Use of Enforcement Techniques in Eliminating Glass Ceiling Barriers

Glass Ceiling ReportGlassCeilingBackground9UseofEnforcement.pdf: 3253 downloads, before Oct. 1, 2020

THERACOM: a systematic review of the evidence base for interventions to improve Therapeutic Communications between black and minority ethnic populations and staff in specialist mental health services.

PMCID: PMC3599664This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.BACKGROUND: Black and Minority Ethnic (BME) groups in receipt of specialist mental health care have reported higher rates of detention under the mental health act, less use of psychological therapies, and more dissatisfaction. Although many explanations have been put forward to explain this, a failure of therapeutic communications may explain poorer satisfaction, disengagement from services and ethnic variations in access to less coercive care. Interventions that improve therapeutic communications may offer new approaches to tackle ethnic inequalities in experiences and outcomes. METHODS: The THERACOM project is an HTA-funded evidence synthesis review of interventions to improve therapeutic communications between black and minority ethnic patients in contact with specialist mental health services and staff providing those services. This article sets out the protocol methods for a necessarily broad review topic, including appropriate search strategies, dilemmas for classifying different types of therapeutic communications and expectations of the types of interventions to improve them. The review methods will accommodate unexpected types of study and interventions. The findings will be reported in 2013, including a synthesis of the quantitative and grey literature. DISCUSSION: A particular methodological challenge is to identify and rate the quality of many different study types, for example, randomised controlled trials, observational quantitative studies, qualitative studies and case studies, which comprise the full range of hierarchies of evidence. We discuss the preliminary methodological challenges and some solutions. (PROSPERO registration number: CRD42011001661)

Trends in research about health in early childhood: economics and equity, from micro-studies to big business

Research about health is concerned with physical and mental well-being, illness and injury. Directly or indirectly, health relates to almost every aspect of early childhood. This article reviews the enormous range of research available, examining the aims and purposes of the studies, their methods and findings and the ways in which childhood and child-adult relationships are conceptualized. In particular, this article is concerned with whether the evidence available arises from studies concerned with cost-effectiveness or with equity and the re-distribution of wealth and resources

Gold standard or fool's gold: the pursuit of certainty in experimental criminology

This article assesses some of the claims made for experimental research in the field of rehabilitation of offenders. It suggests that both policy officials and evaluators have tended to over-invest financially and intellectually in a technocratic model of reducing reoffending that emphasizes programmes for offenders, and to under-invest in models that see the process as a complex ‘people changing’ skill. It argues that the complexity of this process renders it hard to evaluate using experimental methods of evaluation such as randomized controlled trials (RCTs). RCTs provide strong internal validity, but in complex settings offer weak external validity, making it hard to generalize from the experimental setting to other settings. The article suggests that the proper role for evaluative research in this field should be seen as building and testing middle-level theories about how best to change offenders’ behaviour

Economic evaluations of pharmacogenetic and pharmacogenomic screening tests : a systematic review : second update of the literature

Objective : Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature. Methods : A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies' overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument. Results : We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing. Conclusions : Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests' efficacy remains of utmost importance