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Effective Practice (effective + practice)
Selected AbstractsOverview of interventions to enhance primary-care provider management of patients with substance-use disordersDRUG AND ALCOHOL REVIEW, Issue 5 2009PETER ANDERSON Abstract Issues. Despite the evidence for the effectiveness and cost-effectiveness of interventions to manage substance use disorders, which are common presenting complaints in primary care, primary-care providers find managing substance use disorders a difficult business. This paper provides an overview of the evidence for interventions, including training and education programmes, in enhancing the management of alcohol- and tobacco-use disorders by health-care providers. Approach. The Cochrane Library and the database of the Cochrane Effective Practice and Organisation of Care Group were searched for answers to five questions: (i) Can education and training increase the involvement of primary care providers? (ii) Can education and training cause harm? (iii) Can education and training be enhanced with support and other organisational factors? (iv) Can finance systems change provider behaviour? and (v) Is political support needed? Key Findings. Education and training can increase the involvement of primary-care providers in managing alcohol- and tobacco-use disorders, with the impact enhanced by additional support and other organisational factors. There is some evidence that if education and training does not take account of providers' attitudes, then harm can be caused. There is limited evidence that finance systems can change provider behaviour, and that comprehensive policy, in which a health sector response is a part, can increase the potential of primary-care management of alcohol- and tobacco-use disorders. Conclusions. Tailored education and training programmes for the management of alcohol- and tobacco-use disorders need to be broadly implemented and embedded in overall comprehensive policies that provide the necessary organisational and financial incentives for enhancing provider behaviour. There is an urgent need to extend the evidence base on the impact of education and training and other strategies to increase the involvement of providers in managing substance-use disorders.[Anderson P. Overview of interventions to enhance primary-care provider management of patients with substance-use disorders. Drug Alcohol Rev 2009;28:567,574] [source] Teaching the Global Dimension: Key Principles and Effective PracticeINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 1 2008Sue L.T. McGregor No abstract is available for this article. [source] Effective Practice in Probation: An Example of ,Advanced Liberal' Responsibilisation?THE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 1 2002Hazel Kemshall This article argues that the dominant emphasis upon effective practice in probation work, particularly the emergence of effective programmes can be understood as an example of a key mechanism of social control in advanced liberal societies. Utilising Rose's concept of ,responsibilisation' the article examines the role of effective programmes in the emerging social policy agenda of citizen re-moralisation, responsibilisation and inclusion exemplified in late modern advanced liberal welfare states. The article concludes that the embracement of effective programmes has reconstituted the probation service as a key agency in the social control and exclusion of those citizens deemed ,intransigent' or ,irresponsible', thus assisting in the demarcation of those who can play a full role in the welfare society from those who cannot. [source] Evidence-Based Strategies for Reducing Cesarean Section Rates: A Meta-AnalysisBIRTH, Issue 1 2007Nils Chaillet PhD ABSTRACT: Background: Canada's cesarean section rate reached an all-time high of 22.5 percent of in-hospital deliveries in 2002 and was associated with potential maternal and neonatal complications. Clinical practice guidelines represent an appropriate mean for reducing cesarean section rates. The challenge now lies in implementing these guidelines. Objectives of this meta-analysis were to assess the effectiveness of interventions for reducing the cesarean section rate and to assess the impact of this reduction on maternal and perinatal mortality and morbidity. Methods: The Cochrane Library, EMBASE, and MEDLINE were consulted from January 1990 to June 2005. Additional studies were identified by screening reference lists from identified studies and expert suggestions. Studies involving rigorous evaluation of a strategy for reducing overall cesarean section rates were identified. Randomized controlled trials, controlled before-and-after studies, and interrupted time series studies were evaluated according to Effective Practice and Organisation of Care Group criteria. Results: Among the 10 included studies, a significant reduction of cesarean section rate was found by random meta-analysis (pooled RR = 0.81 [0.75, 0.87]). No evidence of publication bias was identified. Audit and feedback (pooled RR = 0.87 [0.81, 0.93]), quality improvement (pooled RR = 0.74 [0.70, 0.77]), and multifaceted strategies (pooled RR=0.73 [0.68, 0.79]) were effective for reducing the cesarean section rate. However, quality improvement based on active management of labor showed mixed effects. Design of studies showed a higher effect for noncontrolled studies than for controlled studies (pooled RR = 0.76 [0.72, 0.81] vs 0.92 [0.88, 0.96]). Studies including an identification of barriers to change were more effective than other interventions for reducing the cesarean section rate (pooled RR = 0.74 [0.71, 0.78] vs 0.88 [0.82, 0.94]). Among included studies, no significant differences were found for perinatal and neonatal mortality