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Child maltreatment (CM) is a major public health problem in the United States which affects millions of children each year. Because parents are responsible for the majority of substantiated CM reports, behavioral parent training is recommended as the primary prevention strategy. In recent years, researchers and clinicians have begun work examining the relevance and effectiveness of making cultural adaptations to parent training programs. The purpose of this study was to explore the need for systemic cultural adaptations to SafeCare®, an evidence-based parent-training child maltreatment prevention program. SafeCare is currently implemented in nine states and SafeCare providers are serving families representing a wide array of cultures and ethnicities. Eleven SafeCare providers, representing six states, participated in individual, semi-structured interviews to determine what, if any, cultural adaptations were in place in the field and whether there was a need for systematic culture-specific or general cultural adaptations to the SafeCare model. The interviews provided evidence that, across sites and populations, adaptations are being made when implementing SafeCare with diverse families. Providers expressed a need to make the language/reading levels of the model materials more relevant for all the populations served. Overall, however, providers found the model to be flexible and amenable to working with families of various cultures and ethnicities. Providers recommended against systematic adaptations of the model for specific ethnic groups.

Knowledge is a critical element for the provision of quality health care. Optimal clinical decision making incorporates multiple types of knowledge including patient knowledge, clinical experiential knowledge and research knowledge. Understanding how knowledge is shared and used in best practice is challenging as a number of factors can facilitate or impede the process. Several authors have highlighted the value of using a theoretical framework when examining knowledge in health care. A theoretical framework provides direction for the generation and testing of hypotheses which can contribute to building a comprehensive body of knowledge in a field of study. Although the majority of knowledge exchanged in practice settings occurs between clinicians, current knowledge exchange and utilization models in health care generally focus specifically on the exchange of research knowledge between the scientific community and the practice community. Acknowledging and understanding the knowledge seeking and sharing behaviours of clinicians is a key element in the larger knowledge translation puzzle. Emergency medicine is a clinical speciality where there is evidence of a knowledge to practice gap, however, there is limited understanding of the factors that contribute to the gap. Emergency practitioners must make decisions in a busy and often chaotic environment that is prone to multiple interruptions and distractions. The challenge for consistent and quality care is also more pronounced in rural and some suburban areas where emergency care needs are similar but resources are limited. The purpose of this program of research is to identify factors relevant to knowledge exchange and utilization in rural and urban emergency departments with the aim of developing a Model for Knowledge Exchange and Utilization in Emergency Practice. A series of studies were carried out using a mixed method research design to further develop and describe 3 key dimensions (individual, context of practice, knowledge) which were identified through a review of the literature. Data was collected using surveys, participant observations and interviews with nurses and physicians working in rural and urban emergency departments in Nova Scotia. Triangulation of results across the studies contributed to developing a comprehensive and rigorous description of the 3 dimensions of interest.

Due to the complicated nature of medical information needs, the time constraints of clinicians, and the linguistic complexities and sheer volume of medical information, most medical questions go unanswered. It has been shown that nearly all of these questions can be answered with the presently available medical sources and that when these questions get answered, patient health benefits. In this work, we design and describe a framework for Evidence-Based medical information research and delivery, MedicInfoSys. This system leverages the strengths of knowledge-based workers and of mature knowledge-based technologies within the medical domain. The most critical element of this framework, is a search interface, PifMed. PifMed uses gold-standard MeSH categorization (presently integrated into medline) as the basis of a navigational structure, which allows users to browse search results with an interactive tree of categories. Evaluation by user study shows it to be superior to PubMed, in terms of speed and usability.

No description available.

This thesis aims to explore how medical social workers/counselors perform their work with people during crisis and how they accumulate and practice scientific crisis knowledge. This study is an empirical research paper based on qualitative interviews conducted with eight medical social workers. The data was analysed with Kvales model for categorization, which constitutes the basis of the research. The results of the research was then analysed with the use of Cullbergs crisis theory and a model of evidence based practice which is described by Topor and Denhov. The results show that the medical social workers practice the evidence based practice model, described by Topor and Denhov, in combination with Cullbergs crisis theory. The medical social workers acknowledged the individuals’ experiences in their work as well as their own experiences and scientific knowledge. Our conclusion is that the practice of medical social workers/counselors is varying, depending on the varying needs of the individuals. The social workers/counselor accumulates most knowledge through their own and the individuals’ experiences, but also from scientific crisis evidence.

