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1.
Compr Rev Food Sci Food Saf ; 23(3): e13344, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38634199

RESUMO

Effective food safety (FS) management relies on the understanding of the factors that contribute to FS incidents (FSIs) and the means for their mitigation and control. This review aims to explore the application of systematic accident analysis tools to both design FS management systems (FSMSs) as well as to investigate FSI to identify contributive and causative factors associated with FSI and the means for their elimination or control. The study has compared and contrasted the diverse characteristics of linear, epidemiological, and systematic accident analysis tools and hazard analysis critical control point (HACCP) and the types and depth of qualitative and quantitative analysis they promote. Systematic accident analysis tools, such as the Accident Map Model, the Functional Resonance Accident Model, or the Systems Theoretical Accident Model and Processes, are flexible systematic approaches to analyzing FSI within a socio-technical food system which is complex and continually evolving. They can be applied at organizational, supply chain, or wider food system levels. As with the application of HACCP principles, the process is time-consuming and requires skilled users to achieve the level of systematic analysis required to ensure effective validation and verification of FSMS and revalidation and reverification following an FSI. Effective revalidation and reverification are essential to prevent recurrent FSI and to inform new practices and processes for emergent FS concerns and the means for their control.


Assuntos
Manipulação de Alimentos , Inocuidade dos Alimentos , Alimentos , Indústria de Processamento de Alimentos , Gestão da Segurança
2.
Augment Altern Commun ; 39(3): 157-169, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37178137

RESUMO

Little is known about what features of AAC systems are regarded by AAC professionals as more suitable for children with different characteristics. A survey was conducted in which participants rated the suitability of hypothetical AAC systems on a Likert scale from 1 (very unsuitable) to 7 (very suitable) alongside a discrete choice experiment. The survey was administered online to 155 AAC professionals in the United Kingdom of Great Britain and Northern Ireland. Statistical modeling was used to estimate how suitable 274 hypothetical AAC systems were for each of 36 child vignettes. The proportion of AAC systems rated at least 5 out of 7 for suitability varied from 51.1% to 98.5% for different child vignettes. Only 12 out of 36 child vignettes had any AAC systems rated at least 6 out of 7 for suitability. The features of the most suitable AAC system depended on the characteristics of the child vignette. The results show that, while every child vignette had several systems that had a good suitability rating, there were variations, that could potentially lead to inequalities in provision.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação , Humanos , Criança , Reino Unido , Inquéritos e Questionários
3.
Environ Evid ; 12(1): 10, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37220478

RESUMO

In civil society we expect that policy and management decisions will be made using the best available evidence. Yet, it is widely known that there are many barriers that limit the extent to which that occurs. One way to overcome these barriers is via robust, comprehensive, transparent and repeatable evidence syntheses (such as systematic reviews) that attempt to minimize various forms of bias to present a summary of existing knowledge for decision-making purposes. Relative to other disciplines (e.g., health care, education), such evidence-based decision-making remains relatively nascent for environment management despite major threats to humanity, such as the climate, pollution and biodiversity crises demonstrating that human well-being is inextricably linked to the biophysical environment. Fortunately, there are a growing number of environmental evidence syntheses being produced that can be used by decision makers. It is therefore an opportune time to reflect on the science and practice of evidence-based decision-making in environment management to understand the extent to which evidence syntheses are embraced and applied in practice. Here we outline a number of key questions related to the use of environmental evidence that need to be explored in an effort to enhance evidence-based decision-making. There is an urgent need for research involving methods from social science, behavioural sciences, and public policy to understand the basis for patterns and trends in environmental evidence use (or misuse or ignorance). There is also a need for those who commission and produce evidence syntheses, as well as the end users of these syntheses to reflect on their experiences and share them with the broader evidence-based practice community to identify needs and opportunities for advancing the entire process of evidence-based practice. It is our hope that the ideas shared here will serve as a roadmap for additional scholarship that will collectively enhance evidence-based decision-making and ultimately benefit the environment and humanity.

