Relevant Evidence (relevant + evidence)

Distribution by Scientific Domains


Selected Abstracts


Are psychiatrists affecting the legal process by answering legal questions?

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2008
Timothy Hardie
Background,Psychiatrists are often asked to answer legal questions. The extent to which they answer strictly legal rather than medical matters is not known. Aim,To investigate how strongly psychiatrists in England and Wales express opinions on one legal question , that of diminished responsibility in respect of a murder charge, and how this is related to outcome in court. Method,Our data were extracted from psychiatric reports and case files supplied by the then Department of Constitutional Affairs (now the Ministry of Justice) on cases heard in the Crown Courts between 1 January 1997 and 31 December 2001 in which the defence of diminished responsibility had been raised. The cases had been selected by the Law Commission in their earlier review of partial defences to murder. We devised a reliable system of rating the presence/absence and strength of expression of a legal opinion in the medical reports. We tested the data for relationship between nature and strength of opinion and progression to trial and verdict. Results,Psychiatric reports were available on 143 of 156 cases in which diminished responsibility was considered. They yielded 338 opinions on at least one aspect of diminished responsibility. In 110 (93%) of the 118 cases in which there was a diminished verdict, this was made without trial and, therefore, without reference to a jury. In only eight (27%) out of the 30 cases that went to trial, was a diminished responsibility verdict made. Half of the reports (169) gave a clear opinion on diminished responsibility, a third (121) invited the court to draw a particular conclusion and only 11% (36) provided relevant evidence without answering the legal questions. When there was an opinion or an invitation to make a finding on the legal question, a trial was less likely. A trial was also less likely if reports agreed on what the verdict should be. Conclusions,Psychiatrists frequently answer the legal question of diminished responsibility. The judiciary and medical experts should join in research to examine the consequences of different styles or approaches in presentation of essentially similar evidence in court. Copyright © 2008 John Wiley & Sons, Ltd. [source]


Clinical practice recommendations for depression

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2009
G. S. Malhi
Objective:, To provide clinically relevant evidence-based recommendations for the management of depression in adults that are informative, easy to assimilate and facilitate clinical decision making. Method:, A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. The recommendations then underwent consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. Results:, The clinical practice recommendations for depression (Depression CPR) summarize evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. Conclusion:, These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation. [source]


Clinical practice recommendations for bipolar disorder

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2009
G. S. Malhi
Objective:, To provide clinically relevant evidence-based recommendations for the management of bipolar disorder in adults that are informative, easy to assimilate and facilitate clinical decision-making. Method:, A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. These preliminary recommendations underwent extensive consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. Results:, The clinical practice recommendations for bipolar disorder (bipolar CPR) summarise evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. Conclusion:, These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of bipolar disorder. Further, the novel style and practical approach should promote their uptake and implementation. [source]


Evaluating extreme risks in invasion ecology: learning from banking compliance

DIVERSITY AND DISTRIBUTIONS, Issue 4 2008
James Franklin
ABSTRACT Increasing international trade has exacerbated the risks of ecological damage due to invasive pests and diseases. For extreme events such as invasions of damaging exotic species or natural catastrophes, there are no or very few directly relevant data, so expert opinion must be relied on heavily. Expert opinion must be as fully informed and calibrated as possible , by available data, by other experts, and by the reasoned opinions of stakeholders. We survey a number of quantitative and non-quantitative methods that have shown promise for improving extreme risk analysis, particularly for assessing the risks of invasive pests and pathogens associated with international trade. We describe the legally inspired regulatory regime for banks, where these methods have been brought to bear on extreme ,operational risks'. We argue that an ,advocacy model' similar to that used in the Basel II compliance regime for bank operational risks and to a lesser extent in biosecurity import risk analyses is ideal for permitting the diversity of relevant evidence about invasive species to be presented and soundly evaluated. We recommend that the process be enhanced in ways that enable invasion ecology to make more explicit use of the methods found successful in banking. [source]


