Doctor of Philosophy / Similar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.

Background: The challenges in the utilization of scientific findings in the fields of prevention and mental health are well documented. Scholars have found significant gaps between the knowledge available and the knowledge applied in healthcare. Studies have suggested that about half of the patients receive the recommended care for their medical condition. In order to address this gap, health systems at global, national, regional and local levels have made diverse efforts to facilitate the uptake of research for example through evidence-based health policy processes. In Sweden, government agencies and health policy actors such as the National Board of Health and Welfare support and control the health care system through evidence-based policies amongst other steering tools. The overall aim of this thesis is to explore evidence-based policy processes, and to further understand barriers to implementation of policies in the fields of preventive and mental health services. Methods: A multiple case study approach was used, and data were collected from several sources. Qualitative content analysis methodology was used. Case 1 comprises the development and early implementation of national guidelines for methods of preventing disease managed by the National Board of Health and Welfare during 2007–2014. Case 2 covers the effort to improve health care for the older population that was undertaken through an agreement between the Swedish government and the Swedish Association of Local Authorities and Regions during 2009–2014. Case 3 involves an effort to implement an adapted version of a systematic review from the Swedish agency for health technology assessment and assessment of social services on treatment of depression in primary health care. Data was collected between 2007 and 2010. In Paper 1, the policies from Case 1 and 2 were studied using a longitudinal, comparative case study approach. Data were collected through interviews, documents and observations. A conceptual model was developed based on prior frameworks. The model was used to organize and analyse the data. In Paper 2, the guideline development process (Case 1) was studied through interviews and the collection of documents. A prior framework on guideline quality was used in order to organize the data. Paper 3 investigated decision-making processes during guideline development using a longitudinal approach. Qualitative data were collected from questionnaires, documents and observations and analysed using conventional and summative content analysis. In Paper 4, the barriers to implementation were investigated through interviews and the collection of documents. Data were analysed using qualitative content analysis with a conceptual model to structure the analysis. Results: The sources and procedures for policy formulation differed in Case 1 and 2, as did the approaches to promote the implementation of the policies. The policy processes were cyclical, and phases overlapped to a large degree. The policy actors intended to promote implementation, both during and after the policy formulation process. The thesis shows variation in how the key policy actors defined and used research evidence in the policy processes. In addition, other types of knowledge (e.g. politics, context, experience) served as alternative or multiple sources to inform the health policies. The composition of sources that informed the policies changed over time in Cases 1 and B. During the policy formulation and implementation process, efforts to integrate research evidence with clinical experiences and values were associated with tension and recurrent dilemmas. On the local level (i.e. primary health care centres), barriers to implementation were found related to the innovation and among health professionals, patients, in social networks as well as in the organizational, economic and political contexts. Conclusion: The concept of evidence holds a key position in terms of goals and means for knowledge based policymaking in the Swedish health system. Broad definitions of evidence – including research and non-research evidence - were requested and to various extents utilized by the policy actors in the studied cases. An explicit terminology and systematic, transparent methodology to define, identify, and assess also non-research evidence in policy processes would potentially strengthen the clarity and validity of these processes and also enhance policy implementation. Particular determinants to implementation, such as the interventions characteristic, are to a considerable degree established early in the policy process, during agenda setting and policy formulation. This early phase offers unique opportunities to assess and build capacity, initiate and facilitate implementation. Early analysis and considerations of target populations and contexts and other implementation determinants related to the specific policy scope (e.g. disease preventive guidelines) could enhance the forth-coming implementation of the policy.

Evidence Based Librarianship (EBL) seeks for and promotes the improvement of the librarian practice through the use of the best available evidence. Strongly used in medical contexts, Evidence Based Practice can be an important tool for the development of LIS, if practice is carefully thought and wisely combined with research and theoretical reflection. In order to achieve a state of equilibrium between theories and empirical studies, a qualitative method –action research- may be applied, as a dialogue between abstract ideas and the facts and signs provided by concrete experiences. Through action research, librarians can collect the evidence –using a series of qualitative tools- and use it for building theoretical knowledge in order to improve their work and their profession. From this viewpoint, after putting something into practice they will be able to know whether it worked as expected or not, make any change if it is necessary, and test the whole process again, searching more and new evidence. The method becomes a progressive helix that leads librarians to continuously evaluate their activities and services and improve them according of their final users’ needs. Fitting these ideas in the general context of “Library 2.0” new LIS model and in the particular situation of Social Sciences libraries, the conference briefly introduces some basic ideas on how action research should be employed for collecting and using evidence in LIS.

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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.