4.
Int J Lang Commun Disord ; 58(3): 910-928, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36565242

RESUMO

BACKGROUND: Those supporting children and young people who use augmentative and alternative communication (AAC) contribute to ongoing complex decision-making about communication aid selection and support. Little is known about how these decisions are made in practice and how attributes of the communication aid are described or considered. AIMS: To understand how communication aid attributes were described by those involved in AAC recommendations and support for children and young people, and how these attributes were described as impacting on AAC use. METHODS & PROCEDURES: A secondary qualitative analysis was completed of interview and focus group data from 91 participants involved in the support of 22 children and young people. Attributes of communication aids described by participants were extracted as themes and this paper reports a descriptive summary of the identified software (non-hardware) attributes. MAIN CONTRIBUTION: Decisions were described in terms of comparisons between commercially available pre-existing vocabulary packages. Attributes related to vocabulary, graphic representation, consistency and intuitiveness of design, and ease of editing were identified. Developmental staging of vocabularies, core and fringe vocabulary, and vocabulary personalization were attributes that were described as being explicitly considered in decisions. The potential impact of graphic symbol choice did not seem to be considered strongly. The physical and social environment was described as the predominant factor driving the choice of a number of attributes. CONCLUSIONS & IMPLICATIONS: Specific attributes that appear to be established in decision-making in these data have limited empirical research literature. Terms used in the literature to describe communication aid attributes were not observed in these data. Practice-based evidence does not appear to be supported by the available research literature and these findings highlight several areas where empirical research is needed in order to provide a robust basis for practice. WHAT THIS PAPER ADDS: What is already known on the subject Communication aid attributes are viewed as a key consideration by practitioners and family members in AAC decision-making; however, there are few empirical studies investigating language and communication attributes of communication aids. It is important to understand how those involved in AAC recommendations and support view communication aid attributes and the impact different attributes have. What this paper adds to existing knowledge This study provides a picture of how communication aids are described by practitioners and family members involved in AAC support of children and young people. A range of attributes is identified from the analysis of these qualitative data as well as information about how participants perceive these attributes as informing decisions. What are the potential or actual clinical implications of this work? This study provides a basis on which practitioners and others involved in AAC support for children and young people can review and reflect on their own practice and so improve the outcomes of AAC decisions. The study provides a list of attributes that appear to be considered in practice and so also provides a resource for researchers looking to ensure there is a strong empirical basis for AAC decisions.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação , Humanos , Criança , Adolescente , Comunicação , Grupos Focais , Família , Vocabulário , Transtornos da Comunicação/diagnóstico , Transtornos da Comunicação/terapia
5.
Front Plant Sci ; 14: 1228850, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38259927

RESUMO

Introduction: Over the last decade, there has been a growing interest in cereal-legume intercropping for sustainable agriculture. As a result numerous papers, including reviews, focus on this topic. Screening this large amount of papers, to identify knowledge gaps and future research opportunities, manually, would be a complex and time consuming task. Materials and methods: Bibliometric analysis combined with text mining and topic modelling, to automatically find topics and to derive a representation of intercropping papers as a potential solution to reduce the workload was tested. Both common (e.g. wheat and soybean) as well as underutilized crops (e.g. buckwheat, lupin, triticale) were the focus of this study. The corpus used for the analysis was retrieved from Web of Science and Scopus on 5th September 2022 and consisted of 4,732 papers. Results: The number of papers on cereal-legume intercropping increased in recent years, with most studies being located in China. Literature mainly dealt with the cereals maize and wheat and the legume soybean whereas buckwheat and lupin received little attention from academic researchers. These underutilized crops are certainly interesting to be used as intercropping partners, however, additional research on optimization of management and cultivar's choice is important. Yield and nitrogen fixation are the most commonly studied traits in cereal-legume intercropping. Last decade, there is an increasing interest in climate resilience, sustainability and biodiversity. Also the term "ecosystem services" came into play, but still with a low frequency. The regulating services and provisioning services seem to be the most studied, in contrast terms related to potential cultural services were not encountered. Discussion: In conclusion, based on this review several research opportunities were identified. Minor crops like lupin and buckwheat need to be evaluated for their role as intercropping partners. The interaction between species based on e.g. root exudates needs to be further unraveled. Also diseases, pests and weeds in relation to intercropping deserve more attention and finally more in-depth research on the additional benefits/ecosystem services associated with intercropping systems is necessary.

