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To construct an evidence-based practice programme for the nutrition management of older adults in nursing homes. The programme will provide a basis for improving or solving the nutrition management problems of older adults in nursing homes.
Design:
The study is based on guideline evidence and Delphi method. The evidence was comprehensively searched, assessed and summarized, and the best evidence and a preliminary programme for nutrition management of older adults in nursing homes were aggregated. Then, the Delphi method was used to assess the applicability of the preliminary programme and the obstacle factors to modify, supplement and improve the nutrition management programme.
Setting:
Baseline survey data were collected from three nursing homes in Ningxia, China, and guideline evidence was obtained through systematic searches of the Cochrane Library, PubMed and other scientific databases, as well as relevant official websites.
Participants:
A total of 350 older adults residing nursing homes and 160 nurses participated in the baseline survey. To ensure the programme’s applicability and identify potential implementation obstacles, fifteen experts from local grade A hospitals, nursing homes and community health centres were consulted for review.
Results:
A fourteen-item, fifty-six-best-evidence nutrition management programme for older adults in nursing homes was developed based on five guideline evidences and baseline survey findings.
Conclusions:
This is a systematic and comprehensive nutritional management programme for older adults in nursing homes based on guideline evidence, which can provide a standardised basis for the implementation of scientific nutritional management in nursing homes in Ningxia. Managers should promote the translation of evidence into practice in accordance with the specific circumstances of individual nursing homes.
This chapter reviews the role of evidence-based practice (EBP) when providing clinical services to LGBTQ+ youth and adults. Evidence-based practice integrates three domains: the best available research evidence, clinical judgment, and patient characteristics, values, and contexts. Each of these domains is discussed in detail in the chapter. The chapter proceeds to review the adaptation of EBPs to be LGBTQ+ affirmative and cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based cognitive therapy as effective evidence-based interventions for mental and behavioral health concerns with LGBTQ+ individuals. Additionally, the chapter provides evidence-informed considerations for addressing self-acceptance, self-esteem, and career-related concerns in counseling for LGBTQ+ individuals. Evidence for group modalities with LGBTQ+ individuals is also provided. Lastly, the chapter provides a resource table outlining how to best integrate affirmative care and EBP when working with LGBTQ+ individuals, along with a clinical case study.
This final chapter revisits all the issues discussed in the textbook in light of their applicability to the real classroom, that is, the relationship between research and practice. It argues for the importance of considering the usefulness of research if and when a researcher hopes to influence classroom teaching via their research. The chapter begins with a description as to how research in general is connected to our daily lives (e.g., medicine, engineering, education). It then overviews the research examining the impact of research on educational practices including second language teaching. Practical and epistemological obstacles to bridging the research–practice gap from practitioners’ and researchers’ sides are discussed. The chapter proposes a variety of actions that practitioners and researchers can take in order to foster a bidirectional, constructive, productive, equitable, and mutually beneficial relationship. The chapter ends with a series of activities designed to ensure the learning outcomes from the textbook.
eHealth development faces the challenge of generating evidence about health effectiveness in real-world settings. Designers can potentially support this challenge but must understand health approaches to evidence generation about health outcomes. This case study investigates how health and care professionals conceptualise health outcomes and their evidence generation in eHealth. Our results identify three key conceptual dimensions: effect, meaning, and collection. We discuss how these inform future design competencies to support evidence generation about health outcomes in eHealth design.
Acculturative stress is a key social driver of health impacting the mental health of immigrants and refugees from Latin America, which contributes to inequities experienced by them. While there is a robust scientific literature describing and evaluating evidence-based treatments targeting a range of psychiatric disorders, these treatments often do not primarily target acculturative stress. Thus, the present study examined how psychotherapists ought to treat acculturative stress directly in their clinical practice. Ten therapists were interviewed using a qualitative descriptive approach. Rapid contemporary content analysis was used to describe Latino/Hispanic immigrants’ most common presenting problems, the context in which they provide care for these problems, and the psychotherapeutic approaches currently utilized or considered effective in mitigating acculturative stress. Findings revealed that common mental health conditions that therapists addressed among this population, including depression, anxiety and trauma-related somatization, including the unique context in which therapy was delivered. Additionally, specific strategies for addressing acculturative stress such as the importance of acknowledging this stressor, drawing out immigration journey narratives, and behavioural activation approaches were shared. The results from this study can be used to improve the effectiveness of mental health interventions addressing acculturative stress among immigrant and refugee populations.
