupation-specific language program for adults. Thirty-six adults in two classes participated in a 10-week study. One group of 16 adults received content-based instruction that included a focus on form…

The readability of expert reports for non-scientist report-users: reports of DNA analysis.

PubMed

Howes, Loene M; Julian, Roberta; Kelty, Sally F; Kemp, Nenagh; Kirkbride, K Paul

2014-04-01

DNA evidence can be extremely compelling. With ongoing scientific advances and applications of DNA evidence in the criminal justice system, it is increasingly important that police, lawyers, and judges recognise both the limitations of DNA evidence and the strength of the evidence in particular cases. Because most forensic sciences are formally communicated via expert reports, we analysed the readability of 68 such reports of DNA evidence from 6 of 8 Australian jurisdictions. We conducted content analyses using three categories: content and sequence, language, and format. Categories contained qualitative and quantitative items drawn from theory and past research. Report styles differed by jurisdiction and by main audience - police and the courts. Reports for police were brief and few links were made between sections in these reports. Reports for courts were less brief and used either legal or scientific styles. Common sections in reports for courts included: the scientist's specialised knowledge; laboratory accreditation information; item list; results; and notes on interpretation. Sections were often not in a logical sequence, due to the use of appendices. According to Flesch Reading Ease scores, reports for police had language that was fairly difficult, and reports for courts, difficult. Difficulty was compounded by the use of specialist terms. Reports for police and the appendices of reports for court often used very small font and single line spacing. Many reports for court contained tables that spanned several pages. Suggestions based on theory and past research are provided to assist scientists to enhance the readability of reports for non-scientists. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Integrating critical thinking and evidence-based dentistry across a four-year dental curriculum: a model for independent learning.

PubMed

Marshall, Teresa A; Straub-Morarend, Cheryl L; Handoo, Nidhi; Solow, Catherine M; Cunningham-Ford, Marsha A; Finkelstein, Michael W

2014-03-01

Introducing critical thinking and evidence-based dentistry (EBD) content into an established dental curriculum can be a difficult and challenging process. Over the past three years, the University of Iowa College of Dentistry has developed and implemented a progressive four-year integrated critical thinking and EBD curriculum. The objective of this article is to describe the development and implementation process to make it available as a model for other dental schools contemplating introduction of critical thinking and EBD into their curricula. The newly designed curriculum built upon an existing problem-based learning foundation, which introduces critical thinking and the scientific literature in the D1 year, in order to expose students to the rationale and resources for practicing EBD in the D2 and D3 years and provide opportunities to practice critical thinking and apply the EBD five-step process in the D2, D3, and D4 years. All curricular content is online, and D3 and D4 EBD activities are integrated within existing clinical responsibilities. The curricular content, student resources, and student activities are described.

Evaluating an Instrument to Measure Mental Load and Mental Effort Considering Different Sources of Validity Evidence

ERIC Educational Resources Information Center

Krell, Moritz

2017-01-01

This study evaluates a 12-item instrument for subjective measurement of mental load (ML) and mental effort (ME) by analysing different sources of validity evidence. The findings of an expert judgement (N = 8) provide "evidence based on test content" that the formulation of the items corresponds to the meaning of ML and ME. An empirical…

To Be Real or Virtual? That is the Question….

PubMed

de Araujo, Luiz Roberto Reis

2016-12-01

This editorial describes a crossroad that many plastic surgeons face when they have to decide how to manage their career. Level of Evidence V This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An examination of the demographic predictors of adolescent breakfast consumption, content, and context

PubMed Central

2014-01-01

Background Breakfast consumption is important to health; however, adolescents often skip breakfast, and an increased understanding of the breakfast consumption patterns of adolescents is needed. The purpose of this study was to identify the predictors of breakfast eating, including the content and context, in an adolescent sample from Australia and England. Methods Four-hundred and eighty-one students completed an online questionnaire measuring breakfast skipping, and breakfast content (what was eaten) and context (who they ate with, involvement in preparation). Logistic regression was conducted to investigate the predictors of skipping breakfast, breakfast context, and consumption of the ten most commonly consumed foods. Chi-square analyses were used to examine differences in breakfast content according to context. Results Most students (88%) had consumed breakfast on the day of the survey; breakfast skipping was more common in England (18%) than in Australia (8%). Country, gender, socioeconomic status, and body mass index (BMI) were all predictors of breakfast content and context. Whether adolescents ate with others and/or were involved in breakfast preparation predicted the content of breakfast consumed. Conclusions This study provides a comprehensive examination of the factors underlying breakfast consumption (content and context) and has important implications for the development of evidence-based interventions to improve rates of breakfast consumption and the quality of food consumed amongst adolescents. PMID:24645936

Content-Based Instruction.

ERIC Educational Resources Information Center

CATESOL Journal, 1992

1992-01-01

This English-as-a-Second Language (ESL) journal periodical devotes entire issues to specific issues. The theme of this issue is "Content-Base Instruction." Articles include: "Syllabus Design in Content-Based Instruction" (David E. Eskey); "How Relevant Is Relevance?: An Examination of Student Needs, Interests, and…

On the road to becoming a responsible leader: A simulation-based training approach for final year medical students

PubMed Central

Schmidt-Huber, Marion; Netzel, Janine; Kiesewetter, Jan

2017-01-01

Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today’s medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians’ success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews (N=19) with relevant personnel (e.g. experienced doctors/nurses, residents) and upon evidence-based leadership contents focusing on ethical leadership behaviors. Method: The training consists of four sessions (3-4 hours each) and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program (N=37). Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer) and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects) and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician). We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific competencies, relevant for effective interprofessional collaboration (active perspective-taking, communication, conflict management, personal competencies). Conclusion: The training of leadership competencies for young physicians seems feasible to develop constructive influence strategies for a successful interprofessional collaboration in early career stages. The simulation-based approach is beneficial for residents to practice leadership behaviour in realistic job situations. PMID:28890925

On the road to becoming a responsible leader: A simulation-based training approach for final year medical students.

PubMed

Schmidt-Huber, Marion; Netzel, Janine; Kiesewetter, Jan

2017-01-01

Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today's medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians' success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews ( N =19) with relevant personnel (e.g. experienced doctors/nurses, residents) and upon evidence-based leadership contents focusing on ethical leadership behaviors. Method: The training consists of four sessions (3-4 hours each) and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program ( N =37). Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer) and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects) and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician). We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific competencies, relevant for effective interprofessional collaboration (active perspective-taking, communication, conflict management, personal competencies). Conclusion: The training of leadership competencies for young physicians seems feasible to develop constructive influence strategies for a successful interprofessional collaboration in early career stages. The simulation-based approach is beneficial for residents to practice leadership behaviour in realistic job situations.

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

PubMed Central

Płaszewski, Maciej; Bettany-Saltikov, Josette

2014-01-01

Background Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Objectives Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Design Systematic overview of systematic reviews. Methods Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews. Results From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Conclusions Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence. Protocol registry number CRD42013003538, PROSPERO PMID:25353954

Non-surgical interventions for adolescents with idiopathic scoliosis: an overview of systematic reviews.

PubMed

Płaszewski, Maciej; Bettany-Saltikov, Josette

2014-01-01

Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Systematic overview of systematic reviews. Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute's hierarchies were applied to analyze the levels of evidence from included reviews. From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence. CRD42013003538, PROSPERO.

[Barriers to evidence-based medicine encountered among GPs - an issue based on misunderstanding? A qualitative study in the general practice setting].

PubMed

Bölter, Regine; Kühlein, Thomas; Ose, Dominik; Götz, Katja; Freund, Tobias; Szecsenyi, Joachim; Miksch, Antje

2010-01-01

The Chronic Care Model (CCM) is a framework for the structured care of patients with chronic conditions. It requires access of both physicians and patients to scientific evidence in order to facilitate shared treatment decision-making on the basis of the patient's individual needs and the best available external evidence. The aim of this study was to find out whether general practitioners (GP) actually make use of evidence-based information and guidelines and whether and how they communicate this information to their patients. We interviewed 14 general practitioners and conducted a content analysis. The majority of these GPs take a sceptical view towards evidence-based guidelines. Their main point of criticism is that guidelines disregard the individual patient's reality and life style. Instead, GPs emphasize the relevance of their own knowledge of the personal and medical history of and the continual care for their patients. Since GPs themselves often do not accept guidelines, they seldom impart their content to their patients. According to the GPs' experience there are contradictions between guideline-conformant therapy and individual treatment. The integrative character of evidence-based medicine is not recognized. The reason is that evidence-based medicine is equated with guidelines and trial results by the majority of the GPs interviewed. To facilitate guideline implementation in everyday practice GPs need to be provided with adequate access to scientific evidence and an understanding of the intentions of guidelines. If the doctors themselves do not accept guidelines, they will not share them with their patients. It must be made clear that guidelines are not intended as normative demands for a specific therapy for every patient, but are rather meant to assist the physician with his struggle for the best therapy for individual patients. Copyright © 2010. Published by Elsevier GmbH.

Using mobile electronic devices to deliver educational resources in developing countries.

PubMed

Mazal, Jonathan Robert; Ludwig, Rebecca

2015-01-01

Developing countries have far fewer trained radiography professionals than developed countries, which exacerbates the limited access to imaging services. The lack of trained radiographers reflects, in part, limited availability of radiographer-specific educational resources. Historically, organizations that provided such resources in the developing world faced challenges related to the limited stock of current materials as well as expenses associated with shipping and delivery. Four mobile electronic devices (MEDs) were loaded with educational content (e-books, PDFs, and digital applications) spanning major radiography topics. The MEDs were distributed to 4 imaging departments in Ghana, India, Nepal, and Nigeria based on evidence of need for radiography-specific resources, as revealed by survey responses. A cost comparison of postal delivery vs digital delivery of educational content was performed. The effectiveness of delivering additional content via Wi-Fi transmission also was evaluated. Feedback was solicited on users' experience with the MEDs as a delivery tool for educational content. An initial average per e-book expense of $30.05, which included the cost of the device, was calculated for the MED delivery method compared with $15.56 for postal delivery of printed materials. The cost of the MED delivery method was reduced to an average of $10.05 for subsequent e-book deliveries. Additional content was successfully delivered via Wi-Fi transmission to all recipients during the 3-month follow-up period. Overall user feedback on the experience was positive, and ideas for enhancing the MED-based method were identified. Using MEDs to deliver radiography-specific educational content appears to be more cost effective than postal delivery of printed materials on a long-term basis. MEDs are more efficient for providing updates to educational materials. Customization of content to department needs, and using projector devices could enhance the usefulness of MEDs for radiographer training.

The selenium content of SEPP1 versus selenium requirements in vertebrates

PubMed Central

Hamre, Kristin; Ellingsen, Ståle

2015-01-01

Selenoprotein P (SEPP1) distributes selenium (Se) throughout the body via the circulatory system. For vertebrates, the Se content of SEPP1 varies from 7 to 18 Se atoms depending on the species, but the reason for this variation remains unclear. Herein we provide evidence that vertebrate SEPP1 Sec content correlates positively with Se requirements. As the Se content of full length SEPP1 is genetically determined, this presents a unique case where a nutrient requirement can be predicted based on genomic sequence information. PMID:26734501

Development of Islamic Spiritual Health Scale (ISHS).

PubMed

Khorashadizadeh, Fatemeh; Heydari, Abbas; Nabavi, Fatemeh Heshmati; Mazlom, Seyed Reza; Ebrahimi, Mahdi; Esmaili, Habibollah

2017-03-01

To develop and psychometrically assess spiritual health scale based on Islamic view in Iran. The cross-sectional study was conducted at Imam Ali and Quem hospitals in Mashhad and Imam Ali and Imam Reza hospitals in Bojnurd, Iran, from 2015 to 2016 In the first stage, an 81-item Likert-type scale was developed using a qualitative approach. The second stage comprised quantitative component. The scale's impact factor, content validity ratio, content validity index, face validity and exploratory factor analysis were calculated. Test-retest and internal consistency was used to examine the reliability of the instrument. Data analysis was done using SPSS 11. Of 81 items in the scale, those with impact factor above 1.5, content validity ratio above 0.62, and content validity index above 0.79 were considered valid and the rest were discarded, resulting in a 61-item scale. Exploratory factor analysis reduced the list of items to 30, which were divided into seven groups with a minimum eigen value of 1 for each factor. But according to scatter plot, attributes of the concept of spiritual health included love to creator, duty-based life, religious rationality, psychological balance, and attention to afterlife. Internal reliability of the scale was calculated by alpha Cronbach coefficient as 0.91. There was solid evidence of the strength factor structure and reliability of the Islamic Spiritual Health Scale which provides a unique way for spiritual health assessment of Muslims.

Content-based fused off-axis object illumination direct-to-digital holography

DOEpatents

Price, Jeffery R.

2006-05-02

Systems and methods are described for content-based fused off-axis illumination direct-to-digital holography. A method includes calculating an illumination angle with respect to an optical axis defined by a focusing lens as a function of data representing a Fourier analyzed spatially heterodyne hologram; reflecting a reference beam from a reference mirror at a non-normal angle; reflecting an object beam from an object the object beam incident upon the object at the illumination angle; focusing the reference beam and the object beam at a focal plane of a digital recorder to from the content-based off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes for Fourier analysis; and digitally recording the content based off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes for Fourier analysis.

User Experiences of the McMaster Optimal Aging Portal’s Evidence Summaries and Blog Posts: Usability Study

PubMed Central

M Barbara, Angela; Dobbins, Maureen; Haynes, R Brian; Iorio, Alfonso; Lavis, John N

2016-01-01

Background Evidence summaries and blogs can support evidence-informed healthy aging, by presenting high-quality health research evidence in plain language for a nonprofessional (citizen) audience. Objective Our objective was to explore citizens’ perceptions about the usability of evidence summaries and blog posts on the Web-based McMaster Optimal Aging Portal. Methods Twenty-two citizens (aged 50 years and older) and informal caregivers participated in a qualitative study using a think-aloud method and semistructured interviews. Eleven interviews were conducted in person, 7 over the telephone, and 4 by Skype. Results We identified themes that fell under 4 user-experience categories: (1) desirability: personal relevance, (2) understandability: language comprehension, grasping the message, dealing with uncertainty, (3) usability: volume of information, use of numbers, and (4) usefulness: intention to use, facility for sharing. Conclusions Participants recognized that high-quality evidence on aging was valuable. Their intended use of the information was influenced by how much it applied to their own health circumstances or those of a loved one. Some specific formatting features that were preferred included consistent layout, content organized by subheadings, catchy titles, numerical information summarized in a table, and inclusion of a glossary. PMID:27542995

Development of a multimedia educational programme for first-time hearing aid users: a participatory design.

PubMed

Ferguson, Melanie; Leighton, Paul; Brandreth, Marian; Wharrad, Heather

2018-05-02

To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

An analysis of state legislation on community trails.

PubMed

Eyler, Amy; Lankford, Tina; Chriqui, Jamie; Evenson, Kelly R; Kruger, Judy; Tompkins, Nancy; Voorhees, Carolyn; Zieff, Susan; Aytur, Semra; Brownson, Ross

2010-03-01

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements. State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance. Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance. There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation.

PubMed

Baskerville, Neill B; Struik, Laura L; Dash, Darly

2018-03-02

Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app. The Spiral Technology Action Research (STAR) 5-cycle model (listen, plan, do, act, and study) was employed to guide the development, implementation, and dissemination of CTC. The approach to development and formative evaluation included focus groups with young adult smokers (n=78) across 2 phases, analysis of the content of existing apps, 2 sessions with content experts, and Google Analytics to assess user behavior during a 12-month pilot. LISTEN-focus groups revealed young adult smoker preferences of (1) positive reinforcement, (2) personalization, (3) social support, (4) quit support, (5) tracking the behavior, and (6) tracking quit benefits. PLAN-informed by evidence for smoking cessation, young adult preferences and an assessment of popular cessation apps, content experts produced a mind map and a storyboard describing app content and structure. DO-focus groups with young adult smokers provided feedback on the first version of the app with opinions on content and suggestions for improvement such as providing alerts and distractions from craving. ACT-refinements were made, and app content was organized using the 4 key design components informed by principles of persuasive technology for behavior change: credibility, task support, dialogue support, and social support. CTC was launched in April 2013 and piloted from the period July 2013 to June 2014 where 1987 Android users had 18,567 sessions, resulting in 59,384 page views and 89.58% (1780/1987) of users returning within the same day to use CTC. STUDY-a pragmatic randomized controlled trial of CTC was launched in August 2014 to demonstrate that including mHealth technology as a population-based intervention can help young adult smokers to quit. The results of this phase will be presented in a subsequent publication. CTC is one of the first smoking cessation apps designed to meet the needs of young adult smokers. The development was informed by the inclusion of young adults in the design and the systematic application of multiple stakeholder input, scientific evidence, and theory. The STAR model approach was followed from the beginning of intervention development, which should facilitate optimization of mHealth interventions in the future. ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i). ©Neill B Baskerville, Laura L Struik, Darly Dash. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.03.2018.

Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation

PubMed Central

2018-01-01

Background Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. Objective The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app. Methods The Spiral Technology Action Research (STAR) 5-cycle model (listen, plan, do, act, and study) was employed to guide the development, implementation, and dissemination of CTC. The approach to development and formative evaluation included focus groups with young adult smokers (n=78) across 2 phases, analysis of the content of existing apps, 2 sessions with content experts, and Google Analytics to assess user behavior during a 12-month pilot. Results LISTEN—focus groups revealed young adult smoker preferences of (1) positive reinforcement, (2) personalization, (3) social support, (4) quit support, (5) tracking the behavior, and (6) tracking quit benefits. PLAN—informed by evidence for smoking cessation, young adult preferences and an assessment of popular cessation apps, content experts produced a mind map and a storyboard describing app content and structure. DO—focus groups with young adult smokers provided feedback on the first version of the app with opinions on content and suggestions for improvement such as providing alerts and distractions from craving. ACT—refinements were made, and app content was organized using the 4 key design components informed by principles of persuasive technology for behavior change: credibility, task support, dialogue support, and social support. CTC was launched in April 2013 and piloted from the period July 2013 to June 2014 where 1987 Android users had 18,567 sessions, resulting in 59,384 page views and 89.58% (1780/1987) of users returning within the same day to use CTC. STUDY—a pragmatic randomized controlled trial of CTC was launched in August 2014 to demonstrate that including mHealth technology as a population-based intervention can help young adult smokers to quit. The results of this phase will be presented in a subsequent publication. Conclusions CTC is one of the first smoking cessation apps designed to meet the needs of young adult smokers. The development was informed by the inclusion of young adults in the design and the systematic application of multiple stakeholder input, scientific evidence, and theory. The STAR model approach was followed from the beginning of intervention development, which should facilitate optimization of mHealth interventions in the future. Trial Registration ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i) PMID:29500157

Sesame Street Picnic: An Introductory Activity to Claims, Evidence, and Rationale

ERIC Educational Resources Information Center

Del Carlo, Dawn; Flokstra, Brittany

2017-01-01

Recent calls for reform in K-16 science, technology, engineering, and mathematics (STEM) education not only emphasize mastery of content, but also call for students to engage in the scientific practice of making evidence-based claims, or scientific argumentation (National Research Council, 2012; NGSS Lead States, 2013). However, students often…

Hierarchical Linear Modeling Meta-Analysis of Single-Subject Design Research

ERIC Educational Resources Information Center

Gage, Nicholas A.; Lewis, Timothy J.

2014-01-01

The identification of evidence-based practices continues to provoke issues of disagreement across multiple fields. One area of contention is the role of single-subject design (SSD) research in providing scientific evidence. The debate about SSD's utility centers on three issues: sample size, effect size, and serial dependence. One potential…

Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study.

PubMed

Morrison, Deborah; Mair, Frances S; Chaudhuri, Rekha; McGee-Lennon, Marilyn; Thomas, Mike; Thomson, Neil C; Yardley, Lucy; Wyke, Sally

2015-07-28

Around 300 million people worldwide have asthma and prevalence is increasing. Self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. We aimed to develop an evidence based, theory informed, online resource to support self-management in adults with asthma, called 'Living well with Asthma', as part of the RAISIN (Randomized Trial of an Asthma Internet Self-Management Intervention) study. We developed Living well with Asthma in two phases. Phase 1: A low fidelity prototype (paper-based) version of the website was developed iteratively through input from a multidisciplinary expert panel, empirical evidence from the literature, and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. Phase 2: The paper-based designs were converted to a website through an iterative user centred process. Adults with asthma (n = 10) took part in think aloud studies, discussing the paper based version, then the web-based version. Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Think aloud transcripts were also thematically analysed, further informing resource development. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback on the contents of the resource was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties. Our multifaceted approach to online intervention development underpinned by theory, using evidence from the literature, co-designed with end users and a multidisciplinary panel has resulted in a resource which end users find relevant to their needs and easy to use. Living well with Asthma is undergoing evaluation within a randomized controlled trial.

[Indication for jointed matrimonial and familial therapy].

PubMed

Carlos Nocetti, J

1975-06-01

Before psychological treatment is prescribed, one should take into account, with utmost detail and depth, the ways and styles of integration of patients into their family-systems. In order to prove this contention we use the theoretical framework of C. A. Paz and D. Liberman, in connection with criteria of "analyzability". We include three clinical examples in which the need for a model allowing for the systemic character of family organization and marriage partnership is put into evidence. The model is built up starting from developments made in the field of Cybernetics which in turn are based upon Set theory.

Documentary Evidence and the Construction of Narratives in Legal and Historical Contexts.

PubMed

Jones, Gwynneth C D

2015-02-01

Based on her experiences as an expert witness in Canadian litigation related to Aboriginal peoples, the author shares some personal reflections on the use of the written record as "evidence" in a legal context. As end users in a litigation context will be constructing their own narratives, a historian can add value in the courtroom by sharing skills in analyzing and providing context for written materials as well as providing a narrative based on their content. This process of simultaneously constructing and deconstructing a narrative can support the legitimacy of multiple narratives and provide space for evidence of other types, particularly oral evidence.

Measurement properties of depression questionnaires in patients with diabetes: a systematic review.

PubMed

van Dijk, Susan E M; Adriaanse, Marcel C; van der Zwaan, Lennart; Bosmans, Judith E; van Marwijk, Harm W J; van Tulder, Maurits W; Terwee, Caroline B

2018-06-01

To conduct a systematic review on measurement properties of questionnaires measuring depressive symptoms in adult patients with type 1 or type 2 diabetes. A systematic review of the literature in MEDLINE, EMbase and PsycINFO was performed. Full text, original articles, published in any language up to October 2016 were included. Eligibility for inclusion was independently assessed by three reviewers who worked in pairs. Methodological quality of the studies was evaluated by two independent reviewers using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Quality of the questionnaires was rated per measurement property, based on the number and quality of the included studies and the reported results. Of 6286 unique hits, 21 studies met our criteria evaluating nine different questionnaires in multiple settings and languages. The methodological quality of the included studies was variable for the different measurement properties: 9/15 studies scored 'good' or 'excellent' on internal consistency, 2/5 on reliability, 0/1 on content validity, 10/10 on structural validity, 8/11 on hypothesis testing, 1/5 on cross-cultural validity, and 4/9 on criterion validity. For the CES-D, there was strong evidence for good internal consistency, structural validity, and construct validity; moderate evidence for good criterion validity; and limited evidence for good cross-cultural validity. The PHQ-9 and WHO-5 also performed well on several measurement properties. However, the evidence for structural validity of the PHQ-9 was inconclusive. The WHO-5 was less extensively researched and originally not developed to measure depression. Currently, the CES-D is best supported for measuring depressive symptoms in diabetes patients.

The nutritive and immunoprotective quality of human milk beyond 1 year postpartum: are lactation-duration-based donor exclusions justified?

PubMed

Perrin, Maryanne Tigchelaar; Fogleman, April; Allen, Jonathan C

2013-08-01

Donor human milk is critical for the fragile preterm infant who does not have access to his or her mother's milk, improving survival rates and quality of survival and decreasing hospital stay. Despite the opening of donor milk banks around the world, shortages continue as demand for donor milk exceeds supply. One potential means of increasing supply is by reducing exclusion criteria that prohibit mothers from donating milk based on duration of lactation. Minimal research has been done on the composition of human milk during the second year of lactation, with most research focusing on the nutritive compounds and not the immunoprotective compounds. Several immunoprotective compounds, including lysozyme, lactoferrin, secretory immunoglobulin A, and oligosaccharides, are abundant in human milk compared to bovine-based infant formula and are partially or fully retained during Holder pasteurization, making them an important differentiating feature of donor milk. A PubMed search was conducted to review studies in human milk composition during the second year of lactation. Limitations of existing research include sample collection protocols, small study sizes, and use of populations that may have been at risk for nutritional deficiencies. Stable concentrations of several components were reported including protein, lactose, iron, copper, lactoferrin, and secretory immunoglobulin A. Lysozyme concentration increased during extended lactation, while zinc and calcium concentrations declined into the second year. Conflicting findings were reported on fat content, and no information was available regarding oligosaccharide content. More research is needed to create evidence-based guidelines regarding the nutritive and immunoprotective value of donor milk throughout the course of lactation.

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools

PubMed Central

2013-01-01

Background Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. Methods A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. Results The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students’ inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Conclusions Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective ‘educating the educators’ strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice. PMID:24267512

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools.

PubMed

Gorgon, Edward James R; Basco, Mark David S; Manuel, Almira T

2013-11-22

Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students' inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective 'educating the educators' strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.

Modulation of the gut microbiome: a systematic review of the effect of bariatric surgery.

PubMed

Guo, Yan; Huang, Zhi-Ping; Liu, Chao-Qian; Qi, Lin; Sheng, Yuan; Zou, Da-Jin

2018-01-01

Bariatric surgery is recommended for patients with obesity and type 2 diabetes. Recent evidence suggested a strong connection between gut microbiota and bariatric surgery. Systematic review. The PubMed and OVID EMBASE were used, and articles concerning bariatric surgery and gut microbiota were screened. The main outcome measures were alterations of gut microbiota after bariatric surgery and correlations between gut microbiota and host metabolism. We applied the system of evidence level to evaluate the alteration of microbiota. Modulation of short-chain fatty acid and gut genetic content was also investigated. Totally 12 animal experiments and 9 clinical studies were included. Based on strong evidence, 4 phyla (Bacteroidetes, Fusobacteria, Verrucomicrobia and Proteobacteria) increased after surgery; within the phylum Firmicutes, Lactobacillales and Enterococcus increased; and within the phylum Proteobacteria, Gammaproteobacteria, Enterobacteriales Enterobacteriaceae and several genera and species increased. Decreased microbial groups were Firmicutes, Clostridiales, Clostridiaceae, Blautia and Dorea. However, the change in microbial diversity is still under debate. Faecalibacterium prausnitzii, Lactobacillus and Coprococcus comes are implicated in many of the outcomes, including body composition and glucose homeostasis. There is strong evidence to support a considerable alteration of the gut microbiome after bariatric surgery. Deeper investigations are required to confirm the mechanisms that link the gut microbiome and metabolic alterations in human metabolism. © 2018 European Society of Endocrinology.

