scholarly journals An Updated Theoretical Framework for Vocal Hyperfunction

2020 ◽  
Vol 29 (4) ◽  
pp. 2254-2260 ◽  
Author(s):  
Robert E. Hillman ◽  
Cara E. Stepp ◽  
Jarrad H. Van Stan ◽  
Matías Zañartu ◽  
Daryush D. Mehta
Keyword(s):  
Longitudinal Studies ◽  
Clinical Management ◽  
Research Evidence ◽  
Theoretical Framework ◽  
Future Research ◽  
Evidence Based ◽  
Fundamental Structure ◽  
Multiple Factors ◽  
Vocal Hyperfunction ◽  
New Knowledge

Purpose The purpose of this viewpoint article is to facilitate research on vocal hyperfunction (VH). VH is implicated in the most commonly occurring types of voice disorders, but there remains a pressing need to increase our understanding of the etiological and pathophysiological mechanisms associated with VH to improve the prevention, diagnosis, and treatment of VH-related disorders. Method A comprehensive theoretical framework for VH is proposed based on an integration of prevailing clinical views and research evidence. Results The fundamental structure of the current framework is based on a previous (simplified) version that was published over 30 years ago (Hillman et al., 1989). A central premise of the framework is that there are two primary manifestations of VH—phonotraumatic VH and nonphonotraumatic VH—and that multiple factors contribute and interact in different ways to cause and maintain these two types of VH. Key hypotheses are presented about the way different factors may contribute to phonotraumatic VH and nonphonotraumatic VH and how the associated disorders may respond to treatment. Conclusions This updated and expanded framework is meant to help guide future research, particularly the design of longitudinal studies, which can lead to a refinement in knowledge about the etiology and pathophysiology of VH-related disorders. Such new knowledge should lead to further refinements in the framework and serve as a basis for improving the prevention and evidence-based clinical management of VH.

Application of evidence-based management to chronic disease healthcare: a framework

2018 ◽  
Vol 56 (10) ◽  
pp. 2125-2147 ◽  
Author(s):  
Saligrama Agnihothri ◽  
Raghav Agnihothri
Keyword(s):  
Chronic Disease ◽  
Patient Outcomes ◽  
Systematic Reviews ◽  
Physician Behavior ◽  
Healthcare Quality ◽  
Theoretical Framework ◽  
Future Research ◽  
Evidence Based ◽  
Content Type ◽  
Ex Post

Purpose The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare. Design/methodology/approach Chronic healthcare is specially characterized by recursive patient-physician interactions in which evidence-based medicine (EBM) is applied. However, implementing evidence-based solutions to improve healthcare quality requires managers to effect changes in many different areas: organizational structure, procedures, technology and in physician/provider behaviors. To complicate matters further, they must achieve these changes using the tools of resource allocation or incentives. The literature contains many systematic reviews evaluating the question of physician and patient behavior under various types and structures of incentives. Similarly, systematic reviews have also been done regarding specific changes to the healthcare process and their effectiveness in improving patient outcomes. Yet, these reviews uniformly lament a lack of appropriate data from well-organized studies on the question of “Why?” solutions may work in one instance while not in another. The authors present a new theoretical framework that aids in answering this question. Findings This paper presents a new theoretical framework (Influence Model of Chronic Healthcare) that identifies: the critical areas in which managers can effect changes that improve patient outcomes; the influence these areas can have on each other, as well as on patient and physician behavior; and the mechanisms by which these influences are exerted. For each, the authors draw upon, and present the evidence in the literature. Ultimately, the authors recognize that this is a complex question that has not yet been fully researched. The contribution of this model is twofold: first, the authors hope to focus future research efforts, and second, provide a useful heuristic to managers who must make decisions with only the lesser-quality evidence the literature contains today. Originality/value This model can be used by managers as a heuristic either ex ante or ex post to determine the effectiveness of their decisions and strategies in improving healthcare quality. In addition, it can be used to analyze why actions or decisions taken achieved a given outcome, and how best to proceed to effect further improvements on patient outcomes. Last, the model serves to focus attention on specific questions for further research.

scholarly journals One step forward and two steps back? The ‘20 Principles’ for questioning vulnerable witnesses and the lack of an evidence-based approach

2018 ◽  
Vol 22 (4) ◽  
pp. 392-410 ◽  
Author(s):  
Penny Cooper ◽  
Coral Dando ◽  
Thomas Ormerod ◽  
Michelle Mattison ◽  
Ruth Marchant ◽  
...  
Keyword(s):  
Empirical Evidence ◽  
Research Evidence ◽  
Theoretical Framework ◽  
Evidence Based ◽  
England And Wales ◽  
Advocacy Training ◽  
One Step

It is a widely held belief that questioning vulnerable witnesses is a specialist skill. In England and Wales vulnerable witness advocacy training built around ‘20 Principles’ has been developed and is being delivered. The 20 Principles do not cite a tested theoretical framework(s) or empirical evidence in support. This paper considers whether the 20 Principles are underpinned by research evidence. It is submitted that advocacy training and the approach to questioning witnesses in the courtroom should take into account the already available research evidence. The authors make recommendations for revision of the training and for a wider review of the approach taken to the handling of witness evidence.

