A Modern Leg Ulcer Service

2001 ◽  
Vol 16 (1) ◽  
pp. 24-28 ◽  
Author(s):  
J. R. Barwell ◽  
J. Deacon ◽  
M. Taylor ◽  
C. Wakely ◽  
K. R. Poskitt ◽  
...  
Keyword(s):  
Lower Limb ◽  
Cost Effective ◽  
Arterial Disease ◽  
Leg Ulcer ◽  
Evidence Based ◽  
High Quality ◽  
Quality Outcomes ◽  
Evidence Based Practices ◽  
Vascular Laboratory ◽  
National Framework

Aim: To define the components and organization of a modern leg ulcer service that is acceptable to patients cost effective and produces high quality outcomes. Method: Analysis of data from published literature as well as experience from the organisation of a leg ulcer service in Gloucestershire. Synthesis: Assessment of leg ulcers requires the services of a vascular laboratory to assess the venous and arteria systems. Effective systems of compression must be employed. Staff and patients must be educated to understand the principals behind their use. For some patients pinch-grafting may be appropriate. Where arterial disease is present in the lower limb, reconstructive surgery should be used for the lower limb vessels The organisation of such a service must ensure good liaison between General Practitioners, community nurses and hospital specialists. Many patients may be managed in community leg ulcer clinics. In some cases, the advice of specialists such as rheumatologists and dermatologists may be required. Conclusions: A national framework for leg ulceir management is needed within which resources are made available in a way that satisfy local needs. Such a framework must be based on management protocols derived from evidence-based practices that have been developed through the experiences of modern leg ulcer services.

Some Key Research Questions for Mindfulness Interventions

2015 ◽  
Vol 8 (4) ◽  
pp. 603-609 ◽  
Author(s):  
Christopher Castille ◽  
Katina Sawyer ◽  
Christian Thoroughgood ◽  
John Buckner V
Keyword(s):  
Return On Investment ◽  
Mindfulness Meditation ◽  
Cost Effective ◽  
Psychological Climate ◽  
Mindfulness Practice ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Mindfulness Interventions ◽  
The Many ◽  
Positive Return

For industrial and organizational psychologists who are unfamiliar with the mindfulness literature, Hyland, Lee, and Mills (2015) nicely introduce the concept by highlighting key findings from prior studies. Although their review focuses on the many benefits of mindfulness, we believe that mindfulness research should address certain questions that will help us understand whether mindfulness interventions result in a cost-effective positive return on investment. In alignment with the perspective of evidence-based practice (Briner & Rousseau, 2011; Pfeffer & Sutton, 2006), we call for a holistic evaluation of mindfulness, including a consideration of when or how unintended side effects emerge. Importantly, we discuss the potential mechanisms by which mindfulness generates valued outcomes (e.g., performance and collective psychological climate) and the need for more sophisticated research to isolate these causal effects. We also consider how the judicious use of utility analytics (e.g., cost effectiveness and return on investment) might help demonstrate the value of mindfulness interventions while also acknowledging questions of causality that must be addressed for such value to be experienced. We close by clarifying that we have the intention of promoting research to further evidence-based practices. There are organizations that have already begun providing mindfulness meditation interventions, and it is our hope that our commentary will help practitioners in these settings to consider the evidence suggesting that there may be unknown nuances regarding mindfulness practice. Ultimately, we believe that mindfulness is an important burgeoning area of research deserving of more scholarly attention.

scholarly journals Statewide implementation of high-fidelity recovery-oriented ACT: A case study

2021 ◽  
Vol 2 ◽  
pp. 263348952199493
Author(s):  
Heidi Herinckx ◽  
Alyssa Kerlinger ◽  
Karen Cellarius
Keyword(s):  
Assertive Community Treatment ◽  
Technical Assistance ◽  
Outcome Data ◽  
Community Treatment ◽  
Evidence Based ◽  
High Fidelity ◽  
Minimum Level ◽  
High Quality ◽  
Evidence Based Practices

