960 resultados para evidence-based approach


Relevância:

100.00% 100.00%

Publicador:

Resumo:

Numerous works have been conducted on modelling basic compliant elements such as wire beams, and closed-form analytical models of most basic compliant elements have been well developed. However, the modelling of complex compliant mechanisms is still a challenging work. This paper proposes a constraint-force-based (CFB) modelling approach to model compliant mechanisms with a particular emphasis on modelling complex compliant mechanisms. The proposed CFB modelling approach can be regarded as an improved free-body- diagram (FBD) based modelling approach, and can be extended to a development of the screw-theory-based design approach. A compliant mechanism can be decomposed into rigid stages and compliant modules. A compliant module can offer elastic forces due to its deformation. Such elastic forces are regarded as variable constraint forces in the CFB modelling approach. Additionally, the CFB modelling approach defines external forces applied on a compliant mechanism as constant constraint forces. If a compliant mechanism is at static equilibrium, all the rigid stages are also at static equilibrium under the influence of the variable and constant constraint forces. Therefore, the constraint force equilibrium equations for all the rigid stages can be obtained, and the analytical model of the compliant mechanism can be derived based on the constraint force equilibrium equations. The CFB modelling approach can model a compliant mechanism linearly and nonlinearly, can obtain displacements of any points of the rigid stages, and allows external forces to be exerted on any positions of the rigid stages. Compared with the FBD based modelling approach, the CFB modelling approach does not need to identify the possible deformed configuration of a complex compliant mechanism to obtain the geometric compatibility conditions and the force equilibrium equations. Additionally, the mathematical expressions in the CFB approach have an easily understood physical meaning. Using the CFB modelling approach, the variable constraint forces of three compliant modules, a wire beam, a four-beam compliant module and an eight-beam compliant module, have been derived in this paper. Based on these variable constraint forces, the linear and non-linear models of a decoupled XYZ compliant parallel mechanism are derived, and verified by FEA simulations and experimental tests.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Background Many breast cancer survivors continue to have a broad range of physical and psychosocial problems after breast cancer treatment. As cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up it is important that comprehensive evidence-based breast cancer survivorship care is implemented to effectively address these needs. Research suggests primary care providers are willing to provide breast cancer survivorship care but many lack the knowledge and confidence to provide evidence-based care. Purpose The overall purpose of this thesis was to determine the challenges, strengths and opportunities related to implementing comprehensive evidence-based breast cancer survivorship guidelines by primary care physicians and nurse practitioners in southeastern Ontario. Methods This mixed-methods research was conducted in three phases: (1) synthesis and appraisal of clinical practice guidelines relevant to provision of breast cancer survivorship care within the primary care practice setting; (2) a brief quantitative survey of primary care providers to determine actual practices related to provision of evidence-based breast cancer survivorship care; and (3) individual interviews with primary care providers about the challenges, strengths and opportunities related to provision of comprehensive evidence-based breast cancer survivorship care. Results and Conclusions In the first phase, a comprehensive clinical practice framework was created to guide provision of breast cancer survivorship care and consisted of a one-page checklist outlining breast cancer survivorship issues relevant to primary care, a three-page summary of key recommendations, and a one-page list of guideline sources. The second phase identified several knowledge and practice gaps, and it was determined that guideline implementation rates were higher for recommendations related to prevention and surveillance aspects of survivorship care and lowest related to screening for and management of long-term effects. The third phase identified three major challenges to providing breast cancer survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden; and three major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. A better understanding of these challenges, strengths and opportunities will inform development of targeted knowledge translation interventions to provide support and education to primary care providers.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

