154 resultados para evidence-based approach


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Many animals, including insects, successfully engage in visual homing. We describe a system that allows a mobile robot to home. Specifically we propose a simple extension to our original homing scheme which significantly improves its performance by incorporating a richer view of the environment. The addition of landmark apparent-size cues assists homing by providing a more robust homing vector as well as providing a simple and effective method of reinforcing landmark avoidance. The homing algorithm allows a mobile robot to incrementally home by moving in such a way as to gradually reduce the discrepancy between the current view and the view obtained from the home position. Both simulation and mobile robot experiments are used to demonstrate the feasibility of this approach. By matching the bearings of features extracted from panoramic views and using a vector summation technique to compute a homing vector we are able to provide a simple, parsimonious and robust robotic homing algorithm.

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Background - Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families.

Methods - This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4).

Discussion -
This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for patients and the general public. The international collaboration also permits exploration of cultural differences that could inform international practice.

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An increasingly diverse range of students are entering higher education, bringing with them a vast range of experiences, skills and pre-existing knowledge. However, approaches to increasing student participation (and therefore success) to date have focused on strategies aimed at supporting non-traditional students to “fit in”, rather than changing existing structures to accommodate their needs. This paper will outline a resource-based approach to student success, which capitalises on the resources and capacities existing within the student, within their performance of the student role and within the environment that surrounds their learning.
This paper will report on a study and propose a resource based approach to student success. Three main sites or domains are identified as a focus of this approach – intrapersonal resources, skills resources and environmental resources. These domains interact with each other to support student success, and three potential methods for implementing a resource based approach are highlighted in the spaces where they intersect. Pedagogical design, mapping and matching, and learning support all have a role in enabling both students and universities to make the most of their existing resources and develop new ones.

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Commonly, surface and solid haptic effects are defined in such a way that they hardly can be rendered together. We propose a method for defining mixed haptic effects including surface, solid, and force fields. These haptic effects can be applied to virtual scenes containing various objects, including polygon meshes, point clouds, impostors, and layered textures, voxel models as well as function-based shapes. Accordingly, we propose a way how to identify location of the haptic tool in such virtual scenes as well as consistently and seamlessly determine haptic effects when the haptic tool moves in the scenes with objects having different sizes, locations, and mutual penetrations. To provide for an efficient and flexible rendering of haptic effects, we propose to concurrently use explicit, implicit and parametric functions, and algorithmic procedures.

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Business process (BP) modeling aims at a better understanding of processes, allowing deciders to improve them. We propose to support this modeling with an approach encompassing methods and tools for BP models quality measurement and improvement. In this paper we focus on semantic quality. The latter is evaluated by aligning BP model concepts with domain knowledge. The alignment is conducted thanks to meta-models. We also define validation rules for checking the completeness of BP models. A medical case study illustrates the main steps of our approach.

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Background Chronic heart-failure management programmes (CHF-MPs) have become part of standard care for patients with chronic heart failure (CHF). Objective To investigate whether programmes had applied evidence-based expert clinical guidelines to optimise patient outcomes. Design A prospective cross-sectional survey was used to conduct a national audit. Setting Community setting of CHF-MPs for patients postdischarge. Sample All CHF-MPs operating during 2005–2006 (n=55). Also 10–50 consecutive patients from 48 programmes were recruited (n=1157). Main outcome measures (1) Characteristics and interventions used within each CHF-MP; and (2) characteristics of patients enrolled into these programmes. Results Overall, there was a disproportionate distribution of CHF-MPs across Australia. Only 6.3% of hospitals nationally provided a CHF-MP. A total of 8000 postdischarge CHF patients (median: 126; IQR: 26–260) were managed via CHF-MPs, representing only 20% of the potential national case load. Significantly, 16% of the caseload comprised patients in functional New York Heart Association Class I with no evidence of these patients having had previous echocardiography to confirm a diagnosis of CHF. Heterogeneity of CHF-MPs in applied models of care was evident, with 70% of CHF-MPs offering a hybrid model (a combination of heart-failure outpatient clinics and home visits), 20% conducting home visits and 16% conducting an extended rehabilitation model of care. Less than half (44%) allowed heart-failure nurses to titrate medications. The main medications that were titrated in these programmes were diuretics (n=23, 96%), β-blockers (n=17, 71%), ACE inhibitors (ACEIs) (n=14, 58%) and spironolactone (n=9, 38%). Conclusion CHF-MPs are being implemented rapidly throughout Australia. However, many of these programmes do not adhere to expert clinical guidelines for the management of patients with CHF. This poor translation of evidence into practice highlights the inconsistency and questions the quality of health-related outcomes for these patients.

