Science.gov

Sample records for evidence-based ethical policies

  1. Understanding evidence-based public health policy.

    PubMed

    Brownson, Ross C; Chriqui, Jamie F; Stamatakis, Katherine A

    2009-09-01

    Public health policy has a profound impact on health status. Missing from the literature is a clear articulation of the definition of evidence-based policy and approaches to move the field forward. Policy-relevant evidence includes both quantitative (e.g., epidemiological) and qualitative information (e.g., narrative accounts). We describe 3 key domains of evidence-based policy: (1) process, to understand approaches to enhance the likelihood of policy adoption; (2) content, to identify specific policy elements that are likely to be effective; and (3) outcomes, to document the potential impact of policy. Actions to further evidence-based policy include preparing and communicating data more effectively, using existing analytic tools more effectively, conducting policy surveillance, and tracking outcomes with different types of evidence.

  2. From evidence based bioethics to evidence based social policies

    PubMed Central

    2007-01-01

    In this issue, Norwegian authors demonstrate that causes of early expulsion out the workforce are rooted in childhood. They reconstruct individual biographies in administrative databases linked by an unique national identification number, looking forward 15 years in early adulthood and looking back 20 years till birth with close to negligible loss to follow up. Evidence based bioethics suggest that it is better to live in a country that allows reconstructing biographies in administrative databases then in countries that forbid access by restrictive legislation based on privacy considerations. The benefits of gained knowledge from existing and accessible information are tangible, particularly for the weak and the poor, while the harms of theoretical privacy invasion have not yet materialised. The study shows once again that disadvantage runs in families. Low parental education, parental disability and unstable marital unions predict early disability pensions and premature expulsion out gainful employment. The effect of low parental education is mediated by low education of the index person. However, in a feast of descriptive studies of socio-economic causes of ill health we still face a famine of evaluative intervention studies. An evidence based social policy should be based on effective interventions that are able to break the vicious circles of disability handed down from generation to generation. PMID:17657572

  3. Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics

    PubMed Central

    Goldenberg, Maya J

    2005-01-01

    Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for

  4. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  5. Evidence-based policy as reflexive practice. What can we learn from evidence-based medicine?

    PubMed

    Bal, Roland

    2016-10-13

    The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.

  6. Ethics and Evidence-Based Medicine: Is There a Conflict?

    PubMed Central

    Loewy, Erich H.

    2007-01-01

    This article addresses the advantages, disadvantages, and traps to which evidence-based medicine (EBM) may lead and suggests that, to be ethically valid, EBM must be aimed at the patient's best interests and not at the financial interests of others. While financial considerations are by no means trivial, it is hypocritical – if not dangerous – to hide them behind words like “evidence” or “quality.” PMID:18092036

  7. Ethics in Distance Education: Developing Ethical Policies.

    ERIC Educational Resources Information Center

    Gearhart, Deb

    2001-01-01

    Examines the changing world of education through distance education and discusses the need for ethics in distance education. Explains how to ethically develop policy for distance education, including Internet ethics, good practices guidelines, and involving faculty. (LRW)

  8. Social construction and the evidence-based drug policy endeavour.

    PubMed

    Lancaster, Kari

    2014-09-01

    'Evidence-based policy' has become the catch-cry of the drug policy field. A growing literature has been dedicated to better realising the goal of evidence-based drug policy: to maximise the use of the best quality research to inform policy decision-making and help answer the question of 'what works'. Alternative accounts in the policy processes literature conceptualise policy activity as an ambiguous and contested process, and the role of evidence as being only marginally influential. Multiple participants jostle for influence and seek to define what may be regarded as a policy problem, how it may be appropriately addressed, which participants may speak authoritatively, and what knowledge(s) may be brought to bear. The question posited in this article is whether the conceptual shift offered by thinking about policy activity as a process of social construction may be valuable for beginning to explore different perspectives of the evidence-based drug policy endeavour. Within a constructionist account of policy, what counts as valid 'evidence' will always be a constructed notion within a dynamic system, based on the privileging and silencing of participants and discourse, and the contestation of those many positions and perspectives. The social construction account shifts our focus from the inherent value of 'evidence' for addressing 'problems' to the ways in which policy knowledge is made valid, by whom and in what contexts. As such, social construction provides a framework for critically analysing the ways in which 'policy-relevant knowledge' may not be a stable concept but rather one which is constructed through the policy process, and, through a process of validation, is rendered useful. We have limited knowledge in the drug policy field about how this happens; how ambiguity about the problems to be addressed, which voices should be heard, and what activities may be appropriate is contested and managed. By unpicking the values and assumptions which underlie drug

  9. Opportunities and Challenges in Evidence-Based Social Policy. Social Policy Report. Volume 28, Number 4

    ERIC Educational Resources Information Center

    Supplee, Lauren H.; Metz, Allison

    2014-01-01

    Despite a robust body of evidence of effectiveness of social programs, few evidence-based programs have been scaled for population-level improvement in social problems. Since 2010 the federal government has invested in evidence-based social policy by supporting a number of new evidence-based programs and grant initiatives. These initiatives…

  10. Health and Wellness Policy Ethics

    PubMed Central

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  11. The Impact of Research on Education Policy in an Era of Evidence-Based Policy

    ERIC Educational Resources Information Center

    Lingard, Bob

    2013-01-01

    Currently, when there is a lot of political talk about the need for "evidence-based policy", and when public policy seeks to calibrate research quality and impact, there is a pressing need to reconsider the relationships between education/al research and education policy. This article seeks to do this, beginning with considerations of the…

  12. Implementing evidence-based policy in a network setting: road safety policy in the Netherlands.

    PubMed

    Bax, Charlotte; de Jong, Martin; Koppenjan, Joop

    2010-01-01

    In the early 1990s, in order to improve road safety in The Netherlands, the Institute for Road Safety Research (SWOV) developed an evidence-based "Sustainable Safety" concept. Based on this concept, Dutch road safety policy, was seen as successful and as a best practice in Europe. In The Netherlands, the policy context has now changed from a sectoral policy setting towards a fragmented network in which safety is a facet of other transport-related policies. In this contribution, it is argued that the implementation strategy underlying Sustainable Safety should be aligned with the changed context. In order to explore the adjustments needed, two perspectives of policy implementation are discussed: (1) national evidence-based policies with sectoral implementation; and (2) decentralized negotiation on transport policy in which road safety is but one aspect. We argue that the latter approach matches the characteristics of the newly evolved policy context best, and conclude with recommendations for reformulating the implementation strategy.

  13. Code of Ethics for Rehabilitation Educators and Counselors: A Call for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Burker, Eileen J.; Kazukauskas, Kelly A.

    2010-01-01

    Given the emphasis on evidence-based practice (EBP) in the 2010 Code of Professional Ethics for Rehabilitation Counselors, it has become even more critical for rehabilitation educators and rehabilitation counselors to understand EBP, how to implement it in teaching and in practice, and how to access available EBP resources. This paper defines and…

  14. Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based healthcare.

    PubMed

    Norlyk, Annelise; Haahr, Anita; Dreyer, Pia; Martinsen, Bente

    2017-01-12

    Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously. The other is a course of democratization based on patients' involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence-based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as 'one best way'. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of 'McNursing'.

  15. Ethical practice of evidence-based medicine: A review for plastic surgeons

    PubMed Central

    Ahuja, Rajeev B.

    2013-01-01

    Last decade has witnessed a spurt in articles focused on the topic of evidence-based medicine (EBM) and medical ethics. These articles are not only educative, but draw attention to the changing scenario of medical practice. Surgeons seem a bit less attentive to practice of EBM, more so in the developing world. The theme is now percolating in our realm for demonstrable incorporation of EBM in our practice, which is allegorical of a good physician and is also likely to become demanding legally. In practicing EBM, several conflicts may arise with the ethical vows of medicine. However, majority of these conflicting issues have germinated from a capitalistic approach to medical practice, where the fear of extraneous compulsions dictating prescriptions and procedures in the garb of ‘evidence-based practice’ conflicts ethical behaviour. This review shall appraise the reader with important definitions of medical ethics, EBM and how to incorporate best evidence into ones practice. While, EBM brings objectivity to treatment to derive measurable outcomes it should not become regimented or metamorphose as a pseudonym for defensive medicine to escalate treatment costs. EBM also has several limitations one of which is to place the onus on the practicing physician to search for the best evidence and the other is the resource constraint of practice in the developing world. How a plastic surgery practice could be made to conform to evidence based (EB) procedures is proposed as insufficient surgical skills can pose a serious threat to not only the practice of EB procedures, but to ethical responsibilities as well. In conclusion, it is necessary to incorporate ethical temperance into EB procedures to withstand societal, peer and legal pressures of current times. PMID:23960301

  16. A code of ethics for evidence-based research with ancient human remains.

    PubMed

    Kreissl Lonfat, Bettina M; Kaufmann, Ina Maria; Rühli, Frank

    2015-06-01

    As clinical research constantly advances and the concept of evolution becomes a strong and influential part of basic medical research, the absence of a discourse that deals with the use of ancient human remains in evidence-based research is becoming unbearable. While topics such as exhibition and excavation of human remains are established ethical fields of discourse, when faced with instrumentalization of ancient human remains for research (i.e., ancient DNA extractions for disease marker analyses) the answers from traditional ethics or even more practical fields of bio-ethics or more specific biomedical ethics are rare to non-existent. The Centre for Evolutionary Medicine at the University of Zurich solved their needs for discursive action through the writing of a self-given code of ethics which was written in dialogue with the researchers at the Institute and was published online in Sept. 2011: http://evolutionäremedizin.ch/coe/. The philosophico-ethical basis for this a code of conduct and ethics and the methods are published in this article.

  17. An Evidence-Based Approach to Integrate Civility, Professionalism, and Ethical Practice Into Nursing Curricula.

    PubMed

    Clark, Cynthia M

    2016-10-04

    This article presents an evidence-based approach to integrate concepts of civility, professionalism, and ethical practice into nursing curricula to prepare students to foster healthy work environments and ensure safe patient care. The author provides evidence to support this approach and includes suggestions for new student orientation, strategies for the first day of class, exemplars for incorporating active learning strategies to enhance student engagement, an emphasis on positive faculty role modeling, and suggestions for curricular integration.

  18. When Ethics and Policy Collide

    ERIC Educational Resources Information Center

    Hightower, Bynum Blake; Klinker, JoAnn Franklin

    2012-01-01

    This case study explores an ethical dilemma faced by a new junior high school principal. It is appropriate for use in all preparation course work, including the internship. Studies show that novice principal decision making differs from that of experienced principals in moral dilemmas, including following policy versus best interests of the…

  19. The need for evidence-based research ethics: a review of the substance abuse literature.

    PubMed

    Anderson, Emily E; DuBois, James M

    2007-01-12

    Participants in substance abuse research may be vulnerable for multiple reasons. International research ethics guidelines and policy statements require that researchers provide extra protections when conducting research with vulnerable subjects, but it is uncertain which measures best protect vulnerable individuals. Concerns about vulnerability have been translated into only the vaguest regulatory requirements, and very little empirical data exist to guide researchers and ethics review committee members who want to protect participants. This article reviews two bodies of substance abuse research ethics literature. First, "normative" articles, that is, articles that discuss ethical issues that may arise in substance abuse research, are discussed. The resulting taxonomy of ethical issues then guides a review of empirical studies on issues like the informed consent process and the use of financial incentives in substance abuse research. While the ethical issues in substance abuse research are numerous and well-documented, the evidentiary base for addressing these issues is inadequate. If any one major theme emerged from the existing studies, it is that many well-intentioned, protectionist concerns--about recruitment incentives, consent comprehension, and drug administration studies--are not supported by empirical data. While these findings are at best tentative, they suggest how research on research ethics might ultimately benefit participants.

  20. Leveraging Evidence-Based Practices: From Policy to Action

    ERIC Educational Resources Information Center

    Detrich, Ronnie; Keyworth, Randy; States, Jack

    2016-01-01

    Education is a public health issue. Poor educational outcomes are correlated with many health and social ills. To improve the quality of education, it will be necessary to take advantage of the leverage points of policy, evidence, and implementation science. The idea of evidence informing policy may be non-controversial, but a closer examination…

  1. Tobacco plain packaging: Evidence based policy or public health advocacy?

    PubMed

    McKeganey, Neil; Russell, Christopher

    2015-06-01

    In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters.

  2. Policy Claims and Problem Frames: A Cross-Case Comparison of Evidence-Based Policy in an Australian Context

    ERIC Educational Resources Information Center

    van Toorn, Georgia; Dowse, Leanne

    2016-01-01

    This paper explores the signification of evidence-based policy as a new policy-making paradigm in Australia through a cross-case comparison of the role of evidence in two key areas: child protection and illicit drug policy. Although evidence makes certain courses of action appear valid and credible, quality evidence is not necessarily the critical…

  3. "Perform, Measure Accurately, Optimise": On the Constitution of (Evidence-Based) Education Policy

    ERIC Educational Resources Information Center

    Decuypere, Mathias; Simons, Maarten; Masschelein, Jan

    2011-01-01

    This article takes its point of departure in the current tendency of education policy to become more and more evidence-based. The use of statistics and numbers seems to be a prerequisite for conducting a policy that is both efficient and effective. The kind of knowledge thus produced is regarded as factual and scientific. This article tries to get…

  4. The productive techniques and constitutive effects of 'evidence-based policy' and 'consumer participation' discourses in health policy processes.

    PubMed

    Lancaster, K; Seear, K; Treloar, C; Ritter, A

    2017-03-01

    For over twenty years there have been calls for greater 'consumer' participation in health decision-making. While it is recognised by governments and other stakeholders that 'consumer' participation is desirable, barriers to meaningful involvement nonetheless remain. It has been suggested that the reifying of 'evidence-based policy' may be limiting opportunities for participation, through the way this discourse legitimates particular voices to the exclusion of others. Others have suggested that assumptions underpinning the very notion of the 'affected community' or 'consumers' as fixed and bounded 'policy publics' need to be problematised. In this paper, drawing on interviews (n = 41) with individuals closely involved in Australian drug policy discussions, we critically interrogate the productive techniques and constitutive effects of 'evidence-based policy' and 'consumer participation' discourses in the context of drug policy processes. To inform our analysis, we draw on and combine a number of critical perspectives including Foucault's concept of subjugated knowledges, the work of feminist theorists, as well as recent work regarding conceptualisations of emergent policy publics. First, we explore how the subject position of 'consumer' might be seen as enacted in the material-discursive practices of 'evidence-based policy' and 'consumer participation' in drug policy processes. Secondly, we consider the centralising power-effects of the dominant 'evidence-based policy' paradigm, and how resistance may be thought about in this context. We suggest that such interrogation has potential to recast the call for 'consumer' participation in health policy decision-making and drug policy processes.

  5. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    PubMed Central

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

  6. Economics, ethics, and climate policy

    SciTech Connect

    Howarth, R.B.; Monahan, P.A.

    1992-11-01

    Are the costs of greenhouse gas emissions abatement justified by the perceived benefits of sustained climate stability Do people of the present generation have a moral right to impose climate risks on their descendants in generations to come This report examines these questions in light of the emergent facts of climate science and their socioeconomic implications. We consider alternative normative criteria for social decision-making with particular emphasis on cost-benefit analysis and the principle of sustainable development. While each framework yields important insights, we argue that the gross uncertainties associated with climate change and the distribution of impacts between present and future generations constrain the usefulness of cost-benefit criteria in evaluating climate policy. If one accepts the ethical proposition that it is morally wrong to impose catastrophic risks on unborn generations when reducing those risks would not noticeably diminish the quality of life of existing persons, a case can be made for concerted policy action to reduce greenhouse gas emissions.

  7. Economics, ethics, and climate policy

    SciTech Connect

    Howarth, R.B.; Monahan, P.A.

    1992-11-01

    Are the costs of greenhouse gas emissions abatement justified by the perceived benefits of sustained climate stability? Do people of the present generation have a moral right to impose climate risks on their descendants in generations to come? This report examines these questions in light of the emergent facts of climate science and their socioeconomic implications. We consider alternative normative criteria for social decision-making with particular emphasis on cost-benefit analysis and the principle of sustainable development. While each framework yields important insights, we argue that the gross uncertainties associated with climate change and the distribution of impacts between present and future generations constrain the usefulness of cost-benefit criteria in evaluating climate policy. If one accepts the ethical proposition that it is morally wrong to impose catastrophic risks on unborn generations when reducing those risks would not noticeably diminish the quality of life of existing persons, a case can be made for concerted policy action to reduce greenhouse gas emissions.

  8. Teaching Ethics and National Security Policy.

    ERIC Educational Resources Information Center

    Harbour, Frances V.

    1987-01-01

    Covers the objectives, subject matter, and requirements of a one-semester course based on ethics and national security policy taught within the School of Public Affairs at the University of Maryland at College Park. The course is designed to give students an opportunity to develop skill in the analysis of moral and ethical issues. (JDH)

  9. Epistemology and ethics of evidence-based medicine: putting goal-setting in the right place.

    PubMed

    Sestini, Piersante

    2010-04-01

    While evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a pivotal position for the understanding of the whole process, and underscores a few aspects which are often overlooked in EBM courses. First in this step internal evidence (including personal expertise) must be appraised and integrated in the problem. Second, issues of applicability of the possible solution should be anticipated. Third, and possibly more important, the goal of the intervention should be set at this stage (typically by choosing the outcome in a PICO question). Depending whether or not goals depend on the goals of others, and whether they concern others' voluntary behaviour, goals may be classified as self-serving, moral, altruistic or moralistic. Thus, delicate ethical questions must be addressed at this stage, which means that patient preferences and values must be carefully sought, so that empathy, counselling and narrative medicine must be mastered to be able to formulate correctly an answerable question. The need to modify the current description of the EBM process to increase the recognition of implicit assumptions and increase the consistency of this model is discussed.

  10. The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of "Evidence-Based" in a Policy Context.

    PubMed

    Walker, Sarah Cusworth; Lyon, Aaron R; Aos, Steve; Trupin, Eric W

    2017-01-01

    As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge. In this paper we review the development of the Washington State Inventory of Evidence-Based, Research-Based and Promising Practices as a case study for the process of defining evidence-based practice in a policy context. As part of this study we also present a comparison of other well-known evidence-based practice inventories and examine consistencies and differences in the process of identifying and developing program ratings.

  11. Migration, Race and Education: Evidence-Based Policy or Institutional Racism?

    ERIC Educational Resources Information Center

    Warren, Simon

    2007-01-01

    The promise of evidence-based policy is that social scientific research can lead to rational planning that will lead to improved outcomes and life chances for people across the whole spectrum of social provision. This article argues that evidence is politically mobilised to legitimise the reproduction of racial and social advantage and construct…

  12. Ethics in American health 1: ethical approaches to health policy.

    PubMed

    Ruger, Jennifer Prah

    2008-10-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy.

  13. Ethics in American Health 1: Ethical Approaches to Health Policy

    PubMed Central

    2008-01-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

  14. The Human Fertilisation and Embryology Authority: evidence based policy formation in a contested context.

    PubMed

    Dawson, Angus

    2004-03-01

    This article briefly reviews the various papers contained in this volume. They were originally presented at a research work shop held at Keele University in the UK in February 2003. It is suggested that the different papers raise a series of related legal, social and ethical issues and can be collectively seen to demonstrate the fact that policy formation in relation to reproductive matters is highly contested. It is concluded that ethical policy formation in this area needs to be based on actual evidence of harm rather than assumed harm and that this therefore entails more empirical research into reproductive matters.

  15. The systematic review of the literature: a tool for evidence-based policy.

    PubMed

    Houde, Susan Crocker

    2009-09-01

    The systematic review of the literature is a valuable tool for gerontological nurses to influence policy decisions. There are several organizations that provide helpful guidelines for the conduct of systematic reviews of the literature, including the Cochrane Collaboration, the Joanna Briggs Institute, and the Evidence for Policy and Practice Information Co-Ordinating Centre at the Institute of Education, University of London. Gerontological nurses who have a strong foundation in research methodology and the skills to synthesize scientific evidence for the purpose of promoting evidence-based policy have the potential to positively influence health care outcomes for older adults. For nurses to assume a leadership role in synthesizing scientific evidence for evidence-based policy development and refinement, nursing education will need to assume a more active role in teaching systematic review methodology. This article presents an overview of resources for con-ducting systematic reviews of the literature and discusses the use of the systematic review as a tool for evidence-based policy.

  16. Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown.

    PubMed

    Lum, Cynthia; Kennedy, Leslie W; Sherley, Alison

    2008-02-01

    Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown. One of the central concerns surrounding counter-terrorism interventions today, given the attention and money spent on them, is whether such interventions are effective. To explore this issue, we conducted a general review of terrorism literature as well as a Campbell systematic review on counter-terrorism strategies. In this article, we summarize some of our findings from these works. Overall, we found an almost complete absence of evaluation research on counter-terrorism strategies and conclude that counter-terrorism policy is not evidence-based. The findings of this review emphasise the need for government leaders, policy makers, researchers, and funding agencies to include and insist on evaluations of the effectiveness of these programs in their agendas.

  17. Biomedical engineering and society: policy and ethics.

    PubMed

    Flexman, J A; Lazareck, L

    2007-01-01

    Biomedical engineering impacts health care and contributes to fundamental knowledge in medicine and biology. Policy, such as through regulation and research funding, has the potential to dramatically affect biomedical engineering research and commercialization. New developments, in turn, may affect society in new ways. The intersection of biomedical engineering and society and related policy issues must be discussed between scientists and engineers, policy-makers and the public. As a student, there are many ways to become engaged in the issues surrounding science and technology policy. At the University of Washington in Seattle, the Forum on Science Ethics and Policy (FOSEP, www.fosep.org) was started by graduate students and post-doctoral fellows interested in improving the dialogue between scientists, policymakers and the public and has received support from upper-level administration. This is just one example of how students can start thinking about science policy and ethics early in their careers.

  18. Evidence-Based Programming in the Context of Practice and Policy. Social Policy Report. Volume XXIII, Number III

    ERIC Educational Resources Information Center

    McCall, Robert B.

    2009-01-01

    Scholars, practice professionals, and policymakers should welcome the new era of evidence-based programming and policies, but these constituencies need to be realistic about the complexities, uncertainties, and limitations that lie beneath what could easily become a simplistic process. This paper discusses some of the requirements for the…

  19. The role of evidence-based media advocacy in the promotion of tobacco control policies.

    PubMed

    Lane, Ch'uyasonqo H; Carter, Marina I

    2012-06-01

    This article discusses the role of evidence-based media advocacy in the promotion of tobacco control policies. Evidence is a driving force for campaigns seeking to implement a tobacco control policy. An effective campaign is based in evidence that demonstrates why a policy should be implemented, and what the potential benefits are. Media advocacy is the process of disseminating information through the communications media where the aim is to effect action, such as a change of policy, or to alter the public's view of an issue. Discussion focuses on: 1) the importance of, and methods for, collecting and communicating evidence and information to make it clear and usable for legislators, the media, and the public; and 2) the role of earned and paid media in advancing tobacco control issues. The discussion is made within the context of a specific advocacy example; in this case the 2010 campaign to increase the tobacco tax in Mexico.

  20. Nursing's Code of Ethics, Social Ethics, and Social Policy.

    PubMed

    Fowler, Marsha D

    2016-09-01

    Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias.

  1. Management of clandestine drug laboratories: need for evidence-based environmental health policies.

    PubMed

    Al-Obaidi, Tamara A; Fletcher, Stephanie M

    2014-01-01

    Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.

  2. Using knowledge brokering to promote evidence-based policy-making: The need for support structures.

    PubMed Central

    van Kammen, Jessika; de Savigny, Don; Sewankambo, Nelson

    2006-01-01

    Knowledge brokering is a promising strategy to close the "know-do gap" and foster greater use of research findings and evidence in policy-making. It focuses on organizing the interactive process between the producers and users of knowledge so that they can co-produce feasible and research-informed policy options. We describe a recent successful experience with this novel approach in the Netherlands and discuss the requirements for effective institutionalization of knowledge brokering. We also discuss the potential of this approach to assist health policy development in low-income countries based on the experience of developing the Regional East-African Health (REACH)-Policy Initiative. We believe that intermediary organizations, such as regional networks, dedicated institutional mechanisms and funding agencies, can play key roles in supporting knowledge brokering. We recommend the need to support and learn from the brokerage approach to strengthen the relationship between the research and policy communities and hence move towards a stronger culture of evidence-based policy and policy-relevant research. PMID:16917647

  3. New directions in evidence-based policy research: a critical analysis of the literature.

    PubMed

    Oliver, Kathryn; Lorenc, Theo; Innvær, Simon

    2014-07-14

    Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence - whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of 'evidence', methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics' research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence - meaning research evidence - use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of 'getting evidence into policy' has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy.

  4. Limits to evidence-based health policymaking: policy hurdles to structural HIV prevention in Tanzania.

    PubMed

    Hunsmann, Moritz

    2012-05-01

    Despite the well-documented role of highly co-endemic biological cofactors in facilitating HIV transmission and the availability of comparatively inexpensive tools to control them, cofactor-related interventions are only hesitantly included into African HIV prevention strategies. Against this background, this study analyzes political obstacles to policy-uptake of evidence concerning structural HIV prevention. The data used stem from fieldwork conducted in Tanzania between 2007 and 2009. They include 92 in-depth interviews with key AIDS policymakers and observations of 8 national-level policy meetings. Adopting a political economy perspective, the study shows that 1) assuming cost-aversion as a spontaneous reflex of policymakers is empirically wrong and analytically misleading, 2) that political constituencies induce a path dependence of allocative decisions inconducive to structural prevention, 3) that interventions' political attractiveness depends on the nature of their outputs and the expected temporality of political returns, 4) that policy fragmentation entailed by vertical disease control disfavours the consideration of broader causalities, and 5) that cofactor-based measures are hampered by policymakers' perception of structural prevention as being excessively complex and ultimately tantamount to poverty eradication. Confronting the policy players' reading of the Tanzanian situation with recent and classical literature on evidence-based decision-making and the politics of public health, this paper shows that, far from being strictly evidence-driven, HIV prevention policies result from a politically negotiated aggregation of competing, frequently non-optimizing rationalities. A realistic appraisal of policy processes suggests that the failure to consider the invariably political nature of HIV-related policymaking hampers the formulation of effective, politically informed strategies for positive change. Consequently, developing policy practitioners

  5. Strengthening vaccination policies in Latin America: an evidence-based approach.

    PubMed

    Tapia-Conyer, Roberto; Betancourt-Cravioto, Miguel; Saucedo-Martínez, Rodrigo; Motta-Murguía, Lourdes; Gallardo-Rincón, Héctor

    2013-08-20

    Despite many successes in the region, Latin American vaccination policies have significant shortcomings, and further work is needed to maintain progress and prepare for the introduction of newly available vaccines. In order to address the challenges facing Latin America, the Commission for the Future of Vaccines in Latin America (COFVAL) has made recommendations for strengthening evidence-based policy-making and reducing regional inequalities in immunisation. We have conducted a comprehensive literature review to assess the feasibility of these recommendations. Standardisation of performance indicators for disease burden, vaccine coverage, epidemiological surveillance and national health resourcing can ensure comparability of the data used to assess vaccination programmes, allowing deeper analysis of how best to provide services. Regional vaccination reference schemes, as used in Europe, can be used to develop best practice models for vaccine introduction and scheduling. Successful models exist for the continuous training of vaccination providers and decision-makers, with a new Latin American diploma aiming to contribute to the successful implementation of vaccination programmes. Permanent, independent vaccine advisory committees, based on the US Advisory Committee on Immunization Practices (ACIP), could facilitate the uptake of new vaccines and support evidence-based decision-making in the administration of national immunisation programmes. Innovative financing mechanisms for the purchase of new vaccines, such as advance market commitments and cost front-loading, have shown potential for improving vaccine coverage. A common regulatory framework for vaccine approval is needed to accelerate delivery and pool human, technological and scientific resources in the region. Finally, public-private partnerships between industry, government, academia and non-profit sectors could provide new investment to stimulate vaccine development in the region, reducing prices in the

  6. Improving the evidence base in palliative care to inform practice and policy: thinking outside the box.

    PubMed

    Aoun, Samar M; Nekolaichuk, Cheryl

    2014-12-01

    The adoption of evidence-based hierarchies and research methods from other disciplines may not completely translate to complex palliative care settings. The heterogeneity of the palliative care population, complexity of clinical presentations, and fluctuating health states present significant research challenges. The aim of this narrative review was to explore the debate about the use of current evidence-based approaches for conducting research, such as randomized controlled trials and other study designs, in palliative care, and more specifically to (1) describe key myths about palliative care research; (2) highlight substantive challenges of conducting palliative care research, using case illustrations; and (3) propose specific strategies to address some of these challenges. Myths about research in palliative care revolve around evidence hierarchies, sample heterogeneity, random assignment, participant burden, and measurement issues. Challenges arise because of the complex physical, psychological, existential, and spiritual problems faced by patients, families, and service providers. These challenges can be organized according to six general domains: patient, system/organization, context/setting, study design, research team, and ethics. A number of approaches for dealing with challenges in conducting research fall into five separate domains: study design, sampling, conceptual, statistical, and measures and outcomes. Although randomized controlled trials have their place whenever possible, alternative designs may offer more feasible research protocols that can be successfully implemented in palliative care. Therefore, this article highlights "outside the box" approaches that would benefit both clinicians and researchers in the palliative care field. Ultimately, the selection of research designs is dependent on a clearly articulated research question, which drives the research process.

  7. Evidence Based Weighing Policy during the First Week to Prevent Neonatal Hypernatremic Dehydration while Breastfeeding

    PubMed Central

    Boer, Suzanne; Unal, Sevim; van Dommelen, Paula

    2016-01-01

    Background Neonatal hypernatremic dehydration is prevented by daily neonatal weight monitoring. We aim to provide evidence-based support of this universally promoted weighing policy and to establish the most crucial days of weighing. Methods Weight measurements of 2,359 healthy newborns and of 271 newborns with clinical hypernatremic dehydration were used within the first seven days of life to simulate various weighting policies to prevent hypernatremic dehydration; its sensitivity, specificity and positive predictive value (PPV) of these policies were calculated. Various referral criteria were also evaluated. Results A policy of daily weighing with a cut-off value of -2.5 Standard Deviation Score (SDS) on the growth chart for weight loss, had a 97.6% sensitivity, 97.6% specificity and a PPV of 2.80%. Weighing at birth and only at days two, four and seven with the same -2.5 SDS cut-off, resulted in 97.3% sensitivity, 98.5% specificity and a PPV of 4.43%. Conclusion A weighing policy with measurements restricted to birth and day two, four and seven applying the -2.5 SDS cut-off seems an optimal policy to detect hypernatremic dehydration. Therefore we recommend to preferably weigh newborns at least on day two (i.e. ~48h), four and seven, and refer them to clinical pediatric care if their weight loss increases below -2.5 SDS. We also suggest lactation support for the mother, full clinical assessment of the infant and weighing again the following day in all newborns reaching a weight loss below -2.0 SDS. PMID:27997557

  8. New directions in evidence-based policy research: a critical analysis of the literature

    PubMed Central

    2014-01-01

    Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence – whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of ‘evidence’, methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics’ research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence – meaning research evidence – use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of ‘getting evidence into policy’ has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy. PMID:25023520

  9. Internet Research Ethics and the Policy Gap for Ethical Practice in Online Research Settings

    ERIC Educational Resources Information Center

    Warrell, Jacqueline G.; Jacobsen, Michele

    2014-01-01

    A growing number of education and social science researchers design and conduct online research. In this review, the Internet Research Ethics (IRE) policy gap in Canada is identified along with the range of stakeholders and groups that either have a role or have attempted to play a role in forming better ethics policy. Ethical issues that current…

  10. Supporting Evidence-Based Policy on Biodiversity and Ecosystem Services: Recommendations for Effective Policy Briefs

    ERIC Educational Resources Information Center

    Balian, Estelle V.; Drius, Liza; Eggermont, Hilde; Livoreil, Barbara; Vandewalle, Marie; Vandewoestjine, Sofie; Wittmer, Heidi; Young, Juliette

    2016-01-01

    Knowledge brokerage on biodiversity and ecosystem services can apply communication tools such as policy briefs to facilitate the dialogue between scientists and policymakers. There is currently considerable debate on how to go beyond the linear communication model, outdated in theoretical debate but still often implicitly leading interaction with…

  11. Research-Based Knowledge: Researchers' Contribution to Evidence-Based Practice and Policy Making in Career Guidance

    ERIC Educational Resources Information Center

    Haug, Erik Hagaseth; Plant, Peter

    2016-01-01

    To present evidence for the outcomes of career guidance is increasingly seen as pivotal for a further professionalization of policy making and service provision. This paper puts an emphasis on researchers' contribution to evidence-based practice and policy making in career guidance. We argue for a broader and more pluralistic research strategy to…

  12. Neoliberal Common Sense and Race-Neutral Discourses: A Critique of "Evidence-Based" Policy-Making in School Policing

    ERIC Educational Resources Information Center

    Nolan, Kathleen

    2015-01-01

    The author of this paper uses critical discourse analysis and draws on critical social theory and policy studies to analyze the interdiscursivity between neoliberal common sense discourses around crime and safety and race-neutral discourses, "evidence-based" policy, and the research that supports school policing programs. The author…

  13. To what extent are Canadian second language policies evidence-based? Reflections on the intersections of research and policy

    PubMed Central

    Cummins, Jim

    2014-01-01

    The paper addresses the intersections between research findings and Canadian educational policies focusing on four major areas: (a) core and immersion programs for the teaching of French to Anglophone students, (b) policies concerning the learning of English and French by students from immigrant backgrounds, (c) heritage language teaching, and (d) the education of Deaf and hard-of hearing students. With respect to the teaching of French, policy-makers have largely ignored the fact that most core French programs produce meager results for the vast majority of students. Only a small proportion of students (<10%) attend more effective alternatives (e.g., French immersion and Intensive French programs). With respect to immigrant-background students, a large majority of teachers and administrators have not had opportunities to access the knowledge base regarding effective instruction for these students nor have they had opportunities for pre-service or in-service professional development regarding effective instructional practices. Educational policies in most jurisdictions have also treated the linguistic resources that children bring to school with, at best, benign neglect. In some cases (e.g., Ontario) school systems have been explicitly prohibited from instituting enrichment bilingual programs that would promote students’ bilingualism and biliteracy. Finally, with respect to Deaf students, policy-makers have ignored overwhelming research on the positive relationship between academic success and the development of proficiency in natural sign languages, preferring instead to leave uncorrected the proposition that acquisition of languages such as American Sign Language by young children (with or without cochlear implants) will impede children’s language and academic development. The paper reviews the kinds of policies, programs, and practices that could be implemented (at no additional cost) if policy-makers and educators pursued evidence-based educational policies

  14. Economic Ethics and Industrial Policy: The Analysis of Ethical Standardization

    ERIC Educational Resources Information Center

    Arnal, Juliette

    2008-01-01

    Beyond the presupposed cleavage between economics and ethics, the institutional dimension of economic ethics needs to be emphasized. The firm can use a large scope of instruments in order to formalize economic ethics. The asset of ethical standards is that they represent a specific way of coordination. They engender positive effects such as the…

  15. Evidence-Based Practice in Group Care: The Effects of Policy, Research, and Organizational Practices

    ERIC Educational Resources Information Center

    Stuart, Carol; Sanders, Larry; Gurevich, Maria; Fulton, Robert

    2011-01-01

    This article describes the effect of a province-wide vision of evidence-based and outcome-based services for children and youth and the challenges of implementing evidence-based practice (EBP) and evidence-based treatment (EBT) approaches within group care settings. The paper is based on the results of a survey of group care settings in the…

  16. Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

    PubMed

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

    2014-05-01

    As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.

