Abstract:

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Como já havia anunciado há alguns posts atrás, no dia 7 de junho, aconteceu o #EBP2008, o encontro de blogueiros publicitários. Em sua terceira edição, esta foi a mais grandiosa, saindo dos bares de São Paulo, onde reuniam apenas alguns blogueiros da capital paulista foi parar na ESPM, uma das melhores escolhas de Propaganda e Marketing do Brasil, reunindo blogueiros publicitários de todo Brasil.

Eu saí diretamente de Campinas, interior de São Paulo, juntamente com a colaboradora do blog, a Marina. Após um ônibus até São Paulo e um metro até a Vila Mariana, chegamos à ESPM.

No evento pudemos presenciar três palestras muito boas com Jean Boechat (Jampa), Jeff Paiva e Wagner Martins (Mr. Manson).

Jean Boechat é diretor de criação da RMG Connect, sua palestra foi bastante descontraída. Ele contou sobre sua história com a internet, sobre a importância da criatividade estratégica, a imporância dos blogs e sobre o twitter. Fez um bate-papo legal com a galera e deixou alguns pontos para a discussão entre os blogueiros.

Jeff Paiva, gerente de Social Media da Agência Click, fez uma palestra com o tema social media, que são estratégias em redes sociais como orkut, blogs, microbloggings, entre outras ferramentas. O defensor do Second Life mostrou vários cases da Click e o que achei mais interessante é como a agência vende para o cliente estes tipos de ferramentas que ainda são alvo de desconfiança de muitos.

Já Wagner Martins da Espalhe, levou o marketing de guerrilha para a discussão. Falou sobre a relação entre RP e guerrilha, como vender para o cliente e os riscos que valem a pena correr. Esta infelizmente foi a única palestra que não pude presenciar até o fim.

Para finalizar, o sorvete distribuído pela Kibon compensou a falta de água no evento, o único ponto negativo que deixo aqui. Parabéns aos organizadores Bruno Delfino, Gabriel Jacob e Gui Cury, o evento estava realmente ótimo. Apesar da minha timidez aproveitei bastante o evento e estarei no próximo com certeza. E que venha o #ebp2009.

Veja algumas fotos no Flickr do Rafael Ziggy e do Ariel Gajardo, do Simviral.

No dia 7 de junho acontece o EBP 2008, que é o encontro de blogueiros publicitários, um evento que vai reunir todo esse pessoal para discutir e conversar sobre blogs, publicidade e tecnologia. É uma ótima chance para conhecer os grandes blogueiros e profissionais da propaganda, além da oportunidade de adquirir e partilhar conhecimento.

O evento já aconteceu em outros anos, mas de uma maneira bem mais informal do que está sendo realizado para este, que possui material de divulgação e tudo mais. Veja abaixo um vídeo produzido para o evento com depoimentos de alguns blogueiros publicitários.

O local do evento será na ESPM, mas precisamente no Cic (Centro de inovação e criatividade), na rua Alvaro Alvim, 123; bairro Vila Mariana em São Paulo. Não sabe onde é ainda? clique aqui.

As inscrições podem ser feitas a partir do site oficial do evento, no www.ebp2008.com.br, lembrando que a inscrição totalmente gratuita e para entrar basta levar apenas 1kg de alimento não-perecível. E para maiores informações estão sendo feitas atualizações no blog oficial e via twitter (@ebp2008)

Se você for de Campinas ou região e for um blogueiro ou publicitário e vai participar, dê um toque aqui nos comentários.

Cornwall College Business (CCB) is giving local businesses the opportunity to discover how they can grow by attracting skilled people to their company at a free event this summer. The event, ‘Attracting young Cornish talent: An opportunity for your business’ is being held on Friday 13th June and is being hosted by Cornwall College Business (CCB).

Running from 1 – 4.15pm at Imerys, Par, the conference will cover how other businesses have benefited from employing young talent; explain how to attract young skilled workers to business, and outline the funding that is available to help them. Free apprentice and graduate training can be provided by CCB and advisors will be on hand to discuss the available options.

