Solid organ transplantation and the probability of transmitting HIV, HBV, or HCV: a systematic review to support an evidence-based guideline

This systematic review addressed 10 Questions (middle column of Table 1) pertaining to solid organ transplantation and three bloodborne pathogens (HIV, HBV, and HCV). These questions were carefully developed by the Centers for Disease Control and Prevention in consultation with the Center for Evidence-based Practice at the University of Pennsylvania and ECRI Institute. These questions are not intended to encompass all important issues related to infectious diseases and organ transplantation. Instead, they were specifically focused to support the development of an evidence-based guideline. The leftmost column of the table shows which section of the guideline pertains to the questions, and the rightmost column provides explanatory comments.Introduction -- Methodology -- Overview of the evidence -- Evidence Reviews: I. Probability of transmission of HIV, HBV, or HCV through solid organ transplantation (SOT) -- Evidence Reviews: II. Methodology to better estimate donor infection with HIV, HBV, or HCV -- Evidence Reviews: III. Donor interventions to decrease transmission of HIV, HBV,or HCV from infected donors -- Evidence Reviews: IV. Potential risks and benefits of transplanting, or not transplanting, solid organs from donors positive for HIV, HBV, or HCV -- Evidence Reviews: V. Potential risks and benefits of transplanting, or not transplanting, solid organs from donors with risk factors for HIV, HBV, or HCV -- Gaps in the current literature -- References -- Appendix A. Details of literature search.Jonathan R. Treadwell, Meredith Noble.April 14, 2010.This report was funded by the Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, GA.Mode of access: World Wide Web as an Acrobat .pdf file (6.97 MB, 530 p.).References: p. 491-502

End-of-life care and outcomes. Summary.

6 pages.Evaluates the effectiveness of end-of-life care

Cancer care quality measures: symptoms and end-of-life care (Evidence report/technology assessment no. 137)

251 pagesEvaluates the quality of end-of-life care for cancer patients. The study was conducted using the medical literature

Evidence-Based Practice in Clinical Social Work

Evidence-based practice (EBP) is a major shaping influence in clinical social work practice, in relation to economic policies, and in professional education. The definition of EBP remains contested; professionals still fail to distinguish EBP as a practice decision-making process from a list of treatments that have some type of research support (which are correctly called empirically supported treatments). All mental health practitioners should understand what EBP is, what it is not, and how it shapes both client options and their own practice experiences. This book explores EBP in depth and in detail. Our focus includes case exemplars that show how the EBP decision-making process is done in practice. There are many recent books about evidence-based practice in social work and in other mental health professions. In reviewing these books, it appeared to us that most of the books on EBP have been written by researchers, bringing a particular point of view and expertise to the technicalities of EBP. These books are important to social workers and other mental health professionals because EBP involves a lot of technical details about research design, methods, and interpretation that are not always covered in other social work texts. On the other hand, the lack of a more direct practice and clinical viewpoint seemed to leave out a lot of the day-to-day realities clinical social workers confront in learning and using EBP in practice. Recent books also lacked much in the way of a broad and critical perspective on EBP as a social movement shaping policy, agency practice, and views of what constitutes “good” research. As we explored other books as resources for our students and for our own practice, we missed both a larger or meta-perspective on EBP and a lack of attention to doing it in clinical practice. This book seeks to illustrate through several cases how important clinical knowledge and expertise are in doing EBP well. We seek to introduce the core ideas and practice of EBP and then illustrate them by applying the concepts and processes to real-world cases. We also take a critical look at how EBP has been implemented in practice, education, and policy. Eight years after we wrote the first edition of this book, EBP continues to be a major influence on clinical practice. Some areas of the book, particularly the research evidence used in our case examples, needed to be updated and mad

Evidence-based practice in teaching: an information perspective.