The significance of the Carolingian advocate

EARLY MEDIEVAL EUROPE, Issue 2 2009
Charles West
This article argues that ninth-century advocates in the Frankish world deserve more attention than they have received. Exploring some of the wealth of relevant evidence, it reviews and critiques both current historiographical approaches to the issue. Instead of considering Carolingian advocates as largely a by-product of the ecclesiastical immunity, or viewing advocacy as a Trojan horse for a subsequent establishment of lordship over monasteries, the article proposes a reading of ninth-century advocacy as intimately linked with wider Carolingian reform, particularly an interest in promoting formal judicial procedure. [source]


The missing dark matter in the wealth of nations and its implications for global imbalances

ECONOMIC POLICY, Issue 51 2007
Ricardo Hausmann
SUMMARY Dark matter and international imbalances Current account statistics may not be good indicators of the evolution of a country's net foreign assets and of its external position's sustainability. The value of existing assets may vary independently of current account flows, so-called ,return privileges' may allow some countries to obtain abnormal returns, and mismeasurement of FDI, unreported trade of insurance or liquidity services, and debt relief may also play a role. We analyse the relevant evidence in a large set of countries and periods, and examine measures of net foreign assets obtained by capitalizing the net investment income and then estimating the current account from the changes in this stock of foreign assets. We call dark matter the difference between our measure of net foreign assets and that measured by official statistics. We find it to be important for many countries, analyse its relationship with theoretically relevant factors, and note that the resulting perspective tends to make global net asset positions appear relatively stable. , Ricardo Hausmann and Federico Sturzenegger [source]


The feasibility of providing community pharmacy-based services for alcohol misuse: A literature review

INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2009
Dr Margaret C. Watson
Abstract Objectives Excessive consumption of alcohol is a major public health concern. The use of community pharmacies and pharmacists as sources of public health information and services is gaining greater recognition. The objective of this review was to provide an overview of the evidence on the feasibility, effectiveness and acceptability of providing community pharmacy-based services to address the excessive consumption of alcohol. Methods Electronic databases were searched for the period 1996,2007 to identify relevant evidence. Searches were also conducted of relevant pharmacy and addiction journals. Information was sought from key contacts in pharmacy and alcohol research. Studies were included if they were conducted in a community pharmacy setting. Key findings The review comprised three feasibility studies which included 14 pharmacies and 500 customers. Non-significant reductions in alcohol consumption were reported with two studies following brief interventions by pharmacists. Between 30% and 53% of pharmacy customers were identified as having hazardous or harmful drinking behaviour. Customer opinion of the pharmacy-based alcohol services was not reported. Conclusions There has been little empirical evaluation of the effectiveness of community pharmacy-based services for alcohol misuse. The evidence presented in this review suggests that community pharmacy-based screening is feasible. Organisations and individuals involved with tackling excessive alcohol consumption should consider the inclusion of community pharmacies and pharmacists as part of their strategies to address this problem. Large-scale studies are needed to evaluate the short- and long-term effects and cost-effectiveness of community pharmacy-based interventions to reduce excessive alcohol consumption, as well as to explore the acceptability of the service to users. [source]


Overview of research addressing ethical dimensions of participation in traumatic stress studies: Autonomy and beneficence

JOURNAL OF TRAUMATIC STRESS, Issue 6 2009
Elana Newman
One element of the design of human research studies is ethically informed decision-making. Key issues include the safety, costs, and benefits of participation. Historically, much of this decision-making was based on opinion rather than formal evidence. Recently, however, investigators in the traumatic stress field have begun to collect data that are relevant to these decisions. In this article, the authors focus on issues emanating from the ethical concepts of autonomy and respect for persons and beneficence and nonmaleficence, and then summarize relevant evidence from studies with trauma-exposed individuals. Discussion addresses implications of this evidence for research practice and policy, and identifies some potentially informative data collections opportunities for future trauma studies. [source]


How many species of cichlid fishes are there in African lakes?