6.
Environ Evid ; 11(12): 1-23, 2022 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38264537

RESUMO

The internal validity of conclusions about effectiveness or impact in systematic reviews, and of decisions based on them, depends on risk of bias assessments being conducted appropriately. However, a random sample of 50 recently-published articles claiming to be quantitative environmental systematic reviews found 64% did not include any risk of bias assessment, whilst nearly all that did omitted key sources of bias. Other limitations included lack of transparency, conflation of quality constructs, and incomplete application of risk of bias assessments to the data synthesis. This paper addresses deficiencies in risk of bias assessments by highlighting core principles that are required for risk of bias assessments to be fit-for-purpose, and presenting a framework based on these principles to guide review teams on conducting risk of bias assessments appropriately and consistently. The core principles require that risk of bias assessments be Focused, Extensive, Applied and Transparent (FEAT). These principles support risk of bias assessments, appraisal of risk of bias tools, and the development of new tools. The framework follows a Plan-Conduct-Apply-Report approach covering all stages of risk of bias assessment. The scope of this paper is comparative quantitative environmental systematic reviews which address PICO or PECO-type questions including, but not limited to, topic areas such as environmental management, conservation, ecosystem restoration, and analyses of environmental interventions, exposures, impacts and risks.

7.
Value Health ; 24(4): 575-584, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33840436

RESUMO

OBJECTIVES: Although literature exists on using qualitative methods to generate potential attributes for a discrete choice experiment (DCE), there is little on selecting which attributes to include. We present a case study in which a best-worst scaling case 1 (BWS-1) survey was used to guide attribute selection for a DCE. The case study's context was the decision making of professionals around the choice of augmentative and alternative communication (AAC) systems for children with limited natural speech. METHODS: BWS-1 survey attributes were generated from literature reviews and focus groups. DCE attributes were selected from BWS-1 attributes. The selection criteria were: include mostly important attributes; create coherent descriptions of children and AAC systems; address the project's research aims; have an appropriate respondent burden. Attributes' importance was judged using BWS-1 relative importance scores. RESULTS: The BWS-1 survey included 19 child and 18 AAC device/system attributes and was administered to N = 93 AAC professionals. Four child and five device/system attributes were selected for the DCE, administered to N = 155 AAC professionals. CONCLUSIONS: In this case study BWS-1 results were useful in DCE attribute selection. Four recommendations are made for future studies: define selection criteria for DCE attributes a priori; consider the impact participant's perspective will have on BWS-1 and DCE results; clearly define key terminology at the start of the study and refine it as the study progresses to reflect interim findings; BWS will be useful when there is little existing stated preference work on a topic and/or qualitative work is difficult.


Assuntos
Comportamento de Escolha , Tomada de Decisões , Preferência do Paciente , Adulto , Criança , Comunicação , Grupos Focais , Humanos , Idioma , Projetos Piloto , Distúrbios da Fala , Inquéritos e Questionários
8.
Environ Sci Policy ; 114: 256-262, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32922207

RESUMO

Evidence-informed decision-making aims to deliver effective actions informed by the best available evidence. Given the large quantity of primary literature, and time constraints faced by policy-makers and practitioners, well-conducted evidence reviews can provide a valuable resource to support decision-making. However, previous research suggests that some evidence reviews may not be sufficiently reliable to inform decisions in the environmental sector due to low standards of conduct and reporting. While some evidence reviews are of high reliability, there is currently no way for policy-makers and practitioners to quickly and easily find them among the many lower reliability ones. Alongside this lack of transparency, there is little incentive or support for review authors, editors and peer-reviewers to improve reliability. To address these issues, we introduce a new online, freely available and first-of-its-kind evidence service: the Collaboration for Environmental Evidence Database of Evidence Reviews (CEEDER: www.environmentalevidence.org/ceeder). CEEDER aims to transform communication of evidence review reliability to researchers, policy-makers and practitioners through independent assessment of key aspects of the conduct, reporting and data limitations of available evidence reviews claiming to assess environmental impacts or the effectiveness of interventions relevant to policy and practice. At the same time, CEEDER will provide support to improve the standards of future evidence reviews and support evidence translation and knowledge mobilisation to help inform environmental decision-making.