Key learning aims
(1) To explore how acculturative stress represents a key driver of mental health for immigrants and refugees from Latin America.
(2) To consider ways that cognitive behavioural therapy (CBT) elements can be applied to treating acculturative stress and mental health problems among immigrants and refugees from Latin America.
(3) To expand upon strategies that can be helpful in rapport-building and establishing trust with patients who are struggling with acculturative stress.
To determine the level of awareness of health technology assessment (HTA) and its predictors among clinical year medical students in public universities in Klang Valley, Malaysia.
Methods
A cross-sectional study using the stratified random sampling method was conducted among clinical year medical students in four public universities in Klang Valley, Malaysia. Data on the level of awareness of HTA and its associated factors were collected using a self-administered online questionnaire. Descriptive, bivariate, and multivariate analyses were performed using IBM SPSS version 27 to determine the level of awareness of HTA and its predictors.
Results
Majority (69 percent) of participants had a low level of awareness of HTA. The predictors of high-level awareness of HTA were attitude toward HTA (adjusted odds ratio (AOR) = 7.417, 95 percent confidence interval (CI): 3.491, 15.758), peer interaction on HTA (AOR = 0.320, 95 percent CI: 0.115, 0.888), and previous training on HTA (AOR = 4.849, 95 percent CI: 1.096, 21.444).
Conclusions
Most future doctors in public universities exhibit a low awareness of HTA. This study highlights the interplay between attitudes toward HTA, peer interaction, and previous training as influential predictors of HTA awareness. An integrated and comprehensive educational approach is recommended to cultivate a positive attitude and harness the positive aspects of peer interaction while mitigating the potential negative impact of misconceptions. Emphasizing early exposure to HTA concepts through structured programs is crucial for empowering the upcoming generation of healthcare professionals, enabling them to navigate HTA complexities and contribute to evidence-based healthcare practices in Malaysia and beyond.
The purpose of this study is to focus on changes in anxiety symptoms among women treated in women’s health practices and under a collaborative care model.
Background:
Research on collaborative care has largely focused on improving depressive and anxiety symptoms among adults in primary care settings. The applicability of collaborative care in other healthcare settings is underreported with limited research investigating if collaborative care has advantages in subpopulations treated in both traditional primary care settings and other healthcare settings, such as women’s health practices.
Methods:
This study, completed through secondary data analysis of the electronic record of N = 219 women across three women’s healthcare centers, evaluated if instituting a collaborative care model is associated with reduced anxiety symptoms and which factors (eg, primary diagnosis, duration of care, and use of psychotropic medications) are associated with anxiety outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) at entry into and at termination from collaborative care services.
Results:
Overall, there was a significant reduction in average anxiety scores from baseline to termination of collaborative care (t(218) = 12.41, P < 0.001). There was a main effect for the duration of time receiving collaborative care services on anxiety score reduction (β = −0.28, SE = 0.06, P < 0.001) with a significant reduction in anxiety symptoms at the 90-day mark (t(218) = 10.58, P < 0.001). Therefore, collaborative care can be useful in women’s health practices in reducing anxiety symptoms over a 90-day time period.
Maintaining a healthy weight during pregnancy is critical for both women's and children's health. Excessive gestational weight gain (GWG) can lead to complications such as gestational diabetes, hypertension and caesarean delivery. Insufficient GWG can cause fetal growth restriction and increase infant mortality risk. Additionally, postpartum weight retention raises risk of obesity, type 2 diabetes and other chronic diseases for both mother and child. This review seeks to identify current obstacles in weight management research during and after pregnancy and explore evidence-based strategies to overcome them. Pregnancy offers a window of opportunity for health behaviour changes as women are more receptive to education and have regular contact with health services. Staying within Institute of Medicine's recommended GWG ranges is associated with better maternal and fetal outcomes. Systematic review evidence supports structured diet and physical activity pregnancy interventions, leading to reduced GWG and fewer complications. Health economic evaluation indicates significant returns from implementation, surpassing investment costs due to decreased perinatal morbidity and adverse events. However, the most effective way to implement interventions within routine antenatal care remains unclear. Challenges increase in the postpartum period due to competing demands on women physically, mentally and socially, hindering intervention reach and retention. Flexible, technology-supported interventions are needed, requiring frameworks such as penetration-implementation-participation-effectiveness and template-for-intervention-description-and-replication for successful implementation. Greater research efforts are necessary to inform practice and investigate fidelity aspects through pragmatic implementation trials during the pregnancy and postpartum periods. Understanding the best ways to deliver interventions will empower women to maintain a healthy weight during their reproductive years.