  17. Scaling up evidence-based practices for children and families in New York State: toward evidence-based policies on implementation for state mental health systems.

    PubMed

    Hoagwood, Kimberly Eaton; Olin, S Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M; Woodlock, Kristin M; Hogan, Michael

    2014-01-01

    Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policymakers, providers, and family support specialists have worked in partnership since 2002 to redesign and evaluate the children's mental health system. Five system strategies driven by empirically based practices and organized within a state-supported infrastructure have been used in the child and family service system with more than 2,000 providers: (a) business practices, (b) use of health information technologies in quality improvement, (c) specific clinical interventions targeted at common childhood disorders, (d) parent activation, and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems.

  18. Biomedical ethics policy in Korea: characteristics and historical development.

    PubMed

    Hahm, Ki-Hyun; Lee, Ilhak

    2012-05-01

    Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature.

  19. Biomedical Ethics Policy in Korea: Characteristics and Historical Development

    PubMed Central

    Hahm, Ki-Hyun

    2012-01-01

    Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature. PMID:22661876

  20. Building the evidence base for effective tobacco control policies: the International Tobacco Control Policy Evaluation Project (the ITC Project).

    PubMed

    Fong, G T; Cummings, K M; Shopland, D R

    2006-06-01

    The Framework Convention on Tobacco Control (FCTC) is a seminal event in tobacco control and in global health. Scientific evidence guided the creation of the FCTC, and as the treaty moves into its implementation phase, scientific evidence can be used to guide the formulation of evidence-based tobacco control policies. The International Tobacco Control Policy Evaluation Project (ITC Project) is a transdisciplinary international collaboration of tobacco control researchers who have created research studies to evaluate and understand the psychosocial and behavioural impact of FCTC policies as they are implemented in participating ITC countries, which together are inhabited by over 45% of the world's smokers. This introduction to the ITC Project supplement of Tobacco Control presents a brief outline of the ITC Project, including a summary of key findings to date. The overall conceptual model and methodology of the ITC Project--involving representative national cohort surveys created from a common conceptual model, with common methods and measures across countries--may hold promise as a useful paradigm in efforts to evaluate and understand the impact of population-based interventions in other important domains of health, such as obesity.

  1. Ethical and public policy challenges for pharmacogenomics.

    PubMed

    Gershon, Elliot S; Alliey-Rodriguez, Ney; Grennan, Kay

    2014-12-01

    It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders.

  2. The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce

    ERIC Educational Resources Information Center

    Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth

    2009-01-01

    Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

  3. The Institute for the Advancement of Social Work Research: Working to Increase Our Practice and Policy Evidence Base

    ERIC Educational Resources Information Center

    Zlotnik, Joan Levy; Solt, Barbara E.

    2006-01-01

    This invitational update on the Institute for the Advancement of Social Work Research (IASWR) provides an overview of the work and progress toward strengthening the evidence base for social work practice and policy through research. The article includes information regarding IASWR work with its supporting social work organizations to provide a…

  4. Evidence-based fitness promotion in an afterschool setting: implementation fidelity and its policy implications.

    PubMed

    Thaw, Jean M; Villa, Manuela; Reitman, David; DeLucia, Christian; Gonzalez, Vanessa; Hanson, K Lori

    2014-01-01

    Little is known about how the adoption of evidence-based physical activity (PA) curricula by out-of-school time (OST) programs affects children's physical fitness, and there are no clear guidelines of what constitutes reasonable gains given the types of PA instruction currently offered in these programs. Using a three-wave, quasi-experimental, naturalistic observation design, this study evaluated the implementation of an evidence-based PA instruction curriculum (Sports, Play, and Active Recreation for Kids [SPARK]) and examined whether the potential health benefits of evidence-based PA instruction can be replicated in this context when compared to OST programs that do not use evidence-based PA curricula. Quality of PA instruction and SPARK implementation fidelity were also assessed. Results indicated that children in the non-evidence-based/standard PA instruction programs engaged in higher levels of moderate-to-vigorous PA (MVPA) and showed greater improvements in fitness levels over time. The findings from this chapter suggest that while it is generally accepted that evidence-based approaches yield higher levels of PA when implemented by researchers under controlled conditions, findings are inconsistent when evidence-based PA instruction is implemented in the field, under presumably less controlled conditions. It appears that when it comes to PA instruction in afterschool, either less structured activities or well-implemented evidence-based practices could be the key to promoting higher PA levels and greater health and fitness for school-aged children.

  5. [Martin Heidegger, beneficence, health, and evidence based medicine--contemplations regarding ethics and complementary and alternative medicine].

    PubMed

    Oberbaum, Menachem; Gropp, Cornelius

    2015-03-01

    Beneficence is considered a core principle of medical ethics. Evidence Based Medicine (EBM) is used almost synonymously with beneficence and has become the gold standard of efficiency of conventional medicine. Conventional modern medicine and EBM in particular are based on what Heidegger called calculative thinking, whereas complementary medicine (CM) is often based on contemplative thinking according to Heidegger's distinction of different thinking processes. A central issue of beneficence is the striving for health and wellbeing. EBM is little concerned directly with wellbeing, though it does claim to aim at improving quality of life by correcting pathological processes and conditions like infectious diseases, ischemic heart disease but also hypertension and hyperlipidemia. On the other hand, wellbeing is central to therapeutic efforts of CM. Scientific methods to gauge results of EBM are quantitative and based on calculative thinking, while results of treatments with CM are expressed in a qualitative way and based on meditative thinking. In order to maximize beneficence it seems important and feasible to use both approaches, by combining EBM and CM in the best interest of the individual patient.

  6. Non-invasive prenatal testing: ethics and policy considerations.

    PubMed

    Vanstone, Meredith; King, Carol; de Vrijer, Barbra; Nisker, Jeff

    2014-06-01

    New technologies analyzing fetal DNA in maternal blood have led to the wide commercial availability of non-invasive prenatal testing (NIPT). We present here for clinicians the ethical and policy issues related to an emerging practice option. Although NIPT presents opportunities for pregnant women, particularly women who are at increased risk of having a baby with an abnormality or who are otherwise likely to access invasive prenatal testing, NIPT brings significant ethics and policy challenges. The ethical issues include multiple aspects of informed decision-making, such as access to counselling about the possible results of the test in advance of making a decision about participation in NIPT. Policy considerations include issues related to offering and promoting a privately available medical strategy in publicly funded institutions. Ethics and policy considerations merge in NIPT with regard to sex selection and support for persons living with disabilities.

  7. Evidence-Based Fitness Promotion in an Afterschool Setting: Implementation Fidelity and Its Policy Implications

    ERIC Educational Resources Information Center

    Thaw, Jean M.; Villa, Manuela; Reitman, David; DeLucia, Christian; Gonzalez, Vanessa; Hanson, K. Lori

    2014-01-01

    Little is known about how the adoption of evidence-based physical activity (PA) curricula by out-of-school time (OST) programs affects children's physical fitness, and there are no clear guidelines of what constitutes reasonable gains given the types of PA instruction currently offered in these programs. Using a three-wave,…

  8. Evidence-Based Decision Making in School District Central Offices: Toward a Policy and Research Agenda

    ERIC Educational Resources Information Center

    Honig, Meredith I.; Coburn, Cynthia

    2008-01-01

    District central office administrators increasingly face policy demands to use "evidence" in their decision making. These demands up the ante on education policy researchers and policy makers to better understand what evidence use in district central offices entails and the conditions that may support it. To that end, the authors conducted a…

  9. Abortion and neonaticide: ethics, practice, and policy in four nations.

    PubMed

    Gross, Michael L

    2002-06-01

    Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible

  10. Coverage with evidence development: ethical issues and policy implications.

    PubMed

    Miller, Franklin G; Pearson, Steven D

    2008-07-01

    Coverage with evidence development (CED) is an evolving method of providing provisional access to novel medical interventions while generating the evidence needed to determine whether unconditional coverage is warranted. In this article we review the policy rationale for CED and present a normative analysis that addresses ethical concerns and policy implications.

  11. Implementing Ethics Policies in Developing Countries: Ploughing on Parched Ground?

    ERIC Educational Resources Information Center

    Mazonde, Isaac N.; Jackson-Malete, Jose; Sugarman, Jeremy

    2007-01-01

    It is globally expected that universities will ensure that policies guiding researchers' conduct are in place and adhered to. This expectation is not waived in developing countries. Successful implementation of an ethics policy is facilitated by an appropriate national regulatory framework on which to base the argument for compliance. However, it…

  12. Developing Science Education Policies: How Far Is It Evidence-Based?

    ERIC Educational Resources Information Center

    Oversby, John; McGregor, Deb

    2012-01-01

    Construction of science education policy is, for most practising educators, somewhat shrouded in mist. Policies are currently conveyed by the present Secretary of State with responsibility for education through presentations of governmental papers and curricular documents. While it may seem strange that a politician can be elected one day, and…

  13. Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines

    PubMed Central

    Satija, Ambika; Rimm, Eric B.; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A.; Stampfer, Meir; Willett, Walter C.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. Methods. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. Conclusions. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy. PMID:27459459

  14. Fostering integrity in postgraduate research: an evidence-based policy and support framework.

    PubMed

    Mahmud, Saadia; Bretag, Tracey

    2014-01-01

    Postgraduate research students have a unique position in the debate on integrity in research as students and novice researchers. To assess how far policies for integrity in postgraduate research meet the needs of students as "research trainees," we reviewed online policies for integrity in postgraduate research at nine particular Australian universities against the Australian Code for Responsible Conduct of Research (the Code) and the five core elements of exemplary academic integrity policy identified by Bretag et al. (2011 ), i.e., access, approach, responsibility, detail, and support. We found inconsistency with the Code in the definition of research misconduct and a lack of adequate detail and support. Based on our analysis, previous research, and the literature, we propose a framework for policy and support for postgraduate research that encompasses a consistent and educative approach to integrity maintained across the university at all levels of scholarship and for all stakeholders.

  15. Fighting Crime by Fighting Misconceptions and Blind Spots in Policy Theories: An Evidence-Based Evaluation of Interventions and Assumed Causal Mechanisms

    ERIC Educational Resources Information Center

    van Noije, Lonneke; Wittebrood, Karin

    2010-01-01

    How effective are policy interventions to fight crime and how valid is the policy theory that underlies them? This is the twofold research question addressed in this article, which presents an evidence-based evaluation of Dutch social safety policy. By bridging the gap between actual effects and assumed effects, this study seeks to make fuller use…

  16. Ethical and policy issues in rehabilitation medicine.

    PubMed

    Caplan, Arthur L; Callahan, Daniel; Haas, Janet

    1987-08-01

    The field of medical rehabilitation is relatively new.... Until recently, the ethical problems of this new field were neglected. There seemed to be more pressing concerns as rehabilitation medicine struggled to establish itself, sometimes in the face of considerable skepticism or hostility. There also seemed no pressing moral questions of the kind and intensity to be encountered, say, in high-technology acute care medicine or genetic engineering.... Those in biomedical ethics could and did easily overlook the quiet, less obtrusive issues of rehabilitation.... The Hastings Center set out in 1985 to rectify that situation.... To explore the issues, the Center assembled a group of practitioners in the field, Hastings Center staff members, and individuals experienced in other areas of medical ethics.... The report that follows was written by Arthur Caplan and Daniel Callahan, assisted by Dr. Janet Haas of the Moss Rehabilitation Hospital in Philadelphia....

  17. European Union research in support of environment and health: Building scientific evidence base for policy.

    PubMed

    Karjalainen, Tuomo; Hoeveler, Arnd; Draghia-Akli, Ruxandra

    2017-04-03

    Opinion polls show that the European Union citizens are increasingly concerned about the impact of environmental factors on their health. In order to respond and provide solid scientific evidence for the numerous policies related to the protection of human health and the environment managed at the Union level, the European Union made a substantial investment in research and innovation in the past two decades through its Framework Programmes for Research and Technological Development, including the current programme, Horizon 2020, which started in 2014. This policy review paper analysed the portfolio of forty collaborative projects relevant to environment and health, which received a total amount of around 228 million euros from the EU. It gives details on their contents and general scientific trends observed, the profiles of the participating countries and institutions, and the potential policy implications of the results obtained. The increasing knowledge base is needed to make informed policy decisions in Europe and beyond, and should be useful to many stakeholders including the scientific community and regulatory authorities.

  18. Evidence-Based Policy-Making: The Usability of the Eurostat Adult Education Survey

    ERIC Educational Resources Information Center

    Boeren, Ellen

    2014-01-01

    This article reflects on European education policy which is driven by benchmarks and indicators. While the European benchmark on adult lifelong learning participation--15% to be achieved by 2020--is measured by the Labour Force Survey, the Eurostat Adult Education Survey (AES) was designed to better understand the topic of adult lifelong learning…

  19. Coordinated and Evidence-Based Policy and Practice for Protecting Children outside of Family Care

    ERIC Educational Resources Information Center

    Boothby, Neil; Balster, Robert L.; Goldman, Philip; Wessells, Michael G.; Zeanah, Charles H.; Huebner, Gillian; Garbarino, James

    2012-01-01

    The 2011 U.S. Government Evidence Summit on Protecting Children Outside of Family Care brought together leading researchers and technical experts to assess the available evidence to inform policies, strategies, and programs relevant to protecting children outside of family care in lower and middle income countries. While child vulnerabilities are…

  20. Vaccinating healthcare workers: Level of implementation, barriers and proposal for evidence-based policies in Turkey.

    PubMed

    Ozisik, Lale; Tanriover, Mine Durusu; Altınel, Serdar; Unal, Serhat

    2017-01-06

    The role of healthcare workers in life-long vaccination is very important in the means of 2 sided infection, rising patient awareness and being a role model for the patients. Numerous organizations publish guidelines for vaccination of HCWs, while healthcare facilities develop vaccination policies according to the accreditation standards. Nevertheless, vaccination rates among HCWs are far below targets. The obstacles to getting vaccinated or recommending vaccination may include rather universal factors such as the vaccine paradox, however in the case of HCWs, probably a different set of factors are included. The aims of this article are to gain an overview of vaccination strategies for HCWs, to assess the coverage rates of HCWs and make in-depth analyses of the potential barriers to vaccination and potential factors to motivate HCWs for vaccination in Turkey and to compare them with the global picture to improve implementation of policies concerning vaccination of HCWs.

  1. Policies and Procedures That Facilitate Implementation of Evidence-Based Clinical Guidelines in U.S. Dental Schools.

    PubMed

    Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J

    2016-01-01

    The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed.

  2. Ethics and Childhood Vaccination Policy in the United States.

    PubMed

    Hendrix, Kristin S; Sturm, Lynne A; Zimet, Gregory D; Meslin, Eric M

    2016-02-01

    Childhood immunization involves a balance between parents' autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus on ethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policy-making.

  3. Evidence-Based Obesity Prevention in Childhood and Adolescence: Critique of Recent Etiological Studies, Preventive Interventions, and Policies123

    PubMed Central

    Reilly, John J.

    2012-01-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the “energy gap” that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers. PMID:22798005

  4. Food and beverage policies and public health ethics.

    PubMed

    Resnik, David B

    2015-06-01

    Government food and beverage policies can play an important role in promoting public health. Few people would question this assumption. Difficult questions can arise, however, when policymakers, public health officials, citizens, and businesses deliberate about food and beverage policies, because competing values may be at stake, such as public health, individual autonomy, personal responsibility, economic prosperity, and fairness. An ethically justified policy strikes a reasonable among competing values by meeting the following criteria: (1) the policy serves important social goal(s); (2) the policy is likely to be effective at achieving those goal(s); (3) less burdensome options are not likely to be effective at achieving the goals; (4) the policy is fair.

  5. Ethics and policy of medical brain drain: a review.

    PubMed

    Kollar, Eszter; Buyx, Alena

    2013-10-25

    Health-worker migration, commonly called "medical brain drain", refers to the mass migration of trained and skilled health professionals (doctors, nurses, midwives) from low-income to high-income countries. This is currently leaving a significant number of poor countries, particularly in sub-Saharan Africa, with critical staff shortages in the healthcare sector. A broad consensus exists that, where medical brain drain exacerbates such shortages, it is unethical, and this review presents the main arguments underpinning this view. Notwithstanding the general agreement, which policies are justifiable on ethical grounds to tackle brain drain and how best to go about implementing them remains controversial. The review offers a discussion of the specific ethical issues that have to be taken into account when deciding which policy measures to prioritise and suggests a strategy of policy implementation to address medical brain drain as a matter of urgency.

  6. Cloning for therapeutic purposes: ethical and policy considerations.

    PubMed

    Hanson, M J

    2001-01-01

    This essay reviews how cloning techniques may be used for therapeutic purposes, analyzes ethical implications, and makes recommendations for public policy discourse. Although cloning may bring many potential benefits, they remain uncertain. Furthermore, human embryo research is morally problematic. Therefore, alternatives to human cloning for therapeutic aims should be sought at present. In addition to central ethical issues, public discourse should maintain an emphasis on the value of the human embryo over scientific expediency, the relativity of health, and the principle of justice. Society should support the laudable mission of medical research, while also attending to the moral concerns often threatened by the promises of scientific progress.

  7. Toward Creating Synergy Among Policy, Procedures, and Implementation of Evidence-Based Models in Child Welfare Systems: Two Case Examples.

    PubMed

    Chamberlain, Patricia

    2017-03-01

    Over the past four to five decades, multiple randomized controlled trials have verified that preventive interventions targeting key parenting skills can have far-reaching effects on improving a diverse array of child outcomes. Further, these studies have shown that parenting skills can be taught, and they are malleable. Given these advances, prevention scientists are in a position to make solid empirically based recommendations to public child service systems on using parent-mediated interventions to optimize positive outcomes for the children and families that they serve. Child welfare systems serve some of this country's most vulnerable children and families, yet they have been slow (compared to juvenile justice and mental health systems) to adopt empirically based interventions. This paper describes two child-welfare-initiated, policy-based case studies that have sought to scale-up research-based parenting skills into the routine services that caseworkers deliver to the families that they serve. In both case studies, the child welfare system leaders worked with evaluators and model developers to tailor policy, administrative, and fiscal system practices to institutionalize and sustain evidence-based practices into usual foster care services. Descriptions of the implementations, intervention models, and preliminary results are described.

  8. Ethics and Childhood Vaccination Policy in the United States

    PubMed Central

    Sturm, Lynne A.; Zimet, Gregory D.; Meslin, Eric M.

    2016-01-01

    Childhood immunization involves a balance between parents’ autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus on ethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policymaking. PMID:26691123

  9. Voices of decision makers on evidence-based policy: A case of evolving TB/HIV co-infection policy in India.

    PubMed

    Reddy, K Srikanth; Sahay, Seema

    2016-01-01

    This study explores decision makers' perspectives on evidence-based policy (EBP) development using the case of TB/HIV co-infection in India. Twelve in-depth interviews were conducted with purposively selected key national and international policy decision makers in India. Verbatim transcripts were processed and analysed thematically using QSR (NUD*IST 6). The decision makers were unequivocal in recognizing the TB/HIV co-infection as an important public health issue in India and stated the problem to be different than Africa. The need of having a "third programme" for co-infection was not felt. According to them, the public health management of this co-infection must be within the realm of these two programmes. The study also emphasized on decision makers' perspectives on evidence and the process of utilization of evidence for decision-making for co-infection. Study findings showed global evidence was not always accepted by the decision makers and study shows several examples of decision makers demanding local evidence for policy decisions. Decision makers did make interim policies based on global evidence but most of the time their mandate was to get local evidence. Thus, operations research/implementation science especially multi-centric studies emerge as important strategy for EBP development. Researcher-policy maker interface was a gap where role of researcher as aggressive communicator of research findings was expected.

  10. Evidence-Based Policy and Practice Leads to Changes in the Criteria for MSM to Donate Blood

    PubMed Central

    Slowther, Anne; Watkins, Nicholas A.; Kelly, Deirdre

    2013-01-01

    Summary On November 7, 2011, the permanent deferral from blood donation of men who have sex with men (MSM) changed in England, Scotland and Wales, to a 12-month deferral since last relevant sexual contact. This change was made following an evidence-based policy review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). The review concluded that the available evidence supported the introduction of a 12-month fixed period deferral and that the risks associated with a 12-month deferral of MSM were equivalent to a permanent deferral. The permanent deferral for MSM was introduced in 1985 in response to the spread of acquired immunodeficiency syndrome (AIDS) caused by HIV. The change was supported by new data on the level of compliance with the permanent deferral, advances in the testing and processing of donated blood, changes in the epidemiology of sexually transmitted infections (STIs) and improved scientific knowledge. This review discusses how the decision to change the deferral period was reached and highlights some of the remaining issues relating to this contentious matter. PMID:23922540

  11. A Longitudinal Study of State Strategies and Policies to Accelerate Evidence-Based Practices in the Context of Systems Transformation

    PubMed Central

    Rieckmann, Traci; Abraham, Amanda; Zwick, Janet; Rasplica, Caitlin; McCarty, Dennis

    2015-01-01

    Objective To profile state agency efforts to promote implementation of three evidence-based practices (EBPs): screening and brief intervention (SBIRT), psychosocial interventions, and medication-assisted treatment (MAT). Data Sources/Study Setting Primary data collected from representatives of 50 states and the District of Columbia’s Single State Authorities from 2007 to 2009. Study Design/Data Collection The study used mixed methods, in-depth, semistructured interviews and quantitative surveys. Interviews assessed state and provider strategies to accelerate implementation of EBPs. Principal Findings Statewide implementation of psychosocial interventions and MAT increased significantly over 3 years. In the first two assessments, states that contracted directly with providers were more likely to link use of EBPs to reimbursement, and states with indirect contract, through counties and other entities, increased recommendations, and some requirements for provision of specific EBPs. The number of states using legislation as a policy lever to promote EBPs was unchanged. Conclusions Health care reform and implementation of parity in coverage increases access to treatment for alcohol and drug use. Science-based substance abuse treatment will become even more crucial as payers seek consistent quality of care. This study provides baseline data on service delivery, contracting, and financing as state agencies and treatment providers prepare for implementation of the Affordable Care Act. PMID:25532616

  12. Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned

    PubMed Central

    2013-01-01

    Background Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers. By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned. Discussion In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients

  13. Employing Policy and Purchasing Levers to Increase the Use of Evidence-Based Practices in Community-Based Substance Abuse Treatment Settings: Reports from Single State Authorities

    ERIC Educational Resources Information Center

    Rieckmann, Traci R.; Kovas, Anne E.; Cassidy, Elaine F.; McCarty, Dennis

    2011-01-01

    State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical…

  14. ETF Yearbook 2012: Evaluation and Monitoring of Vocational Education and Training Systems and the Role of Evidence-Based Policy in Their Reforms

    ERIC Educational Resources Information Center

    European Training Foundation, 2012

    2012-01-01

    The "ETF Yearbook 2012" continues the tradition of highlighting a thematic field of particular importance to the work of the European Training Foundation (ETF). The theme of this yearbook is evaluation and monitoring of vocational education and training (VET) systems and the role of evidence-based policy in VET reforms in ETF partner…

  15. Health Policy, Ethics, and the Kansas Legislative Health Academy

    PubMed Central

    Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St. Peter, Robert

    2015-01-01

    We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945

  16. Biobanking human embryonic stem cell lines: policy, ethics and efficiency.

    PubMed

    Holm, Søren

    2015-12-01

    Stem cell banks curating and distributing human embryonic stem cells have been established in a number of countries and by a number of private institutions. This paper identifies and critically discusses a number of arguments that are used to justify the importance of such banks in policy discussions relating to their establishment or maintenance. It is argued (1) that 'ethical arguments' are often more important in the establishment phase and 'efficiency arguments' more important in the maintenance phase, and (2) that arguments relating to the interests of embryo and gamete donors are curiously absent from the particular stem cell banking policy discourse. This to some extent artificially isolates this discourse from the broader discussions about the flows of reproductive materials and tissues in modern society, and such isolation may lead to the interests of important actors being ignored in the policy making process.

  17. New AGU scientific integrity and professional ethics policy available for review

    USGS Publications Warehouse

    Gundersen, Linda C.

    2012-01-01

    The AGU Task Force on Scientific Ethics welcomes your review and comments on AGU's new Scientific Integrity and Professional Ethics Policy. The policy has at its heart a code of conduct adopted from the internationally accepted "Singapore Statement," originally created by the Second World Conference on Research Integrity (http://www.singaporestatement.org/), held in 2010. The new policy also encompasses professional and publishing ethics, providing a single source of guidance to AGU members, officers, authors, and editors

  18. New AGU scientific integrity and professional ethics policy available for review

    NASA Astrophysics Data System (ADS)

    Gundersen, Linda

    2012-09-01

    The AGU Task Force on Scientific Ethics welcomes your review and comments on AGU's new Scientific Integrity and Professional Ethics Policy. The policy has at its heart a code of conduct adopted from the internationally accepted “Singapore Statement,” originally created by the Second World Conference on Research Integrity (http://www.singaporestatement.org/), held in 2010. The new policy also encompasses professional and publishing ethics, providing a single source of guidance to AGU members, officers, authors, and editors.

  19. Improving biomedical journals' ethical policies: the case of research misconduct.

    PubMed

    Bosch, Xavier

    2014-09-01

    Scientific journals may incur scientific error if articles are tainted by research misconduct. While some journals' ethical policies, especially those on conflicts of interest, have improved over recent years, with some adopting a uniform approach, only around half of biomedical journals, principally those with higher impact factors, currently have formal misconduct policies, mainly for handling allegations. Worryingly, since a response to allegations would reasonably require an a priori definition, far fewer journals have publicly available definitions of misconduct. While some journals and editors' associations have taken significant steps to prevent and detect misconduct and respond to allegations, the content, visibility of and access to these policies varies considerably. In addition, while the lack of misconduct policies may prompt and maintain a de novo approach for journals, potentially causing stress, publication delays and even legal disputes, the lack of uniformity may be a matter of contention for research stakeholders such as editors, authors and their institutions, and publishers. Although each case may need an individual approach, I argue that posting highly visible, readily accessible, comprehensive, consistent misconduct policies could prevent the publication of fraudulent papers, increase the number of retractions of already published papers and, perhaps, reduce research misconduct. Although legally problematic, a concerted approach, with sharing of information between editors, which is clearly explained in journal websites, could also help. Ideally, journals, editors' associations, and publishers should seek consistency and homogenise misconduct policies to maintain public confidence in the integrity of biomedical research publications.

  20. A student proposal for ethical guidelines in anatomical education: Ethical and policy considerations.

    PubMed

    Kahn, Peter A; Gardin, Tova M

    2016-01-01

    The recent publication of a story regarding anatomical dissection in a medical school has revealed the need for increased attention to the ethical and policy aspects of anatomical education. While most of the attention devoted to these questions thus far has been focused on procedures before and after dissection, from the perspective of medical students, there are important considerations during the process of dissection itself. This proposal was developed by two third-year medical students through a review of the relevant published literature, reflection upon their personal experiences in anatomy courses in two separate institutions, and informal discussion of these topics with peers. The proposal is that basic ethical guidelines should be established and monitored by an independent committee tasked with reviewing them. The proposed guidelines include: First, a clear set of expectations about what the student is expected to learn with respect to anatomical knowledge and dissection technique; second, the establishment by schools or national bodies of minimal ethical standards regarding respectful behavior toward the donor bodies, and the communication of these standards to teachers and students involved in educational dissections; third, the use of materials that encourage students to view their donors with respect and ensure proper treatment of them; and fourth, the establishment of an oversight group (at each medical school and at national level) comprising students, faculty, community members, and staff, who will regularly review the anatomical education program and update these ethical guidelines as appropriate. While many of these proposals are already implemented in some anatomy departments, the establishment of clear guidelines at a national as well as a school-by-school level will permit students the freedom to participate fully in their education, knowing they have met the highest ethical standards as they prepare for a career as a humanistic physician.

  1. Ethical, legal, social, and policy implications of behavioral genetics.

    PubMed

    Berryessa, Colleen M; Cho, Mildred K

    2013-01-01

    The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated.

  2. Elective ventilation for organ donation: law, policy and public ethics.

    PubMed

    Coggon, John

    2013-03-01

    This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

  3. Ethical, Legal, Social, and Policy Implications of Behavioral Genetics

    PubMed Central

    Berryessa, Colleen M.; Cho, Mildred K.

    2015-01-01

    The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated. PMID:23452225

  4. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  5. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  6. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued..., Evaluation, and Compliance § 1486.511 What is the general policy regarding ethical conduct? (a) The...

  7. Uncommon Commonalities: Cosmopolitan Ethics as a Framework for Music Education Policy Analysis

    ERIC Educational Resources Information Center

    Richerme, Lauren Kapalka

    2016-01-01

    Contemporary American education policy rhetoric is problematic because its authors' assertions, particularly those about the goals of education, frequently conflict with their implied moral and/or ethical commitments. This philosophical policy analysis uses Appiah's cosmopolitan principles to examine the ethical implications of current education…

  8. Is Social Work Evidence-Based? Does Saying So Make It So? Ongoing Challenges in Integrating Research, Practice and Policy

    ERIC Educational Resources Information Center

    Gambrill, Eileen

    2016-01-01

    The integration of research and practice is of concern in all helping professions. Has social work become an evidence-based profession as some claim? Characteristics of current-day social work are presented that dispute this view, related continuing concerns are suggested, and promising developments (mostly outside social work) are described that…

  9. Adapting Evidence-Based Pedagogy to Local Cultural Contexts: A Design Research Study of Policy Borrowing in Vietnam

    ERIC Educational Resources Information Center

    Pham, Thanh Thi Hong; Renshaw, Peter

    2015-01-01

    This study employs design-based research to investigate how university teachers and their students from Vietnam perceived and adapted an evidence-based pedagogy known as "student-teams achievement division" (STAD). Two hundred and twenty one students and their teachers from three classes at a Vietnamese university participated in this…

  10. Policy and Ethics In Agricultural and Ecological Water Uses.

    NASA Astrophysics Data System (ADS)

    Appelgren, Bo

    Agricultural water use accounts for about 70 percent of abstracted waters reaching 92 percent of the collective uses of all water resources when rain water is included. Agriculture is the traditional first sector and linked to a wide range of social, economic and cultural issues at local and global level that reach beyond the production of cheap food and industrial fibres. With the dominance in agricultural water uses and linkages with land use and soil conservation the sector is critical to the protection of global and local environmental values especially in sensitive dryland systems. Ethical principles related to development and nature conservation have traditionally been focused on sustainability imperatives building on precaution and preventive action or on indisputable natural systems values, but are by necessity turning more and more towards solidarity-based risk management approaches. Policy and management have in general failed to consider social dimensions with solidarity, consistency and realism for societal acceptance and practical application. As a consequence agriculture and water related land degradation is resulting in accelerated losses in land productivity and biodiversity in dryland and in humid eco- systems. Increasingly faced with the deer social consequences in the form of large man-made hydrological disasters and with pragmatic requirements driven by drastic increases in the related social cost the preferences are moving to short-term risk management approaches with civil protection objectives. Water scarcity assessment combined with crisis diagnoses and overriding statements on demographic growth, poverty and natural resources scarcity and deteriorating food security in developing countries have become common in the last decades. Such studies are increasingly questioned for purpose, ethical integrity and methodology and lack of consideration of interdependencies between society, economy and environment and of society's capacity to adapt to

  11. Ethical principles as a guide in implementing policies for the management of food allergies in schools.

    PubMed

    Behrmann, Jason

    2010-06-01

    Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools.