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions.

PubMed

Maar, Marion A; Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-22

Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations' capability, opportunity, and motivation for behavior change. The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes.

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions

PubMed Central

Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-01

Background Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. Objective The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Methods Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Results Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations’ capability, opportunity, and motivation for behavior change. Conclusions The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes. PMID:26800712

Integrating nurse researchers in clinical practice - a challenging, but necessary task for nurse leaders.

PubMed

Hølge-Hazelton, Bibi; Kjerholt, Mette; Berthelsen, Connie Bøttcher; Thomsen, Thora Grothe

2016-05-01

To create awareness among nurse leaders, of what they may need to consider, when integrating nurse researchers as advanced nurse practitioners (ANP) at PhD-level among their staff. In a time of transition nurse leaders may be challenged by the change towards evidence-based clinical nursing, including integrating nurse researchers in ANP positions. A collective case study including three ANPs took place at a large regional hospital in Denmark. The cases were first analysed by focusing on the generic features, functions and skills of ANPs, and second by focusing on the approaches to evidence-based practice seen in the cases. Regardless of same position, formal level of research expertise and overall responsibility, different approaches related to each ANPs professional profile, interest, academic ambitions and personality were seen. Nurse leaders must ensure a process where the content and expectations of the particular role are mutually clarified and adjusted to the individual ANP and to the specific context, in order to create a harmonious match. In order to clarify expectations regarding the inclusion of nurse researchers as ANPs at PhD level, the paper provides firm recommendations that may guide the process. © 2015 John Wiley & Sons Ltd.

Understanding primary school science teachers' pedagogical content knowledge: The case of teaching global warming

NASA Astrophysics Data System (ADS)

Chordnork, Boonliang; Yuenyong, Chokchai

2018-01-01

This aim of this research was to investigate primary school science teachers understanding and teaching practice as well as the influence on teaching and learning a topic like global warming. The participants were four primary science teachers, who were not graduated in science education. Methodology was the case study method, which was under the qualitative research regarded from interpretive paradigm. Data were collected by openended questionnaire, semi-structure interview, and document colleting. The questionnaire examined teachers' background, teachers' understanding of problems and threats of science teaching, desiring of development their PCK, sharing the teaching approaches, and their ideas of strength and weakness. a semi-structured interview was conducted based on the approach for capturing PCK of Loughran [23] content representation (CoRe). And, the document was collected to clarify what evidence which was invented to effect on students' learning. These document included lesson plan, students' task, and painting about global warming, science projects, the picture of activities of science learning, the exercise and test. Data analysis employed multiple approach of evidence looking an issue from each primary science teachers and used triangulation method to analyze the data with aiming to make meaning of teachers' representation of teaching practice. These included descriptive statistics, CoRe interpretation, and document analysis. The results show that teachers had misunderstanding of science teaching practice and they has articulated the pedagogical content knowledge in terms of assessment, goal of teaching and linking to the context of socio cultural. In contrast, knowledge and belief of curriculum, students' understanding of content global warming, and strategies of teaching were articulated indistinct by non-graduate science teacher. Constructing opportunities for personal development, the curiosity of the student learning center, and linking context of socio-culture were the creative factor in the teaching global warming. On the other hand, the teachers had an idea that lack of technology and the defect of child's intelligence were hinder factors teaching global warming.

Clinical intuition in the nursing process and decision-making-A mixed-studies review.

PubMed

Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

2017-12-01

To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise. © 2017 John Wiley & Sons Ltd.

Behavior Change Techniques in Popular Alcohol Reduction Apps: Content Analysis

PubMed Central

Garnett, Claire; Brown, James; West, Robert; Michie, Susan

2015-01-01

Background Mobile phone apps have the potential to reduce excessive alcohol consumption cost-effectively. Although hundreds of alcohol-related apps are available, there is little information about the behavior change techniques (BCTs) they contain, or the extent to which they are based on evidence or theory and how this relates to their popularity and user ratings. Objective Our aim was to assess the proportion of popular alcohol-related apps available in the United Kingdom that focus on alcohol reduction, identify the BCTs they contain, and explore whether BCTs or the mention of theory or evidence is associated with app popularity and user ratings. Methods We searched the iTunes and Google Play stores with the terms “alcohol” and “drink”, and the first 800 results were classified into alcohol reduction, entertainment, or blood alcohol content measurement. Of those classified as alcohol reduction, all free apps and the top 10 paid apps were coded for BCTs and for reference to evidence or theory. Measures of popularity and user ratings were extracted. Results Of the 800 apps identified, 662 were unique. Of these, 13.7% (91/662) were classified as alcohol reduction (95% CI 11.3-16.6), 53.9% (357/662) entertainment (95% CI 50.1-57.7), 18.9% (125/662) blood alcohol content measurement (95% CI 16.1-22.0) and 13.4% (89/662) other (95% CI 11.1-16.3). The 51 free alcohol reduction apps and the top 10 paid apps contained a mean of 3.6 BCTs (SD 3.4), with approximately 12% (7/61) not including any BCTs. The BCTs used most often were “facilitate self-recording” (54%, 33/61), “provide information on consequences of excessive alcohol use and drinking cessation” (43%, 26/61), “provide feedback on performance” (41%, 25/61), “give options for additional and later support” (25%, 15/61) and “offer/direct towards appropriate written materials” (23%, 14/61). These apps also rarely included any of the 22 BCTs frequently used in other health behavior change interventions (mean 2.46, SD 2.06). Evidence was mentioned by 16.4% of apps, and theory was not mentioned by any app. Multivariable regression showed that apps including advice on environmental restructuring were associated with lower user ratings (Β=-46.61, P=.04, 95% CI -91.77 to -1.45) and that both the techniques of “advise on/facilitate the use of social support” (Β=2549.21, P=.04, 95% CI 96.75-5001.67) and the mention of evidence (Β=1376.74, P=.02, 95%, CI 208.62-2544.86) were associated with the popularity of the app. Conclusions Only a minority of alcohol-related apps promoted health while the majority implicitly or explicitly promoted the use of alcohol. Alcohol-related apps that promoted health contained few BCTs and none referred to theory. The mention of evidence was associated with more popular apps, but popularity and user ratings were only weakly associated with the BCT content. PMID:25977135

Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation

PubMed Central

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A

2014-01-01

Background Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. Objective The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Methods Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. Results The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. Conclusions There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool. PMID:25249003

Web-based intervention programs for depression: a scoping review and evaluation.

PubMed

Renton, Tian; Tang, Herman; Ennis, Naomi; Cusimano, Michael D; Bhalerao, Shree; Schweizer, Tom A; Topolovec-Vranic, Jane

2014-09-23

Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool.

Patient-reported outcome instruments that evaluate adherence behaviours in adults with asthma: A systematic review of measurement properties.

PubMed

Gagné, Myriam; Boulet, Louis-Philippe; Pérez, Norma; Moisan, Jocelyne

2018-04-30

To systematically identify the measurement properties of patient-reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers (1) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness; (2) assessed the methodological quality of the included studies; (3) assessed the quality of the measurement properties (positive or negative); and (4) summarised the level of evidence (limited, moderate, or strong). We screened 6,068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (a) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason Scale (MAR-Scale), Medication Adherence Report Scale for Asthma (MARS-A), and Test of the Adherence to Inhalers (TAI); (b) reliability of the TAI; and (c) structural validity of the Adherence Questionnaire, MAR-Scale, MARS-A, and TAI. We also found limited negative evidence of: (d) hypotheses testing of Adherence Questionnaire; (e) reliability of the MARS-A; and (f) criterion validity of the MARS-A and TAI. Our results highlighted the need to conduct further high-quality studies that will positively evaluate the reliability, validity, and responsiveness of the available PROs. This article is protected by copyright. All rights reserved.

Evaluation of the measurement properties of self-reported health-related work-functioning instruments among workers with common mental disorders.

PubMed

Abma, Femke I; van der Klink, Jac J L; Terwee, Caroline B; Amick, Benjamin C; Bültmann, Ute

2012-01-01

During the past decade, common mental disorders (CMD) have emerged as a major public and occupational health problem in many countries. Several instruments have been developed to measure the influence of health on functioning at work. To select appropriate instruments for use in occupational health practice and research, the measurement properties (eg, reliability, validity, responsiveness) must be evaluated. The objective of this study is to appraise critically and compare the measurement properties of self-reported health-related work-functioning instruments among workers with CMD. A systematic review was performed searching three electronic databases. Papers were included that: (i) mainly focused on the development and/or evaluation of the measurement properties of a self-reported health-related work-functioning instrument; (ii) were conducted in a CMD population; and (iii) were fulltext original papers. Quality appraisal was performed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. Five papers evaluating measurement properties of five self-reported health-related work-functioning instruments in CMD populations were included. There is little evidence available for the measurement properties of the identified instruments in this population, mainly due to low methodological quality of the included studies. The available evidence on measurement properties is based on studies of poor-to-fair methodological quality. Information on a number of measurement properties, such as measurement error, content validity, and cross-cultural validity is still lacking. Therefore, no evidence-based decisions and recommendations can be made for the use of health-related work functioning instruments. Studies of high methodological quality are needed to properly assess the existing instruments' measurement properties.

A step-by-step translation of evidence into a psychosocial intervention for everyday activities in dementia: a focus group study.

PubMed

Giebel, Clarissa M; Challis, David; Hooper, Nigel M; Ferris, Sally

2018-03-01

In order to increase the efficacy of psychosocial interventions in dementia, a step-by-step process translating evidence and public engagement should be adhered to. This paper describes such a process by involving a two-stage focus group with people with dementia (PwD), informal carers, and staff. Based on previous evidence, general aspects of effective interventions were drawn out. These were tested in the first stage of focus groups, one with informal carers and PwD and one with staff. Findings from this stage helped shape the intervention further specifying its content. In the second stage, participants were consulted about the detailed components. The extant evidence base and focus groups helped to identify six practical and situation-specific elements worthy of consideration in planning such an intervention, including underlying theory and personal motivations for participation. Carers, PwD, and staff highlighted the importance of rapport between practitioners and PwD prior to commencing the intervention. It was also considered important that the intervention would be personalised to each individual. This paper shows how valuable public involvement can be to intervention development, and outlines a process of public involvement for future intervention development. The next step would be to formally test the intervention.

The Impact of Electronic Knowledge-Based Nursing Content and Decision-Support on Nursing-Sensitive Patient Outcomes

DTIC Science & Technology

2014-02-01

aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information...if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE February 2014 2... Akre , et al., 2006) content and evidence-based clinical decision support (CDS) tools were embedded into the EHR of one large health care system. Since

An educational video to promote multi-factorial approaches for fall and injury prevention in long-term care facilities

PubMed Central

2014-01-01

Background Older adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting. Methods Two educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory. Results The videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection). Conclusions Educational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice. PMID:24884899

[The General Principles of Suicide Prevention Policy from the perspective of clinical psychiatry].

PubMed

Cho, Yoshinori; Inagaki, Masatoshi

2014-01-01

In view of the fact that the suicide rate in Japan has remained high since 1998, the Basic Act on Suicide Prevention was implemented in 2006 with the objective of comprehensively promoting suicide prevention measures on a national scale. Based on this Basic Act, in 2007, the Japanese government formulated the General Principles of Suicide Prevention Policy as a guideline for recommended suicide prevention measures. These General Principles were revised in 2012 in accordance with the initial plan of holding a review after five years. The Basic Act places an emphasis on the various social factors that underlie suicides and takes the perspective that suicide prevention measures are also social measures. The slogan of the revised General Principles is "Toward Realization of a Society in which Nobody is Driven to Commit Suicide". The General Principles list various measures that are able to be used universally. These contents would be sufficient if the objective of the General Principles were "realization of a society that is easy to live in"; however, the absence of information on the effectiveness and order of priority for each measure may limit the specific effectiveness of the measures in relation to the actual prevention of suicide. In addition, considering that nearly 90% of suicide victims are in a state at the time of committing suicide in which a psychiatric disorder would be diagnosed, it would appear from a psychiatric standpoint that measures related to mental health, including expansion of psychiatric services, should be the top priority in suicide prevention measures. However, this is not the case in the General Principles, in either its original or revised form. Revisions to the General Principles related to clinical psychiatry provide more detailed descriptions of measures for individuals who unsuccessfully attempt suicide and identify newly targeted mental disorders other than depression; however, the overall proportion of contents relating to psychiatric care remains small. In particular, it must be noted that almost no measures are provided for individuals with chronic psychiatric disorders. We believe that the role of academic societies involved in suicide prevention, including our own, is to organize the contents of the General Principles based on evidence, to advance research in areas lacking in evidence, and to promote support for implementation of activities in areas with clear evidence.

Dermatology on YouTube.

PubMed

Boyers, Lindsay N; Quest, Tyler; Karimkhani, Chante; Connett, Jessica; Dellavalle, Robert P

2014-06-15

YouTube, reaches upwards of six billion users on a monthly basis and is a unique source of information distribution and communication. Although the influence of YouTube on personal health decision-making is well established, this study assessed the type of content and viewership on a broad scope of dermatology related content on YouTube. Select terms (i.e. dermatology, sun protection, skin cancer, skin cancer awareness, and skin conditions) were searched on YouTube. Overall, the results included 100 videos with over 47 million viewers. Advocacy was the most prevalent content type at 24% of the total search results. These 100 videos were "shared" a total of 101,173 times and have driven 6,325 subscriptions to distinct YouTube user pages. Of the total videos, 35% were uploaded by or featured an MD/DO/PhD in dermatology or other specialty/field, 2% FNP/PA, 1% RN, and 62% other. As one of the most trafficked global sites on the Internet, YouTube is a valuable resource for dermatologists, physicians in other specialties, and the general public to share their dermatology-related content and gain subscribers. However, challenges of accessing and determining evidence-based data remain an issue.

Fluid inclusion from drill hole DW-5, Hohi geothermal area, Japan: Evidence of boiling and procedure for estimating CO2 content

USGS Publications Warehouse

Sasada, M.; Roedder, E.; Belkin, H.E.

1986-01-01

Fluid inclusion studies have been used to derive a model for fluid evolution in the Hohi geothermal area, Japan. Six types of fluid inclusions are found in quartz obtained from the drill core of DW-5 hole. They are: (I) primary liquid-rich with evidence of boiling; (II) primary liquid-rich without evidence of boiling; (III) primary vapor-rich (assumed to have been formed by boiling); (IV) secondary liquid-rich with evidence of boiling; (V) secondary liquid-rich without evidence of boiling; (VI) secondary vapor-rich (assumed to have been formed by boiling). Homogenization temperatures (Th) range between 196 and 347??C and the final melting point of ice (Tm) between -0.2 and -4.3??C. The CO2 content was estimated semiquantitatively to be between 0 and 0.39 wt. % based on the bubble behavior on crushing. NaCl equivalent solid solute salinity of fluid inclusions was determined as being between 0 and 6.8 wt. % after minor correction for CO2 content. Fluid inclusions in quartz provide a record of geothermal activity of early boiling and later cooling. The CO2 contents and homogenization temperatures of fluid inclusions with evidence of boiling generally increase with depth; these changes, and NaCl equivalent solid solute salinity of the fluid can be explained by an adiabatic boiling model for a CO2-bearing low-salinity fluid. Some high-salinity inclusions without CO2 are presumed to have formed by a local boiling process due to a temperature increase or a pressure decrease. The liquid-rich primary and secondary inclusions without evidence of boiling formed during the cooling process. The salinity and CO2 content of these inclusions are lower than those in the boiling fluid at the early stage, probably as a result of admixture with groundwater. ?? 1986.

On the Wrong Track: Process and Content in Moral Psychology

PubMed Central

Kahane, Guy

2012-01-01

According to Joshua Greene's influential dual process model of moral judgment, different modes of processing are associated with distinct moral outputs: automatic processing with deontological judgment, and controlled processing with utilitarian judgment. This article aims to clarify and assess Greene's model. I argue that the proposed tie between process and content is based on a misinterpretation of the evidence, and that the supposed evidence for controlled processing in utilitarian judgment is actually likely to reflect, not ‘utilitarian reasoning’, but a form of moral deliberation which, ironically, is actually in serious tension with a utilitarian outlook. This alternative account is further supported by the results of a neuroimaging study showing that intuitive and counterintuitive judgments have similar neural correlates whether or not their content is utilitarian or deontological. PMID:23335831

Validity evidence for an OSCE to assess competency in systems-based practice and practice-based learning and improvement: a preliminary investigation.

PubMed

Varkey, Prathibha; Natt, Neena; Lesnick, Timothy; Downing, Steven; Yudkowsky, Rachel

2008-08-01

To determine the psychometric properties and validity of an OSCE to assess the competencies of Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP) in graduate medical education. An eight-station OSCE was piloted at the end of a three-week Quality Improvement elective for nine preventive medicine and endocrinology fellows at Mayo Clinic. The stations assessed performance in quality measurement, root cause analysis, evidence-based medicine, insurance systems, team collaboration, prescription errors, Nolan's model, and negotiation. Fellows' performance in each of the stations was assessed by three faculty experts using checklists and a five-point global competency scale. A modified Angoff procedure was used to set standards. Evidence for the OSCE's validity, feasibility, and acceptability was gathered. Evidence for content and response process validity was judged as excellent by institutional content experts. Interrater reliability of scores ranged from 0.85 to 1 for most stations. Interstation correlation coefficients ranged from -0.62 to 0.99, reflecting case specificity. Implementation cost was approximately $255 per fellow. All faculty members agreed that the OSCE was realistic and capable of providing accurate assessments. The OSCE provides an opportunity to systematically sample the different subdomains of Quality Improvement. Furthermore, the OSCE provides an opportunity for the demonstration of skills rather than the testing of knowledge alone, thus making it a potentially powerful assessment tool for SBP and PBLI. The study OSCE was well suited to assess SBP and PBLI. The evidence gathered through this study lays the foundation for future validation work.

Content, Usability, and Utilization of Plain Language in Breast Cancer Mobile Phone Apps: A Systematic Analysis

PubMed Central

Shah, Sayyed Fawad Ali; West, Andrew J; Bentley, Joshua M; Caburnay, Charlene A; Kreuter, Matthew W; Kinney, Anita Y

2017-01-01

Background Breast cancer is one of the leading contributors to preventable illness and death among women. Although mobile phone apps provide unprecedented opportunity to engage women along the cancer continuum, little is known about the availability, content, and usability of breast cancer mobile phone apps. Objective This study analyzed the content and adherence to literate design standards of all breast cancer-related apps available on the App Store and Google Play, as well as the relationship between their content, user ratings, and price. Methods Following identification and downloading of all available breast cancer mobile phone apps in October 2015, 101 apps were confirmed as focusing on breast cancer. Based on prior research, we adapted and applied a content analysis scheme that was specific to breast cancer apps, including their main purpose, relevance to the cancer care continuum, and adherence to usability standards outlined by the Institute of Medicine (IOM). Results The most common aim of apps was educational (73/101, 72.3%), followed by behavior change (24/101, 23.9%), fundraising (20/101, 19.8%), and advocacy (14/101, 13.9%). On the cancer continuum, primary prevention (strategies to prevent cancer cells from occurring) was mentioned in almost one-third of the apps (30/101, 29.7%). Less than half of the apps (46/101, 45.5%) presented information about mammography and/or breast clinical exam, and 53 apps (52.5%) discussed breast self-exam (which is no longer recommended). Symptoms of cancer prediagnosis, such as a lump, were discussed in almost half of the apps (48/101, 47.5%) and a similar number of apps included information about genetic risk for breast cancer (47/101, 46.5%). Information about breast cancer diagnosis was included in 42 apps (41.58%) and 43 (42.6%) apps discussed treatment options. Survivorship issues were addressed in 17 (16.8%) apps. Only one (1.0%) app discussed hospice. Adherence to usability recommendations was low. The median composite score was 3 (mean 2.60, SD 1.20) of the six recommended usability items. With eight plain language items, the median of the composite health literacy score was 5 (mean 5.06, SD 2.00). Most apps did not use easy-to-understand words (44/101, 43.6%) and few (24/101, 23.8%) defined key terms. Conclusions Current breast cancer apps provide important information about breast cancer, but the most common topic covered is breast self-examination, a non-evidence-based screening strategy. Apps that focus on evidence-based strategies on the cancer continuum are needed, with a notable pressing need for apps that would address survivorship and end of life. Finally, developers of breast cancer apps should adhere to IOM standards to meet the needs of diverse populations and reduce current disparities. PMID:28288954

Query-oriented evidence extraction to support evidence-based medicine practice.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cecile

2016-02-01

Evidence-based medicine practice requires medical practitioners to rely on the best available evidence, in addition to their expertise, when making clinical decisions. The medical domain boasts a large amount of published medical research data, indexed in various medical databases such as MEDLINE. As the size of this data grows, practitioners increasingly face the problem of information overload, and past research has established the time-associated obstacles faced by evidence-based medicine practitioners. In this paper, we focus on the problem of automatic text summarisation to help practitioners quickly find query-focused information from relevant documents. We utilise an annotated corpus that is specialised for the task of evidence-based summarisation of text. In contrast to past summarisation approaches, which mostly rely on surface level features to identify salient pieces of texts that form the summaries, our approach focuses on the use of corpus-based statistics, and domain-specific lexical knowledge for the identification of summary contents. We also apply a target-sentence-specific summarisation technique that reduces the problem of underfitting that persists in generic summarisation models. In automatic evaluations run over a large number of annotated summaries, our extractive summarisation technique statistically outperforms various baseline and benchmark summarisation models with a percentile rank of 96.8%. A manual evaluation shows that our extractive summarisation approach is capable of selecting content with high recall and precision, and may thus be used to generate bottom-line answers to practitioners' queries. Our research shows that the incorporation of specialised data and domain-specific knowledge can significantly improve text summarisation performance in the medical domain. Due to the vast amounts of medical text available, and the high growth of this form of data, we suspect that such summarisation techniques will address the time-related obstacles associated with evidence-based medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the sustainability and clinical outcome of alternatives for families: A cognitive-behavioral therapy (AF-CBT) in a child protection center

PubMed Central

Iselin, Anne-Marie R.; Gully, Kevin J.

2011-01-01

This paper examines the sustainability and outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) as delivered by practitioners in a community-based child protection program who had received training in the model several years earlier. Formerly described as Abuse-Focused CBT, AF-CBT is an evidence-based treatment (EBT) for child physical abuse and family aggression/conflict that was included in the National Child Traumatic Stress Network’s initial EBT dissemination efforts in 2002. Seven practitioners participated in a year-long Learning Collaborative in AF-CBT and in similar training programs for 4 other EBTs. The agency’s routine data collection system was used to document the clinical and adjustment outcomes of 52 families presenting with a physically abused child who received their services between 2 and 5 years after the AF-CBT training had ended. Measures of the use of all 5 EBTs documented their frequency, internal consistency, and intercorrelations. Controlling for the unique content of the other four EBTs, the amount of AF-CBT Abuse-specific content delivered was related to improvements on standardized parent rating scales (i.e., child externalizing behavior, anger, anxiety, social competence) and both parent and clinician ratings of the child’s adjustment at discharge (i.e., child more safe, less scared/sad, more appropriate with peers). The amount of AF-CBT General content was related to a few discharge ratings (better child prognosis, helpfulness to parents). These novel data provide suggestive evidence for the sustainability and clinical benefits of AF-CBT in an existing community clinic serving physically abused children and their families, and are discussed in the context of key developments in the treatment model and dissemination literature. PMID:21354619

Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

PubMed Central

Shillington, Alicia C; Col, Nananda; Bailey, Robert A; Jewell, Mark A

2015-01-01

Purpose To describe the process used to develop an evidence-based patient decision aid (PDA) that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM) consistent with International Patient Decision Aids Standards. Methods A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot. Results Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language/readability, testing, and eliciting patient values. Conclusion A PDA was developed to help T2DM patients make decisions regarding medication choice. This approach may be applicable to other chronic conditions. PMID:25995622

The Reviews Are in: A Qualitative Content Analysis of Consumer Perspectives on Apps for Bipolar Disorder

PubMed Central

Fogarty, Andrea S; Boydell, Katherine; Christensen, Helen

2017-01-01

Background The delivery of mobile health (mHealth) services is acceptable to mental health consumers. However, despite the benefits of accessibility, cost-effectiveness, anonymity, and ability to tailor content to individual needs, consumer engagement remains a hurdle for uptake and continued use. This may be unsurprising as few studies have examined app content from the consumer perspective or assessed consumer preferences for the content of apps for mental health management. An opportunity to examine consumer perspectives exists in using naturally generated data that is publically available in the Google Play and Apple app stores. Whereas commercial developers routinely use this data, to date there has been no in-depth evaluation within scientific research. Objective The aim of our study was to explore what consumers consider useful content for mental health management apps, identify unmet needs, and understand user expectations of mental health apps within the context of apps for bipolar disorder. Methods Publically available English language consumer reviews of 48 apps for bipolar disorder were used as data, providing a total of 2173 reviews. Review text was coded and analyzed using a team approach to qualitative content analysis. Results were presented in 2 forms: (1) a quantitative summary of the 9 major and minor themes and (2) a qualitative synthesis of key thematic findings. Results The majority of reviews were for symptom monitoring apps (87.94%, 1911/2173). The qualitative content analysis revealed 5 main themes: (1) laudatory talk, comments regarding the app’s benefits including helpfulness and successful design features (74.00% of reviews, 1608/2173); (2) unfavorable feedback, negative reviews largely concerning unmet needs, privacy and technical issues, and potential dangers of app use (25.54%, 555/2173); (3) conceptions of community, referring to both communities of users with mental ill-health accessed via the app and a community created among app users and developers (24.25%, 527/2173); (4) wishlist features, app features requested by users (17.53%, 381/2173); and (5) apps and therapy, app use within clinical care (10.58%, 230/2173). Four minor themes were also identified: (1) app cost, (2) privacy and data security, (3) comparisons with traditional monitoring, and (4) evidence-based mHealth. Conclusions Although mostly positive, the proportion of reviews containing wishlist requests indicates consumer needs are not adequately addressed by currently available disorder management apps. Consumers value content that is helpful, supportive, and easy to use, and they are integrating apps into their health management and clinical care without necessarily considering the evidence-base or clinical effectiveness of the tool. User expectations regarding developer responsiveness to their needs has implications for community-based participatory research and integrated knowledge translation. However, this expectation is incompatible with current mHealth funding structures. PMID:28389420

Best practice recommendations for the development, implementation, and evaluation of online knowledge translation resources in rehabilitation.

