262,223 research outputs found
THE VALUE OF EVIDENCE-BASED GUIDELINES IN BRIDGING THE GAP BETWEEN RESEARCH AND PRACTICE: FROM THE DEVELOPMENT OF GRADE RECOMMENDATIONS TO THE EVALUATION OF THEIR IMPLEMENTABILITY A project of knowledge translation in the Verona Department of Mental Health
No full textTitolo
Il valore delle linee guida basate sulle evidenze nel superare il gap tra ricerca e pratica: dallo sviluppo di raccomandazioni GRADE alla valutazione della loro implementabilità. Un progetto di traduzione delle conoscenze all’interno del Dipartimento di Salute Mentale di Verona
Background
Le evidenze provenienti dalla ricerca non possono da sole determinare le strategie cliniche, ma quando vengono integrate con i bisogni del paziente e le sue preferenze costituiscono un contributo fondamentale per prendere decisioni riguardo la gestione del trattamento ed il miglioramento della qualità delle cure fornite. Questo è in linea con i principi della medicina basata su evidenze. Tuttavia l’accesso e l’utilizzo dei dati provenienti dalla ricerca non è sempre immediato per la maggior parte dei clinici, e questo può determinare un fallimento nel processo della traduzione dei risultati di ricerca nella pratica clinica; questo è stato descritto come un gap tra ricerca e pratica, e può avere conseguenze negative per i pazienti, che potrebbero non beneficiare delle più recenti conoscenze mediche. Un valido metodo per colmare questa distanza è lo sviluppo di linee guida basate su evidenze. Uno degli approcci più utilizzati per aggregare, sintetizzare e valutare la qualità delle evidenze provenienti da revisioni sistematiche è il metodo GRADE (Grading of Recommendations Assessment, Development and Evaluation).
Obiettivi
I) Sviluppare linee guida basate sulle evidenze che possano costituire un ponte tra risultati della ricerca e la pratica clinica;
II) Costruire una metodologia condivisa per la scelta e la gestione dei trattamenti farmacologici nel contesto del Dipartimento di Salute Mentale di Verona (DISM);
III) Valutare l’impatto delle linee guida sulla pratica clinica.
Metodi
È stato composto un gruppo di lavoro (GDG) formato da psichiatri appartenenti ai quattro servizi del DISM. Il GDG ha prodotto le raccomandazioni con il supporto metodologico e scientifico della Unità di Psicofarmacologia Clinica dell’Università di Verona (segreteria scientifica). Dopo aver identificato le situazioni cliniche complesse, in cui fosse avvertito dai clinici il bisogno di linee guida per l’utilizzo dei farmaci, il GDG ha effettuato una revisione della letteratura per ciascun argomento, e la segreteria scientifica ha riassunto le evidenze utilizzando la metodologia GRADE per la produzione di linee guida basate su evidenze di efficacia. Per ogni argomento sono stati inoltre considerati valori, preferenze ed aspetti di fattibilità legati al contesto. Le raccomandazioni così preparate sono state presentate e discusse in due sessioni plenarie con tutto lo staff medico del DISM per raggiungere un consenso ed un accordo sulla versione finale. Successivamente le raccomandazioni sono state distribuite a tutti i clinici del DISM, con la richiesta di tenerne in considerazione i contenuti nella loro pratica clinica di routine. Infine sono stati identificati alcuni indicatori per monitorare il grado di coerenza tra i contenuti delle linee guida e le reali pratiche prescrittive.
Risultati
Sono state formulate raccomandazioni su 12 argomenti. I risultati della fase di valutazione hanno mostrato che dopo la disseminazione delle linee guida, per alcune di esse l’uso dei farmaci nel DISM segue dei trend che sono coerenti con il contenuto delle stesse, mentre per altre questo non si verifica.