  12. Towards Evidence-Based Policy for Canadian Education = Vers des politiques candiennes d'education fondees sur la recherche.

    ERIC Educational Resources Information Center

    De Broucker, Patrice, Ed.; Sweetman, Arthur, Ed.

    This book is a collection of 19 essays that broadly treat the use of evidence in informing educational policy and practice in Canada: (1) "Knowledge and Action in Educational Policy and Politics" (Benjamin Levin); (2) "Data, Data Everywhere (and We Don't Know What to Do): Using Data for Wise Decisions in Schools" (Lorna M.…

  13. Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

    PubMed

    Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

    2015-07-01

    Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

  14. Using Evidence-Based Policy, Systems, and Environmental Strategies to Increase Access to Healthy Food and Opportunities for Physical Activity Among Asian Americans, Native Hawaiians, and Pacific Islanders

    PubMed Central

    Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

    2015-01-01

    Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities. PMID:25905839

  15. Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships

    PubMed Central

    Carabine, Elizabeth

    2015-01-01

    The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements. PMID:25969796

  16. Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships.

    PubMed

    Carabine, Elizabeth

    2015-04-23

    The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements.

  17. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false What is the general policy regarding ethical conduct? 1486.511 Section 1486.511 Agriculture Regulations of the Department of Agriculture (Continued... ethical conduct? (a) The Recipient shall maintain written standards of conduct governing the...

  18. Evidence-based approach to HIV/AIDS policy and research prioritization in the Islamic Republic of Iran.

    PubMed

    Feizzadeh, A; Nedjat, S; Asghari, S; Keshtkar, A; Heshmat, R; Setayesh, H; Majdzadeh, R

    2010-03-01

    In formulating the second national strategic plan for prevention of HIV/AIDS in the Islamic Republic of Iran a more evidence-based approach was needed. This paper reports on a systematic review of the local evidence about the determinants of HIV/AIDS transmission in 3 categories: poor knowledge and negative attitudes about HIV transmission; injection drug use; and sexual promiscuity. Of 93 reports reviewed, 53 met the inclusion criteria. Information about the prevalence and magnitude of effect for the 3 risk determinants at the national and regional level was scarce. Heterogeneity between studies, even in the same sub-population, was significant. An improved research base and better sharing of information are needed within countries of the Eastern Mediterranean Region.

  19. Contributing to a Quality Patient Experience: Applying Evidence Based Practice to Support Changes in Nursing Dress Code Policies

    PubMed

    West, Margaret Mary; Wantz, Debra; Campbell, Patricia; Rosler, Greta; Troutman, Dawn; Muthler, Crystal

    2016-01-31

    The public image of nurse professionalism is important. Attributes of a professional nurse, such as caring, attentive, empathetic, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of individual uniform and dress choices. This article describes an evidence based practice project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients view as important. A team approach included the voice of nurses at different levels in the process. Ultimately, this work informed a revision of the health system nursing dress code. The study team also reflects on challenges, next steps in the process, and offers recommendations based on their experiences.

  20. Evidence-based policies on school nutrition and physical education: Associations with state-level collaboration, obesity, and socio-economic indicators.

    PubMed

    Pelletier, Jennifer E; Laska, Melissa N; MacLehose, Richard; Nelson, Toben F; Nanney, Marilyn S

    2017-02-13

    Despite calls for more cross-sector collaboration on obesity prevention, little is known about the role of collaborative partnerships, or groups of organizations from different sectors working together toward a shared goal, in state policy activities. This study examined associations between competitive food/beverage and physical education policies and state-level collaboration and state characteristics (obesity, socioeconomic indicators, public health funding levels) for all 50 states and the District of Columbia, USA, in 2012. We examined cross-sectional associations between evidence-based competitive food/beverage and physical education policies from the Classification of Laws Associated with School Students and state characteristics from the School Health Policies and Practices Study and other national data sources using prevalence ratios and generalized linear models. Analyses were conducted in 2016. Cross-sector collaboration (i.e., state staff reports of working together on school nutrition or physical education activities) between state-level nutrition and physical education staff and ten types of organizations was not significantly associated with having state policies. Childhood obesity (RR=1.78, 95% CI[1.11,2.85]), high-school non-completion (RR=2.35, 95% CI[1.36,4.06]), poverty (RR=1.89, 95% CI[1.16,3.09]) and proportion non-white or Hispanic residents (RR=1.75, 95% CI[1.07, 2.85]) were positively associated with the presence of elementary school competitive food/beverage policies. Fewer indicators were associated with policies for middle and high schools. The large investment of time and resources required for cross-sector collaboration demands greater research evidence on how to structure and manage collaborative partnerships for the greatest impact.

  1. Ethics and the 7 `P`s` of computer use policies

    SciTech Connect

    Scott, T.J.; Voss, R.B.

    1994-12-31

    A Computer Use Policy (CUP) defines who can use the computer facilities for what. The CUP is the institution`s official position on the ethical use of computer facilities. The authors believe that writing a CUP provides an ideal platform to develop a group ethic for computer users. In prior research, the authors have developed a seven phase model for writing CUPs, entitled the 7 P`s of Computer Use Policies. The purpose of this paper is to present the model and discuss how the 7 P`s can be used to identify and communicate a group ethic for the institution`s computer users.

  2. AGU Launches Web Site for New Scientific Integrity and Professional Ethics Policy

    NASA Astrophysics Data System (ADS)

    Townsend, Randy

    2013-03-01

    AGU's Scientific Integrity and Professional Ethics policy, approved by the AGU Board of Directors and Council in December 2012, is now available online on a new Web site, http://ethics.agu.org. As the Web site states, the policy embodies a "set of guidelines for scientific integrity and professional ethics for the actions of the members and the governance of the Union in its internal activities; in its public persona; and most importantly, in the research and peer review processes of its scientific publications, its communications and outreach, and its scientific meetings."

  3. Coordinating the norms and values of medical research, medical practice and patient worlds—the ethics of evidence based medicine in orphaned fields of medicine

    PubMed Central

    Vos, R; Willems, D; Houtepen, R

    2004-01-01

    It appears that the primary ethical problem in this context is the lack of attention to the orphaned fields. Although we agree that this issue deserves more attention as a matter of potential injustice, we want to argue that, in order to do justice to the interplay of heterogeneous factors that is so typical of the orphaned fields, other ethical models than justice are required. We propose the coordination model as a window through which to view the important ethical issues which relate to the communication and interaction of scientists, health care workers, and patients. PMID:15082811

  4. Aligning health care policy with evidence-based medicine: the case for funding direct oral anticoagulants in atrial fibrillation.

    PubMed

    Stone, James A; Earl, Karen M; O'Neill, Blair J; Sharma, Mukul; Huynh, Thao; Leblanc, Kori; Ward, Richard; Teal, Philip A; Cox, Jafna L

    2014-10-01

    Misalignment between evidence-informed clinical care guideline recommendations and reimbursement policy has created care gaps that lead to suboptimal outcomes for patients denied access to guideline-based therapies. The purpose of this article is to make the case for addressing this growing access barrier to optimal care. Stroke prevention in atrial fibrillation (AF) is discussed as an example. Stroke is an extremely costly disease, imposing a significant human, societal, and economic burden. Stroke in the setting of AF carries an 80% probability of death or disability. Although two-thirds of these strokes are preventable with appropriate anticoagulation, this has historically been underprescribed and poorly managed. National and international guidelines endorse the direct oral anticoagulants as first-line therapy for this indication. However, no Canadian province has provided these agents with an unrestricted listing. These decisions appear to be founded on silo-based cost assessment-the drug costs rather than the total system costs-and thus overlook several important cost-drivers in stroke. The discordance between best scientific evidence and public policy requires health care providers to use a potentially suboptimal therapy in contravention of guideline recommendations. It represents a significant obstacle for knowledge translation efforts that aim to increase the appropriate anticoagulation of Canadians with AF. As health care professionals, we have a responsibility to our patients to engage with policy-makers in addressing and resolving this barrier to optimal patient care.

  5. Fertility reduction policies and poverty in Third World countries: ethical issues.

    PubMed

    Hernandez, D J

    1985-01-01

    This article begins with a discussion of the motivation for fertility reduction and related population policies. Next, it identifies the two major approaches to evaluating these policies in the population ethics literature: the individualistic approach and the international approach. Each approach is then characterized according to the kinds of policies evaluated, the ethical principles that are most prominent, and the major conclusions drawn. Major empirical gaps in the population ethics literature are identified, and pertinent social science issues concerning the effectiveness of family planning programs, the socioeconomic determinants of fertility, and the interpersonal or community determinants of fertility are discussed. Finally, these issues are linked with the United Nations World Population Plan of Action to identify ethical questions that warrant detailed scrutiny.

  6. The Role of Epidemiology in Evidence-based Policy Making: A Case Study of Tobacco Use in Youth

    PubMed Central

    Aldrich, Melinda C.; Hidalgo, Bertha; Widome, Rachel; Briss, Peter; Brownson, Ross C.; Teutsch, Steven M.

    2014-01-01

    Purpose Sound public health policy is based on relevant and timely information. A brief review of the history of youth tobacco control illustrates the central role of epidemiology to inform policy choices and evaluate their consequences. Methods A narrative review was conducted. Results Epidemiologic studies have shown that most smokers begin as adolescents or young adults and individuals who reach their mid-twenties as non-smokers are unlikely to ever become smokers. This key recognition made it clear that long-term tobacco control must prevent initiation of smoking among youth. Over time, tobacco use prevention interventions have evolved, increasing in reach and effectiveness as they moved from initially focusing on the individual to an approach that targets both populations and communities. Effective interventions for preventing youth smoking include raising tobacco prices, clean indoor air laws, and intensive mass media campaigns. Conclusions Great strides have been made in youth tobacco control but 18% of high school students continue to smoke. It is up to epidemiologists, fellow scientists, practitioners, and advocates to assure that strategies that are known to work are fully implemented as well as to continue to find more successful solutions that can further lower the incidence of youth smoking initiation and can address new tobacco products and changing contexts. PMID:24875267

  7. 7 CFR 1486.511 - What is the general policy regarding ethical conduct?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false What is the general policy regarding ethical conduct... MARKETS PROGRAM Reporting, Evaluation, and Compliance § 1486.511 What is the general policy regarding... neither solicit nor accept gratuities, favors, or anything of monetary value from contractors, or...

  8. Ethics of health policy and systems research: a scoping review of the literature.

    PubMed

    Pratt, Bridget; Paul, Amy; Hyder, Adnan A; Ali, Joseph

    2017-03-15

    Health policy and systems research (HPSR) is increasingly funded and undertaken as part of health system strengthening efforts worldwide. HPSR ethics is also a relatively new and emerging field, with numerous normative and descriptive questions that have largely not been considered. Normative questions include what ethical principles and values should guide HPSR. Descriptive questions include what ethical concerns arise when conducting HPSR. A small but growing body of scholarly work characterizes the various ethics issues inherent in HPSR. Towards informing the future development of ethics guidance for HPSR, a scoping review was undertaken to: (1) identify the range of ethics issues relevant to the conduct of HPSR-with a deliberate (though not exclusive) focus on low- and middle-income country settings and (2) describe existing guidance on key ethics issues relevant to HPSR. Using the Cochrane methods as a basis, the review identified formal and informal literature on HPSR ethics by searching the following databases: PubMed's Medline, Embase, Global Health, Scopus, WHO Global Health Regional Libraries, LILACs, OpenDOAR and Bielefeld Academic Search Engine. In total, 11 062 documents were identified from the formal (10 519) and informal (543) literature. One hundred and seven of these documents (formal 99 and informal 8) met at least one inclusion criterion and underwent thematic analysis. Ethical issues in four main categories were identified: upholding autonomy, identifying and balancing risks and benefits, justice and determination of ethical review requirements. The review indicated that the ethical values behind HPSR place an emphasis on its contributing to the reduction of health disparities. Unsurprisingly then, numerous ethical concerns relating to justice arise in HPSR. However, the majority of existing guidance focuses on obtaining or waiving informed consent and, thus, appears to be insufficient for HPSR. A list of priority ethics issues in HPSR in

  9. Adoption policy and evidence-based domestic adoption practice: a comparison of Romania, Ukraine, India, Guatemala, and Ethiopia.

    PubMed

    Groza, Victor; Bunkers, Kelley M

    2014-01-01

    The United Nations Convention on the Rights of the Child (1989), The Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption (The Hague Permanent Bureau, 1993), and the Guidelines for the Alternative Care of Children (2009) have provided a comprehensive, rights-based framework and guidance for developing domestic adoption and alternative, family based care programs. Domestic adoption is a critical component of any child-protection system and a core part of the range of alternative care options that the United Nations and other international organizations recommend be developed, resourced, and made accessible to children without parental care. This article uses data collected from adoptive parents' postadoption and governmental data in Romania, Ukraine, India, Guatemala, and Ethiopia to focus on domestic adoption in each of these countries. The article highlights both promising practices in domestic adoption as well as policies and practices that require additional research.

  10. An academic, business, and community alliance to promote evidence-based public health policy: the case of primary seat belt legislation.

    PubMed

    Goldzweig, Irwin A; Schlundt, David G; Moore, Wayne E; Smith, Patricia E; Zoorob, Roger J; Levine, Robert S

    2013-08-01

    An academic, business, and community alliance comprising 285 organizations, including 43 national groups represented on a Blue Ribbon Panel organized by the U.S. Secretary of Transportation, targeted Arkansas, Florida, Mississippi, Minnesota, Tennessee, and Wisconsin for high involvement/intervention consisting of community organization and other political action to support passage of primary seat belt laws. State-level alliance activities began in January 2003. All six states enacted a primary seat belt law between 2004 and 2009. From January 2003 to May 2010, passage of primary legislation was 4.5 times as likely (95% CI 1.90, 10.68) in states with high versus low alliance involvement. Positive interaction between high alliance involvement and offers of federal incentives may have occurred as well. This evidence of success suggests that academic-business-community alliances for action to promote evidence-based public health policy may be effective.

  11. The role of food ethics in food policy.

    PubMed

    Mepham, T B

    2000-11-01

    Certain developments in the agricultural and food sciences have far-reaching implications for society and the environment, which suggest the need to examine their ethical acceptability as a standard component of technology assessment. Such considerations have led to the emergence of a new academic discipline, food ethics. The present paper describes how ethical theory may be applied to the analysis of the impacts of prospective food biotechnologies to assess potential effects on four 'interest groups', i.e. consumers, producers, treated organisms and the biota (fauna and flora). The principles which structure the framework used, i.e. the ethical matrix, are adapted to the field of agriculture and food from those applied in medical ethics. Use of the ethical matrix is illustrated by applying it to the specific case of bovine somatotrophin, the genetically-engineered protein hormone which is injected into lactating cattle to increase their milk yields. Ethical analysis is seen to depend on a number of critical requirements, i.e. scientific data, non-scientific evidence and predictions, suitably-qualified assessors ('competent moral judges'), the 'world-views' of the assessors and application of the precautionary principle to cope with 'uncertainty'.

  12. Evidence-Based Practice in Psychology

    ERIC Educational Resources Information Center

    American Psychologist, 2006

    2006-01-01

    The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…

  13. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy

    PubMed Central

    Shonkoff, Jack P.; Fisher, Philip A.

    2016-01-01

    Half a century of research and program evaluation has fueled a diverse landscape of early childhood policies and practices that produce a range of positive effects on the life prospects of children who face the burdens of significant adversity. Drawing on advances in neurobiology, developmental psychology, developmental psychopathology, and prevention science, this paper presents a framework for elucidating underlying causal mechanisms that explain differences in outcomes, formulating enhanced theories of change about how to shift developmental trajectories, designing creative interventions and rethinking the concept of a two-generation strategy to produce breakthrough impacts, and launching a new era of investment in young children and their families that will achieve greater reductions in intergenerational disparities in learning, behavior, and health than those produced by current best practices. Particular attention is focused on the hypothesis that substantially better outcomes for vulnerable, young children could be achieved by greater attention to strengthening the resources and capabilities of the adults who care for them rather than by continuing to focus primarily on the provision of child-focused enrichment, parenting education, and informal support. Central to achieving this goal is the need to establish an innovation-friendly environment that embraces fast-cycle sharing, supports risk taking, and celebrates learning from failure. PMID:24342860

  14. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy.

    PubMed

    Shonkoff, Jack P; Fisher, Philip A

    2013-11-01

    Half a century of research and program evaluation has fueled a diverse landscape of early childhood policies and practices that produce a range of positive effects on the life prospects of children who face the burdens of significant adversity. Drawing on advances in neurobiology, developmental psychology, developmental psychopathology, and prevention science, this paper presents a framework for elucidating underlying causal mechanisms that explain differences in outcomes, formulating enhanced theories of change about how to shift developmental trajectories, designing creative interventions and rethinking the concept of a two-generation strategy to produce breakthrough impacts, and launching a new era of investment in young children and their families that will achieve greater reductions in intergenerational disparities in learning, behavior, and health than those produced by current best practices. Particular attention is focused on the hypothesis that substantially better outcomes for vulnerable, young children could be achieved by greater attention to strengthening the resources and capabilities of the adults who care for them rather than by continuing to focus primarily on the provision of child-focused enrichment, parenting education, and informal support. Central to achieving this goal is the need to establish an innovation-friendly environment that embraces fast-cycle sharing, supports risk taking, and celebrates learning from failure.

  15. Reconnecting the Research-Policy-Practice Nexus in Higher Education: "Evidence-Based Policy" in Practice in National and International Contexts

    ERIC Educational Resources Information Center

    Locke, William

    2009-01-01

    It is often claimed that research on higher education has had little or no impact on HE policy-making, which is regarded as being largely driven by political ideology and the media and reinforced by little more than management consultancy. Recent higher education policy, it has been argued, is "a research-free zone" or at best…

  16. Inclusion of policies on ethical standards in animal experiments in biomedical science journals.

    PubMed

    Rands, Sean A

    2011-11-01

    Most published biomedical research involving animal models is evaluated carefully to ensure that appropriate ethical standards are met. In the current study, 500 journals randomly selected from MedLine were assessed for whether they presented animal research. Of the 138 journals that did, the instructions to authors of 85 (61.6%) included a requirement for author assurance of adherence to ethical standards during experiments involving animals. In comparison to a wider range of biologic journals, biomedical science journals were more likely to have some sort of ethical policy concerning the reporting and presentation of animal experiments.

  17. Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

    PubMed

    Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

    2016-10-29

    Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation.

  18. Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

    PubMed Central

    Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

    2016-01-01

    Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

  19. State-of-the-Science on Postacute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy. An Introduction

    PubMed Central

    Heinemann, Allen W

    2007-01-01

    The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness, along with academic, professional, provider, accreditor, and other organizations, sponsored a 2-day State-of-the-Science of Postacute Rehabilitation Symposium in February 2007. The aim of this symposium was to serve as a catalyst for expanded research on postacute care (PAC) rehabilitation so that health policy is founded on a solid evidence base. The goals were to (a) describe the state of our knowledge regarding utilization, organization, and outcomes of postacute rehabilitation settings, (b) identify methodologic and measurement challenges to conducting research, (c) foster the exchange of ideas among researchers, policy makers, industry representatives, funding agency staff, consumers, and advocacy groups, and (d) identify critical questions related to setting, delivery, payment, and effectiveness of rehabilitation services. Plenary presentation and state-of-the-science summaries were organized around 4 themes: (a) the need for improved measurement of key rehabilitation variables and methods to collect and analyze this information, (b) factors that influence access to postacute rehabilitation care, (c) similarities and differences in quality and quantity of services across PAC settings, and (d) effectiveness of postacute rehabilitation services. The full set of symposium articles, including recommendations for future research, appear in Archives of Physical Medicine and Rehabilitation. PMID:18092560

  20. Policy and ethical issues in applying medical biotechnology in developing countries.

    PubMed

    Bhardwaj, Minakshi; Macer, Darryl R J

    2003-02-01

    A brief review of some of the key issues in policy relating to the ethical issues raised by medical biotechnology in developing countries is presented, using India as an example. A series of some key issues is discussed, including information obtained from interviewing Indian government policy makers. Some of the issues discussed include: Economic and social incentives to encourage biotechnology; Health policy and ethics review; Patents on drugs; Medical genetics; Relationship to traditional medical practices; Positive public attitudes to biotechnology; Limited public participation; Infrastructural hurdles; Indian progress in stem cell research; and dilemmas of expensive technologies. The results show that although the needs of developing countries are different to those of rich countries, government policy utilizing guidelines and ethics committees has evolved as mechanisms to aid ethical health care delivery in India. In all countries there may be some of these concerns that are raised here, however, the integration of traditional medicine and advanced medical technology, and access to medical services by people in need, are particularly important challenges in developing countries. Better public involvement in policy making will require education and infrastructural organization as well as mutual willingness on the part of policy makers and citizens.

  1. Ethical, financial, and policy considerations in hand transplantation.

    PubMed

    Chang, Jeff; Mathes, David W

    2011-11-01

    Currently, more than 65 hand transplants have been performed with studies demonstrating favorable cosmetic and functional outcomes and cortical reintegration of the transplanted hand. Due to such favorable outcomes, many view hand transplant as a potential gold standard for treatment of a double amputee. However, ethical debate continues regarding risks and benefits of this nonlifesaving procedure. Clinicians, patients, and society must agree on whether hand transplantation is ethical and affordable. If a decision is made to transplant a hand, this must be performed in a dedicated center that facilitates integration of multiple specialists, ethicists, pharmacists, and rehabilitationists.

  2. Research Experience and Agreement with Selected Ethics Principles from Canada's "Tri-Council Policy Statement--Ethical Conduct for Research Involving Humans"

    ERIC Educational Resources Information Center

    Fahy, Pat; Spencer, Bob

    2004-01-01

    An online survey was conducted of students, instructors, and researchers in distance education regarding principles for the ethical treatment of human research subjects. The study used an online questionnaire based on principles drawn from Canada's "Tri-Council Policy Statement, Ethical Conduct for Research Involving Humans" (TCPS,…

  3. Current Practice in Research Ethics: Global Trends and New Opportunities for African Universities. Research and Innovation Policy Series. Number 1

    ERIC Educational Resources Information Center

    Roberts, Liam

    2007-01-01

    Research Ethics has emerged as one of the most well-developed policy areas within the sphere of Research and Innovation Management. As such, for African institutions looking to strengthen their policy frameworks, develop increased collaborations, and increase research outputs, a thorough understanding of global trends in Ethics will be vital.…

  4. Balance, Diversity and Ethics in Public Policy Education.

    ERIC Educational Resources Information Center

    Thompson, Paul B.

    Public policy for agriculture and natural resources must change as farming and the use of resources change, but policy also changes to reflect new understandings. The new understandings that will shape future agricultural policy may not come from food producers or agricultural scientists, and may not assume that expanding production is the primary…

  5. Educational Research, Research Ethics and Federal Policy: An Update.

    ERIC Educational Resources Information Center

    Hecht, Jeffrey B.

    The ethical treatment of human participants in medical research has been a focus of discussion for centuries. Less talked about, unfortunately, is how participants of social science research, especially of the kind of research found in educational settings, are protected from unethical procedures or investigators. Title 45 of the U.S. Code of…

  6. Undocumented Status: Implications for Child Development, Policy, and Ethical Research

    ERIC Educational Resources Information Center

    Suárez-Orozco, Carola; Yoshikawa, Hirokazu

    2013-01-01

    Nearly 5.5 million children in the United States grow up in the shadows of undocumented status. We review the ecological domains of influence in children's and adolescents' lives and briefly consider health, cognitive, socioemotional, educational, and labor market outcomes ripe for study. We also reflect upon the ethical policy…

  7. The ethics of interrogation and the American Psychological Association: A critique of policy and process

    PubMed Central

    Olson, Brad; Soldz, Stephen; Davis, Martha

    2008-01-01

    The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights. PMID:18230171

  8. The ethics of interrogation and the American Psychological Association: a critique of policy and process.

    PubMed

    Olson, Brad; Soldz, Stephen; Davis, Martha

    2008-01-29

    The Psychological Ethics and National Security (PENS) task force was assembled by the American Psychological Association (APA) to guide policy on the role of psychologists in interrogations at foreign detention centers for the purpose of U.S. national security. The task force met briefly in 2005, and its report was quickly accepted by the APA Board of Directors and deemed consistent with the APA Ethics Code by the APA Ethics Committee. This rapid acceptance was unusual for a number of reasons but primarily because of the APA's long-standing tradition of taking great care in developing ethical policies that protected anyone who might be impacted by the work of psychologists. Many psychological and non-governmental organizations (NGOs), as well as reputable journalists, believed the risk of harm associated with psychologist participation in interrogations at these detention centers was not adequately addressed by the report. The present critique analyzes the assumptions of the PENS report and its interpretations of the APA Ethics Code. We demonstrate that it presents only one (and not particularly representative) side of a complex set of ethical issues. We conclude with a discussion of more appropriate psychological contributions to national security and world peace that better respect and preserve human rights.

  9. Are the American Psychological Association’s Detainee Interrogation Policies Ethical and Effective?

    PubMed Central

    Pope, Kenneth S.

    2011-01-01

    After 9–11, the United States began interrogating detainees at settings such as Abu Ghraib, Bagram, and Guantanamo. The American Psychological Association (APA) supported psychologists’ involvement in interrogations, adopted formal policies, and made an array of public assurances. This article’s purpose is to highlight key APA decisions, policies, procedures, documents, and public statements in urgent need of rethinking and to suggest questions that may be useful in a serious assessment, such as, “However well intended, were APA’s interrogation policies ethically sound?”; “Were they valid, realistic, and able to achieve their purpose?”; “Were other approaches available that would address interrogation issues more directly, comprehensively, and actively, that were more ethically and scientifically based, and that would have had a greater likelihood of success?”; and “Should APA continue to endorse its post-9–11 detainee interrogation policies?” PMID:22096660

  10. State of the science on postacute rehabilitation: setting a research agenda and developing an evidence base for practice and public policy: an introduction

    PubMed Central

    Heinemann, Allen W

    2007-01-01

    The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness along with academic, professional, provider, accreditor and other organizations, sponsored a 2-day State-of-the-Science of Post-Acute Rehabilitation Symposium in February 2007. The aim of this symposium was to serve as a catalyst for expanded research on postacute care (PAC) rehabilitation so that health policy is founded on a solid evidence base. The goals were to: (1) describe the state of our knowledge regarding utilization, organization and outcomes of postacute rehabilitation settings, (2) identify methodologic and measurement challenges to conducting research, (3) foster the exchange of ideas among researchers, policymakers, industry representatives, funding agency staff, consumers and advocacy groups, and (4) identify critical questions related to setting, delivery, payment and effectiveness of rehabilitation services. Plenary presentation and state-of-the-science summaries were organized around four themes: (1) the need for improved measurement of key rehabilitation variables and methods to collect and analyze this information, (2) factors that influence access to postacute rehabilitation care, (3) similarities and differences in quality and quantity of services across PAC settings, and (4) effectiveness of postacute rehabilitation services. The full set of symposium articles, including recommendations for future research, appear in Archives of Physical Medicine and Rehabilitation. PMID:17980024

  11. Cosmopolitanism and foreign policy for health: ethics for and beyond the state

    PubMed Central

    2013-01-01

    Background Foreign policy holds great potential to improve the health of a global citizenship. Our contemporary political order is, in part, characterized by sovereign states acting either in opposition or cooperation with other sovereign states. This order is also characterized by transnational efforts to address transnational issues such as those featured so prominently in the area of global health, such as the spread of infectious disease, health worker migration and the movement of health-harming products. These two features of the current order understandably create tension for truly global initiatives. Discussion National security has become the dominant ethical frame underlying the health-based foreign policy of many states, despite the transnational nature of many contemporary health challenges. This ethical approach engages global health as a means to achieving national security objectives. Implicit in this ethical frame is the version of humanity that dichotomizes between “us” and “them”. What has been left out of this discourse, for the most part, is the role that foreign policy can play in extending the responsibility of states to protect and promote health of the other, for the sake of the other. Summary The principal purpose of this paper is to review arguments for a cosmopolitan ethics of health-based foreign policy. I will argue that health-based foreign policy that is motivated by security interests is lacking both morally and practically to further global health goals. In other words, a cosmopolitan ethic is not only intrinsically superior as a moral ideal, but also has potential to contribute to utilitarian ends. This paper draws on the cosmopolitanism literature to build robust support for foreign policies that contribute to sustainable systems of global health governance. PMID:23829176

  12. The ethics of moral compromise for stem cell research policy.

    PubMed

    Master, Zubin; Crozier, G K D

    2012-03-01

    In the US, stem cell research is at a moral impasse-many see this research as ethically mandated due to its potential for ameliorating major diseases, while others see this research as ethically impermissible because it typically involves the destruction of embryos and use of ova from women. Because their creation does not require embryos or ova, induced pluripotent stem cells offer the most promising path for addressing the main ethical objections to stem cell research; however, this technology is still in development. In order for scientists to advance induced pluripotent stem cell research to a point of translational readiness, they must continue to use ova and embryos in the interim. How then are we to ethically move forward with stem cell research? We argue that there is personal integrity and value in adopting a 'moral compromise' as a means for moving past the moral impasse in stem cell research. In a moral compromise, each party concedes part of their desired outcome in order to engage in a process that respects the values and desires of all parties equitably. Whereas some contend that moral compromise in stem cell research necessarily involves self-contradiction or loss of personal integrity, we argue that in the US context, stem cell research satisfies many of the key pre-conditions of an effective moral compromise. To illustrate our point, we offer a model solution wherein eggs and embryos are temporarily used until non-egg and non-embryonic sources of pluripotent stem cells are developed to a state of translational readiness.

  13. The Ethics of Human Freedom and Healthcare Policy: A Nursing Theoretical Perspective.

    PubMed

    Milton, Constance L

    2015-07-01

    Global healthcare and healthcare policies are evolving with change at a swift pace. Inherent in the discussions of a person's right to choose health is the notion of freedom. The author in this column compares and contrasts bioethical views of freedom and autonomy with alternative views and possibilities by examining an ethic of freedom grounded from a different paradigm, the humanbecoming nursing theoretical perspective.

  14. Ethical Considerations in a Three-Tiered Approach to School Discipline Policy and Practice

    ERIC Educational Resources Information Center

    Mayworm, Ashley M.; Sharkey, Jill D.

    2014-01-01

    Research indicates that school discipline policies and practices have a significant influence on both student and school functioning. The purpose of this article is to uncover how the ethical standards guiding the field of school psychology inform school decisions about discipline in a three-tiered approach. Various discipline approaches,…

  15. The Potential of Applying Judeo-Christian Ethics to Tax Policy in Foreign Countries

    ERIC Educational Resources Information Center

    Hamill, Susan Pace

    2008-01-01

    This article extends the author's previous domestic analysis of tax policy and education finance under the moral principles of Judeo-Christian ethics to the international arena, beginning with an examination of the English-speaking OECD countries, which are the most economically and culturally similar to the United States. Although the tax and…

  16. ICCE/ICCAI 2000 Full & Short Papers (Policies, Ethics, Standards, and Legal Issues).

    ERIC Educational Resources Information Center

    2000

    This document contains the following full and short papers on policies, ethics, standards, and legal issues from ICCE/ICCAI 2000 (International Conference on Computers in Education/International Conference on Computer-Assisted Instruction): (1) "A Study on the School Information Technology Pilot Scheme: Possibilities of Creative and Lifelong…

  17. Educational Assessment Policy and Practice: A Matter of Ethics

    ERIC Educational Resources Information Center

    Elwood, Jannette

    2013-01-01

    Long-standing concerns within the field of educational assessment consider the impact of assessment policy and practice as matters of equity, inequality and social justice. Yet educational assessment policy and practice continues to have powerful social consequences for key users such as children and young people. This paper re-positions these…

  18. Policy, Performativity and Partnership: An Ethical Leadership Perspective

    ERIC Educational Resources Information Center

    Elliott, Geoffrey

    2012-01-01

    This paper identifies the need to think differently about educational partnerships in a changing and turbulent post-compulsory policy environment in England. The policy and institutional contexts in which universities and colleges currently operate seem to be fuelling performativity at the expense of educational values. There appears to be a sharp…

  19. Leading Dynamic Schools: How to Create and Implement Ethical Policies

    ERIC Educational Resources Information Center

    Rallis, Sharon F.; Rossman, Gretchen B.; Cobb, Casey D.; Reagan, Timothy G.; Kuntz, Aaron

    2007-01-01

    This companion book to "Principals of Dynamic Schools" and "Dynamic Teachers" brings to life the process of making and enacting educational policy and helps decision makers evaluate, interpret, and analyze the policies that govern their schools. In accessible language, this book presents educational leaders with a conceptual framework for…

  20. Statement of Jon Baron, President, Coalition for Evidence-Based Policy. House Committee on Ways and Means, Subcommittee on Human Resources Hearing on the Maternal, Infant, and Early Childhood Home Visiting Program

    ERIC Educational Resources Information Center

    Coalition for Evidence-Based Policy, 2014

    2014-01-01

    In his testimony, Jon Baron, president of Coalition for Evidence-Based Policy, recommends reauthorization of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) Program. He outlines three reasons that support his recommendation: (1) MIECHV represents an important, bipartisan departure from the usual approach to social…

  1. Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment

    PubMed Central

    Small, Dan; Drucker, Ernest

    2006-01-01

    require patients who have been successfully treated with heroin in Canada, to be forced to move back to less effective treatments (treatments that failed to be efficacious in the past)? This essay discusses this dilemma and places it in the broader context of ethics, science, and health policy. It makes the case for continuation of the current successful patients in heroin treatment and the institution of heroin treatment to all Canadian patients living with active addictions who qualify. PMID:16670010

  2. Evidence-Based Programs in Action: Policy and Practice Insights from a Success Story. Research-to-Results Brief. Publication #2010-08

    ERIC Educational Resources Information Center

    Uninsky, Philip

    2010-01-01

    A great deal of attention recently has focused on evidence-based programs--interventions that have been found through rigorous evaluation to have positive effects or impacts on targeted outcomes. Public and private funders want to fund evidence-based programs and are requiring evidence of outcomes. Meanwhile, program providers want to be highly…

  3. Ethical Standards to Guide the Development of Obesity Policies and Programs Comment on "Ethical Agreement and Disagreement about Obesity Prevention Policy in the United States".

