An evidence-based brochure to educate contact lens wearers about safe contact lens wear

Contact lenses are a successful and popular means to correct refractive error and are worn by just under 700,000 Australians1 and approximately 125 million people worldwide. The most serious complication of contact lens wear is microbial keratitis, a potentially sight-threatening corneal infection most often caused by bacteria. Gram-negative bacteria, in particular pseudomonas species, account for the majority of severe bacterial infections. Pathogens such as fungi or amoebae, which feature less often, are associated with significant morbidity. These unusual pathogens have come into the spotlight in recent times with an apparent association with specific lens cleaning solutions...

New Knowledge for Advancing Practice in Pain Management

This chapter contains sections titled: Introduction Advancing practice in pain management Conclusions References

Evidence of effectiveness : high level synthesis of research to prevent obesity and increase physical activity in children

Background Prevention of childhood obesity is a public health priority for Malaysia and many other countries. Physical activity for children is also decreasing at an alarming rate. Both conditions are associated with non-communicable diseases and with significant morbidity and mortality in later life. Systematic reviews of public health interventions provide a useful summary to inform public health practice by combining the results of a range of research studies on a specific intervention into a single report. Systematic reviews are deemed most valuable for health program development and evidence based practice. Unfortunately, many policy makers and practitioners are simply unaware of the evidence: which strategies which are most likely to provide benefit; and which strategies are known to be harmful or useless. This presentation provides a “birds eye” overview based upon recent (since 2007 to present) high quality systematic reviews of public health interventions. Method HealthEvidece.org and the Cochrane Library were searched for systematic reviews which evaluated interventions targeting obesity prevention and increasing physical activity for children. The findings of the included reviews were themed and summarized. Results Seven reviews were identified addressing obesity in the early years, and fifteen reviews addressing obesity more broadly in childhood. Additional reviews were identified aimed at increasing physical activity. The synthesis shows several strategies to be effective, however many popular strategies clearly are not. Several of the reviews were inconclusive due to an absence of robust primary studies. Amongst the findings, interventions undertaken in the school setting appear very promising. Conclusions There is significant evidence from systematic reviews to guide public health practice and policy, and to inform future research.

Linking research and practice

Understanding the key factors that influence the evidentiary basis for practice and using skills in retrieving evidence that informs practice change are essential to the development of a health professional's career, regardless of the discipline. This chapter focuses on the key links between research and practice, particularly how health professionals use various sources of evidence and new knowledge to inform and improve the effectiveness of their practice in order to benefit the health of clients. Evidence-based practice and research utilisation are two major global research/practice initiatives that form the basis for this chapter. Examples that illustrate the real-world application of these initiatives are included in the Research Alive and Case Study sections. How practice change can be facilitated within health organisations is also briefly introduced.

Evidence based physical activity for school-age youth

Objectives To review the effects of physical activity on health and behavior outcomes and develop evidence-based recommendations for physical activity in youth. Study design A systematic literature review identified 850 articles; additional papers were identified by the expert panelists. Articles in the identified outcome areas were reviewed, evaluated and summarized by an expert panelist. The strength of the evidence, conclusions, key issues, and gaps in the evidence were abstracted in a standardized format and presented and discussed by panelists and organizational representatives. Results Most intervention studies used supervised programs of moderate to vigorous physical activity of 30 to 45 minutes duration 3 to 5 days per week. The panel believed that a greater amount of physical activity would be necessary to achieve similar beneficial effects on health and behavioral outcomes in ordinary daily circumstances (typically intermittent and unsupervised activity). Conclusion School-age youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate, enjoyable, and involves a variety of activities.

Using Participatory Design (PD) as youth engagement strategy to inform design and development of evidence-based wellbeing e-tools

The paper presents a participatory design research framework as a primary method for structuring youth engagement, participation and contribution to the design, development and usability evaluation of three evidencebased e-tools for wellbeing, which include smart phone mobile apps as well as e-health websites. The three projects are part of a series of six e-tools part of Safe and Supportive program under Young and Well CRC. The participatory design method, developed by Zelenko (2012) for application in design of online health promoting technologies, was further piloted in partnership with Inspire USA for specific application within the CRC, deploying a combination of creative design workshops and speculative design activities in developing e-tool prototypes with young people. This paper presents the resulting participatory research framework as it was implemented across the e-tool projects to facilitate active youth participation in co-designing the e-tools and ensuring the final designs are relevant to young people and deliver health messages in engaging ways. The principles of Participatory Design (PD) that inform the new framework include a high degree of participant agency in creative decisionmaking and a commitment to the process of co-designing, with young people working alongside designers and developers. The paper will showcase how the PD framework was applied across three projects to increase young people’s contribution to final design outcome.