Background: Assertive Community Treatment (ACT) is a recognized evidence-based practice, but the use of Translation Science to ensure the broad implementation of high quality ACT services has not yet been fully explored. This single intrinsic case study explores how Oregon uses strategies identified through Translation Science to achieve statewide implementation of high-fidelity recovery-oriented ACT. Method: Multiple data sources were used to evaluate this implementation process, including ACT fidelity review reports, programmatic outcome data, a national ACT taskforce survey, and focus groups with program participants. Findings: In 2013, the Oregon Health Authority funded the creation of the Oregon Center of Excellence for Assertive Community Treatment to support the implementation of ACT. It also implemented administrative rules requiring an annual re-certification process with a minimum level of fidelity to the evidence-based model. Other implementation strategies included establishing an ACT Advisory Committee, quarterly reviews of implementation and outcome data, and trainings promoting the role of peer providers and related evidence-based practices. Conclusion: High-fidelity recovery-oriented ACT services in Oregon are maintained through multiple strategies, including codifying the minimum level of ACT implementation into state administrative rule, linking fidelity benchmarks scores to Medicaid reimbursements, and funding ongoing oversight, training and technical assistance through a statewide technical assistance center. Strict adherence to the ACT model has been a key to ensuring a uniform level of high-quality care across Oregon while incorporating additional evidence-based practices without compromising the integrity of the original model. Plain language abstract: Assertive Community Treatment (ACT) is a mental health program serving individuals with the most severe mental illness in the community. While ACT is an evidence-based practice, there is more research needed to explore how ACT is implemented and maintained in different settings. In 2013, Oregon implemented ACT statewide. The Oregon Center of Excellence for ACT was created to provide training and technical assistance to ACT teams and conduct yearly fidelity reviews. Oregon is among the few states who have attached funding to yearly ACT certification, uses community sizes to determine the size of the ACT teams, and the technical assistance center not only provides training but also conducts yearly review of fidelity to the ACT model. This case study will review the steps Oregon took to implement ACT, how it continues to monitor fidelity to the model and provide training and support, and focus on recovery orientation and integrating evidence-based practices. Continued support, training, and the linking of fidelity benchmark scores to program funding are the ways that Oregon makes sure that ACT teams are successfully implementing the ACT model to fidelity with recovery-oriented care.

scholarly journals Health systems fit for the future: promoting better health, economic growth, and social cohesion

2020 ◽  
Vol 30 (Supplement_5) ◽  
Keyword(s):  
Health Systems ◽  
Cost Effective ◽  
Well Being ◽  
Evidence Based ◽  
High Quality ◽  
Quality Health Care ◽  
Quality Health ◽  
The Right ◽  
Sustainable Health ◽  
Improve Health

Abstract High quality, sustainable health systems are essential to enhance health and wealth and to achieve societal well-being. High quality health systems include not only the right to quality health-care but also equity. Evidence-based, cost-effective investments and rigorous assessment are key to guarantee high quality health systems. How can we improve health, wealth and societal well-being by investing in health systems? Which investments inside and beyond the health system should be performed to increase quality and reduce inequities? How can we guarantee that health systems are sustainable, resilient and accessible?

Registered Reports, Replication, and the Canadian Journal of School Psychology: Improving the Evidence in Evidence-Based School Psychology

2019 ◽  
Vol 34 (3) ◽  
pp. 175-187
Author(s):  
Steven R. Shaw ◽  
Joseph S. D’Intino ◽  
Ekaterina Lysenko
Keyword(s):  
School Psychology ◽  
Canadian Journal ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Research ◽  
Evidence Based Practices ◽  
Quality Research ◽  
Replication Studies ◽  
Research Protocols ◽  
Review Model

The Canadian Journal of School Psychology (CJSP) is offering scholars the opportunity to register research reports and make research protocols publicly available to promote replication, transparency, credibility, and utility for clinical practice. The purpose of this article is to outline the challenges regarding replication, reproducibility, and evidence-based practices, as well as describe the submission protocol and criteria for acceptance of registered reports. Advances and criticisms of the registered reports model are discussed. Although CJSP will accept submissions through the traditional peer-review model, registered reports and support of replication studies have the objective of promoting high-quality research to improve the research foundation for evidence-based practices in the profession of school psychology.

Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

2013 ◽  
Vol 18 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rik Lemoncello ◽  
Bryan Ness
Keyword(s):  
Evidence Based Practice ◽  
Single Case ◽  
Quality Data ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
High Quality ◽  
Randomized Controlled Clinical Trials ◽  
Relative Paucity ◽  
Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

Self-Regulation and the Writing Process: Enhancing the Performance of Students With Language and Learning Difficulties

2009 ◽  
Vol 16 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Gary A. Troia
Keyword(s):  
Writing Process ◽  
Self Regulation ◽  
Learning Difficulties ◽  
Evidence Based ◽  
Struggling Learners ◽  
Evidence Based Practices

Abstract This article first provides an overview of components of self-regulation in writing and specific examples of each component are given. The remainder of the article addresses common reasons why struggling learners experience trouble with revising, followed by evidence-based practices to help students revise their papers more effectively.

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