    PubMed

    Buchanan, David

    2013-11-01

    The recent report by Barnhill and King about obesity prevention policy raises important issues for discussion and analysis. In response, this article raises four points for further consideration. First, a distinction between equality and justice needs to be made and consistently maintained. Second, different theories of justice highlight one additional important source of disagreement about the ethical propriety of the proposed obesity prevention policies. Third, another point of contention arises with respect to different understandings of the principle of respect for autonomy due to its often-mistaken equation with simple, unfettered freedom. Finally, based on a more robust definition of autonomy, the key issues in obesity prevention policies can be suitably re-framed in terms of whether they advance just social conditions that enable people to realize human capabilities to the fullest extent possible.

  4. Ethics and computer-mediated communication: implications for practice and policy.

    PubMed

    Torrance, Rebecca J; Lasome, Caterina E M; Agazio, Janice B

    2002-06-01

    Computer-mediated communication, or email, has become a common workplace practice. Interviews with Army nurse managers (n = 9) and their staff nurses (n = 13) revealed that nurses incorporate the ethical principles of autonomy, beneficence, nonmaleficence, and justice into their computer-mediated communication use, but to varying degrees. Without clearly defined policies to guide computer-mediated communication practices, informal norms evolve that have an impact on both individual and corporate communication. The authors provide insight into the ethical considerations that have an impact on computer-mediated communication use. The spectrum of participant interpretation of appropriate use of this type of communication suggests the need for policies to establish clear boundaries for workplace usage. Policy recommendations are included.

  5. Lessons from HeLa Cells: The Ethics and Policy of Biospecimens

    PubMed Central

    Beskow, Laura M.

    2016-01-01

    Human biospecimens have played a crucial role in scientific and medical advances. Although the ethical and policy issues associated with biospecimen research have long been the subject of scholarly debate, the story of attention of a much broader audience. The story has been a catalyst for policy change, including major regulatory changes proposed in the United States surrounding informed consent. These proposals are premised in part on public opinion data, necessitating a closer look at what such data tell us. The development of biospecimen policy should be informed by many considerations—one of which is public input, robustly gathered, on acceptable approaches that optimize shared interests, including access for all to the benefits of research. There is a need for consent approaches that are guided by realistic aspirations and a balanced view of autonomy within an expanded ethical framework. PMID:26979405

  6. Public policy and medical tourism: ethical implications for the Egyptian health care system.

    PubMed

    Haley, Bob

    2011-01-01

    Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population.

  7. Birth control policies in Iran: a public health and ethics perspective.

    PubMed

    Aloosh, Mehdi; Saghai, Yashar

    2016-06-01

    In less than one generation, a unique demographic transition has taken place in Iran. A population growth rate of 4.06% in 1984 fell to 1.15% in 1993 and a total fertility rate of 6.4 births per woman in 1984 declined to 1.9 in 2010. In 2012, Iranian policymakers shifted away from a birth control policy towards a pro-natalist policy. At first glance, this may seem reasonable since its goal is to avoid the consequences of an aging population. However, we argue that the policy package raises serious public health, socioeconomic, environmental and ethical concerns and is likely to fail on its own terms.

  8. Solidarity: a (new) ethic for global health policy.

    PubMed

    Harmon, Shawn H E

    2006-12-01

    This article explores solidarity as an ethical concept underpinning rules in the global health context. First, it considers the theoretical conceptualisation of the value and some specific duties it supports (ie: its expression in the broadest sense and its derivative action-guiding duties). Second, it considers the manifestation of solidarity in two international regulatory instruments. It concludes that, although solidarity is represented in these instruments, it is often incidental. This fact, their emphasis on other values and their internal weaknesses diminishes the action-guiding impact of the solidarity rules. The global health and human subject research scene needs a completely new instrument specifically directed at means by which solidarity can be achieved, and a reformed infrastructure dedicated to realising that value.

  9. Rights, Equality, and the Ethics of School Policy.

    ERIC Educational Resources Information Center

    Diorio, Joseph A.

    1986-01-01

    Where a plurality of opinions exists, the effect of uniform educational policy denies a minority group's desires for equal rights and serves partisan views. Dworkin's theory of rights supports this perspective. Governmental imposition of uniform schooling practices on unwilling persons is an illegitimate devaluation of some citizens' lives. (36…

  10. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.

  11. Ethical and Human Rights Foundations of Health Policy: Lessons from Comprehensive Reform in Mexico.

    PubMed

    Frenk, Julio; Gómez-Dantés, Octavio

    2015-12-10

    This paper discusses the use of an explicit ethical and human rights framework to guide a reform intended to provide universal and comprehensive social protection in health for all Mexicans, independently of their socio-economic status or labor market condition. This reform was designed, implemented, and evaluated by making use of what Michael Reich has identified as the three pillars of public policy: technical, political, and ethical. The use of evidence and political strategies in the design and negotiation of the Mexican health reform is briefly discussed in the first part of this paper. The second part examines the ethical component of the reform, including the guiding concept and values, as well as the specific entitlements that gave operational meaning to the right to health care that was enshrined in Mexico's 1983 Constitution. The impact of this rights-based health reform, measured through an external evaluation, is discussed in the final section. The main message of this paper is that a clear ethical framework, combined with technical excellence and political skill, can deliver major policy results.

  12. The role of ethics in shale gas policies.

    PubMed

    de Melo-Martín, Inmaculada; Hays, Jake; Finkel, Madelon L

    2014-02-01

    The United States has experienced a boom in natural gas production due to recent technological innovations that have enabled natural gas to be produced from unconventional sources, such as shale. There has been much discussion about the costs and benefits of developing shale gas among scientists, policy makers, and the general public. The debate has typically revolved around potential gains in economics, employment, energy independence, and national security as well as potential harms to the environment, the climate, and public health. In the face of scientific uncertainty, national and international governments must make decisions on how to proceed. So far, the results have been varied, with some governments banning the process, others enacting moratoria until it is better understood, and others explicitly sanctioning shale gas development. These policies reflect legislature's preferences to avoid false negative errors or false positive ones. Here we argue that policy makers have a prima facie duty to minimize false negatives based on three considerations: (1) protection from serious harm generally takes precedence over the enhancement of welfare; (2) minimizing false negatives in this case is more respectful to people's autonomy; and (3) alternative solutions exist that may provide many of the same benefits while minimizing many of the harms.

  13. Technical report: Ethical and policy issues in genetic testing and screening of children.

    PubMed

    Ross, Lainie Friedman; Ross, Laine Friedman; Saal, Howard M; David, Karen L; Anderson, Rebecca R

    2013-03-01

    The genetic testing and genetic screening of children are commonplace. Decisions about whether to offer genetic testing and screening should be driven by the best interest of the child. The growing literature on the psychosocial and clinical effects of such testing and screening can help inform best practices. This technical report provides ethical justification and empirical data in support of the proposed policy recommendations regarding such practices in a myriad of settings.

  14. Discourses of dislike: responses to ethics education policies by life scientists in the U.K., Italy, and the U.S.

    PubMed

    Smith-Doerr, Laurel

    2009-06-01

    RECENTLY ESTABLISHED POLICIES FOR ethical conduct of researchers have resulted in efforts to implement those policies through educational practices. While these policies and training efforts have good intentions, how do researchers respond? Little research has been conducted to understand how researchers react to ethics policies, and to ethics education requirements as a particularly salient part of the policies. This research explores variations in the responses of life scientists to policies originating in the U.K., E.U. and U.S., between 2000 and 2003. Semi-structured interviews with 30 life scientists in the U.K., Italy and the U.S. provide the basis for the findings. Across the interviews, scientists consistently reported dislike of the ways the ethics policies and ethics programs are implemented, but with variation by country. U.K. life scientists regarded the policies tied to Research Council (RC) funding with a skeptical attitude, expecting that policies would change with RC leadership. Italian life scientists often noted the lack of funding (and policies) at the national level, and appeared frustrated by what they viewed as overly complex policy requirements at the European level, where successful grantees employed outside consultants to complete the ethics sections of their applications. U.S. life scientists expressed distaste for the implementation of the National Institutes of Health (NIH) policy in web-based ethics training modules. This research suggests that introducing new shallow routines that are separate from daily research and educational practices in science may be worse than no ethics training at all, if it turns off young researchers to the discussion of ethical issues. Observing variation in scientists' discourse on ethics policies allows us to see how education following ethics policies might be more effective, and indicates that ethics policy formation more informed by empirical research is a desirable goal.

  15. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan.

    PubMed

    Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem

    2008-08-01

    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.

  16. Redefining ecological ethics: science, policy, and philosophy at Cape Horn.

    PubMed

    Frodeman, Robert

    2008-12-01

    In the twentieth century, philosophy (especially within the United States) embraced the notion of disciplinary expertise: philosophical research consists of working with and writing for other philosophers. Projects that involve non-philosophers earn the deprecating title of "applied" philosophy. The University of North Texas (UNT) doctoral program in philosophy exemplifies the possibility of a new model for philosophy, where graduate students are trained in academic philosophy and in how to work with scientists, engineers, and policy makers. This "field" (rather than "applied") approach emphasizes the inter- and transdisciplinary nature of the philosophical enterprise where theory and practice dialectically inform one another. UNT's field station in philosophy at Cape Horn, Patagonia, Chile is one site for developing this ongoing experiment in the theory and practice of interdisciplinary philosophic research and education.

  17. A software platform to analyse the ethical issues of electronic patient privacy policy: the S3P example.

    PubMed

    Mizani, M A; Baykal, N

    2007-12-01

    Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P.

  18. A review of management of infertility in Nigeria: framing the ethics of a national health policy

    PubMed Central

    Akinloye, Oluyemi; Truter, Ernest J

    2011-01-01

    Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost–utility analysis (such as Quality Adjusted Life-Year composite index) in the management of infertility in Nigeria entails the need for caution relevant to the country’s efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian) principles. The “worst off ” category of Nigerians includes (1) underweight children less than 5 years of age, with special concern for infants (0–1 years of age) and (2) the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a “fair” allocation and expenditure if, and only if, the situation for these two cohorts is not thereby made worse. Nigerian health policy cannot assume this type of increased allocation of its resources to infertility care without it being hard pressed to warrant defensible moral or rational argument. PMID:21892337

  19. The commercialization of human stem cells: ethical and policy issues.

    PubMed

    Resnik, David B

    2002-01-01

    The first stage of the human embryonic stem (ES) cell research debate revolved around fundamental questions, such as whether the research should be done at all, what types of research may be done, who should do the research, and how the research should be funded. Now that some of these questions are being answered, we are beginning to see the next stage of the debate: the battle for property rights relating to human ES cells. The reason why property rights will be a key issue in this debate is simple and easy to understand: it costs a great deal of money to do this research, to develop new products, and to implement therapies; and private companies, researchers, and health professionals require returns on investments and reimbursements for goods and services. This paper considers arguments for and against property rights relating to ES cells defends the following points: (1) It should be legal to buy and sell ES cells and products. (2) It should be legal to patent ES cells, products, and related technologies. (3) It should not be legal to buy, sell, or patent human embryos. (4) Patents on ES cells, products, and related technologies should not be excessively broad. (5) Patents on ES cells, products, and related technologies should be granted only when applicants state definite, plausible uses for their inventions. (6) There should be a research exemption in ES cell patenting to allow academic scientists to conduct research in regenerative medicine. (7) It may be appropriate to take steps to prevent companies from using patents in ES cells, products, and related technologies only to block competitors. (8) As the field of regenerative medicine continues to develop, societies should revisit issues relating to property rights on a continuing basis in order to develop policies and develop regulations to maximize the social, medical, economic, and scientific benefits of ES cell research and product development.

  20. Cellular Therapies for Heart Disease: Unveiling the Ethical and Public Policy Challenges

    PubMed Central

    Raval, Amish N.; Kamp, Timothy J.; Hogle, Linda F.

    2008-01-01

    Cellular therapies have emerged as a potential revolutionary treatment for cardiovascular disease. Promising pre-clinical results have resulted in a flurry of basic research activity and spawned multiple clinical trials world-wide. However, the optimal cell type and delivery mode have not been determined for target patient populations. Nor has the mechanisms of benefit for the range of cellular interventions been clearly defined. Experiences to date have unveiled a myriad of ethical and public policy challenges which will affect the way researchers and clinicians make decisions for both basic and clinical research. Stem cells derived from embryos are at the forefront of the ethical and political debate, raising issues of which derivation methods are morally and socially permissible to pursue, as much as which are technically feasible. Adult stem cells are less controversial; however, important challenges exist in determining study design, cell processing, delivery mode, and target patient population. Pathways to successful commercialization and hence broad accessibility of cellular therapies for heart disease are only beginning to be explored. Comprehensive, multi-disciplinary and collaborative networks involving basic researchers, clinicians, regulatory officials and policymakers are required to share information, develop research, regulatory and policy standards and enable rational and ethical cell-based treatment approaches. PMID:18155721

  1. The use of human fetal tissue: scientific, ethical, and policy concerns (January 1990)

    PubMed

    Vawter, Dorothy E; Kearney, Warren; Gervais, Karen G; Caplan, Arthur L; Garry, Daniel; Tauer, Carol

    1991-01-01

    The use of fetal tissue in transplants for treating illnesses such as Parkinson's disease and juvenile diabetes has raised the hopes of patients, their families, and the biomedical community. But, this practice has created considerable controversy. Concerns arise because tissue is usually obtained from electively aborted fetuses. Despite the controversy, there has been little systematic and sustained examination of the ethical and policy issues posed by the use of fetal tissue in biomedicine. The lack of information and analysis hampers serious discussion. In the Spring of 1988, the Center for Biomedical Ethics began an interdisciplinary research project on the scientific, ethical, and policy issues raised by the use of fetal tissue in biomedicine. Twenty-five scholars, drawn mainly, but not exclusively, from the faculty of the University of Minnesota, met to undertake the study. The members of this research group included experts in neonatology, pediatrics, neurology, neurosurgery, organ transplantation, tissue procurement, cell biology, immunology, epidemiology, law, philosophy, moral theology, and the behavioral sciences. The group met every three weeks over a period of ten months to collect and review information about the use of fetal tissue -- with special attention to transplantation -- the potential sources of fetal tissue, and the relevant laws and guidelines in the U.S. and other nations. Six members of the research group had primary responsibility for writing this report.

  2. The policies of ethics committees in the management of biobanks used for research: an Italian survey

    PubMed Central

    Porteri, Corinna; Togni, Elena; Pasqualetti, Patrizio

    2014-01-01

    Gaps in regulations pertaining to the collection and storage of biological materials in a biobank, at least in the European context, have made the writing of local guidelines essential from an ethical point of view. Nevertheless, until recently, the elaboration of local guidelines for the collection, use and storage of biological materials in a biobank has been the exception in Italy and all European countries. In this context, it is of value to know the policies, even if they are unwritten, of local ethics committees (ECs) engaged in the evaluation of research protocols involving biobanks and biological materials. This paper presents the results of a survey carried out among local Italian ECs (229) to document their attitudes and policies regarding the management of the ethical issues related to biobanks and the use of biological materials. A questionnaire was developed to investigate the areas regarded as critical from an ethical–legal point of view: informed consent and information to the subjects; protection of confidentiality; communication of research results; access/transfer of biological materials and related data; ownership of samples and data and intellectual property rights; and subjects' remuneration and benefit sharing. Twenty-six ECs from the Italian Institutes for Research and Care (62%) and 26 other ECs (14%) participated in the survey. PMID:23695284

  3. Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy

    PubMed Central

    2011-01-01

    Background A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. Discussion We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Summary Broadening this conversation beyond its primary focus on the use of evidence-based

  4. Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context

    PubMed Central

    Mercer, Dave

    2015-01-01

    In response to the International Journal of Health Policy and Management (IJHPM) editorial, this commentary adds to the debate about ethical dimensions of compassionate care in UK service provision. It acknowledges the importance of the original paper, and attempts to explore some of the issues that are raised in the context of nursing practice, research and education. It is argued that each of these fields of the profession are enacted in an escalating culture of corporatism, be that National Health Service (NHS) or university campus, and global neoliberalism. Post-structuralist ideas, notably those of Foucault, are borrowed to interrogate healthcare as discursive practice and disciplinary knowledge; where an understanding of the ways in which power and language operate is prominent. Historical and contemporary evidence of institutional and ideological degradation of sections of humanity, a ‘history of the present,’ serve as reminders of the import, and fragility, of ethical codes. PMID:26673179

  5. Integrating Values and Ethics into Wildlife Policy and Management—Lessons from North America

    PubMed Central

    Fox, Camilla H.; Bekoff, Marc

    2011-01-01

    Few animals provoke as wide a range of emotions as wolves. Some see wolves as icons of a lost wilderness; others see them as intruders. As the battle continues between wolf proponents and opponents, finding solutions that resolve conflicts while supporting the integrity of nature is challenging. In this essay we argue that we need to make room for wolves and other native carnivores who are re-colonizing areas from which they were extirpated. Strategies that foster coexistence are necessary and wildlife agencies must consider all stakeholders and invest adequate resources to inform the public about how to mitigate conflicts between people/domestic animals, and predators. Values and ethics must be woven into wildlife policy and management and we must be willing to ask difficult ethical questions and learn from past mistakes. PMID:26486219

  6. Integrating Values and Ethics into Wildlife Policy and Management-Lessons from North America.

    PubMed

    Fox, Camilla H; Bekoff, Marc

    2011-01-25

    Few animals provoke as wide a range of emotions as wolves. Some see wolves as icons of a lost wilderness; others see them as intruders. As the battle continues between wolf proponents and opponents, finding solutions that resolve conflicts while supporting the integrity of nature is challenging. In this essay we argue that we need to make room for wolves and other native carnivores who are re-colonizing areas from which they were extirpated. Strategies that foster coexistence are necessary and wildlife agencies must consider all stakeholders and invest adequate resources to inform the public about how to mitigate conflicts between people/domestic animals, and predators. Values and ethics must be woven into wildlife policy and management and we must be willing to ask difficult ethical questions and learn from past mistakes.

  7. Ethical models in bioethics: theory and application in organ allocation policies.

    PubMed

    Petrini, C

    2010-12-01

    Policies for allocating organs to people awaiting a transplant constitute a major ethical challenge. First and foremost, they demand balance between the principles of beneficence and justice, but many other ethically relevant principles are also involved: autonomy, responsibility, equity, efficiency, utility, therapeutic outcome, medical urgency, and so forth. Various organ allocation models can be developed based on the hierarchical importance assigned to a given principle over the others, but none of the principles should be completely disregarded. An ethically acceptable organ allocation policy must therefore be in conformity, to a certain extent, with the requirements of all the principles. Many models for organ allocation can be derived. The utilitarian model aims to maximize benefits, which can be of various types on a social or individual level, such as the number of lives saved, prognosis, and so forth. The prioritarian model favours the neediest or those who suffer most. The egalitarian model privileges equity and justice, suggesting that all people should have an equal opportunity (casual allocation) or priority should be given to those who have been waiting longer. The personalist model focuses on each individual patient, attempting to mesh together all the various aspects affecting the person: therapeutic needs (urgency), fairness, clinical outcomes, respect for persons. In the individualistic model the main element is free choice and the system of opting-in is privileged. Contrary to the individualistic model, the communitarian model identities in the community the fundamental elements for the legitimacy of choices: therefore, the system of opting-out is privileged. This article does not aim at suggesting practical solutions. Rather, it furnishes to decision makers an overview on the possible ethical approach to this matter.

  8. Champions for social change: Photovoice ethics in practice and 'false hopes' for policy and social change.

    PubMed

    Johnston, Gloria

    2016-01-01

    Photovoice methodology is growing in popularity in the health, education and social sciences as a research tool based on the core values of community-based participatory research. Most photovoice projects state a claim to the third goal of photovoice: to reach policy-makers or effect policy change. This paper examines the concerns of raising false hopes or unrealistic expectations amongst the participants of photovoice projects as they are positioned to be the champions for social change in their communities. The impetus for social change seems to lie in the hands of those most affected by the issue. This drive behind collective social action forms, what could be termed, a micro-social movement or comparative interest group. Looking to the potential use of social movement theory and resource mobilisation concepts, this paper poses a series of unanswered questions about the ethics of photovoice projects. The ethical concern centres on the focus of policy change as a key initiative; yet, most projects remain vague about the implementation and outcomes of this focus.

  9. Research Involving Health Providers and Managers: Ethical Issues Faced by Researchers Conducting Diverse Health Policy and Systems Research in Kenya.

    PubMed

    Molyneux, Sassy; Tsofa, Benjamin; Barasa, Edwine; Nyikuri, Mary Muyoka; Waweru, Evelyn Wanjiku; Goodman, Catherine; Gilson, Lucy

    2016-12-01

    There is a growing interest in the ethics of Health Policy and Systems Research (HPSR), and especially in areas that have particular ethical salience across HPSR. Hyder et al (2014) provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative work including observations and individual and group interviews. Many of the ethical dilemmas researchers faced only emerged over the course of the fieldwork, or on completion, and were related to interactions and relationships between individuals operating at different levels or positions in health/research systems. The dilemmas reveal significant ethical challenges for these forms of HPSR, and show that potential 'solutions' to dilemmas often lead to new issues and complications. Our experiences support the value of research ethics frameworks, and suggest that these can be enriched by incorporating careful consideration of context embedded social relations into research planning and conduct. Many of these essential relational elements of ethical practice, and of producing quality data, are given stronger emphasis in social science research ethics than in epidemiological, clinical or biomedical research ethics, and are particularly relevant where health systems are understood as social and political constructs. We conclude with practical and research implications.

  10. [Evidence-based medicine].

    PubMed

    Saad, E D; Grunspun, H

    1996-01-01

    Evidence-based medicine has been described as a new approach to teaching and practicing clinical medicine. Although the search for evidence is an established practice among physicians, what is being proposed is the systematic gathering and critical interpretation of data, which can then be used in the appropriate context. The main objective is to provide better care for patients. This is accomplished by transforming clinical problems in specific questions to be answered by searching the literature for the levels of evidence favoring the possible interventions for one particular case. This has to be done in a systematic and conscientious fashion. Through its method, evidence-based medicine places less value on clinical experience, the study understanding of pathophysiology, and common sense; instead, it emphasizes observation, levels of evidence, and critical interpretation of original literature. In this manner, evidence-based medicine may be seen by the authoritarian physician as a threat. Other obstacles to the acceptance of the method include lack of time and lack of familiarity with computers. One important limitation of evidence-based medicine is the incomplete or contradictory evidence available in many areas of clinical medicine, or the so-called "grey zones". We outline the main aspects of evidence-based medicine, expecting a growing interest among brazilian physicians for this useful clinical tool.

  11. The evolving role of partnerships in addressing community public health issues: policy and ethical implications.

    PubMed

    Wendel, Monica L; Burdine, James N; McLeroy, Kenneth R

    2007-01-01

    The current state of health insurance coverage in the United States is deteriorating. Historically, efforts to address access at the federal level have met with insurmountable opposition. This article describes a model utilizing the Partnership Approach to Community Health Improvement to engage communities in developing creative ways of addressing local health issues, discusses the policy implications of such a model, and explores ethical issues inherent in the discussion of universal access. An argument is presented for a national dialogue seeking societal agreement to approach access and health from a perspective of solidarity.

  12. Mapping and sequencing the human genome: Science, ethics, and public policy. Final report

    SciTech Connect

    McInerney, J.D.

    1993-03-31

    Development of Mapping and Sequencing the Human Genome: Science, Ethics, and Public Policy followed the standard process of curriculum development at the Biological Sciences Curriculum Study (BSCS), the process is described. The production of this module was a collaborative effort between BSCS and the American Medical Association (AMA). Appendix A contains a copy of the module. Copies of reports sent to the Department of Energy (DOE) during the development process are contained in Appendix B; all reports should be on file at DOE. Appendix B also contains copies of status reports submitted to the BSCS Board of Directors.

  13. Evidence-based neurosurgery

    PubMed Central

    Esene, Ignatius N.; Baeesa, Saleh S.; Ammar, Ahmed

    2016-01-01

    Medical evidence is obtainable from approaches, which might be descriptive, analytic and integrative and ranked into levels of evidence, graded according to quality and summarized into strengths of recommendation. Sources of evidence range from expert opinions through well-randomized control trials to meta-analyses. The conscientious, explicit, and judicious use of current best evidence in making decisions related to the care of individual patients defines the concept of evidence-based neurosurgery (EBN). We reviewed reference books of clinical epidemiology, evidence-based practice and other previously related articles addressing principles of evidence-based practice in neurosurgery. Based on existing theories and models and our cumulative years of experience and expertise conducting research and promoting EBN, we have synthesized and presented a holistic overview of the concept of EBN. We have also underscored the importance of clinical research and its relationship to EBN. Useful electronic resources are provided. The concept of critical appraisal is introduced. PMID:27356649

  14. Legislative activity related to the human papillomavirus (HPV) vaccine in the United States (2006–2015): a need for evidence-based policy

    PubMed Central

    Keim-Malpass, Jessica; Mitchell, Emma M; DeGuzman, Pamela B; Stoler, Mark H; Kennedy, Christine

    2017-01-01

    State-based policies to mandate HPV vaccination are politically challenging and have received broad criticisms. There is a critical need to understand the legislative activities that underpin subsequent policy implementation. The objective of this policy analysis was to analyze state legislation that focused on HPV vaccination from 2006–2015. A content analysis was conducted among primary sources of legislative data from HPV vaccine-related bills, including using the National Conference of State Legislatures as a search-source. Findings reveal that much of the legislative activity occurred early after the HPV vaccination was introduced, and focused on increased information for parents, public financing, awareness campaigns, etc. Far fewer states focused on voluntary or mandatory vaccination. Understanding the barriers to achieving mandatory vaccination policy and implementation of such policies for HPV vaccines remains a public health priority. PMID:28331378

  15. Debating Ethics in HIV Research: Gaps between Policy and Practice in Nigeria.

    PubMed

    Folayan, Morenike Oluwatoyin; Peterson, Kristin; Haire, Bridget; Brown, Brandon; Audu, Kadiri; Makanjuola, Olumide; Pelemo, Babatunde; Marsh, Vicki

    2015-12-01

    HIV prevention is a critical health issue in Nigeria; a country that has one of the worst HIV epidemic profiles in the world. With 270,000 new infections in 2012, Nigeria is a prime site for HIV prevention research. One effect of the HIV epidemic has been to revolutionalise ethical norms for the conduct of research: it is now considered unethical to design and implement HIV related studies without community engagement. Unfortunately, there is very little commensurate effort in building the capacity of local persons to engage actively with researchers, and there is no existing platform to facilitate dialogue between researchers and communities engaged in research in Nigeria. In an effort to address this gap, we undertook a series of three community dialogues (Phase One) and two community-researcher interface meetings (Phase Two) in Nigeria. This paper aims to give an empirical account of the dialogue from these community engagement processes and provide a resulting critique of the implementation of research ethics practices in Nigeria. It is anticipated that the outputs will: (i) support researchers in designing community-based research protocols; (ii) inform ethics committees of key considerations during research protocol reviews from a community perspective; and (iii) inform policy makers and research sponsors about issues of primary concern to communities with respect to HIV research.

  16. Genetically modified animals from life-science, socio-economic and ethical perspectives: examining issues in an EU policy context.

    PubMed

    Frewer, L J; Kleter, G A; Brennan, M; Coles, D; Fischer, A R H; Houdebine, L M; Mora, C; Millar, K; Salter, B

    2013-06-25

    The interdisciplinary EC consortium (the PEGASUS project) aimed to examine the issues raised by the development, implementation and commercialisation of genetically modified (GM) animals, and derivative foods and pharmaceutical products. The results integrated existing social (including existing public perception) environmental and economic knowledge regarding GM animals to formulate policy recommendations relevant to new developments and applications. The use of GM in farmed animals (aquatic, terrestrial and pharmaceutical) was mapped and reviewed. A foresight exercise was conducted to identity future developments. Three case studies (aquatic, terrestrial and pharmaceutical) were applied to identify the issues raised, including the potential risks and benefits of GM animals from the perspectives of the production chain (economics and agri-food sector) and the life sciences (human and animal health, environmental impact, animal welfare and sustainable production). Ethical and policy concerns were examined through application of combined ethical matrix method and policy workshops. The case studies were also used to demonstrate the utility of public engagement in the policy process. The results suggest that public perceptions, ethical issues, the competitiveness of EU animal production and risk-benefit assessments that consider human and animal health, environmental impact and sustainable production need to be considered in EU policy development. Few issues were raised with application in the pharmaceutical sector, assuming ethical and economic issues were addressed in policy, but the introduction of agricultural GM animal applications should be considered on a case-by-case basis.

  17. Ethical issues and policy analysis for genetic testing: Huntington's disease as a paradigm for diseases with a late onset.

    PubMed

    Lilani, Anjali

    2005-01-01

    This paper discusses the main ethical issues that arise when testing for genetic diseases with a late adult onset, such as Huntington's disease, take place. It is imperative to study genetic testing for HD and similar diseases because of the potential to influence future medical advances and the growing number of individuals who are considered pre-symptomatic. The main ethical issues are consent and privacy, prenatal testing and its implications, in addition to insurance discrimination. These issues are viewed from the perspective of genetic counselors, patients, the families of patients, and insurance companies. Policies put forth by the United States National Society of Genetic Counselors ("NSGC"), the Task Force on Genetic Testing, and the President's Council for Bioethics are also analyzed. Finally, new recommendations are proposed in order to ameliorate the ethical dilemmas encountered in genetic testing. These recommendations are largely based on existing policies and therefore involve amending current policies rather than revamping them.

  18. Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital.

    PubMed

    Burns, Kara; Belton, Suzanne

    2013-09-01

    Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in northern Australia, examining the legal and ethical implications of this practice. A framework of Northern Territory law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of 'occurrence', 'image use', 'quality of consent', 'cameras and technology', 'confidentiality', 'data storage and security', 'hospital policy and law' and 'cultural issues'. One hundred and seventy surveys and eights interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labeling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and noncompliance with policy and mobile phone use, patients' data is at risk of being distributed into the public domain where unauthorised publication may cause

  19. Between reason and coercion: ethically permissible influence in health care and health policy contexts.

    PubMed

    Blumenthal-Barby, J S

    2012-12-01

    In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats-or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the broad middle terrain-and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the "manipulation" label and relabeling this space "nonargumentative influence," with two subtypes: "reason-bypassing" and "reason-countering." Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to

  20. Evidence-based practice in psychology.

    PubMed

    2006-01-01

    The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005.

  1. Ethics and policies in the face of research into extending human life.

    PubMed

    Bellver Capella, Vicente

    2014-01-01

    If the prediction of some scientists comes true, then we are only few years away from the appearance of the first generation of human beings who will be able to add one year to each remaining year of life expectancy. Faced with this possibility, it seems appropriate to give thought to the public policies that should be adopted. It is better to anticipate the various future scenarios than react to a reality which is a fait accompli. To date, the debate has mainly focused on the ethical question: is it good or bad for us humans to achieve immortal life? Until now, neither legal guidelines at State level nor those of international organisations which deal with bioethical issues have concerned themselves with this matter. But before discussing policies, two other matters should be addressed: first, to show how the prolongation of human life can be as much the unwanted outcome of legitimate efforts in search of healthy aging, as one of the aims of the post-humanist project; second, to present the most consistent and shared ethical reasons for rejecting the human immortality project.

  2. Methods of legitimation: how ethics committees decide which reasons count in public policy decision-making.

    PubMed

    Edwards, Kyle T

    2014-07-01

    In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution.

  3. Ethics.

    PubMed

    Pellegrino, Edmund D

    In this brief annual review of ethical issues in medicine, Pellegrino focuses on two issues, AIDS and surrogate mothers. The AIDS epidemic has generated debate over public health needs vs. individual rights, modification of sexual practices, screening programs to detect infected persons, confidentiality of test results, experimental therapies, and the duty of physicians to care for AIDS patients. Surrogate motherhood arrangements have become one of the more controversial of the new reproductive technologies. The publicity that accompanied the custody battle over New Jersey's "Baby M" intensified debate over the commercialization of childbearing and the regulation of reproduction. Pellegrino concludes that physicians, along with ethicists and policymakers, have an obligation to "lead society in careful and judicious deliberation" of the ethical issues raised by AIDS and by reproductive technologies.

  4. [Evidence based medicine].