and perinatal and maternal morbidity with respect to the mode of delivery. Only 1 study showed a significant reduction of neonatal and perinatal mortality (p < 0.001). Conclusions: The cesarean section rate can be safely reduced by interventions that involve health workers in analyzing and modifying their practice. Our results suggest that multifaceted strategies, based on audit and detailed feedback, are advised to improve clinical practice and effectively reduce cesarean section rates. Moreover, these findings support the assumption that identification of barriers to change is a major key to success. (BIRTH 34:1 March 2007) [source] Practitioners' Perspectives on Effective Practices For Hispanic Teenage Pregnancy PreventionPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 4 2004Stephen T. Russell CONTEXT: In the United States, the pregnancy rate and birthrate of Hispanic teenagers are higher than those of other races and ethnicities. Although recommendations for culturally appropriate pregnancy prevention programs are commonplace, little is known about how practitioners address such recommendations. METHODS: In individual interviews, 58 teenage pregnancy prevention practitioners who work primarily with Mexican American female teenagers from two regions in California were asked about their understanding of recommendations for best practices and discussed the strategies they have used and challenges they have faced in implementing the recommendations. Qualitative methods were used to categorize responses and identify themes. RESULTS: Practitioners indicated that knowledge and awareness of Hispanic culture are essential, as is commitment to teenagers and their needs. They regard activities that encourage educational and career achievement as critical program components, and view both male partners' and family members' involvement in programs as important but challenging. Furthermore, practitioners feel that the implicit program goals of continued education and female self-sufficiency are often at odds with traditional Hispanic cultural values. CONCLUSIONS: Practitioners have valuable insight into the reality of implementing culturally sensitive programs. Programs need to balance the often competing values and goals of prevention programs with those of Hispanic youth culture and experiences. [source] Identification, assessment and intervention,implications of an audit on dyslexia policy and practice in ScotlandDYSLEXIA, Issue 3 2005Gavin Reid Abstract This article reports on research commissioned by the Scottish Executive Education Department (SEED). It aimed to establish the range and extent of policy and provision in the area of specific learning difficulties (SpLD) and dyslexia throughout Scotland. The research was conducted between January and June 2004 by a team from the University of Edinburgh. The information was gathered from a questionnaire sent to all education authorities (100% response rate was achieved). Additional information was also obtained from supplementary interviews and additional materials provided by education authorities. The results indicated that nine education authorities in Scotland (out of 32) have explicit policies on dyslexia and eight authorities have policies on SpLD. It was noted however that most authorities catered for dyslexia and SpLD within a more generic policy framework covering aspects of Special Educational Needs or within documentation on ,effective learning'. In relation to identification thirty-six specific tests, or procedures, were mentioned. Classroom observation, as a procedure was rated high by most authorities. Eleven authorities operated a formal staged process combining identification and intervention. Generally, authorities supported a broader understanding of the role of identification and assessment and the use of standardized tests was only part of a wider assessment process. It was however noted that good practice in identification and intervention was not necessarily dependent on the existence of a dedicated policy on SpLD/dyslexia. Over fifty different intervention strategies/programmes were noted in the responses. Twenty-four authorities indicated that they had developed examples of good practice. The results have implications for teachers and parents as well as those involved in staff development. Pointers are provided for effective practice and the results reflect some of the issues on the current debate on dyslexia particularly relating to early identification. Copyright © 2005 John Wiley & Sons, Ltd. [source] Examining Contextual Effects in a Practice Analysis: An Application of Dual ScalingEDUCATIONAL MEASUREMENT: ISSUES AND PRACTICE, Issue 3 2007André F. De Champlain Practice analyses are routinely used in support of the development of occupational and professional certification and licensure examinations. These analyses usually survey incumbents to obtain importance ratings of (1) specific tasks and (2) knowledge, skill, and ability (KSA) statements deemed by subject matter experts as essential to safe and effective practice. Several researchers have made important criticisms of traditional practice analysis procedures, particularly the lack of attention to contextual constructs and the resulting problematic interpretation of mean importance ratings. The present study provides a framework for assessing the impact of context in practice analysis studies. It focuses on a practice analysis of a health profession that sought to enhance the meaning of incumbents' importance ratings by embedding the statements in the context of patient acuities. Results indicate that incumbents' importance ratings varied as a function of patient acuity. Dual scaling analysis was used to obtain a multidimensional visual representation of the associations