Expert speakers and representatives from local businesses including Christoph Bettin, Manager of Marble Ltd and Phil Nelson, a graduate who has been working with him will explain how business can gain competitive advantage and grow. Attendees will also hear about the changes in the 14-19 curriculum and the impacts they will have on their business.

Delegates will round off their afternoon by indulging in a sumptuous Cornish cream tea while networking with other businesses and talking to specialists and advisors from CCB, Cornwall College, Unlocking Cornish Potential, Education Business Partnership, Deliotte and local schools.

Cornwall College Principal John Latham said: “This event gives businesses the chance to discover how working with Cornwall’s talented young individuals can benefit their business and the Cornish economy, as well as providing opportunities for apprentices and graduates in Cornwall, which will benefit Cornwall’s future.”

Places are limited, so if you would to attend this exciting event, please contact CCB Client Services Advisor, Chris Mackenzie by 30th May 2008 on 0800 731 7594 or email chris.mackenzie@ccb.cornwall.ac.uk

Ends

  A review of evidence-based practice, nursing research and reflection: levelling the hierarchy,

Abstract

Aim. This paper examines the evidence-based practice movement, the hierarchy of evidence and the relationship between evidence-based practice and reflective practice.

Background. Evidence-based practice is equated with effective decision making, with avoidance of habitual practice and with enhanced clinical performance. The hierarchy of evidence has promoted randomized control trials as the most valid source of evidence. However, this is problematic for practitioners as randomized control trials overlook certain types of knowledge that, through the process of reflection, provide useful information for individualized and effective practice.

Method. A literature search was undertaken using CINAHL, medline and Ovid electronic databases in early 2006. The search terms used were: evidence-based practice, research evidence, evidence for practice, qualitative research, reflective practice, reflection and evidence. Other sources included handpicking of books on evidence-based practice, reflection and research. Only material written in English was included.

Findings. The hierarchy of evidence that has promoted randomized control trials as the most valid form of evidence may actually impede the use of most effective treatment because of practical, political/ideological and epistemological contradictions and limitations. Furthermore, evidence-based practice appears to share very similar definitions, aims and procedures with reflective practice. Hence, it appears that the evidence-based practice movement may benefit much more from the use of reflection on practice, rather than the use of the hierarchical structure of evidence.

Conclusion. Evidence-based practice is necessary for nursing, but its’ effective implementation may be hindered by the hierarchy of evidence. Furthermore, evidence-based practice and reflection are both processes that share very similar aims and procedures. Therefore, to enable the implementation of best evidence in practice, the hierarchy of evidence might need to be abandoned and reflection to become a core component of the evidence-based practice movement.

Purpose: The present investigation examines the time, effort, and resources that evidence-based practice (EBP) requires, and looks at what types of results are obtained. Method: Principles of EBP as outlined by the American Speech-Language-Hearing Association were applied to 3 treatment case studies. Results: The cases took between 3 and 7 hr to complete and yielded different amounts and types of results. Individual article searches yielded better results than did searches of systematic reviews. Most evidence found was from small-group and individual case studies. Conclusion: EBP is a necessary part of effective and ethical treatment. The resources needed, time involved, and availability of relevant information make current guidelines for EBP challenging for most full-time practitioners. Specific recommendations to address these concerns are offered. [ABSTRACT FROM AUTHOR]

