949 research outputs found
Methodologies for assessing telemedicine: A systematic review of reviews
No full textBackground and objectives: Previous reviews have expressed concerns about the quality of telemedicine studies. There is debate about shortcomings and appropriate methodologies. The aim of this review of systematic reviews of telemedicine is to summarize methodologies used in telemedicine research, discuss knowledge gaps and recommendations and suggest methodological approaches for further research. Methods: We conducted a review of systematic reviews of telemedicine according to a protocol listing explicit methods, selection criteria, data collection and quality assessment procedures. We included reviews where authors explicitly addressed and made recommendations for assessment methodologies. We did a qualitative analysis of the reviews included, sensitized by two broad methodological positions; positivist and naturalistic approaches. The analysis focused on methodologies used in the primary studies included in the reviews as reported by the review authors, and methodological recommendations made by the review authors. Results: We identified 1593 titles/abstracts. We included 50 reviews that explicitly addressed assessment methodologies. One group of reviews recommended larger and more rigorously designed controlled studies to assess the impacts of telemedicine; a second group proposed standardisation of populations, and/or interventions and outcome measures to reduce heterogeneity and facilitate meta-analysis; a third group recommended combining quantitative and qualitative research methods; and others applying different naturalistic approaches including methodologies addressing mutual adaptations of services and users; politically driven action research and formative research aimed at collaboration to ensure capacity for improvement of services in natural settings. Conclusions: Larger and more rigorous studies are crucial for the production of evidence of effectiveness of unambiguous telemedicine services for pre defined outcome measures. Summative methodologies acknowledging telemedicine as complex innovations and outcomes as partly contingent on values, meanings and contexts are also important. So are formative, naturalistic methodologies that acknowledge telemedicine as ongoing collaborative achievements and engage with stakeholders, including patients to produce and conceptualise new and effective telemedicine innovations
Effectiveness of telemedicine: A systematic review of reviews
No full textObjectives: To conduct a review of reviews on the impacts and costs of telemedicine services. Methods: A review of systematic reviews of telemedicine interventions was conducted. Interventions included all e-health interventions, information and communication technologies for communication in health care, Internet based interventions for diagnosis and treatments, and social care if important part of health care and in collaboration with health care for patients with chronic conditions were considered relevant. Each potentially relevant systematic review was assessed in full text by one member of an external expert team, using a revised check list from EPOC (Cochrane Effective Practice and Organisation of Care Group) to assess quality. Qualitative analysis of the included reviews was informed by principles of realist review. Results: In total 1593 titles/abstracts were identified. Following quality assessment, the review included 80 heterogeneous systematic reviews. Twenty-one reviews concluded that telemedicine is effective, 18 found that evidence is promising but incomplete and others that evidence is limited and inconsistent. Emerging themes are the particularly problematic nature of economic analyses of telemedicine, the benefits of telemedicine for patients, and telemedicine as complex and ongoing collaborative achievements in unpredictable processes. Conclusions: The emergence of new topic areas in this dynamic field is notable and reviewers are starting to explore new questions beyond those of clinical and cost-effectiveness. Reviewers point to a continuing need for larger studies of telemedicine as controlled interventions, and more focus on patients' perspectives, economic analyses and on telemedicine innovations as complex processes and ongoing collaborative achievements. Formative assessments are emerging as an area of interest
Snow cover fraction on land fromt MODIS at the three GEM sites
No full textSnow cover fraction on ground from MODIS.