between importance ratings and contextual content. The implications of the contextual component of the study design for future practice analysis studies are discussed as well as possible applications of this approach to professions in education. [source] Harnessing experience: exploring the gap between evidence-based medicine and clinical practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008M. Cameron Hay PhD Abstract Rationale, aims and objectives, There is mounting evidence of a gap between Evidence-based Medicine (EBM) and physician clinical practice, in part because EBM is averaged global evidence gathered from exogenous populations which may not be relevant to local circumstances. Local endogenous evidence, collected in particular and ,real world' patient populations may be more relevant, convincing and timely for clinical practice. Evidence Farming (EF) is a concept to provide such local evidence through the systematic collection of clinical experience to guide more effective practice. Methods, We report on the findings of a pilot study of 29 individual and three focus group (n = 10) interviews exploring physicians' evaluations how they use multiple sources of information in clinical decision making and their thoughts on EF. Results, Physicians recognize a gap in translating EBM to practice. Physicians reported that when making clinical decisions, they more often rely on clinical experience, the opinions of colleagues and EBM summarizing electronic clinical resources rather than refer directly to EBM literature. Confidence in making decisions based on clinical experience increases over time, yet few physicians reported having systems for tracking their clinical experience in designing treatment plans and patient outcomes. Most physicians saw EF as a promising way to track experience, thereby making scientific evidence more relevant to their own clinical practices. Conclusion, Clinical experience is relatively neglected by the EBM movement, but if that experience were systematically gathered through an approach such as EF, it would meet a need left unfulfilled by EBM. [source] Improving Dean's writing: or, what shall we tell the children?LITERACY, Issue 2 2004Graham Frater Abstract In this paper Graham Frater finds early signs of a revival of explicit instruction in English grammar to pupils of compulsory school age in England; this is accompanied by an expectation that such teaching might play an important part in closing the ,writing gap'. He suggests that, strengthened by the National Literacy Strategy, this early re-awakening invokes again some of the debates that accompanied the construction of the National Curriculum. Rooted in a case study of a text by a low-achieving Y7 writer, and in two surveys of effective practice with writing (covering Key Stages 2,4), this paper argues that purposeful text-level teaching, reading in particular, and the creation of real readerships offer more secure ways of promoting progress in writing. [source] The Influence of Historical Land Use and Water Availability on Grassland RestorationRESTORATION ECOLOGY, Issue 2010Zhuwen Xu The ecological role of historical land use has rarely been explored in the context of grassland restoration. We conducted a 4-year field experiment in a steppe and an old field in Inner Mongolia in northern China to examine the influence of historical land use and water availability on ecosystem restoration. Species richness, evenness, and plant cover were higher in the steppe than in the old field. The steppe was more temporally stable compared with the old field in terms of species richness, evenness, plant density, and cover. Water addition increased peak aboveground biomass, belowground net primary productivity, species richness, plant density, and cover in both the steppe and the old field. Water addition also enhanced the stability of ecosystems and the restoration of grassland. Our findings suggested that historical land use determines community structure and influences the process of grassland restoration. Converting grasslands to farmland in semiarid areas can cause the long-term loss of biodiversity and instability of ecosystem with consequent impacts on ecosystem services. The amendment of limited resources is an effective practice to increase the success of ecosystem restoration. [source] Desistance-Focused Criminal Justice Policy Research: Introduction to a Special Issue on Desistance from Crime and Public PolicyTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 4 2004Stephen Farrall Only recently, however, have researchers started to forge links between studies of desistance from crime and ,What Works' in offender management policy (see especially, Maruna and Immarigeon 2004). This ,coming together' of research into why people stop offending and the (re-)emergence of concerns with effective practice is, like many partnerships, partly the result of good timing, partly the result of fortune, and not without its tensions and struggles. The purpose of this introductory essay, and indeed of this special issue, is to explore these tensions in greater depth than has been possible in previous work. [source] Women Behind Bars: Explanations and ImplicationsTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 2 2003Jo Deakin Increases in the women's prison population in the UK, in line with many other industrialised countries, is occurring at an alarming rate and yet the types of offences for which women are imprisoned and the lengths of sentences they receive suggest that most present little risk to society. However, the personal and social costs to these women and their families of being imprisoned, and the economic costs to society, can be immense. Through an analysis of official statistics, this article explores some possible