443 research outputs found

    Reexamining evidence-based practice in community corrections: beyond 'a confined view' of what works

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    This article aims to reexamine the development and scope of evidence-based practice (EBP) in community corrections by exploring three sets of issues. Firstly, we examine the relationships between the contested purposes of community supervision and their relationships to questions of evidence. Secondly, we explore the range of forms of evidence that might inform the pursuit of one purpose of supervision—the rehabilitation of offenders—making the case for a fuller engagement with “desistance” research in supporting this process. Thirdly, we examine who can and should be involved in conversations about EBP, arguing that both ex/offenders’ and practitioners’ voices need to be respected and heard in this debate

    Policy transfer and convergence within the UK:The case of local government performance improvement regimes

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    Analysis of the development and implementation of local government performance improvement regimes in England, Scotland and Wales over the last decade reveals congruence in policy goals but divergence in policy implementation and outcomes. The governments in all three countries had a common aim of improving local government performance. However, differences in ideology, the nature of central–local government relations, the numbers of councils and a political imperative for newly devolved administrations to be seen to pursue 'home-grown' solutions limited policy learning between different parts of the United Kingdom (UK) and in the case of Wales fuelled determined policy avoidance by policy makers

    Flows of Knowledge, Expertise and Influence:A Method for Assessing Policy and Practice Impacts from Social Science Research

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    Social science research undoubtedly does impact on public policy and practice but Such non-academic impacts are rarely amenable to precise, quantitative metrics. In the of accountability, it is however possible to find proxy indicators of connectivity with research users and these may form steps toward impacts. Understanding these connections can lead to a deeper appreciation of the factors that shape the processes leading to research uptake. This study adopted a detailed and largely qualitative approach to identify the flows of knowledge, expertise and influence that take place during the process of knowledge transfer in order to trial a method for assessing policy and practice impacts from social science research. As a corollary to this assessment, the Study further identified five factors that can influence and enhance the process of knowledge exchange between researchers and users.</p

    Research shapes policy: but the dynamics are subtle

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    Major policy initiatives such as the Quality and Outcomes Framework (QOF) in the national contract for UK general practitioners might variably be informed by evidence at their inception, implementation and subsequent evolution. But what evidence gets admitted into these policy debates—and what is left out? Using QOF as an example, this article demonstrates what an analysis of the relationship between policy and the associated research can tell us about the underlying policy assumptions and about the role of evidence in policy debates

    Hormonal impact of the 17α-hydroxylase/C17,20-lyase inhibitor abiraterone acetate (CB7630) in patients with prostate cancer

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    A series of three dose escalating studies were conducted to investigate the ability of the 17-hydroxylase/C17,20-lyase inhibitor abiraterone acetate, to cause maximum suppression of testosterone synthesis when delivered to castrate and noncastrate males with prostate cancer. Study A was a single dose study in castrate males. Study B was a single dose study in noncastrate males and study C was a multiple dose study in noncastrate males. The drug was given orally in a once-daily dose and blood samples taken to assess pharmacokinetic (PK) parameters and hormone levels in all patients. The study drug was well tolerated with some variability in PKs. Suppression of testosterone levels to <0.14 nmol l-1 was seen in four out of six castrate males treated with a single dose of 500 mg. At 800 mg given days 1–12 in noncastrate males, target suppression was achieved in three out of three patients, but a two- to three-fold increase of Luteinising Hormone (LH) levels in two out of three patients overcame suppression within 3 days. All patients in the multiple dose study developed an abnormal response to a short Synacthen test by day 11, although baseline cortisol levels remained normal. This is the first report of the use of a specific 17-hydroxylase/17,20-lyase inhibitor in humans. Repeated treatment of men with intact gonadal function with abiraterone acetate at a dose of 800 mg can successfully suppress testosterone levels to the castrate range. However, this level of suppression may not be sustained in all patients due to compensatory hypersecretion of LH. The enhanced testosterone suppression achieved in castrate men merits further clinical study as a second-line hormonal treatment for prostate cancer. Adrenocortical suppression may necessitate concomitant administration of replacement glucocorticoid

    The effect of scientific evidence on conservation practitioners' management decisions.

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    A major justification of environmental management research is that it helps practitioners, yet previous studies show it is rarely used to inform their decisions. We tested whether conservation practitioners focusing on bird management were willing to use a synopsis of relevant scientific literature to inform their management decisions. This allowed us to examine whether the limited use of scientific information in management is due to a lack of access to the scientific literature or whether it is because practitioners are either not interested or unable to incorporate the research into their decisions. In on-line surveys, we asked 92 conservation managers, predominantly from Australia, New Zealand, and the United Kingdom, to provide opinions on 28 management techniques that could be applied to reduce predation on birds. We asked their opinions before and after giving them a summary of the literature about the interventions' effectiveness. We scored the overall effectiveness and certainty of evidence for each intervention through an expert elicitation process-the Delphi method. We used the effectiveness scores to assess the practitioners' level of understanding and awareness of the literature. On average, each survey participant changed their likelihood of using 45.7% of the interventions after reading the synopsis of the evidence. They were more likely to implement effective interventions and avoid ineffective actions, suggesting that their intended future management strategies may be more successful than current practice. More experienced practitioners were less likely to change their management practices than those with less experience, even though they were not more aware of the existing scientific information than less experienced practitioners. The practitioners' willingness to change their management choices when provided with summarized scientific evidence suggests that improved accessibility to scientific information would benefit conservation management outcomes.W.J.S. is funded by Arcadia, and L.V.D. is funded by the Natural Environment Research Council, UK (Grant code NE/K015419/1).This is the final published version. It is also available from Wiley at http://onlinelibrary.wiley.com/doi/10.1111/cobi.12370/abstract

    Evidence-informed health policy: are we beginning to get there at last

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    This 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

    The impact of Cochrane Systematic Reviews : a mixed method evaluation of outputs from Cochrane Review Groups supported by the UK National Institute for Health Research

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    © 2014 Bunn et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: There has been a growing emphasis on evidence-informed decision making in health care. Systematic reviews, such as those produced by the Cochrane Collaboration, have been a key component of this movement. The UK National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs). The aim of this study was to identify the impacts of Cochrane reviews published by NIHR funded CRGs during the years 2007-11. Methods: We sent questionnaires to CRGs and review authors, interviewed guideline developers and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane reviews. We used a framework with four categories (knowledge production, research targeting, informing policy development, and impact on practice/services). Results: A total of 1502 new and updated reviews were produced by the 20 NIHR funded CRGs between 2007-11. The clearest impacts were on policy with a total of 483 systematic reviews cited in 247 sets of guidance; 62 were international, 175 national (87 from the UK) and 10 local. Review authors and CRGs provided some examples of impact on practice or services, for example safer use of medication, the identification of new effective drugs or treatments and potential economic benefits through the reduction in the use of unproven or unnecessary procedures. However, such impacts are difficult to objectively document and the majority of reviewers were unsure if their review had produced specific impacts. Qualitative data suggested that Cochrane reviews often play an instrumental role in informing guidance although a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and guideline developers were barriers to their use. Conclusions: Health and economic impacts of research are generally difficult to measure. We found that to be the case with this evaluation. Impacts on knowledge production and clinical guidance were easier to identify and substantiate than those on clinical practice. Questions remain about how we define and measure impact and more work is needed to develop suitable methods for impact analysis.Peer reviewe
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