Gaps due to cloud cover are filled using the last available observation. A description paper is in preparation.Please contact the author directly with any questions
Implementation science: A reappraisal of our journal mission and scope
No full textThe implementation of research findings into healthcare practice has become increasingly recognised as a major priority for researchers, service providers, research funders and policymakers over the past decade. Nine years after its establishment, Implementation Science, an international online open access journal, currently publishes over 150 articles each year. This is fewer than 30% of those submitted for publication. The majority of manuscript rejections occur at the point of initial editorial screening, frequently because we judge them to fall outside of journal scope. There are a number of common reasons as to why manuscripts are rejected on grounds of scope. Furthermore, as the field of implementation research has evolved and our journal submissions have risen, we have, out of necessity, had to become more selective in what we publish. We have also expanded our scope, particularly around patient-mediated and population health interventions, and will monitor the impact of such changes. We hope this editorial on our evolving priorities and common reasons for rejection without peer review will help authors to better judge the relevance of their papers to Implementation Science
Promotion of phonemic phonological perception for 5 – 6 years old children with phonological disorders by using natural materials
No full textDiplomdarba nosaukums: “Fonemātiskās uztveres sekmēšana 5 – 6 gadus veciem bērniem ar fonētiski fonemātiskiem traucējumiem, izmantojot dabas materiālus” Darba autore: Signe Jonase Darba zinātniskā vadītāja: Mg. paed. Egija Laganovska Darba saturs: 61 lapas, 7 attēli, 7 tabulas, 4 pielikumi. Pētījuma mērķis: Teorētiski izpētīt un praktiski pārbaudīt dabas materiālu izmantošanas efektivitāti 5 – 6 gadus veciem bērniem ar fonētiski fonemātiskiem traucējumiem. Pētījuma teorētiskajā daļā tiek analizēta dažādu autoru zinātniskā literatūra. Darba autore apraksta bērnu attīstību kopveselumā (fizisko, emocionālo, kognitīvo un sociālo), fonemātiskā uztvere, tās traucējumi un attīstīšanas paņēmieni. Pētījuma empīriskajā daļā autore apraksta pētnieciski praktisko darbību (novērošanu, runas pārbaudi, anketēšanu), balstoties uz teorētiskajā daļā gūtajām atziņām, kā arī, veic iegūto rezultātu analīzi. Pētījuma rezultātā iegūtie dati tiek apkopoti tabulās un attēlos. Darba noslēgumā tiek izdarīti secinājumi un sniegti ieteikumi vecākiem un pedagogiem. Atslēgas vārdi: logopēdija, runa, valoda, attīstība, skaņu izrunas traucējumi, fonemātiskās uztvere, fonemātiskās uztveres traucējumi, dabas materiāli.Title of graduation work: “Promotion of phonemic phonological perception for 5 – 6 years old children with phonological disorders by using natural materials” Author: Signe Jonase Supervisor: Mg. paed. Egija Laganovska Structure: 61 pages, 7 pictures, 7 tables, 4 attachments Reserch goal: In theory, study and practice the effectiveness of the use of natural materials for children 5 to 6 years old with phonetic phonetic phonemic disorders. The theoretical part of the study analyses the scientific literature of the authors. The author of the work describes the development of children in general (physical, emotional, cognitive and social), phonographic perception, its disorders and development techniques. In the empirical part of the study, the author describes the practice of research (observation, speech testing, anketting), based on the lessons learned from the theoretical part, as well as an analysis of the results obtained. The resulting data from the study is collected in tables and images. The work concludes by drawing conclusions and making recommendations to parents and teachers. Key words: speech therapy, speech, language, development, phonetic disorders, phonetic perception, phonetic perception disorders, natural material
Possibilities of electricity production development in Latvia
No full textLatvija ir viena no ES līderēm atjaunojamo energoresursu izmantošanā elektroenerģijas ražošanā, tomēr vēja potenciāls Latvijā nav apgūts.
Maģistra darba Elektroenerģijas ražošanas attīstības iespējas Latvijā autore Signe Allena izvirzījusi mērķi izvērtēt vēja enerģijas izmantošanas potenciālu Rīgas Tehniskajā universitātē, uzstādot mazās vēja turbīnas. Galvenie uzdevumi mērķa īstenošanai ir analizēt zinātniskās publikācijas un praktisko pieredzi, apkopot vēja mērījumus, noteikt vēja turbīnu iespējamo saražotās elektroenerģijas apjomu, izstrādāt elektroenerģijas cenu scenārijus, izvērtēt atmaksāšanās periodus turbīnu uzstādīšanai un noteikt ekonomiski izdevīgāko vēja turbīnu modeli.
Maģistra darba rezultātā ir izvērtēts vēja enerģijas potenciāls un novērtēts ekonomiskais izdevīgums vēja turbīnu uzstādīšanai Rīgas Tehniskajā universitātē.
Atslēgvārdi: elektroenerģijas ražošana, vēja enerģija, statistiskā analīzeLatvia are one of the leading countries in renewable energy usage in electricity generation at EU level, however wind potential is still unfulfilled.
Author Signe Allena of master thesis Possibilities of electricity production development in Latvia aims to assess the wind energy potentional installing small wind turbines at Riga Technical University. The main tasks are to analyze scientific publications and practical experience, gather wind measurements, determine the potentional electricity amount generated by wind turbines, develop electricity price scenarios, evaluate financial return periods of turbine installation and identify the most economically attractive wind turbine model.
