Bringing values back into evidence-based nursing: the role of patients in resisting empiricism

We examine problems resulting from the narrow empirical focus associated with evidence-based nursing, including the deleterious influence of vested interests, disattention to patients’ experiences, underestimation of the importance of social processes, lack of an individualized research perspective, marginalization of other forms of knowledge, and the undermining of patients’ autonomy. Addressing each problem in turn, we argue that inclusion of patients at all stages of evidence-based practice can counter or ameliorate these problems. While we concede that patient involvement is not a complete solution to the problem of empiricism, it is the most effective means available to defend nursing values.

A Syntax-based approach to measuring the degree of inconsistency for belief bases

Measuring the degree of inconsistency of a belief base is an important issue in many real world applications. It has been increasingly recognized that deriving syntax sensitive inconsistency measures for a belief base from its minimal inconsistent subsets is a natural way forward. Most of the current proposals along this line do not take the impact of the size of each minimal inconsistent subset into account. However, as illustrated by the well-known Lottery Paradox, as the size of a minimal inconsistent subset increases, the degree of its inconsistency decreases. Another lack in current studies in this area is about the role of free formulas of a belief base in measuring the degree of inconsistency. This has not yet been characterized well. Adding free formulas to a belief base can enlarge the set of consistent subsets of that base. However, consistent subsets of a belief base also have an impact on the syntax sensitive normalized measures of the degree of inconsistency, the reason for this is that each consistent subset can be considered as a distinctive plausible perspective reflected by that belief base,whilst eachminimal inconsistent subset projects a distinctive viewof the inconsistency. To address these two issues,we propose a normalized framework formeasuring the degree of inconsistency of a belief base which unifies the impact of both consistent subsets and minimal inconsistent subsets. We also show that this normalized framework satisfies all the properties deemed necessary by common consent to characterize an intuitively satisfactory measure of the degree of inconsistency for belief bases. Finally, we use a simple but explanatory example in equirements engineering to illustrate the application of the normalized framework.

A Holistic vs. an Attribute-based Approach to Agri-Environmental Policy Valuation: Do Welfare Estimates Differ?

Different economic valuation methodologies can be used to value the non-market benefits of an agri-environmental scheme. In particular, the non-market value can be examined by assessing the public's willingness to pay for the policy outputs as a whole or by modelling the preferences of society for the component attributes of the rural landscape that result from the implementation of the policy. In this article we examine whether the welfare values estimated for an agri-environmental policy are significantly different between an holistic valuation methodology (using contingent valuation) and an attribute-based valuation methodology (choice experiment). It is argued that the valuation methodology chosen should be based on whether or not the overall objective is the valuation of the agri-environment policy package in its entirety or the valuation of each of the policy's distinct environmental outputs.

A new model based approach for the prediction and optimisation of thermal homogeneity in single screw extrusion

In polymer extrusion, delivery of a melt which is homogenous in composition and temperature is important for good product quality. However, the process is inherently prone to temperature fluctuations which are difficult to monitor and control via single point based conventional thermo- couples. In this work, the die melt temperature profile was monitored by a thermocouple mesh and the data obtained was used to generate a model to predict the die melt temperature profile. A novel nonlinear model was then proposed which was demonstrated to be in good agreement with training and unseen data. Furthermore, the proposed model was used to select optimum process settings to achieve the desired average melt temperature across the die while improving the temperature homogeneity. The simulation results indicate a reduction in melt temperature variations of up to 60%.

Evidence-based Practice in Cognitive-Behaviour Therapy

book review

An Affordance Based Approach to Decision Making in Sport: Discussing a Novel Methodological Framework

Decision making is a fundamental clement of any sport, particularly open, fast, dynamic team sports such as football, basketball and rugby. At the elite level, athletes appear to consistently make good decisions in situations that are highly temporally constrained. To further understand how this is done has been the aim of researchers within the perception-action field for several decades. The purpose of this article is to present novel contributions, both theoretical and methodological, that are pushing the boundaries of this area of research. The theoretical framework (Ecological psychology) within which the work is posited will be described, followed by a description of Virtual Reality (VR) technology and how it relates to the theoretical aims. Finally, an applied example will be summarised in order to demonstrate how the theoretical approach and the methodological approach come together in practice.

Cancer Cachexia Care: The Contribution of Qualitative Research to Evidence-Based Practice

Background: Despite its prevalence and prognostic impact, primary cachexia is not well understood. Its potential to cause considerable psychological stress indicates the need for qualitative research to help understand the perspectives of those affected.

Objective: The aims of this study were to describe the perspectives of patients with primary cachexia, of their relatives, and of the healthcare professionals involved in their care and to demonstrate how this evidence can be applied in practice at 4 different levels of application ranging from empathy to coaching.

Methods: A review of the qualitative literature and empirical qualitative investigation was used to understand the experiences of patients and relatives and the perspectives of professionals.

Results: The main worries expressed by patients and relatives concerned appetite loss, changing appearance, prognosis, and social interaction. We also describe their coping responses and their views of professionals’ responses. The main concerns of professionals related to poor communication, lack of clinical guidance, and lack of professional education.

Conclusions: Understanding patients’, families’, and professionals’ perspectives, and mapping that understanding onto what we know about the trajectory and prognosis of the condition, provides the evidence base for good practice. Qualitative research has a central role to play in providing the knowledge base for the nursing care of patients with cachexia.

Implications for Practice: The evidence provided can improve nurses’ insight and assist them in assessment of status, the provision of guidance, and coaching. There is a need for the development of a holistic, information-based integrated care pathway for those with cancer cachexia and their families.