In the crisis-prone and complex contemporary business environment, modern organisations and their supply chains, large and small, are challenged by crises more than ever. Knowledge management has been acknowledged as an important discipline able to support the management of complexity in times of crisis. However, the role of effective knowledge retrieval and sharing in the process of crisis prevention, management and survival has been relatively underexplored. In this paper, it is argued that organisational crises create additional challenges for knowledge management, mainly because complex, polymorphic and both structured and unstructured knowledge must be efficiently harnessed, processed and disseminated to the appropriate internal and external supply chain actors, under specific time constraints. In this perspective, a process-based approach is proposed to address the knowledge management needs of organisations during a crisis and to help management in establishing the necessary risk avoidance and recovery mechanisms. Finally, the proposed methodological approach is applied in a knowledge- intensive Greek small and medium enterprise from the pharmaceutical industry, producing empirical results, insights on knowledge pathologies during crises and relevant evaluations.

Relevância:

100.00% 100.00%

Publicador:

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.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Purpose – This paper aims to contribute towards understanding how safety knowledge can be elicited from railway experts for the purposes of supporting effective decision-making. Design/methodology/approach – A consortium of safety experts from across the British railway industry is formed. Collaborative modelling of the knowledge domain is used as an approach to the elicitation of safety knowledge from experts. From this, a series of knowledge models is derived to inform decision-making. This is achieved by using Bayesian networks as a knowledge modelling scheme, underpinning a Safety Prognosis tool to serve meaningful prognostics information and visualise such information to predict safety violations. Findings – Collaborative modelling of safety-critical knowledge is a valid approach to knowledge elicitation and its sharing across the railway industry. This approach overcomes some of the key limitations of existing approaches to knowledge elicitation. Such models become an effective tool for prediction of safety cases by using railway data. This is demonstrated using passenger–train interaction safety data. Practical implications – This study contributes to practice in two main directions: by documenting an effective approach to knowledge elicitation and knowledge sharing, while also helping the transport industry to understand safety. Social implications – By supporting the railway industry in their efforts to understand safety, this research has the potential to benefit railway passengers, staff and communities in general, which is a priority for the transport sector. Originality/value – This research applies a knowledge elicitation approach to understanding safety based on collaborative modelling, which is a novel approach in the context of transport.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Algorithms for concept drift handling are important for various applications including video analysis and smart grids. In this paper we present decision tree ensemble classication method based on the Random Forest algorithm for concept drift. The weighted majority voting ensemble aggregation rule is employed based on the ideas of Accuracy Weighted Ensemble (AWE) method. Base learner weight in our case is computed for each sample evaluation using base learners accuracy and intrinsic proximity measure of Random Forest. Our algorithm exploits both temporal weighting of samples and ensemble pruning as a forgetting strategy. We present results of empirical comparison of our method with îriginal random forest with incorporated replace-the-looser forgetting andother state-of-the-art concept-drift classiers like AWE2.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This paper discusses the development of a children’s rights-based measure of participation and the findings from its use in a survey of 10 to 11 year old children (n= 3773). The measure, which was developed in collaboration with a group of children, had a high reliability (Cronbach’s alpha = .89). Findings suggest that children’s positive experience of their participation rights is higher in school than in community, and higher for girls compared to boys. It is argued that involving children in the ‘measurement’ of their own lives has the potential to generate more authentic data on children’s lived experiences.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This work applies a hybrid approach in solving the university curriculum-based course timetabling problem as presented as part of the 2nd International Timetabling Competition 2007 (ITC2007). The core of the hybrid approach is based on an artificial bee colony algorithm. Past methods have applied artificial bee colony algorithms to university timetabling problems with high degrees of success. Nevertheless, there exist inefficiencies in the associated search abilities in term of exploration and exploitation. To improve the search abilities, this work introduces a hybrid approach entitled nelder-mead great deluge artificial bee colony algorithm (NMGD-ABC) where it combined additional positive elements of particle swarm optimization and great deluge algorithm. In addition, nelder-mead local search is incorporated into the great deluge algorithm to further enhance the performance of the resulting method. The proposed method is tested on curriculum-based course timetabling as presented in the ITC2007. Experimental results reveal that the proposed method is capable of producing competitive results as compared with the other approaches described in literature