Abstract: This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers – The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, 10 from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals, with university affiliations, that emphasize an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. The featured cancer stories suggest positive outcomes based on anecdotal narratives as opposed to the science-based treatment models employed by the cancer centers. An analysis of 30 sample stories found skewed representation of the “cancer experience” that emphasizes positive outcomes while minimizing or excluding more negative realities of cancer diagnosis and treatment. The stories also deemphasize patient agency, instead focusing on deference and gratitude toward the cancer care centers, which are cast in the role of savior.
Abstract: Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.
Abstract: Trends in education affect schooling, needing incorporation into design concepts to support desired learning processes with appropriate and stimulating environments. A design process for school architecture demands research, debates, reflections, and efficient decision-making methods. This paper presents research on evidence-based design, related to middle schools, based on a systematic literature review and the elaboration of a set of architectural design patterns, through a graphic translation of new concepts for classroom configurations, to support programming debates and the synthesis phase of design. The investigation resulted in nine patterns that configure the concepts of boundaries, flexibility, levels of openness, mindsets, neighborhoods, movement and interaction, territories, opportunities for learning, and sightlines for classrooms. The research is part of a continuous investigation of design methods, on contemporary school architecture to produce an architectural pattern matrix based on scientific information translated into an insightful graphic design language.
Abstract: We propose to record Activities of Daily Living
(ADLs) of elderly people using a vision-based system so as to provide
better assistive and personalization technologies. Current ADL-related
research is based on data collected with help from non-elderly subjects
in laboratory environments and the activities performed are predetermined
for the sole purpose of data collection. To obtain more
realistic datasets for the application, we recorded ADLs for the elderly
with data collected from real-world environment involving real elderly
subjects. Motivated by the need to collect data for more effective
research related to elderly care, we chose to collect data in the room of
an elderly person. Specifically, we installed Kinect, a vision-based
sensor on the ceiling, to capture the activities that the elderly subject
performs in the morning every day. Based on the data, we identified
12 morning activities that the elderly person performs daily. To
recognize these activities, we created a HARELCARE framework to
investigate into the effectiveness of existing Human Activity
Recognition (HAR) algorithms and propose the use of a transfer
learning algorithm for HAR. We compared the performance, in terms
of accuracy, and training progress. Although the collected dataset is
relatively small, the proposed algorithm has a good potential to be
applied to all daily routine activities for healthcare purposes such as
evidence-based diagnosis and treatment.
Abstract: Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.
Abstract: Several factors contribute to success in sport and diet is one of them. Evidence-based sport nutrition guidelines underline the importance of macro- and micro-nutrients’ balance and timing in order to improve athlete’s physical status and performance. Nevertheless, a high content of proteins is commonly found in resistance training athletes’ diet with carbohydrate intake that is not enough or not well planned. The aim of the study was to evaluate the impact of different protein and carbohydrate diet contents on body composition and sport performance on a group of resistance training athletes. Subjects were divided as study group (n=16) and control group (n=14). For a period of 4 months, both groups were subjected to the same resistance training fitness program with study group following a specific diet and control group following an ab libitum diet. Body compositions were evaluated trough anthropometric measurement (weight, height, body circumferences and skinfolds) and Bioimpedence Analysis. Physical strength and training status of individuals were evaluated through the One Repetition Maximum test (RM1). Protein intake in studied group was found to be lower than in control group. There was a statistically significant increase of body weight, free fat mass and body mass cell of studied group respect to the control group. Fat mass remains almost constant. Statistically significant changes were observed in quadriceps and biceps circumferences, with an increase in studied group. The MR1 test showed improvement in study group’s strength but no changes in control group. Usually people consume hyper-proteic diet to achieve muscle mass development. Through this study, it was possible to show that protein intake fixed at 1,7 g/kg/d can meet the individual's needs. In parallel, the increased intake of carbohydrates, focusing on quality and timing of assumption, has enabled the obtainment of desired results with a training protocol supporting a hypertrophic strategy. Therefore, the key point seems related to the planning of a structured program both from a nutritional and training point of view.
Abstract: Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.
Abstract: As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.
Abstract: While struggling to succeed in today’s complex market environment and provide better customer experience and services, enterprises encompass digital transformation as a means for reaching competitiveness and foster value creation. A digital transformation process consists of information technology implementation projects, as well as organizational factors such as top management support, digital transformation strategy, and organizational changes. However, to the best of our knowledge, there is little evidence about digital transformation endeavors in organizations and how they perceive it – is it only about digital technologies adoption or a true organizational shift is needed? In order to address this issue and as the first step in our research project, a literature review is conducted. The analysis included case study papers from Scopus and Web of Science databases. The following attributes are considered for classification and analysis of papers: time component; country of case origin; case industry and; digital transformation concept comprehension, i.e. focus. Research showed that organizations – public, as well as private ones, are aware of change necessity and employ digital transformation projects. Also, the changes concerning digital transformation affect both manufacturing and service-based industries. Furthermore, we discovered that organizations understand that besides technologies implementation, organizational changes must also be adopted. However, with only 29 relevant papers identified, research positioned digital transformation as an unexplored and emerging phenomenon in information systems research. The scarcity of evidence-based papers calls for further examination of this topic on cases from practice.
