Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

Guideline adaptation: a methodology to enhance efficiency in guideline development and improve utilization.

BACKGROUND: Developing and updating high-quality guidelines requires substantial time and resources. To reduce duplication of effort and enhance efficiency, we developed a process for guideline adaptation and assessed initial perceptions of its feasibility and usefulness. METHODS: Based on preliminary developments and empirical studies, a series of meetings with guideline experts were organised to define a process for guideline adaptation (ADAPTE) and to develop a manual and a toolkit made available on a website (http://www.adapte.org). Potential users, guideline developers and implementers, were invited to register and to complete a questionnaire evaluating their perception about the proposed process.

CO2 utilization in the perspective of industrial ecology, an overview

Carbon dioxide emissions from anthropic activities have accumulated in the atmosphere in excess of 800 Gigatons since preindustrial times, and are continuously increasing. Among other strategies, CO2 capture and storage is one option to mitigate the emissions from large point sources. In addition, carbon dioxide extraction from ambient air is assessed to reduce the atmospheric concentration of CO2. Both direct and indirect (through photosynthesis) pathways are possible. Geological sequestration has significant disadvantages (high cost, low public acceptance, long term uncertainty) whereas carbon dioxide recycling (or utilization) is more consistent with the basic principle of industrial ecology, almost closing material cycles. In this article, a series of technologies for CO2 capture and valorization is described as integrated and optimized pathways. This integration increases the environmental and economic benefits of each technology. Depending on the source of carbon dioxide, appropriate capture and valorization processes are evaluated based on material and energy constraints.