9.
Environ Int ; 143: 105926, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32653802

RESUMO

BACKGROUND: There are several standards that offer explicit guidance on good practice in systematic reviews (SRs) for the medical sciences; however, no similarly comprehensive set of recommendations has been published for SRs that focus on human health risks posed by exposure to environmental challenges, chemical or otherwise. OBJECTIVES: To develop an expert, cross-sector consensus view on a key set of recommended practices for the planning and conduct of SRs in the environmental health sciences. METHODS: A draft set of recommendations was derived from two existing standards for SRs in biomedicine and developed in a consensus process, which engaged international participation from government, industry, non-government organisations, and academia. The consensus process consisted of a workshop, follow-up webinars, email discussion and bilateral phone calls. RESULTS: The Conduct of Systematic Reviews in Toxicology and Environmental Health Research (COSTER) recommendations cover 70 SR practices across eight performance domains. Detailed explanations for specific recommendations are made for those identified by the authors as either being novel to SR in general, specific to the environmental health SR context, or potentially controversial to environmental health SR stakeholders. DISCUSSION: COSTER provides a set of recommendations that should facilitate the production of credible, high-value SRs of environmental health evidence, and advance discussion of a number of controversial aspects of conduct of EH SRs. Key recommendations include the management of conflicts of interest, handling of grey literature, and protocol registration and publication. A process for advancing from COSTER's recommendations to developing a formal standard for EH SRs is also indicated.


Assuntos
Saúde Ambiental , Revisões Sistemáticas como Assunto , Consenso , Humanos
10.
Cochrane Database Syst Rev ; 4: CD013376, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32270495

RESUMO

BACKGROUND: Aflatoxins are carcinogenic mycotoxins that contaminate many food crops. Maize and groundnuts are prone to aflatoxin contamination, and are the major sources of human exposure to aflatoxins, due to their high intake as staple foods, particularly in low- and middle-income countries (LMICs). Observational studies suggest an association between dietary exposure to aflatoxins during pregnancy and early childhood and linear growth in infants and young children. OBJECTIVES: To assess the effects on pre- and postnatal growth outcomes when agricultural and nutritional education interventions during the post-harvest period that aim to reduce aflatoxin exposure are compared to usual support or no intervention. We assessed this in infants, children, and pregnant and lactating women at the household or community level in LMICs. SEARCH METHODS: In July and August 2019, we searched: CENTRAL, MEDLINE, Embase, CINAHL, Web of Science Core Collection, Africa-Wide, LILACS, CAB Abstracts, Agricola, and two trials registers. We also checked the bibliographies of the included studies and contacted relevant mycotoxin organisations and researchers for additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and cluster-RCTs of agricultural education and nutritional education interventions of any duration, at the household or community level, aimed at reducing aflatoxin intake by infants, children, and pregnant and lactating women, in LMICs during the post-harvest period, compared to no intervention or usual support. We excluded studies that followed participants for less than four weeks. We assessed prespecified prenatal (at birth) and postnatal growth outcomes (during infancy, childhood, and adolescence), with linear growth (as the primary outcome), infectious disease morbidity, and unintended consequences. DATA COLLECTION AND ANALYSIS: Two authors independently assessed study eligibility using prespecified criteria, extracted data, and assessed risk of bias of included RCTs. We evaluated the certainty of the evidence using GRADE, and presented the main results in a 'Summary of findings' table. MAIN RESULTS: We included three recent cluster-RCTs reporting the effects of agricultural education plus post-harvest technologies, compared to usual agricultural support or no intervention. The participants were pregnant women and their children, lactating women and their infants (< 6 months), women of childbearing age, and young children (< 59 months), from rural, subsistence maize-farming communities in Kenya, Zimbabwe, and Tanzania. Two trials randomised villages to the intervention and control groups, including a total of at least 979 mother-child pairs from 60 villages. The third trial randomised 420 households, including 189 mother-child pairs and 231 women of childbearing age. Duration of the intervention and follow-up ranged between five and nine months. Due to risk of attrition bias, the overall risk of bias was unclear in one trial, and high in the other two trials. None of the included studies addressed the effects of nutritional education on pre- and postnatal growth. One trial reported outcomes not prespecified in our review, and we were unable to obtain unpublished growth data from the second trial, even after contacting the authors. The third trial, in lactating women and their infants in Tanzania, reported on the infants' weight-for-age z-score (WAZ) after six months. This trial found that providing agricultural education aimed at changing farmers' post-harvest practices to reduce aflatoxin exposure, by using demonstrations (e.g. handsorting, de-hulling of maize, drying sheets, and insecticides), may improve WAZ in infants from these farmers' households, on average, by 0.57 (95% confidence interval (CI) 0.16 to 0.98; 1 study; 249 participants; very low-certainty evidence), compared to infants from households where the farmers received routine agricultural extension services. Another way of reporting the effect on WAZ is to compare the proportion of underweight infants (WAZ > 2 SD below the reference median value) per group. This trial found that the intervention may reduce the proportion of underweight infants in the intervention households by 6.7% (95% CI -12.6 to -1.4; 249 participants; very low-certainty evidence) compared to control households. No studies reported on unintended effects of agricultural and nutritional education. AUTHORS' CONCLUSIONS: Evidence on the effects on child growth in LMICs of agricultural or nutritional education interventions that reduce aflatoxin exposure was very limited; no included study reported on linear growth. Very low-certainty evidence suggested that agricultural education aimed at changing farmers' post-harvest practices to reduce aflatoxin exposure by using demonstrations, may result in an increase in WAZ, when compared to usual or no education.


