...eight or nine years after Heinlein’s publication, these kinds of remote manipulators popularly known as "Waldoes" were developed in the real world. Using cable and linkages, they were used to move and manipulate hazardous materials and enter hazardous environments inhospitable to humans. The first telepresence robotic arm was developed in the 1950s for the same purpose. Raymond Goertz, an early pioneer in the field of robotics, developed the first master/slave manipulator to handle radioactive material while working for the Atomic Energy Commission at Argonne National Laboratory. . Analysis of Global Context Intuitive Surgical for over a decade has centered their studies on the technology of surgical robotics. The studies were based on the philosophy the da Vinci Sugical System. This invasive surgery has been enforced all over the world and has treated millions of patients. The surgical robot is very appropriate and safe. Intuitive Surgical and performed several research studies to check the accuracy and safety of the product. In order for the company to get the best results of the product...
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...Johnson and Johnson vs. Pzifer (Technology) According to my research, Evidence-Based Medicine (EBM) is the trend in health care that keeps growing. EBM experts compare available clinical evidence for various treatments that may be used in a disease, determine the best standard care (based on the comparison), and apply the “best” standard to care for patients. Evidence-Based Medicine aims for helping health care providers decide which patient should get which treatment, and under what circumstances. After this, the final decision of which treatment is best for an individual is based on the doctor and patient. The evidence that EBM looks at includes: how well the product/therapy works, how effective it is compared with alternative treatments, how safe it is, and how the therapy affects different people differently. It is also a way to keep patients and doctors informed about the potential risks and benefits of a treatment. Another approach is the Health Technology Assessment (HTA). Unlike EBM, HTA tries to determine the cost-effectiveness of the treatment. It looks at how cost-effective the treatment is when used in a large diversified group of people who are covered by a healthy system. It does not address whether the treatment is cost-effective for an individual. Some government-financed health care systems require cost-effectiveness assessments, in addition to regular approval (before a product is made to patients). The disadvantage for the patients is that...
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...appraisal is the process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision. q Critical appraisal is an essential part of evidence-based clinical practice that includes the process of systematically finding, appraising and acting on evidence of effectiveness. q Critical appraisal allows us to make sense of research evidence and thus begins to close the gap between research and practice. q Randomised controlled trials can minimise bias and use the most appropriate design for studying the effectiveness of a specific intervention or treatment. q Systematic reviews are particularly useful because they usually contain an explicit statement of the objectives, materials and methods, and should be conducted according to explicit and reproducible methodology. q Randomised controlled trials and systematic reviews are not automatically of good quality and should be appraised critically. www.evidence-based-medicine.co.uk Prescribing information is on page 8 1 What is critical appraisal What is critical appraisal? Critical appraisal is one step in the process of evidence-based clinical practice. Evidencebased clinical practice is ‘an approach to decision making in which the clinician uses the best evidence available, in consultation with the patient, to decide the option which suits the patient best’.1 To determine what is the ‘best’ evidence, we need critical appraisal skills that will help us to understand...
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...Group 1 Discussion Board 4 Nicholas Alexander Patrick Brinkman Cherbrie Collins Jessica French Liberty University Decision Making Using Evidence Based Management Daft (2013) states that managers should use data and facts to the “extent possible “ to make decisions using evidence-based management. This statement alludes that experience and intuition may be the best course of action. However, top-level managers may be confusing intuition and experience with fear for change. Cohen defines Evidence based management (EbM) as a model using evidence and facts to initiate change through effective decision-making (2012). Cohen goes on to state that most people only use anecdotal, low-level process problem solving where it is acceptable to be lucky. Most businesses cannot survive on luck alone. For EbM to work, Cohen (2012) identifies three components: analytics, decision-making, and problem solving. Managers must use analytics, math, to track data. This data must be incorporated into the decision-making process. Finally, managers have to know there is a problem and how to solve the problem. It would be beneficial if they knew what caused the problem as well. Dr. Shorthell (2006) identifies some ways to promote EbM within the healthcare community that are applicable for all businesses. The most important is that the data from researchers gets to the users in time to make decisions. The data should be clear and concise and explained in person to alleviate confusion...
