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Single Approach (single + approach)
Selected AbstractsUncertainty and multiple objective calibration in regional water balance modelling: case study in 320 Austrian catchmentsHYDROLOGICAL PROCESSES, Issue 4 2007J. Parajka Abstract We examine the value of additional information in multiple objective calibration in terms of model performance and parameter uncertainty. We calibrate and validate a semi-distributed conceptual catchment model for two 11-year periods in 320 Austrian catchments and test three approaches of parameter calibration: (a) traditional single objective calibration (SINGLE) on daily runoff; (b) multiple objective calibration (MULTI) using daily runoff and snow cover data; (c) multiple objective calibration (APRIORI) that incorporates an a priori expert guess about the parameter distribution as additional information to runoff and snow cover data. Results indicate that the MULTI approach performs slightly poorer than the SINGLE approach in terms of runoff simulations, but significantly better in terms of snow cover simulations. The APRIORI approach is essentially as good as the SINGLE approach in terms of runoff simulations but is slightly poorer than the MULTI approach in terms of snow cover simulations. An analysis of the parameter uncertainty indicates that the MULTI approach significantly decreases the uncertainty of the model parameters related to snow processes but does not decrease the uncertainty of other model parameters as compared to the SINGLE case. The APRIORI approach tends to decrease the uncertainty of all model parameters as compared to the SINGLE case. Copyright © 2006 John Wiley & Sons, Ltd. [source] Evidence-based practice: implications and concernsJOURNAL OF NURSING MANAGEMENT, Issue 4 2008BEd (Hons), PETER NOLAN BA (Hons) Aims, The aim of this paper was to undertake a brief critical appraisal of evidence-based practice (EBP) as it is currently perceived in health care settings. Background, The past two decades have seen EBP become increasingly important in health care planning, clinical thinking, and choice of treatments. It is based on scientific rationalism and adherents claim that decisions based on EBP are superior to those based on other approaches to care. Concerns are now being expressed that positivistic approaches to health care fail to take into account people's preferences, their internal resources and their personal understandings of health and wellbeing. It has been argued that there may be multiple types of evidence, all of which have a part to play in the formulation and execution of health care. Methods, After a literature search, this paper argues that whereas EBP may be useful in treating conditions that have a biological cause, it may be less helpful in understanding and treating conditions that have their origins in the social, psychological or spiritual domains. Results, The nature, strengths and limitations of evidence-based practice is discussed in this paper. Nurses are encouraged to develop the critical skills of evaluating EBP in the lives and experiences of the people they care for. Conclusions, Evidence-based practice has a part to play in improving the treatment provided for patients. Nonetheless, nurses should be aware of other kinds of evidence, and appreciate that any single approach to determining care, no matter how popular, is likely to lead to a service that does not truly meet the complex individual needs of patients. Implications for nursing management, In order for evidence-based practice to be safe, the nursing workforce must be able to evaluate the strength and relevance of research findings, and be able to understand that there are different kinds of evidence which should be called upon in order to respond sensitively and appropriately to the preferences of patients. A responsive workforce embraces multiple ways of thinking, respects different paradigms of care, and is able to respond to and respect the forms of care people value and seek. [source] Clinical supervision: what do we know and what do we need to know?JOURNAL OF NURSING MANAGEMENT, Issue 8 2006A review, commentary Aims, This study is addressed to nurses but the issues are of equal concern to both midwives and health visitors. Clinical supervision ideally both challenges nurses as well as help their practice. There is need to identify critical elements that help professional practice and understand more clearly the changing nature of supervisory relationships. Background, Clinical supervision in nursing is over a decade old in the UK and yet emerging nursing literature suggests that many ideas remain unfamiliar to nursing practice. The resistance shown by nurse towards clinical supervising remains perplexing. Moreover, ideas concerning clinical supervision have been applied without a substantive evidence base. Methods, The discussion draws on varied ideas concerning