    PubMed

    Cuestas, Eduardo

    2005-01-01

    Evidence based medicine is a systematic method employed to secure the best scientific available evidence when making clinical decisions. Several steps are taken in these process, describing a clinical scenario, formulating a specific clinical question, searching the literature for the pertinent studies, selecting the relevant articles using rules of evidence, understanding and calculating measures of effect, and finally incorporating the evidence and patients preferences in the clinical decision process.

  5. Policy Reform Efforts and Equal Opportunity--An Evidence-Based Link? An Analysis of Current Sector Reforms in the Austrian School System

    ERIC Educational Resources Information Center

    Geppert, Corinna; Bauer-Hofmann, Sonja; Hopmann, Stefan Thomas

    2012-01-01

    The main focus of the present paper is to answer two different questions: From the perspective of Austrian education policy, which core areas of schooling are linked to the demand for equal opportunity? Can these reform efforts sustain the current state of research, and what are the consequences for schooling? The paper draws on an analysis by…

  6. Enhancing Children against Unhealthy Behaviors—An Ethical and Policy Assessment of Using a Nicotine Vaccine

    PubMed Central

    Lev, Ori; Wilfond, Benjamin S.; McBride, Colleen M.

    2013-01-01

    Health behaviors such as tobacco use contribute significantly to poor health. It is widely recognized that efforts to prevent poor health outcomes should begin in early childhood. Biomedical enhancements, such as a nicotine vaccine, are now emerging and have potential to be used for primary prevention of common diseases. In anticipation of such enhancements, it is important that we begin to consider the ethical and policy appropriateness of their use with children. The main ethical concerns raised by enhancing children relate to their impact on children’s well-being and autonomy. These concerns are significant, however they do not appear to apply in the case of the nicotine vaccine; indeed the vaccine could even further these goals for children. Nevertheless, concerns about broadly applying this enhancement may be more challenging. The vaccine may be less cost-effective than alternative public efforts to prevent tobacco use, utilizing it could distract from addressing the foundational causes of smoking and it might not be publically acceptable. Empirical research about these concerns is needed to ascertain their likelihood and impact as well as how they could be minimized. This research could help determine whether behavior-related enhancements hold promise for improving children’s health. PMID:23864909

  7. To give or sell human gametes--the interplay between pragmatics, policy and ethics.

    PubMed

    Daniels, K R

    2000-06-01

    The ever-growing acceptance and use of assisted human reproduction techniques has caused demand for "donated" sperm and eggs to outstrip supply. Medical professionals and others argue that monetary reward is the only way to recruit sufficient numbers of "donors". Is this a clash between pragmatics and policy/ethics? Where monetary payments are the norm, alternative recruitment strategies used successfully elsewhere may not have been considered, nor the negative consequences of commercialism on all participants thought through. Considerations leading some countries to ban the buying and selling of sperm, eggs and embryos are outlined and a case made that the collective welfare of all involved parties be the primary consideration in this, at times heated, debate.

  8. Recent trends in reproductive tourism and international surrogacy: ethical considerations and challenges for policy

    PubMed Central

    Deonandan, Raywat

    2015-01-01

    Reproductive tourism, or “cross-border reproductive care”, is the phenomenon of people crossing international borders to access reproductive technologies. One of the fastest-growing categories of cross-border reproductive care is international surrogacy, the act of infertile clients traveling internationally to engage the paid services of foreign surrogates to carry their babies to term. It is a multibillion-dollar global industry presenting unique legal, ethical, and risk-management challenges. Clients tend to be price-sensitive, middle-income individuals seeking services from surrogates who in the global market are thought to be of quite low socioeconomic status. Risks are experienced by all parties involved in the transaction, including the client’s countries of origin and destination. The risks to the surrogate evolve from the potential to exploit her economic vulnerability in order to encourage both consent and unfair pricing. Opportunities for policy development are explored. PMID:26316832

  9. Peter Bourne's drug policy and the perils of a public health ethic, 1976-1978.

    PubMed

    Clark, Claire D; Dufton, Emily

    2015-02-01

    As President Jimmy Carter's advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne's critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne's resignation, and present the story of his departure as a cautionary tale for today's drug policy reformers.

  10. Evidence-based Science Communication

    NASA Astrophysics Data System (ADS)

    Kahan, D.

    2012-12-01

    This presentation will describe a concrete strategy for bridging the gap between the *science* of science communication and the practice of it. In recent years, social scientists have made substantial progress in identifying the psychological influences that shape public receptivity to scientific information relating to climate change and other public policy issues. That work, however, has consisted nearly entirely of laboratory experiments and public opinion surveys; these methods identify general mechanisms of information processing but do not yield concrete prescriptions for communication in field settings. In order to integrate the findings of the science of science communication with the practice of it, field communication must now be made into a meaningful site of science communication research. "Evidence-based science communication" will involve collaborative work between social scientists and practitioners aimed at formulating and testing scientifically informed communication strategies in real-world contexts.

  11. Ethical policies on animal experiments are not compromised by whether a journal is freely accessible or charges for publication.

    PubMed

    Rands, S A

    2009-11-01

    The advent of the open access (OA) movement in publishing has been instrumental in causing a shift in the accessibility of research findings published in academic journals. The adoption of OA and other online publication models means that the results of scientific research published in journals using a free access (FA) framework are now available, free of charge, to anyone with access to the Internet. FA journals typically require a payment from the authors of a manuscript, which has raised concerns about the quality of work published in them; accepting payment from an author may compromise a journal's acceptance criteria. This study addresses whether journal policy on the treatment of animals is influenced by whether a journal follows a FA publishing model, and whether a requirement to pay for publication has an influence. A random sample of 332 biomedical journals listed in the ISI Web of Knowledge and Directory of Open Access Journals databases were assessed for whether they had an ethical policy on publishing animal studies, and what form of publication framework they used (103 of the journals followed a FA framework; 101 charged in some way for publication). Only 135 (40.7%) of the journals surveyed demanded that submissions comply with a pre-defined ethical stance. FA journals are just as likely to have an ethical policy on the treatment and presentation of animal studies as 'traditional', non-FA journals (significance of there being a difference: P = 0.98), and there is no relationship between policy and whether an author is required to pay for publication (significance of there being a difference: P = 0.57). Older journals are more likely to have an ethical policy (P = 0.03). There is, therefore, no obvious compromise shown by FA journals in the explicit policies on reporting studies involving animals. However, since anyone can read published FA studies online, FA journals that do not have an explicit policy about publishing animal research are urged to

  12. Internet Ethics.

    ERIC Educational Resources Information Center

    Emmans, Cindy

    2000-01-01

    Focuses on the issue of ethical use of the Internet in schools, and suggests that by devising and implementing acceptable use policies, and providing students with a set of ethical guidelines, schools and libraries can deal with the situation before it becomes a problem. Discusses and the need for parents to be included in policy formation and to…

  13. The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan.

    PubMed

    Higashi, Takahiro; Nakamura, Fumiaki; Shibata, Akiko; Emori, Yoshiko; Nishimoto, Hiroshi

    2014-01-01

    Monitoring the current status of cancer care is essential for effective cancer control and high-quality cancer care. To address the information needs of patients and physicians in Japan, hospital-based cancer registries are operated in 397 hospitals designated as cancer care hospitals by the national government. These hospitals collect information on all cancer cases encountered in each hospital according to precisely defined coding rules. The Center for Cancer Control and Information Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report. The report reveals the national profiles of patient characteristics, route to discovery, stage distribution, and first-course treatments of the five major cancers in Japan. A system designed to follow up on patient survival will soon be established. Findings from the analyses will reveal characteristics of designated cancer care hospitals nationwide and will show how characteristics of patients with cancer in Japan differ from those of patients with cancer in other countries. The database will provide an infrastructure for future clinical and health services research and will support quality measurement and improvement of cancer care. Researchers and policy-makers in Japan are encouraged to take advantage of this powerful tool to enhance cancer control and their clinical practice.

  14. The social and policy contexts of the New Brunswick Declaration on Research Ethics, Integrity, and Governance: a commentary.

    PubMed

    van den Hoonaard, Will C

    2013-04-01

    This paper explores the social and policy implications of the "New Brunswick Declaration on Research Ethics, Integrity, and Governance" developed at the Ethics Rupture Summit in Fredericton, N.B., Canada, October 2012. It discusses the Declaration and the Summit in relation to the usual criticism and analysis of research ethics regimes, and considers reasons why the immense prior literature has had little impact on regulatory bodies. Because the Declaration, like the Illinois White Paper, has quickly achieved considerable attention relative to most other such documents, and because much further deliberation has evolved since the Summit, we offer here a commentary on each of the eight principles contained in the Declaration in the hope of further stimulating discussion and consolidating the progress that now seems underway.

  15. Evidence-based neuroethics for neurodevelopmental disorders.

    PubMed

    Racine, Eric; Bell, Emily; Di Pietro, Nina C; Wade, Lucie; Illes, Judy

    2011-03-01

    Many neurodevelopmental disorders affect early brain development in ways that are still poorly understood; yet, these disorders can place an enormous toll on patients, families, and society as a whole and affect all aspects of daily living for patients and their families. We describe a pragmatic, evidence-based framework for engaging in empiric ethics inquiry for a large consortium of researchers in neurodevelopmental disorders and provide relevant case studies of pragmatic neuroethics. The 3 neurodevelopmental disorders that are at the focus of our research, cerebral palsy (CP), autism spectrum disorder (ASD), and fetal alcohol spectrum disorder (FASD), bring unique and intersecting challenges of translating ethically research into clinical care for children and neonates. We identify and discuss challenges related to health care delivery in CP; neonatal neurological decision making; alternative therapies; and identity, integrity, and personhood.

  16. How should we regulate risk in biomedical research? An ethical analysis of recent policy proposals and initiatives.

    PubMed

    Rid, Annette

    2014-09-01

    The existing regulatory framework for research is increasingly attacked for its "one-size-fits-all" approach. Many stakeholders contend that existing regulations formulate the same regulatory requirements for research involving very different levels of risk, and thereby unnecessarily stifle medical progress. To address this criticism, regulators are currently developing more risk-adapted approaches to regulating research. A key feature of these approaches is that they aim to calibrate subject protections, including ethical review and safety monitoring, to the risks that studies pose to participants. Risk-adapted systems of research oversight are ethically appealing because they have the potential to promote research within the constraints of adequate subject protection. However, this potential can only be realized if the complexities surrounding research risk can be addressed. The present paper offers the first systematic overview and ethical analysis of how European and U.S. regulators approach the development of more risk-adapted regulations. The analysis finds that so-called stratified approaches are ethically preferable because they specify risk categories with corresponding subject protections, and thereby reduce unwarranted variation in how research participants are protected in different studies. But the recent proposals for stratifying risk and subject protections raise various ethical concerns, for example regarding the accuracy of risk categories. Building on this analysis, the paper develops recommendations for future policy.

  17. Ethical considerations of research policy for personal genome analysis: the approach of the Genome Science Project in Japan.

    PubMed

    Minari, Jusaku; Shirai, Tetsuya; Kato, Kazuto

    2014-12-01

    As evidenced by high-throughput sequencers, genomic technologies have recently undergone radical advances. These technologies enable comprehensive sequencing of personal genomes considerably more efficiently and less expensively than heretofore. These developments present a challenge to the conventional framework of biomedical ethics; under these changing circumstances, each research project has to develop a pragmatic research policy. Based on the experience with a new large-scale project-the Genome Science Project-this article presents a novel approach to conducting a specific policy for personal genome research in the Japanese context. In creating an original informed-consent form template for the project, we present a two-tiered process: making the draft of the template following an analysis of national and international policies; refining the draft template in conjunction with genome project researchers for practical application. Through practical use of the template, we have gained valuable experience in addressing challenges in the ethical review process, such as the importance of sharing details of the latest developments in genomics with members of research ethics committees. We discuss certain limitations of the conventional concept of informed consent and its governance system and suggest the potential of an alternative process using information technology.

  18. Responsibility, capability, and Active SETI: Policy, law, ethics, and communication with extraterrestrial intelligence

    NASA Astrophysics Data System (ADS)

    Vakoch, Douglas A.

    2011-02-01

    With recently growing interest in the Active Search for Extraterrestrial Intelligence (SETI), in which humankind would send intentional signals to extraterrestrial civilizations, there have been increased concerns about appropriate policy, as well as the role of space law and ethics in guiding such activities. Implicit in these discussions are notions of responsibility and capability that affect judgments about whether humans or other civilizations should initiate transmissions. Existing protocols that guide SETI research address transmissions from Earth, but there is debate over whether these guidelines should inform de novo transmissions as well. Relevant responsibilities to address include (1) looking out for the interests of humankind as a whole, (2) being truthful in interstellar messages, and (3) benefiting extraterrestrial civilizations. Our capabilities as a species and a civilization affect how well we can fulfill responsibilities, as seen when we consider whether we will be able to reach consensus about message contents (and whether that would be desirable), and whether we have the capacity to decode messages from beings that rely on different sensory modalities. The interplay of these responsibilities and capabilities suggests that humankind should place increased emphasis on Active SETI.

  19. Evidence-Based Medicine: Rhinoplasty.

    PubMed

    Lee, Matthew K; Most, Sam P

    2015-08-01

    Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed.

  20. A Comparative Study of Government and Non-Government Ethics Programs, Practices, and Policies

    DTIC Science & Technology

    1992-06-01

    felt to be a foundation for answering the survey questions. The Ethics Resource Center conducted a survey of American business schools and...and under- graduate business school programs. Although ninety percent of the business schools responding indicated that ethics is included in their...there is already some impetus towards standardization. 2. Emphasis« formal ethics training in all undergraduate and graduate business schools . Core

  1. Decoupling Policy and Practice: How Life Scientists Respond to Ethics Education

    ERIC Educational Resources Information Center

    Smith-Doerr, Laurel

    2008-01-01

    Many graduate programmes in science now require courses in ethics. However, little is known about their reception or use. Using websites and interviews, this essay examines ethics requirements in the field of biosciences in three countries (the United States of America, the United Kingdom, and Italy) between 2000 and 2005. Evidence suggests that…

  2. Code of Ethical Conduct for Computer-Using Educators: An ICCE Policy Statement.

    ERIC Educational Resources Information Center

    Computing Teacher, 1987

    1987-01-01

    Prepared by the International Council for Computers in Education's Ethics and Equity Committee, this code of ethics for educators using computers covers nine main areas: curriculum issues, issues relating to computer access, privacy/confidentiality issues, teacher-related issues, student issues, the community, school organizational issues,…

  3. Stem cell tourism and future stem cell tourists: policy and ethical implications.

    PubMed

    Einsiedel, Edna F; Adamson, Hannah

    2012-04-01

    Stem cell tourism is a small but growing part of the thriving global medical tourism marketplace. Much stem cell research remains at the experimental stage, with clinical trials still uncommon. However, there are over 700 clinics estimated to be operating in mostly developing countries--from Costa Rica and Argentina to China, India and Russia--that have lured many patients, mostly from industrialized countries, driven by desperation and hope, which in turn continue to fuel the growth of such tourism. While much research has focused on such dimensions as the promotions that allow such businesses to make their services known, media coverage, some patient research, and regulatory conditions for developing country clinics, little attention has been paid to the non-affected members of the general population, the future potential users of such services. This empirical study based on five focus group discussions with a diverse group of healthy adults in a Canadian city, explored participant views of patients who use stem cell tourism services, the likelihood they would avail themselves of such services if they were to suffer similar illnesses, and the conditions under which they might do so, and the impact that admonitions and advice from international expert bodies might have on their decisions. Our findings suggest that these healthy adults are sympathetic to the drivers of hope and desperation, and, despite cautions about research limitations, may seek such treatments themselves under similar conditions. These findings are discussed in the context of the policy and ethical issues raised by this form of medical tourism.

  4. Genomics for public health improvement: relevant international ethical and policy issues around genome-wide association studies and biobanks.

    PubMed

    Pang, T

    2013-01-01

    Genome-wide association studies and biobanks are at the forefront of genomics research and possess unprecedented potential to improve public health. However, for public health genomics to ultimately fulfill its potential, technological and scientific advances alone are insufficient. Scientists, ethicists, policy makers, and regulators must work closely together with research participants and communities in order to craft an equitable and just ethical framework, and a sustainable environment for effective policies. Such a framework should be a 'hybrid' form which balances equity and solidarity with entrepreneurship and scientific advances. A good balance between research and policy on one hand, and privacy, protection and trust on the other is the key for public health improvement based on advances in genomics science.

  5. Publishing SNP genotypes of human embryonic stem cell lines: policy statement of the International Stem Cell Forum Ethics Working Party.

    PubMed

    Knoppers, Bartha M; Isasi, Rosario; Benvenisty, Nissim; Kim, Ock-Joo; Lomax, Geoffrey; Morris, Clive; Murray, Thomas H; Lee, Eng Hin; Perry, Margery; Richardson, Genevra; Sipp, Douglas; Tanner, Klaus; Wahlström, Jan; de Wert, Guido; Zeng, Fanyi

    2011-09-01

    Novel methods and associated tools permitting individual identification in publicly accessible SNP databases have become a debatable issue. There is growing concern that current technical and ethical safeguards to protect the identities of donors could be insufficient. In the context of human embryonic stem cell research, there are no studies focusing on the probability that an hESC line donor could be identified by analyzing published SNP profiles and associated genotypic and phenotypic information. We present the International Stem Cell Forum (ISCF) Ethics Working Party's Policy Statement on "Publishing SNP Genotypes of Human Embryonic Stem Cell Lines (hESC)". The Statement prospectively addresses issues surrounding the publication of genotypic data and associated annotations of hESC lines in open access databases. It proposes a balanced approach between the goals of open science and data sharing with the respect for fundamental bioethical principles (autonomy, privacy, beneficence, justice and research merit and integrity).

  6. The gap between law and ethics in human embryonic stem cell research: overcoming the effect of U.S. federal policy on research advances and public benefit.

    PubMed

    Taylor, Patrick L

    2005-10-01

    Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States. These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S. patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical review with the many legal compliance issues U.S. federal and state laws create.

  7. Pain in Intellectually Disabled Children: Towards Evidence-Based Pharmacotherapy?

    PubMed

    Valkenburg, Abraham J; de Leeuw, Tom G; van Dijk, Monique; Tibboel, Dick

    2015-10-01

    This critical opinion article deals with the challenges of finding the most effective pharmacotherapeutic options for the management of pain in intellectually disabled children and provides recommendations for clinical practice and research. Intellectual disability can be caused by a wide variety of underlying diseases and may be associated with congenital anomalies such as cardiac defects, small-bowel obstructions or limb abnormalities as well as with comorbidities such as scoliosis, gastro-esophageal reflux disease, spasticity, and epilepsy. These conditions themselves or any necessary surgical interventions are sources of pain. Epilepsy often requires chronic pharmacological treatment with antiepileptic drugs. These antiepileptic drugs can potentially cause drug-drug interactions with analgesic drugs. It is unfortunate that children with intellectual disabilities often cannot communicate pain to caregivers. Although these children are at high risk of experiencing pain, researchers nevertheless often have to exclude them from trials on pain management because of ethical considerations. We therefore make a plea for prescribers, researchers, patient organizations, pharmaceutical companies, and policy makers to study evidence-based, safe and effective pharmacotherapy in these children through properly designed studies. In the meantime, parents and clinicians must resort to validated pain assessment tools such as the revised FLACC scale.

  8. Evidence-Based Cancer Imaging

    PubMed Central

    Khorasani, Ramin

    2017-01-01

    With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients. PMID:28096722

  9. How to understand and conduct evidence-based medicine

    PubMed Central

    2016-01-01

    Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM. PMID:27703623

  10. How to understand and conduct evidence-based medicine.

    PubMed

    Kang, Hyun

    2016-10-01

    Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.

  11. Ethical Implications of Probabilistic Event Attribution for Policy Discussions about Loss and Damage

    NASA Astrophysics Data System (ADS)

    Otto, F. E. L.; Thompson, A.

    2014-12-01

    deaths in a heatwave to man-made climate change is from an ethical point of you very significant and we argue that this has widespread implications, e.g. for pending policy decisions concerning the Warsaw International Mechanism for Loss and Damage.

  12. Future Public Policy and Ethical Issues Facing the Agricultural and Microbial Genomics Sectors of the Biotechnology Industry: A Roundtable Discussion

    SciTech Connect

    Diane E. Hoffmann

    2003-09-12

    On September 12, 2003, the University of Maryland School of Law's Intellectual Property and Law & Health Care Programs jointly sponsored and convened a roundtable discussion on the future public policy and ethical issues that will likely face the agricultural and microbial genomics sectors of the biotechnology industry. As this industry has developed over the last two decades, societal concerns have moved from what were often local issues, e.g., the safety of laboratories where scientists conducted recombinant DNA research on transgenic microbes, animals and crops, to more global issues. These newer issues include intellectual property, international trade, risks of genetically engineered foods and microbes, bioterrorism, and marketing and labeling of new products sold worldwide. The fast paced nature of the biotechnology industry and its new developments often mean that legislators, regulators and society, in general, must play ''catch up'' in their efforts to understand the issues, the risks, and even the benefits, that may result from the industry's new ways of conducting research, new products, and novel methods of product marketing and distribution. The goal of the roundtable was to develop a short list of the most significant public policy and ethical issues that will emerge as a result of advances in these sectors of the biotechnology industry over the next five to six years. More concretely, by ''most significant'' the conveners meant the types of issues that would come to the attention of members of Congress or state legislators during this time frame and for which they would be better prepared if they had well researched and timely background information. A concomitant goal was to provide a set of focused issues for academic debate and scholarship so that policy makers, industry leaders and regulators would have the intellectual resources they need to better understand the issues and concerns at stake. The goal was not to provide answers to any of the

  13. Banking on it: public policy and the ethics of stem cell research and development.

    PubMed

    Giacomini, Mita; Baylis, Francoise; Robert, Jason

    2007-10-01

    If the therapeutic potential of stem cell-based therapies is ever realized, demand for stem cells and derivative tissues will be tremendous and will create new challenges for health care systems, especially publicly funded health care systems. We propose a framework for the ethical analysis of stem cell research and development that considers the welfare of communities, tissue recipients, and cell sources in relation to a range of stem cell production and distribution options. Ethical desiderata include: equitable access, maximized potential therapeutic benefit across demographic and disease groups, and reasonable cost. Other ethical priorities include the minimization of stem cell line and tissue wastage, risk of immune rejection, risk of transmitting diseases, the use of human embryos, and risk to those contributing source cells. We array plausible sources of stem cells and distribution strategies to characterize 12 potential models for producing and distributing cells and tissues in the future. We describe "personalized", "matched", and "universalized" models, and compare the ethical acceptability of these models. Popular and scientific discourses about stem cells typically emphasize personalized or matched stem cell distribution models. We show that universalized models may ultimately best serve the interest of taxpayers, communities and patients who hold high stakes in the therapeutic success of stem cell science. They are therefore highly worthy of scientific pursuit. This conclusion is provisional and the framework must be reapplied as scientific knowledge, technological capacity and ethical mores evolve.

  14. Changing values for nursing and health promotion: exploring the policy context of professional ethics.

    PubMed

    Molloy, J; Cribb, A

    1999-09-01

    In this article we illustrate, and argue for, the importance of researching the social context of health professionals' ethical agendas and concerns. We draw upon qualitative interview data from 20 nurses working in two occupational health sites, and our discussion focuses mainly upon aspects of the shifting 'ethical context' for those nurses with a health promotion remit who are working in the British National Health Service. Within this discussion we also raise a number of potentially substantive issues, including the risks of colluding in 'double standards', and the tensions between the practitioner and managerial roles in nursing. Overall, we hope to pose questions about the best ways to understand the ethical agency and responsibilities of health professionals.

  15. Relational narratives: solving an ethical dilemma concerning an individual's insurance policy.

    PubMed

    Lindsay, R; Graham, H

    2000-03-01

    Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient's nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin's care. Gadow's concept of a relational narrative and Keller's concept of a relational autonomy guide this particular case. As an ethics framework influenced by feminist ethical theory, Gadow's, Keller's and Tisdale's ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing.

  16. Stem cell research as innovation: expanding the ethical and policy conversation.

    PubMed

    Dresser, Rebecca

    2010-01-01

    Research using human embryonic stem cells raises an array of complex ethical issues, including, but by no means limited to, the moral status of developing human life. Unfortunately much of the public discussion fails to take into account this complexity. Advocacy for liberal and conservative positions on human embryonic stem cell research can be simplistic and misleading. Ethical concepts such as truth-telling, scientific integrity, and social justice should be part of the debate over federal support for human embryonic stem cell research. Moreover, the debate should be conducted in accord with principles of deliberative democracy, including respect for people holding competing views.

  17. The ethics of policy writing: how should hospitals deal with moral disagreement about controversial medical practices?

    PubMed Central

    Winkler, E

    2005-01-01

    Every healthcare organisation (HCO) enacts a multitude of policies, but there has been no discussion as to what procedural and substantive requirements a policy writing process should meet in order to achieve good outcomes and to possess sufficient authority for those who are asked to follow it. Using, as an example, the controversy about patient's refusal of blood transfusions, I argue that a hospital wide policy is preferable to individual decision making, because it ensures autonomy, quality, fairness, and efficiency. Policy writing for morally controversial medical practices needs additional justification compared to policies on standard medical practices and secures legitimate authority for HCO members by meeting five requirements: all parties directed by the policy are represented; the deliberative process encompasses all of the HCO's obligations; the rationales for the policy are made available; there is a mechanism for criticising, and for evaluating the policy. PMID:16199594

  18. Mapping and Sequencing the Human Genome: Science, Ethics, and Public Policy.

    ERIC Educational Resources Information Center

    Cutter, Mary Ann G.; Drexler, Edward; McCullough, Laurence B.; McInerney, Joseph D.; Murray, Jeffrey C.; Rossiter, Belinda; Zola, John

    The human genome project started in 1989 with the collaboration of the National Institutes of Health (NIH) and the U.S. Department of Energy (DOE). This document aims to develop an understanding among students of the human genome project and relevant issues. Topics include the science and technology of the human genome project, and the ethical and…

  19. Aequilibrium prudentis: on the necessity for ethics and policy studies in the scientific and technological education of medical professionals

    PubMed Central

    2013-01-01

    Background The importance of strong science, technology, engineering, and mathematics education continues to grow as society, medicine, and the economy become increasingly focused and dependent upon bioscientific and technological innovation. New advances in frontier sciences (e.g., genetics, neuroscience, bio-engineering, nanoscience, cyberscience) generate ethical issues and questions regarding the use of novel technologies in medicine and public life. Discussion In light of current emphasis upon science, technology, engineering, and mathematics education (at the pre-collegiate, undergraduate, graduate, and professional levels), the pace and extent of advancements in science and biotechnology, the increasingly technological orientation and capabilities of medicine, and the ways that medicine – as profession and practice – can engage such scientific and technological power upon the multi-cultural world-stage to affect the human predicament, human condition, and perhaps nature of the human being, we argue that it is critical that science, technology, engineering, and mathematics education go beyond technical understanding and directly address ethical, legal, social, and public policy implications of new innovations. Toward this end, we propose a paradigm of integrative science, technology, ethics, and policy studies that meets these needs through early and continued educational exposure that expands extant curricula of science, technology, engineering, and mathematics programs from the high school through collegiate, graduate, medical, and post-graduate medical education. We posit a synthetic approach that elucidates the historical, current, and potential interaction of scientific and biotechnological development in addition to the ethico-legal and social issues that are important to educate and sustain the next generation of medical and biomedical professionals who can appreciate, articulate, and address the realities of scientific and biotechnological

  20. School Centered Evidence Based Accountability

    ERIC Educational Resources Information Center

    Milligan, Charles

    2015-01-01

    Achievement scores drive much of the effort in today's accountability system, however, there is much more that occurs in every school, every day. School Centered Evidence Based Accountability can be used from micro to macro giving School Boards and Administration a process for monitoring the results of the entire school operation effectively and…

  1. A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

    PubMed

    Ferrie, Suzie

    2006-04-01

    Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

  2. Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy

    PubMed Central

    Sarnaik, Ajit A.

    2015-01-01

    The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation. PMID:26636051

  3. Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy.

    PubMed

    Sarnaik, Ajit A

    2015-01-01

    The lifesaving processes of organ donation and transplantation in neonatology and pediatrics carry important ethical considerations. The medical community must balance the principles of autonomy, non-maleficence, beneficence, and justice to ensure the best interest of the potential donor and to provide equitable benefit to society. Accordingly, the US Organ Procurement and Transplantation Network (OPTN) has established procedures for the ethical allocation of organs depending on several donor-specific and recipient-specific factors. To maximize the availability of transplantable organs and opportunities for dying patients and families to donate, the US government has mandated that hospitals refer potential donors in a timely manner. Expedient investigation and diagnosis of brain death where applicable are also crucial, especially in neonates. Empowering trained individuals from organ procurement organizations to discuss organ donation with families has also increased rates of consent. Other efforts to increase organ supply include recovery from donors who die by circulatory criteria (DCDD) in addition to donation after brain death (DBD), and from neonates born with immediately lethal conditions such as anencephaly. Ethical considerations in DCDD compared to DBD include a potential conflict of interest between the dying patient and others who may benefit from the organs, and the precision of the declaration of death of the donor. Most clinicians and ethicists believe in the appropriateness of the Dead Donor Rule, which states that vital organs should only be recovered from people who have died. The medical community can maximize the interests of organ donors and recipients by observing the Dead Donor Rule and acknowledging the ethical considerations in organ donation.

  4. A proposed non-consequentialist policy for the ethical distribution of scarce vaccination in the face of an influenza pandemic.

    PubMed

    McLachlan, Hugh V

    2012-05-01

    The current UK policy for the distribution of scarce vaccination in an influenza pandemic is ethically dubious. It is based on the planned outcome of the maximum health benefit in terms of the saving of lives and the reduction of illness. To that end, the population is classified in terms of particular priority groups. An alternative policy with a non-consequentialist rationale is proposed in the present work. The state should give the vaccination, in the first instance, to those who are at risk of catching the pandemic flu in the line of their duties of public employment. Thereafter, if there is not sufficient vaccine to give all citizens equally an effective dose, the state should give all citizens an equal chance of receiving an effective dose. This would be the just thing to do because the state has a duty to treat each and all of its citizens impartially and they have a corresponding right to such impartial treatment. Although this article specifically refers to the UK, it is considered that the suggested alternative policy would be applicable generally. The duty to act justly is not merely a local one.

  5. Ethics, Education Policy and Research: The Phonics Question Reconsidered

    ERIC Educational Resources Information Center

    Ellis, Sue; Moss, Gemma

    2014-01-01

    This paper argues that direct control of the early years literacy curriculum recently exercised by politicians in England has made the boundaries between research, policy and practice increasingly fragile. It describes how policy came to focus most effort on the use of synthetic phonics programmes in the early years. It examines why the…

  6. Epistemology as Ethics in Research and Policy: The Use of Case Studies

    ERIC Educational Resources Information Center

    Elliott, John; Lukes, Dominik

    2008-01-01

    This article examines the ethnographic case study in education in the context of policy making with particular emphasis on the practice of research and policy making. The central claim of the article is that it is impossible to establish a transcendental epistemology of the case study on instrumental rationality. Instead it argues for the notion…

  7. Peter Bourne’s Drug Policy and the Perils of a Public Health Ethic, 1976–1978

    PubMed Central

    Dufton, Emily

    2015-01-01

    As President Jimmy Carter’s advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne’s critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne’s resignation, and present the story of his departure as a cautionary tale for today’s drug policy reformers. PMID:25521893

  8. Does the Shoe Fit? Ethical, Legal, and Policy Considerations of Global Positioning System Shoes for Individuals with Alzheimer's Disease.

    PubMed

    Yang, Y Tony; Kels, Charles G

    2016-08-01

    As the overall incidence of Alzheimer's disease rises, the burden on caregivers and law enforcement institutions will increase to find individuals who wander. As such, technological innovations that could reduce this burden will become increasingly important. One such innovation is the GPS Shoe. As with any innovation involving the transfer of personal data to third parties, potential pitfalls with respect to loss of privacy and inadequate consent counterbalance the substantial promise of GPS shoes. To some extent, advance planning can mitigate these concerns, wherein individuals willingly elect to be monitored before their impairments progress to a stage that makes such authorization impractical. Nonetheless, tension may arise between the peace of mind of caregivers and family members and other important considerations at the intersection of autonomy, privacy, dignity, and consent. Ultimately, confronting ethical, legal, and policy considerations at the front end of product development and deployment will help ensure that new technologies are used wisely and that their lifesaving potential is realized.

  9. Putting Public Health Ethics into Practice: A Systematic Framework

    PubMed Central

    Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

    2015-01-01

    It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

  10. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

    PubMed

    Rudrum, Sarah

    2016-01-01

    The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

  11. Ethics and policy issues for stem cell research and pulmonary medicine.

    PubMed

    Lowenthal, Justin; Sugarman, Jeremy

    2015-03-01

    Stem cell research and related initiatives in regenerative medicine, cell-based therapy, and tissue engineering have generated considerable scientific and public interest. Researchers are applying stem cell technologies to chest medicine in a variety of ways: using stem cells as models for drug discovery, testing stem cell-based therapies for conditions as diverse as COPD and cystic fibrosis, and producing functional lung and tracheal tissue for physiologic modeling and potential transplantation. Although significant scientific obstacles remain, it is likely that stem cell-based regenerative medicine will have a significant clinical impact in chest medicine. However, stem cell research has also generated substantial controversy, posing a variety of ethical and regulatory challenges for research and clinical practice. Some of the most prominent ethical questions related to the use of stem cell technologies in chest medicine include (1) implications for donors, (2) scientific prerequisites for clinical testing and use, (3) stem cell tourism, (4) innovation and clinical use of emerging stem cell-based interventions, (5) responsible translation of stem cell-based therapies to clinical use, and (6) appropriate and equitable access to emerging therapies. Having a sense of these issues should help to put emerging scientific advances into appropriate context and to ensure the responsible clinical translation of promising therapeutics.