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...components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient preferences and experiences. The area of clinical practice to be studied is within a community district nursing team consisting of 7 qualified nurses and 3 health care assistants. The location is situated within a seaside town with a large population of over 65 year olds. Through clinical experience, the author has found a flaw in quality of care when nursing staff are using the overview assessment document which has been adapted from the single assessment process produced by the Department of Health (DOH, 2002). When assessing nutrition there is a series of six questions and an asterisk to consider the “Malnutrition Universal Screening Tool” (MUST, 2003) however experience in practice would suggest the tool (MUST, 2003) isn't used and a local unknown screening tool is used on some rare occasions. The author feels management of these vulnerable patients is lacking and in order to improve patient care a clarification of guidance and service change maybe required. Exploring Cullum's (2007) theory of decision making, the author needs to justify the service change with valid researched evidence. As a nurse in practice it can be...
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...Cover Sheet Title The Effectiveness of Parental Involvement for Improving the Academic Performance of Elementary School Children Reviewers Chad Nye, PhD Jamie Schwartz, PhD Herb Turner, PhD Contact reviewer Chad Nye UCF Center for Autism & Related Disabilities 12001 Science Drive, Suite 145 Orlando, FL 32826 Phone : 407-737-2566 FAX : 407-737-2571 email : cnye@mail.ucf.edu 1 1.0 BACKGROUND The role of parents has long been thought to be centrally important to the academic achievement of their children. However, this role had neither been analyzed nor systematically studied using an experimental design until the 1960’s. The evaluation of the Head Start Program in the United States (Coleman, Campbell, Hobson, McPartland, Mod, Weinfeld, & York, 1966) fostered a national focus on outcomes related to parental involvement by suggesting a substantial relationship between parental involvement in their child’s education and their child’s success in academic domains. Subsequent studies have been presented which support the findings from Coleman, et al. (Duff & Adams, 1981; Henderson, 1987; 1988). Even so, other studies have reported either mixed or no significant differences between experimental and control groups when measuring the effect of parental involvement on student achievement (Griffith, 1996; Heller, & Fantuzzo, 1993; Henry, 1974; Keith, Reimers, Ferman, Pottenbaum, & Aubrey ,1986; Ryan, 1964; Searles, Lewis & Morrow, 1982). Some of the discrepancy across studies...
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...appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were within the last five years. Statistical data was gathered by experts and calculations made through third party experts, lending validity to the study. This article does not use the words ‘Evidence-Based Practice’ (EBP), but the CMC model is an EBP model, and many of the newer references make note to EBP. Although this was an interesting article, I may not use this in my final project. I...
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...WHAT IS EBM: Evidence-based management (EBM) is a new study that has been implemented in today’s organizations. The best example of EBM is applied in Medical field. But question arise here, why todays organizations need EBM, especially mangers. From the past records of mangers works, it is found out that most of the managers rely on old management style, which includes: • Past experience • Market trends • Old business records The result of old management style result into two outcomes; Success or Failed badly. WHY EBM: From all kind of managerial field (medical to education), EBM is used to evaluate and apply scientific research to find and solve the situation in best possible way. By using scientific solutions, organizations can save both their time and resources. Dr. David Sackett, gives the example of medical field in which new medicine experience is only gained by experience and practice. HOW TO APPLY EBM: Before we implement any condition in work place, we need to apply rules on test bases and watch out the outcome of system/conditions weather it is in positive or negative by taking a feedback from employees. These system/conditions can also be applied by market research, company product & services or customer feedback. But before taking such steps, we can always refer to experienced persons or companies, who implemented such systems and check there possible outcomes and problems they faced during and after EBM system. We can also reward people...