supervision, including those outside of nursing, to ask what do we know and still need to know about clinical supervision. This study suggests that, a single approach to clinical supervision could be unhelpful to nursing. Findings and conclusion, Nursing knowledge concerning many aspects of clinical supervision is increasing because of research. Much of the literature suggests that clinical supervision is scholarly activity requiring much the same attention to relationships as the therapeutic activities it supports. This discussion concludes with the idea that clinical supervision might work at its best as a quiet activity allowing nurses to think about nursing work in ways that suit individual learning styles. [source] Action research, change and methodological rigourJOURNAL OF NURSING MANAGEMENT, Issue 4 2000T. G. Badger BSC (HONS) Aim To critically examine concepts of methodological rigour in action research and consider how these affect its capacity to enable change. Key issues Action research is potentially attractive to managers of nursing because it is a problem-focused approach. As action research is identified as a continuum of definitions and philosophies rather than a single approach, caution is expressed that the search for definition may obscure the underlying process of change. Issues of reliability and validity are explored, suggesting that concern for methodological rigour may limit the potential for change and improvement in practice. Ethical issues in action research are considered identifying areas for tension between researchers, managers and practitioners. Some examples of action research in nursing are discussed. Conclusion Action research may be valuable in individual practitioners' development or in fostering collaboration between academe and practice. However the demands for methodological rigour in research limit its effectiveness as a strategy for managing change. [source] The Evaluation of School-Based Violence Prevention Programs: A Meta-Analysis,JOURNAL OF SCHOOL HEALTH, Issue 9 2008Hyoun-Kyoung Park-Higgerson PhD ABSTRACT Background:, Youth violence and related aggressive behaviors have become serious public health issues with physical, economic, social, and psychological impacts and consequences. This study identified and evaluated the characteristics of successful school-based violence prevention programs. Methods:, Twenty-six randomized controlled trial (RCT), school-based studies that were designed to reduce externalizing, aggressive, and violent behavior between the 1st and 11th grades were analyzed for assessing the effects of 5 program characteristics by comparing results of intervention groups to control groups (no intervention) after intervention using a meta-analysis. Electronic databases and bibliographies were systematically searched, and a standardized mean difference was used for analysis. Results:, There was no significant difference between interventions, although programs that used non,theory-based interventions, focused on at-risk and older children, and employed intervention specialists had slightly stronger effects in reducing aggression and violence. Interventions using a single approach had a mild positive effect on decreasing aggressive and violent behavior (effect size =,0.15, 95% CI =,0.29 to ,0.02, p = .03). Conclusions:, Unlike previous individual study findings, this meta-analysis did not find any differential effects for 4 of the 5 program characteristics. In addition, the significant effect noted was contrary to expectation, exemplifying the complexity of identifying effective program strategies. This study adds to the current literature by assessing the program characteristics of RCT studies in an effort to determine what factors may affect school-based violence prevention program success. [source] Review of methods for measuring and comparing center performance after organ transplantationLIVER TRANSPLANTATION, Issue 10 2010James Neuberger The assessment of outcomes after transplantation is important for several reasons: it provides patients with data so that they can make informed decisions about the benefits of transplantation and the success of the transplant unit; it informs commissioners that resources are allocated properly; and it provides clinicians reassurance that results are acceptable or, if they are not, provides early warning so that problems can be identified, corrections can be instituted early, and all interested parties can be reassured that scarce resources are used fairly. The need for greater transparency in reporting outcomes after liver transplantation and for comparisons both between and within centers has led to a number of approaches being adopted for monitoring center performance. We review some of the commonly used methods, highlight their strengths and weaknesses, and concentrate on methods that incorporate risk adjustment. Measuring and comparing outcomes after transplantation is