MOLECULAR ECOLOGY, Issue 3 2001
George F. Turner
Abstract The endemic cichlid fishes of Lakes Malawi, Tanganyika and Victoria are textbook examples of explosive speciation and adaptive radiation, and their study promises to yield important insights into these processes. Accurate estimates of species richness of lineages in these lakes, and elsewhere, will be a necessary prerequisite for a thorough comparative analysis of the intrinsic and extrinsic factors influencing rates of diversification. This review presents recent findings on the discoveries of new species and species flocks and critically appraises the relevant evidence on species richness from recent studies of polymorphism and assortative mating, generally using behavioural and molecular methods. Within the haplochromines, the most species-rich lineage, there are few reported cases of postzygotic isolation, and these are generally among allopatric taxa that are likely to have diverged a relatively long time in the past. However, many taxa, including many which occur sympatrically and do not interbreed in nature, produce viable, fertile hybrids. Prezygotic barriers are more important, and persist in laboratory conditions in which environmental factors have been controlled, indicating the primary importance of direct mate preferences. Studies to date indicate that estimates of alpha (within-site) diversity appear to be robust. Although within-species colour polymorphisms are common, these have been taken into account in previous estimates of species richness. However, overall estimates of species richness in Lakes Malawi and Victoria are heavily dependent on the assignation of species status to allopatric populations differing in male colour. Appropriate methods for testing the specific status of allopatric cichlid taxa are reviewed and preliminary results presented. [source]


Charitable Donations and the Estate Tax: A Tale of Two Hypotheses

AMERICAN JOURNAL OF ECONOMICS AND SOCIOLOGY, Issue 3 2010
William Beranek
Regression studies have suggested that reducing estate-tax rates would lead to a net reduction in total charitable donations distributed at death. Not only is this notion counterintuitive, our empirical analysis yields the contrary conclusion: overall donations would increase. In rationalizing this donation-decline outcome, investigators have pointed to the tax deductibility of donations in assessing estate-tax liability. These efforts, we show, are dubious. The view that donations will decline is also shown to be inconsistent with axioms of generally accepted economic theory. Two distinct sets of indifference curves that imply these two antithetical views are suggested, their observable predictions derived and compared to the relevant evidence, showing that the increasing-donation hypothesis is confirmed, offering overall a clear challenge to the decline-in-donation position. Our empirical results suggest that most estate-tax payers possess indifference curves consistent with those that embody the increasing-donation hypothesis. [source]


Attachment theory and emotions in close relationships: Exploring the attachment-related dynamics of emotional reactions to relational events

PERSONAL RELATIONSHIPS, Issue 2 2005
Mario Mikulincer
Attachment theory is a powerful framework for understanding affect regulation. In this article, we examine the role played by attachment orientation in shaping emotional reactions to interpersonal transactions within close relationships. Using our recent integrative model of attachment-system activation and dynamics as a guide (M. Mikulincer & P. R. Shaver, 2003), we review relevant evidence, present new findings, and propose hypotheses concerning how people with different attachment styles are likely to react emotionally to relational events. Specifically, we focus on attachment-related variations in the emotional states elicited by a relationship partner's positive and negative behaviors and by signals of a partner's (relationship relevant or relationship irrelevant) distress or pleasure. In so doing, we organize existing knowledge and point the way to future research on attachment-related emotions in close relationships. [source]


Religious Belief and the Epistemology of Disagreement

PHILOSOPHY COMPASS (ELECTRONIC), Issue 8 2010
Michael Thune
Consider two people who disagree about some important claim (e.g. the future moral and political consequences of current U.S. economic policy are X). They each believe the other person is in possession of relevant evidence, is roughly equally competent to evaluate that evidence, etc. From the epistemic point of view, how should such recognized disagreement affect their doxastic attitude toward the original claim? Recent research on the epistemology of disagreement has converged upon three general ways of answering this question. The focus of this article is twofold: first, we summarize and give a brief evaluation of the main accounts of the epistemic significance of disagreement; then, we look at what these accounts suggest about how to epistemically assess both inter-religious and intra-religious disagreements. A final section offers recommendations for further research. [source]


