793 resultados para implementing evidence in practice


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Design influences behaviour, whether it's planned or not. Service Design has a great opportunity to lead the emerging field of design for behavioural change, helping guide and shape experiences to benefit users, service providers and wider society. In this article, presented as an evolving conversation between research and practice, Nick Marsh (EMC Consulting) and Dan Lockton (Brunel University) discuss and explore design patterns for influencing behaviour through Service Design, and how Service Designers and academics can work together for social benefit.

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Tesis (Licenciado en Lenguas Castellana, Inglés y Francés).--Universidad de La Salle. Facultad de Ciencias de La Educación. Licenciatura en Lengua Castellana, Inglés y Francés, 2014

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This study aims at providing evidence of the effectiveness of the Program-Guide to Develop Emotional Competences in promoting positive parenting. Contextual, institutional, methodological and professional issues were taken into account to develop a social innovation experience to support parenting as a preventive measure to family conflicts. The study describes both the contents of the Program-Guide and the methodological and evaluation issues that trained professionals need to consider when delivering the Program-Guide to families in natural contexts. Information was gathered and analyzed from 259 parents with children of ages 1-18 who participated in 26 parent training groups. A pre- and post-test design showed that after finishing the sessions parents perceived themselves more competent as parents according to the five dimensions of parenting competences considered: (1) emotional self-regulation abilities; (2) self-esteem and assertiveness; (3) communication strategies; (4) strategies to solve conflicts and to negotiate; and (5) strategies to establish coherent norms, limits and consequences to promote positive discipline. The study presents a discussion on these results from evidence-based parenting programs, as well as some strengths and limitations of the study, together with some suggestions for further research.

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The purpose of this study was to examine the reliability and validity of the School Anxiety Inventory (SAI) using a sample of 646 Slovenian adolescents (48% boys), ranging in age from 12 to 19 years. Single confirmatory factor analyses replicated the correlated four-factor structure of scores on the SAI for anxiety-provoking school situations (Anxiety about School Failure and Punishment, Anxiety about Aggression, Anxiety about Social Evaluation, and Anxiety about Academic Evaluation), and the three-factor structure of the anxiety response systems (Physiological Anxiety, Cognitive Anxiety, and Behavioral Anxiety). Equality of factor structures was compared using multigroup confirmatory factor analyses. Measurement invariance for the four- and three-factor models was obtained across gender and school-level samples. The scores of the instrument showed high internal reliability and adequate test–retest reliability. The concurrent validity of the SAI scores was also examined through its relationship with the Social Anxiety Scale for Adolescents (SASA) scores and the Questionnaire about Interpersonal Difficulties for Adolescents (QIDA) scores. Correlations of the SAI scores with scores on the SASA and the QIDA were of low to moderate effect sizes.

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It is a fact that the uncertainty about a firm’s future has to be measured and incorporated into a company’s valuation throughout the explicit analysis period – in the continuing or terminal value within valuation models. One of the concerns that can influence the continuing value of enterprises, which is not explicitly considered in traditional valuation models, is a firm’s average life expectancy. Although the literature has studied the life cycle of a firm, there is still a considerable lack of references on this topic. If we ignore the period during which a company has the ability to produce future cash flows, the valuations can fall into irreversible errors, leading to results markedly different from market values. This paper aims to provide a contribution in this area. Its main objective is to construct a mortality table for non-listed Portuguese enterprises, showing that the use of a terminal value through a mathematical expression of perpetuity of free cash flows is not adequate. We provide the use of an appropriate coefficient to perceive the number of years in which the company will continue to operate until its theoretical extinction. If well addressed regarding valuation models, this issue can be used to reduce or even to eliminate one of the main problems that cause distortions in contemporary enterprise valuation models: the premise of an enterprise’s unlimited existence in time. Besides studying the companies involved in it, from their existence to their demise, our study intends to push knowledge forward by providing a consistent life and mortality expectancy table for each age of the company, presenting models with an explicitly and different survival rate for each year. Moreover, we show that, after reaching a certain age, firms can reinvent their business, acquiring maturity and consequently postponing their mortality through an additional life period.

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This article considers the issue of poor care and how nurses should respond when they encounter it. Several reports and inquiries into failings in care have called into question the standards of care provided by nurses. Of equal concern is the observation that in some instances, poor care is unreported. While there may be underlying structural and organisational reasons for this, it is contended that nurses have a legal, moral and professional obligation to report poor care when they become aware of it.

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This thesis examines cultural policy for film in Scotland, from 1997 to 2010. It explores the extent to which the industry is shaped by film policy strategies and through the agency of public funding bodies. It reflects on how Scottish Screen, Scotland’s former screen agency, articulated its role as a national institution concerned with both commercial and cultural remits, with the conflicting interests of different industry groups. The study examines how the agency developed funding schemes to fulfil policy directives during a tumultuous period in Scottish cultural policy history, following the establishment of the Scottish Parliament with the Scotland Act 1998 and preceding the Independence Referendum Act 2013. In order to investigate how policy has shaped the development of a national film industry, a further two case studies are explored. These are Tartan Shorts, Scotland’s former flagship short film scheme, and the Audience Development Fund, Scotland’s first project based film exhibition scheme. The first study explores the planning, implementation and evaluation of the scheme as part of the agency’s talent development strategy. The outcomes of this study show the potential impact of funding methods aimed at developing and retaining Scottish filmmaking talent. Thereafter, the Scottish exhibition sector is discussed; a formerly unexplored field within film policy discussions and academic debate. It outlines Scottish Screen’s legacy to current film exhibition funding practices and the practical mechanisms the agency utilised to foster Scottish audiences. By mapping the historical and political terrain, the research analyses the specificity of Scotland within the UK context and explores areas in which short-term, context-driven policies become problematic. The work concludes by presenting the advantages and issues caused by film funding practices, advocating what is needed for the film industry in Scotland today with suggestions for long-term and cohesive policy development.