Purpose: Using a sample of culturally/linguistically diverse children, we present data to illustrate the value of empirically derived combinations of tools and cutoffs for determining eligibility in child language impairment. Method: Data were from 95 4- and 6-year-olds (40 African American, 55 White; 18 with language impairment, 77 without) who lived in the rural South; they involved primarily scores from the Comprehension subtest of the Stanford-Binet Intelligence Scale--Fourth Edition (CSSB; R. Thorndike, E. Hagen, & J. Sattler, 1986), but scores from an experimental nonword repetition task (NRT; C. Dollaghan & T. Campbell, 1998) were also included as supplements to these scores. Results: Although the CSSB led to low fail rates in children without impairment and a statistically reliable group difference as a function of the children's clinical status but not their race, only 56% of children with impairment were accurately classified when -1 SD was employed as the cutoff. Diagnostic accuracy improved to 81% when an empirically derived cutoff of -.5 SD was used. When scores from the NRT were added to those from the CSSB, diagnostic accuracy increased to 90%. Implications: This illustrative case adds to the growing number of studies that call for empirically derived combinations of tools and cutoffs as one option within an evidence-based practice framework. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the validity of 3 discourse comprehension measures for preschool children and the ability of a combination of them to classify children with and without language impairment. Method: Thirty-seven children with typical language and 12 children with language impairment completed 3 measures of oral story comprehension: the Joint Story Retell task, the Expectancy Violation Detection task, and comprehension questions. Results: Discriminant analyses revealed that each measure successfully classified pre-identified groups. The clinical combination of all 3 measures resulted in 96% accurate identification of the language status of this cohort. Conclusion: Results support these procedures as valid measures of discourse comprehension and monitoring and provide preliminary evidence that their combination can be validly employed for identifying young children with language comprehension impairment. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review focuses on peer-reviewed articles published since 1985 that assess the outcomes of language intervention practices for school-age students with spoken language disorders. Method: We conducted computer searches of electronic databases and hand searches of other sources for studies that used experimental designs that were considered to be reliable and valid: randomized clinical trials, nonrandomized comparison studies, and multiple-baseline single-subject design studies. Results: The review yielded 21 studies concerning the efficacy or effectiveness of language intervention practices with school-age children since 1985. Eleven of the studies limited participants to children in kindergarten and first grade, and no studies were located that focused on students in middle grades or high school. The relatively high quality of the studies that met our criteria, and the moderate-to-high effect sizes we calculated for the majority of studies, suggests that clinicians can have some confidence in the specific language intervention practices examined. Conclusion: The fact that only 21 studies met our criteria means that there is relatively little evidence supporting the language intervention practices that are currently being used with school-age children with language disorders. We outline significant gaps in the evidence and discuss the implications for clinical practice in schools. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present investigation was to examine the impact of early intervention on speech and lexical measures for toddlers with cleft palate. Method: Speech measures of ten 27-month-old toddlers with cleft palate who had been referred for therapy at 17 months of age were compared to those of 10 toddlers with cleft palate who had been referred but did not receive therapy. Both groups were compared to 2 other groups of children who had never been referred for therapy. Results: Multivariate analysis of variance revealed only 1 significant difference between the children who received therapy and those who did not receive therapy. Children who received therapy produced a significantly greater percentage of glides (p < .001) than did children who did not receive therapy. Conclusion: The findings of this study indicated that early intervention as conducted by the speech-language pathologists in this study was not as effective as expected for this group of toddlers with cleft palate. [ABSTRACT FROM AUTHOR]

No abstract available.

Objective  To review the incidence of aspiration after chemoradiation therapy in patients with head and neck cancer (HNC).

Design  Retrospective review.

Setting  Academic institution.

Patients  One hundred thirty patients with advanced HNC underwent chemoradiation therapy at our institution between 1998 and 2002 as part of a larger, multi-institutional, prospective study of induction chemotherapy followed by chemoradiation therapy; the 118 patients (91%) for whom oropharyngeal motility (OPM) study data were available are discussed in this article.

Main Outcome Measures  Incidence of trace ( 5% of swallowed bolus) and frank (> 5%) aspiration (deep laryngeal or tracheal penetration) as determined by pretreatment and posttreatment OPM studies and correlation of the findings with the patients' reported symptoms.

Results  Eighty-one patients (69%) underwent at least 1 OPM study demonstrating aspiration within the first year after chemoradiation therapy, with 30 (25%) demonstrating frank aspiration. Of the patients who aspirated, 61 (75%) reported no symptoms of coughing or choking (80% of trace and 67% of frank aspirators). The patients with cancer of the larynx and hypopharynx were more likely to be aspirators (P = .007 and P = .004, respectively). Of the 62 patients with available pretreatment OPM data, 33 (53%) demonstrated aspiration at baseline.

