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The dissemination of evidence-based practice in German physiotherapy is limited by several barriers. However, a recent study shows that some German physiotherapists are already successfully implementing such a practice. Based on Everett M. Rogers’ diffusion of innovations theory, this study defined evidence-based practice as an innovation in German physiotherapy to gain insight into therapists’ strategies to overcome these barriers.

For many centuries and in many cultures, jesters recited tales of heroic exploits, but they did more than simply recount past events--they amused, cajoled, and spun tales that transported listeners to the edge of mysterious, unmapped territories. Through the transformative power of play and the imagination, they reworked what was already understood and created from it new realities that transcended the established order. The author maintains that such imaginative play is vital to creativity in any medium and is fundamental for optimal human development. She explores possibilities for cultivating creativity through the playful, paradoxical stance of the jester--a serendipitous and purposeful, strange and familiar, disruptive and productive figure. Her discussion, grounded in a visual-arts practice that leverages uncertainty and randomness, considers the role of play in light of its wider implications for knowledge and creativity. (Contains 17 notes.)

Dr. Diane Rosen is a principal at Compass Consultants, a business consultancy. In this article, she discusses how nonprofit leadership is different from the for‐profit sector and how to optimize impact through authentic leadership. [ABSTRACT FROM AUTHOR]

Dr. Diane Rosen is a principal at Compass Consultants, a business consultancy. In this article, she leads a discussion on the pros and cons of mission/vision/values exercises. [ABSTRACT FROM AUTHOR]

Radically redefining art from static product to idea entwining object, observer and time, Marcel Duchamp essentially prefigured a dynamical systems view of creativity. That was the 1910's; Poincaré was a primary influence. Since then, complex systems theory has immeasurably deepened our understanding of transformative emergent process in all the arts. This paper focuses on the interactive art installation as an instantiated experience of complexity. Specifically it is proposed that viewers, referred to as Participant-Viewers, embody creativity through cognitive-emotional and often physical trajectories within an installation's high dimensional phase space: from perceptual/conceptual disorientation (entropy), to adaptive micro-stabilizations (bifurcations), to self-organization of novel understandings or perspectives (emergence). Beyond individuals' interactions with/within a given artwork, these dynamic spaces of possibility are considered in terms of their potential for motivating a broadened ecology of self, society, and environment. [ABSTRACT FROM AUTHOR]

NDS theory has been meaningfully applied to the dynamics of creativity and psychology. These complex systems have much in common, including a broad definition of "product" as new order emerging from disorder, a new whole (etymologically, "health") out of disintegration or destabilization. From a nonlinear dynamical systems perspective, this paper explores the farfrom- equilibrium zone of creative incubation: first in the Jungian night sea journey, a primordial myth of psychological and creative transformation: then in the neuroscience of mind wandering, the wellspring of creative ideation within the larger neural matrix. Finally, chaos theoiy grounds the elusive subject of creativity, modeling chaotic generation of idea elements that tend toward strange attractors, combine unpredictably, and produce change by means of tension between opposites, particularly noetic consciousness (light) and the poetic unconscious (darkness). Examples from my own artwork illustrate this dialectical process. Considered together, the unconscious mythic sea journey, the unknowing wandering mind, and the generative paradigm of deterministic chaos suggest conditions that facilitate creativity across disciplines, providing fresh indications that the darkness of the unknown or irrational is, paradoxically, the illuminative source and strength of creativity. [ABSTRACT FROM AUTHOR]

Dada, a self-proclaimed (anti)art (non)movement, took shape in 1916 among a group of writers and artists who rejected the traditions of a stagnating bourgeoisie. Instead, they adopted means of creative expression that embraced chaos, stoked instability and undermined logic, an outburst that overturned centuries of classical and Romantic aesthetics. Paradoxically, this insistence on disorder foreshadowed a new order in understanding creativity. Nearly one hundred years later, Nonlinear Dynamical Systems theory (NDS) gives renewed currency to Dada's visionary perspective on chance, chaos and creative cognition. This paper explores commonalities between NDS-theory and this early precursor of the nonlinear paradigm, suggesting that their conceptual synergy illuminates what it means to "be creative" beyond the disciplinary boundaries of either. Key features are discussed within a 5P model of creativity based on Rhodes ' 4P framework (Person, Process, Press, Product), to which I add Participant-Viewer for the interactivity of observer-observed. Grounded in my own art practice, several techniques are then put forward as non-methodical methods that invoke creative border zones, those regions where Dada 's chance and design are wedded in a dialectical tension of opposites. [ABSTRACT FROM AUTHOR]