Assuntos
Aflatoxinas/intoxicação , Agricultura/educação , Países em Desenvolvimento , Contaminação de Alimentos/prevenção & controle , Crescimento , Adulto , Agricultura/métodos , Aleitamento Materno , Pré-Escolar , Feminino , Humanos , Lactente , Quênia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Tanzânia , Magreza/prevenção & controle , Zimbábue
11.
Disabil Rehabil Assist Technol ; 15(6): 652-662, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31012746

RESUMO

Background: Symbol communication aids are used by children with little or no intelligible speech as an Augmentative and Alternative Communication strategy. Graphic symbols are used to help support understanding of language and used in symbol communication aids to support expressive communication. The decision making related to the selection of a symbol communication aid for a child is poorly understood and little is known about what language and communication attributes are considered in this selection.Aim: To identify from the literature the language or communication attributes of graphic symbol communication aids that currently influence AAC practice.Method and Procedure: A search strategy was developed and searches were performed on a range of electronic databases for papers published since 1970. Quality appraisal was carried out using the CCAT tool and papers rated as weak were not included in the review.Results: Eleven studies were included in the review reporting data from 66 participants. Weaknesses were identified in most studies that would limit the validity of the results for application to practice. Included studies investigated aspects of vocabulary organization and design, the process of vocabulary selection, and the choice of the symbol system and encoding method. Two studies also evaluated innovative communication aid attributes.Conclusions: Information from studies reported in the research literature provides a sparse source of information about symbol communication aids from which clinicians, children or family members may make informed decisions.Implications for RehabilitationThis review is the first to systematically appraise the literature to answer the question what evidence exists to inform clinical decision making in relation to the language or communication attributes of graphic symbol based communication aids? The review establishes that there is a paucity of evidence from studies and that these decisions must thus be based on other information and factors.The review does establish a small number of language or communication attributes of symbol communication aids, but no synthesis of the results of these studies was possible. This review thus suggests that vocabulary design and organization, symbol system and encoding method, and the choice of vocabulary selection method are attributes that clinicians may carefully review in order to inform decisions.Clinicians encountering symbol vocabulary packages claiming to be 'evidence based' should query the nature of this evidence.The rehabilitation research community should debate and develop appropriate research designs that will facilitate future robust studies investigating the effect of specific language or communication attributes of communication aids.


Assuntos
Tomada de Decisão Clínica , Auxiliares de Comunicação para Pessoas com Deficiência , Crianças com Deficiência/reabilitação , Idioma , Criança , Humanos
12.
BMJ Open ; 9(11): e030274, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31791963

RESUMO

OBJECTIVES: Many children with varied disabilities, for example, cerebral palsy, autism, can benefit from augmentative and alternative communication (AAC) systems. However, little is known about professionals' decision-making when recommending symbol based AAC systems for children. This study examines AAC professionals' preferences for attributes of AAC systems and how they interact with child characteristics. DESIGN: AAC professionals answered a discrete choice experiment survey with AAC system and child-related attributes, where participants chose an AAC system for a child vignette. SETTING: The survey was administered online in the UK. PARTICIPANTS: 155 UK-based AAC professionals were recruited between 20 October 2017 and 4 March 2018. OUTCOMES: The study outcomes were the preferences of AAC professionals' as quantified using a mixed logit model, with model selection performed using a step-wise procedure and the Bayesian Information Criterion. RESULTS: Significant differences were observed in preferences for AAC system attributes, and large interactions were seen between child attributes included in the child vignettes, for example, participants made more ambitious choices for children who were motivated to communicate using AAC, and predicted to progress in skills and abilities. These characteristics were perceived as relatively more important than language ability and previous AAC experience. CONCLUSIONS: AAC professionals make trade-offs between attributes of AAC systems, and these trade-offs change depending on the characteristics of the child for whom the system is being provided.