As a result of the master thesis the potential of wind energy has been identified and economic advantage of turbine installation at Riga Technical University has been assessed.
Keywords: power generation, wind power, statistical analysi
Work environment risks in metalworking industry and prevention measures
No full text“Metālapstrādē nodarbināto darba vides riski un to novēršanas pasākumi”. Darba autore Signe Vējkrīgere. Darba zinātniskā vadītāja: asoc. profesore, Dr. med. Ženija Roja. Maģistra darbs sastāv no 4 nodaļām, secinājumiem un praktiskajām rekomendācijām. Pirmajā nodaļā literatūras avotos publicētā informācija par metālapstrādes nozarē sastopamajiem darba vides riska faktoriem, to cēloņiem un ietekmi uz nodarbināto veselību. Otrajā daļā aprakstītas darbā izmantotās risku novērtēšanas metodes, bet trešajā daļā – apkopoti un analizēti pētījuma rezultāti. Ceturtā nodaļa ir vadlīnijas veselīgas un drošas darba vides nodrošināšanai metālapstrādē nodarbinātajiem, iekļaujot risku novēršanas un samazināšanas pasākumus nozarē. Darba apjoms ir 76 lpp., satur 21 attēlu, 12 tabulas, 12 pielikumus, izmantots 51 literatūras avots. Darbs uzrakstīts latviešu valodā. Atslēgvārdi: Darba vide, analīze, vadlīnijas, metālapstrāde“Work environment risks in metalworking industry and prevention measures”. Author: Signe Vējkrīgere. Scientific advisor: asoc. prof., Dr. med. Ženija Roja. Master’s thesis consists of four sections, conclusions. The first section analyzes published information from literature sources on occupational risk factors, their causes and impact on employees health in metalworking industry. The second section describes risk assessment methods, that are used in this thesis, but the third section – summary and analysis of results. Fourth section is guidelines how to provide safe and healthy work environment for metalworking industry’s employees, which includes occupational risk reduction and prevention measures. Master’s thesis contain 76 pages, including 21 figures, 12 tables, 51 literature references, 12 appendices. Thesis is written in Latvian. Keywords: Work environment, analysis, guidelines, metalworking
Use of Evidence to Decision frameworks for evidence-informed decision-making in healthcare
No full textObjectius:
La tesi té tres objectius principals: 1) analitzar les experiències dels usuaris de la plataforma interactiva dels marcs Evidence to Decision (iEtD); 2) identificar i descriure els processos i marcs EtD suggerits als manuals metodològics per al desenvolupament de guies en salut; i 3) avaluar la relació entre l'ús dels marcs EtD i la qualitat de les guies i les seves recomanacions.
Mètodes:
La tesi es presenta com un compendi de tres articles publicats en revistes científiques. El primer estudi és una anàlisi qualitativa de les experiències d'usuaris de l'iEtD, utilitzant entrevistes semiestructurades i anàlisi de contingut. El segon estudi és una revisió sistemàtica dels marcs i processos proposats als manuals metodològics per al desenvolupament de guies en salut, identificant els criteris utilitzats en la formulació de recomanacions. El tercer estudi avalua la relació entre l'ús d'un marc EtD i la qualitat de les guies i recomanacions en una mostra de guies publicades.
Resultats:
Primer Estudi:
Es va entrevistar 8 de 20 persones que van utilitzar l'iEtD en escenaris de presa de decisions, principalment en el desenvolupament de guies. Els participants van informar experiències positives, utilitzant la majoria dels criteris del marc GRADE-EtD. Tot i això, es van observar esforços d'adaptació, com l'eliminació de criteris i l'edició de títols. Alguns van optar per exportar els marcs a Word per facilitar-ne l'ús fora de línia.
Segon Estudi:
Es van revisar 68 manuals metodològics, i la majoria de les organitzacions tenien un procés per graduar la força de les recomanacions. El 66% va proposar un marc EtD, amb el marc GRADE-EtD sent el més comú. L'ús d'un marc EtD es va associar amb la inclusió de més criteris rellevants, especialment en àrees com valors i preferències, equitat, i acceptabilitat.
Tercer Estudi:
Es van analitzar 66 guies de 17 països. El 45% d'aquestes guies va utilitzar un marc EtD per formular recomanacions. Les guies que van utilitzar un marc EtD van obtenir puntuacions més altes en qualitat metodològica i recomanacions en comparació amb les que no el van utilitzar. No hi va haver diferències significatives entre les guies que van utilitzar el marc GRADE-EtD i altres marcs.