explanations for the growth in female imprisonment set within the framework of effective practice with a particular emphasis on the actuarial approach to managing offenders. [source] Effective Practice in Probation: An Example of ,Advanced Liberal' Responsibilisation?THE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 1 2002Hazel Kemshall This article argues that the dominant emphasis upon effective practice in probation work, particularly the emergence of effective programmes can be understood as an example of a key mechanism of social control in advanced liberal societies. Utilising Rose's concept of ,responsibilisation' the article examines the role of effective programmes in the emerging social policy agenda of citizen re-moralisation, responsibilisation and inclusion exemplified in late modern advanced liberal welfare states. The article concludes that the embracement of effective programmes has reconstituted the probation service as a key agency in the social control and exclusion of those citizens deemed ,intransigent' or ,irresponsible', thus assisting in the demarcation of those who can play a full role in the welfare society from those who cannot. [source] A Community Justice Dimension to Effective Probation PracticeTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 2 2000John Harding This article builds on earlier articles by McWilliams and Pease in suggesting that the probation service requires a transcendent justification for its activities. The author supports the need for greater links between prison and probation services in promoting effective practice and public protection but asserts that probation' authority also derives from its understanding of crime in a community context. In developing a community justice framework for the probation service the author discusses three principles: justice, penance, and community, particularly as they might impact on the most marginalised and vulnerable in our inner cities. The case for a community justice dimension to effective practice is further endorsed by a recent Home Office study of the social factors most associated with reconviction. Best outcomes in relation to crime reduction are most likely to be achieved by a bridge-building effort between criminal justice professionals and the involvement of communities most at risk. [source] Developing Nations and the Compulsory License: Maximizing Access to Essential Medicines While Minimizing Investment Side EffectsTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 2 2009Robert C. Bird This manuscript addresses how developing countries can maximize access to essential medicines and minimize unwanted side-effects within the legal environment of a compulsory license regime. While compulsory licensing can play a role in improving public health, external social and political conditions must be considered in order to make licensing an effective practice. [source] The Sufic Paradigm for Stress Management and its Contribution to a Model of Social Work PracticeASIAN SOCIAL WORK AND POLICY REVIEW, Issue 2 2009Zulkarnain A. Hatta This article presents Sufism as a model for helping to alleviate human miseries. As the instability, contradictions, and stress of the socioeconomic structure create a frantic search for relevant modes of treatment, the theories and methods espoused in Sufism present an alternative approach to be taken up in the interest of more effective practice; especially in the field of social work, psychology, and counseling. Sufic masters or teachers, by the nature of their work are social workers; hence, their role in helping stressed people is discussed. Existing tools of measurement that can test stress levels are used in order to present Sufism as being compatible with the mode of scientific inquiry. The article shows that sticking to traditional psychoanalytic, behavioral, transactional and analytical practices, to name a few, limits the avenues of help that can be offered to those in need. Social workers and human service agencies have to work in collaboration with religious institutions and other spiritual organizations in order to better serve the population. [source] ,And When did You Last See Your Father?' Exploring the Views of Children with Learning Difficulties/DisabilitiesBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 1 2004Ann Lewis The Gulliford Lecture 2003 was given by Professor Ann Lewis of the School of Education at the University of Birmingham. Professor Lewis's lecture, on which this article is based, focused on the process of listening to the views of children and, in particular, children with learning difficulties. Following the near-universal ratification of the United Nations (UN) Convention on the Rights of the Child, a plethora of recent initiatives, both in the UK and internationally, has encouraged professionals to access children's views about provision (educational, health-related, social and legal). A range of materials has been developed to support this process, often by, or in liaison with, children's charities. At the same time, research provides valuable insights into effective practice in exploring the views of children with learning difficulties. In this article, Ann Lewis reviews ten strategies for gathering the views of children and raises four challenges for the further development of policy and practice. She closes her argument with a call for greater rigour and critical evaluation in this crucial and demanding area. [source] Reflections on training in child abuse and neglect prevention: Experiences in BrazilCHILD ABUSE REVIEW, Issue 6 2007Victoria Gabrielle Lidchi Abstract In cooperation with an international partner, Brazilian professionals based in Rio de Janeiro designed a training programme in child protection to respond to the