Thesis (M.S.)--Iowa State University, 2008. / Adviser: Annette M. O'Connor. Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.

Research in Practice is a column in the Evidence Based Library and Information Practice journal, published quarterly.

The most thoroughly researched topic in relation to Autism Spectrum Disorders (ASD) is the evaluation of interventions. Despite there being systematic literature reviews identifying evidence-based interventions (EBIs) for students with ASD, it is not clear to what extent educational psychologists (EPs) are using EBIs in their practice. The first paper in this thesis is a systematic literature review exploring which school-based interventions are reported in educational and school psychology journals and highlights the challenges of applying research data to idiographic individual casework. The second paper in this thesis is an empirical study investigating the extent to which EPs are using EBIs in their practice and the factors which influence EPs’ decision-making when planning interventions for students with ASD. The survey findings indicate that EPs are using many EBIs for ASD; however, there are many they are unfamiliar with. The most salient factors influencing EPs’ decision-making when planning interventions for students with ASD include the student’s individual needs and factors related to the school context. The third paper in this study discusses the dissemination of evidence to professional practice and looks at the implications of this research for individual EP roles, Educational Psychology Services and future research. Finally, a strategy for disseminating the findings will be outlined alongside a strategy for evaluating the impact of the dissemination.

AN ABSTRACT OF THE DISSERTATION OF MICHAEL A. STROUD, for Doctor of Philosophy degree in HEALTH EDUCATION, presented on MARCH 20, 2014, at Southern Illinois University Carbondale. TITLE: PHYSICAL THERAPISTS' CLINICAL PRACTICES REAGARDING INTRINSIC AND EXTRINSIC FALL RISK FACTORS AND THEIR ATTITUDES TOWARD THE USE OF EVIDENCE-BASED PRACTICE MAJOR PROFESSOR: Dr. Stephen Brown The phenomenon of falls among community-dwelling adults--coupled with an aging baby boomer generation and an increasing life expectancy--presents a significant concern for an increased number of unintentional deaths and injuries and their associated costs. The risk factors associated with falling are often categorized as intrinsic and extrinsic. Physical therapists have a unique opportunity to positively impact issues involving physical dysfunction and to educate their community-dwelling adult patients about the environmental risk factors and interventions that lessen their risk of falling. Abundant evidence-based research exists regarding interventions for the treatment and prevention of falls; however, this research indicates that physical therapists fail to consistently utilize evidence-based practice (EBP) in their daily clinical practices. The diffusion of innovations theory examines how innovations are adopted (Rogers, 2012). However, the innovation of EBP is not always adopted by physical therapists. Lack of time to conduct literature searches was the most common barrier noted by physical therapists for not adopting EBP (Jette et al., 2003; Fruth et al., 2010; Salbach, Jagial, Korner-Bitensky, Rappolt, & Davis, 2007). This study, which utilized a cross-sectional descriptive research design, provided insight into physical therapists' clinical practices regarding intrinsic and extrinsic fall risks in the treatment of community-dwelling adults aged 65 years and older. It examined physical therapists' attitudes and beliefs toward the use of EBP and identified the barriers to their adoption of it. The demographic data provided a descriptive overview of the study respondents. There were 3,523 potential physical therapist respondents, and the study's return rate was 9% (316 respondents. The majority of the respondents held doctoral degrees (49.4%), more than half (55.4%) worked in an outpatient physical therapy clinical setting, and approximately half indicated that they were American Physical Therapy Association (APTA)-certified instructors. The results of the study indicated that physical therapists who had more experience displayed a higher level of attention to clinical practices than those with less experience. The physical therapists who were APTA-certified clinical instructors demonstrated a higher level of attention to the intrinsic and extrinsic risks of falling than those who were not APTA-certified instructors. The physical therapists whose highest level of education was a doctorate placed greater importance on the utilization of EBP than respondents with a baccalaureate or master's degree. Although most physical therapists believe that the utilization of EBP holds significant value, they do not always access or apply it. Insufficient time for using EBP was the major barrier noted by most physical therapists. The results of this study concurred with those of previous studies regarding common barriers to physical therapists' adoption of EBP. Rehabilitation organizations may want to examine methods to promote the use of the most current physical therapy practices based on the evidence revealed in the literature and to explore options for improving staff access to and utilization of EBP research.

