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Background: Moving the latest evidence from research into nursing practice remains a challenge. We are only beginning to recognize the processes involved and little is known as to which approaches are effective in different contexts. Facilitation is an intervention that involves helping practitioners recognize what it is they need to change in practice and how to make these changes to incorporate evidence into practice. Objective: To describe the role, function, and practice of facilitation in moving evidence into nursing practice. A secondary element is to determine if a provisional facilitation framework, developed to reflect the concept in guideline adaptation and the early stages of implementation, accurately depicts facilitation in the context of actual implementation. Methods: The thesis employs an emergent mixed-methods design and is composed of two phases each with multiple components. The first phase explores the conceptual, theoretical, and experiential foundations of facilitation and examines: (1) how the concept has evolved over 16 years in a comprehensive literature review, (2) facilitation as described by experienced nurses in guideline implementation, and (3) how facilitation relates to other guideline implementation interventions in a review of studies included in an existing systematic review. The second phase describes the practical foundations of facilitation and follows the facilitation occurring naturally over time in a guideline implementation involving front-line nurses at the point of care. Results: The comprehensive review provides a description of how facilitation has evolved and presents a current synopsis of the state of knowledge regarding facilitation. The conceptual, theoretical, and empirical understandings of the concept were integrated with the practical foundations to confirm and refine the framework to reflect facilitation across the continuum from guideline adaptation to implementation. The revised framework is displayed and represents a comprehensive view and understanding of facilitation of evidence-based practice in nursing from multiple perspectives. Conclusions: The detail in the revised framework provides a useful guide for practitioners and organizations in planning for change. Further testing is required to determine its applicability and usability in the practice setting. / Thesis (Ph.D, Nursing) -- Queen's University, 2013-09-29 23:34:20.869

UNIVERZITA KARLOVA V PRAZE FAKULTA TĚLESNÉ VÝCHOVY A SPORTU Objektivizace svalového napětí při použití kinesiotapingu pomocí myotonometru Diplomová práce Vedoucí diplomové práce: Vypracovala: PhDr. Petr Šifta, PhD. Bc. Kristýna Fleišmanová Praha, duben 2012 2 Prohlašuji, že jsem diplomovou práci zpracovala samostatně a že jsem uvedla všechny použité informační zdroje a literaturu. Tato práce ani její podstatná část nebyla předložena k získání jiného nebo stejného akademického titulu. V Praze, dne …………………… …..…………………… Bc. Kristýna Fleišmanová 3 EVIDENČNÍ LIST KNIHOVNY Souhlasím se zapůjčením své diplomové práce ke studijním účelům. Uživatel svým podpisem stvrzuje, že tuto diplomovou práci použil ke studiu a prohlašuje, že ji uvede mezi použitými prameny. Jméno a příjmení: Fakulta / katedra: Datum vypůjčení: Podpis: 4 Děkuji PhDr. Petru Šiftovi, PhD. za cenné rady, připomínky a podněty, které mi pomohly orientovat se v dané problematice, a tak ulehčily a zkvalitnily zpracování této diplomové práce. 5 ABSTRAKT Název: Objektivizace svalového napětí při použití kinesiotapingu pomocí myotonometru Cíle práce: Cílem této diplomové práce je shrnout teoretické poznatky týkající se dané problematiky a vypracovat pilotní studii zaměřenou na ověření facilitační a inhibiční funkce v kinesiotapingu. Experiment má na...