  12. Involving citizens in the ethics of biobank research: informing institutional policy through structured public deliberation.

    PubMed

    O'Doherty, Kieran C; Hawkins, Alice K; Burgess, Michael M

    2012-11-01

    This paper reports on the design, implementation, and results of a structured public deliberation on human tissue biobanking conducted in Vancouver, Canada, in 2009. This study builds on previous work on the use of deliberative democratic principles and methods to engage publics on the social and ethical implications of human tissue biobanking. In a significant refinement of methods, we focus on providing public input to institutional practice and governance of biobanks using a tailored workbook structure to guide participants' discussion. Our focus is on the local context and practices of a particular institution, the BC BioLibrary. However, elements of both the methodological innovations and the ethical guidance implied by our findings are generalisable for biobanking internationally. Recommendations from the deliberative forum include issues of informed consent, privacy protections, collection of biospecimens, governance of biobanks, and how to manage the process of introduction between biobanks and potential donors. Notable findings include public support for research use of anonymised un-consented tissue samples when these come from archived collections, but lack of support when they are collected prospectively.

  13. Research infrastructures, policies and the 'web of prevention': the ethical implications of inadequate research environments.

    PubMed

    Bezuidenhout, Louise

    2012-01-01

    The dual-use potential of scientific research refers to the possibility that any beneficial scientific research may be misused for nefarious purposes by a third party. This potential within the life sciences has led to much discussion regarding ways to raise awareness and limit possible harm. The concept of a 'web of prevention' as a multifaceted system for addressing this potential for harm provides a comprehensive method of conceptualizing a system of controls in the life sciences. The web of prevention involves multiple stakeholders, from diverse backgrounds such as science, public health, security studies and governance. Research within the life sciences relies on a number of different structures, such as waste disposal and border controls, which provide a comprehensive environment for scientists to work in. The web of prevention relies on the assumption of these systems working to support any further initiatives that are proposed. Unfortunately, in many countries around the world, these systems are insufficiently addressed, which may raise ethical problems. Structural problems may undermine the web of prevention and alter the responsibilities attributed to the individual scientist within this system. Examples from sub-Saharan Africa illustrate two pertinent structural difficulties, and these are discussed in relation to ethical responsibilities.

  14. Ethics and Policy Issues for Stem Cell Research and Pulmonary Medicine

    PubMed Central

    Lowenthal, Justin

    2015-01-01

    Stem cell research and related initiatives in regenerative medicine, cell-based therapy, and tissue engineering have generated considerable scientific and public interest. Researchers are applying stem cell technologies to chest medicine in a variety of ways: using stem cells as models for drug discovery, testing stem cell-based therapies for conditions as diverse as COPD and cystic fibrosis, and producing functional lung and tracheal tissue for physiologic modeling and potential transplantation. Although significant scientific obstacles remain, it is likely that stem cell-based regenerative medicine will have a significant clinical impact in chest medicine. However, stem cell research has also generated substantial controversy, posing a variety of ethical and regulatory challenges for research and clinical practice. Some of the most prominent ethical questions related to the use of stem cell technologies in chest medicine include (1) implications for donors, (2) scientific prerequisites for clinical testing and use, (3) stem cell tourism, (4) innovation and clinical use of emerging stem cell-based interventions, (5) responsible translation of stem cell-based therapies to clinical use, and (6) appropriate and equitable access to emerging therapies. Having a sense of these issues should help to put emerging scientific advances into appropriate context and to ensure the responsible clinical translation of promising therapeutics. PMID:25732448

  15. Ethics in Practice

    ERIC Educational Resources Information Center

    Medlin, E. Lander

    2010-01-01

    Ethics is defined as a set of guidelines and/or rules for the conduct of individual behavior in an organization or civil society. This ethical code of conduct is intended to guide policies, practices, and decision-making for employees on behalf of the organization. This article explores the importance of ethics, the basis for making ethical…

  16. Sepsis management: An evidence-based approach.

    PubMed

    Baig, Muhammad Akbar; Shahzad, Hira; Jamil, Bushra; Hussain, Erfan

    2016-03-01

    The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care units are not adequately equipped and financial concerns limit implementation of expensive treatment strategies. Healthcare policy-makers should be notified in order to alleviate financial restrictions and ensure delivery of standard care to septic patients.

  17. Not Funding the Evidence-Based Model in Ohio

    ERIC Educational Resources Information Center

    Edlefson, Carla

    2010-01-01

    The purpose of this descriptive case study was to describe the implementation of Ohio's version of the Evidence-Based Model (OEBM) state school finance system in 2009. Data sources included state budget documents and analyses as well as interviews with local school officials. The new system was responsive to three policy objectives ordered by the…

  18. Are ethical norms and current policies still relevant in face of the recent mass terror events?

    PubMed

    Simon, Tomer; Goldberg, Avishay; Adini, Bruria

    2016-10-04

    The widespread utilization of social media in recent terror attacks in major European cities should raise a "red flag" for the emergency medical response teams. The question arises as to the impact of social media during terror events on the healthcare system. Information was published well before any emergency authority received a distress call or was requested to respond. Photos published at early stages of the attacks, through social media were uncensored, presenting identifiable pictures of victims. Technological advancements of recent years decrease and remove barriers that enable the public to use them as they see fit. These attacks raise ethical considerations for the patients and their rights as they were outsourced from the medical community, into the hands of the public. The healthcare system should leverage social media and its advantages in designing response to terror, but this requires a re-evaluation and introspection into the current emergency response models.

  19. Street Children and The Work Ethic: New Policy for an Old Moral, Nairobi (Kenya)

    ERIC Educational Resources Information Center

    Droz, Yvan

    2006-01-01

    Kenyan policy-makers use the language of children's rights to legitimize, within the new global political order, an old colonial concern about controlling the urban marginal population. The local business community's worries about the safety of Nairobi's streets stand paramount, while the growing financial and political leverage of NGOs…

  20. Ethical Principles as a Guide in Implementing Policies for the Management of Food Allergies in Schools

    ERIC Educational Resources Information Center

    Behrmann, Jason

    2010-01-01

    Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to…

  1. Sport Governance and Policy Development: An Ethical Approach to Managing Sport in the 21st Century

    ERIC Educational Resources Information Center

    Sawyer, Thomas H.; Bodey, Kimberly J.; Judge, Lawrence W.

    2008-01-01

    "Sport Governance and Policy Development" is written with the sport management student in mind. Designed to address the curriculum standards set by the National Association for Sport and Physical Education and the North American Society for Sport Management, this book provides information to meet core and related competency areas required for the…

  2. The influence and ethics of interest groups on policy incentives for clean energy development

    NASA Astrophysics Data System (ADS)

    Maguire, Mariana C.

    The clean energy revolution in the United States is not going to happen until diverse stakeholders in the coalition of clean energy proponents strengthen their cohesion and influence—two critical tools for interest group's to be successful in driving the formulation of public policy. Currently, clean energy technology and resource development is supported by a highly diverse coalition of interest groups such as environmental groups, health organizations, industry, and the Defense Department, whose primary goals are often unrelated. Yet their objectives are increasingly well served by pursuing clean energy development by pushing lawmakers for supportive policies. However, characteristics of this ad hoc coalition can hinder its influence and cohesion. Whereas, fossil fuel interests—exemplified by the coalition of oil proponents—are highly cohesive and influential. This thesis will analyze whether there is a correlation between public policies on clean energy, and the strength of interest group influence over those policy decisions. It will begin with an analysis of interest group theories. Next it will analyze the histories of the oil industry as the model opponent of clean energy policies, and the biofuels, wind energy, and solar energy industries as the model proponents of clean energy policies. The composition of the respective coalitions will reveal if they are diverse or similar, with broad or narrow goals, and other important characteristics. Their respective policy positions and messages will show what values are important to them, and the presidential support each coalition has been achieved, or failed to achieve, will provide further insight into their effectiveness. This thesis will then apply interest group theories to the supporter and opponent coalitions. Results obtained indicate that the coalition of oil interests is large, yet very cohesive and influential, while the coalition for clean energy is large, generally diffuse but with some important

  3. Strategies for Teaching Internet Ethics.

    ERIC Educational Resources Information Center

    Rader, Martha H.

    2002-01-01

    Ten strategies for teaching Internet ethics are as follows: establish acceptable use policy; communicate ethical codes; model behaviors and values; encourage discussion of ethical issues; reinforce ethical conduct; monitor student behavior; secure systems and software; discourage surfing without supervision; monitor e-mail and websites; and…

  4. Addressing the ethical, policy, and social challenges of preclinical Alzheimer disease.

    PubMed

    Karlawish, Jason

    2011-10-11

    Research suggests that Alzheimer disease (AD) pathophysiology begins prior to the clinical expression of the disease and that biomarker measures may provide direct evidence of this process. As a result, it may be possible to uncouple the diagnosis of AD from the clinical expression of the disease. The shifting boundaries between normal brain aging and disease present 3 challenges: 1) establishing guidelines for researchers and clinicians to safely and effectively communicate the diagnosis of preclinical AD, 2) setting up a process that effectively translates this diagnosis into practice and policy, and 3) adapting laws, regulations, and professional practices to the diagnosis of preclinical AD. The field of genetic testing for AD suggests how to balance a patient's desire to know his or her risk of developing dementia with a clinician's desire to mitigate the potential harms of that information. The development of diagnostic and treatment guidelines for other diseases of aging, such as cardiovascular disease, suggests the need for a National Alzheimer's Education Program to develop policies and procedures to translate preclinical AD into both clinical practice and policy. Revisions are needed to laws, regulations, and professional practices governing driving, financial management and planning, and privacy and confidentiality.

  5. Addressing the ethical, policy, and social challenges of preclinical Alzheimer disease

    PubMed Central

    2011-01-01

    Research suggests that Alzheimer disease (AD) pathophysiology begins prior to the clinical expression of the disease and that biomarker measures may provide direct evidence of this process. As a result, it may be possible to uncouple the diagnosis of AD from the clinical expression of the disease. The shifting boundaries between normal brain aging and disease present 3 challenges: 1) establishing guidelines for researchers and clinicians to safely and effectively communicate the diagnosis of preclinical AD, 2) setting up a process that effectively translates this diagnosis into practice and policy, and 3) adapting laws, regulations, and professional practices to the diagnosis of preclinical AD. The field of genetic testing for AD suggests how to balance a patient's desire to know his or her risk of developing dementia with a clinician's desire to mitigate the potential harms of that information. The development of diagnostic and treatment guidelines for other diseases of aging, such as cardiovascular disease, suggests the need for a National Alzheimer's Education Program to develop policies and procedures to translate preclinical AD into both clinical practice and policy. Revisions are needed to laws, regulations, and professional practices governing driving, financial management and planning, and privacy and confidentiality. PMID:21917767

  6. What does social justice require for the public's health? Public health ethics and policy imperatives.

    PubMed

    Gostin, Lawrence O; Powers, Madison

    2006-01-01

    Justice is so central to the mission of public health that it has been described as the field's core value. This account of justice stresses the fair disbursement of common advantages and the sharing of common burdens. It captures the twin moral impulses that animate public health: to advance human well-being by improving health and to do so particularly by focusing on the needs of the most disadvantaged. This Commentary explores how social justice sheds light on major ongoing controversies in the field, and it provides examples of the kinds of policies that public health agencies, guided by a robust conception of justice, would adopt.

  7. Broader impacts: international implications and integrative ethical consideration of policy decisions about US chimpanzee research.

    PubMed

    Bennett, Allyson J; Panicker, Sangeeta

    2016-12-01

    Recent decisions and unprecedented evaluative processes about research with chimpanzees (Pan troglodytes) by the US National Institutes of Health (NIH) continue to attract widespread attention by the public, media, and scientific community. Over the past 5 years, actions by the NIH and the United States Fish and Wildlife Services, have significantly truncated valuable scientific research and jeopardized future research. From a global perspective, the decisions have broad consequences for research aimed not only at human health, but also the conservation and welfare of other species. Full consideration of the role that research plays in improving animal welfare in captivity and in the wild, and the impact of the loss of access to chimpanzees for research, remains largely unexamined. At the same time, legal initiatives aimed at protecting chimpanzees by granting them "personhood" status have increasingly raised questions about equity in standards, oversight, and transparency for chimpanzees in other captive settings. Together, the decisions, subsequent actions, and public discussion put the growing need for a more integrative and global approach to decision-making about the future of captive chimpanzees into sharp relief. In this paper, we outline an expansive framework for ethical consideration to guide dialogue and decisions about animal research, welfare, and equitable treatment of nonhuman animals across settings. Regardless of the setting in which animals live, science plays an indispensable role in informing decisions about individual, species, societal, and environmental health. Thus, the scientific community and broader public need to engage in serious and thoughtful deliberations to weigh the harms and benefits of conducting (or failing to conduct) research that transcends geographic borders and that can guide responsible and informed decisions about the future of chimpanzees.

  8. [Evidence-based TEP technique].

    PubMed

    Köckerling, F

    2017-01-13

    The guidelines of all international hernia societies recommend as procedures of choice the laparoendoscopic techniques total extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) as well as the open Lichtenstein operation for elective inguinal hernia repair. The learning curve associated with the laparoendoscopic techniques, in particular TEP, is longer than that for the open Lichtenstein technique due to the complexity of the procedures. Accordingly, for laparoendoscopic techniques it is particularly important that the operations are conducted in a standardized manner in compliance with the evidence-based recommendations given for the technical details. When procedures are carried out in strict compliance with the guidelines of the international hernia societies, low rates of perioperative complications, complication-related reoperations, recurrences and chronic pain can be expected for TEP. Compliance with the guidelines can also positively impact mastery of the learning curve for TEP. The technical guidelines on TEP are based on study results and on the experiences of numerous experts; therefore, it is imperative that they are implemented in routine surgical practice.

  9. From Opinion-Based to Evidence-Based Social Work: The Swedish Case

    ERIC Educational Resources Information Center

    Sundell, Knut; Soydan, Haluk; Tengvald, Karin; Anttila, Sten

    2010-01-01

    This article presents an account of Sweden's Institute for Evidence-Based Social Work Practice (IMS), located in Stockholm, Sweden. The article places IMS in the context of making Swedish social care services less opinion-based and more evidence-based. The institute is an example of how policy-driven processes promote the use of evidence-based…

  10. Is Evidence-Based Practice Diverse Enough? Philosophy of Science Considerations

    ERIC Educational Resources Information Center

    Wendt, Dennis C., Jr.; Slife, Brent D.

    2007-01-01

    In its policy rationale for evidence-based practice in psychology (EBPP), the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) claims to have constituted itself with "scientists and practitioners from a wide range of perspectives and traditions, reflecting the diverse perspectives within the field" (p. 273). We…

  11. Network Influences on Dissemination of Evidence-Based Guidelines in State Tobacco Control Programs

    ERIC Educational Resources Information Center

    Luke, Douglas A.; Wald, Lana M.; Carothers, Bobbi J.; Bach, Laura E.; Harris, Jenine K.

    2013-01-01

    Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's "Best Practices for Comprehensive Tobacco Control Programs," are…

  12. Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

    ERIC Educational Resources Information Center

    Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

    2012-01-01

    Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

  13. Perspectives on the ethical concerns and justifications of the 2006 Centers for Disease Control and Prevention HIV testing: HIV screening policy changes

    PubMed Central

    2013-01-01

    Background The 2006 Centers for Disease Control and Prevention (CDC) revised recommendations for HIV testing in clinical settings contained seven specific changes to how health care facilities should provide HIV testing. These seven elements have been both supported and challenged in the lay and medical literature. Our first paper in BMC Medical Ethics presented an analysis of the three HIV testing procedural changes included in the recommendations. In this paper, we address the four remaining elements that concern HIV screening policy changes: (1) nontargeted HIV screening, (2) making HIV screening similar to screening for other treatable conditions, (3) increasing HIV screening without assured additional funding for linkage to care, and (4) making patients bear the costs of increased HIV screening in health care settings. Methods We interviewed 25 members from the fields of US HIV advocacy, care, policy, and research about the ethical merits and demerits of the four changes to HIV screening policies. We performed a qualitative analysis of the participant responses in the interviews and summarized the major themes. Results Participants commented that nontargeted HIV screening and making HIV screening similar to screening for other treatable medical conditions was ethical when it broadened the scope of people being tested for HIV. However, they believed it was unethical when it did not respect the exceptional nature of HIV and HIV testing. Some participants favored more testing regardless if there was assured additional funding for linkage to care or if patients might bear the costs of testing because they believed that merely alerting patients of their status was beneficial and would lead to positive consequences. Other participants found ethical flaws with testing without assured linkage to care and patients bearing the costs of testing, as this could discriminate against those who could not pay. Conclusions Our findings suggest that there are fundamental ethical

  14. Global health: the importance of evidence-based medicine

    PubMed Central

    2013-01-01

    Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes. PMID:24228722

  15. Global health: the importance of evidence-based medicine.

    PubMed

    Birbeck, Gretchen L; Wiysonge, Charles S; Mills, Edward J; Frenk, Julio J; Zhou, Xiao-Nong; Jha, Prabhat

    2013-10-16

    Global health is a varied field that comprises research, evaluation and policy that, by its definition, also occurs in disparate locations across the world. This forum article is introduced by our guest editor of the Medicine for Global Health article collection, Gretchen Birbeck. Here, experts based across different settings describe their personal experiences of global health, discussing how evidence-based medicine in resource-limited settings can be translated into improved health outcomes.

  16. Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context: Comment on "Why and How Is Compassion Necessary to Provide Good Quality Healthcare?".

    PubMed

    Mercer, Dave

    2015-07-10

    In response to the International Journal of Health Policy and Management (IJHPM) editorial, this commentary adds to the debate about ethical dimensions of compassionate care in UK service provision. It acknowledges the importance of the original paper, and attempts to explore some of the issues that are raised in the context of nursing practice, research and education. It is argued that each of these fields of the profession are enacted in an escalating culture of corporatism, be that National Health Service (NHS) or university campus, and global neoliberalism. Post-structuralist ideas, notably those of Foucault, are borrowed to interrogate healthcare as discursive practice and disciplinary knowledge; where an understanding of the ways in which power and language operate is prominent. Historical and contemporary evidence of institutional and ideological degradation of sections of humanity, a 'history of the present,' serve as reminders of the import, and fragility, of ethical codes.

  17. The development of evidence-based nursing.

    PubMed

    French, P

    1999-01-01

    This paper argues that the current conception of evidence-based medicine has its limitations in the promotion of research which effects the quality of service in any health care system. It also poses something of a difficulty for the development of evidence-based nursing in particular. This paper advocates the more broad based concept of evidence-based practice and discusses its potential for addressing theory/practice problems and the uptake of nursing research. The broader conceptualization of evidence-based practice focuses on the integration of available evidence and the tacit knowledge of the investigator. An evidence-based practice project undertaken in Hong Kong is outlined as this provided the basis of many of the conclusions made in this paper. Three vignettes are given in order to demonstrate the nature of the evidence-based practice projects which have been conducted. The critical elements of evidence-based practice projects are outlined. Finally issues concerning the process of generating evidence, the relationship to continuous quality improvement and the cost effectiveness of evidence-based practice are discussed in more detail.

  18. Making Evidence-based Practice Educational.

    ERIC Educational Resources Information Center

    Elliott, John

    2001-01-01

    Examines David Hargreaves' ideas about the nature of evidence-based practice and the future direction for educational research. States that one major theme is that current discourse about evidence-based teaching is uninformed by an articulate educational theory, therefore excluding thoughtful consideration of implications of such a theory for…

  19. An evidence-based business planning process.

    PubMed

    Brandt, Julie A; Reed Edwards, Donna; Cox Sullivan, Sheila; Zehler, Jean K; Grinder, Sandra; Scott, Karen J; Cook, Judy H; Roper, Debra; Dickey, Aurora; Maddox, Kathleen L

    2009-12-01

    Using a systematic, evidence-based approach for developing a business plan allows nurse executives to forecast the needs of the organization, involve nursing staff at all levels, evaluate the direction of the profession, and present a plan with clear, concise goals. The authors describe 4 steps necessary in developing an effective evidence-based business plan.

  20. Evidence-Based Practices in Secondary Transition

    ERIC Educational Resources Information Center

    Test, David W.; Fowler, Catherine H.; Richter, Sharon M.; White, James; Mazzotti, Valerie; Walker, Allison R.; Kohler, Paula; Kortering, Larry

    2009-01-01

    A literature review was conducted to identify evidence-based practices in secondary transition using quality indicator checklists for experimental research. Practices were categorized by the Taxonomy for Transition Programming. Overall, 32 secondary transition evidence-based practices were identified. Two practices had a strong level of evidence,…

  1. Evidence-based practice and the need for paradigmatic pluralism in cognitive behavioural psychotherapy.

    PubMed

    Grant, A

    2009-05-01

    The scientist-practitioner model, which is based on positivistic methodological assumptions, is influential in the development, training and practice of cognitive behavioural psychotherapists. As the emergence of 'Nurse Cognitive Behavioural Therapist' training in the early 1970s in Britain, many of those trained have been mental health nurses and with the emergence of the Increased Access to Psychological Therapies agenda many more are likely to undergo training. Despite some acceptance of its relevance, the scientist-practitioner model is subject of criticism on the grounds of its achievability and contemporary relevance, and its exclusion of other modalities of counselling and psychotherapy without an, as yet, disseminated evidence base. In line with key policy-related work, the empirical and political issues inscribed within the scientist-practitioner model have direct implications for the educational preparation and ongoing professional development of cognitive behavioural practitioners. Specifically, in this polemical paper it is argued that there is a moral and educational need for 'senior' practitioners to question the philosophy of science assumptions underpinning the overwhelming dominance of the quantitative-experimental approach in cognitive behavioural psychotherapy. Such a critically evaluative and pluralistic stance would arguably distinguish senior practitioners in terms of them being able to make broad rather than narrow appraisals of the evidence base for their practice. A recognition of the relevance of paradigmatic and epistemological pluralism in cognitive behavioural work would, it is argued, confer considerable advantages on our practice communities and clients. A range of emerging implications for cognitive behavioural education, practice and relational ethics are described and discussed.

  2. Towards Evidence Based Usability in Health Informatics?

    PubMed

    Marcilly, Romaric; Peute, Linda W; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W

    2015-01-01

    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still lacking. This paper underlines the need for evidence based HIT design and provides a definition of evidence based usability practice as the conscientious, explicit and judicious use of current best evidence in making decisions in design of interactive systems in health by applying usability engineering and usability design principles that have proven their value in practice. Current issues that hamper evidence based usability practice are highlighted and steps needed to achieve evidence are presented.

  3. The need for perspective in evidence-based medicine.

    PubMed

    Woolf, S H

    Research advances are generating a growing body of clinical trial and other data on the effects of tests and treatments on outcomes, but there is no information resource within the health care system that systematically puts that information in perspective. Policy makers, clinicians, and individuals lack a ready means to compare the relative effectiveness of various interventions in prolonging survival or preventing the occurrence or complications of a disease: information that is critical in setting priorities. A crude analysis of preventable deaths suggests that evidence-based primary prevention (getting the population to stop smoking, exercise, lower cholesterol levels, and control blood pressure) would prevent considerably more deaths per year than would various evidence-based treatments for cardiovascular disease. Examining evidence from this perspective calls attention to mismatched priorities-most health care expenditures in the United States go toward treatment of diseases and their late-stage complications and relatively few resources are devoted to primary prevention and health promotion. Similar analyses at the individual level can help patients put personal options in perspective. This article proposes a bibliographic evidence-collection center and simulation modeling program to estimate potential benefits and harms of competing interventions for populations and individuals. Such evidence-based projections would enable policy makers, clinicians, and patients to judge whether they give due priority to the interventions most likely to improve health. With the steady growth in research data, the need for a system that enables society and individuals to put evidence in perspective will become progressively more urgent.

  4. Environmental Studies and Utilitarian Ethics

    ERIC Educational Resources Information Center

    Wolff, Brian G.

    2008-01-01

    Environmental ethicists have focused much attention on the limits of utilitarianism and have generally defined "environmental ethics" in a manner that treats utilitarian environmental ethics as an oxymoron. This is unfortunate because utilitarian ethics can support strong environmental policies, and environmental ethicists have not yet produced a…

  5. Environmental Studies and Utilitarian Ethics

    ERIC Educational Resources Information Center

    Wolff, Brian G.

    2009-01-01

    Environmental ethicists have focused much attention on the limits of utilitarianism and have generally defined "environmental ethics" in a manner that treats utilitarian environmental ethics as an oxymoron. This is unfortunate because utilitarian ethics can support strong environmental policies, and environmental ethicists have not yet produced a…

  6. Argument-based medical ethics: a formal tool for critically appraising the normative medical ethics literature.

    PubMed

    McCullough, Laurence B; Coverdale, John H; Chervenak, Frank A

    2004-10-01

    Although there are critical appraisal tools for other genres of the medical literature, there currently is no formal tool for physicians to use in their critical appraisal of the normative medical ethics literature. We present a formal assessment tool for the critical appraisal of the normative medical ethics literature that incorporates the intellectual standards of argument-based medical ethics and evidence-based medicine. We draw on the intellectual standards of argument-based ethics, ethical analysis and argument, and the literature on evidence-based medicine. The tool involves 4 questions about normative medical ethics papers: (1) Does the article address a focused ethics question? (2) Are the arguments that support the results of the article valid? (3) What are the results? (4) Will the results help me in clinical practice? Obstetrician-gynecologists can use this tool to appraise the normative literature of ethics in obstetrics and gynecology formally.

  7. Yesterday's war; tomorrow's technology: peer commentary on ‘Ethical, legal, social and policy issues in the use of genomic technologies by the US military’

    PubMed Central

    Evans, Nicholas G.; Moreno, Jonathan D.

    2014-01-01

    A recent article by Maxwell J. Mehlman and Tracy Yeheng Li, in the Journal of Law and the Biosciences, sought to examine the ethical, legal, social, and policy issues associated with the use of genetic screening and germ-line therapies (‘genomic technologies’) by the US Military. In this commentary, we will elaborate several related matters: the relationship between genetic and non-genetic screening methods, the history of selection processes and force strength, and the consequences and ethics of, as Mehlman and Li suggest, engineering enhanced soldiers. We contend, first, that the strengths of genomic testing as a method of determining enrollment in the armed forces has limited appeal, given the state of current selection methods in the US armed forces. Second, that the vagaries of genetic selection, much like other forms of selection that do not bear causally or reliably on soldier performance (such as race, gender, and sexuality), pose a systematic threat to force strength by limiting the (valuable) diversity of combat units. Third, that the idea of enhancing warfighters through germ-line interventions poses serious ethical issues in terms of the control and ownership of ‘enhancements’ when members separate from service. PMID:27774182

  8. Issues in biomedical ethics.

    PubMed

    Vevaina, J R; Nora, L M; Bone, R C

    1993-12-01

    Bioethics is the discipline of ethics dealing with moral problems arising in the practice of medicine and the pursuit of biomedical research. Physicians may confront ethical dilemmas regularly in their individual relationships with patients and in institutional and societal decisions on health care policy. Ethical problem solving requires the application of certain ethical rules and principles to specific situations. Although ethical theories differ, certain ethical rules and principles appear consistently. These include nonmaleficence, beneficence, respect for individual autonomy, confidentiality, and justice. This article discusses some of the ethical issues that arise in clinical practice, including informed consent, do-not-resuscitate orders, noninitiation and termination of medical therapy, genetic intervention, allocation of scarce health resources, and infection with the human immunodeficiency virus (HIV). Some of these problems require ethical analysis at the bedside; others require physician involvement on a broader level. Perspectives on the different ethical issues are presented; however, absolute answers to these ethical dilemmas are not provided. Interpretation of the ethical principles and the application of these principles to each clinical situation demands the thoughtful attention of the practitioner.

  9. [Ethics, empiricism and uncertainty].

    PubMed

    Porz, R; Zimmermann, H; Exadaktylos, A K

    2011-01-01

    Accidents can lead to difficult boundary situations. Such situations often take place in the emergency units. The medical team thus often and inevitably faces professional uncertainty in their decision-making. It is essential to communicate these uncertainties within the medical team, instead of downplaying or overriding existential hurdles in decision-making. Acknowledging uncertainties might lead to alert and prudent decisions. Thus uncertainty can have ethical value in treatment or withdrawal of treatment. It does not need to be covered in evidence-based arguments, especially as some singular situations of individual tragedies cannot be grasped in terms of evidence-based medicine.

  10. Ethical, legal, social, and policy issues in the use of genomic technology by the U.S. Military

    PubMed Central

    Mehlman, Maxwell J.; Li, Tracy Yeheng

    2014-01-01

    Advances in genomic science are attracting the interest of the U.S. military for their potential to improve medical care for members of the military and to aid in military recruitment, training, specialization, and mission accomplishment. While researchers have explored the ethical, legal, and social issues raised by the use of genomic science in a wide variety of contexts, there has been virtually no examination of these issues in connection with the use of genomics by the military. This article identifies potential uses of genomic science by the military, proposes an applicable ethical and legal framework, and applies the framework to provide ethical and legal guidance for military decision-makers. PMID:25937933

  11. PHM-Ethics and ETICA: complementary approaches to ethical assessment.

    PubMed

    Mittelstadt, Brent; Stahl, Bernd; Fairweather, Ben

    2013-01-01

    The chapter undertakes a comparison of different approaches to the ethical assessment of novel technologies by looking at two recent research projects. ETICA was a FP7 sister project to PHM-Ethics, responsible for identification and ethical evaluation of information and communication technologies emerging in the next 10-15 years. The aims, methods, outcomes and recommendations of ETICA are compared to those of PHM-Ethics, with identification of linkages and similar findings. A relationship is identified between the two projects, in which the assessment methodologies developed in the projects are shown to operate at separate, but complementary levels. ETICA sought to reform EU ethics governance for emerging ICTs. The outcomes of PHM-Ethics are analyzed within the policy recommendations of ETICA, which demonstrate how the PHM-Ethics toolbox can contribute to ethics governance reform and context-sensitive ethical assessment of the sort called for by ETICA.

  12. [Evidence based medicine. A new paradigm for medical practice].

    PubMed

    Carneiro, A V

    1998-01-01

    Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.

  13. How much is a child worth? Providers' and patients' views and responses concerning ethical and policy challenges in paying for ART.

    PubMed

    Klitzman, Robert

    2017-01-01

    Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers. These individuals face multiple uncertainties about costs and insurance, related to unclear causes of fertility, treatment length, costs and outcomes, and odds that insurers will cover expenses. Insurers frequently decline to agree to reimbursement beforehand, and decide only afterwards, case-by-case, generating stress. Patients and providers thus may not be able to predict how best to allocate limited resources. Providers may advocate for patients, but are usually unsuccessful. Patients may adopt several strategies: e.g., moving/seeking treatment elsewhere, switching or feeling "stuck" in jobs because of insurance, seeking "free" medications, going into debt, or using funds intended for other purposes. Patients do not perceive and respond to resource limitations as fixed phenomena-i.e., patients do not see treatment simply as "affordable" or not. Rather, patients face quandaries of how much to keep spending-how much a child is worth-and are forced to make complex risk/benefit calculations. Couples can disagree, straining relationships. In sum, these data, the first to explore how providers and patients struggle, view, and make decisions regarding limited insurance and resources for infertility, raise several critical ethical and policy issues. These data suggest that individuals have difficulty translating profoundly life-altering, deeply personal quests for meaning and fulfillment into purely economic terms

  14. How much is a child worth? Providers’ and patients’ views and responses concerning ethical and policy challenges in paying for ART

    PubMed Central

    Klitzman, Robert

    2017-01-01

    Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers. These individuals face multiple uncertainties about costs and insurance, related to unclear causes of fertility, treatment length, costs and outcomes, and odds that insurers will cover expenses. Insurers frequently decline to agree to reimbursement beforehand, and decide only afterwards, case-by-case, generating stress. Patients and providers thus may not be able to predict how best to allocate limited resources. Providers may advocate for patients, but are usually unsuccessful. Patients may adopt several strategies: e.g., moving/seeking treatment elsewhere, switching or feeling “stuck” in jobs because of insurance, seeking “free” medications, going into debt, or using funds intended for other purposes. Patients do not perceive and respond to resource limitations as fixed phenomena—i.e., patients do not see treatment simply as “affordable” or not. Rather, patients face quandaries of how much to keep spending—how much a child is worth—and are forced to make complex risk/benefit calculations. Couples can disagree, straining relationships. In sum, these data, the first to explore how providers and patients struggle, view, and make decisions regarding limited insurance and resources for infertility, raise several critical ethical and policy issues. These data suggest that individuals have difficulty translating profoundly life-altering, deeply personal quests for meaning and fulfillment into purely

  15. Implementation of evidence-based practice and organizational performance.

    PubMed

    Hovmand, Peter S; Gillespie, David F

    2010-01-01

    Administrators of mental health services may expect evidence-based practice (EBP) to offer strategic benefits. Existing theory suggests that the benefits of implementing EBP vary by organizational characteristics. This paper presents a conceptual framework for considering how implementation impacts organizational performance. The framework is developed as a system dynamics simulation model based on existing literature, organizational theory, and key informant interviews with mental health services administrators and clinical directors. Results from the simulations show how gains in performance depended on organizations' initial inertia and initial efficiency and that only the most efficient organizations may see benefits in organizational performance from implementing EBP. Implications for administrators, policy makers, and services researchers are discussed.