Schools across the country are dedicating significant resources to the selection, adoption, and durable implementation of evidence-based practices (EBPs); however, the research-to-practice gap remains a significant challenge facing education today (DuFour & Mattos, 2013). Coaching is one of the implementation variables most consistently cited for improving the high-fidelity adoption of new practices. This study used two concurrent multiple baseline, single-case designs across participants with counterbalanced intervention phases to examine the effects of coaching on teachers’ use of evidence-based, class-wide behavior management practices. Specifically, the study examined the extent to which a functional relation exists between (a) coach-delivered prompting, (b) coach-delivered performance feedback, and (c) the interaction effects of coach-delivered prompting with performance feedback and an increase in teachers’ use of evidence-based classroom management practices and a decrease in class-wide disruptive behavior. Results indicate that coach-delivered prompting and performance feedback is functionally related to an increase in teacher use of evidence-based classroom management practices and a reduction in classroom disruption; however, no additional effects were observed when prompting and performance feedback were delivered together. Potential contributions of the study are discussed in terms of establishing a more nuanced understanding of the active ingredients of effective coaching to support the selection, training, evaluation, and ongoing support of coaches in K-12 educational settings.

Nursing is a permanently developing field of activity. Research plays an irreplaceable role in this field. We moreover more and more often see the term Evidence Based Practice nowadays. However a lot of general nurses do not know that this term also relates to the field of nursing, where it is called Evidence Based Nursing. Quantitative research was chosen for this thesis. The research was performed in South Bohemian and Central Bohemian regions among general nurses with bachelor degree. The aim of the questionnaire research was to confirm or refute the hypotheses set for this thesis. The first goal of the thesis was to find out whether general nurses with bachelor degree were willing to participate in research in nursing. The second goal was to find out whether general nurses with bachelor degree had come across the term Evidence Based Practice. The third goal was focused on finding whether general nurses with bachelor degree knew the names of databases that might be used in planning nursing care based on evidence. The fourth goal was to find out whether general nurses with bachelor degree were willing to participate on application of research results to nursing practice. The fifth goal was to find out whether general nurses with bachelor degree had met with application of research results to nursing practice. The goals of the thesis have been met. Five hypotheses were set for achievement of the above goals. H1: General nurses with bachelor degree are willing to participate in research in nursing. H2: General nurses with bachelor degree are able to define the term Evidence Based Practice. H3: General nurses with bachelor degree know the names of databases they may use in planning nursing care based on evidence. H4: General nurses with bachelor degree are willing to participate in introduction and application of research results to nursing practice. H5: General nurses with bachelor degree meet application of research results to nursing practice. The first, second and fourth hypotheses were confirmed, the third and fifth ones were not confirmed. Although the issues of Evidence Based Practice appear more and more often in literature, and we might expect nurses with tertiary education to apply the practice based on evidence in nursing, there are still general nurses who have lack of information in this sphere. Nevertheless there are a lot of general nurses with tertiary education who would like to participate in research and application of the research results to nursing practice. A proposal for a whole-life educational course focused on application of Evidence Based Practice to nursing was elaborated upon the research results. The results may also be used in hospital seminars and in education of nursing students.