PubMed

Levac, Danielle; Glegg, Stephanie M N; Camden, Chantal; Rivard, Lisa M; Missiuna, Cheryl

2015-04-01

The knowledge-to-practice gap in rehabilitation has spurred knowledge translation (KT) initiatives aimed at promoting clinician behavior change and improving patient care. Online KT resources for physical therapists and other rehabilitation clinicians are appealing because of their potential to reach large numbers of individuals through self-paced, self-directed learning. This article proposes best practice recommendations for developing online KT resources that are designed to translate evidence into practice. Four recommendations are proposed with specific steps in the development, implementation, and evaluation process: (1) develop evidence-based, user-centered content; (2) tailor content to online format; (3) evaluate impact; and (4) share results and disseminate knowledge. Based on KT evidence and instructional design principles, concrete examples are provided along with insights gained from experiences in creating and evaluating online KT resources for physical therapists. In proposing these recommendations, the next steps for research are suggested, and others are invited to contribute to the discussion. © 2015 American Physical Therapy Association.

Web-based distance continuing education: a new way of thinking for students and instructors.

PubMed

Garrison, J A; Schardt, C; Kochi, J K

2000-07-01

As people have more difficulty taking time away from work to attend conferences and workshops, the idea of offering courses via the Web has become more desirable. Addressing a need voiced by Medical Library Association membership, the authors developed a Web-based continuing-education course on the subject of the librarian's role in evidence-based medicine. The aim of the course was to provide medical librarians with a well-constructed, content-rich learning experience available to them at their convenience via the Web. This paper includes a discussion of the considerations that need to be taken into account when developing Web-based courses, the issues that arise when the information delivery changes from face-to-face to online, the changing role of the instructor, and the pros and cons of offering Web-based versus traditional courses. The results of the beta test and future plans for the course are also discussed.

Web-based distance continuing education: a new way of thinking for students and instructors

PubMed Central

Garrison, Julie A.; Schardt, Connie; Kochi, Julia K.

2000-01-01

As people have more difficulty taking time away from work to attend conferences and workshops, the idea of offering courses via the Web has become more desirable. Addressing a need voiced by Medical Library Association membership, the authors developed a Web-based continuing-education course on the subject of the librarian's role in evidence-based medicine. The aim of the course was to provide medical librarians with a well-constructed, content-rich learning experience available to them at their convenience via the Web. This paper includes a discussion of the considerations that need to be taken into account when developing Web-based courses, the issues that arise when the information delivery changes from face-to-face to online, the changing role of the instructor, and the pros and cons of offering Web-based versus traditional courses. The results of the beta test and future plans for the course are also discussed. PMID:10928706

Exploring Mechanisms for Effective Technology-Enhanced Simulation-based Education in Wilderness Medicine: A Systematic Review.

PubMed

MacKinnon, Ralph; Aitken, Deborah; Humphries, Christopher

2015-12-17

 Technology-enhanced simulation is well-established in healthcare teaching curricula, including those regarding wilderness medicine. Compellingly, the evidence base for the value of this educational modality to improve learner competencies and patient outcomes are increasing.  The aim was to systematically review the characteristics of technology-enhanced simulation presented in the wilderness medicine literature to date. Then, the secondary aim was to explore how this technology has been used and if the use of this technology has been associated with improved learner or patient outcomes.  EMBASE and MEDLINE were systematically searched from 1946 to 2014, for articles on the provision of technology-enhanced simulation to teach wilderness medicine. Working independently, the team evaluated the information on the criteria of learners, setting, instructional design, content, and outcomes.  From a pool of 37 articles, 11 publications were eligible for systematic review. The majority of learners in the included publications were medical students, settings included both indoors and outdoors, and the main focus clinical content was initial trauma management with some including leadership skills. The most prevalent instructional design components were clinical variation and cognitive interactivity, with learner satisfaction as the main outcome.  The results confirm that the current provision of wilderness medicine utilizing technology-enhanced simulation is aligned with instructional design characteristics that have been used to achieve effective learning. Future research should aim to demonstrate the translation of learning into the clinical field to produce improved learner outcomes and create improved patient outcomes.

Evidence and argument in policymaking: development of workplace smoking legislation

PubMed Central

Apollonio, Dorie E; Bero, Lisa A

2009-01-01

Background We sought to identify factors that affect the passage of public health legislation by examining the use of arguments, particularly arguments presenting research evidence, in legislative debates regarding workplace smoking restrictions. Methods We conducted a case-study based content analysis of legislative materials used in the development of six state workplace smoking laws, including written and spoken testimony and the text of proposed and passed bills and amendments. We coded testimony given before legislators for arguments used, and identified the institutional affiliations of presenters and their position on the legislation. We compared patterns in the arguments made in testimony to the relative strength of each state's final legislation. Results Greater discussion of scientific evidence within testimony given was associated with the passage of workplace smoking legislation that provided greater protection for public health, regardless of whether supporters outnumbered opponents or vice versa. Conclusion Our findings suggest that an emphasis on scientific discourse, relative to other arguments made in legislative testimony, might help produce political outcomes that favor public health. PMID:19534777

Evidence review and clinical guidance for the use of ziprasidone in Canada

PubMed Central

2013-01-01

While indicated for schizophrenia and acute mania, ziprasidone’s evidence base and use in clinical practice extends beyond these regulatory approvals. We, an invited panel of experts led by a working group of 3, critically examined the evidence and our collective experience regarding the effectiveness, tolerability and safety of ziprasidone across its clinical uses. There was no opportunity for manufacturer input into the content of the review. As anticipated, ziprasidone was found to be effective for its indicated uses, although its utility in mania and mixed states lacked comparative data. Beyond these uses, the available data were either unimpressive or were lacking. An attractive characteristic is its neutral effect on weight thereby providing patients with a non-obesogenic long-term treatment option. Key challenges in practice include the need for dosing on a full stomach and managing its early onset adverse effect of restlessness. Addressing these issues are critical to its long-term success PMID:23347694

GeoMapApp Learning Activities: Grab-and-go inquiry-based geoscience activities that bring cutting-edge technology to the classroom

NASA Astrophysics Data System (ADS)

Goodwillie, A. M.; Kluge, S.

2011-12-01

NSF-funded GeoMapApp Learning Activities (http://serc.carleton.edu/geomapapp) provide self-contained learning opportunities that are centred around the principles of guided inquiry. The activities allow students to interact with and analyse research-quality geoscience data to explore and enhance student understanding of underlying geoscience content and concepts. Each activity offers ready-to-use step-by-step student instructions and answer sheets that can be downloaded from the web page. Also provided are annotated teacher versions of the worksheets that include teaching tips, additional content and suggestions for further work. Downloadable pre- and post- quizzes tied to each activity help educators gauge the learning progression of their students. Short multimedia tutorials and details on content alignment with state and national teaching standards round out the package of material that comprises each "grab-and-go" activity. GeoMapApp Learning Activities expose students to content and concepts typically found at the community college, high school and introductory undergraduate levels. The activities are based upon GeoMapApp (http://www.geomapapp.org), a free, easy-to-use map-based data exploration and visualisation tool that allows students to access a wide range of geoscience data sets in a virtual lab-like environment. Activities that have so far been created under this project include student exploration of seafloor spreading rates, a study of mass wasting as revealed through geomorphological evidence, and an analysis of plate motion and hotspot traces. The step-by-step instructions and guided inquiry approach lead students through each activity, thus reducing the need for teacher intervention whilst also boosting the time that students can spend on productive exploration and learning. The activities can be used, for example, in a classroom lab with the educator present and as self-paced assignments in an out-of-class setting. GeoMapApp Learning Activities are hosted on the SERC-Carleton web site.

Occupational safety and health interventions to reduce musculoskeletal symptoms in the health care sector.

PubMed

Tullar, Jessica M; Brewer, Shelley; Amick, Benjamin C; Irvin, Emma; Mahood, Quenby; Pompeii, Lisa A; Wang, Anna; Van Eerd, Dwayne; Gimeno, David; Evanoff, Bradley

2010-06-01

Health care work is dangerous and multiple interventions have been tested to reduce the occupational hazards. A systematic review of the literature used a best evidence synthesis approach to address the general question "Do occupational safety and health interventions in health care settings have an effect on musculoskeletal health status?" This was followed by an evaluation of the effectiveness of specific interventions. The initial search identified 8,465 articles, for the period 1980-2006, which were reduced to 16 studies based on content and quality. A moderate level of evidence was observed for the general question. Moderate evidence was observed for: (1) exercise interventions and (2) multi-component patient handling interventions. An updated search for the period 2006-2009 added three studies and a moderate level of evidence now indicates: (1) patient handling training alone and (2) cognitive behavior training alone have no effect on musculoskeletal health. Few high quality studies were found that examined the effects of interventions in health care settings on musculoskeletal health. The findings here echo previous systematic reviews supporting exercise as providing positive health benefits and training alone as not being effective. Given the moderate level of evidence, exercise interventions and multi-component patient handling interventions (MCPHI) were recommended as practices to consider. A multi-component intervention includes a policy that defines an organizational commitment to reducing injuries associated with patient handling, purchase of appropriate lift or transfer equipment to reduce biomechanical hazards and a broad-based ergonomics training program that includes safe patient handling and/or equipment usage. The review demonstrates MCPHI can be evaluated if the term multi-component is clearly defined and consistently applied.

Role of Ideas and Ideologies in Evidence-Based Health Policy

PubMed Central

Prinja, S

2010-01-01

Policy making in health is largely thought to be driven by three ‘I’s namely ideas, interests and institutions. Recent years have seen a shift in approach with increasing reliance being placed on role of evidence for policy making. The present article ascertains the role of ideas and ideologies in shaping evidence which is used to aid in policy decisions. The article discusses different theories of research-policy interface and the relative freedom of research-based evidence from the influence of ideas. Examples from developed and developed countries are cited to illustrate the contentions made. The article highlights the complexity of the process of evidence-based policy making, in a world driven by existing political, social and cultural ideologies. Consideration of this knowledge is paramount where more efforts are being made to bridge the gap between the ‘two worlds’ of researchers and policy makers to make evidence-based policy as also for policy analysts. PMID:23112991

Peer discussions in lecture-based tutorials in introductory physics

NASA Astrophysics Data System (ADS)

Leinonen, Risto; Asikainen, Mervi A.; Hirvonen, Pekka E.

2017-06-01

This study analyzes the types of peer discussion that occur during lecture-based tutorial sessions. It focuses in particular on whether discussions of this kind have certain characteristics that might indicate success in the post-testing phase. The data were collected during an introductory physics course. The main data set was gathered with the aid of audio recordings. Data-driven content analysis was applied in the analysis to facilitate the placement of students' discussions in particular categories related to different types of discussions. Four major discussion types were found: discussions related to the content knowledge, metalevel discussions including metaconceptual and metacognitive elements, discussions related to practical issues, and creating a base for discussion, seen here in the order of their prevalence. These categories were found to possess individual substructures that involved, for example, asking and answering questions, participating in a dialogue, or disagreeing with a peer. Analyzing the substructures of the categories revealed that there were evident differences between the groups, some of them related to the group size. With regard to the characteristics of discussions considered to be connected to a better learning outcome, it was observed that a great number of lines uttered related to the physics content or metalevel discussions seemed to have a direct bearing on success in the post test at the group level. For individual students, answering content-related questions posed by their peers might also indicate success in the post test. We would encourage researchers to continue this type of research in order to discover the essential characteristics of students' discussions that facilitate learning.

Passage-Based Bibliographic Coupling: An Inter-Article Similarity Measure for Biomedical Articles

PubMed Central

Liu, Rey-Long

2015-01-01

Biomedical literature is an essential source of biomedical evidence. To translate the evidence for biomedicine study, researchers often need to carefully read multiple articles about specific biomedical issues. These articles thus need to be highly related to each other. They should share similar core contents, including research goals, methods, and findings. However, given an article r, it is challenging for search engines to retrieve highly related articles for r. In this paper, we present a technique PBC (Passage-based Bibliographic Coupling) that estimates inter-article similarity by seamlessly integrating bibliographic coupling with the information collected from context passages around important out-link citations (references) in each article. Empirical evaluation shows that PBC can significantly improve the retrieval of those articles that biomedical experts believe to be highly related to specific articles about gene-disease associations. PBC can thus be used to improve search engines in retrieving the highly related articles for any given article r, even when r is cited by very few (or even no) articles. The contribution is essential for those researchers and text mining systems that aim at cross-validating the evidence about specific gene-disease associations. PMID:26440794

Passage-Based Bibliographic Coupling: An Inter-Article Similarity Measure for Biomedical Articles.

PubMed

Liu, Rey-Long

2015-01-01

Biomedical literature is an essential source of biomedical evidence. To translate the evidence for biomedicine study, researchers often need to carefully read multiple articles about specific biomedical issues. These articles thus need to be highly related to each other. They should share similar core contents, including research goals, methods, and findings. However, given an article r, it is challenging for search engines to retrieve highly related articles for r. In this paper, we present a technique PBC (Passage-based Bibliographic Coupling) that estimates inter-article similarity by seamlessly integrating bibliographic coupling with the information collected from context passages around important out-link citations (references) in each article. Empirical evaluation shows that PBC can significantly improve the retrieval of those articles that biomedical experts believe to be highly related to specific articles about gene-disease associations. PBC can thus be used to improve search engines in retrieving the highly related articles for any given article r, even when r is cited by very few (or even no) articles. The contribution is essential for those researchers and text mining systems that aim at cross-validating the evidence about specific gene-disease associations.

Social Aspects of Classroom Learning: Results of a Discourse Analysis in an Inquiry-Oriented Physical Chemistry Class

ERIC Educational Resources Information Center

Becker, Nicole M.

2012-01-01

Engaging students in classroom discourse offers opportunities for students to participate in the construction of joint understandings, to negotiate relationships between different types of evidence, and to practice making evidence-based claims about science content. However, close attention to social aspects of learning is critical to creating…

Mexican Americans and the American Nation: A Response to Professor Huntington

ERIC Educational Resources Information Center

Telles, Edward

2006-01-01

This essay is based on a talk I delivered at Texas A&M University on December 10, 2005, in response to an earlier lecture at the university by Professor Samuel P. Huntington. It relies on social science evidence to first address Huntington's contention that Mexicans are overwhelming American borders. It then turns to evidence that Mexican…

A rapid evidence review on the effectiveness of institutional health partnerships.

PubMed

Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

2015-12-14

Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically address the benefits and values of partnership working and how these relate to effectiveness. These indicators need to be content neutral of specific interventions which are already measured through routine project monitoring and evaluation. This will allow the development of methodological pathways to assess the effectiveness of institutional health partnerships. Until more primary research is conducted or published there is little benefit in further systematic reviews.

The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

PubMed

McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

2014-01-01

This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.

Promoting pedagogical experimentation: using a wiki in graduate level education.

PubMed

Martin, Carolyn Thompson

2012-12-01

Learning to write in a scholarly manner is often a challenge for graduate students. This study describes nursing students' use of a wiki to encourage writing collaboration among students by allowing them to cocreate, review, and edit each other's material as it is created. Students are introduced to the online wiki site the first week of the course. A technology representative assists students with a short introduction and class visits. All students participate in making decisions related to the overall character of the site. They create pages on topics related to their clinical placements. Student pages are peer and content expert reviewed for accuracy and comprehensiveness. Students include pictures, YouTube links, attachments, videos, and Web site links into their pages. Evidence-based content includes pharmacology, diagnostic criteria, pathophysiology, history, genetics, and references. Students present their pages, and feedback questionnaires are collected at the end of the semester. The wiki writing assignment introduces students, faculty, and the community to graduate student projects while exposing students to new technology. Areas explored include issues and best practices regarding classroom pedagogy, as well as student support and technical challenges in the use of a wiki. Suggestions for improvement are discussed.

Involving women in personalised decision-making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid.

PubMed

Schoorel, E N C; Vankan, E; Scheepers, H C J; Augustijn, B C C; Dirksen, C D; de Koning, M; van Kuijk, S M J; Kwee, A; Melman, S; Nijhuis, J G; Aardenburg, R; de Boer, K; Hasaart, T H M; Mol, B W J; Nieuwenhuijze, M; van Pampus, M G; van Roosmalen, J; Roumen, F J M E; de Vries, R; Wouters, M G A J; van der Weijden, T; Hermens, R P M G

2014-01-01

To develop a patient decision aid (PtDA) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean (VBAC) with the elicitation of patient preferences and evidence-based information. A PtDA was developed and pilot tested using the International Patients Decision Aid Standards (IPDAS) criteria. Obstetric health care in the Netherlands. A multidisciplinary steering group, an expert panel, and 25 future users of the PtDA, i.e. women with a previous caesarean section. The development consisted of a construction phase (definition of scope and purpose, and selection of content, framework, and format) and a pilot testing phase by interview. The process was supervised by a multidisciplinary steering group. Usability, clarity, and relevance. The construction phase resulted in a booklet including unbiased balanced information on mode of birth after caesarean section, a preference elicitation exercise, and tailored risk information, including a prediction model for successful VBAC. During pilot testing, visualisation of risks and clarity formed the main basis for revisions. Pilot testing showed the availability of tailored structured information to be the main factor involving women in decision-making. The PtDA meets 39 out of 50 IPDAS criteria (78%): 23 out of 23 criteria for content (100%) and 16 out of 20 criteria for the development process (80%). Criteria for effectiveness (n = 7) were not evaluated. An evidence-based PtDA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the PtDA enhances the quality of decision-making on mode of birth after caesarean section. © 2013 Royal College of Obstetricians and Gynaecologists.

Developing and evaluating an automated appendicitis risk stratification algorithm for pediatric patients in the emergency department.

PubMed

Deleger, Louise; Brodzinski, Holly; Zhai, Haijun; Li, Qi; Lingren, Todd; Kirkendall, Eric S; Alessandrini, Evaline; Solti, Imre

2013-12-01

To evaluate a proposed natural language processing (NLP) and machine-learning based automated method to risk stratify abdominal pain patients by analyzing the content of the electronic health record (EHR). We analyzed the EHRs of a random sample of 2100 pediatric emergency department (ED) patients with abdominal pain, including all with a final diagnosis of appendicitis. We developed an automated system to extract relevant elements from ED physician notes and lab values and to automatically assign a risk category for acute appendicitis (high, equivocal, or low), based on the Pediatric Appendicitis Score. We evaluated the performance of the system against a manually created gold standard (chart reviews by ED physicians) for recall, specificity, and precision. The system achieved an average F-measure of 0.867 (0.869 recall and 0.863 precision) for risk classification, which was comparable to physician experts. Recall/precision were 0.897/0.952 in the low-risk category, 0.855/0.886 in the high-risk category, and 0.854/0.766 in the equivocal-risk category. The information that the system required as input to achieve high F-measure was available within the first 4 h of the ED visit. Automated appendicitis risk categorization based on EHR content, including information from clinical notes, shows comparable performance to physician chart reviewers as measured by their inter-annotator agreement and represents a promising new approach for computerized decision support to promote application of evidence-based medicine at the point of care.

Healthy eating for life: rationale and development of an English as a second language (ESL) curriculum for promoting healthy nutrition.

PubMed

Martinez, Josefa L; Rivers, Susan E; Duncan, Lindsay R; Bertoli, Michelle; Domingo, Samantha; Latimer-Cheung, Amy E; Salovey, Peter

2013-12-01

Low health literacy contributes significantly to cancer health disparities disadvantaging minorities and the medically underserved. Immigrants to the United States constitute a particularly vulnerable subgroup of the medically underserved, and because many are non-native English speakers, they are pre-disposed to encounter language and literacy barriers across the cancer continuum. Healthy Eating for Life (HE4L) is an English as a second language (ESL) curriculum designed to teach English language and health literacy while promoting fruit and vegetable consumption for cancer prevention. This article describes the rationale, design, and content of HE4L. HE4L is a content-based adult ESL curriculum grounded in the health action process approach to behavior change. The curriculum package includes a soap opera-like storyline, an interactive student workbook, a teacher's manual, and audio files. HE4L is the first teacher-administered, multimedia nutrition-education curriculum designed to reduce cancer risk among beginning-level ESL students. HE4L is unique because it combines adult ESL principles, health education content, and behavioral theory. HE4L provides a case study of how evidence-based, health promotion practices can be implemented into real-life settings and serves as a timely, useful, and accessible nutrition-education resource for health educators.

Embryology and histology education in North American dental schools: the Basic Science Survey Series.

PubMed

Burk, Dorothy T; Lee, Lisa M J; Lambert, H Wayne

2013-06-01

As part of the Basic Science Survey Series (BSSS) for Dentistry, members of the American Dental Education Association (ADEA) Anatomical Sciences Section surveyed faculty members teaching embryology and histology courses at North American dental schools. The survey was designed to assess, among other things, curriculum content, utilization of laboratories, use of computer-assisted instruction (CAI), and recent curricular changes. Responses were received from fifty-nine (88.1 percent) of the sixty-seven U.S. and Canadian dental schools. Findings suggest the following: 1) a trend toward combining courses is evident, though the integration was predominantly discipline-based; 2) embryology is rarely taught as a stand-alone course, as content is often covered in gross anatomy, oral histology, and/or in an integrated curriculum; 3) the number of contact hours in histology is decreasing; 4) a trend toward reduction in formal laboratory sessions, particularly in embryology, is ongoing; and 5) use of CAI tools, including virtual microscopy, in both embryology and histology has increased. Additionally, embryology and histology content topic emphasis is identified within this study. Data, derived from this study, may be useful to new instructors, curriculum and test construction committees, and colleagues in the anatomical sciences, especially when determining a foundational knowledge base.

Health risk behaviors in adolescents and emerging adults with congenital heart disease: psychometric properties of the Health Behavior Scale-Congenital Heart Disease.

PubMed

Goossens, Eva; Luyckx, Koen; Mommen, Nele; Gewillig, Marc; Budts, Werner; Zupancic, Nele; Moons, Philip

2013-12-01

To optimize long-term outcomes, patients with congenital heart disease (CHD) should adopt health-promoting behaviors. Studies on health behavior in afflicted patients are scarce and comparability of study results is limited. To enlarge the body of evidence, we have developed the Health Behavior Scale-Congenital Heart Disease (HBS-CHD). We examined the psychometric properties of the HBS-CHD by providing evidence for (a) the content validity; (b) validity based on the relationships with other variables; (c) reliability in terms of stability; and (d) responsiveness. Ten experts rated the relevance of the HBS-CHD items. The item content validity index (I-CVI) and the averaged scale content validity index (S-CVI/Ave); the modified multi-rater Kappa and proportion of missing values for each question were calculated. Relationships with other variables were evaluated using six hypotheses that were tested in 429 adolescents with CHD. Stability of the instrument was assessed using Heise's method; and responsiveness was tested by calculating the Guyatt's Responsiveness Index (GRI). Overall, 86.3% of the items had a good to excellent content validity; the S-CVI/Ave (0.81) and multi-rater Kappa (0.78) were adequate. The average proportion of missing values was low (1.2%). Because five out of six hypotheses were confirmed, evidence for the validity of the HBS-CHD based on relationships with other variables was provided. The stability of the instrument could not be confirmed based on our data. The GRI showed good to excellent capacity of the HBS-CHD to detect clinical changes in the health behavior over time. We found that the HBS-CHD is a valid and responsive questionnaire to assess health behaviors in patients with CHD.

About This Website

Cancer.gov

The National Cancer Institute (NCI) website serves to disseminate authoritative, evidence-based, and up-to-date information about cancer and NCI-supported cancer research. Much of the information is available for content reuse and syndication.

Identifying high quality medical education websites in Otolaryngology: a guide for medical students and residents.

PubMed

Yang, Nathan; Hosseini, Sarah; Mascarella, Marco A; Young, Meredith; Posel, Nancy; Fung, Kevin; Nguyen, Lily H P

2017-05-25

Learners often utilize online resources to supplement formalized curricula, and to appropriately support learning, these resources should be of high quality. Thus, the objectives of this study are to develop and provide validity evidence supporting an assessment tool designed to assess the quality of educational websites in Otolaryngology- Head & Neck Surgery (ORL-HNS), and identify those that could support effective web-based learning. METHODS: After a literature review, the Modified Education in Otolaryngology Website (MEOW) assessment tool was designed by a panel of experts based on a previously validated website assessment tool. A search strategy using a Google-based search engine was used subsequently to identify websites. Those that were free of charge and in English were included. Websites were coded for whether their content targeted medical students or residents. Using the MEOW assessment tool, two independent raters scored the websites. Inter-rater and intra-rater reliability were evaluated, and scores were compared to recommendations from a content expert. The MEOW assessment tool included a total of 20 items divided in 8 categories related to authorship, frequency of revision, content accuracy, interactivity, visual presentation, navigability, speed and recommended hyperlinks. A total of 43 out of 334 websites identified by the search met inclusion criteria. The scores generated by our tool appeared to differentiate higher quality websites from lower quality ones: websites that the expert "would recommend" scored 38.4 (out of 56; CI [34.4-42.4]) and "would not recommend" 27.0 (CI [23.2-30.9]). Inter-rater and intra-rater intraclass correlation coefficient were greater than 0.7. Using the MEOW assessment tool, high quality ORL-HNS educational websites were identified.

Starting Strong: Feasibility of an Indicated Prevention Programme during the Transition to Kindergarten

ERIC Educational Resources Information Center

Eisenhower, Abbey; Baker, Bruce L.; Taylor, Heather

2016-01-01

School-based mental health services are a promising context for evidence-based interventions to promote early socio-emotional development, yet implementation presents significant challenges. This paper describes the rationale, content and format of a school-based intervention, Starting Strong in Kindergarten (Starting Strong). Starting Strong is a…

A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice.