scholarly journals EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis

2017 ◽  
Vol 76 (9) ◽  
pp. 1484-1494 ◽  
Author(s):  
Garifallia Sakellariou ◽  
Philip G Conaghan ◽  
Weiya Zhang ◽  
Johannes W J Bijlsma ◽  
Pernille Boyesen ◽  
...  
Keyword(s):  
Clinical Management ◽  
Task Force ◽  
Imaging Modality ◽  
Conventional Radiography ◽  
Added Value ◽  
Future Research ◽  
Evidence Based ◽  
Eular Recommendations ◽  
First Choice

The increased information provided by modern imaging has led to its more extensive use. Our aim was to develop evidence-based recommendations for the use of imaging in the clinical management of the most common arthropathy, osteoarthritis (OA). A task force (including rheumatologists, radiologists, methodologists, primary care doctors and patients) from nine countries defined 10 questions on the role of imaging in OA to support a systematic literature review (SLR). Joints of interest were the knee, hip, hand and foot; imaging modalities included conventional radiography (CR), MRI, ultrasonography, CT and nuclear medicine. PubMed and EMBASE were searched. The evidence was presented to the task force who subsequently developed the recommendations. The strength of agreement for each recommendation was assessed. 17 011 references were identified from which 390 studies were included in the SLR. Seven recommendations were produced, covering the lack of need for diagnostic imaging in patients with typical symptoms; the role of imaging in differential diagnosis; the lack of benefit in monitoring when no therapeutic modification is related, though consideration is required when unexpected clinical deterioration occurs; CR as the first-choice imaging modality; consideration of how to correctly acquire images and the role of imaging in guiding local injections. Recommendations for future research were also developed based on gaps in evidence, such as the use of imaging in identifying therapeutic targets, and demonstrating the added value of imaging. These evidence-based recommendations and related research agenda provide the basis for sensible use of imaging in routine clinical assessment of people with OA.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

Focused Tasks, Mental Actions and Second Language Learning. Cognitive and Connectionist Accounts of Task Effectiveness

2006 ◽  
Vol 152 ◽  
pp. 35-53 ◽  
Author(s):  
Machteld Moonen ◽  
Rick de Graaff ◽  
Gerard Westhoff
Keyword(s):  
Second Language ◽  
Language Learning ◽  
Learning Strategies ◽  
Cognitive Processes ◽  
Second Language Learning ◽  
Theoretical Framework ◽  
Future Research ◽  
Depth Of Processing ◽  
Mental Actions ◽  
Involvement Load Hypothesis

Abstract This paper presents a theoretical framework to estimate the effectiveness of second language tasks in which the focus is on the acquisition of new linguistic items, such as vocabulary or grammar, the so-called focused tasks (R. Ellis, 2003). What accounts for the learning impact offocused tasks? We shall argue that the task-based approach (e.g. Skehan, 1998, Robinson, 2001) does not provide an in-depth account of how cognitive processes, elicited by a task, foster the acquisition of new linguistic elements. We shall then review the typologies of cognitive processes derived from research on learning strategies (Chamot & O'Malley, 1994), from the involvement load hypothesis (Laufer & Hulstijn, 2001), from the depth of processing hypothesis (Craik & Lockhart, 1972) and from connectionism (e.g Broeder & Plunkett, 1997; N. Ellis, 2003). The combined insights of these typologies form the basis of the multi-feature hypothesis, which predicts that retention and ease of activation of new linguistic items are improved by mental actions which involve a wide variety of different features, simultaneously and frequently. A number of implications for future research shall be discussed.

An Evidence-Based Review of Antitussive Herbs Containing Essential Oils in Traditional Persian Medicine

2020 ◽  
Vol 17 ◽  
Author(s):  
Ayda Hosseinkhani ◽  
Bijan Ziaeian ◽  
Kamran Hessami ◽  
Mohammad Mehdi Zarshenas ◽  
Ali Kashkooe ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Essential Oils ◽  
Scientific Evidence ◽  
Herbal Remedies ◽  
Future Research ◽  
Evidence Based ◽  
Online Databases ◽  
Persian Medicine ◽  
Troublesome Symptom ◽  
Traditional Persian Medicine

Background: Cough is one of the most common medical symptoms for which medical advice is sought. Although cough is a protective reflex responsible for clearing the airways from secretions and foreign bodies, it can be a troublesome symptom that causes discomfort to patients. Due to the increasing interest in herbal remedies in the both developed and developing countries, in the current study, we aimed to overview medicinal herbs containing essential oils used as antitussive agents according to the Traditional Persian Medicine [TPM] textbooks. We summarized the relevant scientific evidence on their possible pharmacological actions. Methods: To collect the evidence for treatment of cough or “seaal” [cough in ancient books] from TPM sources, five main medicinal Persian manuscripts were studied. The antitussive herbs were listed and their scientific names were identified and authenticated in accordance with botanical reference books. ScienceDirect and PubMed online databases were searched for related mechanisms of action of the reported medicinal plants. Results: The number of 49 herbs containing essential oils were recommended in TPM for the treatment of cough; 21 of them had at least one known mechanism of action for cough suppression in the scientific literature. According to this review, most of the cited medicinal plants were assessed for either nitric oxide inhibitory or antitussive/expectorant activities. Conclusion: In addition to advantageous effects of antitussive herbs noted by TPM, the present review highlighted some recent evidence-based data on these promising candidates that could be used as an outline for future research on their medicinal use.

Sign in / Sign up

Export Citation Format

Share Document