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Trata-se de uma revisÃo integrativa da literatura, que teve como objetivo buscar e avaliar as evidÃncias disponÃveis na literatura sobre o cuidado no perÃodo perioperatÃrio prestado à paciente submetida à mastectomia. Para a seleÃÃo dos estudos, foram consultadas as bases de dados PUBMED, LILACS e CINAHL. A amostra constituiu-se de sete estudos. NÃo foi identificado nenhum estudo nas bases de dados LILACS e CINAHL, sete estudos foram provenientes do PUBMED. Houve uma prevalÃncia de seis estudos (86%) com nÃvel de evidÃncia 2 e um estudo (14%) com nÃvel de evidÃncia 3. ApÃs a anÃlise dos aspectos abordados nestes artigos, reuniu-se em uma categoria temÃtica: o manejo da dor, contendo os sete estudos. O primeiro estudo concluiu que uma dose de 600 mg de gabapentina administrada uma hora antes da cirurgia produz analgesia pÃs-operatÃria significativa apÃs a mastectomia total. O segundo estudo demonstrou que o uso do EMLA em pacientes mastectomizadas reduziu a solicitaÃÃo de analgÃsicos no pÃs-operatÃrio e uma reduÃÃo da incidÃncia e a intensidade da dor crÃnica. No terceiro estudo nÃo foram encontradas diferenÃas no manejo da dor pÃs-operatÃria entre 3,75 mg / ml de ropivacaÃna e infiltraÃÃo da ferida com soluÃÃo salina antes da mastectomia. O quarto estudo concluiu que a administraÃÃo preventiva com cetoprofeno por via endovenosa (100 mg) produz maior alÃvio da dor pÃs-operatÃria em pacientes submetidas à mastectomia. O quinto estudo evidenciou que a administraÃÃo de 8 mg de dexametasona diminui efetivamente o uso de analgÃsicos em mulheres submetidas à anestesia geral para a mastectomia. O sexto estudo nÃo demonstrou associaÃÃo entre o Ãndice de Ãxido nÃtrico e o desenvolvimento de dor crÃnica pÃs-operatÃria. O sÃtimo estudo concluiu que a administraÃÃo perioperatÃria de venlafaxina reduz significativamente a incidÃncia de sÃndrome da dor pÃs-mastectomia. O estudo apresentou como limitaÃÃes o fato de que ao longo dos 10 anos pesquisados, o Ãnico cuidado perioperatÃrio da cirurgia de mastectomia encontrado na literatura foi relacionado ao manejo farmacolÃgico da dor, ademais os estudos analisados nÃo mostraram uma associaÃÃo entre si, visto que em cada um foi avaliado uma droga diferente, dificultando o consenso e a recomendaÃÃo relacionada ao uso de fÃrmacos para o controle/minimizaÃÃo da dor. A evidÃncia nÃo apresentou um consenso para o cuidado perioperatÃrio de mastectomia, pois encontrou-se uma diversidade de uso de fÃrmacos para o controle da dor e em grande parte dos estudos existiu divergÃncias e divisÃo de opiniÃes. Contudo, observou-se a preocupaÃÃo por parte dos profissionais em minimizar/prevenir a dor prÃ, intra e pÃs-operatÃria. Desse modo, a enfermagem deve estar atenta, tanto à atualizaÃÃo dos tratamentos farmacolÃgicos no manejo da dor quanto ao desenvolvimento de futuras pesquisas relacionadas ao cuidado de enfermagem no perÃodo perioperatÃrio de mastectomia. / It is an integrative literature review, which aimed to search and evaluate the available evidence in the literature on perioperative care provided to patients undergoing mastectomy. To select the studies were consulted the databases PUBMED, LILACS and CINAHL and the sample consisted of seven studies. No study has been identified in the databases LILACS and CINAHL, and all seven studies were from the PUBMED. There was a prevalence of 6 studies (86%) with level of evidence 2 and 1 study (14%) with level of evidence 3. After analyzing the issues addressed in these articles, gathered in atopical category: pain management, containing the seven studies. The first study found that a dose of 600 mg of gabapentin administered 1 h before surgery produces significant postoperative analgesia after total mastectomy. The second study showed that use of EMLA in mastectomy patientsreduced the request of analgesics postoperatively and a reductionin the incidence and intensity of chronic pain. In the study 03 found no differences in the management of postoperative pain between 3.75 mg / ml and ropivacaine wound infiltration with saline prior to mastectomy. The fourth study found that preventive administration of ketoprofen intravenously (100 mg) produces greater relief of postoperative pain in patients undergoing mastectomy. The fifth study showed that administration of dexamethasone 8 mgeffectively decreases the use of analgesics in women undergoinggeneral anesthesia for mastectomy. The sixth study showed no association between the index of nitric oxide and the development of chronic postoperative pain. The seventh study found that perioperative administration of venlafaxine significantly reduces the incidence of pain syndromeafter mastectomy. The study had limitations the fact that over the 10 years studied, the only perioperative care of the mastectomy surgery in the literature was related to the pharmacological management of pain and the studies analyzed did not show an association between them, since in each was assessed a different drug, hindering consensus and recommendation regarding the use of drugs to control / minimize the pain. The evidence did not show a consensus for the perioperative care of mastectomy, because we found a diversity of use of drugs for pain control and in most studies there were differences and division of opinion. However, we noted the concern on the part of professionals to minimize / prevent pain before, during and after surgery, and nursing must be attentive to both the update of pharmacological treatments in pain management, for the development of future research related to the care of perioperative nursing.