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...WHERE'S THE EVIDENCE? COMPLETING SECTION C Section C is due WEEK 3. This is where you present the RESEARCH evidence for your proposed change. Note that you must have 6 RESEARCH studies. Please use the required form for completion of the research reports and follow the directions closely. Completion of this form will ensure that you have found RESEARCH studies and will also provide you with an opportunity to consider the strength of the evidence that you have. In section C you will be locating 6 research studies on to support your proposed change. EACH study must address the focus of this concern. Once you find the research studies, you will examine EACH study and describe the SETTING, PURPOSE, RESEARCH DESIGN, SAMPLE, and FINDINGS. This will be quite easy to do as it should be clearly identified in the study. Fill this in the REVIEW OF THE EVIDENCE FORM for each study. PLEASE USE THE FORM PROVIDED - IT IS REQUIRED. Note that you must attach PDF versions of the six research studies for me to review. Next you will need to ascertain the level of evidence that each study represents. To learn more about this, please go to this Evidence Based Practice Tutorial and watch the VIDEO and then take the tutorial. When you finish, you will have a much clearer idea about the nature of evidence and why we need a body of knowledge to support our nursing actions and desired outcomes. USE THIS TABLE TO MAKE A JUDGMENT AS TO THE LEVEL EACH RESEARCH ARTICLE FITS. Rating System for the Hierarchy of...
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...due to lack of evidence for a clear benefit. As for acupuncture, there are actually a lot more well-designed studies done on this field when compared to Chinese herbs, mostly because Europe and the West have become very interested over the last couple decades and are funding better clinical trials. The evidence trail is building, which is great for everyone. So, what works, and what doesn’t? The New York Times has a very readable article (http://well.blogs.nytimes.com/2010/08/23/studying-acupuncture-one-needle-prick-at-a-time/?hpw) which covers this issue. The gist of the article discusses the most recent, well-designed studies on back pains and other disorders; the studies usually show no difference between acupuncture and placebo (usually a “sham” needle that doesn’t penetrate the skin). In other words, the best studies lately are usually showing that most of the perceived effect from acupuncture is simply a placebo effect. These recent findings are by no means surprising, as most of the best studies have been reporting similar conclusions for many years. The best collection of acupuncture research is from the Cochrane Review Group, which performs the world’s most rigorous reviews of all treatments, including alternative medicines. They have an outstanding collection of the best literature on acupuncture (http://www.thecochranelibrary.com/details/collection/691705/Acupuncture-ancient-tradition-meets-modern-science.html) which details the best evidence regarding a number...
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...Inquiry into health care Assignment 1 This essay aims to thoroughly examine the importance of evidence-based practice within the health care setting. The use of evidence-based practice as a practical framework to locate, appraise and apply the best research will further discussed throughout this essay. In addition this essay will explore how health care professionals can use the five steps of evidence based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying the best research evidence in relation to Occupational Health and Safety (OHS). The use of hand washing in relation to infection control will be the OHS area explored. Evidence based practice is a framework that involves an expert finding experimental evidence concerning the value of or effectiveness of altered treatment options, the significance of this evidence is then established in relation to the patients situation (Liamputtong, 2010).Evidence Based Practice generates the need for clinically vital information regarding clinical and health care issues (Liamputtong, 2010). This clinically vital information is gathered by altering evidence into answerable questions, once this information is gathered the appraised information will be put into clinical practice and evaluated based on performance (Liamputtong, 2010). The importance of the five steps of Evidence Based Practice is consistent and conclusive. Before EBP, clinical knowledge was primarily relied on in areas...
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...Liverpool Care Pathway (LCP) is an integrated care pathway developed in the late 1990’s (Ellershaw et al, 1997) as a means of transferring best practice in care of the dying, from the hospice environment to other sectors starting in the acute setting. Currently the LCP is a recognised tool used by clinicians in the United Kingdom as well as over twenty countries, to give appropriate care to patients who have reached the last hours or days of their lives. Described to provide comfort to the dying and also address the needs of the carers (Chapman 2009). During this assignment the author will highlight and explain how a data search was conducted, and will analyse the data retrieved, explaining and evaluating the data to build a discussion based on the chosen topic of end of life care, with a focus on the Liverpool Care Pathway. The author will conclude by producing recommendations for practice. Although described above that the Liverpool Care Pathway is an appropriate tool for providing adequate care for patients, it can also be seen as a controversial pathway, being described as a ‘tick box’ approach rather than a humanistic approach (Chapman 2010). It has been referred to by the UK’s Daily Telegraph as ‘sentenced to death on the National Health Service’ (Devlin 2009). The author has a keen interest in palliative care, after researching is interested in enhancing knowledge surrounding the LCP as there are many ethical debates surrounding the pathway despite being endorsed by the...