School libraries, teacher-librarians and student outcomes : presenting and using the evidence

Evidence is required to ensure the future viability of school libraries and teacher-librarians. Education policy makers and school principals need detailed, reliable evidence to support informed decision-making about school library resourcing and staffing. Teacher-librarians need evidence to guide their professional practice and demonstrate their contribution to student learning outcomes. This review, which arises from recent Australian research (Hughes, 2013), collates international and Australian research about the impacts of school libraries and teacher librarians. It strengthens the evidence base, and recommends how this evidence can be best used to advance school libraries and teacher-librarians and enhance student learning.

Managing peripheral intravenous devices in the adults' general surgical setting: a best practice implementation report

AIM The aim of this evidence-based practice (EBP) project was to promote adherence to the current best practice in monitoring and optimal replacement of peripheral intravenous device (PIVD). METHODS This EBP project took place in a 30-bed acute general surgical ward. Twenty in-patients with PIVD in situ for 4 days or more were recruited. There were five stages in the project: identification of EBP topic, criteria, sample and setting; baseline; dissemination of baseline audit results and identification of best practice barriers; identification of barriers to EBP and implementation of strategies promoting EBP; and postimplementation audit. RESULTS There were eight criteria in this project. The first audit showed moderate compliance in PIVD monitoring and optimal replacement. The project identified three barriers: lack of awareness of the current evidence-based guidelines, hospital policy not being aligned with current guidelines and no standard form of documentation. In order to overcome these barriers the following strategies were used: audit and feedback, interactive educational meetings, reminders and hospital policy change. The second audit showed minor improvements in each criterion. Compliance with documentation remained a challenge, possibly because of the lack of standardised documentation. DISCUSSION Although the project did not render us the results we aimed for, it was successful because it highlighted the current EBP in PIVD management. The major challenges of the project were time and the lack of opinion leaders in our project team. We felt that more time was needed to adapt to the practice change and standardised documentation could not be developed in such a short time period. Further, the role of the opinion leader proved to be vital in this project. We felt that had we recruited more than one opinion leader, the results would have been different.

Development of an evidence-based symptom checklist for symptoms of recurrence in women with endometrial cancer

Objective Women treated for endometrial cancer currently commonly attend clinic-based follow-up examinations for up to five years. This is based on little evidence and alternative models need to be investigated. This study aimed to identify currently available symptom checklists, determine the comprehensiveness of identified checklists, and generate an updated list of symptoms potentially associated with a recurrence of endometrial cancer for future testing within a prospective study. Methods/materials We conducted a systematic review of the literature extracting; routine follow-up schedules; proportion of patients with symptomatic or asymptomatic recurrence; symptoms of recurrence; prevalence of these symptoms at recurrence. Results Overall, three previous checklists, and 12 retrospective studies were identified meeting the selection criteria. The average rate of recurrence across the studies was 13% (range 3%-19%). The proportion of patients identified with a symptomatic recurrence varied widely (overall average 67%;range 41% to 91%). The most commonly reported symptoms were vaginal bleeding (25%), pain [not further described] (16%) and abdominal pain and/or discomfort and swelling (15%) which combined, represented 56% of the total reported symptoms. The three previous checklists listed 14 and this review identified an additional 24 symptoms (e.g. vaginal discharge, leg pain, constipation, headache and self-detected mass) not previously identified. Conclusion The newly developed symptom checklist expands previous ones, by an additional 24 symptoms. It will be used in a prospective cohort study to assess whether it is sensitive and specific enough to identify recurrence compared to current standard follow-up examinations.

Evidence-based business process management: Using digital opportunities to drive organizational innovation

Process improvement and innovation are risky endeavors, like swimming in unknown waters. In this chapter, I will discuss how process innovation through BPM can benefit from Research-as-a-Service, that is, from the application of research concepts in the processes of BPM projects. A further subject will be how innovations can be converted from confidence-based to evidence-based models due to affordances of digital infrastructures such as large-scale enterprise soft-ware or social media. I will introduce the relevant concepts, provide illustrations for digital capabilities that allow for innovation, and share a number of key takeaway lessons for how organizations can innovate on the basis of digital opportunities and principles of evidence-based BPM: the foundation of all process decisions in facts rather than fiction.

