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PubMedDate not supplied

A successful teaching strategy for applying evidence-based practice.

Evidence-based practice (EBP) is the conscientious use of the best evidence contained in the literature to guide healthcare decisions. The authors describe how their baccalaureate program prepares its graduates to be successful in implementing EBP in their nursing practice. Outcomes of sustained student projects in agency settings are presented. They posit that bachelor of science in nursing students, agency personnel, and faculty can lead practice innovations supported by EBP.

Attitude of Health Personnel↗

PubMed1999

Metabolic engineering.

Metabolic engineering is the science that combines systematic analysis of metabolic and other pathways with molecular biological techniques to improve cellular properties by designing and implementing rational genetic modifications. As such, metabolic engineering deals with the measurement of metabolic fluxes and elucidation of their control as determinants of metabolic function and cell physiology. A novel aspect of metabolic engineering is that it departs from the traditional reductionist paradigm of cellular metabolism, taking instead a holistic view. In this sense, metabolic engineering is well suited as a framework for the analysis of genome-wide differential gene expression data, in combination with data on protein content and in vivo metabolic fluxes. The insights of the integrated view of metabolism generated by metabolic engineering will have profound implications in biotechnological applications, as well as in devising rational strategies for target selection for screening candidate drugs or designing gene therapies. In this article we review basic concepts of metabolic engineering and provide examples of applications in the production of primary and secondary metabolites, improving cellular properties, and biomedical engineering.

Biomedical Engineering↗

PubMed2004

Health psychological theory in promoting population health in Päijät-Häme, Finland: first steps toward a type 2 diabetes prevention study.

In public health promotion, behavioural science theories and theory-based methods should be translated into practical strategies that fit environmental conditions and are feasible for implementation. In this article, an effort to meet this challenge is presented. As a starting point we describe the conditions for development and success of the previous generation of public health promotion programmes in Finland. However, changes both in the population structure and in the population health bring new demands for programme development. We consider possibilities offered by health psychology and give a practical example of how theories and theory-based methods are applied in a community programme for type 2 diabetes prevention implemented in the Finnish primary health care.

Behavioral Medicine↗

PubMed2006

Multi-photon excitation microscopy.

Multi-photon excitation (MPE) microscopy plays a growing role among microscopical techniques utilized for studying biological matter. In conjunction with confocal microscopy it can be considered the imaging workhorse of life science laboratories. Its roots can be found in a fundamental work written by Maria Goeppert Mayer more than 70 years ago. Nowadays, 2PE and MPE microscopes are expected to increase their impact in areas such biotechnology, neurobiology, embryology, tissue engineering, materials science where imaging can be coupled to the possibility of using the microscopes in an active way, too. As well, 2PE implementations in noninvasive optical bioscopy or laser-based treatments point out to the relevance in clinical applications. Here we report about some basic aspects related to the phenomenon, implications in three-dimensional imaging microscopy, practical aspects related to design and realization of MPE microscopes, and we only give a list of potential applications and variations on the theme in order to offer a starting point for advancing new applications and developments.

Animals↗

PubMed2000

Shopping for health information.

In this time of ongoing health care changes, consumers need to become better informed to actively participate in their health care decisions. As a result, hospital libraries are being challenged to address this need. Scottsdale Healthcare's Health Sciences Libraries have responded to this challenge by establishing a Health Information Center at the premiere shopping mall in the area. Implementing a Health Information Center at a mall is a unique way to bring medical information to the community. The purpose of this paper is to describe the planning process, the implementation, and the future vision of the Health Information Center at Scottsdale Fashion Square.

Arizona↗

PubMed2005

Metabonomics in preclinical drug development.

Metabonomics has emerged as a key technology in preclinical drug discovery and development. The technology enables noninvasive systems assessment of untoward effects induced by candidate compounds characterising a broad spectrum of biological responses on an individual animal basis in a relatively rapid-throughput fashion, thus making it an ideal addition to early preclinical safety assessment. However, the implementation and interpretation of the technology and data it generates is not something that should be trivialised. Proper expertise in biological sciences, analytical sciences (nuclear magnetic resonance and/or mass spectrometry) and chemometrics should all be considered necessary prerequisites. If these factors are properly considered, the technology can add significant value as a tool for preclinical toxicologists.

Animals↗

PubMed2006

A standard interface between simulation programs and systems analysis software.