  16. Evidence-based dentistry: what's new?

    PubMed

    Ballini, A; Capodiferro, S; Toia, M; Cantore, S; Favia, G; De Frenza, G; Grassi, F R

    2007-06-06

    The importance of evidence for every branch of medicine in teaching in order to orient the practitioners among the great amount of most actual scientific information's, and to support clinical decisions, is well established in health care, including dentistry. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning which leads to the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. Nowadays the practice of dentistry is becoming more complex and challenging because of the continually changing in dental materials and equipments, an increasingly litigious society, an increase in the emphasis of continuing professional development, the information explosion and the consumer movement associated with advances on the Internet. The need for reliable information and the electronic revolution have come together to allow the "paradigm shift" towards evidence-based health care. Recent years have seen an increase in the importance of evidence-based dentistry, aiming to reduce to the maximum the gap between clinical research and real world dental practice. Aim of evidence-based practice is the systematic literature review, which synthesizes the best evidences and provides the basis for clinical practice guidelines. These practice guidelines give a brief review of what evidence-based dentistry is and how to use it.

  17. Evidence-based periodontal therapy: An overview

    PubMed Central

    Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma

    2008-01-01

    Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947

  18. Data sharing in stem cell translational science: policy statement by the International Stem Cell Forum Ethics Working Party.

    PubMed

    Bredenoord, Annelien L; Mostert, Menno; Isasi, Rosario; Knoppers, Bartha M

    2015-01-01

    Data and sample sharing constitute a scientific and ethical imperative but need to be conducted in a responsible manner in order to protect individual interests as well as maintain public trust. In 2014, the Global Alliance for Genomics and Health (GA4GH) adopted a common Framework for Responsible Sharing of Genomic and Health-Related Data. The GA4GH Framework is applicable to data sharing in the stem cell field, however, interpretation is required so as to provide guidance for this specific context. In this paper, the International Stem Cell Forum Ethics Working Party discusses those principles that are specific to translational stem cell science, including engagement, data quality and safety, privacy, security and confidentiality, risk-benefit analysis and sustainability.

  19. A Research Agenda for Humanitarian Health Ethics

    PubMed Central

    Hunt, Matthew; Schwartz, Lisa; Pringle, John; Boulanger, Renaud; Nouvet, Elysée; O'Mathúna, Dónal; Arya, Neil; Bernard, Carrie; Beukeboom, Carolyn; Calain, Philippe; de Laat, Sonya; Eckenwiler, Lisa; Elit, Laurie; Fraser, Veronique; Gillespie, Leigh-Anne; Johnson, Kirsten; Meagher, Rachel; Nixon, Stephanie; Olivier, Catherine; Pakes, Barry; Redwood-Campbell, Lynda; Reis, Andreas; Renaldi, Teuku; Singh, Jerome; Smith, Maxwell; Von Schreeb, Johan

    2014-01-01

    This paper maps key research questions for humanitarian health ethics: the ethical dimensions of healthcare provision and public health activities during international responses to situations of humanitarian crisis. Development of this research agenda was initiated at the Humanitarian Health Ethics Forum (HHE Forum) convened in Hamilton, Canada in November 2012. The HHE Forum identified priority avenues for advancing policy and practice for ethics in humanitarian health action. The main topic areas examined were: experiences and perceptions of humanitarian health ethics; training and professional development initiatives for humanitarian health ethics; ethics support for humanitarian health workers; impact of policies and project structures on humanitarian health ethics; and theoretical frameworks and ethics lenses. Key research questions for each topic area are presented, as well as proposed strategies for advancing this research agenda. Pursuing the research agenda will help strengthen the ethical foundations of humanitarian health action. PMID:25687273

  20. Evidence-Based Special Education in the Context of Scarce Evidence-Based Practices

    ERIC Educational Resources Information Center

    TEACHING Exceptional Children, 2014

    2014-01-01

    Evidence-based practices (EBPs) are supported as generally effective for populations of learners by bodies of high-quality and experimental research and, when aligned with stakeholder values and practical needs, should be prioritized for implementation. However, evidence-based practices are not currently available for all learner types in all…

  1. Best practices in policy approaches to obesity prevention.

    PubMed

    Fox, Ashley M; Horowitz, Carol R

    2013-01-01

    The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy responses have a limited evidence base, are overly paternalistic, and have the potential to increase rather than shrink obesity-related disparities. The purpose of this article is to evaluate obesity policies in terms of the adequacy of evidence for action and along two ethical dimensions: their potential effect on liberty and equity. To evaluate evidence, we engage in a systematic review of reviews and rate policies in terms of the sufficiency of evidence of effectiveness at combating obesity. We then apply a libertarian-paternalist framework to assess policies in terms of their impact on liberty and inverse-equity theory to assess impact on disparities. This article provides a framework to assist decision-makers in assessing best practices in obesity using a more multi-faceted set of dimensions.

  2. Best Practices in Policy Approaches to Obesity Prevention

    PubMed Central

    Fox, Ashley M.; Horowitz, Carol R.

    2014-01-01

    The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy responses have a limited evidence base, are overly paternalistic, and have the potential to increase rather than shrink obesity-related disparities. The purpose of this article is to evaluate obesity policies in terms of the adequacy of evidence for action and along two ethical dimensions: their potential effect on liberty and equity. To evaluate evidence, we engage in a systematic review of reviews and rate policies in terms of the sufficiency of evidence of effectiveness at combating obesity. We then apply a libertarian-paternalist framework to assess policies in terms of their impact on liberty and inverse-equity theory to assess impact on disparities. This article provides a framework to assist decision-makers in assessing best practices in obesity using a more multi-faceted set of dimensions. PMID:23727973

  3. Evidence-Based Classroom Behaviour Management Strategies

    ERIC Educational Resources Information Center

    Parsonson, Barry S.

    2012-01-01

    This paper reviews a range of evidence-based strategies for application by teachers to reduce disruptive and challenging behaviours in their classrooms. These include a number of antecedent strategies intended to help minimise the emergence of problematic behaviours and a range of those which provide positive consequences for appropriate student…

  4. Evidence-Based Teaching: Rhetoric and Reality

    ERIC Educational Resources Information Center

    Wrigley, Terry

    2015-01-01

    This essay connects a number of recent books relating, in different ways, to the contentious issue of how teaching might be better guided by research evidence. In order to shed light on this problematic area, Terry Wrigley begins by pointing out that raising awkward questions about terms such as "evidence- based teaching" is not the same…

  5. Evidence-based orthopaedics: A brief history

    PubMed Central

    Hoppe, Daniel J; Bhandari, Mohit

    2008-01-01

    Evidence-based medicine was recently noted as one of the top 15 most important medical discoveries over the past 160 years. Since the term was coined in 1990, EBM has seen unparalleled adoption in medicine and surgery. We discuss the early origins of EBM and its dissemination in medicine, especially orthopaedic surgery. PMID:19826513

  6. Evidence Based Education Request Desk. EBE #510

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2009

    2009-01-01

    This Evidence Based Education (EBE) request focused on research-supported vocabulary interventions for middle elementary students. Limited vocabulary is an important factor in underachievement of children in disadvantaged homes. Children with larger vocabularies find reading easier, read more widely, and do better in school (Lubliner & Smetana,…

  7. Finding Evidence-Based Practice Information

    ERIC Educational Resources Information Center

    Childs, Gary M.

    2009-01-01

    Locating sources that are rich in evidence-based practice information can be more difficult for physical as well as occupational therapists in practice settings in which there is not direct access to a health sciences library. In addition, once information has been found, there may not be an easy way to access the data. This commentary will…

  8. Evidence-Based Practices and Autism

    ERIC Educational Resources Information Center

    Mesibov, Gary B.; Shea, Victoria

    2011-01-01

    Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…

  9. Evidence-Based Practice Goes beyond Google

    ERIC Educational Resources Information Center

    Klitzing, Sandra

    2012-01-01

    Evidence-based practice (EBP) is applying research to assist in the selection of interventions that result in increased client quality care. Recently the Commission on Accreditation of Allied Health Education Programs (2010), a new accreditation body for recreational therapy education, included standards that state students should obtain knowledge…

  10. Multicultural Issues in Evidence-Based Interventions

    ERIC Educational Resources Information Center

    Ingraham, Colette L.; Oka, Evelyn R.

    2006-01-01

    School psychologists involved in the delivery of psychological and educational interventions face the challenge of identifying interventions that will work within their schools. The evidence-based intervention (EBI) approach has received attention as a promising way to identify effective interventions. The national Task Force on Evidence Based…

  11. Evidence-based approaches to dissemination and diffusion of physical activity interventions.

    PubMed

    Owen, Neville; Glanz, Karen; Sallis, James F; Kelder, Steven H

    2006-10-01

    With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

  12. Data science ethics in government.

    PubMed

    Drew, Cat

    2016-12-28

    Data science can offer huge opportunities for government. With the ability to process larger and more complex datasets than ever before, it can provide better insights for policymakers and make services more tailored and efficient. As with all new technologies, there is a risk that we do not take up its opportunities and miss out on its enormous potential. We want people to feel confident to innovate with data. So, over the past 18 months, the Government Data Science Partnership has taken an open, evidence-based and user-centred approach to creating an ethical framework. It is a practical document that brings all the legal guidance together in one place, and is written in the context of new data science capabilities. As part of its development, we ran a public dialogue on data science ethics, including deliberative workshops, an experimental conjoint survey and an online engagement tool. The research supported the principles set out in the framework as well as provided useful insight into how we need to communicate about data science. It found that people had a low awareness of the term 'data science', but that showing data science examples can increase broad support for government exploring innovative uses of data. But people's support is highly context driven. People consider acceptability on a case-by-case basis, first thinking about the overall policy goals and likely intended outcome, and then weighing up privacy and unintended consequences. The ethical framework is a crucial start, but it does not solve all the challenges it highlights, particularly as technology is creating new challenges and opportunities every day. Continued research is needed into data minimization and anonymization, robust data models, algorithmic accountability, and transparency and data security. It also has revealed the need to set out a renewed deal between the citizen and state on data, to maintain and solidify trust in how we use people's data for social good.This article is part

  13. Research infrastructures, policies and the ‘web of prevention’: the ethical implications of inadequate research environments

    PubMed Central

    Bezuidenhout, Louise

    2016-01-01

    The dual-use potential of scientific research refers to the possibility that any beneficial scientific research may be misused for nefarious purposes by a third party. This potential within the life sciences has led to much discussion regarding ways to raise awareness and limit possible harm. The concept of a ‘web of prevention’ as a multifaceted system for addressing this potential for harm provides a comprehensive method of conceptualizing a system of controls in the life sciences. The web of prevention involves multiple stakeholders, from diverse backgrounds such as science, public health, security studies and governance. Research within the life sciences relies on a number of different structures, such as waste disposal and border controls, which provide a comprehensive environment for scientists to work in. The web of prevention relies on the assumption of these systems working to support any further initiatives that are proposed. Unfortunately, in many countries around the world, these systems are insufficiently addressed, which may raise ethical problems. Structural problems may undermine the web of prevention and alter the responsibilities attributed to the individual scientist within this system. Examples from sub-Saharan Africa illustrate two pertinent structural difficulties, and these are discussed in relation to ethical responsibilities. PMID:22606758

  14. [Looking for evidence-based medical informatics].

    PubMed

    Coiera, Enrico

    2016-03-01

    e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work.

  15. Evidence-based guidelines in labor management.

    PubMed

    Millen, Katherine Rodewald; Kuo, Kelly; Zhao, Lulu; Gecsi, Kimberly

    2014-04-01

    Evidence-based care of women in labor requires a thorough understanding of both "normal" and abnormal labor progress. In response to the growing cesarean delivery rate for dystocia at our institution, a multidisciplinary team of attending physicians, nurse-midwives, resident physicians, and nurses was established to review the literature and create evidence-based guidelines. This article describes the background literature and consensus guidelines reached for the diagnosis of active phase labor, active phase arrest, second-stage arrest, protraction of the active phase, and failed induction of labor. Our review illustrates that slower labor patterns than traditionally described often result in a vaginal delivery without unacceptable increases in maternal or neonatal morbidity.

  16. Evidence-based management of ANCA vasculitis.

    PubMed

    Carruthers, David; Sherlock, Jonathan

    2009-06-01

    The vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs) present to and are managed by a wide spectrum of physicians, reflecting the multi-organ nature of the conditions. Treatment strategies for these primary inflammatory vascular diseases have varied based on the outcomes of different clinical trials and practice reviews. The individual drugs used and their route of administration, dose, and duration of therapy have varied and have been the source of much debate. Advances in our understanding of disease immunopathogenesis, clinical assessment and outcome have formed the basis for several recent good-quality clinical trials. Now, with the results of these large-scale multicentre collaborative studies, there is a firmer evidence base to guide management decisions for individual patients. This evidence base, reviewed here, has led to the publication of treatment guidelines which importantly encompass many of the broader aspects of disease management.

  17. Critical thinking and evidence-based practice.

    PubMed

    Profetto-McGrath, Joanne

    2005-01-01

    Critical thinking (CT) is vital to evidence-based nursing practice. Evidence-based practice (EBP) supports nursing care and can contribute positively to patient outcomes across a variety of settings and geographic locations. The nature of EBP, its relevance to nursing, and the skills needed to support it should be required components of baccalaureate education and must be introduced early in students' development as independent, self-directed learners and as professional nurses. Among the knowledge, skills, and processes needed to support EBP, CT is paramount. The development of CT can prepare nurses with the necessary skills and dispositions (habits of mind, attitudes, and traits) to support EBP. The intents of this study were to explore the importance of CT as an essential skill to support EBP and to describe some of the strategies and processes considered key to the ongoing development of CT.

  18. Evidence-based practice of periodontics.

    PubMed

    Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana

    2010-01-01

    Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

  19. Evidence-based practices and autism.

    PubMed

    Mesibov, Gary B; Shea, Victoria

    2011-01-01

    Interventions for autism are increasing being held to standards such as 'evidence-based practice' in psychology and 'scientifically-based research' in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special education has raised additional concerns. An analysis of the benefits and limitations of current approaches to empiricism in autism interventions is presented, and suggestions for future research are made.

  20. Evidence-based librarianship: an overview

    PubMed Central

    Eldredge, Jonathan D.

    2000-01-01

    Objective: To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Method: Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. Results: First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Conclusions: Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors. PMID:11055296

  1. Evidence-based Medicine in Animal Reproduction.

    PubMed

    Arlt, S P; Heuwieser, W

    2014-09-01

    With new knowledge being generated and published daily, the importance of evidence-based approaches in veterinary medicine is obvious. Clinicians must stay current or risk making poor decisions that clients may challenge. Especially in animal reproduction, several new substances and procedures to diagnose or treat reproductive disorders have been introduced in the last years. On the other hand, a closer look at the quality of published literature on animal reproduction reveals major deficits in methodology and reporting of many clinical trials. We strongly recommend systematically assessing the quality of scientific information when reading journal papers before using the given information in practice. The aim of evidence-based medicine (EBM) is to base the decisions in the practice of medicine on valid, clinically relevant research data. Therefore, we suggest that students should become familiar with the concepts of evidence-based veterinary medicine (EBVM) at the beginning of their veterinary education. Concepts and supporting tools such as checklists for literature assessment have been developed and validated. The purpose of this article is to review and discuss the importance of incorporating EBVM in animal reproduction. The need for further research that produces strong evidence in different fields of animal reproduction and better reporting of relevant study information is obvious.

  2. Evidence-based pathology: umbilical cord coiling.

    PubMed

    Khong, T Y

    2010-12-01

    The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

  3. What Is Evidence-Based Behavior Analysis?

    PubMed Central

    Smith, Tristram

    2013-01-01

    Although applied behavior analysts often say they engage in evidence-based practice, they express differing views on what constitutes “evidence” and “practice.” This article describes a practice as a service offered by a provider to help solve a problem presented by a consumer. Solving most problems (e.g., increasing or decreasing a behavior and maintaining this change) requires multiple intervention procedures (i.e., a package). Single-subject studies are invaluable in investigating individual procedures, but researchers still need to integrate the procedures into a package. The package must be standardized enough for independent providers to replicate yet flexible enough to allow individualization; intervention manuals are the primary technology for achieving this balance. To test whether the package is effective in solving consumers' problems, researchers must evaluate outcomes of the package as a whole, usually in group studies such as randomized controlled trials. From this perspective, establishing an evidence-based practice involves more than analyzing the effects of discrete intervention procedures on behavior; it requires synthesizing information so as to offer thorough solutions to problems. Recognizing the need for synthesis offers behavior analysts many promising opportunities to build on their existing research to increase the quality and quantity of evidence-based practices. PMID:25729130

  4. Ethical and Economic Issues: Trustee Interest and Involvement in Academic Policies for Faculty Consulting, Overload Teaching and Intellectual Property Rights.

    ERIC Educational Resources Information Center

    Marsh, Herbert W.; And Others

    Governing board chairmen of 176 selected postsecondary institutions were surveyed to determine their levels of knowledge, involvement, and satisfaction concerning policies for extra-income-earning activities of the faculty. Such activities provide benefits to the faculty, the university, and to society, but potential conflicts of interest and…

  5. Is evidence-based practice diverse enough? Philosophy of science considerations.

    PubMed

    Wendt, Dennis C; Slife, Brent D

    2007-09-01

    In its policy rationale for evidence-based practice in psychology (EBPP), the APA Presidential Task Force on Evidence-Based Practice claims to have constituted itself with "scientists and practitioners from a wide range of perspectives and traditions, reflecting the diverse perspectives within the field" (p. 273). We applaud this attention to diversity but contend that an entire perspective of the debate was omitted in the Task Force's newly approved policy and its underlying report. The failure to consider a philosophy of science perspective led the Task Force to make a number of epistemological assumptions that are not based on evidence or rationale and that thus violate the very spirit of evidence-based decision making. In this comment, we reveal a few of these assumptions and discuss their detrimental consequences.

  6. Three Collaborative Models for Scaling Up Evidence-Based Practices

    PubMed Central

    Roberts, Rosemarie; Jones, Helen; Marsenich, Lynne; Sosna, Todd; Price, Joseph M.

    2015-01-01

    The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed. PMID:21484449

  7. Queer challenges to evidence-based practice.

    PubMed

    Zeeman, Laetitia; Aranda, Kay; Grant, Alec

    2014-06-01

    This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge.

  8. Evidence-based practice: a practical approach to implementation.

    PubMed

    Newhouse, Robin; Dearholt, Sandra; Poe, Stephanie; Pugh, Linda C; White, Kathleen M

    2005-01-01

    Organizations often do not have processes in place to support nurses through a systematic approach for developing and evaluating nursing interventions, protocols, critical pathways, and policies that are derived from scientific evidence. The development of a framework to guide inquiry will have a positive impact on patients. This process may foster a higher level of professional engagement by nurses that may, in the long-term, help improve nurse retention and recruitment. The authors discuss a nursing evidence-based practice model and guidelines that were developed by a team of hospital and academic nurse leaders and is practical and easy to use. This model has been successfully implemented across the department of nursing as a strategic initiative. Results of the implementation have shown that staff nurses can effectively use this model with the help of knowledgeable mentors.

  9. The oil crisis, risk and evidence-based practice.

    PubMed

    Traynor, Michael

    2002-09-01

    Evidence-based practice has risen to prominence over the last 20 years. Different professions have taken it up in different ways and for different purposes. It has been seen as holding both threats and advantages to professionalising endeavours and professional identity. It has engendered controversy but some criticisms of it have been unconvincing. It is possible to account for its rise as a response to tightening financial constraints on state spending in the west, as a sign of a culture increasingly concerned with risk, distrust of professionals and experts, as well as a way for professionals themselves to maintain control over their activity in the face of growing managerialism. This paper reviews the literature of some of the movement's proponents as well as criticism from various professional groups. It concludes that more useful than either arguing for or against it, is to understand the policy background and sociological reasons for its emergence and spread.

  10. Observation, Sherlock Holmes, and Evidence Based Medicine.

    PubMed

    Osborn, John

    2002-01-01

    Sir Arthur Conan Doyle, the creator of the fictional detective Sherlock Holmes, studied medicine at the University of Edinburgh between 1876 and 1881 under Doctor Joseph Bell who emphasised in his teaching the importance of observation, deduction and evidence. Sherlock Holmes was modelled on Joseph Bell. The modern notions of Evidence Based Medicine (EBM) are not new. A very brief indication of some of the history of EBM is presented including a discussion of the important and usually overlooked contribution of statisticians to the Popperian philosophy of EBM.

  11. Progress in evidence based reproductive surgery

    PubMed Central

    Bosteels, J.; Weyers, S.; Siristatidis, C.; Bhattacharya, S.; D’Hooghe, T.

    2011-01-01

    The Consolidated Standards of Reporting Trials (CONSORT) was introduced in 1996 to improve the methodological quality of published reports of randomised controlled trials. By doing a systematic review of randomised controlled trials on reproductive surgery, our group can demonstrate that the overall quality of the published reports of randomised studies on reproductive surgical interventions has improved after CONSORT. Nevertheless, some problems still remain. By discussing the benefits and pitfalls of randomised trials in reproductive surgery, our opinion paper aims to stimulate the reader’s further interest in evidence-based practice in reproductive surgery. PMID:24753872

  12. The Good, the Bad, and the Ugly of Evidence-Based Practice

    ERIC Educational Resources Information Center

    Bouffard, Marcel; Reid, Greg

    2012-01-01

    The evidence-based practice (EBP) movement has been extremely influential over the last 20 years. Fields like medicine, physiotherapy, occupational therapy, nursing, psychology, and education have adopted the idea that policy makers and practitioners should use interventions that have demonstrated efficiency and effectiveness. This apparently…

  13. Building the Evidence Base for Population-Level Interventions: Barriers and Opportunities

    ERIC Educational Resources Information Center

    Lifsey, Sarah; Cash, Amanda; Anthony, Jodi; Mathis, Sheryl; Silva, Sandra

    2015-01-01

    Population-level interventions focused on policy, systems, and environmental change strategies are increasingly being used to affect and improve the health of populations. At the same time, emphasis on implementing evidence-based public health practices and programming is increasing, particularly at the federal level. Valuing strategies in the…

  14. Coupling Changing Student Demographics with Evidence-Based Leadership Practices: Leading Hispanic Friendly Learning Organizations

    ERIC Educational Resources Information Center

    Farmer, Tod Allen

    2012-01-01

    The study assessed the need for learning organizations to implement evidence-based policies and practices designed to enhance the academic and social success of Hispanic learners. Descriptive statistics and longitudinal data from the National Center for Educational Statistics (NCES) and the National Clearinghouse for English Language Acquisition…

  15. How Evidence-Based Teaching Practices Are Challenged by a Deweyan Approach to Education

    ERIC Educational Resources Information Center

    Webster, R. Scott

    2009-01-01

    The claim is made in this paper that the discourse of education offers a challenge to evidence-based practices because this latter approach is embedded in the discourse of management. Although claiming the status of being "scientific", this latter development is drawn upon problematically by policy makers to provide the warrant for stipulating…

  16. Implementing Evidence-Based Substance Use Prevention Curricula in North Carolina Public School Districts.

    ERIC Educational Resources Information Center

    Pankratz, Melinda M.; Hallfors, Denise D.

    2004-01-01

    The Safe and Drug-Free Schools and Communities Act (SDFSCA) provides funding for prevention education to nearly every school district in the nation. Recent federal policy requires SDFSCA recipients to implement evidence-based prevention programs. This paper reports the extent to which North Carolina public school districts implement evidence-based…

  17. Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

    PubMed

    Brooke, Joanne Mary; Mallion, Jaimee

    2016-08-01

    The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses.

  18. Cultural competence in the era of evidence-based practice.

    PubMed

    Engebretson, Joan; Mahoney, Jane; Carlson, Elizabeth D

    2008-01-01

    Cultural competence has become an important concern for contemporary health care delivery, with ethical and legal implications. Numerous educational approaches have been developed to orient clinicians, and standards and position statements promoting cultural competence have been published by both the American Medical Association and the American Nurses Association. Although a number of health care regulatory agencies have developed standards or recommendations, clinical application to patient care has been challenging. These challenges include the abstract nature of the concept, essentializing culture to race or ethnicity, and the attempts to associate culture with health disparities. To make cultural competence relevant to clinical practice, we linked a cultural competency continuum that identifies the levels of cultural competency (cultural destructiveness, cultural incapacity, cultural blindness, cultural precompetence, and cultural proficiency) to well-established values in health care. This situates cultural competence and proficiency in alignment with patient-centered care. A model integrating the cultural competency continuum with the components of evidence-based care (i.e., best research practice, clinical expertise, and patient's values and circumstances) is presented.

  19. Toward an Ethic of Higher Education.

    ERIC Educational Resources Information Center

    Kadish, Mortimer R.

    This book presents an alternative ethic of higher education and considers policy choices of higher education resulting from this ethic. This alternative ethic asserts that higher education constitutes a primary social means for the forming of selves capable of participating widely and effectively in the affairs of a modern complex world. This…

  20. 5 CFR 2638.102 - General policies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....102 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS OFFICE OF GOVERNMENT ETHICS AND EXECUTIVE AGENCY ETHICS PROGRAM RESPONSIBILITIES General Provisions § 2638.102 General policies. (a) The Office of Government Ethics (“the Office”) provides overall direction and...

  1. Evidence-based radiology: review and dissemination.

    PubMed

    Medina, L Santiago; Blackmore, C Craig

    2007-08-01

    Evidence-based radiology (EBR) is an important tool for the practice of radiology. The user of the EBR approach identifies evidence in a systematic fashion and then assimilates information through in-depth, explicit critical review of the best-designed and most recent literature on the subject in question. Clinical decision making is then based on the best current evidence, clinical expertise, and patient values. Substantial progress has been made in the review and dissemination of EBR. Dissemination of EBR within radiology has two critical aspects. The first is increased understanding of the methods required for EBR and of the appropriate use of EBR. The second important component is the dissemination of the data and critical literature reviews necessary to allow use of the EBR approach. Resources available for both EBR methods and EBR data in radiology include societies, journals, medical meetings, Web sites, and textbooks. Although radiology has made important progress in this field in recent years, the specialty is still behind other specialties that have been at the forefront of evidence-based medicine in the past decade.

  2. Evidence-based Assessment of Pediatric Pain

    PubMed Central

    Lemanek, Kathleen; Blount, Ronald L.; Dahlquist, Lynnda M.; Lim, Crystal S.; Palermo, Tonya M.; McKenna, Kristine D.; Weiss, Karen E.

    2008-01-01

    Objective To conduct an evidence-based review of pediatric pain measures. Methods Seventeen measures were examined, spanning pain intensity self-report, questionnaires and diaries, and behavioral observations. Measures were classified as “Well-established,” “Approaching well-established,” or “Promising” according to established criteria. Information was highlighted to help professionals evaluate the instruments for particular purposes (e.g., research, clinical work). Results Eleven measures met criteria for “Well-established,” six “Approaching well-established,” and zero were classified as “Promising.” Conclusions There are a number of strong measures for assessing children's pain, which allows professionals options to meet their particular needs. Future directions in pain assessment are identified, such as highlighting culture and the impact of pain on functioning. This review examines the research and characteristics of some of the commonly used pain tools in hopes that the reader will be able to use this evidence-based approach and the information in future selection of assessment devices for pediatric pain. PMID:18024983

  3. [Acupressure and Evidence-Based Nursing].

    PubMed

    Chen, Li-Li; Lin, Jun-Dai

    2015-12-01

    Acupressure is a traditional Chinese medicine approach to disease prevention and treatment that may be operated by nurses independently. Therefore, acupressure is being increasingly applied in clinical nursing practice and research. Recently, the implementation of evidence-based nursing (EBN) in clinical practice has been encouraged to promote nursing quality. Evidence-based nursing is a method-ology and process of implementation that applies the best-available evidence to clinical practice, which is acquired through the use of empirical nursing research. Therefore, in this paper, we address the topic of acupressure within the context of empirical nursing practice. We first introduce the current status of acupressure research and provide the locations of common acupoints in order to guide future empirical nursing research and to help nurses use these acupoints in clinical practice. Finally, we describe the steps that are necessary to apply the current empirical information on acupressure as well as provide suggestions to promote safety and efficacy in order to guide nurses in the accurate application of acupressure in nursing practice.

  4. Who needs evidence-based health care?

    PubMed Central

    Tsafrir, J; Grinberg, M

    1998-01-01

    The vast amount of published material in clinical and biomedical sciences, and conflicting results on diagnostic and therapeutic procedures may introduce doubts in decision-making for patient care. Information retrieving skills and the critical appraisal of published literature, together with elaboration of practice guidelines based on epidemiological methodology, form the basis of the trend towards evidence-based health care, which aims to overcome these problems. A survey conducted by questionnaire at the Chaim Sheba Medical Center analyzed which types of information sources are considered most relevant and useful for patient care by a cross-section of physicians with varying degrees of experience. They considered review articles and meta-analyses extremely reliable for information purposes, while for practical patient-care purposes they tended to rely more on the opinions of peers and experts. As the requirements of evidence-based health care may influence the attitudes of clinicians to the published literature and its evaluation, they have implications for medical libraries and information centers. Specifically, information specialists will be called upon more and more to impart information-retrieval and critical appraisal skills to clinicians. The involvement of information specialists in information gathering and selection will provide added value to the expertise and knowledge of in-house experts for decision-making. PMID:9549011

  5. [The historical background and present development of evidence-based healthcare and clinical nursing].

    PubMed

    Tsai, Jung-Mei

    2014-12-01

    Evidence-based healthcare (EBHC) emphasizes the integration of the best research evidence with patient values, specialist suggestions, and clinical circumstances during the process of clinical decision-making. EBHC is a recognized core competency in modern healthcare. Nursing is a professional discipline of empirical science that thrives in an environment marked by advances in knowledge and technology in medicine as well as in nursing. Clinical nurses must elevate their skills and professional qualifications, provide efficient and quality health services, and promote their proficiency in EBHC. The Institute of Medicine in the United States indicates that evidence-based research results often fail to disseminate efficiently to clinical decision makers. This problem highlights the importance of better promoting the evidence-based healthcare fundamentals and competencies to frontline clinical nurses. This article describes the historical background and present development of evidence-based healthcare from the perspective of modern clinical nursing in light of the importance of evidence-based healthcare in clinical nursing; describes the factors associated with evidence-based healthcare promotion; and suggests strategies and policies that may improve the promotion and application of EBHC in clinical settings. The authors hope that this paper provides a reference for efforts to improve clinical nursing in the realms of EBHC training, promotion, and application.

  6. From both sides now: librarians' experiences at the Rocky Mountain Evidence-Based Health Care Workshop

    PubMed Central

    Traditi, Lisa K.; Le Ber, Jeanne Marie; Beattie, Michelle; Meadows, Susan E.

    2004-01-01

    The Colorado Health Outcomes (COHO) Department of the School of Medicine at the University of Colorado Health Sciences Center (UCHSC) coordinates the Rocky Mountain Evidence-Based Health Care (EBHC) Workshop, which has been held annually since 1999. The goals of the workshop include helping participants—physicians, pharmacists, health care policy makers, journalists and librarians—learn and apply skills for critically appraising medical research literature and for effective use of evidence-based information resources. Participants are encouraged to share ideas and to plan local services and instruction for those working in clinical settings. Each year, librarians from UCHSC Denison Memorial Library participate as faculty by teaching searching skills (PubMed, Cochrane Library, ACP Journal Club, etc.), providing support to small groups, and staffing two computer labs. In 2002, Denison Library received a National Network of Libraries of Medicine (NN/LM) MidContinental Region Impact Award to fund the attendance of three health sciences librarians from the MidContinental Region, an academic education librarian, a clinical medical librarian, and a department librarian. In this paper, the participating librarians share the lessons they learned about how health care practitioners approach evidence-based practice. The participating librarians also share how they incorporated these lessons into their support of evidence-based practice related to teaching about evidence-based resources, assisting health care practitioners with developing answerable questions, enhancing the clinician-librarian partnership, and assisting practitioners in selecting evidence-based resources for quick answers to clinical questions. PMID:14762465

  7. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

    PubMed Central

    Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2013-01-01

    In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and

  8. Analysis of the ethical issues in the breastfeeding and bedsharing debate.

    PubMed

    Fetherston, Catherine M; Leach, J Shaughn

    2012-11-01

    Recommendations advising against mothers and their infants sharing a bed during sleep (bedsharing) have sparked heated debate in recent years, the effects of which are that bedsharing is now most often only considered in the polarised contexts of being either 'the norm' or 'inherently unsafe'. This has resulted in significant tensions between supporters of bedsharing and public health bodies who seek to eliminate the risks associated with SIDS. This paper considers the issues surrounding this debate by examining the evidence associated with bedsharing, SIDS and breastfeeding. This is undertaken using Baum's six-step framework for analysing potential ethical tensions in public health policy, which includes the principles of utility, evidence base and effectiveness of action, fairness, accountability, costs and burdens, and community acceptance. This framework has allowed us to examine the competing principles involved in the bedsharing and breastfeeding debate, and arrive at a position constructed using ethical considerations.

