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Used Evidence (used + evidence)
Selected AbstractsReplacing ineffective early alcohol/drug education in the United States with age-appropriate adolescent programmes and assistance to problematic usersDRUG AND ALCOHOL REVIEW, Issue 6 2007Professor, RODNEY SKAGER PhD Abstract Issues. Despite more than a decade of federal sponsorship of ,evidence-based' alcohol/drug education, there has been no consistent downward trend in overall prevalence among youth over the past 15 years. Reasons underlying this situation are examined. Approach. Published technical critiques of initial research supporting widely used evidence-based programs are reviewed along with replication studies conducted later by independent researchers not associated with initial program development. Social and institutional barriers in the US against changes in AOD policy and practice for young people are also suggested. Key Findings. Emerging use of diverted pharmaceuticals (now second to cannabis in prevalence) may underlie moderate recent decline in use of alcohol. Early federal certification standards for ,evidence based' prevention education have been seriously compromised. Technical critiques of initial evaluations and negative replication studies of these programs are consistent with lack of impact. Finally, fidelity of implementation in regular school settings is commonly flawed. Implications. Failure of these mainly pre-secondary educational programs may underlie recent federal support for forced random AOD testing of secondary school students. A new approach to drug education for adolescent students seems warranted as a positive alternative to personally intrusive surveillance. Conclusion. An interactive approach at the secondary school level that incorporates an age-appropriate educational process is proposed. While advising abstinence, this approach also facilitates identifying and assisting problematic AOD users. [source] An international survey of training programs for treating tobacco dependenceADDICTION, Issue 2 2009Nancy A. Rigotti ABSTRACT Aims The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires countries to implement tobacco dependence treatment programs. To provide treatment effectively, a country needs trained individuals to deliver these services. We report on the global status of programs that train individuals to provide tobacco dependence treatment. Design Cross-sectional web-based survey of tobacco treatment training programs in a stratified convenience sample of countries chosen to vary by WHO geographic region and World Bank income level. Participants Key informants in 48 countries; 70% of 69 countries who were sent surveys responded. Measurements Program prevalence, frequency, duration and size; background of trainees; content (adherence to pre-defined core competencies); funding sources; challenges. Findings We identified 61 current tobacco treatment training programs in 37 (77%) of 48 countries responding to the survey. Three-quarters of them began in 2000 or later, and 40% began after 2003, when the FCTC was adopted. Programs estimated training 14 194 individuals in 2007. Training was offered to a variety of professionals and paraprofessionals, but most often to physicians and nurses. Median program duration was 16 hours, but programs' duration, intensity and size varied widely. Most programs used evidence-based guidelines and reported adherence to core tobacco treatment competencies. Training programs were less frequent in low-income countries and in Africa. Securing funding was the major challenge for most programs; current funding sources were government (58%), non-government organizations (23%), pharmaceutical companies (17%) and, in one case, the tobacco industry. Conclusion Training programs for tobacco treatment providers are diverse and growing. Most upper- and middle-income countries have programs, and most programs appear to be evidence-based. However, funding is a major challenge. In particular, more programs are needed for non-physicians and for low-income countries. [source] Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient servicesJOURNAL OF NURSING MANAGEMENT, Issue 2 2007BA (Hons), JO ALLEYNE DProf Aim, The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. Background, This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, ,Our Health, Our Care, Our Say' and the recent proposals from the article Modernising Nursing Career, to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. Method, The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop ,actionable knowledge'. Group clinical supervision was not practised in this study as a form of ,therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. Findings, ,,Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. ,,Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. ,,A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. Conclusion, It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that ,good nursing' is accepted as being synonymous with ,good management'. This is the future of ,new nursing'. [source] Rates of Holocene isostatic uplift and relative sea-level lowering of the Baltic in SW Finland based on studies of isolation contactsBOREAS, Issue 1 2001MATTI ERONEN Southwestern Finland was covered by the Weichselian ice sheet and experienced rapid glacio-isostati c rebound after early Holocene deglaciation. The present mean overall apparent uplift rate is of the order of 4,5 mm/yr, but immediately after deglaciation the rate of crustal rebound was several times higher. Concurrently with land uplift, relative sea level in the Baltic basin during the past more than 8000 years was also strongly affected by the eustatic changes in sea level. There is ample evidence from earlier studies that during the early Litorina Sea stage on the southeastern coast of Finland around 7000 yr BP (7800 cal. yr BP), the rise in sea level exceeded the rate of land uplift, resulting in a short-lived transgression. Because of a higher rate of uplift, the transgression was even more short-lived or of negligible magnitude in the southwestern part of coastal Finland, but even in this latter case a slowing down in the rate of regression can still be detected. We used evidence from isolation basins to obtain a set of 71 14C dates, and over 30 new sea-level index points. The age-elevation data, obtained from lakes in two different areas and located between c. 64 m and 1.5 m above present sea level, display a high degree of internal consistency. This suggests that the dates are reliable, even though most of them were based on bulk sediment samples. The two relative sea-level curves confirm the established model of relatively gradually decreasing rates of relative sea-level lowering since c. 6100 yr BP (7000 cal. yr BP) and clearly indicate that the more northerly of the two study areas experienced the higher rate of glacio-isostati c recovery. In the southerly study area, changes in diatom assemblages and lithostratigraphy suggest that during the early Litorina Sea stage (8300,7600 cal. yr BP) eustatic sea-level rise exceeded land uplift for hundreds of years. Evidence for this transgressio n was discovered in a lake with a basin threshold at an elevation of 41 m above sea level, which is markedly higher than any previously known site with evidence for the Litorina transgression in Finland. We also discuss evidence for subsequent short-term fluctuations superimposed on the main trends of relative sea-level changes. [source] | ||||||||||