A Motivation Framework to Promote Knowledge Translation in Healthcare

Globally,there is a great gulf between medical knowledge and clinical practice.Translating knowledge into clinical decision support(CDS) application has become the biggest challenge faced by evidence based medicine.This paper proposed a comprehensive motivation framework to facilitate knowledge translation in healthcare.Based on a unified medical knowledge ontology and knowledge base,the framework provides an infrastructure of fundamental services,such as inference service and data acquisition,to support development of knowledge-driven CDS applications and integration into clinical workflow.The framework has been implemented in a 2600-bed Chinese hospital,and is able to reduce the time and cost of developing typical CDS applications.

Dissemination and Enrichment of Knowledge About Normal Birth to Bring About a Change to Society

The birth of a child is a pivotal time in the life of a mother,her family and society.The health and well-being of a mother and child at birth largely determines the future health and wellness of the entire family(World Health Organization(WHO),2005).Normal birth has enormous benefits for mothers,neonates,families,and societies.The growing supportive evidence for the promotion of normal birth certainly relies on multidisciplinary collaborations to continue spreading knowledge about the advantages of normal birth and enhancing the understanding of how knowledge about normal birth can change society.Knowledge about normal birth varies among different groups of healthcare professionals,and it would be useful to identify how it is clinically translated to become accessible to other professionals and research teams,consumers,the public,significant decision-or policy makers,the industry,funding bodies,and volunteer health teams.

On the Role of Cognitive Environment of Translation for English- Chinese Translation

This paper put forward the concept of cognitive environment of translation based on the concept of cognitive context and proposed world knowledge,language knowledge and translation knowledge as its three constituents.World knowledge can also be referred to as encyclopedic knowledge,including all the knowledge acquired about diverse aspects of internal and external life through direct and indirect experience.Language knowledge refers to all the knowledge about the phonetics,phonology,lexicology,syntax,pragmatics,stylistics,etc.of the two languages involved and the comparative and contrastive features between the two languages.Translation knowledge concerns all the knowledge about the strategies and techniques for translation in general and specific solutions applicable for the translation between the two languages in question.The three types of knowledge get involved at different stages of translation:world knowledge and language knowledge about the source text facilitate accurate understanding of the source text,knowledge about the target language and knowledge about the comparative and contrastive features between the source and the target language,in combination with translation knowledge help with the translation process.All the knowledge can be activated more than once in case any uncertainty occurred at understanding or translation stages.As regards English-Chinese translation,translators are expected to use Chinese words,syntactic and textual structures most acceptable to the Chinese readers to replace the original English text,rendering them as close as possible in content,style and receptor effect.Efforts must be made to cater to the Chinese conventions of language use.Three major suggestions,among others,can be summarized in the paper.The first one is to use suitable words or expressions to match the Chinese ways of expression in various cases.The second one is to break the chains off the long and sophisticated English sentences,using shorter Chinese ones with a subject or theme,converting the nouns in English back to the verb or adjective they are derived from,etc.The third is to re-organize the textual structure of the target text according to the temporal,spatial and logical ways of expression in Chinese.

Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.

Study and promotion of safety culture using mixed methods research

Objective:With a positive safety culture,institutions offer the best quality and safe care to their patients.The objective of this study was to analyze patient safety culture from the perspective of the multidisciplinary team,to identify factors that influence patient safety culture,and to create/promote-jointly with the study participants-strategies for improving processes of change.Methods:The study design represented a mixed methods research approach,with a sequential explanatory design.A multidisciplinary team of workers at a general hospital was eligible for the study.To collect quantitative data,we administered the Safety Attitudes Questionnaire(SAQ).The qualitative phase was accomplished via focus groups(FGs),with participants from the first phase of the study using the principles of deliberative dialogue(DD)as a knowledge-translation strategy.The STROBE guideline was used to develop the study.Results:The overall SAQ score was positive(75.1±10.4).Negative scores were found in the fields of Safety Climate,Working Conditions,and Stress Recognition.Focus group discussions identified the aspects that create a negative impact on safety culture,such as ineffective communication,punitive approach in the event of errors,the lack of commitment and adherence to the protocols,and the non-recognition of the stress and the mistakes.Actions for the promotion of safety culture were developed and implemented during the study.Conclusions:The use of the principles of DD as a strategy for knowledge translation(KT)made it possible to identify and plan for joint actions to generate improvements in safety culture.

Research on vector-borne diseases: implementation of research communication strategies

Background:Effective communication of research findings on vector-borne diseases in Africa is challenging for a number of reasons.Following the experiences of a number of researchers over the life of a project,this article looks for lessons that can be shared with the wider research community.Main body:Between 2014 and 2017,a set of five inter-disciplinary teams from seven African countries collaborated on a project focusing on vector-borne diseases in the context of climate change.A central objective of this work was to influence policy and programming with relevant research findings.This article examines how principles of research communication,derived from the literature and current guidelines,can be applied in practice.Several challenges and lessons are highlighted,showing that research communication takes place within difficult constraints and in complex,fluid institutional and political environments.The processes of communication between policymakers and researchers including stakeholder mapping,defining research communication plans and tailoring communication products are discussed.Conclusions:The article concludes that while guidelines and frameworks for research communication are helpful,they should not detract from the ability of local teams to adapt to circumstances.Of key importance are the relationships and networks of local research teams.