Conclusioni
Questo progetto di produzione di linee guida include molti aspetti peculiari, tra cui un approccio bottom-up; ciò significa che i medici sono stati coinvolti fin dalle prime fasi dello sviluppo delle linee guida, a partire dalla scelta degli argomenti sui quali formulare le raccomandazioni. Il progetto è stato strutturato e condotto con criteri metodologici rigorosi, dalle fasi di scelta degli argomenti e produzione delle raccomandazioni fino alla loro disseminazione e valutazione.Title
The value of evidence-based guidelines in bridging the gap between research and practice: from the development of GRADE recommendations to the evaluation of their implementability. A project of knowledge translation in the Verona Department of Mental Health.
Background
Research evidence alone cannot determine clinical strategies, but when integrated with patients’ clinical needs and wishes, it provides a fundamental input for producing meaningful decisions about treatment management and quality improvement. This is in line with the principles of evidence-based medicine. However, access and use of research findings may not be straightforward for most doctors, and this may determine a failure in the process of translating research findings into practice. This failure has often been described as a gap between evidence and practice, with negative consequences for patients who may not benefit optimally from advances in healthcare. In order to fill this gap, the development of evidence-based treatment guidelines has been suggested as a valuable link between primary research and daily clinical practice. One of the best developed approaches for aggregating, synthesizing and grading the quality of evidence extracted from systematic reviews is the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.
Objectives
I) To develop a set of evidence-based guidelines which may bring research findings into clinical practice;
II) To build up a shared strong methodology for choosing and managing pharmacological treatments in the context of the Verona Department of Mental Health;
III) To assess guideline impact on clinical practice.
Methods
A Guideline Development Group (GDG), including representatives of the four Mental Health Services of the Verona Department of Mental Health (DMH), was created. The GDG developed recommendations supported by the Unit of Clinical Psychopharmacology of the University of Verona. After identification of the most problematic clinical situations where recommendations in the field of psychotropic drugs were thought to be needed, the GDG reviewed all available evidence for each topic, and the Scientific Committee summarized the evidence base using the GRADE methodology for the production of recommendations sustained by evidence of efficacy. For each question, values, preferences, and feasibility considerations relating to the local context were also taken into account. Draft recommendations were presented and discussed in two plenary sessions with all medical staff of the DMH in order to reach a consensus and a formal agreement. After that, recommendations were distributed to all clinicians of the DMH, with the request of taking them into consideration in their routine clinical practice. As final step, some indicators were identified to monitor the degree of coherence between what the guidelines report and what is actually done.
Results
Recommendations were formulated on 12 topics. The results of the evaluation phase showed that after the dissemination of guidelines the use of medicines in the DMH follows a trend that is consistent with the content of their content for some recommendations, but not for others.
Conclusions
This project of guidelines development included several peculiar aspects, such as a bottom-up approach; this means that physicians were involved since the very initial steps of guideline production, starting from the choice of topics on which formulate recommendations. A methodologically sound procedure, from the phases of guidelines choice and production, to the one of their dissemination and evaluation, was conceptualized and structured. To our knowledge, not many examples of such a methodology are available in the literature
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Protecting Animals 36: Author Witi Ihimaera
No full textIn this very special episode of Knowing Animals I am joined by beloved New Zealand author Witi Ihimaera. Witi has written many books featuring nonhuman animals. He offers us a non-colonial lens through which to think about the human/nonhuman relationship
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Author in Essay by I. A. Goncharov “Pepiniere”