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...PICOT Literature Review Mia Fisher Grand Canyon University EBP 325 Wendy Cockron PICOT Literature Review This literature review examines the available research on the topic of the administration of natural surfactant vs synthetic surfactant in neonates with respiratory distress syndrome. Respiratory distress syndrome is caused by a deficiency, dysfunction, or inactivation of pulmonary surfactant and is a significant cause of morbidity or mortality of preterm infants. The literature reviewed, highlights the differences in extracted natural surfactants and synthetic surfactants and whether one proves to be more beneficial over the other. Pfister RH, Soll R, Wiswell TE. Protein-containing synthetic surfactant versus protein-free synthetic surfactant for the prevention and treatment of respiratory distress syndrome. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD006180. DOI: 10.1002/14651858.CD006180.pub2. In the above article the use of synthetic surfactant is discussed with regards to protein containing or non-protein containing synthetics. The synthetics that contain proteins have shown a higher efficacy in preventing respiratory distress syndrome than those without. The research suggests the reasoning for this is due to the synthetic containing proteins acting like naturally occurring surfactant proteins. This research lends to the rationale that the synthetic containing protein surfactants effectiveness being like that of a natural surfactant...
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...Critique of Systematic Review Mary Odenwalder Nur 518 April 7, 2014 Jane Cash Critique of Systematic Review The World Health Organization (WHO) recommends that all infants breastfeed exclusively until six months old to achieve optimum growth. Despite this recommendation, only one out of every three children are exclusively breastfed for the first six months. This includes countries that have a high rate of breastfeeding initiation. Recent data has shown that the exclusive breastfeeding rates over the last 15 years have only risen about six per cent, from 33% to 39%. Breask milk protects children against childhood illnesses such as gastroenteritis, respiratory tract infections, otitis media, atopic dermatitis, asthma, and SIDS. Studies have also shown that children that are breastfeed have improved cognitive development and decreased risk for childhood obesity (Haroon, Das, Salam, Imdad, & Bhutta, 2013) . A systematic review begins with a specific research question and then the author has a specific method which will be used to find the articles that are relevant for the study. Systematic reviews attempt to remove biases from the process. The research question being answered in this review is regarding breastfeeding promotion inventions and breastfeeding practices. The topic is an appropriate topic for a systematic review because it is broad enough that there are many studies that have been performed, but specific enough to allow for the researchers to...
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...Evidence-based practice has gained particular salience in nursing and health care and is also applicable to social practice.(Photo: Medioimages/Photodisc/Photodisc/Getty Images) In theory, practice and theory are the same. In practice, they are not. Evidence-based practice has gained prominence over more theoretical approaches in several areas, particularly in the field of health care. Theory-guided and evidence-based practice share the common goal of making the right decision and finding the most effective solution for a perceived problem. However, they have some core philosophical differences. Sponsored Links * Full-Text Journal Library Browse millions of journal articles from top academic publications. www.questia.com/Journals Features Greek philosopher(Photo: Maros Markovic/iStock/Getty Images) At its core, the divide between evidence-based practice and theory-guided practice can be traced back to an ancient divide often found in science and philosophy: That of rationalism versus empiricism. Extreme rationalists claim that our senses are limited and place all their trust in reason. In contrast, empiricists claim that sense experience is the source of all our concepts and knowledge. While their positions are not so extreme, theory-guided practice follows a rather rationalist approach, while evidence-based practice favor empirical knowledge. Read more : http://www.ehow.com/about_6646089_difference-practice-evidence-based-practice.html The movement for evidence-based...
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