Evidence Based Library & Information Practice (EBLIP) is a way of using the best research to solve practical problems in the library. This session will cover the fundamentals of EBLIP, along with possible applications. “Evidence-Based Librarianship is an approach to information science that promotes the collection, interpretation and integration of valid, important and applicable user-reported, librarian observed, and research-derived evidence. The best available evidence, moderated by user needs and preferences, is applied to improve the quality of professional judgements” (Booth & Brice, 2004). Evidence-Based Library and Information Practice (EBLIP) evolved from the evidence-based medicine (EBM) movement which is a systematic way to review and apply the medical literature to medical practice. EBM began to find its way into other health disciplines and eventually was applied to health sciences librarianship and then to librarianship as a whole.

Monitoring results is the final step that determines the impact of an evidencebased practice (EBP) decision. A variety of health outcomes can be expected to change following rehabilitation; therefore, outcome measures (OMs) are a major focus of EBP in rehabilitation. For instance, in patients with hand injuries, physiotherapy (PT) services focus on enabling patients to improve their functional use of the traumatized hand. Examining current practice of physiotherapists (PTs) in Saudi Arabia with respect to use of EBP and OMs can serve as a basis for understanding any identified gaps in knowledge before the full effect of translation and adoption of new patient self-reported outcomes (PROs) instruments can be seen in clinical practice. Therefore, this thesis was designed in two phases, incorporating two papers, to address EBP and PROs and their adoption in the evolving PT practice in Saudi. The first paper is a survey that aimed to determine the current self-reported attitudes, skills, and knowledge of PTs in Saudi Arabia toward EBP and outcome measures, including PROs. The second paper describes the process of crosscultural Arabic translation and adaptation of the Patient-Rated Wrist and Hand Evaluation (PRWHE) and reports estimates of the psychometrics properties of the translated measure. Finally, the thesis addresses overall areas of limitations and includes suggestions for future refinement and research in order to foster and facilitate EBP implementation in the cultural context of the evolving physiotherapy profession in the health systems of Saudi Arabia. / Thesis / Master of Science Rehabilitation Science (MSc)

Bakgrund: Övergången från student till kliniskt verksam innebär en stor omställning för hälso- och sjukvårdsprofessioner, men det finns bristfällig information om ämnet gällande fysioterapeuter i en svensk primärvårdskontext. Det finns också utmaningar med att implementera evidensbaserad praktik i ett fysioterapeutiskt arbete trots en positiv inställning. Syfte: Syftet var att kartlägga fysioterapeuters upplevelser i och med övergången från student till kliniskt verksam fysioterapeut inom primärvården under det första arbetsåret samt att undersöka möjligheter och utmaningar gällande evidens och dess implementering i arbetet. Design och metod: En kvalitativ studie genomfördes med fem semistrukturerade intervjuer av fysioterapeuter inom primärvården vilka rekryterats genom ett bekvämlighetsurval. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Elva kategorier identifierades. Sex rörande övergången i sig från student till kliniker (“Tiden som kritisk faktor för att komma in i jobbet”, “Arbetsgivarens förväntningar på nyutexaminerade kan både vara hindrande och stöttande”, “Kollegornas viktiga roll”, “Inre föreställningar kan både hjälpa och stjälpa”, “Kunskapsluckor som behöver fyllas”, “Att växa in i sin profession”) och fem kategorier rörande evidens och dess implementering (“Svårt att veta vad som ska implementeras”, “Förutsättningar från arbetsgivaren är avgörande”, “Kollegornas inflytande på den formbara fysioterapeuten” “Grundkunskaper och tankesätt för evidensbaserad praktik från utbildningen”, “Personliga egenskaper och erfarenheters inverkan på evidensbaserad praktik”). Konklusion: Resultaten belyser betydelsen av arbetsplats-, person- och utbildningsfaktorer från olika vinklar i både underlättande och utmanande bemärkelse. Faktorerna var bland annat kopplade till tid, kollegor, förväntningar från arbetsplatsen samt personliga erfarenheter och egenskaper. / Background: The transition from student to clinical practitioner represents a significant adjustment for healthcare professionals, but there is insufficient information about physiotherapists in a Swedish primary care context. There are also challenges in implementing evidence-based practice in physiotherapy despite a positive attitude. Purpose: To explore physiotherapists' experiences related to their transition from student to clinical practitioner in primary care during their first year of work and investigate opportunities and challenges regarding evidence and its implementation in practice. Design and method: A qualitative study was conducted with five semi-structured interviews of physiotherapists in primary care, recruited through convenience sampling. The material was analyzed using qualitative content analysis. Results: Eleven categories were identified. Six categories were related to the transition from student to clinical practitioner ("Time as a critical factor in getting into the job”, “Employer expectations of new graduates can be both hindering and supportive”, “The important role of colleagues”, “Internal beliefs can both help and hinder”, “Knowledge gaps that need to be filled”, “Growing into one's profession”), and five categories related to evidence and its implementation (“Difficulty in knowing what to implement”, “Employer expectations are crucial”, “The influence of colleagues on the moldable physiotherapist”, “Basic knowledge and mindset for evidence-based practice from education”, “The impact of personal characteristics and experiences on evidence-based practice”).  Conclusion: The results highlight the importance of workplace, personal, and educational factors from different perspectives, both facilitating and challenging. The factors were linked to time, colleagues, workplace expectations, personal experiences and traits.