A simple interface between simulation programs and systems analytical software is proposed. This interface is designed to facilitate linkage of environmental simulation programs with systems analytical software and thus can contribute to remedying the deficiency in applying systems analytical techniques to environmental modelling studies. The proposed concept, consisting of a text file interface combined with a batch mode simulation program call, is independent of model structure, operating system and programming language. It is open for implementation by academic and commercial simulation and systems analytical software developers and is very simple to implement. Its practicability is demonstrated by implementations for three environmental simulation packages (AQUASIM, SWAT and LEACHM) and two systems analytical program packages (UNCSIM, SUFI). The properties listed above and the demonstration of the ease of implementation of the approach are prerequisites for the stimulation of a widespread implementation of the proposed interface that would be beneficial for the dissemination of systems analytical techniques in the environmental and engineering sciences. Furthermore, such a development could stimulate the transfer of systems analytical techniques between different fields of application.

Environment↗

PubMed1999

Evidence-based medicine and its implications for audiological science.

Evidence-based medicine is the use of current best evidence in making decisions about individual patients. It involves formulating a question, searching for information, appraisal of the literature, implementation and subsequent audit. Two case studies involving a non-linear hearing aid and cochlear implantation are used to illustrate the process. Critical appraisal of the evidence-based medicine in the general literature shows little sign that the approach is effective and indicates that further rigorous evaluation is a priority. It is suggested that systematic reviews and clinical practice guidelines should be a high priority for audiologists and that a working group of audiologists should form to promote their production.

Adolescent↗

PubMed1999

Allied health applications of a computerized clinical log database system.

Preliminary research in the development and use of computerized clinical log records began in 1987 in an allied health college at a midwestern academic health center. This article reviews development and implementation of a computerized system for managing clinical log records to improve and enhance allied health educational programs in the radiation sciences. These clinical log databases are used for quantitative and qualitative analyses of student participation in clinical procedures, and educational planning for each student. Collecting and recording data from clinical log records serves as a valuable instructional tool for students, with both clinical and didactic applications.

Accreditation↗

PubMedDate not supplied

Chlorpyrifos: probabilistic assessment of exposure and risk.

FQPA requires determination of the combined potential risk from both dietary (food and drinking water) and non-dietary (residential) routes of exposures to pesticides. Critical to the implementation and ultimately to the impact of FQPA are the validity of the risk assessments. Fundamental to the practice of sound science in risk assessment is accuracy in representing real-world exposures and the resulting risk. Too often, simplistic and overly conservative approaches and exposure data are employed. The resulting assessments are often termed "worst-case" and the inherent inaccuracies justified as additional safety factors. A scientific, tiered approach can be employed to improve the accuracy of risk assessments and provide more realistic estimates of risk. A case study using chlorpyrifos, a widely-studied insecticide, will be presented to show the levels of refinement which can be obtained through the use of more relevant exposure data, recognition of the patterns of uses and exposures, and higher-tier probabilistic methodologies. Results show a 7- to 26-fold decrease in estimated acute dietary risk and a 30- to 80-fold decrease in estimated aggregate risk using these refinements. These decreases proved to be critical, since the change in results also change the conclusions about risk and indicate the levels are within acceptable limits.

Chlorpyrifos↗

PubMed2003

[Two editors in dialog. The example of Justus von Liebig (1803-1873) and Johann Bartholomäus Trommsdorff (1770-1837) and their letters].

Today, scientists willing to publish results face a wide range of requirements (instructions for authors, peer review procedure). During the 18th and 19th century manuscripts were treated in a less formal way. However, the scientific discussion was vital and implemented intensely via various means, especially by letters. This study analyses the dialog of two distinguished contributors to chemical and pharmaceutical sciences, both experienced journal editors, from January 1828 to February 1837.

Germany↗

PubMed2003

A perspective on nutrition communication in developing countries: from theory to practice.

Though nutrition communities are still far from understanding how to bring science to bear in formulating effective policies and programs, the contributions of nutrition science have provided recommendations leading to ways and means to improve nutrition in developing countries. To transfer these recommendations into successful implementation, effective nutrition communication has played an important role in the development. Nevertheless, its success has been limited due to several factors including the fact that there is likely only a small proportion of professionals who consistently aim to use theory as a tool to guide action. This paper highlights the importance of using theoretical frameworks to guide the design and implementation. Based on Thailand's experience, social cognitive theory and social marketing are suggested for further applications in developing country context. It is proposed that the role of researchers/practitioners should be formed to facilitate nutrition implementation. Issues relating to the creation of supportive structures and environments i.e. quality personnel, capacity building, proper status and reasonable budgets, are also identified.

Developing Countries↗

PubMed2005

Precautionary information-generation in science and the law.

An information-generation system should be part of precautionary approaches to protecting the public's health and the environment. Such a system would include inventories or surveys of health and the environment, monitoring of them, as well as scoping out or scouting for threats or other harmful things that could occur and providing sentinels to try to identify threats before they materialize. I, then, suggest some ways in which such strategies could be adopted in science and the law as part of a precautionary approach. Doing more to generate information in an anticipatory way will assist implementation of the precautionary principle and help remove some of the uncertainty in environmental and public health protections.