Get PDFFeatures of the embodiment of the author’s position in the essay by I. A. Goncharov “Pepiniere” are considered. The relevance of the study is due to the poorly studied poetics of this work. A review of the scientific literature on relevant topics is performed. Methodological and theoretical definitions are given. The scientific novelty of the article is in the fact that for the first time attention is paid to artistic techniques that allow to identify the author's position in the specified literary text. The author of the article grounds her opinion from the fact that, despite the dominance of the subjective point of view, other characters’ views stand out in the work. It is concluded in the study that the text of the work represents a biographical author and author-creator. It was established that the position of the author-creator is expressed through the title, epigraphs, which are quotes, as well as through different points of view, including the author-character, the author-narrator, the characters of the work. The author of the article dwells in detail on different ways of expressing the points of view of the author-character and the author-narrator. It is proved that the point of view of the author-character and the author-narrator can intersect, they are interchanged. The author's development of the term comic “point of view” is presented in the article
Short-acting intramuscular second-generation antipsychotic drugs for acutely agitated patients with schizophrenia spectrum disorders. A systematic review and network meta-analysis
No full textBackground: Psychomotor agitation is a common condition in patients with psychotic disorders. One treatment possibility is intramuscular (IM) second-generation antipsychotics. Yet their efficacy in this formulation and for this aim is unclear. This network meta-analysis aims to evaluate the efficacy of short-acting IM second-generation antipsychotic drugs, haloperidol and placebo in patients with diagnosis of schizophrenia and schizophrenia-like disorders that present acute agitation. Methods: We searched the Cochrane Schizophrenia Group Controlled Trials Register, MEDLINE, EMBASE, PsycINFO, Cochrane Library, PubMed, BIOSIS, ClinicalTrials.gov and WHO ICTRP up to November 2018 and PubMed until March 2020. Study selection and outcome extraction were performed independently by two reviewers. Pairwise and network meta-analyses were conducted to compare the different IM second-generation antipsychotics among themselves and with IM haloperidol and placebo. The primary outcome was the number of responders at 2 h after the first injection. Responders at 24 h were also analysed. Results: 10 studies with 1964 patients were included in the meta-analysis. Ziprasidone, olanzapine, aripiprazole and haloperidol were more efficacious than placebo in calming patients at 2 h after administration. Furthermore, olanzapine was superior to aripiprazole. The results at 24 h confirmed the superiority of aripiprazole, olanzapine and haloperidol over placebo, while for ziprasidone no data were available. Conclusions: All second-generation antipsychotics available as intramuscular medications were effective in reducing agitation in people with schizophrenia. Olanzapine was somewhat more efficacious than aripiprazole
Espai i identitat en l'obra de Jordi Pere Cerdà. Una geografia literària cerdaniana
Get PDFL'obra de l'autor nord-català Jordi Pere Cerdà (1920-2011) teixeix una cartografia literària que abasta tota dimensió espacial -real, imaginada i ficcional. Les prospeccions que assagen els seus texts es fonen en el medi natural i rural, canten a l'amor, als veïns i als éssers fantàstics del folklore català, es comprometen amb els refugiats encarant-se a tota frontera i, també, a tot abisme interior i exterior que oprimesca l'ésser. El mapatge cognitiu i literari que crea Cerdà sobrepassa qualsevol obstacle per construir espais oberts i possibles, en comunió amb l'altre. Partint d'una aproximació teòrica geocrítica, aquest treball d'investigació aprofundeix en diverses nocions sobre l'espacialitat lligades a un context convuls, ple de transformacions a nivell socioeconòmic, polític, cultural i lingüístic, el qual determinarà la vida d'un autor i d'un territori transfronterer com el de la Cerdanya i la Catalunya del Nord. En definitiva, la rica experiència vital de Jordi Pere Cerdà ens permet reflexionar sobre les relacions que vulguem establir entre els individus i amb el nostre hàbitat natural i cultural, a fi d'esdevenir membres actius que participen de la transformació dels espais que configuren les nostres identitats.The work of the North Catalan author Jordi Pere Cerdà (1920-2011) weaves a literary cartography which reaches all spatial dimensions -real, imagined and fictional. The prospections proved by their texts merge with the natural and rural environment, sing to love, neighbours and the fantastic beings of the Catalan folklore. Such prospections also commit themselves with the refugees facing every frontier and, also, facing all interior and exterior abyss that oppresses the being. The cognitive and literary mapping created by Cerdà overcomes any obstacle to construct opened and possible spaces, in communion with the other. Based on the theoretical approach called geocriticism, this research study delves into various notions about spatiality linked to a convulsive context, full of transformations at a socioeconomic, political, cultural and linguistic level; these transformations will determine the life of an author and a cross-border territory such as Cerdagne and Northern Catalonia. In short, the rich experience of Jordi Pere Cerdà allows us to reflect on the relationships we want to establish between individuals, as well as between human groups and our natural and cultural habitat, in order to become active members that participate in the transformation of the spaces that make up our identities.Programa de Doctorat en Llengües Aplicades, Literatura i Traducci