PubMed

Champion, Katrina Elizabeth; Chapman, Cath; Newton, Nicola Clare; Brierley, Mary-Ellen; Stapinski, Lexine; Kay-Lambkin, Frances; Nagle, Jack; Teesson, Maree

2018-03-20

The use of crystal methamphetamine (ice) and the associated harms for individuals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal methamphetamine for the community is a critical component of an effective public health response. This paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal methamphetamine for the Australian community. Development of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal methamphetamine users, families and friends of someone using crystal methamphetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs; (2) content and Web development; and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit's acceptability, relevance, and appeal. Initial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal methamphetamine were "to get information for myself" (185/451, 41.0%) and "to find out how to help a friend or a family member" (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal methamphetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection, improving the ease of navigation, and balancing a "low prevalence of use, yet high impact" message. A total of 9138 users visited the website in the 3 months immediately post launch, and over 25,000 hard-copy Cracks in the Ice booklets and flyers were distributed across Australia. Of these resources, 60.93% (15,525/25,480) were distributed to relevant organizations and mailing list subscribers, and 39.07% (9955/25,480) were ordered directly by individuals, services, and community groups via the Cracks in the Ice website. The codevelopment process resulted in an engaging Web-based resource for the Australian community to access up-to-date and evidence-based resources about crystal methamphetamine. The Cracks in the Ice Community Toolkit provides much-needed information and support for individuals, families, and communities. ©Katrina Elizabeth Champion, Cath Chapman, Nicola Clare Newton, Mary-Ellen Brierley, Lexine Stapinski, Frances Kay-Lambkin, Jack Nagle, Maree Teesson. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.03.2018.

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

PubMed Central

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C

2016-01-01

Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Conclusions Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible. PMID:27489143

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition.

PubMed

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C; Moynihan, Paula

2016-08-03

Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.

Exercise rehabilitation following hospital discharge in survivors of critical illness: an integrative review

PubMed Central

2012-01-01

Although clinical trials have shown benefit from early rehabilitation within the ICU, rehabilitation of patients following critical illness is increasingly acknowledged as an area of clinical importance. However, despite recommendations from published guidelines for rehabilitation to continue following hospital discharge, there is limited evidence to underpin practice during this intermediate stage of recovery. Those patients with ICU-acquired weakness on discharge from the ICU are most likely to benefit from ongoing rehabilitation. Despite this, screening based on strength alone may fail to account for the associated level of physical functioning, which may not correlate with muscle strength, nor address non-physical complications of critical illness. The aim of this review was to consider which patients are likely to require rehabilitation following critical illness and to perform an integrative review of the available evidence of content and nature of exercise rehabilitation programmes for survivors of critical illness following hospital discharge. Literature databases and clinical trials registries were searched using appropriate terms and groups of terms. Inclusion criteria specified the reporting of rehabilitation programmes for patients following critical illness post-hospital discharge. Ten items, including data from published studies and protocols from trial registries, were included. Because of the variability in study methodology and inadequate level of detail of reported exercise prescription, at present there can be no clear recommendations for clinical practice from this review. As this area of clinical practice remains in its relative infancy, further evidence is required both to identify which patients are most likely to benefit and to determine the optimum content and format of exercise rehabilitation programmes for patients following critical illness post-hospital discharge. PMID:22713336

Development of an evidence-based guideline for supervisor training in promoting mental health: literature review.

PubMed

Tsutsumi, Akizumi

2011-01-01

To review published studies to assess the effects of supervisor training on the mental health of subordinate workers, and thereby develop an evidence-based guideline for supervisor training in promoting workers' mental health. Seven studies that assessed the effect of supervisor training, whose outcomes included psychological stress responses of (subordinate) employees, were retrieved for assessment from PubMed, the Cochrane Library, MEDLINE, the Web of Science, and Ichushi-Web. An additional five studies were also reviewed for discussion on the content and types of training. Providing supervisors with necessary skills and information on mental health, including relevant occupational stressors, has a favorable effect on workers' mental health, at least in the short term. The subject populations had a background of requiring mental health measures. The effect of the training varied depending on the participation rate of supervisors, suggesting that the overall effect on an organization may be limited without a certain extent of participation by supervisors. There is no evidence of a long-term (over 1 yr) effect of supervisor training, and the effect of education on the supervisors' knowledge and behavior tends to be lost after 6 mo. The current evidence indicates that the following items should be taken into consideration for the development of a guideline for supervisor training: identification of high-priority populations requiring education, development of a strategy to improve the participation rate in education, inclusion of occupational stressors as well as basic information in workplace mental health teaching materials, and regular repetition of the program.

New pathways to physics instruction: Blending a MOOC and in-person discussion to train physics graduate students and postdocs in evidence-based teaching

NASA Astrophysics Data System (ADS)

Goldberg, Bennett

A challenge facing physics education is how to encourage and support the adoption of evidence-based instructional practices that decades of physics education research has shown to be effective. Like many STEM departments, physics departments struggle to overcome the barriers of faculty knowledge, motivation and time; institutional cultures and reward systems; and disciplinary traditions. Research has demonstrated successful transformation of department-level approaches to instruction through local learning communities, in-house expertise, and department administrative support. In this talk, I will discuss how physics and other STEM departments can use a MOOC on evidence-based instruction together with in-person seminar discussions to create a learning community of graduate students and postdocs, and how such communities can affect departmental change in teaching and learning. Four university members of the 21-university network working to prepare future faculty to be both excellent researchers and excellent teachers collaborated on an NSF WIDER project to develop and deliver two massive open online courses (MOOCs) in evidence-based STEM instruction. A key innovation is a new blended mode of delivery where groups of participants engaged with the online content and then meet weekly in local learning communities to discuss content, communicate current experiences, and delve deeper into particular techniques of local interest. The MOOC team supported these so-called MOOC-Centered Learning Communities, or MCLCs, with detailed facilitator guides complete with synopses of online content, learning goals and suggested activities for in-person meetings, as well as virtual MCLC communities for sharing and feedback. In the initial run of the first MOOC, 40 MCLCs were created; in the second run this past fall, more than 80 MCLCs formed. Further, target audiences of STEM graduate students and postdocs completed at a 40-50% rate, indicating the value they place in building their knowledge in evidence-based instruction. We will present data on the impact of being in an MCLC on completion and learning outcomes, as well as data on departmental change in physics supported by MCLCs. Work supported by NSF DUE-1347605.

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline

PubMed Central

Herdman, Susan J.; Whitney, Susan L.; Cass, Stephen P.; Clendaniel, Richard A.; Fife, Terry D.; Furman, Joseph M.; Getchius, Thomas S. D.; Goebel, Joel A.; Shepard, Neil T.; Woodhouse, Sheelah N.

2016-01-01

Background: Uncompensated vestibular hypofunction results in postural instability, visual blurring with head movement, and subjective complaints of dizziness and/or imbalance. We sought to answer the question, “Is vestibular exercise effective at enhancing recovery of function in people with peripheral (unilateral or bilateral) vestibular hypofunction?” Methods: A systematic review of the literature was performed in 5 databases published after 1985 and 5 additional sources for relevant publications were searched. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case control series, and case series for human subjects, published in English. One hundred thirty-five articles were identified as relevant to this clinical practice guideline. Results/Discussion: Based on strong evidence and a preponderance of benefit over harm, clinicians should offer vestibular rehabilitation to persons with unilateral and bilateral vestibular hypofunction with impairments and functional limitations related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) as specific exercises for gaze stability. Based on moderate evidence, clinicians may offer specific exercise techniques to target identified impairments or functional limitations. Based on moderate evidence and in consideration of patient preference, clinicians may provide supervised vestibular rehabilitation. Based on expert opinion extrapolated from the evidence, clinicians may prescribe a minimum of 3 times per day for the performance of gaze stability exercises as 1 component of a home exercise program. Based on expert opinion extrapolated from the evidence (range of supervised visits: 2-38 weeks, mean = 10 weeks), clinicians may consider providing adequate supervised vestibular rehabilitation sessions for the patient to understand the goals of the program and how to manage and progress themselves independently. As a general guide, persons without significant comorbidities that affect mobility and with acute or subacute unilateral vestibular hypofunction may need once a week supervised sessions for 2 to 3 weeks; persons with chronic unilateral vestibular hypofunction may need once a week sessions for 4 to 6 weeks; and persons with bilateral vestibular hypofunction may need once a week sessions for 8 to 12 weeks. In addition to supervised sessions, patients are provided a daily home exercise program. Disclaimer: These recommendations are intended as a guide for physical therapists and clinicians to optimize rehabilitation outcomes for persons with peripheral vestibular hypofunction undergoing vestibular rehabilitation. Video Abstract available for more insights from the author (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A124). PMID:26913496

Automatic information timeliness assessment of diabetes web sites by evidence based medicine.

PubMed

Sağlam, Rahime Belen; Taşkaya Temizel, Tuğba

2014-11-01

Studies on health domain have shown that health websites provide imperfect information and give recommendations which are not up to date with the recent literature even when their last modified dates are quite recent. In this paper, we propose a framework which assesses the timeliness of the content of health websites automatically by evidence based medicine. Our aim is to assess the accordance of website contents with the current literature and information timeliness disregarding the update time stated on the websites. The proposed method is based on automatic term recognition, relevance feedback and information retrieval techniques in order to generate time-aware structured queries. We tested the framework on diabetes health web sites which were archived between 2006 and 2013 by Archive-it using American Diabetes Association's (ADA) guidelines. The results showed that the proposed framework achieves 65% and 77% accuracy in detecting the timeliness of the web content according to years and pre-determined time intervals respectively. Information seekers and web site owners may benefit from the proposed framework in finding relevant and up-to-date diabetes web sites. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Dermatology on Reddit: elucidating trends in dermatologic communications on the world wide web.

PubMed

Buntinx-Krieg, Talayesa; Caravaglio, Joseph; Domozych, Renee; Dellavalle, Robert P

2017-07-15

Platforms of social media, including the website Reddit, have become increasingly popular sites for users to communicate medical information. A study investigating dermatology content on Reddit has not been performed in the current literature. The purpose of this study is to enumerate the dermatology subreddits, quantify subscribers, and characterize posts to estimate the presence of dermatology-related content on Reddit. A Reddit search of the fourteen most common skin diseases globally was performed. Additionally, the terms "dermatology", and "skin" were searched in order to identify more subreddits relevant to the field. Dermatology-related subreddits that had ≥1000 subscribers were evaluated for content and categorized for analysis. We identified 38 subreddits related to dermatology with subscriber numbers ranging from 52 to 209,973. For 17 of the 38 subreddits that were further analyzed, most posts fell under the category of "seeking health/cosmetic advice." Reddit serves as a communication stage for individuals to discuss, engage, and connect on dermatologic topics. Furthermore, the platform offers an opportunity for medical professionals to distribute evidence-based information concerning dermatologic conditions.

Linking implementation of evidence-based parenting programs to outcomes in early intervention.

PubMed

Kilburn, Janice E; Shapiro, Cheri J; Hardin, James W

2017-11-01

In the field of early intervention, only a few studies of parenting interventions include both participant and facilitator behaviors. Fidelity and supervision (facilitator characteristics) and dosage and satisfaction (participant characteristics) were tested on the outcome of improved parenting style in a sample of 36 parents of young children with disabilities. Results indicated that the facilitator behavior of fidelity was significantly and negatively related to the program outcome of parenting style; no effect was found for the facilitator behavior of supervision. For the participant behaviors, both dosage and satisfaction had non-significant relationships with the program outcome of parenting style at follow-up. The surprising negative relationship between content fidelity and parenting style was discussed.Two possible explanations were: (1) process or quality of intervention delivery is more influential than content fidelity, which considers only adherence to the intervention manual, and (2) the developmental stage of early intervention families calls for more focus on relationships between facilitators and parents and less on content of the specific intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions.

PubMed

Baumel, Amit; Faber, Keren; Mathur, Nandita; Kane, John M; Muench, Fred

2017-03-21

Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects. As a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims). A total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary concurrent validity analysis pointed to positive correlations of combined quality scores with selected variables. The combined score that did not include therapeutic persuasiveness and therapeutic alliance descriptively underperformed the other combined scores. This paper provides empirical evidence supporting the importance of persuasive design and therapeutic alliance within the context of a program's evaluation. Reliability metrics and preliminary concurrent validity analysis indicate the potential of Enlight in examining eHealth programs regardless of delivery mediums and clinical aims. ©Amit Baumel, Keren Faber, Nandita Mathur, John M Kane, Fred Muench. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.03.2017.

Polymer-based oral rehydration solution for treating acute watery diarrhoea

PubMed Central

Gregorio, Germana V; Gonzales, Maria Liza M; Dans, Leonila F; Martinez, Elizabeth G

2016-01-01

Background Acute diarrhoea is one of the main causes of morbidity and mortality among children in low-income countries. Glucose-based oral rehydration solution (ORS) helps replace fluid and prevent further dehydration from acute diarrhoea. Since 2004, the World Health Organization (WHO) has recommended the osmolarity of less than 270 mOsm/L (ORS ≤ 270) versus greater than 310 mOsm/L formulation (ORS ≥ 310). Polymer-based ORS (for example, prepared using rice or wheat) slowly releases glucose and may be superior to glucose-based ORS. Objectives To compare polymer-based oral rehydration solution (polymer-based ORS) with glucose-based oral rehydration solution (glucose-based ORS) for treating acute watery diarrhoea. Search methods We searched the following sources up to 5 September 2016: the Cochrane Infectious Diseases Group (CIDG) Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), MEDLINE (1966 to 5 September 2016), EMBASE (1974 to 5 September 2016), LILACS (1982 to 5 September 2016), and mRCT (2007 to 5 September 2016). We also contacted researchers, organizations, and pharmaceutical companies, and searched reference lists. Selection criteria We included randomized controlled trials (RCTs) of people with acute watery diarrhoea (cholera and non-cholera associated) that compared polymer-based and glucose-based ORS (with identical electrolyte contents). Data collection and analysis Two review authors independently assessed the search results and risk of bias, and extracted data. In multiple-treatment arms with two or more treatment groups, we combined outcomes as appropriate and compared collectively with the control group. Main results Thirty-five trials that included 4284 participants met the inclusion criteria: 28 trials exclusively included children, five included adults, and two included both adults and children. Polymer-based ORS versus glucose-based ORS (osmolarity ≤ 270) Eight trials (752 participants) evaluated this comparison, and seven trials used rice as a polymer source. Polymer-based ORS may decrease mean stool output in the first 24 hours by 24 mL/kg (mean difference (MD) −24.60 mL/kg, 95% CI −40.69 to −8.51; one trial, 99 participants, low quality evidence). The average duration of diarrhoea may be reduced by eight hours (MD −8.24 hours, 95% CI −13.17 to −3.30; I² statistic = 86%, five trials, 364 participants, low quality evidence) with polymer ORS but results are heterogeneous. Limited trials showed no observed difference in the risk of unscheduled use of intravenous fluid (RR 0.66, 95% CI 0.43 to 1.02; I² statistic = 30%; four trials, 376 participants, very low quality evidence), vomiting (very low quality evidence), and hyponatraemia (very low quality evidence). Polymer-based ORS versus glucose-based ORS (osmolarity ≥ 310) Twenty-seven trials (3532 participants) evaluated this comparison using a variety of polymers. On average, polymer ORS may reduce the total stool output in the first 24 hours by around 65 mL/kg (MD −65.47 mL/kg, 95% CI −83.92 to −47.03; 16 trials, 1483 participants, low quality evidence), and may reduce the duration of diarrhoea by around eight hours (MD −8.57 hours; SD −13.17 to −4.03; 16 trials, 1137 participants, low quality evidence) with substantial heterogeneity. The proportion of participants that required intravenous hydration was low in most trials with fewer in the polymer ORS group (RR 0.75, 95% CI 0.57 to 0.98; 19 trials, 1877 participant, low quality evidence) . Subgroup analysis by type of pathogen suggested an effect on unscheduled intravenous fluid in those infected with mixed pathogens (RR 0.63, 95% CI 0.41 to 0.96; 11 trials, 928 participants, low quality evidence), but not in participants positive for Vibrio cholerae (RR 0.94, 95% CI 0.66 to 1.34; 7 trials, 535 participants, low quality evidence). No difference was observed in the number of patients who developed vomiting (RR 0.91, 95% CI 0.72 to 1.14; 10 trials, 584 participants, very low quality evidence), hyponatraemia (RR 1.82, 95% CI 0.52 to 6.44; 4 trials, 385 participants, very low quality evidence), hypokalaemia (RR 1.29, 95% CI 0.74 to 2.25; 2 trials, 260 participants, low quality evidence), or persistent diarrhoea (RR 1.28, 95% CI 0.68 to 2.41; 2 trials, 885 participants, very low quality evidence). Authors' conclusions Polymer-based ORS shows advantages compared to glucose-based ORS (at ≥ 310 mOsm/L). Comparisons favoured polymer-based ORS over ORS ≤ 270 but analysis was underpowered. Food-based oral rehydration solution for acute diarrhoea What is polymer-based ORS and how might it help Acute diarrhoea is a common cause of death and illness in developing countries. Oral rehydration solutions (ORS) have had a massive impact worldwide in reducing the number of deaths related to diarrhoea. The original ORS was based on glucose and had an osmolarity of ≥ 310 mOsm/L (ORS ≥ 310). Glucose-based ORS with a lower osmolarity was later introduced in attempts to improve efficacy, and is considered better at reducing the amount and duration of diarrhoea. Most ORS is in the form of a sugar–salt solution, but over the years people have tried adding a variety of compounds ('glucose polymers') such as whole rice, wheat, sorghum, and maize. The aim is to slowly release glucose into the gut and improve the absorption of the water and salt in the solution. This review updates a Cochrane Review published in 2009, and assesses the available evidence on the use of polymer-based ORS (both rice and non-rice based) versus glucose-based ORS. What the research says Cochrane researchers examined the available evidence up to 5 September 2016. Thirty-five trials including 4284 participants met the inclusion criteria: 28 trials included children; five included adults; and two included both. Most trials compared polymer-based ORS with a sugar–salt ORS with a particular strength (ORS ≥ 310), which is slightly more salty than the currently agreed best formula (≤ 270 mOsm/L). The trials' methodological quality varied. In people given polymer-based ORS versus sugar-salt ORS ≤ 270 mOsm/L there was insufficient evidence to show that one is better than the other (low tovery low quality of evidence). In those given polymer-based ORS versus sugar-salt ORS ≥ 310 mOsm/L, there was a lower amount of stool and shorter time of diarrhoea in the polymer-based ORS group. No difference was observed between the two groups regarding the number of people who needed a drip to be rehydrated. Adverse events were similar (low tovery low quality of evidence). PMID:27959472

Content Management and the Future of Academic Libraries.

ERIC Educational Resources Information Center

Wu, Yuhfen Diana; Liu, Mengxiong

2001-01-01

Discusses Internet-based electronic content management in digital libraries and considers the future of academic libraries. Topics include digital technologies; content management systems; standards; bandwidth; security and privacy concerns; legal matters, including copyrights and ownership; lifecycle; and multilingual access and interface. (LRW)

Nanobiotechnology can boost crop production and quality: first evidence from increased plant biomass, fruit yield and phytomedicine content in bitter melon (Momordica charantia).

PubMed

Kole, Chittaranjan; Kole, Phullara; Randunu, K Manoj; Choudhary, Poonam; Podila, Ramakrishna; Ke, Pu Chun; Rao, Apparao M; Marcus, Richard K

2013-04-26

Recent research on nanoparticles in a number of crops has evidenced for enhanced germination and seedling growth, physiological activities including photosynthetic activity and nitrogen metabolism, mRNA expression and protein level, and also positive changes in gene expression indicating their potential use in crop improvement. We used a medicinally rich vegetable crop, bitter melon, as a model to evaluate the effects of seed treatment with a carbon-based nanoparticle, fullerol [C60(OH)20], on yield of plant biomass and fruit characters, and phytomedicine contents in fruits. We confirmed the uptake, translocation and accumulation of fullerol through bright field imaging and Fourier transform infra-red spectroscopy. We observed varied effects of seed treatment at five concentrations, including non-consequential and positive, on plant biomass yield, fruit yield and its component characters, and content of five phytomedicines in fruits. Fullerol-treatment resulted in increases up to 54% in biomass yield and 24% in water content. Increases of up to 20% in fruit length, 59% in fruit number, and 70% in fruit weight led to an improvement up to 128% in fruit yield. Contents of two anticancer phytomedicines, cucurbitacin-B and lycopene, were enhanced up to 74% and 82%, respectively, and contents of two antidiabetic phytomedicines, charantin and insulin, were augmented up to 20% and 91%, respectively. Non-significant correlation inter se plant biomass, fruit yield, phytomedicine content and water content evidenced for separate genetic control and biosynthetic pathways for production of plant biomass, fruits, and phytomedicines in fruits, and also no impact of increased water uptake. While our results indicated possibility of improving crop yield and quality by using proper concentrations of fullerol, extreme caution needs to be exercised given emerging knowledge about accumulation and toxicity of nanoparticles in bodily tissues.

Nanobiotechnology can boost crop production and quality: first evidence from increased plant biomass, fruit yield and phytomedicine content in bitter melon (Momordica charantia)

PubMed Central

2013-01-01

Background Recent research on nanoparticles in a number of crops has evidenced for enhanced germination and seedling growth, physiological activities including photosynthetic activity and nitrogen metabolism, mRNA expression and protein level, and also positive changes in gene expression indicating their potential use in crop improvement. We used a medicinally rich vegetable crop, bitter melon, as a model to evaluate the effects of seed treatment with a carbon-based nanoparticle, fullerol [C60(OH)20], on yield of plant biomass and fruit characters, and phytomedicine contents in fruits. Results We confirmed the uptake, translocation and accumulation of fullerol through bright field imaging and Fourier transform infra-red spectroscopy. We observed varied effects of seed treatment at five concentrations, including non-consequential and positive, on plant biomass yield, fruit yield and its component characters, and content of five phytomedicines in fruits. Fullerol-treatment resulted in increases up to 54% in biomass yield and 24% in water content. Increases of up to 20% in fruit length, 59% in fruit number, and 70% in fruit weight led to an improvement up to 128% in fruit yield. Contents of two anticancer phytomedicines, cucurbitacin-B and lycopene, were enhanced up to 74% and 82%, respectively, and contents of two antidiabetic phytomedicines, charantin and insulin, were augmented up to 20% and 91%, respectively. Non-significant correlation inter se plant biomass, fruit yield, phytomedicine content and water content evidenced for separate genetic control and biosynthetic pathways for production of plant biomass, fruits, and phytomedicines in fruits, and also no impact of increased water uptake. Conclusions While our results indicated possibility of improving crop yield and quality by using proper concentrations of fullerol, extreme caution needs to be exercised given emerging knowledge about accumulation and toxicity of nanoparticles in bodily tissues. PMID:23622112

Quality of Mobile Phone and Tablet Mobile Apps for Speech Sound Disorders: Protocol for an Evidence-Based Appraisal

PubMed Central

Morris, Meg E; Erickson, Shane; Serry, Tanya A

2016-01-01

Background Although mobile apps are readily available for speech sound disorders (SSD), their validity has not been systematically evaluated. This evidence-based appraisal will critically review and synthesize current evidence on available therapy apps for use by children with SSD. Objective The main aims are to (1) identify the types of apps currently available for Android and iOS mobile phones and tablets, and (2) to critique their design features and content using a structured quality appraisal tool. Methods This protocol paper presents and justifies the methods used for a systematic review of mobile apps that provide intervention for use by children with SSD. The primary outcomes of interest are (1) engagement, (2) functionality, (3) aesthetics, (4) information quality, (5) subjective quality, and (6) perceived impact. Quality will be assessed by 2 certified practicing speech-language pathologists using a structured quality appraisal tool. Two app stores will be searched from the 2 largest operating platforms, Android and iOS. Systematic methods of knowledge synthesis shall include searching the app stores using a defined procedure, data extraction, and quality analysis. Results This search strategy shall enable us to determine how many SSD apps are available for Android and for iOS compatible mobile phones and tablets. It shall also identify the regions of the world responsible for the apps’ development, the content and the quality of offerings. Recommendations will be made for speech-language pathologists seeking to use mobile apps in their clinical practice. Conclusions This protocol provides a structured process for locating apps and appraising the quality, as the basis for evaluating their use in speech pathology for children in English-speaking nations. PMID:27899341

Quality of Mobile Phone and Tablet Mobile Apps for Speech Sound Disorders: Protocol for an Evidence-Based Appraisal.

PubMed

Furlong, Lisa M; Morris, Meg E; Erickson, Shane; Serry, Tanya A

2016-11-29

Although mobile apps are readily available for speech sound disorders (SSD), their validity has not been systematically evaluated. This evidence-based appraisal will critically review and synthesize current evidence on available therapy apps for use by children with SSD. The main aims are to (1) identify the types of apps currently available for Android and iOS mobile phones and tablets, and (2) to critique their design features and content using a structured quality appraisal tool. This protocol paper presents and justifies the methods used for a systematic review of mobile apps that provide intervention for use by children with SSD. The primary outcomes of interest are (1) engagement, (2) functionality, (3) aesthetics, (4) information quality, (5) subjective quality, and (6) perceived impact. Quality will be assessed by 2 certified practicing speech-language pathologists using a structured quality appraisal tool. Two app stores will be searched from the 2 largest operating platforms, Android and iOS. Systematic methods of knowledge synthesis shall include searching the app stores using a defined procedure, data extraction, and quality analysis. This search strategy shall enable us to determine how many SSD apps are available for Android and for iOS compatible mobile phones and tablets. It shall also identify the regions of the world responsible for the apps' development, the content and the quality of offerings. Recommendations will be made for speech-language pathologists seeking to use mobile apps in their clinical practice. This protocol provides a structured process for locating apps and appraising the quality, as the basis for evaluating their use in speech pathology for children in English-speaking nations. ©Lisa M Furlong, Meg E Morris, Shane Erickson, Tanya A Serry. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 29.11.2016.

Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline.

PubMed

Azziz, Ricardo; Carmina, Enrico; Dewailly, Didier; Diamanti-Kandarakis, Evanthia; Escobar-Morreale, Hector F; Futterweit, Walter; Janssen, Onno E; Legro, Richard S; Norman, Robert J; Taylor, Ann E; Witchel, Selma F

2006-11-01

The Androgen Excess Society (AES) charged a task force to review all available data and recommend an evidence-based definition for polycystic ovary syndrome (PCOS), whether already in use or not, to guide clinical diagnosis and future research. Participants included expert investigators in the field. Based on a systematic review of the published peer-reviewed medical literature, by querying MEDLINE databases, we tried to identify studies evaluating the epidemiology or phenotypic aspects of PCOS. The task force drafted the initial report, following a consensus process via electronic communication, which was then reviewed and critiqued by the AES Board of Directors. No section was finalized until all members were satisfied with the contents and minority opinions noted. Statements that were not supported by peer-reviewed evidence were not included. Based on the available data, it is the view of the AES Task Force on the Phenotype of PCOS that there should be acceptance of the original 1990 National Institutes of Health criteria with some modifications, taking into consideration the concerns expressed in the proceedings of the 2003 Rotterdam conference. A principal conclusion was that PCOS should be first considered a disorder of androgen excess or hyperandrogenism, although a minority considered the possibility that there may be forms of PCOS without overt evidence of hyperandrogenism but recognized that more data are required before validating this supposition. Finally, the task force recognized, and fully expects, that the definition of this syndrome will evolve over time to incorporate new research findings.