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

Title: Analysis of Pharmacotherapy by patients with diagnosis of arterial hypertension Student: Vasiliki Kontou Tutor: Prof. RNDr. Jiri Vlcek, CSs Department of Social and Clinical Pharmacy, Charles University of Prague, Faculty of Pharmacy in Hradec Kralove Introduction: Arterial Hypertension (AH) is characterized by elevated blood pressure, which often leads to increased morbidity and mortality. AH divided into primary and secondary. Aim: In the theoretical part the aim is to analyse the etiopathogenesis, methods of diagnosis and the treatment strategies of arterial hypertension in the recent literature. In the experimental part the aim is to analyse the provisions of the above diagnosis of arterial hypertension. Method: During a six month period were collected 58 prescriptions with the diagnosis of arterial hypertension from a pharmacy that provided pharmaceutical care in the Greek village, Mytikas. Only one prescription for one patient was analysed. In the prescriptions were collected data on drugs, patients and physicians. Results: The pilot study included 58 prescriptions. Most patients were elderly, over 65 years old and 30% were in age 71 - 80 years. General practitioners prescribed 65% of the medical prescriptions. Most frequently prescribed ARBs with hydrochlorothiazide drugs (27%) and...

Information literacy (IL) is recognized as the overall critical literacy for the 21st Century. Although large amounts of digital information are available, there is concern within higher education that students lack the competencies to assess and analyse sources in terms of relevance to their courses. Information literacy skills are of critical importance in teaching medical students to engage with evidence-based medicine (EBM), often within a problem-based learning (PBL) curriculum. Information practices that underpin academic and professional life should be embedded into the learning experience of the subject, and not taught extraneously in isolated silos. Attitudes of teaching staff at the Faculty of Health Sciences, University of the Witwatersrand towards embedding evidence-based information literacy skills into the Graduate Entry Medical Programme 1 and 2 curriculum were examined. Existing integration of IL skills into the curriculum was shown to be limited, and not as high as perceived by educators. Five barriers against the integration of IL skills, and six opportunities for embedding information literacy, were identified in the curriculum. Awareness of evidence-based practice was found to be high, and collaborative teaching of IL skills with librarians was accepted by a large majority of educators. Dynamic Purposeful Learning (DPL) was proposed as a constructivist framework into which collaborative teaching of IL skills could be placed. DPL draws on active and collaborative learning, as well as cognitive scaffolding and apprenticeship, and is suited to PBL in the context of medical education.

Sometimes it feels as though everybody has an opinion on how you should bring up your child – and no two people seem to agree on how it should be done for the best! Parenting with Reason cuts through the masses of confusing and often contradictory advice about parenting by providing hard evidence to back up the tough decisions all parents face. Unlike many self-help guides to parenting which are based on the opinion of one author, this book is based on many findings from scientific research, giving you a trustworthy, ‘evidence-based’ guide to help see your way through parenting dilemmas. Written by a clinical psychologist, a developmental psychologist and a doctor of family medicine, the book looks at pressing questions such as: 'What should I do when my child acts up?', 'How can I get my baby to sleep through the night?' and 'How do I begin to toilet-train my child?' The authors, who are also parents themselves, debunk common myths about parenting, such as the notion that a healthy baby needs to be able to breastfeed at will throughout the night, or the idea that children who are adopted need specialized counselling. They also cover issues such as how children might be affected by seeing violence on television, how a parent’s psychological health can affect their child, what the scientific evidence is for and against circumcision, and how divorce and adoption affect a child’s development. The end of each chapter gives you 'The Bottom Line', a handy summary of the key points of each issue. This book is ideal for new or prospective parents, and paediatricians, family health providers and anyone who works with children and their parents will also find the book’s objective, scientific approach useful in their work. / https://dc.etsu.edu/etsu_books/1208/thumbnail.jpg

In a Southern state at a rural high school, leadership staff implemented phonics-based strategies with 9th grade English teachers to improve students' Lexile reading scores. The absence of formative data related to program implementation left stakeholders without a clear understanding of the influence of the phonics-based strategies. The purpose of this qualitative exploratory case study was to obtain formative information from teachers to discern the perceived influence of the phonics-based strategies on reading. Dual coding theory was used to examine teachers' perceptions of the influence of phonics-based strategies on students' motivation, fluency, and self-efficacy. Data were collected using interviews with 9 purposefully selected English teachers who taught Grade 9 students and had at least 1 year of experience using the phonics-based strategies. Data were coded in NVivo and analyzed using thematic analysis. Results indicated that phonics-based strategies were perceived to benefit students' extrinsic motivation and fluency; conversely, teachers perceived the strategies had a limited effect on students' intrinsic motivation and self-efficacy. Implementation of recommendations presented in a white paper based on these findings could result in positive social change by strengthening students' reading and promoting their academic success.