This chapter explores two experiences in which transformative agency and the elaboration of innovative mediating artifacts contributed to change in childbirth care in Brazil. In the first case, we analyze how an organized group of women built cultural tools to expose the excess of cesarean sections in the private health sector, leading to change in regulatory policy. In the second case, we analyze the elaboration of an institutional birth plan model in a formative intervention inspired by the Change Laboratory methodology. Both experiences can be understood as efforts to promote social participation and informed choice, using mediating artifacts to foster agency. The processes ignited by them are also analyzed by the perspective of pedagogy of autonomy as proposed by Freire, in the sense that women are able to build knowledge and act on that knowledge in a meaningful and effective way.
Many of the larger employers in this country and abroad have benefited from industrial-organizational (I/O) psychologists’ evidence-based practice. However, charitable and not-for-profit organizations have not always been aware of our services or able to afford them when cognizant of them. Volunteering professional services to charitable organizations provides an opportunity to extend these benefits. In addition, volunteers reap the intrinsic rewards of service, acquire opportunities to hone their skills, and learn from others, and pro bono work has the potential of informing our understanding of the science and practice of I/O psychology. This paper provides five case studies from five I/O psychologists who share their volunteer experiences in their own words. Each case study describes what the I/O psychologist did for the organization, how he or she became involved, and what he or she got out of the experience and learned. The paper offers ways SIOP and the SIOP Foundation might facilitate volunteer activities and concludes by inviting readers to share their own volunteer experiences and suggestions for encouraging volunteer work.
To assess the alignment of YouTube® videos providing dietary recommendations for gout with evidence-based guidelines targeted at the United Kingdom (UK) population and to establish their quality.
Design:
A content analysis of YouTube® videos providing dietary recommendations for gout was undertaken. Videos were categorised by video source. Each video’s dietary recommendations for gout were compared with three evidence-based guidelines for gout, producing a compliance score. Presence of non-guideline advice was assessed. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool for Audio-Visual Materials. Reliability was assessed using an adapted-DISCERN tool and educational quality using the Global Quality Score Five-Point Scale. Differences between video source and continuous variables were assessed using one-way Kruskal–Wallis H tests. For categorical variables, associations were investigated using Fisher–Freeman–Halton tests.
Setting:
Online, May–June 2020.
Participants:
One-hundred thirty-one videos.
Results:
Alignment of videos with evidence-based guidelines was poor (median compliance score 27 % (interquartile range 17–37 %)). Additionally, 57 % of videos contained non-guideline advice. The health professional source group had the fewest videos containing non-guideline advice, but this was only significantly lower than the naturopath group (31 % v. 81 %, P = 0·009). Almost 70 % of videos were considered poorly actionable and 50 % poorly understandable. Most videos were rated poor for reliability (79 %) and poor to generally poor for educational quality (49 %).
Conclusions:
YouTube® videos providing dietary recommendations for gout frequently fail to conform to evidence-based guidelines, and their educational quality, reliability, understandability and actionability are often poor. More high-quality, comprehensive, evidence-based YouTube® videos are required for UK gout patients.
Evidence-based practices play an essential role in the development of eHealth systems. Prior research has investigated the challenge of shared understanding between professionals from the fields of health sciences and design and has highlighted the need for effective alignment of development and research practices in eHealth. However, there is a limited understanding of epistemological differences between these fields and how professionals conceptualise evidence. In this paper, we investigate how healthcare and design professionals think about evidence and how they implement evidence practices in their work. We interviewed eight professionals and used reflexive thematic analysis to identify the challenges and strategies associated with their evidence practices. Our results identify five shared evidence practices between healthcare and design professionals: stakeholder-driven, process-driven, problem-driven, effect-driven, and solution-driven. These five evidence practices indicate opportunities for closer alignment of development and research practices among healthcare and design professionals and offer a basis to create a shared understanding of evidence between both fields.