Muitos estudos vêm comprovando a importância das interações positivas sobre a distribuição e diversidade das espécies em comunidades de plantas. Interações positivas e negativas ocorrem simultaneamente e o efeito líquido de uma espécie sobre a outra é o produto dessas interações combinadas. O principal objetivo do presente trabalho foi avaliar se leguminosas fixadoras de nitrogênio facilitam outras espécies arbóreas em um ambiente com baixa disponibilidade desse recurso. Para isso, estudamos o efeito da presença de leguminosas sobre a densidade de espécies e indivíduos pertencentes a dois estratos (DAP > 1 cm e 1 ; DAP ; 10 cm) em seu entorno, bem como os padrões de associação espacial entre as leguminosas e outras espécies arbóreas na área de estudo, utilizando uma abordagem com modelos nulos. Os resultados obtidos foram dependentes da espécie de leguminosa considerada. No capítulo 1, a leguminosa Balizia pedicellaris (DC.) Barneby & J.W.Grimes apresentou maior densidade de espécies em seu entorno, em ambos os estratos, embora não tenha ocorrido efeito sobre a densidade de indivíduos. A espécie Ormosia arborea Harms não apresentou efeito sobre a densidade de espécies nem de indivíduos em seu entorno. A espécie Andira anthelmia (Vell.) J. F. Macbr. apresentou um efeito negativo sobre a densidade de espécies e indivíduos do estrato superior (1 &#8804 DAP ≥ 10 cm), contrariando a nossa hipótese de trabalho. No capítulo 2, os padrões de associação espacial também foram distintos entre as espécies de leguminosas, com diferenças na identidade das espécies associadas, bem como no tipo de associação (positiva ou negativa). Os resultados indicam que, apesar de pertencerem ao mesmo grupo funcional, as leguminosas influenciam diferentemente as espécies em seu entorno, dependendo de suas características morfológicas e fisiológicas, como a capacidade de fixar nitrogênio em determinado sistema ou até mesmo de produzir compostos alelopáticos. / Many studies have been proving the importance of positive interactions to the distribution and diversity of species in plant communities. Positive and negative interactions occur simultaneously and the net effect of a species on another is the product of these combined interactions. The objetive of the present study was to evaluate if nitrogen fixing legumes facilitate other tree species in a nitrogen poor environment. We studied the effect of the presence of legumes on the density of species and individuals belonging to two different layers (DBH > 1 cm and 1≤ DBH ≥ 10 cm) around them and also patterns of spatial association between the legumes and other tree species, using a null models approach. The results obtained were dependent on the legume species considered. In chapter 1, the legume Balizia pedicellaris (DC.) Barneby & J.W.Grimes presented higher species density around it, for both layers, although there was no effect on the density of individuals. The species Ormosia arborea Harms did not present effect on the density of species and individuals around it. For the first layer Andira anthelmia (Vell.) J. F. Macbr. did not show effect on the densities, but this species presented a negative effect on the density of species and individuals of the upper layer (1 ≤ DBH ≥ 10 cm), in opposition to our hypothesis. In chapter 2, the spatial association patterns were also distinct between the legume species that showed different species identity associated and different kinds of association (positive or negative). The results indicate that, in spite of belonging to the same functional group, the legumes influence the species around them differently, depending on their morphological and physiological characteristics, as the ability to fix nitrogen in some systems or even the ability to produce alellopathic compounds.

Magister Philosophiae - MPhil / It is necessary to improve on Africa poor and stagnated share of the global trade and to attract bigger share of the global investments funds to meet the growing developmental challenges. The bottlenecks at the borders of most countries have made Africa the continent with the highest cost of trade. This has worsened the competitiveness of the continent’s economy thereby imparting its ability to draw full benefits from the global trading system. The introduction of simpler trade procedures is expected to lower trade costs and boosts flows of goods among African countries and with the global community. It is imperative then to explore frameworks for innovative trade facilitating instruments within the ambits of the multilateral trading system to enhance intra-African trade. The idea is to evolve an Afrocentric framework that will not precipitate retaliatory measures from the trading partners. This study encourages African countries policy makers to avail themselves of the concessionary provisions in the WTO agreement to design a targeted trade facilitation framework. It is posited that an Afrocentric trade facilitation legal and regulatory policies are necessary to improve African countries capabilities to trade more with each other and with other countries at similar stage of development. This must be structured to specifically facilitate intra-Africa trade via the development of regional or sectoral competitive advantages rather than the multilateral trade facilitation protocols that is targeted to boost African trade with the international partners. A mega-regional trade agreement that will facilitate intra-African trade in the specific sectors and then use the bigger economies of scale to develop competitiveness on the global stage, is proposed. Based on the continent abundant agricultural and natural resources, and the huge and growing young populations, it is found that investments in value creating manufacturing industries in the agricultural, power and the transport sectors as well as the service sectors were found to hold the biggest potentials. This is necessary to generate large jobs and employment opportunities and diversify exports. In these sectors, region-owned companies in each sub-region to be complemented with private investors are being proposed. This is necessary due to the huge resources outlay and the poor margin that will not encourage private investors to commit into this sector. To protect the companies being proposed without precipitating retaliatory actions by the trading partners, Article XXIV, the Enabling Clause and the contingent trade protection measures as contained in Article XIX of the GATT Agreement (the safeguard measures and the subsidies and countervailing measures) were presented to be sufficient.

