Supporting therapist engagement in evidence based practice: Developing a continuing education programme through participatory action research

Therapists find it challenging to integrate research evidence into their clinical decision-making because it may involve modifying their existing practices. Although continuing education (CE) programmes for evidence-based practice (EBP) have employed various approaches to increase individual practitioner’s knowledge and skills, these have been shown to have little impact in changing customary behaviours. To date, there has been little attempt to actively engage therapists as collaborators in developing educational processes concerning EBP. The researcher collaborated with seven clinical therapists (one occupational therapist, four physiotherapists and two speech and language therapists) enrolled in a new post-qualification Implementing Evidence in Therapy Practice (IETP) MSc module to monitor and adapt the learning programme over ten weeks. The participating therapists actively engaged in participatory action research (PAR) iterative cycles of reflecting→ planning→ acting→ observing→ reflecting with the researcher. Mixed methods were used to evaluate the IETP module and its influence on therapists’ subsequent engagement in EBP activities. Data were gathered immediately on completion of the module and five months later. Immediate post-module findings revealed four components as being important to the therapists: 1) characteristics of the learning environment; 2) acquisition of relevant EBP skills; 3) nature of the learning process; and 4) acquiring confidence. The two themes and sub-themes which emerged from individual interviews conducted five months post-module expanded on the four components already identified. Theme 1: Experiencing the learning (sub-themes: module organisation; learning is relational; improving the module); and theme 2: Enacting the learning through a new way of being (sub-themes: criticality and reflection; self agency; modelling EBP behaviours; positioning self in an EB work culture). The therapists’ perspectives had by then shifted from that of a learner to that of a clinician constructing a new sense of self as an evidence-based practitioner. Findings from this study underline the importance of the process of socially constructed knowledge and of empowering learners through collaboratively designed continuing education programmes. In the student-driven learning environment, therapists chose repetitive skill-building and authentic problem-solving activities which reflected the complexity of the environments to which they were expected to transfer their learning. These findings have implications for educators designing EBP continuing education programmes, during which students develop professional ways of being.

Identification of RNA editing in the human exome and development of DARNED DatabaseSF

RNA editing is a biological phenomena that alters nascent RNA transcripts by insertion, deletion and/or substitution of one or a few nucleotides. It is ubiquitous in all kingdoms of life and in viruses. The predominant editing event in organisms with a developed central nervous system is Adenosine to Inosine deamination. Inosine is recognized as Guanosine by the translational machinery and reverse-transcriptase. In primates, RNA editing occurs frequently in transcripts from repetitive regions of the genome. In humans, more than 500,000 editing instances have been identified, by applying computational pipelines on available ESTs and high-throughput sequencing data, and by using chemical methods. However, the functions of only a small number of cases have been studied thoroughly. RNA editing instances have been found to have roles in peptide variants synthesis by non-synonymous codon substitutions, transcript variants by alterations in splicing sites and gene silencing by miRNAs sequence modifications. We established the Database of RNA EDiting (DARNED) to accommo-date the reference genomic coordinates of substitution editing in human, mouse and fly transcripts from published literatures, with additional information on edited genomic coordinates collected from various databases e.g. UCSC, NCBI. DARNED contains mostly Adenosine to Inosine editing and allows searches based on genomic region, gene ID, and user provided sequence. The Database is accessible at http://darned.ucc.ie RNA editing instances in coding region are likely to result in recoding in protein synthesis. This encouraged me to focus my research on the occurrences of RNA editing specific CDS and non-Alu exonic regions. By applying various filters on discrepancies between available ESTs and their corresponding reference genomic sequences, putative RNA editing candidates were identified. High-throughput sequencing was used to validate these candidates. All predicted coordinates appeared to be either SNPs or unedited.

Improved kinematic sensing for motion control applications

New compensation methods are presented that can greatly reduce the slit errors (i.e. transition location errors) and interval errors induced due to non-idealities in optical incremental encoders (square-wave). An M/T-type, constant sample-time digital tachometer (CSDT) is selected for measuring the velocity of the sensor drives. Using this data, three encoder compensation techniques (two pseudoinverse based methods and an iterative method) are presented that improve velocity measurement accuracy. The methods do not require precise knowledge of shaft velocity. During the initial learning stage of the compensation algorithm (possibly performed in-situ), slit errors/interval errors are calculated through pseudoinversebased solutions of simple approximate linear equations, which can provide fast solutions, or an iterative method that requires very little memory storage. Subsequent operation of the motion system utilizes adjusted slit positions for more accurate velocity calculation. In the theoretical analysis of the compensation of encoder errors, encoder error sources such as random electrical noise and error in estimated reference velocity are considered. Initially, the proposed learning compensation techniques are validated by implementing the algorithms in MATLAB software, showing a 95% to 99% improvement in velocity measurement. However, it is also observed that the efficiency of the algorithm decreases with the higher presence of non-repetitive random noise and/or with the errors in reference velocity calculations. The performance improvement in velocity measurement is also demonstrated experimentally using motor-drive systems, each of which includes a field-programmable gate array (FPGA) for CSDT counting/timing purposes, and a digital-signal-processor (DSP). Results from open-loop velocity measurement and closed-loop servocontrol applications, on three optical incremental square-wave encoders and two motor drives, are compiled. While implementing these algorithms experimentally on different drives (with and without a flywheel) and on encoders of different resolutions, slit error reductions of 60% to 86% are obtained (typically approximately 80%).