Plant protein and animal proteins: do they differentially affect cardiovascular disease risk?

PubMed

Richter, Chesney K; Skulas-Ray, Ann C; Champagne, Catherine M; Kris-Etherton, Penny M

2015-11-01

Proteins from plant-based compared with animal-based food sources may have different effects on cardiovascular disease (CVD) risk factors. Numerous epidemiologic and intervention studies have evaluated their respective health benefits; however, it is difficult to isolate the role of plant or animal protein on CVD risk. This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied. Dietary protein is derived from many food sources, and each provides a different composite of nonprotein compounds that can also affect CVD risk factors. Increasing the consumption of protein-rich foods also typically results in lower intakes of other nutrients, which may simultaneously influence outcomes. Given these complexities, blanket statements about plant or animal protein may be too general, and greater consideration of the specific protein food sources and the background diet is required. The potential mechanisms responsible for any specific effects of plant and animal protein are similarly multifaceted and include the amino acid content of particular foods, contributions from other nonprotein compounds provided concomitantly by the whole food, and interactions with the gut microbiome. Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat. © 2015 American Society for Nutrition.

Plant Protein and Animal Proteins: Do They Differentially Affect Cardiovascular Disease Risk?12

PubMed Central

Richter, Chesney K; Skulas-Ray, Ann C; Champagne, Catherine M; Kris-Etherton, Penny M

2015-01-01

Proteins from plant-based compared with animal-based food sources may have different effects on cardiovascular disease (CVD) risk factors. Numerous epidemiologic and intervention studies have evaluated their respective health benefits; however, it is difficult to isolate the role of plant or animal protein on CVD risk. This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied. Dietary protein is derived from many food sources, and each provides a different composite of nonprotein compounds that can also affect CVD risk factors. Increasing the consumption of protein-rich foods also typically results in lower intakes of other nutrients, which may simultaneously influence outcomes. Given these complexities, blanket statements about plant or animal protein may be too general, and greater consideration of the specific protein food sources and the background diet is required. The potential mechanisms responsible for any specific effects of plant and animal protein are similarly multifaceted and include the amino acid content of particular foods, contributions from other nonprotein compounds provided concomitantly by the whole food, and interactions with the gut microbiome. Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat. PMID:26567196

Rationale and design of a randomized trial to evaluate an evidence-based prescription drug label on actual medication use.

PubMed

Shrank, William H; Parker, Ruth; Davis, Terry; Pandit, Anjali U; Knox, Joann P; Moraras, Pear; Rademaker, Alfred; Wolf, Michael S

2010-11-01

Medication errors are an important public health concern, and poor understanding of medication labels are a root cause. Research shows that labels are variable, of poor quality, and not patient-centered. No real-world trials have evaluated whether improved medication labels can affect appropriate medication use, adherence or health outcomes. We developed an evidence-based prescription label that addresses both content and format. The enhanced label includes a universal medication schedule (UMS) that standardizes the directions for use incorporating 1) standard time periods for administration (morning, noon, evening, and bedtime), 2) numeric vs. alpha characters, 3) 'carriage returns' to separate daily dose and 4) a graphic aid to visually depict dose and frequency. We will evaluate the effect of providing this label to randomly sampled patients who receive their care from free clinics, mobile vans and federally qualified health centers (FQHCs) in Northern Virginia. We will recruit patients with diabetes or hypertension; these patients will be randomly assigned to receive all of their medications with improved labels or to receive prescriptions with standard labels. The primary outcome will be the patient's ability to correctly demonstrate dosing instructions. Other outcomes include adherence, error rates and health outcomes. To our knowledge, this trial is the first to evaluate the effect of prescription label improvement on understanding, medication use and outcomes in a clinical setting. If successful, these findings could be implemented broadly to promote safe and appropriate medication use and to support evidence-based standards in the development of labels. Copyright © 2010 Elsevier Inc. All rights reserved.

Lessons Learned for Collaborative Clinical Content Development

PubMed Central

Collins, S.A.; Bavuso, K.; Zuccotti, G.; Rocha, R.A.

2013-01-01

Background Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project. Objectives We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation. Methods We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations. Results Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams. Conclusions Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training. PMID:23874366

Effects of multimedia vocabulary instruction on adolescents with learning disabilities.

PubMed

Kennedy, Michael J; Deshler, Donald D; Lloyd, John Wills

2015-01-01

The purpose of this experimental study is to investigate the effects of using content acquisition podcasts (CAPs), an example of instructional technology, to provide vocabulary instruction to adolescents with and without learning disabilities (LD). A total of 279 urban high school students, including 30 with LD in an area related to reading, were randomly assigned to one of four experimental conditions with instruction occurring at individual computer terminals over a 3-week period. Each of the four conditions contained different configurations of multimedia-based instruction and evidence-based vocabulary instruction. Dependent measures of vocabulary knowledge indicated that students with LD who received vocabulary instruction using CAPs through an explicit instructional methodology and the keyword mnemonic strategy significantly outperformed other students with LD who were taught using the same content, but with multimedia instruction that did not adhere to a specific theoretical design framework. Results for general education students mirrored those for students with LD. Students also completed a satisfaction measure following instruction with multimedia and expressed overall agreement that CAPs are useful for learning vocabulary terms. © Hammill Institute on Disabilities 2013.

On the Reliability of Vocational Workplace-Based Certifications

ERIC Educational Resources Information Center

Harth, H.; Hemker, B.T.

2013-01-01

The assessment of vocational workplace-based qualifications in England relies on human assessors (raters). These assessors observe naturally occurring, non-standardised evidence, unique to each learner and evaluate the learner as competent/not yet competent against content standards. Whilst these are considered difficult to measure, this study…

Complementary and Alternative Medicine: Core Competencies for Family Nurse Practitioners.

ERIC Educational Resources Information Center

Burman, Mary E.

2003-01-01

Directors of family nurse practitioner education programs (n=141) reported inclusion of some complementary/alternative medicine content (CAM), most commonly interviewing patients about CAM, critical thinking, evidence-based medicine, laws, ethics, and spiritual/cultural beliefs. Definition of CAM was medically, not holistically based. More faculty…

Who's on First? Gender Differences in Performance on the "SAT"® Test on Critical Reading Items with Sports and Science Content. Research Report. ETS RR-16-26

ERIC Educational Resources Information Center

Chubbuck, Kay; Curley, W. Edward; King, Teresa C.

2016-01-01

This study gathered quantitative and qualitative evidence concerning gender differences in performance by using critical reading material on the "SAT"® test with sports and science content. The fundamental research questions guiding the study were: If sports and science are to be included in a skills test, what kinds of material are…

An Assessment for Learning System Called ACED: Designing for Learning Effectiveness and Accessibility. Research Report. ETS RR-07-26

ERIC Educational Resources Information Center

Shute, Valerie J.; Hansen, Eric G.; Almond, Russell G.

2007-01-01

This paper reports on a 3-year, NSF-funded research and development project called ACED: Adaptive Content with Evidence-based Diagnosis. The purpose of the project was to design, develop, and evaluate an assessment for learning (AfL) system for diverse students, using Algebra I content related to geometric sequences (i.e., successive numbers…

Decision-making and evidence use during the process of prenatal record review in Canada: a multiphase qualitative study.

PubMed

Semenic, Sonia; Edwards, Nancy; Premji, Shahirose; Olson, Joanne; Williams, Beverly; Montgomery, Phyllis

2015-03-31

Prenatal records are potentially powerful tools for the translation of best-practice evidence into routine prenatal care. Although all jurisdictions in Canada use standardized prenatal records to guide care and provide data for health surveillance, their content related to risk factors such as maternal smoking and alcohol use varies widely. Literature is lacking on how prenatal records are developed or updated to integrate research evidence. This multiphase project aimed to identify key contextual factors influencing decision-making and evidence use among Canadian prenatal record committees (PRCs), and formulate recommendations for the prenatal record review process in Canada. Phase 1 comprised key informant interviews with PRC leaders across 10 Canadian jurisdictions. Phase 2, was a qualitative comparative case study of PRC factors influencing evidence-use and decision-making in five selected jurisdictions. Interview data were analysed using qualitative content analysis. Phase 3 involved a dissemination workshop with key stakeholders to review and refine recommendations derived from Phases 1 and 2. Prenatal record review processes differed considerably across Canadian jurisdictions. PRC decision-making was complex, revealing the competing functions of the prenatal record as a clinical guide, documentation tool and data source. Internal contextual factors influencing evidence use included PRC resources to conduct evidence reviews; group composition and dynamics; perceived function of the prenatal record; and expert opinions. External contextual factors included concerns about user buy-in; health system capacities; and pressures from public health stakeholders. Our recommendations highlight the need for: broader stakeholder involvement and explicit use of decision-support strategies to support the revision process; a national template of evidence-informed changes that can be used across jurisdictions; consideration of both clinical and surveillance functions of the prenatal record; and dissemination plans to communicate prenatal record modifications. Decision-making related to prenatal record content involves a negotiated effort to balance research evidence with the needs and preferences of prenatal care providers, health system capacities as well as population health priorities. The development of a national template for prenatal records would reduce unnecessary duplication of PRC work and enhance the consistency of prenatal care delivery and perinatal surveillance data across Canada.

Development and evaluation of an audiovisual information resource to promote self-management of chemotherapy side-effects.

PubMed

Carey, Mariko; Jefford, Michael; Schofield, Penelope; Kelly, Siobhan; Krishnasamy, Meinir; Aranda, Sanchia

2006-04-01

Based on a theoretical framework, we developed an audiovisual resource to promote self-management of eight common chemotherapy side-effects. A patient needs analysis identified content domains, best evidence for preparing patients for threatening medical procedures and a systematic review of effective self-care strategies informed script content. Patients and health professionals were invited to complete a written evaluation of the video. A 25-min video was produced. Fifty health professionals and 37 patients completed the evaluation. All considered the video informative and easy to understand. The majority believed the video would reduce anxiety and help patients prepare for chemotherapy. Underpinned by a robust theoretical framework, we have developed an evidence-based resource that is perceived by both patients and health professionals as likely to enhance preparedness for chemotherapy.

Ontology based log content extraction engine for a posteriori security control.

PubMed

Azkia, Hanieh; Cuppens-Boulahia, Nora; Cuppens, Frédéric; Coatrieux, Gouenou

2012-01-01

In a posteriori access control, users are accountable for actions they performed and must provide evidence, when required by some legal authorities for instance, to prove that these actions were legitimate. Generally, log files contain the needed data to achieve this goal. This logged data can be recorded in several formats; we consider here IHE-ATNA (Integrating the healthcare enterprise-Audit Trail and Node Authentication) as log format. The difficulty lies in extracting useful information regardless of the log format. A posteriori access control frameworks often include a log filtering engine that provides this extraction function. In this paper we define and enforce this function by building an IHE-ATNA based ontology model, which we query using SPARQL, and show how the a posteriori security controls are made effective and easier based on this function.

Factor analysis methods and validity evidence: A systematic review of instrument development across the continuum of medical education

NASA Astrophysics Data System (ADS)

Wetzel, Angela Payne

Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across the continuum of medical education had not been previously identified. Therefore, the purpose for this study was critical review of instrument development articles employing exploratory factor or principal component analysis published in medical education (2006--2010) to describe and assess the reporting of methods and validity evidence based on the Standards for Educational and Psychological Testing and factor analysis best practices. Data extraction of 64 articles measuring a variety of constructs that have been published throughout the peer-reviewed medical education literature indicate significant errors in the translation of exploratory factor analysis best practices to current practice. Further, techniques for establishing validity evidence tend to derive from a limited scope of methods including reliability statistics to support internal structure and support for test content. Instruments reviewed for this study lacked supporting evidence based on relationships with other variables and response process, and evidence based on consequences of testing was not evident. Findings suggest a need for further professional development within the medical education researcher community related to (1) appropriate factor analysis methodology and reporting and (2) the importance of pursuing multiple sources of reliability and validity evidence to construct a well-supported argument for the inferences made from the instrument. Medical education researchers and educators should be cautious in adopting instruments from the literature and carefully review available evidence. Finally, editors and reviewers are encouraged to recognize this gap in best practices and subsequently to promote instrument development research that is more consistent through the peer-review process.

Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

PubMed Central

2007-01-01

Background Evidence-based practice (EBP) is an expected approach to improving the quality of patient care and service delivery in health care systems internationally that is yet to be realized. Given the current evidence-practice gap, numerous authors describe barriers to achieving EBP. One recurrently identified barrier is the setting or context of practice, which is likewise cited as a potential part of the solution to the gap. The purpose of this study is to identify key contextual elements and related strategic processes in organizations that find and use evidence at multiple levels, in an ongoing, integrated fashion, in contrast to those that do not. Methods The core theoretical framework for this multi-method explanatory case study is Pettigrew and Whipp's Content, Context, and Process model of strategic change. This framework focuses data collection on three entities: the Why of strategic change, the What of strategic change, and the How of strategic change, in this case related to implementation and normalization of EBP. The data collection plan, designed to capture relevant organizational context and related outcomes, focuses on eight interrelated factors said to characterize a receptive context. Selective, purposive sampling will provide contrasting results between two cases (departments of nursing) and three embedded units in each. Data collection methods will include quantitative tools (e.g., regarding culture) and qualitative approaches including focus groups, interviews, and documents review (e.g., regarding integration and “success”) relevant to the EBP initiative. Discussion This study should provide information regarding contextual elements and related strategic processes key to successful implementation and sustainability of EBP, specifically in terms of a pervasive pattern in an acute care hospital-based health care setting. Additionally, this study will identify key contextual elements that differentiate successful implementation and sustainability of EBP efforts, both within varying levels of a hospital-based clinical setting and across similar hospital settings interested in EBP. PMID:17266756

Advancing the science of health research capacity strengthening in low-income and middle-income countries: a scoping review of the published literature, 2000–2016

PubMed Central

Dean, Laura; Gregorius, Stefanie; Pulford, Justin

2017-01-01

Objectives Substantial development assistance and research funding are invested in health research capacity strengthening (HRCS) interventions in low-income and middle-income countries, yet the effectiveness, impact and value for money of these investments are not well understood. A major constraint to evidence-informed HRCS intervention has been the disparate nature of the research effort to date. This review aims to map and critically analyse the existing HRCS effort to better understand the level, type, cohesion and conceptual sophistication of the current evidence base. The overall goal of this article is to advance the development of a unified, implementation-focused HRCS science. Methods We used a scoping review methodology to identify peer-reviewed HRCS literature within the following databases: PubMed, Global Health and Scopus. HRCS publications available in English between the period 2000 and 2016 were included. 1195 articles were retrieved of which 172 met the final inclusion criteria. A priori thematic analysis of all included articles was completed. Content analysis of identified HRCS definitions was conducted. Results The number of HRCS publications increased exponentially between 2000 and 2016. Most publications during this period were perspective, opinion or commentary pieces; however, original research publications were the primary publication type since 2013. Twenty-five different definitions of research capacity strengthening were identified, of which three aligned with current HRCS guidelines. Conclusions The review findings indicate that an HRCS research field with a focus on implementation science is emerging, although the conceptual and empirical bases are not yet sufficiently advanced to effectively inform HRCS programme planning. Consolidating an HRCS implementation science therefore presents as a viable option that may accelerate the development of a useful evidence base to inform HRCS programme planning. Identifying an agreed operational definition of HRCS, standardising HRCS-related terminology, developing a needs-based HRCS-specific research agenda and synthesising currently available evidence may be useful first steps. PMID:29217727

Evidence-based communications strategies: NWPERLC response to training on effectively reaching limited English-speaking (LEP) populations in emergencies.

PubMed

DʼAmbrosio, Luann; Huang, Claire E; Sheng Kwan-Gett, Tao

2014-01-01

Identifying and overcoming barriers to effective emergency preparedness and response is one of the objectives for the Centers for Disease Control and Prevention's network of 14 Preparedness and Emergency Response Learning Centers (PERLCs) and 9 Preparedness and Response Research Centers (PERRCs). This report describes how a PERLC and a PERRC colocated at the Northwest Center for Public Health Practice responded to Los Angeles County Department of Public Health's (DPH's) request to improve emergency communications with limited English-proficient (LEP) populations. Activities included an assessment of training needs of the DPH preparedness workforce, a training series on social media and community engagement, and a toolkit of evidence-based findings to improve LEP populations' emergency communications and community resilience. Most respondents to the training needs assessment considered themselves essential personnel during an emergency and stated that they have received proper training. Respondents would like to receive further emergency preparedness training, including additional clarity on their role during an emergency. The majority of participants rated the training series as excellent/very good and agreed that they will be able to apply the course content to their work. The percentage of participants who reported confidence in their knowledge and skills related to each course learning objective increased from the precourse survey to the postcourse survey. This article discusses how the colocation of PERRC and PERLC offers efficiencies and expertise to accomplish multicomponent evidence-based requests. The ability to translate research findings quickly into evidence-based training and best practice resources is a strategic benefit to public health practice agencies working on emergency preparedness. LA County DPH was able to use knowledge and lessons learned gained from this work to design and prioritize education and training offerings to improve the capacity to effectively engage and communicate with LEP communities before and during public health emergencies.

Management of bleeding and coagulopathy following major trauma: an updated European guideline

PubMed Central

2013-01-01

Introduction Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved. Methods The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. Results Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. Conclusions A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond. Please see related letter by Morel et alhttp://ccforum.com/content/17/4/442 PMID:23601765

Information literacy as the foundation for evidence-based practice in graduate nursing education: a curriculum-integrated approach.

PubMed

Jacobs, Susan Kaplan; Rosenfeld, Peri; Haber, Judith

2003-01-01

As part of a system-wide initiative to advance evidence-based practice among clinicians, graduate students, and educators, the New York University Division of Nursing embarked on a curricular initiative to integrate components of information literacy in all core courses of the master's program. Increasing competency in information literacy is the foundation for evidence-based practice and provides nursing professionals with the skills to be literate consumers of information in an electronic environment. Competency in information literacy includes an understanding of the architecture of information and the scholarly process; the ability to navigate among a variety of print and electronic tools to effectively access, search, and critically evaluate appropriate resources; synthesize accumulated information into an existing body of knowledge; communicate research results clearly and effectively; and appreciate the social issues and ethical concerns related to the provision, dissemination, and sharing of information. In collaboration with the New York University Division of Libraries' Health Sciences Librarian, instructional modules in information literacy relevant to each of the 5 core nursing master's courses were developed, complemented by a Web-based tutorial: http://library.nyu.edu/research/health/tutorial. The Web site is multifaceted, with fundamentals for the beginner, as well as more complex content for the advanced user. Course assignments were designed to promote specific competencies in information literacy and strategies for evaluating the strength of the evidence found. A survey of information literacy competencies, which assessed students' knowledge, misconceptions, and use of electronic information resources, was administered when students entered the program and at 1-year intervals thereafter.

The availability of health information system for decision-making with evidence-based medicine approach-a case study: Kermanshah, Iran.

PubMed

Safari, Ameneh; Safari, Yahya

2018-08-01

Evidence-based medicine (EBM) is defining proper and wise use of the best evidence in clinical decision for patient׳s care. This study have done with the aim of evaluating health information system for decision-making with EBM approach in educational hospital of Kermanshah city. The statistical population include all the specialist and specialty, and also head nurses of educational hospitals in Kermanshah city. The data collected by researcher made questionnaire. The content validities of the questionnaire were confirmed by experts to complete the questions of the questionnaire. Then, the reliability of the questionnaire was evaluated using the Cronbach׳s alpha coefficient. The results have showed that the accessibility rate to the internet sources is in desirable level. The results have showed that there was a significant difference at least in one group between the availability of hospital information system EBM establishment in terms of accessing to the internet based data, according to the academic major ( P = 0.021 ). The sufficiency of hospital information system in evidence-based medicine establishment in terms of necessary knowledge for implementing it according to the educational major have showed a significant statistical difference at least in one group ( P = 0.001 ). Kermanshah׳s hospital have a desirable condition in terms of accessibility to the internet sources, knowledge of EBM and its implementation which this have showed the availability of desirable platform for decision-making with the EBM approach. However, it is better to implement regulate educational periods for educating the doctors and nurses in order to reach practical implementation of the EBM approach.

Exploring science teachers' pedagogical content knowledge in the teaching of genetics in Swaziland

NASA Astrophysics Data System (ADS)

Mthethwa-Kunene, Khetsiwe Eunice Faith

Recent trends show that learners' enrolment and performance in science at secondary school level is dwindling. Some science topics including genetics in biology are said to be difficult for learners to learn and thus they perform poorly in examinations. Teacher knowledge base, particularly topic-specific pedagogical content knowledge (PCK), has been identified by many researchers as an important factor that is linked with learner understanding and achievement in science. This qualitative study was an attempt to explore the PCK of four successful biology teachers and how they developed it in the context of teaching genetics. The purposive sampling technique was employed to select the participating teachers based on their schools' performance in biology public examinations and recommendations by science specialists and school principals. Pedagogical content knowledge was used as a theoretical framework for the study, which guided the inquiry in data collection, analysis and discussion of the research findings. The study adopted the case study method and various sources of evidence including concept maps, lesson plans, pre-lesson interviews, lesson observations, post-teaching teacher questionnaire, post-lesson interviews and document analysis were used to collect data on teachers' PCK as well as how PCK was assumed to have developed. The data were analysed in an attempt to determine the individual teachers' school genetics' content knowledge, related knowledge of instructional strategies and knowledge of learners' preconceptions and learning difficulties. The analysis involved an iterative process of coding data into PCK categories of content knowledge, pedagogical knowledge and knowledge of learners' preconceptions and learning difficulties. The findings of the study indicate that the four successful biology teachers generally have the necessary content knowledge of school genetics, used certain topic-specific instructional strategies, but lacked knowledge of genetics-related learners' preconceptions and learning difficulties despite having taught the topic for many years. There were some instructional deficits in their approaches and techniques in teaching genetics. The teachers failed to use physical models, teacher demonstration and/or learner experimentation in their lessons (or include them in their lesson plans) to assist learners in visualizing or internalizing the genetics concepts or processes located at the sub-microscopic level. The teachers' PCK in genetics teaching was assumed to have developed mainly through formal university education programmes, classroom teaching experiences, peer support and participation in in-service workshops. The implications for biology teacher education are also discussed.

The Impact of Tier 1 Reading Instruction on Reading Outcomes for Students in Grades 4-12: A Meta-Analysis

ERIC Educational Resources Information Center

Swanson, Elizabeth; Stevens, Elizabeth A.; Scammacca, Nancy K.; Capin, Philip; Stewart, Alicia A.; Austin, Christy R.

2017-01-01

Understanding the efficacy of evidence-based reading practices delivered in the Tier 1 (i.e. general classroom) setting is critical to successful implementation of multi-tiered systems, meeting a diverse range of student learning needs, and providing high quality reading instruction across content areas. This meta-analysis presents evidence on the…

Teacher argumentation in the secondary science classroom: Images of two modes of scientific inquiry

NASA Astrophysics Data System (ADS)

Gray, Ron E.

The purpose of this exploratory study was to examine scientific arguments constructed by secondary science teachers during instruction. The analysis focused on how arguments constructed by teachers differed based on the mode of inquiry underlying the topic. Specifically, how did the structure and content of arguments differ between experimentally and historically based topics? In addition, what factors mediate these differences? Four highly experienced high school science teachers were observed daily during instructional units for both experimental and historical science topics. Data sources include classroom observations, field notes, reflective memos, classroom artifacts, a nature of science survey, and teacher interviews. The arguments were analyzed for structure and content using Toulmin's argumentation pattern and Walton's schemes for presumptive reasoning revealing specific patterns of use between the two modes of inquiry. Interview data was analyzed to determine possible factors mediating these patterns. The results of this study reveal that highly experienced teachers present arguments to their students that, while simple in structure, reveal authentic images of science based on experimental and historical modes of inquiry. Structural analysis of the data revealed a common trend toward a greater amount of scientific data used to evidence knowledge claims in the historical science units. The presumptive reasoning analysis revealed that, while some presumptive reasoning schemes remained stable across the two units (e.g. 'causal inferences' and 'sign' schemes), others revealed different patterns of use including the 'analogy', 'evidence to hypothesis', 'example', and 'expert opinion' schemes. Finally, examination of the interview and survey data revealed five specific factors mediating the arguments constructed by the teachers: view of the nature of science, nature of the topic, teacher personal factors, view of students, and pedagogical decisions. These factors influenced both the structure and use of presumptive reasoning in the arguments. The results have implications for classroom practice, teacher education, and further research.

Experimental evidences for reducing Mg activation energy in high Al-content AlGaN alloy by MgGa δ doping in (AlN)m/(GaN)n superlattice

NASA Astrophysics Data System (ADS)

Wang, Xiao; Wang, Wei; Wang, Jingli; Wu, Hao; Liu, Chang

2017-03-01

P-type doping in high Al-content AlGaN alloys is a main challenge for realizing AlGaN-based deep ultraviolet optoelectronics devices. According to the first-principles calculations, Mg activation energy may be reduced so that a high hole concentration can be obtained by introducing nanoscale (AlN)5/(GaN)1 superlattice (SL) in Al0.83Ga0.17N disorder alloy. In this work, experimental evidences were achieved by analyzing Mg doped high Al-content AlGaN alloys and Mg doped AlGaN SLs as well as MgGa δ doped AlGaN SLs. Mg acceptor activation energy was significantly reduced from 0.378 to 0.331 eV by using MgGa δ doping in SLs instead of traditional doping in alloys. This new process was confirmed to be able to realize high p-type doping in high Al-content AlGaN.

Experimental evidences for reducing Mg activation energy in high Al-content AlGaN alloy by MgGa δ doping in (AlN)m/(GaN)n superlattice.

PubMed

Wang, Xiao; Wang, Wei; Wang, Jingli; Wu, Hao; Liu, Chang

2017-03-14

P-type doping in high Al-content AlGaN alloys is a main challenge for realizing AlGaN-based deep ultraviolet optoelectronics devices. According to the first-principles calculations, Mg activation energy may be reduced so that a high hole concentration can be obtained by introducing nanoscale (AlN) 5 /(GaN) 1 superlattice (SL) in Al 0.83 Ga 0.17 N disorder alloy. In this work, experimental evidences were achieved by analyzing Mg doped high Al-content AlGaN alloys and Mg doped AlGaN SLs as well as Mg Ga δ doped AlGaN SLs. Mg acceptor activation energy was significantly reduced from 0.378 to 0.331 eV by using Mg Ga δ doping in SLs instead of traditional doping in alloys. This new process was confirmed to be able to realize high p-type doping in high Al-content AlGaN.