Environment↗

PubMed2006

New IOM report underscores ongoing threat of med errors.

Technology may improve the error rate, but careful implementation is absolutely critical. Health care provider groups should actively monitor their progress in improving medication safety. Medication reconciliation is a worthy goal, but implementation is proving more difficult than anticipated.

Humans↗

PubMed1995

The role of research in systems reform.

Knowledge concerning the care of people with severe and persistent mental illness has grown dramatically, but that knowledge is seldom translated into improvements in care. The authors describe their involvement in three service delivery projects in Ontario and discuss how, by assuming multiple roles, they were able to ensure that planning and policy development were informed by current knowledge. In addition to being an investigator, such roles may include being an administrator, planner, consultant and advocate. The redevelopment of Whitby Psychiatric Hospital resulted in an innovative plan for a comprehensive, integrated service delivery system based upon community support services research. Implementation of the Graham Report in Ontario provided an array of district mental health plans which incorporate current knowledge with regard to service delivery. Ontario's mental health reform strategy represents a close connection between public policy and scientific information. The authors recommend that researchers be prepared to assume multiple roles in the service delivery field so as to reduce the gap between science and practice.

Comprehensive Health Care↗

PubMed2006

Alberta biodiversity monitoring program - monitoring effectiveness of sustainable forest management planning.

A conceptual model of sustainable forest management is described based on three connected and necessary components: Policy/Strategic Planning, Operational Planning, and Effectiveness Monitoring/Science. Alberta's proposed Forest Management Planning Standard is described as an example of operational planning. The standard utilizes coarse and fine filter approaches to conserving biodiversity and sets requirements for implementation monitoring. The Alberta Biodiversity Monitoring Program (ABMP) is described as an example of effectiveness monitoring supporting Operational Planning. The ABMP is a rigorous science-based initiative that is being developed to monitor and report on biodiversity status and trends throughout the province of Alberta, Canada. The basic survey design consists of 1656 sites, 20 km apart, evenly spaced on a grid pattern across Alberta. Sites will be sampled over a five-year period at a rate of 350 sites/year. Standardized sampling protocols will be used to cover a broad range of species and habitat elements within terrestrial and aquatic environments, as well as broader landscape-level features. Trends and associations detected by ABMP products will be validated through cause-effect research. ABMP focuses research on critical issues and informs both operational planning and the development of policy and strategic-level plans. The Alberta Forest Management Planning Standard and the ABMP are described as key components to implementing resource planning based on ecosystem management principles.

Alberta↗

PubMed2001

The Interdisciplinary Generalist Curriculum Project at Joan C. Edwards School of Medicine at Marshall University.

The Interdisciplinary Generalist Curriculum (IGC) Project was designed to enhance interest in and support of generalism during the first two years of medical education. The original goals at Joan C. Edwards School of Medicine at Marshall University included the design and implementation of a core curriculum, Introduction to Patient Care (IPC), and enhancement of teaching excellence through faculty development. The core curriculum facilitated integration with the basic sciences and early introduction of physical examination skills, which were further developed in longitudinal clinical experiences with mentors. Although it was not originally intended to include basic scientists in the preceptor groups, they became important additions and created additional opportunities for interdisciplinary teaching and reciprocal learning. The mentor program, another well-received and intended curriculum change, evolved from a structured experience to a more flexible component of the curriculum. The program met the requirements of the IGC Project but 53% of the originally intended mentor time was achievable, due to curriculum constraints. Faculty development, another success, was originally intended to target IPC faculty but ultimately became a university-wide effort. The changes implemented as a result of the IGC Project continue to flourish beyond the funding period and have become integral aspects of the curriculum and the medical school.

Curriculum↗

PubMed1996

Intervention research: a model from the National Cancer Institute's Smoking and Tobacco Control Program.

Recognizing that the scientific method is as critical to cancer control as it is to basic laboratory research, the National Cancer Institute (NCI) established a well-defined, systematic strategy for attaining its cancer control goals and objectives. This strategy, operationalized in the early 1980s as a five-phase process, emphasized cancer control as a research science rather than a demonstration science. The five phases of NCI's cancer control research strategy progress from hypothesis development, to methods development, to controlled intervention trials, to defined population studies, and finally to demonstration and implementation programs. This research base provides the foundation for nationwide prevention and health services programs. The application of this five-phase approach to NCI's efforts to reduce morbidity and mortality attributable to tobacco use is described, and some of the challenges that faced the Institute in this process are identified. These experiences provide an important framework for other disciplines faced with the challenge of translating science into practice.

Controlled Clinical Trials as Topic↗