Rationale Aims and Objectives Method Results Conclusion Clinical Practice Guidelines (CPGs) represent evidence‐based tools designed to assist healthcare practitioners and patients in decisions in clinical practice. Evidence supports the clinical benefits of adhering to CPGs. However, their successful implementation and adherence in clinical settings often encounter challenges.This systematic review aimed to explore barriers and facilitators influencing adherence to CPGs in Germany.The protocol of this study was registered in the Open Science Framework (OSF) registry (DOI: 10.17605/OSF. IO/GMFUB). In November 2022 we searched on PubMed and Embase for primary studies employing qualitative, quantitative and mixed‐methods approaches that focus on barriers or facilitators to CPGs adherence in the Germany. Two reviewers independently screened articles, extracted data, and evaluated the quality of the studies. The collected data on barriers and facilitators of CPG adherence were systematically categorized and analyzed using the Theoretical Domains Framework (TDF).A total of 24 studies were included, mainly focusing on adherence to national CPGs. This review introduces a new domain, guideline characteristics, reflecting the need to address barriers and facilitators to CPG development, implementation, dissemination and format, which couldn't be encompassed within the existing 14 domains of TDF framework. Among healthcare professionals, the most frequently reported influencing factors were related to the environmental context and resources (encompassing aspects such as employer support for CPG utilization), the CPG development and dissemination process (including layout, wording, and interactive tools) and beliefs about consequences (such as contradictions with practical experience). Knowledge (knowledge about the content of CPGs, awareness about published CPGs), primarily as a barrier, and reinforcement facilitators (notably financial support), were also frequently reported.The findings revealed multilevel factors contributing to CPG adherence, with environmental context and resources emerging as the most frequently reported considerations. This systematic review offer holistic insights into the barriers and facilitators of CPG adherence in Germany. The results contribute to a better understanding of the topic and serve as a resource for developing targeted strategies to enhance CPG adherence and implementation within the German healthcare system. [ABSTRACT FROM AUTHOR]

To determine how obstetricians and gynecologists (OB/GYNs) perceive the gynecologic health effects of obesity and to identify perceived obstacles to counseling. OB/GYNs with 3 St. Louis health systems were emailed a 46-question survey regarding physicians' role in counseling women on the health risks of obesity and barriers faced in achieving this counseling. Differences between respondents' gender, age, practice type, years in practice, and body mass index were assessed using Chi-square or Fisher's exact tests as appropriate. Of 318 OB/GYNs emailed, 134 completed surveys, including 82 generalists and 52 subspecialists. 93% of respondents believed it was necessary to educate patients on health risks of obesity. 90% and 75%, respectively, cited diagnoses of endometrial hyperplasia and cancer as teachable moments for counseling. The most frequently cited barriers to successful counseling were lack of time, referral services, and patient tools/information. Most did not believe they had adequate reimbursement (65%), training (53%) or educational resources (50%) to counsel patients. Survey answers differed by practice setting, gender, and provider age. Although most OB/GYN providers consider obesity counseling important, execution is hindered by perceived barriers that differ by provider gender, age, and practice type. For OB/GYNs, more effective weight management counseling will require better training and practice-specific strategies. Based on survey responses, better reimbursement combined with increased resources for appropriate referrals and cancer prevention counseling are needed in order to improve weight management implementation in OB/GYN. •The majority of OB/GYNs believe obesity counseling is important•Perceptions of obesity counseling differ based on provider/practice characteristics.•Lack of time, referral services, and patient tools are the biggest cited barriers to counseling.•Improved obesity counseling could improve downstream OB/GYN morbidities.