Evidence-based medicine and patient choice: the case of heart failure care.

PubMed

Sanders, Tom; Harrison, Stephen; Checkland, Kath

2008-04-01

The implementation of evidence-based medicine and policies aimed at increasing user involvement in health care decisions are central planks of contemporary English health policy. Yet they are potentially in conflict. Our aim was to explore how clinicians working in the field of heart failure resolve this conflict. Qualitative semi-structured interviews were carried out with health professionals who were currently caring for patients with heart failure, and observations were conducted at one dedicated heart failure clinic in northern England. While clinicians acknowledged that patients' ideas and preferences should be an important part of treatment decisions, the widespread acceptance of an evidence-based clinical protocol for heart failure among the clinic doctors significantly influenced the content and style of the consultation. Evidence-based medicine was used to buttress professional authority and seemed to provide an additional barrier to the adoption of patient-centred clinical practice.

Chronic fatigue syndrome in the media: a content analysis of newspaper articles

PubMed Central

Knudsen, Ann Kristen; Omenås, Anne Nagelgaard; Harvey, Samuel B; Løvvik, Camilla MS; Lervik, Linn V; Mykletun, Arnstein

2011-01-01

Objectives Although cognitive behavioural therapy and graded exercise treatment are recognized evidence-based treatments for chronic fatigue syndrome/myalgic encephalomyelitis (ME), their use is still considered controversial by some patient groups. This debate has been reflected in the media, where many patients gather health information. The aim of this study was to examine how treatment for chronic fatigue syndrome/ME is described in the newspaper media. Design Content analysis of newspaper articles. Setting The digitalized media archive Atekst was used to identify Norwegian newspaper articles where chronic fatigue syndrome/ME was mentioned. Participants Norwegian newspaper articles published over a 20-month period, from 1 January 2008 to 31 August 2009. Main outcome measures Statements regarding efficiency of various types of treatment for chronic fatigue syndrome/ME and the related source of the treatment advice. Statements were categorized as being either positive or negative towards evidence-based or alternative treatment. Results One hundred and twenty-two statements regarding treatment of chronic fatigue syndrome/ME were identified among 123 newspaper articles. The most frequent statements were positive statements towards alternative treatment Lightning Process (26.2%), negative statements towards evidence-based treatments (22.1%), and positive statements towards other alternative treatment interventions (22.1%). Only 14.8% of the statements were positive towards evidence-based treatment. Case-subjects were the most frequently cited sources, accounting for 35.2% of the statements, followed by physicians and the Norwegian ME association. Conclusions Statements regarding treatment for chronic fatigue syndrome/ME in newspapers are mainly pro-alternative treatment and against evidence-based treatment. The media has great potential to influence individual choices. The unbalanced reporting of treatment options for chronic fatigue syndrome/ME in the media is potentially harmful. PMID:21637403

Chronic fatigue syndrome in the media: a content analysis of newspaper articles.

PubMed

Knudsen, Ann Kristen; Omenås, Anne Nagelgaard; Harvey, Samuel B; Løvvik, Camilla Ms; Lervik, Linn V; Mykletun, Arnstein

2011-05-01

Although cognitive behavioural therapy and graded exercise treatment are recognized evidence-based treatments for chronic fatigue syndrome/myalgic encephalomyelitis (ME), their use is still considered controversial by some patient groups. This debate has been reflected in the media, where many patients gather health information. The aim of this study was to examine how treatment for chronic fatigue syndrome/ME is described in the newspaper media. Content analysis of newspaper articles. The digitalized media archive Atekst was used to identify Norwegian newspaper articles where chronic fatigue syndrome/ME was mentioned. Norwegian newspaper articles published over a 20-month period, from 1 January 2008 to 31 August 2009. Statements regarding efficiency of various types of treatment for chronic fatigue syndrome/ME and the related source of the treatment advice. Statements were categorized as being either positive or negative towards evidence-based or alternative treatment. One hundred and twenty-two statements regarding treatment of chronic fatigue syndrome/ME were identified among 123 newspaper articles. The most frequent statements were positive statements towards alternative treatment Lightning Process (26.2%), negative statements towards evidence-based treatments (22.1%), and positive statements towards other alternative treatment interventions (22.1%). Only 14.8% of the statements were positive towards evidence-based treatment. Case-subjects were the most frequently cited sources, accounting for 35.2% of the statements, followed by physicians and the Norwegian ME association. Statements regarding treatment for chronic fatigue syndrome/ME in newspapers are mainly pro-alternative treatment and against evidence-based treatment. The media has great potential to influence individual choices. The unbalanced reporting of treatment options for chronic fatigue syndrome/ME in the media is potentially harmful.

Evidence-based adaptation and scale-up of a mobile phone health information service.

PubMed

L'Engle, Kelly; Plourde, Kate F; Zan, Trinity

2017-01-01

The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. m4RH-Mobile for Reproductive Health-is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up through licensing and toolkit development, research into new business/distribution models, and serving as the foundation for derivative NGO and quasi-governmental mHealth platforms. The m4RH platform provides an excellent case study of how to apply best practices to successfully scale up mobile phone interventions for health improvement. Applying principles of scale can inform the successful scale-up, sustainability, and potential impact of mHealth programs across health topics and settings.

Analysis of Five Junior High School Physics Textbooks Used in China for Representations of Nature of Science

NASA Astrophysics Data System (ADS)

Li, Xiying; Tan, Zuyu; Shen, Jiliang; Hu, Weiping; Chen, Yinghe; Wang, Jingying

2018-04-01

Based on the analytical framework of nature of science (NOS) in junior school science textbooks, a content analysis method was adopted to analyze the NOS in junior middle school physical textbooks (grade 8) of five editions authorized by the Ministry of Education of China, and the features of NOS were analyzed and compared. It was found that all five textbooks presented poor representations of NOS. None of these five editions were scientifically objective, nor did they include discussions of scientific laws and theories. Furthermore, they rarely presented empirical evidence to support their arguments. The explicit representations of NOS were particularly inadequate.

Learning Strategies for Adolescents with Mild Disabilities

ERIC Educational Resources Information Center

Conderman, Greg; Koman, Kara; Schibelka, Mary; Higgin, Karen; Cooper, Cody; Butler, Jordyn

2013-01-01

Learning strategy instruction is an evidence-based practice for teaching adolescents with mild disabilities. However, researchers have not developed strategies for every content area or skill. Therefore, teachers need to be able develop strategies based on the needs of their students. This article reviews the process for developing and teaching…

Guidelines for randomized clinical trial protocol content: a systematic review

PubMed Central

2012-01-01

Background All randomized clinical trials (RCTs) require a protocol; however, numerous studies have highlighted protocol deficiencies. Reporting guidelines may improve the content of research reports and, if developed using robust methods, may increase the utility of reports to stakeholders. The objective of this study was to systematically identify and review RCT protocol guidelines, to assess their characteristics and methods of development, and to compare recommendations. Methods We conducted a systematic review of indexed literature (MEDLINE, EMBASE and the Cochrane Methodology Register from inception to September 2010; reference lists; related article features; forward citation searching) and a targeted search of supplementary sources, including a survey of major trial funding agencies in six countries. Records were eligible if they described a content guideline in English or French relevant to RCT protocols. Guidelines were excluded if they specified content for protocols for trials of specific procedures or conditions or were intended to assess trial quality. We extracted guideline characteristics and methods. Content was mapped for a subset of guidelines that described development methods or had institutional endorsement. Results Forty guidelines published in journals, books and institutional reports were included in the review; seven were specific to RCT protocols. Only eight (20%) described development methods which included informal consensus methods, pilot testing and formal validation; no guideline described all of these methods. No guideline described formal consensus methods or a systematic retrieval of empirical evidence to inform its development. The guidelines included a median of 23 concepts per guideline (interquartile range (IQR) = 14 to 34; range = 7 to 109). Among the subset of guidelines (n = 23) for which content was mapped, approximately 380 concepts were explicitly addressed (median concepts per guideline IQR = 31 (24,80); range = 16 to 150); most concepts were addressed in a minority of guidelines. Conclusions Existing guidelines for RCT protocol content varied substantially in their recommendations. Few reports described the methods of guideline development, limiting comparisons of guideline validity. Given the importance of protocols to diverse stakeholders, we believe a systematically developed, evidence-informed guideline for clinical trial protocols is needed. PMID:23006870

Guidelines for randomized clinical trial protocol content: a systematic review.

PubMed

Tetzlaff, Jennifer M; Chan, An-Wen; Kitchen, Jessica; Sampson, Margaret; Tricco, Andrea C; Moher, David

2012-09-24

All randomized clinical trials (RCTs) require a protocol; however, numerous studies have highlighted protocol deficiencies. Reporting guidelines may improve the content of research reports and, if developed using robust methods, may increase the utility of reports to stakeholders. The objective of this study was to systematically identify and review RCT protocol guidelines, to assess their characteristics and methods of development, and to compare recommendations. We conducted a systematic review of indexed literature (MEDLINE, EMBASE and the Cochrane Methodology Register from inception to September 2010; reference lists; related article features; forward citation searching) and a targeted search of supplementary sources, including a survey of major trial funding agencies in six countries. Records were eligible if they described a content guideline in English or French relevant to RCT protocols. Guidelines were excluded if they specified content for protocols for trials of specific procedures or conditions or were intended to assess trial quality. We extracted guideline characteristics and methods. Content was mapped for a subset of guidelines that described development methods or had institutional endorsement. Forty guidelines published in journals, books and institutional reports were included in the review; seven were specific to RCT protocols. Only eight (20%) described development methods which included informal consensus methods, pilot testing and formal validation; no guideline described all of these methods. No guideline described formal consensus methods or a systematic retrieval of empirical evidence to inform its development. The guidelines included a median of 23 concepts per guideline (interquartile range (IQR) = 14 to 34; range = 7 to 109). Among the subset of guidelines (n = 23) for which content was mapped, approximately 380 concepts were explicitly addressed (median concepts per guideline IQR = 31 (24,80); range = 16 to 150); most concepts were addressed in a minority of guidelines. Existing guidelines for RCT protocol content varied substantially in their recommendations. Few reports described the methods of guideline development, limiting comparisons of guideline validity. Given the importance of protocols to diverse stakeholders, we believe a systematically developed, evidence-informed guideline for clinical trial protocols is needed.

Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey.

PubMed

Bjurling-Sjöberg, Petronella; Jansson, Inger; Wadensten, Barbro; Engström, Gabriella; Pöder, Ulrika

2014-02-01

To identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. A descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. CPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. Progress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed. © 2013 John Wiley & Sons, Ltd.

Enhancing Critical Thinking Via a Clinical Scholar Approach.

PubMed

Simpson, Vicki; McComb, Sara A; Kirkpatrick, Jane M

2017-11-01

Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.]. Copyright 2017, SLACK Incorporated.

Typology of delivery quality: latent profile analysis of teacher engagement and delivery techniques in a school-based prevention intervention, keepin’ it REAL curriculum

PubMed Central

Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.

2014-01-01

Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may or may not have a prevention background. The goal of the current study is to add to the scholarly literature on implementation quality for a school-based substance use prevention intervention. Twenty-five schools in Ohio and Pennsylvania implemented the original keepin’ REAL (kiR) substance use prevention curriculum. Each of the 10, 40–45 min lessons of the kiR curriculum was video recorded. Coders observed and rated a random sample of 276 videos reflecting 78 classes taught by 31 teachers. Codes included teachers’ delivery techniques (e.g. lecture, discussion, demonstration and role play) and engagement with students (e.g. attentiveness, enthusiasm and positivity). Based on the video ratings, a latent profile analysis was run to identify typology of delivery quality. Five profiles were identified: holistic approach, attentive teacher-orientated approach, enthusiastic lecture approach, engaged interactive learning approach and skill practice-only approach. This study provides a descriptive typology of delivery quality while implementing a school-based substance use prevention intervention. PMID:25274721

Developing an evidence-based public health informatics course.

PubMed

Yu, Xinyu; Xie, Yue; Pan, Xuequn; Mayfield-Johnson, Susan; Whipple, Jessica; Azadbakht, Elena

2015-10-01

This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course. Community assessments employing focus group interviews and an online survey were utilized to determine course need and content. Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information. A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library's profile.

What physicians need to know about dreams and dreaming.

PubMed

Pagel, James F

2012-11-01

An overview of the current status of dream science is given, designed to provide a basic background of this field for the sleep-interested physician. No cognitive state has been more extensively studied and is yet more misunderstood than dreaming. Much older work is methodologically limited by lack of definitions, small sample size, and constraints of theoretical perspective, with evidence equivocal as to whether any special relationship exists between rapid eye movement (REM) sleep and dreaming. As the relationship between dreams and REM sleep is so poorly defined, evidence-based studies of dreaming require a dream report. The different aspects of dreaming that can be studied include dream and nightmare recall frequency, dream content, dreaming effect on waking behaviors, dream/nightmare associated medications, and pathophysiology affecting dreaming. Whether studied from behavioral, neuroanatomical, neurochemical, pathophysiological or electrophysiological perspectives, dreaming reveals itself to be a complex cognitive state affected by a wide variety of medical, psychological, sleep and social variables.

Science and alcohol policy: a case study of the EU Strategy on Alcohol.

PubMed

Gordon, Rebecca; Anderson, Peter

2011-03-01

To describe the extent to which the content of the European Commission's Communication on alcohol reflects public health-based scientific evidence. Document retrieval and content analysis. European Union. Background documents leading up to the European Commission's Communication on alcohol, the Communication itself and implementation actions following the Communication. Documents were read and analyzed for evidence-based alcohol policy content. Although the Communication acknowledges and supports existing interventions which have high evidence for effectiveness, such as enforcing blood alcohol concentration (BAC) limits for drivers, it extensively promotes other interventions which have been shown to be ineffective; for example, recommending education and persuasion strategies as a measure across all its five priority areas. Measures to influence price are mentioned only once in relation to sales in drinking venues limiting two-for-one drinks offers. Measures to control physical availability are mentioned infrequently. The Communication reflects the science, in that it acknowledges the significance of alcohol as a social and health determinant in Europe. However, it places more emphasis on policy actions with less evidence for effectiveness than on those with strong evidence. It also focuses its efforts more on mapping member state actions and coordinating knowledge exchange than on providing concrete recommendations for action or developing Europe-wide policy measures. This may be a compromise between the rights of Member States to develop national policy and legislation and the obligation of the European Union as a collaborative body to protect health. Furthermore, it has been suggested that the European Union's roots as a trading block emphasizes collaboration with industry stakeholders and this influences the ability to prioritize health over trade considerations. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Stability and Performance of Rapid-Acting Insulin Analogs Used for Continuous Subcutaneous Insulin Infusion: A Systematic Review

PubMed Central

Kerr, David; Wizemann, Erik; Senstius, Jakob; Zacho, Mette; Ampudia-Blasco, Francisco Javier

2013-01-01

Aim: We review and summarize the literature on the safety and stability of rapid-acting insulin analogs used for continuous subcutaneous insulin infusion (CSII) in patients with diabetes. Methods Two predefined search strategies were systematically implemented to search Medline and the Cochrane Register of Clinical Trials for publications between 1996 and 2012. Results Twenty studies were included in the review: 13 in vitro studies and 7 clinical studies. In vitro studies investigated the effects of extreme CSII conditions (high temperature and mechanical agitation) on the risk of catheter occlusions and insulin stability factors, such as potency, purity, high molecular weight protein content, pH stability, and preservative content (m-cresol, phenol). Under these conditions, the overall stability of rapid-acting insulin analogs was similar for insulin lispro, insulin aspart, and insulin glulisine, although insulin glulisine showed greater susceptibility to insulin precipitation and catheter occlusions. A limited number of clinical trials were identified; this evidence-based information suggests that the rate of catheter occlusions in patients with type 1 diabetes using CSII treatment may vary depending on the rapid-acting analog used. Conclusions Based on a limited amount of available data, the safety, stability, and performance of the three available rapid-acting insulin analogs available for use with CSII were similar. However, there is limited evidence suggesting that the risk of occlusion may vary with the insulin preparation under certain circumstances. PMID:24351186

The Vanguard Faculty program: research training for complementary and alternative medicine faculty.

PubMed

Connelly, Erin N; Elmer, Patricia J; Morris, Cynthia D; Zwickey, Heather

2010-10-01

The increasing use of complementary and alternative medicine (CAM) treatment is paralleled by a growing demand for an evidence-based approach to CAM practice. In 2007, the Helfgott Research Institute at the National College of Natural Medicine (NCNM), in partnership with Oregon Health & Science University (OHSU), both in Portland, OR, began a National Institutes of Health-funded initiative to increase the quality and quantity of evidence-based medicine (EBM) content in the curricula at NCNM. One key strategy of the Research in Complementary and Alternative Medicine Program (R-CAMP) initiative was to create a faculty development program that included four components: intensive training in EBM; professional skills enhancement; peer and mentored support; and, ultimately, utilization of these skills to incorporate EBM into the curricula. This initiative is centered on a core group of faculty at NCNM, called the Vanguard Faculty, who receives early, intensive training in EBM and works to incorporate this training into classes. Training consists of an intensive, week-long course, monthly group meetings, and periodic individualized meetings. Vanguard Faculty members also receive mentorship and access to resources to pursue individualized faculty development, research or scholarly activities. Early evaluations indicate that this effort has been successful in increasing EBM content in the curricula at NCNM. This article describes the Vanguard Faculty program in an effort to share the successes and challenges of implementing a wide-ranging faculty development and curricular initiative at a complementary and alternative medicine institution.

Infant Skin Care Products: What Are the Issues?

PubMed

Kuller, Joanne McManus

2016-10-01

Infant skin is susceptible to dryness and irritation from external factors, including topical skin care products not formulated for the infant's skin. This may increase the risk of contact dermatitis. Parents frequently express concern regarding potential harm from ingredients in skin care products and seek information. This is complicated by several skin care myths. The purpose of this literature review was to provide evidence-based information to educate parents on the use of products for preterm and term infants. Multiple searches using PubMed were conducted including the search terms "infant skin care," "infant products," "infant bath," "emollients," "diaper skin care," and "diaper wipes." Reference lists of comprehensive reviews were also scanned. Google searches were used to assess consumer information, product information, and regulatory guidelines. There is little scientific evidence to support safety of natural/organic products on infant skin. Raw materials originate from different sources, complicating testing and comparisons of ingredients. Research shows that cleansers formulated for infant skin do not weaken the skin barrier the way harsher soaps and detergents can. Oils with the lowest oleic acid content provide a lower risk of irritant contact dermatitis. Nurses must be informed about natural and organic products, preservatives, and fragrances and know the definition of commonly used marketing terms. Decisions regarding the use of infant products in preterm and term infants should be evidence based. More research is needed to support claims regarding the safety of products used on infant skin.

Using a knowledge transfer framework to identify factors facilitating implementation of family-based treatment.

PubMed

Couturier, Jennifer; Kimber, Melissa; Jack, Susan; Niccols, Alison; Van Blyderveen, Sherry; McVey, Gail

2014-05-01

To conduct a qualitative study to identify factors that would facilitate the transfer of the research evidence on Family-Based Treatment (FBT) into clinical practice. Fundamental qualitative description guided sampling, data collection, and analytic decisions for this study. Forty therapists who treat children and adolescents under the age of 18 with Anorexia Nervosa (AN) and belong to Ontario's provincial network of specialized eating disorder services completed an in-depth interview focusing on elements proposed by the Lavis knowledge transfer framework. An experienced coder conducted content analysis, with 20% of the interviews double-coded for reliability purposes. Participants requested training in the FBT model, including the provision of research evidence (i.e., journal articles), as well as the specific tenets of the model according to the FBT manual. The suggested audience for implementation included not only therapists themselves, but administrators, physicians, and community members. The development of best practice guidelines was also supported. Local FBT experts were suggested as credible messengers. Infrastructure relating to financial support and time away from clinical duties were reported to be essential for training. Ongoing supervision and mentorship were reported to be important elements of implementation and evaluation processes. Suggestions for moving FBT into practice were consistent with previous research, however, the importance of obtaining the evidence in the form of primary research articles and obtaining team buy-in were remarkable. Developing context-specific training programs and administrative processes for the implementation of FBT are warranted. Copyright © 2013 Wiley Periodicals, Inc.

Ethical issues with colorectal cancer screening-a systematic review.

PubMed

Hofmann, Bjørn

2017-06-01

Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA. A literature search in MEDLINE, Embase, PsycINFO, PubMed Bioethics subset, ISI Web of Knowledge, Bioethics Literature Database (BELIT), Ethics in Medicine (ETHMED), SIBIL Base dati di bioetica, LEWI Bibliographic Database on Ethics in the Sciences and Humanities, and EUROETHICS identified 870 references of which 114 were found relevant according to title and abstract. The content of the included papers were subject to ethical analysis to highlight the ethical issues, concerns, and arguments. A wide range of important ethical issues were identified. The main benefits are reduced relative CRC mortality rate, and potentially incidence rate, but there is no evidence of reduced absolute mortality rate. Potential harms are bleeding, perforation, false test results, overdetection, overdiagnosis, overtreatment (including unnecessary removal of polyps), and (rarely) death. Other important issues are related to autonomy and informed choice equity, justice, medicalization, and expanding disease. A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening. © 2016 John Wiley & Sons, Ltd.

When All Signs Point to You: Lies Told in the Face of Evidence

PubMed Central

Evans, Angela D.; Xu, Fen; Lee, Kang

2012-01-01

Young children’s ability to tell a strategic lie by making it consistent with the physical evidence of their transgression was investigated along with the sociocognitive correlates of such lie-telling behaviors. In Experiment 1, 247 Chinese children between 3 and 5 years of age (126 boys) were left alone in a room and asked not to lift a cup to see the contents. If children lifted up the cup, the contents would be spilled and evidence of their transgression would be left behind. Upon returning to the room, the experimenter asked children whether they peeked and how the contents of the cup ended up on the table. Experiment 1 revealed that young children are able to tell strategic lies to be consistent with the physical evidence by about 4 or 5 years of age, and this ability increases in sophistication with age. Experiment 2, which included 252 Chinese 4-year-olds (127 boys), identified 2 sociocognitive factors related to children’s ability to tell strategic lies. Specifically, both children’s theory-of-mind understanding and inhibitory control skills were significantly related to their ability to tell strategic lies in the face of physical evidence. The present investigation reveals that contrary to the prevailing views, even young children are able to tell strategic lies in some contexts. PMID:21244148

Best practices for online Canadian prenatal health promotion: A public health approach.

PubMed

Chedid, Rebecca A; Terrell, Rowan M; Phillips, Karen P

2017-11-04

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women. Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided. Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity. Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities. Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive prenatal online resources. Copyright © 2017 Australian College of Midwives. All rights reserved.

Performance indicators for public mental healthcare: a systematic international inventory

PubMed Central

2012-01-01

Background The development and use of performance indicators (PI) in the field of public mental health care (PMHC) has increased rapidly in the last decade. To gain insight in the current state of PI for PMHC in nations and regions around the world, we conducted a structured review of publications in scientific peer-reviewed journals supplemented by a systematic inventory of PI published in policy documents by (non-) governmental organizations. Methods Publications on PI for PMHC were identified through database- and internet searches. Final selection was based on review of the full content of the publications. Publications were ordered by nation or region and chronologically. Individual PI were classified by development method, assessment level, care domain, performance dimension, diagnostic focus, and data source. Finally, the evidence on feasibility, data reliability, and content-, criterion-, and construct validity of the PI was evaluated. Results A total of 106 publications were included in the sample. The majority of the publications (n = 65) were peer-reviewed journal articles and 66 publications specifically dealt with performance of PMHC in the United States. The objectives of performance measurement vary widely from internal quality improvement to increasing transparency and accountability. The characteristics of 1480 unique PI were assessed. The majority of PI is based on stakeholder opinion, assesses care processes, is not specific to any diagnostic group, and utilizes administrative data sources. The targeted quality dimensions varied widely across and within nations depending on local professional or political definitions and interests. For all PI some evidence for the content validity and feasibility has been established. Data reliability, criterion- and construct validity have rarely been assessed. Only 18 publications on criterion validity were included. These show significant associations in the expected direction on the majority of PI, but mixed results on a noteworthy number of others. Conclusions PI have been developed for a broad range of care levels, domains, and quality dimensions of PMHC. To ensure their usefulness for the measurement of PMHC performance and advancement of transparency, accountability and quality improvement in PMHC, future research should focus on assessment of the psychometric properties of PI. PMID:22433251

Brief Communication: visual-field superiority as a function of stimulus type and content: further evidence.

PubMed

Basu, Anamitra; Mandal, Manas K

2004-07-01

The present study examined visual-field advantage as a function of presentation mode (unilateral, bilateral), stimulus structure (facial, lexical), and stimulus content (emotional, neutral). The experiment was conducted in a split visual-field paradigm using a JAVA-based computer program with recognition accuracy as the dependent measure. Unilaterally, rather than bilaterally, presented stimuli were significantly better recognized. Words were significantly better recognized than faces in the right visual-field; the difference was nonsignificant in the left visual-field. Emotional content elicited left visual-field and neutral content elicited right visual-field advantages. Copyright Taylor and Francis Inc.

Characteristics of evidence-based medicine training in Royal College of Physicians and Surgeons of Canada emergency medicine residencies - a national survey of program directors.