Edited by
David Weisburd, Hebrew University of Jerusalem and George Mason University, Virginia,Tal Jonathan-Zamir, Hebrew University of Jerusalem,Gali Perry, Hebrew University of Jerusalem,Badi Hasisi, Hebrew University of Jerusalem
Evidence-based policing requires not only the production of high-quality research but also the implementation of those research findings as part of a police organization’s work. To date, there has been relatively limited empirical assessment of how to best achieve successful implementation. This chapter presents findings from the process evaluation of the EMUN reform in the Israel Police. The reform institutionalized several evidence-based policing approaches and has been demonstrated as effective in reducing and preventing crime. Our qualitative analysis uncovered three themes associated with a heightened capability to practice evidence-based policing: the ability to analyze data and reflect on it, organizational flexibility, and local engagement with the reform. These themes resonate with the existing literature in the field and are of broad relevance.
Avoidant Restrictive Food Intake Disorder (ARFID) is a condition characterised by a disturbance in eating behaviour that leads to a significant negative impact on physical, social and nutritional health. The diagnosis of ARFID relies on a comprehensive, multi-disciplinary assessment to understand the individual’s history, physical, social and mental health risk, and any co-occurring mental health difficulties. Consensus guidance suggests that psychological treatment, alongside medical and dietetic input is delivered with consideration of any appropriate adaptions to accommodate developmental stage and/or common co-occurring presentations. This paper has been authored by clinicians working in an out-patient setting for children and adolescents with ARFID, and focuses on the presentation and assessment of ARFID and cognitive behavioural therapy (CBT) approaches that can help children, young people and their families. After an introductory section, the paper is split into four sections: assessment of ARFID; drivers of avoidant restrictive eating behaviour; multi-disciplinary formulation and intervention planning; and treatment. The treatment section provides an overview of the available research on CBT for ARFID, and a brief summary of the broader evidence base for CBT in children and young people with anxiety. Following a review of the evidence base, three case descriptions are provided to illustrate the clinical application of CBT where fear-based avoidance is the main driver. The paper concludes with practice points for clinicians to take forward when working with children and young people with ARFID.
Key learning aims
(1) To be aware of the international consensus for the use of psychological interventions as a component of ARFID treatment alongside medical and dietetic input.
(2) To understand that ARFID is characterised as a disturbance of eating behaviour, and as such, psychological intervention should target the drivers of this disturbance to promote behavioural change.
(3) To gain an overview of the multi-disciplinary team assessment as an important tool to understand the contribution of each of the three drivers proposed to underpin an ARFID presentation.
(4) To recognise when a CBT approach might be indicated, the current best evidence base for CBT for ARFID and how to adapt CBT to accommodate developmental stage and/or common co-occurring presentations.
This paper investigates how socio-spatial aspects of creativity, operationalized as the causal relations between the built environment and perceived creativity in university campuses’ public spaces, are currently applied in practice. Moreover, it discusses practitioners’ perceptions regarding research-generated evidence on socio-spatial aspects of creativity according to three effectiveness aspects: credibility, relevance, and applicability. The “research-generated evidence” is herein derived from data-driven knowledge generated by multi-disciplinary methodologies (e.g., self-reported perceptions, participatory tools, geospatial analysis, observations). Through a thematic analysis of interviews with practitioners involved in the (re)development of campuses public spaces of inner-city campuses and science parks in Amsterdam, Utrecht, and Groningen. We concluded that socio-spatial aspects of creativity concepts were addressed only at the decision-making level for Utrecht Science Park. Correspondingly, while presented evidence was considered by most practitioners as relevant for practice, perceptions of credibility and applicability vary according to institutional goals, practitioners’ habits in practice, and their involvement in projects’ roles and phases. The newfound interrelationships between the three effectiveness aspects highlighted (a) the institutional fragmentation issues in campuses and public spaces projects, (b) the research-practice gap related to such projects, which occur beyond the university campuses’ context, and (c) insights on the relationship between evidence generated through research-based data-driven knowledge and urban planning practice, policy, and governance related to knowledge environments. We concluded that if research-generated evidence on socio-spatial aspects of creativity is to be integrated into the evidence-based practice of campuses’ public spaces, an alignment between researchers, multiple actors involved, policy framing, and goal achievements are fundamental.