Magister Scientiae (Physiotherapy) - MSc(Physio) / There has recently been an increased pressure in all-healthcare disciplines to provide interventions that are scientific, safe, efficient and cost-effective. Evidence-based practice is said to be the current best approach to address these attributes. All healthcare professionals including physiotherapists need to adopt it. Numerous physiotherapy studies have been carried out to ascertain the attitudes towards, knowledge of, engagement in as well as the barriers of evidence-based practice. These studies were mostly carried out in the developed countries and almost none in the devloping African countries. By means of an exploratory cross-sectional study, deploying both quantitative and qualitative methods, this study investigated the Tanzanian physiotherapists attitudes towards the concept of evidence-absed practice. The study also examined the knowledge that they possess, that could enable them engage in evidence-based related activities. In addition, this study explored the barriers they experience while practicing evidence-based practice. / South Africa

A medical negligence case presented to the court is based on averments of neglected duty of care of the defending doctor, a duty owed in accordance with the law of delict, and alternatively and/or accumulatively averments that the contractual agreement between the complainant and the defending doctor was not honoured. In order to prove failure of duty of care and/or breach of agreement, the complainant bears the onus of proof to present to the court reliable medical evidence that would enable the court to reach a decision. The courts have ruled for and against many plaintiffs throughout the years, setting the standards and yardsticks for the requirements of medical negligence. The value or lack thereof of the medical evidence presented came under the magnifying glass in the case of Michael vs Linksfield Park Clinic (Pty) Ltd 2001 (3) SA 1188 SCA and the court indicated the necessity for a "collective mind" from the medical profession. Brilliant legal writers published on this topic and the search and need created this dissertation. The study sets as goal to scrutinize the quality of medical evidence in general, and more specific the Michael-case. From a wide perspective medical evidence was researched, and the term evidence-based medicine led the study to an existing "collective mind" of the medical profession. The study investigated the history and development of evidence-based medicine in order to evaluate whether it can be seen as the "collective mind" of the medical profession. Satisfied that the "collective mind" was found the study tested the available medical evidence, randomly searched, against specific medical issues in the Michael-case and the study compiled substantial medical evidence to work with. An independent expert was consulted and the medical evidence was scrutinized with commentary, explanation and the basis formulated for negligence. The Michael-case was deconstructed and subsequently reconstructed, and the outcome predictably different, based on sound medical evidence. The study explained and warned against exploitation of the statistical data and incorrect interpretation of results. The study concluded that the court as the ultimate trier of the facts should determine whether the medical evidence presented to the court forms part of the "collective mind", and whether it complied with logical principles and reasoning prior to reaching a decision. General notes: <ul> <lo>1. Wikipedia and e-medicine was used as first search and easy reference and not for court purposes or proper reference;</lo> <lo>2. Note that the dissertation has a legal component and medical component and the references in the Bibliography is split under legal and medical references;</lo> <lo>3. Note all the chapter regarding the Michael-case reference to: epinephrine=adrenaline; nor-epinephrine=nor-adrenaline; propranolol=propanolol (American spelling versus the English spelling, both accepted in South Africa);</lo> <lo>4. The spelling of nomenclature like anaesthetist versus anesthetist, gynaecologist versus gynecologist; paediatrist versus pediatrist etc are used inconsistently as it is once again the American spelling versus the British spelling, which are accepted in South Africa.</lo> </ul> / Dissertation (LLM)--University of Pretoria, 2011. / Public Law / unrestricted