<p>This was a cross-sectional study done in Lagos, Nigeria on 114 dentists. The aim of the study was to describe the knowledge and attitudes of dentists towards the concept of evidence-based dentistry (EBD). This study also attempted to create an awareness of this concept in the minds of previously uninformed dentists as well as demonstrate its need in continuous professional education via seminars, updates, lectures and short-term courses in Lagos, Nigeria.</p>

The need to utilize research in decision making is considered critical in the present health care environment. For health research to be applied, it must have value. However, the question of the value of research has not been fully explored in the literature. The purpose of this study is to gain an understanding of occupational therapists’ perceptions of the value of research. Semi-structured interviews were completed in Winnipeg, Manitoba with 10 occupational therapists. The four themes in the study influencing their perceptions of the value of research were their experiences with research, the purpose of research, the resources to support research and the clinician and researcher culture. A number of elements were identified which may have informed the occupational therapists’ perceptions of the value of research. Having an understanding of the elements that may influence the perceptions of the value of research may assist with developing effective research utilization programs.

This thesis seeks to acknowledge the issues and challenges, as well as the opportunities and successes that continue to present for Māori learners accessing special education services in Aotearoa New Zealand. Year after year, strategic educational documents, policies and services are revisited, reviewed or restructured in order to effect a series of considered and realistic responses that are able to address the inequities that perpetuate for Māori learners. Discussions and debates specific to what needs to change, how this should be done, and who has the authority to decide, continue to be had. Perceptions vary between interested groups about the relevance and appropriateness of much of the research evidence that is drawn on to inform special education policy and practice directions for use with Māori learners. This research study investigates two key special education constructs; culturally responsive practice, and evidence based practice. The overall aims are to ascertain what Māori perceive to be the key components that comprise both of these individual terms; to determine if (and how) they are dissimilar or synonymous terms from a Māori perspective; and, to understand how these perceptions differ or are in tandem with special education (western) thinking. It is argued that these terms are regularly defined for Māori by non-Māori, without input or consultation from the former, and that this (in effect) perpetuates a cycle of special education service provision that is unable to respond adequately to, or connect culturally with, Māori realities. The scene is set wherein a three-circle evidence based practice framework that has been adopted by special education is used (in tandem with the Māori concept of mana), as the structure for selecting the research participants; all of whom are Māori / Māori affiliated. It is my contention that a range of Māori perspectives that are reflective of all of the three types of evidence that special education acknowledges is a worthy starting point for determining parallels and distinctions. From the three evidence domains of research, practice, and whānau, 18 leaders share their respective and collective knowledge, expertise, thoughts and wisdom about the two key constructs. What transpires throughout this study is the emergence of six strong components that are unanimously privileged by these leaders as critical to culturally responsive evidence based special education practice for Māori tamariki and whānau. These components are then drawn on to uncover a range of kaupapa Māori frameworks that are reflective of the participants’ discourses.

Child maltreatment (CM) and unintentional childhood injury affects millions of children and cost society billions of dollars annually. The population at risk for CM has congruent demographic characteristics as children that are more likely to have unintentional injuries. Preventing CM through evidence-based home-visiting programs has been shown effective and cost efficient, and the inclusion of home safety in such programs, demonstrates significant reduction of hazards in the home. The overarching goal of the current research is to make a statistical connection between the population at risk for CM and amount of hazards in the home; that these two populations have enough overlap to validate the inclusion of home safety components in CM prevention programs. This study uses data from an ongoing research project that braids two evidence-based parenting programs: SafeCare® and Parents as Teachers. Findings indicate that the correlation between potential for abuse, measured by BCAP scores, and hazards in the home, measured by the HAPI, show a significant correlation r = .23, p < .05. Other variables such as loneliness, distress, and marital status were also found to contribute to this relationship.