Assuntos
Comportamento de Escolha , Tomada de Decisão Clínica/métodos , Auxiliares de Comunicação para Pessoas com Deficiência/estatística & dados numéricos , Pessoal de Saúde , Transtornos do Desenvolvimento da Linguagem/terapia , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reino Unido , Adulto Jovem
14.
Augment Altern Commun ; 35(3): 180-192, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31271046

RESUMO

High-tech communication aids are one form of augmentative and alternative communication (AAC) intervention offered to children following an assessment process to identify the most appropriate system based on their needs. Professional recommendations are likely to include consideration of child characteristics and communication aid attributes. Recommendations may be influenced by contextual factors related to the cultural work practices and service context of professionals involved, as well as by contextual factors from the child's life including their family environment and wider settings. The aim of this study was to explore the influence of cultural and contextual factors on the real-time decision-making processes of specialized AAC professionals in the UK. A total of six teams were recruited to the study. Each team carried out an assessment appointment related to a communication aid recommendation for a child and family. Following the appointment, each team participated in a focus group examining their decision-making processes during the preceding assessment. Inductive coding was used to analyse the transcribed data, and three organizing themes emerged relating to the global theme of Cultural and Contextual Influencers on communication aid decision-making. An explanatory model was developed to illustrate the funnelling effect that contextual factors may have on decision-making, which can substantially alter the nature and timing of a communication aid recommendation. Implications for clinical practice and future research are discussed.


Assuntos
Tomada de Decisão Clínica , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Família , Instituições Acadêmicas , Meio Social , Adolescente , Criança , Pré-Escolar , Feminino , Grupos Focais , Pessoal de Saúde , Humanos , Masculino , Terapeutas Ocupacionais , Pesquisa Qualitativa , Patologia da Fala e Linguagem , Reino Unido
15.
Augment Altern Commun ; 35(3): 167-179, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31290334

RESUMO

Existing research suggests the provision of communication aids for children with complex communication needs can have significant positive impacts on health and quality-of-life. The process of clinical decision-making related to the recommendation of high-tech communication aids is not well documented or evaluated, and research evidence related to the provision of these aids remains limited. This study aimed to understand the factors that specialized AAC professionals in the UK consider when recommending high-tech communication aids. Purposive sampling was used to recruit teams to six focus groups, each of which centred on a team's recent recommendation process (i.e. a discussion following a real-time assessment session, where the team attempted to arrive at an agreed recommendation for a specific child). Thematic network analysis was used to interpret data from the focus group discussions. Participants identified a wide range of child characteristics, access features, and communication aid attributes in weighing up decisions for individual children. Findings suggest that specialized AAC professionals in the UK prioritize access features over language considerations in their communication aid recommendations. An explanatory model was developed to illustrate the interaction effect that several competing considerations may have on decision-making. Implications for clinical practice and future research are discussed.


Assuntos
Tomada de Decisão Clínica , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Adolescente , Criança , Pré-Escolar , Prática Clínica Baseada em Evidências , Feminino , Grupos Focais , Pessoal de Saúde , Humanos , Masculino , Terapeutas Ocupacionais , Pesquisa Qualitativa , Patologia da Fala e Linguagem , Reino Unido
16.
Ecol Evol ; 9(8): 4532-4543, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31031925

RESUMO

Farmland vegetative strips are a proven source of support for ecosystem services and are globally used to mitigate effects of agricultural intensification. However, increasing pressures on agricultural land require increases in their functionality, such as supporting multiple ecosystem services concurrently.The plant species sown in a vegetative strip seed mix determine the establishment, plant community, and ecosystem services that are supported. Currently, there is no clearly defined or structured method to select plant species for multifunctional vegetative strips.Plant traits determine how plants support ecosystem services. Also, the establishment and persistence of plant communities is influenced by key internal and external factors. We propose a novel, evidence-informed method of multifunctional vegetative strip design based on these essential traits and factors.This study had three distinct stages. The first identified plant traits that support water quality protection, pollinators and/or crop pest natural enemies, using existing research evidence. We then identified key factors affecting plant community establishment and persistence. Finally, we applied these standardized methods to design a multifunctional vegetative strip for a specific case study (UK lowland farmland).Key plant traits identified, included floral display size, flower color, nectar content, leaf surface area, leaf trichome density, percentage fine roots, root length, rooting depth, and root density. Key internal and external establishment factors included life history, native status, distribution, established competitive strategy, associated floristic diversity, flowering time and duration, and preferred soil type and pH. In the United Kingdom case study, we used five different plant traits and all of the identified factors to design a seed mix for a multifunctional vegetative strip.We present a transferable method of vegetative strip design that can be adapted for other ecosystem services and climates. It provides landowners and advisors with an evidence-informed approach to increase field margin functionality while supporting farmland biodiversity. OPEN RESEARCH BADGES: This article has earned an Open Data Badge for making publicly available the digitally-shareable data necessary to reproduce the reported results. The data is available at https://doi.org/10.5061/dryad.8t52n38.

17.
Augment Altern Commun ; 35(2): 80-94, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30767575

RESUMO

The choice of which AAC device to provide for a child can have long lasting consequences, but little is known about the decision-making of AAC professionals who make recommendations in this context. A survey was conducted with AAC professionals using best-worst scaling methodology examining what characteristics of children and attributes of AAC devices are considered most important in decision-making. A total of 19 child characteristics and 18 device attributes were selected by the authors from lists generated from literature reviews and from focus groups with AAC professionals, people who use AAC, and other stakeholders. The characteristics and attributes were used to develop two best-worst scaling surveys that were administered to 93 AAC professionals based in the UK. The relative importance of characteristics/attributes was estimated using statistical modelling. Child characteristics related to language and communication, cognitive and learning abilities, and personality traits were generally found to be more important than physical features. Communication, language, and interface-related AAC device attributes were generally more important than hardware and physical attributes. Respondent demographics (e.g., experience, professional background) did not seem to influence the importance assigned to device characteristics or attributes. Findings may inform both future quantitative research into decision-making and efforts to improve decision-making in practice.


Assuntos
Tomada de Decisão Clínica , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Adulto , Atitude do Pessoal de Saúde , Criança , Cognição , Feminino , Grupos Focais , Pessoal de Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Aprendizagem , Alfabetização , Masculino , Pessoa de Meia-Idade , Terapeutas Ocupacionais , Patologia da Fala e Linguagem , Inquéritos e Questionários , Reino Unido , Visão Ocular , Adulto Jovem
18.
Stud Health Technol Inform ; 242: 347-350, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28873821

RESUMO

A systematic review of the language and communication characteristics of communication aids considered in identifying the appropriate aid for a child is introduced. The aim is to improve the decision-making around the provision of symbol communication aids to children.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Tomada de Decisões , Idioma , Criança , Comunicação , Humanos
19.
Eval Rev ; 41(2): 155-172, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27600770

RESUMO

BACKGROUND: Conducting a systematic review in social policy is a resource-intensive process in terms of time and funds. It is thus important to understand the scope of the evidence base of a topic area prior to conducting a synthesis of primary research in order to maximize these resources. One approach to conserving resources is to map out the available evidence prior to undertaking a traditional synthesis. A few examples of this approach exist in the form of gap maps, overviews of reviews, and systematic maps supported by social policy and systematic review agencies alike. Despite this growing call for alternative approaches to systematic reviews, it is still common for systematic review teams to embark on a traditional in-depth review only. OBJECTIVES: This article describes a three-stage approach to systematic reviewing that was applied to a systematic review focusing in interventions for smallholder farmers in Africa. We argue that this approach proved useful in helping us to understand the evidence base. RESULTS: By applying preliminary steps as part of a three-stage approach, we were able to maximize the resources needed to conduct a traditional systematic review on a more focused research question. This enabled us to identify and fill real knowledge gaps, build on work that had already been done, and avoid wasting resources on areas of work that would have no useful outcome. It also facilitated meaningful engagement between the review team and our key policy stakeholders.


Assuntos
Agricultura , Medicina Baseada em Evidências , Literatura de Revisão como Assunto , Humanos , Projetos de Pesquisa
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