Abstract: Delays in the construction industry are a global phenomenon. Many construction projects experience extensive delays exceeding the initially estimated completion time. The main purpose of this study is to identify construction projects typical behaviors in order to develop a prognosis and management tool. Being able to know a construction projects schedule tendency will enable evidence-based decision-making to allow resolutions to be made before delays occur. This study presents an innovative approach that uses Cluster Analysis Method to support predictions during Earned Value Analyses. A clustering analysis was used to predict future scheduling, Earned Value Management (EVM), and Earned Schedule (ES) principal Indexes behaviors in construction projects. The analysis was made using a database with 90 different construction projects. It was validated with additional data extracted from literature and with another 15 contrasting projects. For all projects, planned and executed schedules were collected and the EVM and ES principal indexes were calculated. A complete linkage classification method was used. In this way, the cluster analysis made considers that the distance (or similarity) between two clusters must be measured by its most disparate elements, i.e. that the distance is given by the maximum span among its components. Finally, through the use of EVM and ES Indexes and Tukey and Fisher Pairwise Comparisons, the statistical dissimilarity was verified and four clusters were obtained. It can be said that construction projects show an average delay of 35% of its planned completion time. Furthermore, four typical behaviors were found and for each of the obtained clusters, the interim milestones and the necessary rhythms of construction were identified. In general, detected typical behaviors are: (1) Projects that perform a 5% of work advance in the first two tenths and maintain a constant rhythm until completion (greater than 10% for each remaining tenth), being able to finish on the initially estimated time. (2) Projects that start with an adequate construction rate but suffer minor delays culminating with a total delay of almost 27% of the planned time. (3) Projects which start with a performance below the planned rate and end up with an average delay of 64%, and (4) projects that begin with a poor performance, suffer great delays and end up with an average delay of a 120% of the planned completion time. The obtained clusters compose a tool to identify the behavior of new construction projects by comparing their current work performance to the validated database, thus allowing the correction of initial estimations towards more accurate completion schedules.
Abstract: Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.
Abstract: Policy makers are increasingly looking to make evidence-based decisions. Evidence-based decisions have historically used rigorous methodologies of empirical studies by research institutes, as well as less reliable immediate survey/polls often with limited sample sizes. As we move into the era of Big Data analytics, policy makers are looking to different methodologies to deliver reliable empirics in real-time. The question is not why did these people do this for the last 10 years, but why are these people doing this now, and if the this is undesirable, and how can we have an impact to promote change immediately. Big data analytics rely heavily on government data that has been released in to the public domain. The open data movement promises greater productivity and more efficient delivery of services; however, Australian government agencies remain reluctant to release their data to the general public. This paper considers the barriers to releasing government data as open data, and how these barriers might be overcome.
Abstract: This paper highlights an innovative and nontraditional
violence prevention program that is making a noticeable impact in
what was once one of the country’s most violent communities. With
unique and tailored strategies, the Operation Peacemaker Fellowship,
established in Richmond, California, combines components of
evidence-based practices with a community-oriented focus on
relationships and mentoring to fill a gap in services and increase
community safety. In an effort to highlight these unique strategies
and provide a blueprint for other communities with violent crime
problems, the authors of this paper hope to clearly delineate how one
community is moving forward with vanguard approaches to invest in
the lives of young men who once were labeled their community’s
most violent, even most deadly, youth. The impact of this program is
evidenced through the fellows’ own voices as they illuminate the
experience of being in the Fellowship. In interviews, fellows describe
how participating in this program has transformed their lives and the
lives of those they love. The authors of this article spent more than
two years researching this Fellowship program in order to conduct an
evaluation of it and, ultimately, to demonstrate how this program is a
testament to the power of relationships and love combined with
evidence-based practices, consequently enriching the lives of youth
and the community that embraces them.
Abstract: Availability of different genetic tests after completion
of Human Genome Project increases the physicians’ responsibility to
keep themselves update on the potential implementation of these
genetic tests in their daily practice. However, due to numbers of
barriers, still many of physicians are not either aware of these tests or
are not willing to offer or refer their patients for genetic tests. This
study was conducted an anonymous, cross-sectional, mailed-based
survey to develop a primary data of Malaysian physicians’ level of
knowledge and perception of gene profiling. Questionnaire had 29
questions. Total scores on selected questions were used to assess the
level of knowledge. The highest possible score was 11. Descriptive
statistics, one way ANOVA and chi-squared test was used for
statistical analysis. Sixty three completed questionnaires were
returned by 27 general practitioners (GPs) and 36 medical specialists.
Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4).
About 40% of the participants rated themselves as having poor level
of knowledge in genetics in general whilst 60% believed that they
have fair level of knowledge; however, almost half (46%) of the
respondents felt that they were not knowledgeable about available
genetic tests. A majority (94%) of the responders were not aware of
any lab or company which is offering gene profiling services in
Malaysia. Only 4% of participants were aware of using gene profiling
for detection of dosage of some drugs. Respondents perceived greater
utility of gene profiling for breast cancer (38%) compared to the
colorectal familial cancer (3%). The score of knowledge ranged from
2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score
of knowledge of GPs and specialists were observed, with score of
4.19 and 4.58 respectively. There was no significant association
between any demographic factors and level of knowledge. However,
those who graduated between years 2001 to 2005 had higher level of
knowledge. Overall, 83% of participants showed relatively high level
of perception on value of gene profiling to detect patient’s risk of
disease. However, low perception was observed for both statements
of using gene profiling for general population in order to alter their
lifestyle (25%) as well as having the full sequence of a patient
genome for the purpose of determining a patient’s best match for
treatment (18%). The lack of clinical guidelines, limited provider
knowledge and awareness, lack of time and resources to educate
patients, lack of evidence-based clinical information and cost of tests
were the most barriers of ordering gene profiling mentioned by
physicians. In conclusion Malaysian physicians who participate in
this study had mediocre level of knowledge and awareness in gene
profiling. The low exposure to the genetic questions and problems
might be a key predictor of lack of awareness and knowledge on
available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling
into practice for eligible patients.
Abstract: Adolescents with Autism Spectrum Disorders (ASD)
often experience social-communication difficulties that negatively
impact their social interactions with typical peers. However, unlike
other age and disability groups, there is little intervention research to
inform best practice for these students. One evidence-based strategy
for younger students with ASD is peer-mediated intervention (PMI).
PMI may be particularly promising for use with adolescents, as peers
are readily available and are natural experts for encouraging authentic
high school conversations. This paper provides a review of previous
research that evaluated the use of PMI to improve the socialcommunication
skills of students with ASD. Specific intervention
features associated with positive student outcomes are identified and
recommendations for future research are provided. Adolescents with
ASD are targeted due the critical importance of social conversation at
the high school level.
Abstract: There are pending discussions over the mapping of
country export potential in order to refocus export strategy of firms
and its evidence-based promotion by the Export Credit Agencies
(ECAs) and other permitted vehicles of governments.
In this paper we develop our version of an applied model that
offers “stepwise” elimination of unattractive markets. We modify and
calibrate the model for the particular features of the Czech Republic
and specific pilot cases where we apply an individual approach to
each sector.
Abstract: Automated intelligent, clinical decision support systems generally promote to help or to assist physicians and patients regarding to prevention of diseases or treatment of illnesses using computer represented knowledge and information. In this paper, assessment factors affecting the proper design of clinical decision support system were investigated. The required procedure steps for gathering the data from clinical trial and extracting the information from large volume of healthcare repositories were listed, which are necessary for validation and verification of evidence-based implementation of clinical decision support system. The goal of this paper is to extract useful evaluation factors affecting the quality of the clinical decision support system in the design, development, and implementation of a computer-based decision support system.
Abstract: There is widespread emphasis on reform in the teaching of introductory statistics at the college level. Underpinning this reform is a consensus among educators and practitioners that traditional curricular materials and pedagogical strategies have not been effective in promoting statistical literacy, a competency that is becoming increasingly necessary for effective decision-making and evidence-based practice. This paper explains the historical context of, and rationale for reform-oriented teaching of introductory statistics (at the college level) in the health, social and behavioral sciences (evidence-based disciplines). A firm understanding and appreciation of the basis for change in pedagogical approach is important, in order to facilitate commitment to reform, consensus building on appropriate strategies, and adoption and maintenance of best practices. In essence, reform-oriented pedagogy, in this context, is a function of the interaction among content, pedagogy, technology, and assessment. The challenge is to create an appropriate balance among these domains.
Abstract: Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.
Abstract: These days we face with so many advertisements in
magazines, those mentioned coaching is pragmatic specialties which
help people make change in their lives. Up to know Specialty coaches
are not necessarily therapists, consultants or psychologist, thus they
may not know psychological theories. The International Coach
Federation identifies "facilitating learning and results" as one of its
four core coach competencies, without understanding learning
theories coaching practice hangs in theoretical abyss. Thus the aim of
this article is investigating learning theories within coaching process.
Therefore, I reviewed some cognitive and behavioral learning
theories and analyzed their contribution with coaching process which
has been introduced in mentor coaches and ICF certified coaches'
papers and books. The result demonstrated that coaching profession
is strongly grounded in learning theories, and it will be strengthened
by the validation of theories and evidence-based research as we move
forward. Thus, it needs more research in order to applying effective
theoretical frameworks.