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Diese Arbeit behandelt Controlled Traffic Farming (CTF) Anbausysteme, bei denen für alle Arbeitsgänge satellitengesteuert immer dieselben Fahrspuren benutzt werden. Lässt sich mit CTF die Belastung des Bodens verringern und die Effizienz von Direktsaat-Anbausystemen steigern? Neben agronomischen und bodenphysikalischen Parametern wurden Auswirkungen von Lenksystemen und Umsetzungsmöglichkeiten von CTF in die Praxis untersucht. Die Analyse einer CTF-Umsetzung unter europäischen Bedingungen mit der Verwendung von Standardmaschinen zeigte, dass sich CTF-Anbausysteme mit den heute zur Verfügung stehenden Maschinen für Dauergrünland, Mähdruschfrüchte und Mais auf kleiner und grösser strukturierten Flächen relativ einfach mechanisieren lassen. Bei Zuckerrüben und Kartoffeln können Kompromisse notwendig sein. Generell erfordern CTF-Anbausysteme eine sorgfältige Planung und Umsetzung in die Praxis. Im dreijährigen Feldversuch (Winterweizen, Wintergerste, Kunstwiese mit Kleegrasmischung) auf einem Lehmboden wurde CTF-Direktsaat mit konventionell zufällig befahrenen Direktsaat- und Pflugverfahren verglichen. Unter CTF zeigte sich eine Differenzierung der nicht, gering und intensiv befahrenen Varianten. Auf dem vorliegenden kompakten Boden mit 1150 mm Jahresniederschlag waren die Unterschiede zwischen den nicht befahrenen Flächen und den mit niedrigem Kontaktflächendruck befahrenen Flächen eher gering. In den nicht befahrenen Flächen entwickelten Eindringwiderstand und Kohlendioxidgehalt der Bodenluft nach drei Jahren signifikant bessere Werte. Bodendichte und Porosität zeigten hingegen keinen eindeutig interpretierbaren Trend. Aufgrund teils suboptimaler Feldaufgänge liess sich keine generelle agronomische Tendenz ableiten. Die intensive Befahrung der Pflegefahrgassen zeigte allerdings klar negative bodenkundliche und planzenbauliche Auswirkungen. Es bietet sich daher an, vor allem für Pflegearbeiten permanent dieselben Fahrspuren zu nutzen. In der Untersuchung zu den Auswirkungen von Lenksystemen zeigten sich signifikante Vorteile von Lenksystemen in einer Verminderung der Fahrerbelastung und einer höheren Lenkgenauigkeit vor allem bei grossen Arbeitsbreiten ohne Spuranreisser. Die meisten anderen Messparameter waren mit Lenksystem leicht vorteilhafter als ohne, unterschieden sich aber nicht signifikant voneinander. Fahrer und naturräumliche Gegebenheiten wie die Schlagform hatten einen wesentlich grösseren Einfluss. Gesamthaft betrachtet erweitert CTF in Kombination mit weiteren Bodenschutzmass-nahmen die Möglichkeiten, Bodenverdichtungen zu vermeiden, den Bedarf an energieintensiver Bodenlocke-rung zu reduzieren und die Entwicklung einer stabileren Bodenstruktur mit höherer Tragfähigkeit zu fördern. Zusammen mit einer an Kultur und Anbausystem angepassten Saatbettbereitung und den in geraden Reihen einfacher durchführbaren mechanischen Pflegemassnahmen ergeben sich gute Voraussetzungen für die Gestaltung agronomisch leistungsfähiger und ökologisch nachhaltiger Anbausysteme.

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Background
Evidence-based practice advocates utilising best current research evidence, while reflecting patient preference and clinical expertise in decision making. Successfully incorporating this evidence into practice is a complex process. Based on recommendations of existing guidelines and systematic evidence reviews conducted using the GRADE approach, treatment pathways for common spinal pain disorders were developed.

Aims
The aim of this study was to identify important potential facilitators to the integration of these pathways into routine clinical practice.

Methods
A 22 person stakeholder group consisting of patient representatives, clinicians, researchers and members of relevant clinical interest groups took part in a series of moderated focus groups, followed up with individual, semi-structured interviews. Data were analysed using content analysis.

Results
Participants identified a number of issues which were categorized into broad themes. Common facilitators to implementation included continual education and synthesis of research evidence which is reflective of everyday practice; as well as the use of clear, unambiguous messages in recommendations. Meeting additional training needs in new or extended areas of practice was also recognized as an important factor. Different stakeholders identified specific areas which could be associated with successful uptake. Patients frequently defined early involvement in a shared decision making process as important. Clinicians identified case based examples and information on important prognostic indicators as useful tools to aiding decisions.

Conclusion
A number of potential implementation strategies were identified. Further work will examine the impact of these and other important factors on the integration of evidence-based treatment recommendations into clinical practice.

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General practitioners wanting to practise evidence-based medicine (EBM) are constrained by time factors and the great diversity of clinical problems they deal with. They need experience in knowing what questions to ask, in locating and evaluating the evidence, and in applying it. Conventional searching for the best evidence can be achieved in daily general practice. Sometimes the search can be performed during the consultation, but more often it can be done later and the patient can return for the result. Case-based journal clubs provide a supportive environment for GPs to work together to find the best evidence at regular meetings. An evidence-based literature search service is being piloted to enhance decision-making for individual patients. A central facility provides the search and interprets the evidence in relation to individual cases. A request form and a results format make the service akin to pathology testing or imaging. Using EBM in general practice appears feasible. Major difficulties still exist before it can be practised by all GPs, but it has the potential to change the way doctors update their knowledge.