PubMed

Bednarczyk, Joseph; Pauls, Merril; Fridfinnson, Jason; Weldon, Erin

2014-03-21

Recent surveys suggest few emergency medicine (EM) training programs have formal evidence-based medicine (EBM) or journal club curricula. Our primary objective was to describe the methods of EBM training in Royal College of Physicians and Surgeons of Canada (RCPSC) EM residencies. Secondary objectives were to explore attitudes regarding current educational practices including e-learning, investigate barriers to journal club and EBM education, and assess the desire for national collaboration. A 16-question survey containing binary, open-ended, and 5-pt Likert scale questions was distributed to the 14 RCPSC-EM program directors. Proportions of respondents (%), median, and IQR are reported. The response rate was 93% (13/14). Most programs (85%) had established EBM curricula. Curricula content was delivered most frequently via journal club, with 62% of programs having 10 or more sessions annually. Less than half of journal clubs (46%) were led consistently by EBM experts. Four programs did not use a critical appraisal tool in their sessions (31%). Additional teaching formats included didactic and small group sessions, self-directed e-learning, EBM workshops, and library tutorials. 54% of programs operated educational websites with EBM resources. Program directors attributed highest importance to two core goals in EBM training curricula: critical appraisal of medical literature, and application of literature to patient care (85% rating 5 - "most importance", respectively). Podcasts, blogs, and online journal clubs were valued for EBM teaching roles including creating exposure to literature (4, IQR 1.5) and linking literature to clinical practice experience (4, IQR 1.5) (1-no merit, 5-strong merit). Five of thirteen respondents rated lack of expert leadership and trained faculty educators as potential limitations to EBM education. The majority of respondents supported the creation of a national unified EBM educational resource (4, IQR 1) (1-no support, 5- strongly support). RCPSC-EM programs have established EBM teaching curricula and deliver content most frequently via journal club. A lack of EBM expert educators may limit content delivery at certain sites. Program directors supported the nationalization of EBM educational resources. A growing usage of electronic resources may represent an avenue to link national EBM educational expertise, facilitating future collaborative educational efforts.

What Are Health-Related Users Tweeting? A Qualitative Content Analysis of Health-Related Users and Their Messages on Twitter

PubMed Central

DeCamp, Matthew; Dredze, Mark; Chisolm, Margaret S; Berger, Zackary D

2014-01-01

Background Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals’ behavior on Twitter. Objective Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. Methods We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a “testable” claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Results Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6% (61/346) were personal in nature; 61% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Conclusions Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users—especially patients—interpret the content of tweets posted by health providers. PMID:25591063

What are health-related users tweeting? A qualitative content analysis of health-related users and their messages on twitter.

PubMed

Lee, Joy L; DeCamp, Matthew; Dredze, Mark; Chisolm, Margaret S; Berger, Zackary D

2014-10-15

Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals' behavior on Twitter. Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a "testable" claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6% (61/346) were personal in nature; 61% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users-especially patients-interpret the content of tweets posted by health providers.

Lunar and Planetary Science XXXV: Special Session: Oxygen in the Solar System, II

NASA Technical Reports Server (NTRS)

2004-01-01

The Special Session: Oxygen in the Solar System, II, included the following reports:Evolution of Oxygen Isotopes in the Solar Nebula; Disequilibrium Melting of Refractory Inclusions: A Mechanism for High-Temperature Oxygen; Isotope Exchange in the Solar Nebula; Oxygen Isotopic Compositions of the Al-rich Chondrules in the CR Carbonaceous Chondrites: Evidence for a Genetic Link to Ca-Al-rich Inclusions and for Oxygen Isotope Exchange During Chondrule Melting; Nebular Formation of Fayalitic Olivine: Ineffectiveness of Dust Enrichment; Water in Terrestrial Planets: Always an Oxidant?; Oxygen Barometry of Basaltic Glasses Based on Vanadium Valence Determination Using Synchrotron MicroXANES; A New Oxygen Barometer for Solar System Basaltic Glasses Based on Vanadium Valence; The Relationship Between Clinopyroxene Fe3+ Content and Oxygen Fugacity ; and Olivine-Silicate Melt Partitioning of Iridium.

GeoMapApp Learning Activities: Enabling the democratisation of geoscience learning

NASA Astrophysics Data System (ADS)

Goodwillie, A. M.; Kluge, S.

2011-12-01

GeoMapApp Learning Activities (http://serc.carleton.edu/geomapapp) are step-by-step guided inquiry geoscience education activities that enable students to dictate the pace of learning. They can be used in the classroom or out of class, and their guided nature means that the requirement for teacher intervention is minimised which allows students to spend increased time analysing and understanding a broad range of geoscience data, content and concepts. Based upon GeoMapApp (http://www.geomapapp.org), a free, easy-to-use map-based data exploration and visualisation tool, each activity furnishes the educator with an efficient package of downloadable documents. This includes step-by-step student instructions and answer sheet; a teacher's edition annotated worksheet containing teaching tips, additional content and suggestions for further work; quizzes for use before and after the activity to assess learning; and a multimedia tutorial. The activities can be used by anyone at any time in any place with an internet connection. In essence, GeoMapApp Learning Activities provide students with cutting-edge technology, research-quality geoscience data sets, and inquiry-based learning in a virtual lab-like environment. Examples of activities so far created are student calculation and analysis of the rate of seafloor spreading, and present-day evidence on the seafloor for huge ancient landslides around the Hawaiian islands. The activities are designed primarily for students at the community college, high school and introductory undergraduate levels, exposing students to content and concepts typically found in those settings.

Evidence-based narratives to improve recall of opioid prescribing guidelines: a randomized experiment.

PubMed

Kilaru, Austin S; Perrone, Jeanmarie; Auriemma, Catherine L; Shofer, Frances S; Barg, Frances K; Meisel, Zachary F

2014-03-01

Physicians adopt evidence-based guidelines with variable consistency. Narratives, or stories, offer a novel dissemination strategy for clinical recommendations. The study objective was to compare whether evidence-based narrative versus traditional summary improved recall of opioid prescribing guidelines from the American College of Emergency Physicians (ACEP). This was a prospective, randomized controlled experiment to compare whether narrative versus summary promoted short-term recall of six themes contained in the ACEP opioid guideline. The experiment was modeled after the free-recall test, an established technique in studies of memory. At a regional conference, emergency physicians (EPs) were randomized to read either a summary of the guideline (control) or a narrative (intervention). The fictional narrative was constructed to match the summary in content and length. One hour after reading the text, participants listed all content that they could recall. Two reviewers independently scored the responses to assess recall of the six themes. The primary outcome was the total number of themes recalled per participant. Secondary outcomes included the proportion of responses in each study arm that recalled individual themes and the proportion of responses in each arm that contained falsely recalled or extraneous information. Ninety-five physicians were randomized. Eighty-two physicians completed the experiment, for a response rate of 86%. The mean of the total number of themes recalled per participant was 3.1 in the narrative arm versus 2.0 in the summary arm (difference = 1.1, 95% confidence interval [CI] = 0.6 to 1.7). For three themes, the proportion of responses that recalled the theme was significantly greater in the narrative arm compared to the summary arm, with the differences ranging from 20% to 51%. For one theme, recall was significantly greater in the summary arm. For two themes, there was no statistically significant difference in recall between the arms. In the summary arm, 54% of responses were found to contain falsely recalled or extraneous information versus 21% of responses in the narrative arm (difference = 33%, 95% CI = 14% to 53%). Physicians exposed to a narrative about opioid guidelines were more likely to recall guideline content at 1 hour than those exposed to a summary of the guidelines. Future studies should examine whether the incorporation of narratives in dissemination campaigns improves guideline adoption and changes clinical practice

Evidence-based Narratives to Improve Recall of Opioid Prescribing Guidelines: A Randomized Experiment

PubMed Central

Kilaru, Austin S.; Perrone, Jeanmarie; Auriemma, Catherine L.; Shofer, Frances S.; Barg, Frances K.; Meisel, Zachary F.

2014-01-01

Objectives Physicians adopt evidence-based guidelines with variable consistency. Narratives, or stories, offer a novel dissemination strategy for clinical recommendations. The study objective was to compare whether evidence-based narrative versus traditional summary improved recall of opioid prescribing guidelines from the American College of Emergency Physicians (ACEP). Methods This was a prospective, randomized controlled experiment to compare whether narrative versus summary promoted short-term recall of six themes contained in the ACEP opioid guideline. The experiment was modeled after the free-recall test, an established technique in studies of memory. At a regional conference, emergency physicians were randomized to read either a summary of the guideline (control) or a narrative (intervention). The fictional narrative was constructed to match the summary in content and length. One hour after reading the text, participants listed all content that they could recall. Two reviewers independently scored the responses to assess recall of the six themes. The primary outcome was the total number of themes recalled per participant. Secondary outcomes included the proportion of responses in each study arm that recalled individual themes and the proportion of responses in each arm that contained falsely recalled or extraneous information. Results Ninety-five physicians were randomized. Eighty-two physicians completed the experiment, for a response rate of 86%. The mean of the total number of themes recalled per participant was 3.1 in the narrative arm versus 2.0 in the summary arm (difference = 1.1, 95% confidence interval [CI] = 0.6 to 1.7). For three themes, the proportion of responses that recalled the theme was significantly greater in the narrative arm compared to the summary arm, with the differences ranging from 20% to 51%. For one theme, recall was significantly greater in the summary arm. For two themes, there was no statistically significant difference in recall between the arms. In the summary arm, 54% of responses were found to contain falsely recalled or extraneous information versus 21% of responses in the narrative arm (difference = 33%, 95% CI = 14% to 53%). Conclusions Physicians exposed to a narrative about opioid guidelines were more likely to recall guideline content at 1 hour than those exposed to a summary of the guidelines. Future studies should examine whether the incorporation of narratives in dissemination campaigns improves guideline adoption and changes clinical practice. PMID:24761456

Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review

PubMed Central

Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

2018-01-01

Background The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users’ ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Objective Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. Methods To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. Results The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on health outcomes, behavioral outcomes, or website engagement. One publication studied the isolated impact of information architecture on outcomes of interest (ie, website use and engagement; health-related knowledge, attitudes, and beliefs; and health behaviors), while the other two publications studied the impact of information architecture, website features (eg, interactivity, email prompts, and forums), and tailored content on these outcomes. The paper that investigated IA exclusively found that a tunnel IA improved site engagement and behavior knowledge, but it decreased users’ perceived efficiency. The first study that did not isolate IA found that the enhanced site condition improved site usage but not the amount of content viewed. The second study that did not isolate IA found that a tailored site condition improved site usage, behavior knowledge, and some behavior outcomes. Conclusions No clear conclusion can be made about the relationship between IA and health outcomes, given limited evidence in the peer-reviewed literature connecting IA to behavioral outcomes and website engagement. Only one study reviewed solely manipulated IA, and we therefore recommend improving the scientific evidence base such that additional empirical studies investigate the impact of IA in isolation. Moreover, information from the gray literature and expert opinion might be identified and added to the evidence base, in order to lay the groundwork for hypothesis generation to improve empirical evidence on information architecture and health and behavior outcomes. PMID:29563076

Developing a web-based information resource for palliative care: an action-research inspired approach

PubMed Central

Street, Annette F; Swift, Kathleen; Annells, Merilyn; Woodruff, Roger; Gliddon, Terry; Oakley, Anne; Ottman, Goetz

2007-01-01

Background General Practitioners and community nurses rely on easily accessible, evidence-based online information to guide practice. To date, the methods that underpin the scoping of user-identified online information needs in palliative care have remained under-explored. This paper describes the benefits and challenges of a collaborative approach involving users and experts that informed the first stage of the development of a palliative care website [1]. Method The action research-inspired methodology included a panel assessment of an existing palliative care website based in Victoria, Australia; a pre-development survey (n = 197) scoping potential audiences and palliative care information needs; working parties conducting a needs analysis about necessary information content for a redeveloped website targeting health professionals and caregivers/patients; an iterative evaluation process involving users and experts; as well as a final evaluation survey (n = 166). Results Involving users in the identification of content and links for a palliative care website is time-consuming and requires initial resources, strong networking skills and commitment. However, user participation provided crucial information that led to the widened the scope of the website audience and guided the development and testing of the website. The needs analysis underpinning the project suggests that palliative care peak bodies need to address three distinct audiences (clinicians, allied health professionals as well as patients and their caregivers). Conclusion Web developers should pay close attention to the content, language, and accessibility needs of these groups. Given the substantial cost associated with the maintenance of authoritative health information sites, the paper proposes a more collaborative development in which users can be engaged in the definition of content to ensure relevance and responsiveness, and to eliminate unnecessary detail. Access to volunteer networks forms an integral part of such an approach. PMID:17854509

International Society for the Study of Fatty Acids and Lipids 2016 Debate: For Science-Based Dietary Guidelines on Fats, Meta-Analysis and Systematic Reviews Are Decisive.

PubMed

Nettleton, Joyce A; von Schacky, Clemens; Brouwer, Ingeborg A; Koletzko, Berthold

2017-01-01

This paper summarizes a debate on whether meta-analyses and systematic reviews are decisive in formulating guidelines for dietary fat. Held during the 12th congress of the International Society for the Study of Fatty Acids and Lipids in Stellenbosch, South Africa, September 7, 2016, the debate was hosted by the International Union of Nutritional Sciences and the International Expert Movement to Improve Dietary Fat Quality (IEM, www.theiem.org). Clemens von Schacky, Ludwig Maximilians-University, Munich, Germany, supported the statement, describing the types of weaknesses in individual studies and clinical trials. With examples of how to overcome such limitations, he concluded that nutritional guidelines on fat need a proper scientific basis in which randomized controlled trials (RCTs) with clinical endpoints and their meta-analyses are essential and decisive. In contention, Ingeborg Brouwer, Vrije Universiteit, Amsterdam, declared that recommendations on dietary fat intake should always be based on the totality of the evidence, including physiologic and biochemical knowledge and associations from observational epidemiology. RCTs and meta-analyses have their shortcomings, but well-conducted systematic reviews and meta-analyses support a transparent process for developing dietary fat guidelines. Participants agreed that evidence-based decision-making for dietary guidance should consider all the best available evidence using a transparent, systematic review. © 2017 The Author(s) Published by S. Karger AG, Basel.

Exploring Mechanisms for Effective Technology-Enhanced Simulation-based Education in Wilderness Medicine: A Systematic Review

PubMed Central

MacKinnon, Ralph; Humphries, Christopher

2015-01-01

Background: Technology-enhanced simulation is well-established in healthcare teaching curricula, including those regarding wilderness medicine. Compellingly, the evidence base for the value of this educational modality to improve learner competencies and patient outcomes are increasing. Aims: The aim was to systematically review the characteristics of technology-enhanced simulation presented in the wilderness medicine literature to date. Then, the secondary aim was to explore how this technology has been used and if the use of this technology has been associated with improved learner or patient outcomes. Methods: EMBASE and MEDLINE were systematically searched from 1946 to 2014, for articles on the provision of technology-enhanced simulation to teach wilderness medicine. Working independently, the team evaluated the information on the criteria of learners, setting, instructional design, content, and outcomes. Results: From a pool of 37 articles, 11 publications were eligible for systematic review. The majority of learners in the included publications were medical students, settings included both indoors and outdoors, and the main focus clinical content was initial trauma management with some including leadership skills. The most prevalent instructional design components were clinical variation and cognitive interactivity, with learner satisfaction as the main outcome. Conclusions: The results confirm that the current provision of wilderness medicine utilizing technology-enhanced simulation is aligned with instructional design characteristics that have been used to achieve effective learning. Future research should aim to demonstrate the translation of learning into the clinical field to produce improved learner outcomes and create improved patient outcomes. PMID:26824012

Evaluation of training programme uptake in an attempt to reduce obstetric anal sphincter injuries: the SUPPORT programme.

PubMed

Rahman, Nadia; Vinayakarao, Latha; Pathak, Sangeeta; Minden, Dawn; Melson, Louise; Vitue, Ella; Pradhan, A

2017-03-01

The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies. Feedback forms using a Likert scale (1-4) were completed and analysed. The setting was an evidence-based quality improvement programme (Strategy for Using Practical aids for Prevention of OASIS, Recording episiotomies and clinician Training [SUPPORT]) at two National Health Service (NHS) Hospitals in the UK. The participants were midwives and doctors attending the SUPPORT training programme RESULTS: All of the participants (100 %) would recommend the training programme to a friend or colleague. 92 % felt that the training session improved their knowledge of the impact of PBL and perineal distension and their knowledge of the relationship between episiotomy angle and OASIS "a lot" or "somewhat". Based on this feedback, we recommend the addition of the knowledge content of the SUPPORT programme to other centres providing perineal assessment and repair courses.

A Content Analysis of General Chemistry Laboratory Manuals for Evidence of Higher-Order Cognitive Tasks

NASA Astrophysics Data System (ADS)

Domin, Daniel S.

1999-01-01

The science laboratory instructional environment is ideal for fostering the development of problem-solving, manipulative, and higher-order thinking skills: the skills needed by today's learner to compete in an ever increasing technology-based society. This paper reports the results of a content analysis of ten general chemistry laboratory manuals. Three experiments from each manual were examined for evidence of higher-order cognitive activities. Analysis was based upon the six major cognitive categories of Bloom's Taxonomy of Educational Objectives: knowledge, comprehension, application, analysis, synthesis, and evaluation. The results of this study show that the overwhelming majority of general chemistry laboratory manuals provide tasks that require the use of only the lower-order cognitive skills: knowledge, comprehension, and application. Two of the laboratory manuals were disparate in having activities that utilized higher-order cognition. I describe the instructional strategies used within these manuals to foster higher-order cognitive development.

Preparing Dental Students and Residents to Overcome Internal and External Barriers to Evidence-Based Practice.

PubMed

Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D

2016-10-01

In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.

Oxidative stress and cardiomyocyte necrosis with elevated serum troponins: pathophysiologic mechanisms.

PubMed

Robinson, Antwon D; Ramanathan, Kodangudi B; McGee, Jesse E; Newman, Kevin P; Weber, Karl T

2011-08-01

The progressive nature of heart failure is linked to multiple factors, including an ongoing loss of cardiomyocytes and necrosis. Necrotic cardiomyocytes leave behind several footprints: the spillage of their contents leading to elevations in serum troponins; and morphologic evidence of tissue repair with scarring. The pathophysiologic origins of cardiomyocyte necrosis relates to neurohormonal activation, including the adrenergic nervous system. Catecholamine-initiated excessive intracellular Ca accumulation and mitochondria Ca overloading in particular initiate a mitochondriocentric signal-transducer-effector pathway to necrosis and which includes the induction of oxidative stress and opening of their inner membrane permeability transition pore. Hypokalemia, ionized hypocalcemia and hypomagnesemia, where consequent elevations in parathyroid hormone further account for excessive intracellular Ca accumulation, hypozincemia and hyposelenemia each compromise metalloenzyme-based antioxidant defenses. The necrotic loss of cardiomyocytes and adverse structural remodeling of myocardium is related to the central role played by a mitochondriocentric pathway initiated by neurohormonal activation.

Providing web-based mental health services to at-risk women

PubMed Central

2011-01-01

Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. Conclusions We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes. PMID:21854563

Providing web-based mental health services to at-risk women.

PubMed

Lipman, Ellen L; Kenny, Meghan; Marziali, Elsa

2011-08-19

We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes.

Content, Usability, and Utilization of Plain Language in Breast Cancer Mobile Phone Apps: A Systematic Analysis.

PubMed

Ginossar, Tamar; Shah, Sayyed Fawad Ali; West, Andrew J; Bentley, Joshua M; Caburnay, Charlene A; Kreuter, Matthew W; Kinney, Anita Y

2017-03-13

Breast cancer is one of the leading contributors to preventable illness and death among women. Although mobile phone apps provide unprecedented opportunity to engage women along the cancer continuum, little is known about the availability, content, and usability of breast cancer mobile phone apps. This study analyzed the content and adherence to literate design standards of all breast cancer-related apps available on the App Store and Google Play, as well as the relationship between their content, user ratings, and price. Following identification and downloading of all available breast cancer mobile phone apps in October 2015, 101 apps were confirmed as focusing on breast cancer. Based on prior research, we adapted and applied a content analysis scheme that was specific to breast cancer apps, including their main purpose, relevance to the cancer care continuum, and adherence to usability standards outlined by the Institute of Medicine (IOM). The most common aim of apps was educational (73/101, 72.3%), followed by behavior change (24/101, 23.9%), fundraising (20/101, 19.8%), and advocacy (14/101, 13.9%). On the cancer continuum, primary prevention (strategies to prevent cancer cells from occurring) was mentioned in almost one-third of the apps (30/101, 29.7%). Less than half of the apps (46/101, 45.5%) presented information about mammography and/or breast clinical exam, and 53 apps (52.5%) discussed breast self-exam (which is no longer recommended). Symptoms of cancer prediagnosis, such as a lump, were discussed in almost half of the apps (48/101, 47.5%) and a similar number of apps included information about genetic risk for breast cancer (47/101, 46.5%). Information about breast cancer diagnosis was included in 42 apps (41.58%) and 43 (42.6%) apps discussed treatment options. Survivorship issues were addressed in 17 (16.8%) apps. Only one (1.0%) app discussed hospice. Adherence to usability recommendations was low. The median composite score was 3 (mean 2.60, SD 1.20) of the six recommended usability items. With eight plain language items, the median of the composite health literacy score was 5 (mean 5.06, SD 2.00). Most apps did not use easy-to-understand words (44/101, 43.6%) and few (24/101, 23.8%) defined key terms. Current breast cancer apps provide important information about breast cancer, but the most common topic covered is breast self-examination, a non-evidence-based screening strategy. Apps that focus on evidence-based strategies on the cancer continuum are needed, with a notable pressing need for apps that would address survivorship and end of life. Finally, developers of breast cancer apps should adhere to IOM standards to meet the needs of diverse populations and reduce current disparities. ©Tamar Ginossar, Sayyed Fawad Ali Shah, Andrew J West, Joshua M Bentley, Charlene A Caburnay, Matthew W Kreuter, Anita Y Kinney. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.03.2017.

Information Seeking in Social Media: A Review of YouTube for Sedentary Behavior Content.

PubMed

Knight, Emily; Intzandt, Brittany; MacDougall, Alicia; Saunders, Travis J

2015-01-20

The global prevalence of sedentary lifestyles is of grave concern for public health around the world. Moreover, the health risk of sedentary behaviors is of growing interest for researchers, clinicians, and the general public as evidence demonstrates that prolonged amounts of sedentary time increases risk for lifestyle-related diseases. There is a growing trend in the literature that reports how social media can facilitate knowledge sharing and collaboration. Social sites like YouTube facilitate the sharing of media content between users. The purpose of this project was to identify sedentary behavior content on YouTube and describe features of this content that may impact the effectiveness of YouTube for knowledge translation. YouTube was searched on a single day by 3 independent reviewers for evidence-based sedentary behavior content. Subjective data (eg, video purpose, source, and activity type portrayed) and objective data (eg, number of views, comments, shares, and length of the video) were collected from video. In total, 106 videos met inclusion criteria. Videos were uploaded from 13 countries around the globe (ie, Australia, Barbados, Belgium, Canada, Colombia, Kenya, New Zealand, Russia, South Africa, Spain, Ukraine, United Kingdom, United States). The median video length was 3:00 minutes: interquartile range (IQR) 1:44-5:40. On average, videos had been on YouTube for 15.0 months (IQR 6.0-27.5) and had been viewed 239.0 times (IQR 44.5-917.5). Videos had remarkably low numbers of shares (median 0) and comments (median 1). Only 37.7% (40/106) of videos portrayed content on sedentary behaviors, while the remaining 66 videos portrayed physical activity or a mix of behaviors. Academic/health organizations (39.6%, 42/106) and individuals (38.7%, 41/106) were the most prevalent source of videos, and most videos (67.0%, 71/106) aimed to educate viewers about the topic. This study explored sedentary behavior content available on YouTube. Findings demonstrate that there is confusion between physical activity and sedentary behaviors, that content is being uploaded to the site from around the globe, that content is primarily from health organizations and individuals with the purpose of educating fellow users, but that low views, comments, and shares suggest that sedentary behavior content is relatively underutilized on YouTube. Future research may wish to leverage social platforms, such as YouTube, to facilitate implementation and sharing of evidence-based sedentary behavior content.

Information Seeking in Social Media: A Review of YouTube for Sedentary Behavior Content

PubMed Central

2015-01-01

Background The global prevalence of sedentary lifestyles is of grave concern for public health around the world. Moreover, the health risk of sedentary behaviors is of growing interest for researchers, clinicians, and the general public as evidence demonstrates that prolonged amounts of sedentary time increases risk for lifestyle-related diseases. There is a growing trend in the literature that reports how social media can facilitate knowledge sharing and collaboration. Social sites like YouTube facilitate the sharing of media content between users. Objective The purpose of this project was to identify sedentary behavior content on YouTube and describe features of this content that may impact the effectiveness of YouTube for knowledge translation. Methods YouTube was searched on a single day by 3 independent reviewers for evidence-based sedentary behavior content. Subjective data (eg, video purpose, source, and activity type portrayed) and objective data (eg, number of views, comments, shares, and length of the video) were collected from video. Results In total, 106 videos met inclusion criteria. Videos were uploaded from 13 countries around the globe (ie, Australia, Barbados, Belgium, Canada, Colombia, Kenya, New Zealand, Russia, South Africa, Spain, Ukraine, United Kingdom, United States). The median video length was 3:00 minutes: interquartile range (IQR) 1:44-5:40. On average, videos had been on YouTube for 15.0 months (IQR 6.0-27.5) and had been viewed 239.0 times (IQR 44.5-917.5). Videos had remarkably low numbers of shares (median 0) and comments (median 1). Only 37.7% (40/106) of videos portrayed content on sedentary behaviors, while the remaining 66 videos portrayed physical activity or a mix of behaviors. Academic/health organizations (39.6%, 42/106) and individuals (38.7%, 41/106) were the most prevalent source of videos, and most videos (67.0%, 71/106) aimed to educate viewers about the topic. Conclusions This study explored sedentary behavior content available on YouTube. Findings demonstrate that there is confusion between physical activity and sedentary behaviors, that content is being uploaded to the site from around the globe, that content is primarily from health organizations and individuals with the purpose of educating fellow users, but that low views, comments, and shares suggest that sedentary behavior content is relatively underutilized on YouTube. Future research may wish to leverage social platforms, such as YouTube, to facilitate implementation and sharing of evidence-based sedentary behavior content. PMID:25604433

The Reviews Are in: A Qualitative Content Analysis of Consumer Perspectives on Apps for Bipolar Disorder.