complex, and there is no single approach that gives a complete picture. All those using analyses of outcomes must understand the merits and limitations of individual methods. When used properly, such methods are invaluable in ensuring that a scarce resource is used effectively, any adverse trend in outcomes is identified promptly and remedied, and best performers are identified; they thus allow the sharing of best practices. However, when they are used inappropriately, such measurements may lead to inappropriate conclusions, encourage risk-averse behavior, and discourage innovation. Liver Transpl 16:1119,1128, 2010. © 2010 AASLD. [source] Left ventricular unloading and concomitant total cardiac output increase by the use of percutaneous impella recover LP 2.5 assist device during high-risk coronary interventionCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005Marco Valgimigli Abstract A number of techniques have been proposed for circulatory support during high-risk percutaneous coronary interventions (PCI), but no single approach has achieved wide acceptance so far. We report on a patient with severe left ventricular (LV) impairment who underwent a PCI with the use of a new left ventricular assist device, the Impella Recover LP 2.5 system. The effects on global cardiac output were determined by thermodilution (TD) and LV pressure-volume loops obtained by conductance catheter. The activation of the pump resulted in a rapid and sustained unloading effect of the LV. At the same time, the continuous expulsion of blood into ascending aorta throughout the cardiac cycle produced by the pump resulted in an increase of systemic overall CO, measured by the TD technique, of 1.43 L/min. The procedure was uncomplicated and the patient remained uneventful at follow-up. Our single experience gives new input for future trials to assess the effect of the Impella Recover LP 2.5 assist device on outcome in this subset of patients. © 2005 Wiley-Liss, Inc. [source] The Integrated Children's System and disabled childrenCHILD & FAMILY SOCIAL WORK, Issue 3 2008Wendy Mitchell ABSTRACT The Integrated Children's System (ICS) is premised on a single approach to assessment/review, ideally providing a more coherent, comprehensive and efficient system of electronic information recording and sharing among different groups of practitioners. Despite its holistic aims for all children in need, questions have been raised about the use of ICS with certain groups of children, especially those who do not follow normative patterns, such as disabled children. This paper explores the introduction of ICS with disabled children and their families within four pilot authorities in England and Wales. Drawing on interviews and questionnaires with 16 social workers and 22 families experiencing assessment/reviews under the new ICS, this paper suggests that important questions and concerns regarding the appropriateness and usefulness for disabled children of the ICS remain, especially the use of ,standardized' exemplars. Five disability-specific areas of concern are identified, and their implications are considered. [source] Mixed tree-vegetative barrier designs: experiences from project works in northern VietnamLAND DEGRADATION AND DEVELOPMENT, Issue 4 2002A. Fahlén Abstract There has been an increased interest in the use of vegetative barriers in acid-infertile upland management systems in Southeast Asia. This paper analyses the experimental designs and policies in early-1990s of using vetiver grass barriers (Vetiveria zizanioides L.) in microwatersheds with short-rotation tree plantations in Vinh Phu Province, Vietnam. Four different mixed tree-vetiver models on degraded Ferric-Plinthic Acrisols are discussed. It is concluded that the institutional approach of demonstrating vetiver barriers as a model had a poor cost-wise performance, and that the model itself did not address the underlying issues of land degradation due to uncontrolled harvest of organic matter from the forest floors. The institutional approach was tainted with price distortions and ,disbursement-oriented' actions. Alternative and more flexible on-farm approaches, using V. zizanioides or the indigenous leguminous shrub Tephrosia candida (Roxb.) DC as vegetative barriers, were found to be more cost-effective and likely to have a higher rate of adoption among farmers. The institutional changes in land allocation policies (securing long-term usufruct users and transfer rights of agricultural and forest land) that took place in Vietnam in the early 1990s, in combination with a reorientation of programme policies to support needs of individuals and farmers' households, are hypothesized to have contributed more to the ,regreening' of the hills, than any single approaches of technical barrier designs by the Swedish-Vietnamese Forestry Co-operation Programme (FCP) in northern Vietnam. Copyright © 2002 John Wiley & Sons, Ltd. [source] | ||||||||||