Els llibres d'il·lustració infantil i juvenil en l'Educació Artística. Un cas concret a partir de l’autora Olga de Dios
Get PDFTreball Final de Grau en Mestre o Mestra d'Educació Primària (Pla de 2018). Codi: MP1840. Curs acadèmic: 2021/2022El treball de fi de grau que aneu a veure a continuació, és un projecte que consisteix en com es poden
treballar a les aules de primària els llibres de l’autora i il·lustradora Olga de Dios. Tractant de treballar
el llibre com a objecte artístic a nivell elemental. A més, de presentar a l’autora i il·lustradora, donarla a conèixer i veure els valors que transmet, també llegiríem quatre de les seues obres a l’aula com
són: “Leotolda”, “En familia”, “Rana de Tres Ojos”, i “Pájaro Amarillo”. Tot açò sumat a la
realització d’un quadern de classe on es colorejaria alguns dels seus personatges de les obres seguint
pautes a nivell curricular. Realitzaríem també una eixida a la biblioteca municipal, on a banda de
rebre una educació no formal, ens facilitaria una mica el fet d’endinsar-nos al món de la il·lustració
infantil, on allí dins, el professional encarregat ens guiarà pels llibres que hi haurà a la biblioteca. I,
per a concloure, elaboraríem un llibre creat per l’alumnat on seguint unes pautes establertes per Olga
de Dios al seu llibre “Leotolda” buscaríem fer una retroalimentació intentant contactar amb ella.
D’aquesta manera tancaríem el cicle que vam començar donant-la a conèixer com a escriptora i
il·lustradora, i exploraríem on està el límit de la creativitat del propi alumnat.The final degree project you are going to see below is a project that looks at how books by author and
illustrator Olga de Dios can be worked on in primary school classrooms. Considering the book as an
artistic object at an elementary level. Besides presenting the author and illustrator, introducing her,
and seeing the values she transmits, we would also read four of her works in the classroom, such as:
"Leotolda”, "In the family", "Three-Eyed Frog", and "Yellow Bird.". All this, in addition to the
creation of a class notebook in which some of his characters from her work would be colored
following guidelines at the curricular level. We would also go out to the local library, where in
addition to receiving a non-formal education, it would make it a little easier for us to enter the world
of children's illustration, where inside, the professional in charge will guide us through the books
which will be in the library. And, to conclude, we would make a book created by the students, where
following some guidelines established by Olga de Dios in her book "Leotolda" we would look for
feedback by trying to contact her. In this way, we would close the cycle that we started by presenting
her as an author and illustrator, and we would explore where the limit of creativity of the students
themselves is
The construction of Karen Karnak: The multi-author-function
No full textThis thesis is situated within the comparatively recent developments of Web 2.0 and the emergence of interactive WikiMedia, and explores the mode of authorship within a Read/Write culture compared to that of a Read/Only tradition. The hypothesis of this study is that the role of the audience has become merged with the author, and as such, represents new functions and attributes, distinct from a more conventional concept of authorship, in which the roles of audience and author are more separate. Read/Write and participatory culture, as defined by this study, is focused on collaboration, and includes the influences of D.I.Y. culture, Open-Source practices and the production of text by multiple authors. Multi-authorship presents a re-thinking of several concepts which support the notion of the individual author, since the focus of multi-authorship is not on attribution and ownership of a finished text, but on the continued malleability of a text. Modes of multi-authorship, demonstrated in the use of the pseudonyms Alan Smithee and Karen Eliot, represent declarative authors whose names signify multiple origins, whilst concurrently indicating a distinct body of work. The function of these names form an important context to this study, since primary research involves the construction of an experimental mode of multi-authorship utilising WikiMedia technology and the interaction of thirty nine participants, who are invited to create a body of work under the collective pseudonym Karen Karnak. The data generated by this experiment is analysed using aspects of Michel Foucault's author-function to identify and determine power structures inherent in the WikiMedia context. The interplay of power structures, including concepts such as identity, ownership and the body of work, affect the resulting mode of authorship and contribute to the construction of Karen Karnak, suggesting further areas of research into the emerging multi-author
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