PubMed

Nicholas, Jennifer; Fogarty, Andrea S; Boydell, Katherine; Christensen, Helen

2017-04-07

The delivery of mobile health (mHealth) services is acceptable to mental health consumers. However, despite the benefits of accessibility, cost-effectiveness, anonymity, and ability to tailor content to individual needs, consumer engagement remains a hurdle for uptake and continued use. This may be unsurprising as few studies have examined app content from the consumer perspective or assessed consumer preferences for the content of apps for mental health management. An opportunity to examine consumer perspectives exists in using naturally generated data that is publically available in the Google Play and Apple app stores. Whereas commercial developers routinely use this data, to date there has been no in-depth evaluation within scientific research. The aim of our study was to explore what consumers consider useful content for mental health management apps, identify unmet needs, and understand user expectations of mental health apps within the context of apps for bipolar disorder. Publically available English language consumer reviews of 48 apps for bipolar disorder were used as data, providing a total of 2173 reviews. Review text was coded and analyzed using a team approach to qualitative content analysis. Results were presented in 2 forms: (1) a quantitative summary of the 9 major and minor themes and (2) a qualitative synthesis of key thematic findings. The majority of reviews were for symptom monitoring apps (87.94%, 1911/2173). The qualitative content analysis revealed 5 main themes: (1) laudatory talk, comments regarding the app's benefits including helpfulness and successful design features (74.00% of reviews, 1608/2173); (2) unfavorable feedback, negative reviews largely concerning unmet needs, privacy and technical issues, and potential dangers of app use (25.54%, 555/2173); (3) conceptions of community, referring to both communities of users with mental ill-health accessed via the app and a community created among app users and developers (24.25%, 527/2173); (4) wishlist features, app features requested by users (17.53%, 381/2173); and (5) apps and therapy, app use within clinical care (10.58%, 230/2173). Four minor themes were also identified: (1) app cost, (2) privacy and data security, (3) comparisons with traditional monitoring, and (4) evidence-based mHealth. Although mostly positive, the proportion of reviews containing wishlist requests indicates consumer needs are not adequately addressed by currently available disorder management apps. Consumers value content that is helpful, supportive, and easy to use, and they are integrating apps into their health management and clinical care without necessarily considering the evidence-base or clinical effectiveness of the tool. User expectations regarding developer responsiveness to their needs has implications for community-based participatory research and integrated knowledge translation. However, this expectation is incompatible with current mHealth funding structures. ©Jennifer Nicholas, Andrea S Fogarty, Katherine Boydell, Helen Christensen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.04.2017.

Smartphone Applications for Educating and Helping Non-motivating Patients Adhere to Medication That Treats Mental Health Conditions: Aims and Functioning.

PubMed

Kassianos, Angelos P; Georgiou, Giorgos; Papaconstantinou, Electra P; Detzortzi, Angeliki; Horne, Rob

2017-01-01

Background: Patients prescribed with medication that treats mental health conditions benefit the most compared to those prescribed with other types of medication. However, they are also the most difficult to adhere. The development of mobile health (mHealth) applications ("apps") to help patients monitor their adherence is fast growing but with limited evidence on their efficacy. There is no evidence on the content of these apps for patients taking psychotropic medication. The aim of this study is to identify and evaluate the aims and functioning of available apps that are aiming to help and educate patients to adhere to medication that treats mental health conditions. Method: Three platform descriptions (Apple, Google, and Microsoft) were searched between October 2015 and February 2016. Included apps need to focus on adherence to medication that treats mental health conditions and use at least a reinforcement strategy. Descriptive information was extracted and apps evaluated on a number of assessment criteria using content analysis. Results: Sixteen apps were identified. All apps included self-monitoring properties like reminders and psycho-educational properties like mood logs. It was unclear how the latter were used or how adherence was measured. Major barriers to medication adherence like patients' illness and medication beliefs and attitudes were not considered nor where information to patients about mediation side effects. Very few apps were tailored and none was developed based on established theories explaining the processes for successful medication adherence like cognitions and beliefs. Reported information on app development and validation was poor. Discussion: A variety of apps with different properties that tackle both intentional and unintentional non-adherence from a different perspective are identified. An evidence-based approach and co-creation with patients is needed. This will ensure that the apps increase the possibility to impact on non-adherence. Theories like social cognition models can be useful in ensuring that patients' education, motivation, skills, beliefs, and type of adherence are taken into consideration when developing the apps. Findings from this study can help clinicians and patients make informed choices and pursue policy-makers to integrate evidence when developing future apps. Quality-assurance tools are needed to ensure the apps are systematically evaluated.

Smartphone Applications for Educating and Helping Non-motivating Patients Adhere to Medication That Treats Mental Health Conditions: Aims and Functioning

PubMed Central

Kassianos, Angelos P.; Georgiou, Giorgos; Papaconstantinou, Electra P.; Detzortzi, Angeliki; Horne, Rob

2017-01-01

Background: Patients prescribed with medication that treats mental health conditions benefit the most compared to those prescribed with other types of medication. However, they are also the most difficult to adhere. The development of mobile health (mHealth) applications (“apps”) to help patients monitor their adherence is fast growing but with limited evidence on their efficacy. There is no evidence on the content of these apps for patients taking psychotropic medication. The aim of this study is to identify and evaluate the aims and functioning of available apps that are aiming to help and educate patients to adhere to medication that treats mental health conditions. Method: Three platform descriptions (Apple, Google, and Microsoft) were searched between October 2015 and February 2016. Included apps need to focus on adherence to medication that treats mental health conditions and use at least a reinforcement strategy. Descriptive information was extracted and apps evaluated on a number of assessment criteria using content analysis. Results: Sixteen apps were identified. All apps included self-monitoring properties like reminders and psycho-educational properties like mood logs. It was unclear how the latter were used or how adherence was measured. Major barriers to medication adherence like patients' illness and medication beliefs and attitudes were not considered nor where information to patients about mediation side effects. Very few apps were tailored and none was developed based on established theories explaining the processes for successful medication adherence like cognitions and beliefs. Reported information on app development and validation was poor. Discussion: A variety of apps with different properties that tackle both intentional and unintentional non-adherence from a different perspective are identified. An evidence-based approach and co-creation with patients is needed. This will ensure that the apps increase the possibility to impact on non-adherence. Theories like social cognition models can be useful in ensuring that patients' education, motivation, skills, beliefs, and type of adherence are taken into consideration when developing the apps. Findings from this study can help clinicians and patients make informed choices and pursue policy-makers to integrate evidence when developing future apps. Quality-assurance tools are needed to ensure the apps are systematically evaluated. PMID:29075216

Responding to Hostility: Evidence-Based Guidance for Communication during Planned Organizational Change

ERIC Educational Resources Information Center

Campbell, Kim Sydow; Carmichael, Pierson; Naidoo, Jefrey S.

2015-01-01

Hostile challenges to planned organization change are common and challenging to deal with effectively. Little research has explained successful responses to such stakeholder hostility. To address this gap, we use the concept of readiness to characterize the content of hostile challenges. We also use rhetorical strategies based on speech act theory…

Collaboration: a SWOT analysis of the process of conducting a review of nursing workforce policies in five European countries.

PubMed

Uhrenfeldt, Lisbeth; Lakanmaa, Riitta-Liisa; Flinkman, Mervi; Basto, Marta Lima; Attree, Moira

2014-05-01

This paper critically reviews the literature on international collaboration and analyses the collaborative process involved in producing a nursing workforce policy analysis. Collaboration is increasingly promoted as a means of solving shared problems and achieving common goals; however, collaboration creates its own opportunities and challenges. Evidence about the collaboration process, its outcomes and critical success factors is lacking. A literature review and content analysis of data collected from six participants (from five European countries) members of the European Academy of Nursing Science Scholar Collaborative Workforce Workgroup, using a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis template. Two major factors affecting scholarly collaboration were identified: Facilitators, which incorporated personal attributes and enabling contexts/mechanisms, including individual commitment, responsibility and teamwork, facilitative supportive structures and processes. The second, Barriers, incorporated unmet needs for funding; time; communication and impeding contexts/mechanisms, including workload and insufficient support/mentorship. The literature review identified a low level of evidence on collaboration processes, outcomes, opportunities and challenges. The SWOT analysis identified critical success factors, planning strategies and resources of effective international collaboration. Collaboration is an important concept for management. Evidence-based knowledge of the critical success factors facilitating and impeding collaboration could help managers make collaboration more effective. © 2012 John Wiley & Sons Ltd.

Development of Evidence-Based Disease Education Literature for Pakistani Rheumatoid Arthritis Patients.

PubMed

Naqvi, Atta Abbas; Hassali, Mohamed Azmi; Aftab, Muhammad Tariq; Naqvi, Syed Baqir Shyum; Zehra, Fatima; Ahmad, Rizwan; Ahmad, Niyaz

2017-11-20

Rheumatoid arthritis affects 0.5% to 1% of the population globally and is one of the most common causes of disability. Patient education plays a key role in improving treatment outcomes. The purpose of this study was to discuss the process involved in designing an evidence-based disease education literature for rheumatoid arthritis patients of Pakistan in Urdu language with culturally relevant illustrations. A study was conducted to develop disease education literature using Delphi consensus, content validity, and patient feedback. A panel of experts comprised of university professors and health care experts, including health practitioners and pharmacists as well as a social scientist, was set up to assess the need. Eight patients were randomly selected and were asked to give their feedback. Their feedback was incorporated in the development process. The entire process was carried out in eight steps. A disease education literature for patients of rheumatoid arthritis was developed and edited in the form of a booklet. The booklet contained evidence-based information that must be provided to patients in both Urdu and English languages with culturally relevant illustrations. The availability of such literature is significant, as it enables the patients to seek knowledge at home at their convenience. This home-based knowledge support is as helpful as any other means of medical care. The developed literature is planned to be used in further studies which will evaluate its impact in improving knowledge of RA patients.

Colostomy irrigation: current knowledge and practice of WOC nurses.

PubMed

Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S

2015-01-01

This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for ostomy nurses unprepared and/or unfamiliar with CI, as well as staff nurses in acute care units who could offer accurate information and additional resources to patients to increase their informed decisions.

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality.

PubMed

Nicholas, Jennifer; Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-08-17

With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.

Breast Pocket Irrigation with Antibiotic Solution at Implant Insertion: A Systematic Review and Meta-Analysis.

PubMed

Lynch, Jessica M; Sebai, Mohamad E; Rodriguez-Unda, Nelson A; Seal, Stella; Rosson, Gedge D; Manahan, Michele A

2018-06-08

Antibiotic irrigation is routinely used during implant insertion in augmentation mammoplasty procedures. However, the evidence for whether this reduces the incidence of infection or capsular contracture is unclear. Five databases were used to search for all randomized control trials, retrospective cohort and prospective cohort studies containing original data related to the primary outcomes being investigated in this study. The primary outcomes were the effects of antibiotic breast pocket irrigation on clinical infection and capsular contracture. The literature search was designed to combine three concepts: implant or tissue expander-based breast surgery, antibiotic irrigation and clinical infection or capsular contracture. Studies found were screened using specific eligibility criteria. Risk ratios (RR) and 95% confidence interval (CI) were calculated using pooled acquired data from all included studies. The search identified 1256 citations. Three independent screeners identified seven studies that met the inclusion criteria with a pooled population of 4725. This included one prospective and six retrospective studies. A meta-analysis of pooled study data showed significant reductions in clinical infection (RR 0.52, 95% CI 0.33-0.81) and capsular contracture (RR 0.36, 95% CI 0.16-0.83) as a result of antibiotic irrigation. The meta-analyses support the use of antibiotic irrigation of the breast pocket. However, the results of this study are limited by the large proportion of retrospective studies, the small number of studies included, the lack of randomized controlled trials and the heterogeneity of the antibiotic and control regimes used. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Scientific Evidence and Potential Barriers in the Management of Brazilian Protected Areas.

PubMed

Giehl, Eduardo L H; Moretti, Marcela; Walsh, Jessica C; Batalha, Marco A; Cook, Carly N

2017-01-01

Protected areas are a crucial tool for halting the loss of biodiversity. Yet, the management of protected areas is under resourced, impacting the ability to achieve effective conservation actions. Effective management depends on the application of the best available knowledge, which can include both scientific evidence and the local knowledge of onsite managers. Despite the clear value of evidence-based conservation, there is still little known about how much scientific evidence is used to guide the management of protected areas. This knowledge gap is especially evident in developing countries, where resource limitations and language barriers may create additional challenges for the use of scientific evidence in management. To assess the extent to which scientific evidence is used to inform management decisions in a developing country, we surveyed Brazilian protected area managers about the information they use to support their management decisions. We targeted on-ground managers who are responsible for management decisions made at the local protected area level. We asked managers about the sources of evidence they use, how frequently they assess the different sources of evidence and the scientific content of the different sources of evidence. We also considered a range of factors that might explain the use of scientific evidence to guide the management of protected areas, such as the language spoken by managers, the accessibility of evidence sources and the characteristics of the managers and the protected areas they manage. The managers who responded to our questionnaire reported that they most frequently made decisions based on their personal experience, with scientific evidence being used relatively infrequently. While managers in our study tended to value scientific evidence less highly than other sources, most managers still considered science important for management decisions. Managers reported that the accessibility of scientific evidence is low relative to other types of evidence, with key barriers being the low levels of open access research and insufficient technical training to enable managers to interpret research findings. Based on our results, we suggest that managers in developing countries face all the same challenges as those in developed countries, along with additional language barriers that can prevent greater use of scientific evidence to support effective management of protected areas in Brazil.

Patient Storytelling in the Classroom: A Memorable Way to Teach Spiritual Care.

PubMed

Garner, Shelby L

2016-01-01

Storytelling is an evidence-based teaching and learning strategy that engages students and promotes critical thinking. Although most nursing textbooks incorporate spiritual nursing care, the texts lack examples of how to tie evidence-based spiritual interventions to specific medical-suigical content. Stories told from the patient's perspective can communicate insights that nurses and students can use when planning spiritual carefor patients. Stories shared by patients with undergraduate nursing students were effective in promoting learning and offered concrete examples of supportive spiritual resources for patients.

What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context.

PubMed

French, Beverley; Thomas, Lois H; Baker, Paula; Burton, Christopher R; Pennington, Lindsay; Roddam, Hazel

2009-05-19

Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualize and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across domains suggests that there is scope within EBP for supplementing the current emphasis on human and technical resources to support information uptake and use by individuals. Consideration of measurement tools from the fields of KM and OL shows more content related to social mechanisms to facilitate knowledge recognition, translation, and transfer between individuals and groups.

What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context

PubMed Central

French, Beverley; Thomas, Lois H; Baker, Paula; Burton, Christopher R; Pennington, Lindsay; Roddam, Hazel

2009-01-01

Background Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualise and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. Methods A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Results Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. Conclusion If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across domains suggests that there is scope within EBP for supplementing the current emphasis on human and technical resources to support information uptake and use by individuals. Consideration of measurement tools from the fields of KM and OL shows more content related to social mechanisms to facilitate knowledge recognition, translation, and transfer between individuals and groups. PMID:19454008

Creative classroom strategies for teaching nursing research.

PubMed

Phillips, Regina Miecznikoski

2014-01-01

Faculty are constantly challenged to find interesting classroom activities to teach nursing content and engage students in learning. Nursing students and graduates need to use research skills and evidence-based practice as part of their professional care. Finding creative and engaging ways to teach this material in undergraduate nursing programs are essential. This article outlines several successful strategies to engage nursing students in research content in the time and space constraints of the classroom.

Developing authentic clinical simulations for effective listening and communication in pediatric rehabilitation service delivery.

PubMed

King, Gillian; Shepherd, Tracy A; Servais, Michelle; Willoughby, Colleen; Bolack, Linda; Strachan, Deborah; Moodie, Sheila; Baldwin, Patricia; Knickle, Kerry; Parker, Kathryn; Savage, Diane; McNaughton, Nancy

2016-10-01

To describe the creation and validation of six simulations concerned with effective listening and interpersonal communication in pediatric rehabilitation. The simulations involved clinicians from various disciplines, were based on clinical scenarios related to client issues, and reflected core aspects of listening/communication. Each simulation had a key learning objective, thus focusing clinicians on specific listening skills. The article outlines the process used to turn written scenarios into digital video simulations, including steps taken to establish content validity and authenticity, and to establish a series of videos based on the complexity of their learning objectives, given contextual factors and associated macrocognitive processes that influence the ability to listen. A complexity rating scale was developed and used to establish a gradient of easy/simple, intermediate, and hard/complex simulations. The development process exemplifies an evidence-based, integrated knowledge translation approach to the teaching and learning of listening and communication skills.

Effect of multicomponent interventions on competence of family caregivers of people with dementia: A systematic review.

PubMed

Ying, Jie; Wang, Yonghong; Zhang, Meiling; Wang, Shouqi; Shi, Ying; Li, Huanhuan; Li, Yuan; Xing, Zhuangjie; Sun, Jiao

2018-05-01

This review aims to summarise and evaluate multicomponent interventions focused on improving the competence of family members of people with dementia (PwD) who undertake the caregiving tasks. Caregiver competence is essential for family members of PwD acting as caregivers. Competence affects the physical and mental health of both PwD and caregivers. Many kinds of multicomponent interventions are used to improve caregiver competence. A systematic review. A literature search from six databases was conducted. Articles published until January 2017 were screened. Intervention studies that measured caregiver competence of family members of PwD as an outcome were included. The Oxford Center Evidence-based Medicine criteria and the Cochrane Handbook for Systematic Reviews of Interventions were used for quality assessment. Fifteen studies were included, and number of participants was 1096. The characteristics of the included studies and key findings were analysed. Multicomponent interventions may improve the family caregivers' competence. Caregivers in the intervention group were confident and skilful in managing their role. The intervention design, treatment content and length and intensity of the intervention varied in the included studies. Given that heterogeneity was high, combining these results via narrative synthesis is more appropriate than a meta-analysis. The current study provides recommendations regarding the formulation and implementation of interventions based on relevant literature. In view of existing research, researchers should conduct an in-depth study in this area and provide evidence-based interventions to support family members caring for PwD. The competence of family caregivers is essential for the life quality of PwD. To promote the health of the family caregiver and PwD, multicomponent interventions may be appropriate for nurses to practice. © 2018 John Wiley & Sons Ltd.

Diagnostic and procedural imaging curricula in physical therapist professional degree programs.

PubMed

Boissonnault, William G; White, Douglas M; Carney, Sara; Malin, Brittany; Smith, Wayne

2014-08-01

Descriptive survey. To describe the status of diagnostic and procedural imaging curricula within United States physical therapist professional degree programs. As patient direct access to physical therapy services increases, the ability to refer patients directly for diagnostic imaging could promote more efficient delivery of care. Appropriate patient referral is contingent on physical therapists having the requisite knowledge base and skills. While evidence describing imaging competence of physical therapists with advanced training in military institutions exists, evidence is lacking for other physical therapists, including new graduates of physical therapist professional degree programs. Faculty members teaching imaging at 206 United States physical therapist professional degree programs recognized by the Commission on Accreditation in Physical Therapy Education were recruited via e-mail correspondence. An e-mail attachment included the survey on which faculty reported imaging curricula and faculty qualifications, attitudes, and experiences. Faculty from 155 (75.2%) programs responded to the survey, with imaging being included in the curriculum of 152 programs. Content was integrated by required standalone courses or clinical science track courses, and/or through elective courses. The average reported estimate of imaging contact hours was 24.4 hours (range, 2-75 hours). Emphasis was on the musculoskeletal system, including 76.3% of the required standalone course content. Student competence was assessed in 147 (96.7%) programs, primarily by written (66.7%) and practical (19.7%) examinations. Faculty rated student competence on a scale of 1 (not competent) to 5 (competent), with ratings ranging from a high of 4.0 (identifying normal anatomy on plain-film radiography) to a low of 1.9 (identifying common tissue pathological processes/injuries on ultrasound). While a majority of programs reported including imaging curricula, variability was noted in all curricular aspects. These results may serve as a benchmark for faculty to assess existing curricula, allow for further development of imaging curricula, and provide a benchmark for the profession regarding current level of training for recent graduates of entry-level physical therapist professional degree programs.

Using the Theoretical Domains Framework (TDF) to understand adherence to multiple evidence-based indicators in primary care: a qualitative study.

PubMed

Lawton, Rebecca; Heyhoe, Jane; Louch, Gemma; Ingleson, Emma; Glidewell, Liz; Willis, Thomas A; McEachan, Rosemary R C; Foy, Robbie

2016-08-08

There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. Here, we explore health professionals' perceived determinants of adherence to these indicators, examining the degree to which determinants were indicator-specific or potentially generalisable across indicators. We interviewed 60 general practitioners, practice nurses and practice managers in West Yorkshire, the UK, about adherence to four indicators: avoidance of risky prescribing; treatment targets in type 2 diabetes; blood pressure targets in treated hypertension; and anticoagulation in atrial fibrillation. Interview questions drew upon the Theoretical Domains Framework (TDF). Data were analysed using framework analysis. Professional role and identity and environmental context and resources featured prominently across all indicators whilst the importance of other domains, for example, beliefs about consequences, social influences and knowledge varied across indicators. We identified five meta-themes representing more general organisational and contextual factors common to all indicators. The TDF helped elicit a wide range of reported determinants of adherence to 'high-impact' indicators in primary care. It was more difficult to pinpoint which determinants, if targeted by an implementation strategy, would maximise change. The meta-themes broadly underline the need to align the design of interventions targeting general practices with higher level supports and broader contextual considerations. However, our findings suggest that it is feasible to develop interventions to promote the uptake of different evidence-based indicators which share common features whilst also including content-specific adaptations.

Biodegradable Nanocomposite Films Based on Sodium Alginate and Cellulose Nanofibrils

PubMed Central

Deepa, B.; Abraham, Eldho; Pothan, Laly A.; Cordeiro, Nereida; Faria, Marisa; Thomas, Sabu

2016-01-01

Biodegradable nanocomposite films were prepared by incorporation of cellulose nanofibrils (CNF) into alginate biopolymer using the solution casting method. The effects of CNF content (2.5, 5, 7.5, 10 and 15 wt %) on mechanical, biodegradability and swelling behavior of the nanocomposite films were determined. The results showed that the tensile modulus value of the nanocomposite films increased from 308 to 1403 MPa with increasing CNF content from 0% to 10%; however, it decreased with further increase of the filler content. Incorporation of CNF also significantly reduced the swelling percentage and water solubility of alginate-based films, with the lower values found for 10 wt % in CNF. Biodegradation studies of the films in soil confirmed that the biodegradation time of alginate/CNF films greatly depends on the CNF content. The results evidence that the stronger intermolecular interaction and molecular compatibility between alginate and CNF components was at 10 wt % in CNF alginate films. PMID:28787850

Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

PubMed Central

Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

2015-01-01

Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be concluded from the number of visitors and the number of questions submitted to the website, the website fills a gap. PMID:26350824

Legitimacy of concerns about caffeine and energy drink consumption.

PubMed

Wesensten, Nancy J

2014-10-01

Whether caffeine and energy drink consumption presents a critical emerging health problem is not currently known. Available evidence suggests that energy drink consumption represents a change in the ways in which individuals in the United States consume caffeine but that the amount of caffeine consumed daily has not appreciably increased. In the present review, the question of whether Americans are sleep deprived (a potential reason for using caffeine) is briefly explored. Reported rates of daily caffeine consumption (based on beverage formulation) and data obtained from both civilian and military populations in the United States are examined, the efficacy of ingredients other than caffeine in energy drinks is discussed, and the safety and side effects of caffeine are addressed, including whether evidence supports the contention that excessive caffeine/energy drink consumption induces risky behavior. The available evidence suggests that the main legitimate concern regarding caffeine and energy drink use is the potential negative impact on sleep but that, otherwise, there is no cause for concern regarding caffeine use in the general population. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Smartphone apps for orthopaedic sports medicine - a smart move?

PubMed

Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M

2015-01-01

With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

Decoding the content of recollection within the core recollection network and beyond.

PubMed

Thakral, Preston P; Wang, Tracy H; Rugg, Michael D

2017-06-01

Recollection - retrieval of qualitative information about a past event - is associated with enhanced neural activity in a consistent set of neural regions (the 'core recollection network') seemingly regardless of the nature of the recollected content. Here, we employed multi-voxel pattern analysis (MVPA) to assess whether retrieval-related functional magnetic resonance imaging (fMRI) activity in core recollection regions - including the hippocampus, angular gyrus, medial prefrontal cortex, retrosplenial/posterior cingulate cortex, and middle temporal gyrus - contain information about studied content and thus demonstrate retrieval-related 'reinstatement' effects. During study, participants viewed objects and concrete words that were subjected to different encoding tasks. Test items included studied words, the names of studied objects, or unstudied words. Participants judged whether the items were recollected, familiar, or new by making 'remember', 'know', and 'new' responses, respectively. The study history of remembered test items could be reliably decoded using MVPA in most regions, as well as from the dorsolateral prefrontal cortex, a region where univariate recollection effects could not be detected. The findings add to evidence that members of the core recollection network, as well as at least one neural region where mean signal is insensitive to recollection success, carry information about recollected content. Importantly, the study history of recognized items endorsed with a 'know' response could be decoded with equal accuracy. The results thus demonstrate a striking dissociation between mean signal and multi-voxel indices of recollection. Moreover, they converge with prior findings in suggesting that, as it is operationalized by classification-based MVPA, reinstatement is not uniquely a signature of recollection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pain education in pre-registration professional health courses: a protocol for a scoping review.

PubMed

Thompson, Kate; Milligan, James; Johnson, Mark I; Briggs, Michelle

2016-07-18

Pain is a global health concern causing significant health and social problems with evidence that patients experiencing pain are receiving inadequate care. The content of pain education in pre-registration professional health courses is thought to be lacking both in the UK and internationally which is unacceptable considering the prevalence of pain. Evaluating the effect of education is complex in that the outcome (improved healthcare) is some distance from the educational approach. Best evidence medical education has been proposed as a continuum between 'opinion-based teaching' and 'evidence-based teaching'. Searching for evidence to inform best practice in health education is complex. A scoping review provides a practical and comprehensive strategy to locate and synthesise literature of varied methodology including reports from a variety of sources. The aim of this article is to describe a protocol for a scoping review that will locate, map and report research, guidelines and policies for pain education in pre-registration professional health courses. The extent, range and nature of reports will be examined, and where possible titles for potential systematic review will be identified. Reports will be included for review that are directly relevant to the development of the pain curriculum in pre-registration professional health courses, eg nursing, medicine, physiotherapy. The search strategy will identify reports that include [pain] AND [pre-registration education or curriculum] AND [health professionals] in the title or abstract. Two authors will independently screen retrieved studies against eligibility criteria. A numerical analysis regarding the extent, nature and distribution of reports will be given along with a narrative synthesis to describe characteristics of relevant reports. Formal ethical approval was not required to undertake this scoping review. Findings will be published in scientific peer-reviewed journals and via conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Utilizing Secondary Agricultural Education Programs to Deliver Evidence-Based Grain Safety Training for Young and Beginning Workers.

PubMed

Cheng, Yuan-Hsin; Field, William E; Tormoehlen, Roger L; French, Brian F

2017-01-01

Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted nationally and made available for free download from www.agconfinedspaces.org . Findings further confirmed the value of delivering safety programming through established programs such as secondary agricultural education programs and FFA Chapters serving youth.