particular challenges to effective practice posed by the local environment and to address obstacles to its achievement in the existing child protection system. Training participants used a structured process to identify and address such external challenges and internal obstacles. The use of the framework included an exploration of beliefs held by Brazilian child protection professionals. The training was itself envisaged as an intervention opportunity for participants to promote ,bottom up' processes of local systemic change. The programme aimed to provide training that accessed the experience of the international partner's ,community of expertise', but mitigated the risk to effectiveness of a ,transplant' programme that fails to engage with the surrounding social reality and culture. As part of a nine-country international training project initiative (ITPI, International Training Project Initiative by ISPCAN) sponsored by the International Society for the Prevention of Child Abuse and Neglect (ISPCAN), standardised tools were adopted to monitor and evaluate the training process. Copyright © 2007 John Wiley & Sons, Ltd. [source] Context and its significance in identifying ,what works' in child protectionCHILD ABUSE REVIEW, Issue 3 2005Adrian Barton Abstract The repetitive nature of the underlying problems with child protection systems identified by many inquiries into child deaths suggests that the ability to transpose successful strategies from one area to another may be contingent on more than a ,technical' approach to best practice. Current policy responses to failing child protection systems are arguably based on an assumption that practices that work in one area may be applied in other areas without reference to the existing base for practice. Drawing on our own experiences in the field, we attempt to explore some methodological issues relevant to the evaluation of service provision and the dissemination of effective practice in interagency working. Copyright © 2005 John Wiley & Sons, Ltd. [source] T cell responses induced by allergen-specific immunotherapyCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 1 2010E. Maggi Summary Allergen-specific immunotherapy is recognized as a highly effective practice in the treatment of patients with severe allergic rhinitis and/or asthma and is recommended by World Health Organization as an integrated part of allergy management strategy. Several studies have shown that allergen-specific immunotherapy, based on the administration of increasing doses of allergen, achieves a hyposensitization and reduces both early and late responses occurring during the natural exposure to the allergen itself. This is the unique antigen-specific immunomodulatory treatment in current use for human diseases. Successful immunotherapy is associated with reductions in symptoms and medication scores and improved quality of life. After interruption it usually confers long-term remission of symptoms and prevents the onset of new sensitizations in children up to a number of years. Subcutaneous immunotherapy usually suppresses the allergen-induced late response in target organs, likely due to the reduction of the infiltration of T cells, eosinophils, basophils, mast cells and neutrophils. In addition to the reduction of cells of allergic inflammation, immunotherapy also decreases inflammatory mediators at the site of allergen exposure. This review provides an update on the immunological T cell responses induced by conventional subcutaneous and sublingual immunotherapy, and gives a unifying view to reconciling the old dualism between immunoredirecting and immunoregulating mechanisms. [source] Early Intervention in an International PerspectiveJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2006Michael J. Guralnick Abstract, The importance and potential value of a worldwide commitment to provide comprehensive early intervention services for children at risk for or with identified intellectual disabilities are considered in the context of this special issue on early intervention. Further refinement of policies and advances in effective practices will result through the application of relevant research findings, through the development and implementation of comprehensive professional training programs, and through model program development with corresponding efforts to bring programs to scale. Articles in this special issue are discussed as representing major early intervention themes in the international community. [source] Breaking New Ground in Juvenile Justice Settings: Assessing for Competencies in Juvenile OffendersJUVENILE AND FAMILY COURT JOURNAL, Issue 2 2005JULIETTE R. MACKIN ABSTRACT The field of juvenile justice has made great strides in developing a research base of effective practices and principles, including an understanding of risk factors and needs that contribute to juvenile offending. However, the research base and practice of systematic assessment has not yet fully incorporated youth, family, and community strengths. To address this need, three juvenile justice agencies in the northwestern United States participated in a pilot study to develop and implement an assessment tool (the Youth Competency Assessment) and process that would identify and utilize strengths to help balance the risk and needs focus of their assessment and case planning practices. This article provides descriptions and implementation strategies of the three pilot sites. The article concludes with recommended system changes and policy interventions to support ongoing utilization of this kind of strength-based tool in juvenile justice settings, and a clear set of recommendations for other communities wishing to implement strength-based assessment in their own agencies. [source] | ||||||||||||||||||||||