Promoting evidence-based psychosocial care for cancer patients,

PSYCHO-ONCOLOGY, Issue 1 2009
Paul B. Jacobsen
Abstract With numerous studies demonstrating that psychosocial care reduces distress and improves quality of life, practitioners have an obligation to treat cancer patients in a manner consistent with this evidence. Although the rationale is straightforward, major challenges exist in achieving the goal of translating research into clinical practice. One challenge has been the nature of the evidence, with many studies of psychosocial interventions characterized by poor methodological quality, absence of eligibility criteria specifying heightened distress, and minimal consideration of dissemination potential. A second challenge has been to make practitioners aware of relevant evidence. Targeted efforts at dissemination, such as the issuance of clinical practice guidelines and evidence-based recommendations and the distribution of intervention materials via the Internet, appear to be more effective than passive efforts in providing practitioners with useful information. Perhaps the most challenging aspect has been to persuade practitioners to change how they practice. One approach currently under development would allow practitioners and health-care organizations to perform self-evaluations of the quality of their psychosocial care based on review of medical records. Feedback showing quality of care to be less than optimal is likely to motivate change, especially if the quality indicators assessed are considered to be important and reliable and point to specific actions that can be taken. The use of evidence to promote changes in clinical practice represents one of the major ways in which the field of psycho-oncology can fully realize its potential to positively affect the lives of people with cancer. Copyright © 2008 John Wiley & Sons, Ltd. [source]


Research Review: What is the association between the social-communication element of autism and repetitive interests, behaviours and activities?

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2008
William P.L. Mandy
Autism is currently conceptualised as a unitary disorder, in which social-communication impairments are found alongside repetitive interests, behaviours and activities (RIBAs). This relies upon the validity of the assumption that social-communication impairments and RIBAs co-occur at an above chance level as a result of sharing underlying causes. In the current review it is argued that the evidence for this assumption is scarce: the very great majority of RIBA research has not been intended for or suited to its examination. In fact only three studies are fit to address directly the question of the relationship between social-communication impairment and RIBAs, and these contradict each other. In consequence, further relevant evidence was sought in the behavioural and genetic literature. This approach suggested that the correlation between social-communication impairments and RIBAs has been exaggerated in the current consensus about the autism syndrome, and that these aspects of autism may well share largely independent underlying causes. Some clinical and research implications are discussed. [source]


"Developing Good Taste in Evidence": Facilitators of and Hindrances to Evidence-Informed Health Policymaking in State Government

THE MILBANK QUARTERLY, Issue 2 2008
CHRISTOPHER J. JEWELL
Context: Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real-life context in which policymakers are situated and make decisions also is crucial to the development of evidence-informed policy. Methods: This qualitative study expands on other studies of research utilization at the state level through interviews with twenty-eight state legislators and administrators about their real-life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances. Findings: Hindrances to evidence-informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence-based skills; and developing research venues and collaborative relationships in order to generate relevant evidence. Conclusions: Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence-informed health policymaking are amenable to change. Policymakers could benefit from evidence-based skills training to help them identify and evaluate high-quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy. [source]


The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform

THE MILBANK QUARTERLY, Issue 1 2001
David Mechanic
The focus on managed care and the managed care backlash divert attention from more important national health issues, such as insurance coverage and quality of care. The ongoing public debate often does not accurately convey the key issues or the relevant evidence. Important perceptions of reduced encounter time with physicians, limitations on physicians' ability to communicate options to patients, and blocked access to inpatient care, among others, are either incorrect or exaggerated. The public backlash reflects a lack of trust resulting from cost constraints, explicit rationing, and media coverage. Inevitable errors are now readily attributed to managed care practices and organizations. Some procedural consumer protections may help restore the eroding trust and refocus public discussion on more central issues. [source]


Evidence-based Reviews and Databases: Are They Worth the Effort?

ACADEMIC EMERGENCY MEDICINE, Issue 11 2007
Developing Evidence Summaries for Emergency Medicine
A broad range of relevant evidence-based resources within and outside of emergency medicine (EM) collates and summarizes research evidence pertaining to many questions relevant to clinical emergency care. Such resources may or may not constitute the equivalent of health care recommendations, and their relationship to clinical decision-making may be complex. Many efforts in evidence-based medicine resource development, and their products, are marginally relevant to EM practice but may serve as useful models for parallel EM relevant efforts. A trade-off exists between synthesis quality and ease of practitioner access and use. Keeping all such resources up to date is a major challenge. Although observational evidence suggests that dynamic interactivity and information retrieval technology may enhance practitioner utilization, little evidence exists supporting the absolute or comparative effectiveness of different kinds of resources and databases in enhancing evidence uptake or changing clinician behavior. [source]