Performance dispersion for evidence-based classification of stationary throwers

Background There is a need for better understanding of the dispersion of classification-related variable to develop an evidence-based classification of athletes with a disability participating in stationary throwing events. Objectives The purposes of this study are (A) to describe tools designed to comprehend and represent the dispersion of the performance between successive classes, and (B) to present this dispersion for the elite male and female stationary shot-putters who participated in Beijing 2008 Paralympic Games. Study design Retrospective study Methods This study analysed a total of 479 attempts performed by 114 male and female stationary shot-putters in three F30s (F32-F34) and six F50s (F52-F58) classes during the course of eight events during Beijing 2008 Paralympic Games. Results The average differences of best performance were 1.46±0.46 m for males between F54 and F58 classes as well as 1.06±1.18 m for females between F55 and F58 classes. The results demonstrated a linear relationship between best performance and classification while revealing two male Gold Medallists in F33 and F52 classes were outliers. Conclusions This study confirms the benefits of the comparative matrices, performance continuum and dispersion plots to comprehend classification-related variables. The work presented here represents a stepping stone into biomechanical analyses of stationary throwers, particularly on the eve of the London 2012 Paralympic Games where new evidences could be gathered.

Clinical data warehousing for evidence based decision making

Large volumes of heterogeneous health data silos pose a big challenge when exploring for information to allow for evidence based decision making and ensuring quality outcomes. In this paper, we present a proof of concept for adopting data warehousing technology to aggregate and analyse disparate health data in order to understand the impact various lifestyle factors on obesity. We present a practical model for data warehousing with detailed explanation which can be adopted similarly for studying various other health issues.

Left on the side of the road? A review of deterrence-based theoretical developments in road safety

Deterrence-based initiatives form a cornerstone of many road safety countermeasures. This approach is informed by Classical Deterrence Theory, which proposes that individuals will be deterred from committing offences if they fear the perceived consequences of the act, especially the perceived certainty, severity and swiftness of sanctions. While deterrence-based countermeasures have proven effective in reducing a range of illegal driving behaviours known to cause crashes such as speeding and drink driving, the exact level of exposure, and how the process works, remains unknown. As a result the current study involved a systematic review of the literature to identify theoretical advancements within deterrence theory that has informed evidence-based practice. Studies that reported on perceptual deterrence between 1950 and June 2015 were searched in electronic databases including PsychINFO and ScienceDirect, both within road safety and non-road safety fields. This review indicated that scientific efforts to understand deterrence processes for road safety were most intense during the 1970s and 1980s. This era produced competing theories that postulated both legal and non-legal factors can influence offending behaviours. Since this time, little theoretical progression has been made in the road safety arena, apart from Stafford and Warr's (1993) reconceptualisation of deterrence that illuminated the important issue of punishment avoidance. In contrast, the broader field of criminology has continued to advance theoretical knowledge by investigating a range of individual difference-based factors proposed to influence deterrent processes, including: moral inhibition, social bonding, self-control, tendencies to discount the future, etc. However, this scientific knowledge has not been directed towards identifying how to best utilise deterrence mechanisms to improve road safety. This paper will highlight the implications of this lack of progression and provide direction for future research.

Nursing care of children in general practice settings: roles and responsibilities

Aims. To examine roles and responsibilities of Practice Nurses in the area of child health and development and in advising parents about child health issues. Background. As the focus of Australia’s health care system shifts further towards the primary health care sector, governmental initiatives require that Practice Nurses are knowledgeable, confident and competent in providing care in the area of child health and development. Little is known about roles and responsibilities of Practice Nurses in this area. Design. Cross-sectional survey design. Methods. Practice Nurses completed a national online survey examining the roles and responsibilities in child health and development, professional development needs and role satisfaction. Data were collected from June 2010–April 2011. Results. Respondents (N = 159) reported having a significant role in well and sick child care and were interested in extending their role. Frequent activities included immunization, phone triage/advice, child health/development advice, wound care and Healthy Kids Checks. However, few had paediatric/child nursing backgrounds or postgraduate qualifications in paediatric nursing and they reported limited preparation for the role. Practice Nurses reported difficulties with keeping up-to-date with child health information and advising parents confidently. Satisfaction was relatively low regarding opportunities and encouragement to undertake professional development and expand scope of practice. Conclusion. Practice Nurses are largely unprepared to meet the demands of their child health role and need support to develop and maintain the skills and knowledge base necessary for high-quality, evidence-based practice. Both financial and time support is needed to enable Practice Nurses to access child health professional development.