This thesis explores the quality and sustainability of facilitated co-operative processes in organisations, and the difficulties and opportunities associated with this way of working. Three complementary research methods have been used: a survey, an Internet dialogue and a co-operative inquiry of facilitators, managers and academics. The survey revealed that facilitators have diverse and sometimes contradictory approaches to their organisational work, co-operative processes are not easy to sustain within hierarchical organisations, and that facilitator ethics need clarification. The development of a Statement of Values and Code of Ethics by the International Association of Facilitators formed the content for the Internet dialogue part of this research. The co-operative inquiry highlighted that sustainable co-operation depends on embodied whole people connecting with love and compassion, and with the commitment and courage to speak their own truth and deeply engage with the collective wisdom of the group. It is shown that co-operative organisational forms, methods, processes, values and ethics are only part of what is needed to support co-operative endeavour. Underpinning all of these are ways of being that are learnt through modelling and mutually supportive interactions between persons in relationship. These ways of being need to be transmitted along with conceptual frameworks, processes and methods for ‘co-operacy’ to be sustainable in groups and organisations / Doctor of Philosophy (PhD)

Increased knowledge of plant interactions is important for our understanding of how ecosystems will respond to climate changes. Using four common low-herb and three tall- herb species as phytometers I measured the net outcome of plant interactions in an alpine environment by a neighbour removal experiment. Grazing and climate were tested as explanatory factors for differences in the outcome of plant interactions, with two altitudes representing different climates. The most important finding in this experiment is that competition is the dominating interaction among plants in this habitat, regardless of plant size, climate and grazing. Climatic exposure and grazing only influenced tall-herb species while low-herbs were mainly limited by competition, presumably for light. These results are important since facilitative interactions and net facilitation in plant communities are often reported to become more common in severe climates.

The respiratory system is attentive, adaptive, learns and has memory. The respiratory system remembers repeated respiratory challenges to fine tune its motor activity by modulating neuronal synaptic strength. This phenomenon, respiratory long term facilitation (LTF), functions to strengthen the ability of respiratory motor neurons to enhance contraction of breathing muscles. LTF could serve as a protective mechanism against obstructive sleep apnea, a disease characterized by the collapse of upper airways, by restoring upper airway patency. LTF can be induced through modulation of vagal afferent feedback via repeated apneas. Here, we used reverse microdialysis, electrophysiology, neuropharmacology, and histology to determine if the nucleus of the solitary tract (NTS), a brain region exclusively receiving vagal afferents, is the origin of the neural circuit responsible for apnea-induced plasticity. My work shows bilateral injection of 5% lidocaine into the NTS prevented LTF. We conclude the NTS is required for triggering apnea-induced LTF.

The respiratory system is attentive, adaptive, learns and has memory. The respiratory system remembers repeated respiratory challenges to fine tune its motor activity by modulating neuronal synaptic strength. This phenomenon, respiratory long term facilitation (LTF), functions to strengthen the ability of respiratory motor neurons to enhance contraction of breathing muscles. LTF could serve as a protective mechanism against obstructive sleep apnea, a disease characterized by the collapse of upper airways, by restoring upper airway patency. LTF can be induced through modulation of vagal afferent feedback via repeated apneas. Here, we used reverse microdialysis, electrophysiology, neuropharmacology, and histology to determine if the nucleus of the solitary tract (NTS), a brain region exclusively receiving vagal afferents, is the origin of the neural circuit responsible for apnea-induced plasticity. My work shows bilateral injection of 5% lidocaine into the NTS prevented LTF. We conclude the NTS is required for triggering apnea-induced LTF.

This study explored the experience of engaging in reflective practice through the framework of Levelising. Reflective practice has been of interest to professionals and educators of professionals for many years. However, Levelising is a recently introduced approach. Levelising categorizes the reflective process into four modes. These modes include an awareness of what is occurring (Level I), considering one’s actions (Level II), considering one’s conceptual frame (Level III), and considering the conceptual frames of others (Level IV). This study focuses on my personal experience of improving my facilitation using Levelising as a framework for reflective practice. The context of the study was a professional development workshop conducted over a nine-week period with 10 participants attending. This study was conducted as action research in the form of an autoethnography. I kept a reflexive journal of my workshop experiences and used the journal entries to reflect after each workshop session. My reflections were the data I used to study my use of Levelising to improve my facilitation practice. I engaged in on-going formative analysis during the course of the workshop. A summative analysis was performed following the conclusion of the workshop to identify how engaging in Levelising as a framework for reflections informed the decisions I made to improve practice. Findings indicated that the use of Levelising in my reflection on practice increased my awareness of aspects of my facilitation that needed to be changed. Levelising revealed differences in my espoused theories and theories in practice. I became more aware of the need to question my assumptions, values, beliefs, and biases prior to, during, and following facilitation experiences.