Conclusions  Aspiration is highly prevalent among patients with advanced HNC at baseline and is worse in the posttreatment period after chemoradiation therapy. The majority of these patients report no symptoms. All patients with advanced HNC should undergo instrumental swallow assessment, even in the absence of symptoms, to detect subclinical aspiration and to institute therapeutic maneuvers and swallow precautions as well as to determine the safety of oral feeding.

OBJECTIVES: We sought to describe the findings of modified barium swallow study after chemoradiation in patients with head and neck cancer and to correlate these findings with clinical variables, including gastrostomy tube dependence and clinical pneumonia. METHODS: We retrospectively reviewed 49 patients at a tertiary care center who underwent modified barium swallow study for dysphagia after chemoradiation. RESULTS: Patients with nonlaryngeal lesions had increased cricopharyngeal impairment (27.8% versus 0.0%; p = .04). Patients who underwent concomitant chemotherapy had increased epiglottic changes relative to those who had radiotherapy alone (66.7% versus 30.8%; p = .05). Clinical pneumonia developed in 31.9% of the patients, and 79.6% required gastrostomy tube placement for a mean duration of 18.1 months. CONCLUSIONS: Chemoradiation effects deglutition at multiple levels. A large percentage of patients will develop pneumonia and feeding tube dependence. This study is among the largest to correlate the results of modified barium swallow studies to clinical variables in this patient population. This study highlights the significant incidence of gastrostomy tube dependence and pneumonia in these patients.

The next morning we were wasted and friends started to trickle in. We had to make a Safeway run in order to get cups. On our way out of Safeway one of the employees shouted, "you forgot your keys." I turned to watch him toss them on to the floor, down the aisle, and into my hands. I gladly accepted them.

In the parking lot I searched for the Ford automobile. One of the keys said Festiva and there weren't many cars in the lot. Within no time I was racing around the parking lot. I don't think I even had a drivers permit at this time. After I got my fix I parked the car and left the keys on the dash. That would be my one and only official joy ride.

Back at the house the drink was back on. We drank and drank and drank. It was still early in the morning. It was before noon, and not even the whole tribe had shown up, before I passed out face down in the back yard.

Shortly after I woke up I had to go pee. I did my business and then looked in the mirror. My eyebrow was gone. Somebody had also gotten to one of my armpits. My shock turned to rage. I went on a man hunt. I was throwing blows right and left. "Who did it," i yelled. Finally Henan fessed up. Turns out it was He and Scho's older brother. Scho's older brother had left the party so all my rage was focused on Henan. We wrestled around and eventually smashed into a large glass window. At some point someone tried to knock me out with a large piece of wood by hitting me on the head from behind. Finally, the fight was broken up.

I ended up in a bedroom, laying on a bed. I was balling and one of my friends was trying to counsel me. Nob's mom walked in, accompanied by Nob and some other members of the clan. She told me to chill out and I called her a bitch. Nob then jumped through the air an landed a good one on me. At that point my mother was called to pick me up. Soon after that I was escorted out of the house by my mom. I cried and yelled at my friends.

Back at home I dropped like a rock. When I awoke it was night time and everybody was asleep. My rage kicked back in. I grabbed an ax handle, my mom's keys, and pushed my mom's car part way down the street. Once I was far enough away from my parents ears I started up the car and b-lined it straight back to Nob's house. Luckily my sister saw me from the other side of the street on her way home.

Back at Nob's I searched for a way into the house. I got into the back yard and tried to open the sliding glass door. I was having no luck, or "good" luck I could say, when my dad showed up. He found me laying in the side yard of Nob's house with an ax handle in my hand.

Yes, EBP broke up that day. I was the leader, and what turned out to be the glue. Some of the guys started a new gang, some stayed friends with me, and in the following year I was absorbed into a new group as well. The black eye went away, the armpit hair grew back, and I eventually appreciated the lack of eyebrow. I recall going golfing with a snazzy, blue-curled, drawn on eyebrow, later that month...