778 resultados para evidence-based guidelines
Resumo:
Advocates of ‘local food’ claim it serves to reduce food miles and greenhouse gas emissions, improve food safety and quality, strengthen local economies and enhance social capital. We critically review the philosophical and scientific rationale for this assertion, and consider whether conventional scientific approaches can help resolve the debate. We conclude that food miles are a poor indicator of the environmental and ethical impacts of food production. Only through combining spatially explicit life cycle assessment with analysis of social issues can the benefits of local food be assessed. This type of analysis is currently lacking for nearly all food chains.
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This study is to investigate the middle school teachers’ concerns and perspectives during the implementation of an evidence-based curriculum that supports the development of both content knowledge and scientific practices. Two themes emerge from data analysis: consonance and conflict.
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Purpose: This study involved an extensive search for randomized controlled clinical trials comparing bilateral balanced and canine-guided dentures, and questioned whether a bilateral balanced occlusion is imperative for successful denture treatment. Materials and Methods: Studies were identified by searching electronic databases (PubMed/MEDLINE, ISI Web of Science, LILACS, and BBD). The keywords “denture” and “occlusion” were used. The minimum inclusion requirements were (1) randomized controlled trials with patients of any age wearing both maxillary and mandibular conventional complete dentures (CDs), (2) comparison between bilateral balanced and canine-guided dentures, and (3) assessment of masticatory function and/or patients’ satisfaction. Results: The search resulted in the identification of 5166 articles. Subsequently, 5156 articles were excluded on the basis of title and abstract. By the end of the search phase, seven randomized controlled trials were considered eligible. Conclusions: Current scientific evidence suggests that bilateral balanced occlusion is not imperative for successful treatment with conventional CDs in average patients. More studies are necessary to identify if specific clinical conditions may benefit from a balanced occlusion.
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Component-based Software Engineering (CBSE) and Service-Oriented Architecture (SOA) became popular ways to develop software over the last years. During the life-cycle of a software system, several components and services can be developed, evolved and replaced. In production environments, the replacement of core components, such as databases, is often a risky and delicate operation, where several factors and stakeholders should be considered. Service Level Agreement (SLA), according to ITILv3’s official glossary, is “an agreement between an IT service provider and a customer. The agreement consists on a set of measurable constraints that a service provider must guarantee to its customers.”. In practical terms, SLA is a document that a service provider delivers to its consumers with minimum quality of service (QoS) metrics.This work is intended to assesses and improve the use of SLAs to guide the transitioning process of databases on production environments. In particular, in this work we propose SLA-Based Guidelines/Process to support migrations from a relational database management system (RDBMS) to a NoSQL one. Our study is validated by case studies.
Resumo:
In August 2000, the federal government began an internal review of the Access to Information Act (ATIA). The ATIA gives Canadians a qualified right of access to records held by federal institutions. Decisions about reform should be based on good evidence about the operation of the Act and the likely impact of proposed reforms. This paper describes how data on ATIA operations is collected by federal institutions and provides a guide to academic researchers interested in conducting empirical research on the operation of the law. It constructs a small dataset that describes the processing of a sample of 663 requests received in 1999, and uses this dataset to illustrate the potential of an evidence-based approach to ATIA reform. The dataset can be downloaded from http://evidence.foilaw.net. The project was supported by a $4,800 grant from the Principal’s Development Fund of Queen’s University awarded in May 2001. Comments should be sent to the principal investigator, Alasdair Roberts, at roberts@policystudies.ca.
Resumo:
Background: Implementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation. Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care.
Methods: A systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models’ characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria.
Results: From 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0–32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported.
Conclusions: The QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised.