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Basing treatment, policy and planning decisions on the best available research knowledge remains a central principle in modern health care around the world, yet many health professionals find acquiring and managing published research knowledge challenging. In this paper, we report on a Soft Systems Methodology-based collaborative action research initiative with a specialist mental health service from the United Kingdom's National Health Service. Our objective was to design and implement improvements to their knowledge acquisition and management activities in order to facilitate sustained and effective evidence-based practices. We report on both the factors found to impede effective research knowledge acquisition and management and the development of more integrated knowledge management processes designed to improve the situation.  相似文献   
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Gowers  Richard 《Metascience》2003,12(2):253-256
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Externalities as conventionally defined miss many of the spillovers that are both causes and consequences of the technological changes that underlie economic growth. We introduce a much wider concept called technological complementarities. New general purpose technologies (GPTs) rejuvenate the growth process by creating technological complementarities, which are adequately measured neither by total factor productivity (TFP) nor by externalities. There would be major gains from technological change even if the returns on capital invested in innovation never exceeded the returns on investing in existing technologies so that there were neither externalities nor positive changes in TFP.  相似文献   
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Graduate students suffer from issues with mental and emotional wellbeing at a high rate. While most commonly understood as an individual issue, the high prevalence of mental health problems suggests that their causes may extend beyond personal factors. A closer look at the environment that a graduate student operates in suggests systemic or organizational factors that exert notable pressures that students have to cope with. This article examines four levels of systems that create a structural environment that negatively impacts mental health and wellbeing among graduate students: (1) the academic system, (2) the institutional and departmental systems, (3) lab or cohort systems, and (4) the social-economic system. In light of this analysis, we propose a model of how systemic stress affects mental health. This model sheds light on the systems-level process improvements that can be instituted to help universities prevent mental health issues among graduate students.  相似文献   
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OBJECTIVE: The purpose of this article is to describe patterns of forgetting and remembering childhood sexual abuse (CSA) in a nationally representative sample of US adult women. METHOD: The respondents were a national probability sample of 711 women, aged 26 years to 54 years, residing in noninstitutional settings in the contiguous 48 states. In a 1996 face-to-face interview survey, trained female interviewers asked each respondent whether she had experienced any sexual coercion by family members or nonfamily members while growing up; whether she believed that she had been sexually abused (by family members or others); and whether she had ever forgotten the CSA experiences and, if so, how she had subsequently remembered them. RESULTS: Twenty-one and six-tenths percent of respondents reported having sexually coercive experiences while growing up; of these, 69.0% indicated that they felt they had been sexually abused. More than one-fourth of respondents who felt sexually abused reported that they had forgotten the abuse for some period of time but later remembered it on their own. Only 1.8% of women self-described as sexually abused reported remembering the abuse with the help of a therapist or other professional person. CONCLUSIONS: The findings indicate that, among women who report CSA, forgetting and subsequently remembering abuse experiences is not uncommon. According to the women surveyed, however, very few (1.8%) of those who felt abused recovered memories of CSA with help from therapists or other professionals. As one of the few studies of CSA memories in a nationally representative sample, this study suggests that therapist-assisted recall is not a major source of CSA memories among women in the US general population.  相似文献   
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