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Short-Term Medical Missions (STMMs) seek to provide healthcare services to people where poverty remains prevalent and limited healthcare access remains prevalent. While STMMs increase access to quality healthcare, contributions may not yet be optimal. Traveling medical professionals make a diagnosis and treatment plan based on previously established knowledge. While these treatment plans may prove to be acceptable, plans may not fully consider local customs, or ongoing medication access. A comprehensive literature review was conducted to determine best practices in developing a formulary for STMMs to investigate if an evidence-based Diagnosis & Treatment Formulary (D&TF) improves cost and time efficiency. The World Health Organization (WHO) executive summary, global essential medicines list, and the International Pharmaceutical Federation and WHO joint guidelines on good pharmacy practice were reviewed for best practices and formulary guidance. The National Institutes of Health’s PubMed, Cumulative Index to Nursing and Allied Health Literature, and the Web of Science Core Collection were searched using keywords cost-effective, evidence-based, formulary, missions, and pharmacy. Fourteen articles were identified and reviewed with inclusion criteria including English language and both within the U.S. and outside the U.S. Exclusion criteria included reviews, editorials, letter publications, and publications prior to 2005. Current best practices for STMM formularies include utilizing the WHO’s sample formulary and guiding principles to develop a team formulary. Formularies for STMMs should be specific to the WHO region, address primary health needs while including medications based on disease prevalence, utilize locally available and affordable medications, and incorporate easy-to-read pictorial medication dispensing labels in the region’s native language. Through literature review, considerations for development and implementation of WHO regional D&TFs have been identified. Appropriate diagnoses and provision of optimal medication regimens relevant to a region’s primary health needs are critical in delivering healthcare services during STMMs. Improving provider confidence in prescribing, increasing team efficiency in medication provision, and advancing equitable health care that is patient-centered and safe, are possible benefits of improved formulary practices. D&TFs go beyond a list of medications by providing an evidence-based treatment regimen for each diagnosis. A need for D&TFs for STMMs that can be further individualized has been identified. The recommended prescription for developing a D&TF for STMMs is for it to include evidence-based treatment plans, utilize essential medicines, be cost-effective, and locally relevant. Pictorial labels should be developed, utilizing local language on any text. STMM teams will need education on the prescription utilized to develop the formulary and its expected benefits to assist with implementation.

Evidence-based dentistry (EBD), an evolving educational tool that started its rise in the late 1990’s and early 2000’s, is being used more every year in dentistry. EBD combines the most current scientific and clinical evidence with the dentists’ expertise and the patients’ needs and preferences to formulate the best option to treat the patient. Since patients are taking more time to research their oral health issues before seeing their dentists, the dentists and the dental team must be prepared for all types of questions. Having the tools necessary to understand the latest and most significant research allows dental professionals to consistently educate themselves. However, there is no independent committee that handles the current issues facing dentistry. Using the topic of asymptomatic removal of third molars as a framework for EBD education, it can be used to help improve how schools educate their students. It is important that both the dental community and the public understand the scientific literature behind the removal of third molars because the existing practice of removing third molars without adverse symptoms is not statistically supported. Unfortunately, there is not enough evidence in favor of either side of the situation. Major databases, like PubMed, contain very little research on the asymptomatic removal of third molars, and those studies were not done recently. For EBD to be successful in dentistry, it must function in the clinical environment, but initial training in the concepts of EBD must start during pre-doctoral education. The dental practitioner still must rely on his or her own experience, but the patient must also trust his or her dentist. EBD is based on trust because it is based on the trust you have demonstrated through your skills and your usage of all available resources. If the dentist can compile pertinent scientific data and information to share with the patient and make the best decision together, then the use of EBD will be beneficial to the field of dentistry.

A number of research studies have highlighted the importance of using empirically supported treatment (evidence-based practices (EBPs)) as the most effective means to reduce addiction. Even though significant federal funding has been committed to support implementation of EBPs in community-based treatment organizations (CBOs) (Glasner-Edwards & Rawson, 2010; NIDA, 2006; IOM, 2003) systematic study of the policy-components of EBP implementation is limited to date. This study examined whether the federal-funder-specific activities (measured as: recommending specific EBPs rather than promoting CBO selection of EBPs, activities associated with specific funding mechanisms, and providing training through ATTCs) were associated with staff perception of level of barriers to implementing federally-funded EBPs. Data sources included interviews with 510 clinical staff from CBOs nationwide who received SAMHSA funding (2003-2008) to implement EBPs. Bivariate analysis and regression modeling methods examined the relationship between federal-funder specific activities and three dependent variables: level of barriers experienced when implementing the EBP, level of modifications made to the EBP that was implemented, and a series of questions regarding attitudes about the usefulness of EBPs. In the regression models, the study controlled for staff, geographic and treatment unit characteristics. It also controlled for variables related to organizational capacity. Findings include: 1. whether or not federal-funders promoted the use of a specific EBP or whether the organization self-selected the EBP to implement was not significantly associated with the level of barriers experienced, the modifications made to the EBP or the attitudes about EBPs. 2. Staff receiving funding from different federal funding mechanisms was associated with reporting different levels of barriers, modifications and attitudes toward EBP implementation. 3. Finally, having received ATTC training was not significantly associated with having more positive attitudes about specific EBPs or the level of modifications or barriers to EBP implementation.