Sediment Ecosystem Assessment Protocol (SEAP): An Accurate and Integrated Weight-of-Evidence Based System

2011 ◽  
Author(s):  
G. A. Burton ◽  
Bart Chadwick ◽  
Gunther Rosen ◽  
Marc Greenberg
2015 ◽  
Vol 34 (12) ◽  
pp. 1245-1252 ◽  
Author(s):  
RC James ◽  
JK Britt ◽  
NC Halmes ◽  
PS Guzelian

We introduced Evidence-based Toxicology (EBT) in 2005 to address the disparities that exist between the various Weight-of-Evidence (WOE) methods typically applied in the regulatory hazard decision-making arena and urged toxicologists to adopt the evidence-based guidelines long-utilized in medicine (i.e., Evidence-Based Medicine or EBM). This review of the activities leading to the adoption of evidence-based methods and EBT during the last decade demonstrates how fundamental concepts that form EBT, such as the use of systematic reviews to capture and consider all available information, are improving toxicological evaluations performed by various groups and agencies. We reiterate how the EBT framework, a process that provides a method for performing human chemical causation analyses in an objective, transparent and reproducible manner, differs significantly from past and current regulatory WOE approaches. We also discuss why the uncertainties associated with regulatory WOE schemes lead to a definition of the term “risk” that contains unquantifiable uncertainties not present in this term as it is used in epidemiology and medicine. We believe this distinctly different meaning of “risk” should be clearly conveyed to those not familiar with this difference (e.g., the lay public), when theoretical/nomologic risks associated with chemical-induced toxicities are presented outside of regulatory and related scientific parlance.


Partner Abuse ◽  
2016 ◽  
Vol 7 (4) ◽  
pp. 355-460 ◽  
Author(s):  
Julia Babcock ◽  
Nicholas Armenti ◽  
Clare Cannon ◽  
Katie Lauve-Moon ◽  
Fred Buttell ◽  
...  

In the United States, the judicial system response to violence between intimate partners, or intimate partner violence (IPV), typically mandates that adjudicated perpetrators complete a batterer intervention program (BIP). The social science data has found that these programs, on the whole, are only minimally effective in reducing rates of IPV. The authors examined the social science literature on the characteristics and efficacy of BIPs. More than 400 studies were considered, including a sweeping, recently conducted survey of BIP directors across the United States and Canada. Results of this review indicate that the limitations of BIPs are due, in large part, to the limitations of current state standards regulating these programs and, furthermore, that these standards are not grounded in the body of empirical research evidence or best practices. The authors, all of whom have considerable expertise in the area of domestic violence perpetrator treatment, conducted an exhaustive investigation of the following key intervention areas: overall effectiveness of BIPs; length of treatment/length of group sessions; number of group participants and number of facilitators; group format and curriculum; assessment protocol and instruments; victim contact; modality of treatment; differential treatment; working with female perpetrators; working with perpetrators in racial and ethnic minority groups; working with lesbian, gay, bisexual, and transgender (LGBT) perpetrators; perpetrator treatment and practitioner–client relationships; and required practitioner education and training. Recommendations for evidence-based national BIP standards were made based on findings from this review.


Author(s):  
Doris Lydahl

This article uses a material semiotic perspective to study a highly influential model of healthcare policy and practice today: person-centred care. While person-centred care is often regarded as implying a turn away from technology and standardization towards more humanistic values in care, this article shows that mundane standardization technologies, such as an assessment protocol, are integral components of person-centred care. Building on interviews and observational studies at a Swedish hospital introducing person-centred care, the article analyses the person-centred protocol in situ. The article teases out three core concerns inscribed in the protocol: a concern for the patient experience and perspective, a valuing of evidence-based knowledge and a managerial imperative. The article illustrates how these contrasting values were rendered compatible through the continuous tinkering of healthcare professionals. Finally, it shows how users modified the script of the protocol under analysis and how relations between the three core concerns were adjusted in the process. The article concludes that tinkering and user–technology relations are of significance for the fate of person-centred care at large.


2014 ◽  
Author(s):  
Peter B. Goldblum ◽  
Kimberly F. Balsam ◽  
Jagruti P. Bhakta ◽  
Scott L. Johnston

ESC CardioMed ◽  
2018 ◽  
pp. 2686-2690
Author(s):  
Juhani Knuuti ◽  
Antti Saraste

This chapter provides a summary of pre- and perioperative assessment and management of patients with pre-existing cardiovascular disease undergoing non-cardiac surgery. More detailed presentations can be found in the preceding chapters in this section. An individualized, stepwise cardiac risk assessment protocol, integrating clinical risk indices and specific test results with the estimated stress of the planned surgical procedure is presented. For each step, evidence-based recommendations on medical therapy and cardiac interventions as well as considerations on surgical and anaesthetic techniques are presented in order to optimize the patient’s perioperative condition.


2017 ◽  
Vol 280 ◽  
pp. S133 ◽  
Author(s):  
Judith Madden ◽  
Julia Pletz ◽  
Steven Webb ◽  
Steven Enoch ◽  
Mark Cronin

2018 ◽  
Author(s):  
Véronique Nabelsi ◽  
Sylvain Croteau

BACKGROUND The rapid advancements in health care can make it difficult for general physicians and specialists alike to keep their knowledge up to date. In medicine today, there are deficiencies in the application of knowledge translation (KT) in clinical practice. Some medical procedures are not required, and therefore, no value is added to the patient’s care. These unnecessary procedures increase pressures on the health care system’s resources, reduce the quality of care, and expose the patients to stress and to other potential risks. KT tools and better access to medical recommendations can lead to improvements in physicians’ decision-making processes depending on the patient’s specific clinical situation. These tools can provide the physicians with the available options and promote an efficient professional practice. Software for the Evolution of Knowledge in MEDicine (SEKMED) is a technological solution providing access to high-quality evidence, based on just-in-time principles, in the application of medical recommendations for clinical decision-making processes recognized by community members, accreditation bodies, the recommendations from medical specialty societies made available through campaigns such as Choosing Wisely, and different standards or accreditive bodies. OBJECTIVE The main objective of this protocol is to assess the usefulness of the SEKMED platform used within a real working clinical practice, specifically the Centre intégré de santé et des services sociaux de l’Outaouais in Quebec, Canada. To achieve our main objective, 20 emergency physicians from the Hull and Gatineau Hospitals participate in the project as well as 20 patient care unit physicians from the Hull Hospital. In addition, 10 external students or residents studying family medicine from McGill University will also participate in our study. METHODS The project is divided into 4 phases: (1) orientation; (2) data synthesis; (3) develop and validate the recommendations; and (4) implement, monitor, and update the recommendations. These phases will enable us to meet our 6 specific research objectives that aim to measure the integration of recommendations in clinical practices, the before and after improvements in practices, the value attributed by physicians to recommendations, the user’s platform experience, the educational benefits according to medical students, and the organizational benefits according to stakeholders. The knowledge gained during each phase will be applied on an iterative and continuous basis to all other phases over a period of 2 years. RESULTS This project was funded in April 2018 by the Fonds de soutien à l’innovation en santé et en services sociaux for 24 months. Ethics approval has been attained, the study began in June 2018, the data collection will be complete at the end of December 2019, and the data analysis will start in winter 2020. Both major city hospitals in the Outaouais region, Quebec, Canada, have agreed to participate in the project. CONCLUSIONS If results show preliminary efficacy and usability of the system, a large-scale implementation will be conducted. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11754


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