Conclusions:
L'ús de l'iEtD ha estat limitat, encara que les experiències reportades són majoritàriament positives. Es van identificar àrees de millora per a l'eina, que podrien aplicar-se a altres marcs EtD. L'ús de marcs EtD s'associa amb la inclusió de criteris rellevants i amb una millor qualitat metodològica de les guies i recomanacions. L'adopció d'aquests marcs per part de les organitzacions podria millorar la qualitat de les guies clíniques.Objetivos:
La tesis tiene tres objetivos principales: 1) analizar las experiencias de los usuarios de la plataforma interactiva de los marcos Evidence to Decision (iEtD); 2) identificar y describir los procesos y marcos EtD sugeridos en los manuales metodológicos para el desarrollo de guías en salud; y 3) evaluar la relación entre el uso de los marcos EtD y la calidad de las guías y sus recomendaciones.
Métodos:
La tesis se presenta como un compendio de tres artículos publicados en revistas científicas. El primer estudio es un análisis cualitativo de las experiencias de usuarios del iEtD, usando entrevistas semiestructuradas y análisis de contenido. El segundo estudio es una revisión sistemática de los marcos y procesos propuestos en los manuales metodológicos para el desarrollo de guías en salud, identificando los criterios usados en la formulación de recomendaciones. El tercer estudio evalúa la relación entre el uso de un marco EtD y la calidad de las guías y recomendaciones en una muestra de guías publicadas.
Resultados:
Primer Estudio:
Se entrevistó a 8 de 20 personas que usaron el iEtD en escenarios de toma de decisiones, mayormente en el desarrollo de guías. Los participantes informaron experiencias positivas, usando la mayoría de los criterios del marco GRADE-EtD. Sin embargo, hubo esfuerzos de adaptación, como la eliminación de criterios y la edición de títulos. Algunos optaron por exportar los marcos a Word para mayor facilidad de uso offline.
Segundo Estudio:
Se revisaron 68 manuales metodológicos, y la mayoría de las organizaciones tenía un proceso para graduar la fuerza de las recomendaciones. El 66 % propuso un marco EtD, con el marco GRADE-EtD siendo el más común. El uso de un marco EtD se asoció con la inclusión de más criterios relevantes, especialmente en áreas como valores y preferencias, equidad, y aceptabilidad.
Tercer Estudio:
Se analizaron 66 guías de 17 países. El 45 % de estas guías utilizó un marco EtD para formular recomendaciones. Las guías que utilizaron un marco EtD obtuvieron puntuaciones más altas en calidad metodológica y recomendaciones en comparación con las que no lo usaron. No hubo diferencias significativas entre las guías que usaron el marco GRADE-EtD y otros marcos.
Conclusiones:
El uso del iEtD ha sido limitado, aunque las experiencias reportadas son mayormente positivas. Se identificaron áreas de mejora para la herramienta, que podrían aplicarse a otros marcos EtD. El uso de marcos EtD se asocia con la inclusión de criterios relevantes y con una mejor calidad metodológica de las guías y recomendaciones. La adopción de estos marcos por parte de las organizaciones podría mejorar la calidad de las guías clínicas.**Summary of the Doctoral Thesis**
**Objectives:**
The thesis has three main objectives: 1) to analyze the experiences of users of the interactive platform for Evidence to Decision (iEtD) frameworks; 2) to identify and describe the processes and EtD frameworks suggested in methodological manuals for the development of health guidelines; and 3) to evaluate the association between the use of EtD frameworks and the quality of both the guidelines and their individual recommendations.
**Methods:**
The thesis is presented as a compendium of three articles published in peer-reviewed scientific journals. The first study is a qualitative analysis of iEtD user experiences, using semi-structured interviews and content analysis. The second study is a systematic review of the frameworks and processes proposed in methodological manuals for health guideline development, identifying the criteria used in the formulation of recommendations. The third study evaluates the relationship between the use of an EtD framework and the quality of guidelines and recommendations in a sample of published guidelines.
**Results:**
1. **First Study:**
Eight out of twenty people who used the iEtD in decision-making scenarios were interviewed, mainly in the development of guidelines. Participants reported positive experiences, using most of the criteria from the GRADE-EtD framework. However, there were adaptation efforts, such as the removal of certain criteria and the editing of titles. Some participants chose to export the frameworks to Word for easier offline use.