Purpose The purpose of this research is to explore UK teachers' use of research-based information, with a particular focus on issues relating to access to information in schools, information literacy, and the role of the school librarian and school library services. Design/methodology/approach The study adopts a mixed methodology. In-depth qualitative data gathered through vignette interviews ( n=28), group exercises (four groups of between three and five teachers) and a discussion forum were supplemented by quantitative data gathered through surveys of teachers ( n=312), head teachers ( n=78), school librarians ( n=78) and school library services ( n=26). Findings Teachers' professional use of research information reflects a preference for predigested information and informal sources. Although professional bodies and government departments promote the use of research by teachers and provide a range of customised web sites for information, lack of ready local access to information and lack of time were cited as major barriers to the use of research information. Teachers also revealed uncertainties and lack of confidence in their own ability to find and evaluate such information. The findings suggest scope for more targeted provision by school librarians of both information and skills to support the professional development of teachers. However, this raises issues of priorities and resources, and needs to be seen in the context of a wider change in ethos supported by senior management. The study also raises questions about teachers' own experiences and approaches to the use of information in professional learning, and how this might impact on the provision of support for their pupils and the potential for collaborative working between librarians and teachers. Research limitations/implications The qualitative aspects of the study provided a rich source of data from teachers with varying levels of experience and involvement with the use of research information. However, a low response to the teacher questionnaire survey (10.9 per cent, overall, 312 teachers) resulted in a bias towards more research-oriented teachers in that particular data set. While the data from research-oriented teachers do appear to triangulate, it is difficult to generalise to other teachers. Therefore teacher survey data have been treated with some caution and drawn on only to aid further understanding of the issues raised in interviews and group exercises. Originality/value In focusing attention on teachers' information behaviour and information literacy, this paper provides a new perspective on the issues affecting the lack of uptake of research evidence within the teaching profession, contributes to the literature on information behaviour and information literacy in professional contexts, and contributes to the understanding of factors which may have a bearing on the development of student information literacy in schools

Perceptions of Nursing Students Regarding Evidence-Based Practice

The purpose of this descriptive quantitative study was to explore the nursing students\u27 perceptions of their attitude and knowledge regarding evidence-based practice (EBP). The Research Awareness Questionnaire (RAQ), previously used only with healthcare professionals was slightly modified and piloted with senior nursing students (N=22). Eighty-two percent (n=18) of the participants believe that EBP is part of their role. Only 41% (n=9) were confident to undertake research. On the actual knowledge measures, 96% (n=21) could define qualitative research, and 86 % (n=19) correctly defined quantitative research. Suggestions for revising the RAQ are discussed. With modifications, this instrument could be utilized by other schools to measure nursing students\u27 perceptions of their attitude and knowledge towards EBP

Evidence-Based Practice and Organizational Development in Libraries

This article is written for a Festschrift for F. W. Lancaster, and it summarizes the author???s library school experiences as a student of Professor Lancaster and Professor Herbert Goldhor at the University of Illinois. Both professors instilled in students a strong inclination to use real and appropriate information in evaluating situations, making decisions, delivering information services, and managing libraries. The author suggests that this Lancaster-Goldhor approach to information, and to data-driven decision making, anticipated the current movement toward evidence-based practice (EBP) in libraries. He suggests that libraries embrace the premises, philosophy, values, and practices of organizational development (OD) as an overarching discipline that facilitates EBP in the library culture, and ultimately leads to healthier and more effective organizations. This article complements a 2004 Library Trends article on OD, and numerous recent publications on OD and related topics are cited.published or submitted for publicatio

Clinical experience as evidence in evidence-based practice

Background. This paper's starting point is the recognition (descriptive not normative) that, for the vast majority of day-to-day clinical decision-making situations, the 'evidence' for decision-making is experiential knowledge. Moreover, reliance on this knowledge base means that nurses must use cognitive shortcuts or heuristics for handling information when making decisions. These heuristics encourage systematic biases in decision-makers and deviations from the normative rules of 'good' decision-making. Aims. The aim of the paper is to explore three common heuristics and the biases that arise when handling complex information in clinical decision-making (overconfidence, hindsight and base rate neglect) and, in response to these biases, to illustrate some simple techniques for reducing the negative influence of heuristics. Discussion. Nurses face a limited range of types of uncertainty in their clinical decisions and draw primarily on experiential knowledge to handle these uncertainties. This paper argues that experiential knowledge is a necessary but not sufficient basis for clinical decision-making. It illustrates how overconfidence in one's knowledge base, being correct 'after the event' or with the benefit of hindsight, and ignoring the base rates associated with events, conditions or health states, can impact on professional judgements and decisions. The paper illustrates some simple strategies for minimizing the impact of heuristics on the real-life clinical decisions of nurses. Conclusion. The paper concludes that more research knowledge of the impact of heuristics and techniques to combat them in nursing decisions is needed