Edited by
James Law, University of Newcastle upon Tyne,Sheena Reilly, Griffith University, Queensland,Cristina McKean, University of Newcastle upon Tyne
Research agendas in health and education are largely driven by professionals, resulting in a bias against the concerns of the participants in or receivers of the research. There is growing evidence of the positive influence of public and patient involvement (PPI) in research and within the field of language development and disorders, and there is increasing involvement of parents and children in research design and implementation. In this chapter, we discuss the importance of involving parents and children with language disorders in research and the facilitators and barriers to their involvement. The views of parents and children can redress bias in our research and provide balance to our evidence base. We argue that the voices of parents and children can inform our understanding of the social dimension of language development and disorder and shape the development of outcome measures that are valued and meaningful to children and their families. We also reflect on the contradictions in the professional discourse that reflect attitudes towards parents and children. We end with a consideration of how listening to parents and children might inform the study of language development and language disorder in large cohort studies and in the development and evaluation of interventions.
Research evidence in early childhood education and care underscores the importance of high-quality interactions between children and educators – be they teachers, childcare workers, parents or family members – for improving children’s outcomes. We know that rich conversations can support and extend children’s interests through language and attuned feedback, essential for children’s learning and development. The introductory chapter explained that while the importance of high-quality interactions is widely acknowledged in early childhood education, how this can be achieved deserves more attention. Every chapter in this book details particular types of talk between children, their peers and educators, where all authors use conversation analysis to achieve this goal. The aim of this chapter is to introduce and explain the fundamentals of the methodology of conversation analysis and how conversation analysis is ‘done’ so that readers can engage with the analysis and findings in the chapters that follow. We also draw attention to the usefulness of a conversation analysis approach in ECEC research and practice.
Autism spectrum disorder (ASD) is a neurodevelopmental condition that can affect a person’s ability to manage the complexities of varied social and environmental situations. This is particularly evident in the dynamic context of a school classroom. To assist students with ASD to navigate the complexities of Australian primary and secondary mainstream classrooms, educators are required to provide ‘reasonable adjustments’ to support learning; that is, to make changes that are practicable and achievable in order for students to access learning on the same basis as their peers. We present an argument that the ‘reasonable adjustments’ made by schools to ensure that students with ASD have equitable learning opportunities should meet a criterion of acceptability where the adjustment is evidence based. The paper also offers a summary of evidence-based pedagogical strategies that have been effective for students with ASD and concludes with a discussion offering evidence-based practices as a solution to meeting legislative requirements for students with disability.
Clinical psychology is at an exciting point in time. We describe the current state of clinical psychology, framing it in terms of a trajectory from the foundation of the scientist-practitioner model topresent developments. The chapter outlines how the how core competencies of clinical psychology practice are framed by the question, “How would a scientist-practitioner think and act?”We present a model of science-informed practice of clinical psychology and illustrate how this model allows individual practitioners to provide value for money in a competitive health care market indelibly shaped by the forces of accountability and cost containment. The model illustrates how the client is viewed through a lens of evidence-based literature and clinical experience, and how a clinical psychologist collaborates with a client in assessment, case formulation, treatment planning, process-informed treatment delivery, treatment measurement and monitoring, to permit evaluation and accountability. It concludes with a consideration of the perspectives of the key stakeholders, namely the client, the therapist and the broader society, and how these perspectives shape interest in the monitoring of effectiveness, efficacy and understanding of the mechanisms and processes responsible for mental health problems.
Clinical psychology trainees embarking on a professional career are faced with the prospect of work that, daily, has ethical questions and challenges to respond to people from varied cultures and social groups. The chapter describes how to provide a culturally-sensitive clinical psychology practice. It evaluates the current evidence-base antecedencesguiding practice. The chapter suggests how Structured Problem Solving can be applied to help acquire greater skills in engaging with people from different cultures and groups (e.g., the elderly). The same Structured Problem Solving approach is then applied to ethical decision-making and illustrated with a discussion on confidentiality and dual relationships. The chapter outlines how these approaches may help the clinical psychologist respect the humanity of their clients in all facets of their engagement.