2. **Second Study:**
Sixty-eight methodological manuals were reviewed, and most organizations had a process for grading the strength of recommendations. 66% proposed an EtD framework, with the GRADE-EtD framework being the most common. The use of an EtD framework was associated with the inclusion of more relevant criteria, especially in areas such as values and preferences, equity, and acceptability.
3. **Third Study:**
Sixty-six guidelines from 17 different countries were analyzed. Forty-five percent of these guidelines used an EtD framework to formulate recommendations. The guidelines that used an EtD framework scored higher in methodological quality and recommendations compared to those that did not. No significant differences were observed between the guidelines that used the GRADE-EtD framework and those that used other EtD frameworks.
**Conclusions:**
The use of the iEtD has been limited, although user experiences have been generally positive. Areas for improvement of the tool were identified, which could also apply to other EtD frameworks. The use of EtD frameworks is associated with the inclusion of relevant criteria and with better methodological quality of guidelines and recommendations. The adoption of these frameworks by guideline-developing organizations could enhance the quality of clinical guidelines.Universitat Autònoma de Barcelona. Programa de Doctorat en Metodologia de la Recerca Biomèdica i Salut Públic
Awareness raising of ecological lifestyle for children of older preschool age
No full textTemats – Ekoloģiska dzīvesveida izpratnes pilnveide vecākajā pirmsskolas vecumā Darba autore – Signe Sokova Darba vadītāja – Dr. Psych. Tija Zīriņa Pētījuma mērķis – pētīt ekoloģiska dzīvesveida izpratnes pilnveidi vecākā pirmsskolas vecuma bērniem mācību jomu centros. Darbs sastāv no teorētiskās un empīriskās daļas. Teorētiskajā daļā, analizējot V. Zelmeņa, G. Svences un citu latviešu un ārzemju psihologu un pedagogu darbus, izpētīts izpratnes un ekoloģijas jēdziens. Darbā raksturots vecākā pirmsskolas vecuma bērna attīstības likumsakarības pētāmās problēmas kontekstā. Empīriskajā daļā tiek raksturoti bērni pēc viņu uzvedības īpatnībām, veikta analīze. Pētītas metodes, ar kādām sekmīgāk veidot izpratni par ekoloģiska dzīvesveida pamatprincipiem. Atslēgas vārdi: ekoloģiskais dzīvesveids, izpratne, vecākā pirmsskolas vecuma bērni, vecumposmu likumsakarības.Research topic– Awareness raising of ecological lifestyle for children of older preschool age Author – Signe Sokova Supervisor – Dr. psych. Tija Zīriņa Research objective- study awareness raising improvement of ecological lifestyle for children of older preschool age in learning centers. The research consists of a theoretical and an empirical part. In the theoretical part, analyzing the works of V. Zemlenis, G. Svence and other Latvian and foreign psychologists and teachers, the concept of understanding and ecology is studied. The paper describes peculiarities of the oldest preschool age in the context of the research problem. In the empirical part, children are described according to their behavioral characteristics, analysis is performed. Methods for better understanding of the basic principles of ecological lifestyle have been studied. Key words: ecological lifestyle, awareness, children of the older pre-school age, peculiarities of the age period
Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods
No full textAbstract Background Theories of behaviour change indicate that an analysis of factors that facilitate or impede change is helpful when trying to influence professional practice. The aim of this study was to identify barriers to implementing evidence-based guidelines for urinary tract infection and sore throat in general practice in Norway, and to tailor interventions to address these barriers. Methods We used a checklist to identify barriers and possible interventions to address these in an iterative process that included a review of the literature, brainstorming, focus groups, a pilot study, small group discussions and interviews. Results We identified at least one barrier for each category. Both guidelines recommended increased use of telephone consultations and reduced use of laboratory tests, and the barriers and the interventions were similar for the two guidelines. The complexity of changing routines involving patients, general practitioners and general practitioner assistants, loss of income with telephone consultations, fear of overlooking serious disease, perceived patient expectations and lack of knowledge about the evidence for the guidelines were the most prominent barriers. The interventions that were tailored to address these barriers included support for change processes in the practices, increasing the fee for telephone consultations, patient information leaflets and computer-based decision support and reminders. Conclusion A systematic approach using qualitative methods helped identify barriers and generate ideas for tailoring interventions to support the implementation of guidelines for the management of urinary tract infections and sore throat. Lack of resources limited our ability to address all of the barriers adequately.</p
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