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Aim.  The aim of this study was to develop a potential scoring algorithm for interventions in a chronic heart failure management programme – the Heart Failure Intervention Score – to facilitate quality improvement and programme auditing.

Background.  The overall efficacy of chronic heart failure management programmes has been demonstrated in several meta-analyses. However, meta-analyses did not determine individual interventions in a programme that resulted in beneficial patient outcomes.

Design.
  A prospective cross-sectional survey design.

Method. 
All chronic heart failure management programmes in Australia (n = 62), identified by a national register, were surveyed to determine programme characteristics and interventions.

Results.
  Of the 62 national chronic heart failure management programmes, 48 (77%) completed the survey and 27 individual interventions were identified. Variability in the use of the key interventions was common among the programmes. Each intervention was given an arbitrary weighted score according to the level of supportive evidence available and a total score calculated. Programmes were then categorised into low or high complexity based on several interventions implemented and their weighted score. A total score of ≥190 (median = 178, interquartile range 176–195) was used to divide programmes into two groups. Nine programmes were categorised into high Heart Failure Intervention Score group and majority of these were based in the acute hospital setting (78%). In the low Heart Failure Intervention Score group, there were 39 programmes of which there were a higher proportion of community-based programmes (38%) and programmes in small community hospitals (10%).

Conclusion.  The Heart Failure Intervention Score provides a potential evidence-based quality improvement tool through which a set of minimum standards can be developed. Implementation of the Heart Failure Intervention Score provides guidance to programme coordinators to enable monitoring of standards of heart failure programmes, which may potentially result in better patient outcomes.

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Background:
Depression can have a strongly negative impact on a person’s ability to engage with and participate in activities of daily living. Clinicians currently seeking guidance on best practice in this area currently need to access and critique a wide range of evidence from a number of disciplines. While some clinical practice guidelines are available, this form of evidence presentation presents several barriers to implementation.

Procedures:
This article proposes a new procedure for developing guidance for clinicians, known as evidence based guidelines. The purpose of the guidelines presented here is to provide guidance on appropriate assessment and intervention strategies with people experiencing depression, who wish to improve their engagement and participation in daily activities. They were constructed using a multiple methods procedure, with five phases.

Results:
Evidence based guidelines for the general population, older adults and people with co-morbid physical conditions are presented at the conclusion of this article.

Conclusion:
The procedure described here produces evidence based guidelines with built in measures to promote implementation into practice. The resulting guidelines for depression will enable clinicians from all disciplines to engage in best practice, and assist people with depression participate more fully in their lives.

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There is now a substantial amount of published literature describing the range of programs and interventions that have been implemented in an attempt to improve aspects of community safety. Only a small body of this work, however, has examined the outcomes of those programs delivered to Indigenous Australians or, indeed, the communities in which they live. This Issues paper provides an overview of those programs that were identified in a systematic search of relevant research databases. 


Although a wide range of programs have been described, the diversity of these programs—combined with the limited published data available that documents their outcomes—makes it difficult to articulate what constitutes effective practice in this area.

It is concluded that an evidence-based approach to practice in this area is essential if the long-term aim of the Closing the Gap initiative is to be achieved. To generate this evidence, however, more attention is needed to develop evaluation methods that assess the impact of program activities on medium and longer term outcomes. 

In addition, information about program outcomes needs to be integrated with what is known about the mechanisms by which effective programs are delivered, as well as with knowledge about how they might be most effectively implemented in different communities.