  9. The architecture of evidence-based gynaecology.

    PubMed

    Khan, Khalid S

    2006-10-01

    Modern evidence-based medicine (EBM) and its predecessor 'Medecin d'Observation' both emphasise that potential advances in healthcare must be researched and proven to do more good than harm using the principles of clinical epidemiology before they are incorporated into medical practice. EBM is considered an important advance in improving clinical care in gynaecology but EBM skills have traditionally not been covered in undergraduate or postgraduate education. Therefore there is a perceived need to compile texts on various aspects of gynaecological practice using EBM principles. This is what these two issues of the Best Practice series hope to achieve. The various chapters will provide readers with clinical advice generated from critically appraised information that has been identified as addressing relevant questions.

  10. Evidence-based management of recurrent miscarriages

    PubMed Central

    Jeve, Yadava B.; Davies, William

    2014-01-01

    Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

  11. Nanotheranostics in evidence based personalized medicine.

    PubMed

    Sharma, Sushil

    2014-01-01

    Efficient drug delivery systems are exceedingly important for novel drug discovery. The evidence-based personalized medicine (EBPM) promises to deliver the right drug at the right time to a right patient as it covers clinicallysignificant genetic predisposition and chronopharmacological aspects of nanotheranostics. Recently nanotechnology has provided clinically-significant information at the cellular, molecular, and genetic level to facilitate evidence-based personalized treatment. Particularly drug encapsulation in pegylated liposomes has improved pharmacodynamics of cancer, cardiovascular diseases, and neurodegenerative diseases. Long-circulating liposomes and block copolymers concentrate slowly via enhanced permeability and retention (EPR) effect in the solid tumors and are highly significant for the drug delivery in cancer chemotherapeutics. Selective targeting of siRNA and oligonucleotides to tumor cells with a potential to inhibit multi-drug resistant (MDR) malignancies has also shown promise. In addition, implantable drug delivery devices have improved the treatment of several chronic diseases. Recently, microRNA, metallothioneins (MTs), α-synuclein index, and Charnoly body (CB) have emerged as novel drug discovery biomarkers. Hence CB antagonists-loaded ROSscavenging targeted nanoparticles (NPs) may be developed for the treatment of neurodegenerative and cardiovascular diseases. Nonspecific induction of CBs in the hyper-proliferative cells may cause alopecia, gastrointestinal tract (GIT) symptoms, myelosuppression, neurotoxicity, and infertility. Therefore selective CB agonists may be developed to augment cancer stem cell specific CB formation to eradicate MDR malignancies with minimum or no adverse effects. This review highlights recent advances on safe, economical, and effective treatment of neurodegenerative diseases, cardiovascular diseases, and cancer by adopting emerging nanotheranostic strategies to accomplish EBPM.

  12. Joanna Briggs Institute: an evidence-based practice database.

    PubMed

    Vardell, Emily; Malloy, Michele

    2013-01-01

    The Joanna Briggs Institute Evidence-Based Practice Database offers systematic reviews, practice recommendations, and consumer information designed to support evidence-based practice. A sample search was conducted within the Ovid platform to demonstrate functionality and available tools.

  13. Sports medicine and ethics.

    PubMed

    Testoni, Daniela; Hornik, Christoph P; Smith, P Brian; Benjamin, Daniel K; McKinney, Ross E

    2013-01-01

    Physicians working in the world of competitive sports face unique ethical challenges, many of which center around conflicts of interest. Team-employed physicians have obligations to act in the club's best interest while caring for the individual athlete. As such, they must balance issues like protecting versus sharing health information, as well as issues regarding autonomous informed consent versus paternalistic decision making in determining whether an athlete may compete safely. Moreover, the physician has to deal with an athlete's decisions about performance enhancement and return to play, pursuit of which may not be in the athlete's long-term best interests but may benefit the athlete and team in the short term. These difficult tasks are complicated by the lack of evidence-based standards in a field influenced by the lure of financial gains for multiple parties involved. In this article, we review ethical issues in sports medicine with specific attention paid to American professional football.

  14. Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example

    ERIC Educational Resources Information Center

    Schoenwald, Sonja K.

    2008-01-01

    This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

  15. Operationalizing Evidence-Based Practice: The Development of an Institute for Evidence-Based Social Work

    ERIC Educational Resources Information Center

    Regehr, Cheryl; Stern, Susan; Shlonsky, Aron

    2007-01-01

    Although evidence-based practice (EBP) has received increasing attention in social work in the past few years, there has been limited success in moving from academic discussion to engaging social workers in the process of implementing EBP in practice. This article describes the challenges, successes, and future aims in the process of developing a…

  16. Evidence-based practice. The role of staff development.

    PubMed

    Krugman, Mary

    2003-01-01

    Knowledge and use of evidence-based practice are essential to ensure best practices and safe patient outcomes. Staff development specialists must be leaders in this initiative to support clinical nurses toward improved practice outcomes. This article describes the background for understanding the historical evolution from research utilization to evidence-based practice, defines some key concepts related to evidence-based practice, and suggests essential components for building evidence-based practice programs in healthcare institutions.

  17. Doing the right thing by incorporating evidence and professional goals in the ethics consult.

    PubMed

    Catlin, Anita

    2013-07-01

    Classic ethical decision-making models are discussed, and two recommendations are provided. The author proposes applying evidence-based position statements to ethical deliberation and suggests acknowledging the differing philosophical underpinnings and goals of various stakeholders, including nurses, physicians, families, institutions, and the nation. Examples are provided throughout. When combined with evidence-based information and consideration of group goals, traditional ethical analysis may help nurses "do the right thing."

  18. Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences

    PubMed Central

    Brouwer, Kimberly C.; Jimenez, Teresita Rocha; Miranda, Sonia Morales; Mindt, Monica Rivera

    2016-01-01

    Background Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers. Methods Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013–February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops. Results Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers. Conclusions Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization

  19. Evidence-Based Medicine in the Education of Psychiatrists

    ERIC Educational Resources Information Center

    Srihari, Vinod

    2008-01-01

    Objective: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. Methods: The author develops a broader conception of clinical…

  20. E-Learning and Evidence Based Practice in Schools

    ERIC Educational Resources Information Center

    Quong, Terrence

    2016-01-01

    JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…

  1. Implications of holding ideas of evidence-based practice in nursing.

    PubMed

    Mitchell, Gail J

    2013-04-01

    The author of this paper examines emerging implications of holding ideas about evidence and evidence-based practice. Evidence has a very specific role in the delivery of safe clinical care, but it is creating a serious problematic for the practice of nursing. It is proposed that: evidence-based practice be re-situated or reconstructed as a collective and organizational responsibility and not the responsibility of individual nurses in practice; nurses re-focus on articulating a more ethical foundation for praxis, one that emerges from nursing philosophy and one that is co-constituted with persons/families/groups; and nurse leaders and educators establish teaching-learning and practice environments that enable a peer-to-peer process of critical review and curious inquiry of available evidence in the contexts of shared work.

  2. Pregnancy after kidney transplantation: an evidence-based approach.

    PubMed

    Mezza, E; Oggé, G; Attini, R; Rossetti, M; Soragna, G; Consiglio, V; Burdese, M; Vespertino, E; Tattoli, F; Gai, M; Motta, D; Segoloni, G P; Todros, T; Piccoli, G B

    2004-12-01

    Despite the relatively little space for transplantation in most medical schools, this issue is considered interesting by the students both for its clinical and ethical implications. The students were asked to choose a particular aspect of nephrology for a 2-hour case discussion. They chose the case of a 35-year-old female, kidney transplant recipient now 1.5 years postoperatively, who was coming to seek advice about pregnancy. The aim of the present work is to report an integration between narrative and evidence-based medicine (EBM) approaches. The search strategy was developed within a multidisciplinary working group, two of whose members were also masters in the methodology of systematic revisions. The first step in the discussion was the identification of ethical and methodological problem. In a rapidly developing field, books are unlikely to be able to give updated information. One needs to interact with electronic databases. In this context, no randomized controlled trial on pregnancy is expected. The evidence is likely to be heterogeneous. Prenatal care delivery differs around the world in part related to attitudes toward pregnancy, which depend upon religion and traditions. The second step was the definition of the search strategy. The third step, was selecting and cataloging the evidence. The titles and abstracts retrieved by the search strategy (272 items) were examined to identify full papers to be retrieved. The evidence retrieved was screened for the type of paper (reviews, primary studies, case reports, case series) and for the authors to give an indirect idea of duplicate publication bias. Teaching a complex and ever-changing subject, such as kidney transplantation, is a difficult task. The case of a young woman seeking information on the probability to undergo a successful pregnancy was particularly likely to exemplify the importance of being aware of the biases of the book-based information and on the need to interact with the internet. The search

  3. Redefining Residential: Integrating Evidence-Based Practices

    ERIC Educational Resources Information Center

    Residential Treatment for Children & Youth, 2009

    2009-01-01

    This is the fifth in a series of papers being issued by the American Association of Children's Residential Centers (AACRC) regarding key program and policy issues facing the field of residential treatment. AACRC is the longest standing national association focused exclusively on the needs of children who require residential treatment and their…

  4. Evidence Based Education Request Desk. EBE #652

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Southeast, 2010

    2010-01-01

    Which states are using which turnaround models, as represented in the recent U.S. Department of Education's "Blueprint for Reform: The Reauthorization of the Elementary and Secondary Education Act?" A search for state-level policies on turnaround models was completed based on the targeted states list provided. According to US Department…

  5. Evidence-based medicine and epistemological imperialism: narrowing the divide between evidence and illness.

    PubMed

    Crowther, Helen; Lipworth, Wendy; Kerridge, Ian

    2011-10-01

    Evidence-based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine.

  6. Steps in Moving Evidence-Based Health Informatics from Theory to Practice

    PubMed Central

    Magrabi, Farah; Scott, Philip; Doupi, Persephone; Hypponen, Hannele; Ammenwerth, Elske

    2016-01-01

    Objectives To demonstrate and promote the importance of applying a scientific process to health IT design and implementation, and of basing this on research principles and techniques. Methods A review by international experts linked to the IMIA Working Group on Technology Assessment and Quality Development. Results Four approaches are presented, linking to the creation of national professional expectations, adherence to research-based standards, quality assurance approaches to ensure safety, and scientific measurement of impact. Conclusions Solely marketing- and aspiration-based approaches to health informatics applications are no longer ethical or acceptable when scientifically grounded evidence-based approaches are available and in use. PMID:27895956

  7. [Big data analysis and evidence-based medicine: controversy or cooperation].

    PubMed

    Chen, Xinzu; Hu, Jiankun

    2016-01-01

    The development of evidence-based medicince should be an important milestone from the empirical medicine to the evidence-driving modern medicine. With the outbreak in biomedical data, the rising big data analysis can efficiently solve exploratory questions or decision-making issues in biomedicine and healthcare activities. The current problem in China is that big data analysis is still not well conducted and applied to deal with problems such as clinical decision-making, public health policy, and should not be a debate whether big data analysis can replace evidence-based medicine or not. Therefore, we should clearly understand, no matter whether evidence-based medicine or big data analysis, the most critical infrastructure must be the substantial work in the design, constructure and collection of original database in China.

  8. Teaching strategies to support evidence-based practice.

    PubMed

    Winters, Charlene A; Echeverri, Rebecca

    2012-06-01

    Evidence-based practice is an expected core competency of all health care clinicians regardless of discipline. Use of evidence-based practice means integrating the best research with clinical expertise and patient values to achieve optimal health outcomes. Evidence-based practice requires nurses to access and appraise evidence rapidly before integrating it into clinical practice. Role modeling and integrating the skills necessary to develop evidence-based practice into clinical and nonclinical courses is an important part in developing positive attitudes toward evidence-based practice, an essential first step to using evidence to guide practice decisions. The step-by-step approach to evidence-based practice proposed by Melnyk and colleagues provides an excellent organizing framework for teaching strategies specifically designed to facilitate nurses' knowledge and skill development in evidence-based practice.

  9. Ethical Impotence

    ERIC Educational Resources Information Center

    Sternberg, Robert J.

    2015-01-01

    Ethical impotence occurs when one wants to act ethically but feels powerless to do anything about the perceived unethical behavior. One may feel that one's actions will have no impact or that those actions actually will have harmful consequences to oneself and/or others. Ethical impotence can be understood in terms of an eight-step model of…

  10. [Searching for evidence-based data].

    PubMed

    Dufour, J-C; Mancini, J; Fieschi, M

    2009-08-01

    The foundation of evidence-based medicine is critical analysis and synthesis of the best data available concerning a given health problem. These factual data are accessible because of the availability on the Internet of web tools specialized in research for scientific publications. A bibliographic database is a collection of bibliographic references describing the documents indexed. Such a reference includes at least the title, summary (or abstract), a set of keywords, and the type of publication. To conduct a strategically effective search, it is necessary to formulate the question - clinical, diagnostic, prognostic, or related to treatment or prevention - in a form understandable by the research engine. Moreover, it is necessary to choose the specific database or databases, which may have particular specificity, and to analyze the results rapidly to refine the strategy. The search for information is facilitated by the knowledge of the standardized terms commonly used to describe the desired information. These come from a specific thesaurus devoted to document indexing. The most frequently used is MeSH (Medical Subject Heading). The principal bibliographic database whose references include a set of describers from the MeSH thesaurus is Medical Literature Analysis and Retrieval System Online (Medline), which has in turn become a subpart of a still more vast bibliography called PubMed, which indexes an additional 1.4 million references. Numerous other databases are maintained by national or international entities. These include the Cochrane Library, Embase, and the PASCAL and FRANCIS databases.

  11. Evidence-Based Management of Anticoagulant Therapy

    PubMed Central

    Schulman, Sam; Witt, Daniel M.; Vandvik, Per Olav; Fish, Jason; Kovacs, Michael J.; Svensson, Peter J.; Veenstra, David L.; Crowther, Mark; Guyatt, Gordon H.

    2012-01-01

    Background: High-quality anticoagulation management is required to keep these narrow therapeutic index medications as effective and safe as possible. This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: Most practical clinical questions regarding the management of anticoagulation, both oral and parenteral, have not been adequately addressed by randomized trials. We found sufficient evidence for summaries of recommendations for 23 questions, of which only two are strong rather than weak recommendations. Strong recommendations include targeting an international normalized ratio of 2.0 to 3.0 for patients on vitamin K antagonist therapy (Grade 1B) and not routinely using pharmacogenetic testing for guiding doses of vitamin K antagonist (Grade 1B). Weak recommendations deal with such issues as loading doses, initiation overlap, monitoring frequency, vitamin K supplementation, patient self-management, weight and renal function adjustment of doses, dosing decision support, drug interactions to avoid, and prevention and management of bleeding complications. We also address anticoagulation management services and intensive patient education. Conclusions: We offer guidance for many common anticoagulation-related management problems. Most anticoagulation management questions have not been adequately studied. PMID:22315259

  12. [Prevention of atopic eczema. Evidence based guidelines].

    PubMed

    Schäfer, T

    2005-03-01

    With an estimated prevalence of 12% for preschool children and 3% for adults, atopic eczema is a serious public health problem. This disease severely jeopardizes quality of life and is associated with considerable costs. Since there is still no causal therapy, primary and secondary prevention are especially important. Here the evidence basis for recommendations on prevention of atopic eczema is discussed on the basis of the first evidence-based consensus guideline (S3) on allergy prevention. This recommends that babies should be breastfed exclusively for at least 4 months and exposure to passive smoking be avoided even during pregnancy; restriction of the maternal diet during pregnancy has no influence, though during breastfeeding it can lower the incidence of eczema among babies at risk. Thereby this measure should be balanced with potential consequences of malnutrition. There seems to be a positive correlation between keeping small rodents (rabbits, guinea pigs), and possibly cats, and the occurrence of atopic eczema, while keeping dogs has no effect or even a protective effect. Avoidance of an unfavorable indoor climate is probably also helpful in preventing eczema. There is no evidence to support deviating from the current recommendations of the standing committee for vaccination.

  13. Evidence-based medicine: a new tool for resource allocation?

    PubMed

    Nunes, Rui

    2003-01-01

    Evidence-Based Medicine (EBM) is defined as the conscious, and judicious use of current best evidence in making decisions about the care of individual patients. The greater the level of evidence the greater the grade of recommendation. This pioneering explicit concept of EBM is embedded in a particular view of medical practice namely the singular nature of the patient-physician relation and the commitment of the latter towards a specific goal: the treatment and the well being of his or her client. Nevertheless, in many European countries as well as in the United States, this "integration of the best evidence from systematic research with clinical expertise and patient values" appears to be re-interpreted in light of the scarcity of healthcare resources. The purpose of this paper is double. First, to claim that from an ethical perspective EBM should be a guideline to clinical practice; and second, that in specific circumstances EBM might be a useful tool in macro-allocation of healthcare resources. Methodologically the author follows Norman Daniels' theory of "democratic accountability" to justify this assumption. That is, choices in healthcare must be accountable by democratic procedures. This perspective of distributive justice is responsible for the scope and limits of healthcare services. It follows that particular entitlements to healthcare--namely expensive innovative treatments and medicines--may be fairly restricted as long as this decision is socially and democratically accountable and imposed by financial restrictions of the system. In conclusion, the implementation of EBM, as long as it limits the access to drugs and treatments of unproven scientific results is in accordance with this perspective. The use of EBM is regarded as an instrument to facilitate the access of all citizens to a reasonable level of healthcare and to promote the efficiency of the system.

  14. Ethical issues in infertility.

    PubMed

    Serour, Gamal I; Serour, Ahmed G

    2017-03-01

    Infertility is a global medico-socio-cultural problem with gender-based suffering particularly in developing countries. Conventional methods of treatment for infertility do not usually raise ethical concerns. However, assisted reproductive technology (ART) has initiated considerable ethical debate, disagreement, and controversy. There are three ethical principles that provide an ethical basis for ART: the principle of liberty, principle of utility, and principle of justice. Medical ethics are based on the moral, religious, and philosophical ideas and principles of the society and are influenced by economics, policies, and law. This creates tension between the principles of justice and utility, which can result in disparity in the availability of and access to ART services between the rich and the poor. The moral status of the embryo is the key for all the ethical considerations and law regarding ART in different societies. This has resulted in cross-border ART. Conscientious objection of healthcare providers should not deprive couples from having access to a required ART service.

  15. [Medical ethics as professional ethics].

    PubMed

    Kwon, Ivo

    2012-09-25

    Contemporary medical ethics is far from the traditional concept of "In-Sul (benevolent art)" or "Yul-Li (倫, ethics), which emphasizes so much the personality or the character of a doctor. Nowadays, medical ethics should be considered as "professional ethics" which regulates the acts and medical practices of ordinary doctors in their daily practice. The key concepts of the professional ethics are "autonomy", "integrity", and "professional standard" established by medical organizations such as medical societies or associations. Most of Korean doctors have not been familiar with the concept of professional ethics or professionalism, which is due to the modern history of Korea. However, the concept of professional ethics is really critical to Korean doctors from the perspective of professional dignity and social respect to this profession. The current healthcare system of Korea is suffering from many problems of both private and public sector. Nonetheless, the professional ethics is urgently demanded for that very reason.

  16. Rethinking research ethics.

    PubMed

    Rhodes, Rosamond

    2010-10-01

    Contemporary research ethics policies started with reflection on the atrocities perpetrated upon concentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research.

  17. An Evidence-Based Public Health Approach to Climate Change Adaptation

    PubMed Central

    Eidson, Millicent; Tlumak, Jennifer E.; Raab, Kristin K.; Luber, George

    2014-01-01

    Background: Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Objectives: Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. Methods: We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. Discussion: A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. Conclusions: The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders. Citation: Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G. 2014. An evidence-based public

  18. Continuing Education in Research Ethics for the Clinical Nurse.

    ERIC Educational Resources Information Center

    Jeffers, Brenda Recchia

    2002-01-01

    Review of professional nursing statements, federal policy, and recommendations for protection of human research subjects resulted in a topic and content outline for research ethics training for nurses. Suggestions for continuing education programs on research ethics were formulated. (SK)

  19. Ethics in biomedical engineering.

    PubMed

    Morsy, Ahmed; Flexman, Jennifer

    2008-01-01

    This session focuses on a number of aspects of the subject of Ethics in Biomedical Engineering. The session starts by providing a case study of a company that manufactures artificial heart valves where the valves were failing at an unexpected rate. The case study focuses on Biomedical Engineers working at the company and how their education and training did not prepare them to deal properly with such situation. The second part of the session highlights the need to learn about various ethics rules and policies regulating research involving human or animal subjects.

  20. 13 CFR 120.140 - What ethical requirements apply to participants?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false What ethical requirements apply to... LOANS Policies Applying to All Business Loans Ethical Requirements § 120.140 What ethical requirements... “Participants”), must act ethically and exhibit good character. Ethical indiscretion of an Associate of...

  1. 13 CFR 120.140 - What ethical requirements apply to participants?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false What ethical requirements apply to... LOANS Policies Applying to All Business Loans Ethical Requirements § 120.140 What ethical requirements... “Participants”), must act ethically and exhibit good character. Ethical indiscretion of an Associate of...

  2. 13 CFR 120.140 - What ethical requirements apply to participants?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false What ethical requirements apply to... LOANS Policies Applying to All Business Loans Ethical Requirements § 120.140 What ethical requirements... “Participants”), must act ethically and exhibit good character. Ethical indiscretion of an Associate of...

  3. 13 CFR 120.140 - What ethical requirements apply to participants?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false What ethical requirements apply to... LOANS Policies Applying to All Business Loans Ethical Requirements § 120.140 What ethical requirements... “Participants”), must act ethically and exhibit good character. Ethical indiscretion of an Associate of...

  4. Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy

    PubMed Central

    Parco, Sergio; Vascotto, Fulvia; Visconti, Patrizia

    2013-01-01

    nontreponemal rapid plasma reagin VDRL (75.0%) tests (P < 0.05, χ2 test). The specificity link between the two automatic methods versus microscopes for WBC dosing and NRBC interference was r2 = 0.08 (ADVIA 120) and r2 = 0.94 (XE-2100). The public system does not include human T-cell lymphotropic virus testing; this is reserved for the population from endemic zones. Conclusion In northeastern Italy current legislation prevents the establishment of private fee-based banks for storage of CB-SC. The cryopreservation, for future autologous personal or family use, is possible only by sending to foreign private banks, with a further fee of €300. These regulations confirm that Italian legislation tries to increase the anonymous allogenic donations and the number of CB-CS bags stored in the free-cost public system, that are available to anyone with therapeutic needs. Private banking is used almost exclusively by the wealthier local population. In the public system, many physicians continue to use older Italian laws regarding syphilis diagnosis, and NRBC interference on WBC count may have an impact on cord blood harvesting. Our findings suggest that in the EU there is no consensus policy on donor management. The value of storage for potential use within the family is useful only with collaboration between the public and the private systems. PMID:23610532

  5. Response: Clinical wisdom and evidence-based medicine are complementary.

    PubMed

    De Freitas, Julian; Haque, Omar S; Gopal, Abilash A; Bursztajn, Harold J

    2012-01-01

    A long-debated question in the philosophy of health, and contingent disciplines, is the extent to which wise clinical practice ("clinical wisdom") is, or could be, compatible with empirically validated medicine ("evidence-based medicine"--EBM). Here we respond to Baum-Baicker and Sisti, who not only suggest that these two types of knowledge are divided due to their differing sources, but also that EBM can sometimes even hurt wise clinical practice. We argue that the distinction between EBM and clinical wisdom is poorly defined, unsupported by the methodology employed, and ultimately incorrect; crucial differences exist, we argue, not in the source of a particular piece of clinical knowledge, but in its dependability. In light of this subtle but fundamental revision, we explain how clinical wisdom and EBM are--by necessity--complementary, rather than in conflict. We elaborate on how recognizing this relationship can have far-reaching implications for the domains of clinical practice, medical education, and health policy.

  6. Good and not so good medical ethics.

    PubMed

    Rhodes, Rosamond

    2015-01-01

    In this paper, I provide a brief sketch of the purposes that medical ethics serves and what makes for good medical ethics. Medical ethics can guide clinical practice and biomedical research, contribute to the education of clinicians, advance thinking in the field, and direct healthcare policy. Although these are distinct activities, they are alike in several critical respects. Good medical ethics is coherent, illuminating, accurate, reasonable, consistent, informed, and measured. After this overview, I provide specific examples to illustrate some of the ways in which medical ethics could go wrong as a caution and a reminder that taking on the role of an ethicist involves serious responsibilities that must be exercised with care.

  7. Prospects for Evidence -Based Software Assurance: Models and Analysis

    DTIC Science & Technology

    2015-09-01

    PROSPECTS FOR EVIDENCE-BASED SOFTWARE ASSURANCE: MODELS AND ANALYSIS CARNEGIE MELLON UNIVERSITY SEPTEMBER 2015 FINAL TECHNICAL REPORT APPROVED...TITLE AND SUBTITLE PROSPECTS FOR EVIDENCE-BASED SOFTWARE ASSURANCE: MODELS AND ANALYSIS 5a. CONTRACT NUMBER FA8750-12-2-0139 5b. GRANT NUMBER N/A...assurance case, sandboxing, adaptive software 147 i Prospects for evidence-based software assurance: models and analysis Final Technical Report

  8. Anthropogenic versus natural processes and pollution in Padana Valley in last years involving new communication/policy strategies and ethical issues in research evaluation

    NASA Astrophysics Data System (ADS)

    Quattrocchi, Fedora; Vaccaro, Carmela; Boschi, Enzo

    2014-05-01

    Smart grids-Smat cities "fashion" requires management plans of highly urbanized areas located over the Padanian floodplain, which are prone to diffuse pollution of both lands and urban sectors, mostly after the disasters caused by tremendous alluvial rains in January 2014, when shallow aquifers and agricultural matters could have increase pollution over wide territory. Moreover the urban expansion has affected areas previously used for industrial activity and in some cases such for landfills. When the loss of memory of previous activity prevails after urbanization, with health issues, ethical questions are inevitable, accompanied by social conflicts and economic impacts. The alluvial plains of active tectonic areas - as the Padania Valley - in additions to widespread "anthropogenic pollution" is suffering from widespread "natural pollution" of deep fluid sources - mainly methane - corresponding to areas prone to uprising gaseous brines, along faults. Some of them were partially activated during the 2012 Emilia seismic sequence. This noteworthy seismic sequence engaged discussion about the possible role of gas storages and hydrocarbons production or the simple/exploring drilling activity to trigger typical tectonic seismicity. The paper deepen this troubled communication strategy, their gaps and peculiar geopolicy case histories, to avoid the same strategy, in the future. On the other hand, gas burst or brine-gas-contamination in shallow aquifers, soils and indoor, should be studied by simple and cheap methods, by deepening stratigraphic gaps for the tectonics effects on sedimentation: natural processes should be recalled prior to recall anthropogenic causes, if any. Policy should be more responsible in state clearly the role of research in study infrastructures/processes, also when engaged by private companies, for sites selected by ministries mostly to star research: relevant gaps involves serious confusion in the public as regards responsibility and an exact

  9. Ethical and social implications of genetic testing for communication disorders

    PubMed Central

    Arnos, Kathleen S.

    2013-01-01

    Advances in genetics and genomics have quickly led to clinical applications to human health which have far-reaching consequences at the individual and societal levels. These new technologies have allowed a better understanding of the genetic factors involved in a wide range of disorders. During the past decade, incredible progress has been made in the identification of genes involved in the normal process of hearing. The resulting clinical applications have presented consumers with new information and choices. Many of the same gene identification techniques are increasingly being applied to the investigation of complex disorders of speech and language. In parallel with gene identification, studies of the legal, ethical and psychosocial impacts of the clinical application of these advances and their influence on specific behaviors of individuals with communication disorders are paramount, but often lag behind. These studies will help to ensure that new technologies are introduced into clinical practice in a responsible manner. Learning outcomes As a result of this activity, the participant will be able to (1) explain the differences between Mendelian and complex forms of inheritance and why these differences complicate the ethical impact of genetic testing, (2) explain how publicly funded genome research through the Human Genome Project, the International HapMap Project and others have examined the ethical, legal and social implications of genome research, (3) list some of the ethical complexities of prenatal, newborn and predictive testing for various genetic disorders and (4) discuss the importance of evidence-based practice to the development of public policy for the introduction and clinical use of genetic tests. PMID:18452941

  10. Evidence-based therapy for cutaneous sarcoidosis.

    PubMed

    Doherty, Christy B; Rosen, Ted

    2008-01-01

    Although healthcare providers have arrived at a relatively comfortable zone of accepted clinical practice in the management of cutaneous sarcoidosis, virtually every treatment is based on minimal evidence-based data and relies almost exclusively on anecdotal information. Although it would be convenient to blame this state of affairs on the lack of certainty about disease aetiology, the unavoidable fact is that little has been executed, even in the realm of well designed comparative trials. Nonetheless, worldwide accepted standard therapies for sarcoidosis include the administration of corticosteroids, antimalarials and methotrexate. A stepwise approach to patient care is appropriate, and potent topical corticosteroids (e.g. clobetasol) or repeated intralesional injections of triamcinolone (3-10 mg/mL) may be all that is needed in mild skin-limited disease. In patients requiring systemic therapy for recalcitrant or deforming skin lesions (or for widespread disease), corticosteroids (e.g. prednisone 40-80 mg/day, tapered accordingly) used alone or in combination with antimalarials or methotrexate may be indicated. Antimalarials and methotrexate are considered second-line interventions and may be used as monotherapy for steroid-resistant sarcoidosis or in patients unable to tolerate steroids. Given the concern regarding ocular toxicity, the maximum dosages of chloroquine and hydroxychloroquine should not exceed 3.5 and 6.5 mg/kg/day, respectively. Methotrexate is given in weekly doses of 10-30 mg, with the caveat that haematological, gastrointestinal, pulmonary and hepatic toxicities are possible. Despite universal acceptance as standard care, the aforementioned treatments often result in an incomplete clinical response or unacceptable adverse events. In such situations, more innovative treatment options may be used. Treatments that may well gain widespread future use include the tumour necrosis factor-alpha inhibitors infliximab and adalimumab. Experience is limited

  11. Deconstructing the evidence-based discourse in health sciences: truth, power and fascism.

    PubMed

    Holmes, Dave; Murray, Stuart J; Perron, Amélie; Rail, Geneviève

    2006-09-01

    Background  Drawing on the work of the late French philosophers Deleuze and Guattari, the objective of this paper is to demonstrate that the evidence-based movement in the health sciences is outrageously exclusionary and dangerously normative with regards to scientific knowledge. As such, we assert that the evidence-based movement in health sciences constitutes a good example of microfascism at play in the contemporary scientific arena. Objective  The philosophical work of Deleuze and Guattari proves to be useful in showing how health sciences are colonised (territorialised) by an all-encompassing scientific research paradigm - that of post-positivism - but also and foremost in showing the process by which a dominant ideology comes to exclude alternative forms of knowledge, therefore acting as a fascist structure. Conclusion  The Cochrane Group, among others, has created a hierarchy that has been endorsed by many academic institutions, and that serves to (re)produce the exclusion of certain forms of research. Because 'regimes of truth' such as the evidence-based movement currently enjoy a privileged status, scholars have not only a scientific duty, but also an ethical obligation to deconstruct these regimes of power.

  12. Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice.

    PubMed

    Ross, Jacqueline

    2010-04-01

    Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas.

  13. Revitalising the evidence base for public health: an assets model.

    PubMed

    Morgan, Antony; Ziglio, Erio

    2007-01-01

    Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast 'assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a 'salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective

  14. 5 CFR 2601.103 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Policy. 2601.103 Section 2601.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY General Provisions § 2601.103 Policy. (a) Scope. The Office of Government Ethics may use...

  15. 5 CFR 2601.103 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Policy. 2601.103 Section 2601.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY General Provisions § 2601.103 Policy. (a) Scope. The Office of Government Ethics may use...

  16. 5 CFR 2601.103 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Policy. 2601.103 Section 2601.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY General Provisions § 2601.103 Policy. (a) Scope. The Office of Government Ethics may use...

  17. 5 CFR 2601.103 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Policy. 2601.103 Section 2601.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY General Provisions § 2601.103 Policy. (a) Scope. The Office of Government Ethics may use...

  18. Evidence-Based Practice: Integrating Classroom Curriculum and Field Education

    ERIC Educational Resources Information Center

    Tuchman, Ellen; Lalane, Monique

    2011-01-01

    This article describes the use of problem-based learning to teach the scope and consequences of evidence-based practices in mental health through an innovative assignment that integrates classroom and field learning. The authors illustrate the planning and implementation of the Evidence-Based Practice: Integrating Classroom Curriculum and Field…

  19. Opening Pandora's Box: Evidence-Based Practice for Educational Psychologists

    ERIC Educational Resources Information Center

    Fox, Mark

    2003-01-01

    Over the past few years evidence-based practice has become of central concern to health and social services in this country. The fundamental tenant is that there must be a clear link between professional practice and its research base. This paper outlines the concept of evidence-based practice and how it rests on the concept of good quality…

  20. Evidence-Based Practice in Rehabilitation Counseling: Perceptions and Practices

    ERIC Educational Resources Information Center

    Bezyak, Jill L.; Kubota, Coleen; Rosenthal, David

    2010-01-01

    This study describes certified rehabilitation counselors' attitudes (n=163) about evidence based practice, knowledge and skills related to obtaining and evaluating evidence, use of literature in practice, availability of information, and perceived barriers to evidence-based practice. Responses related to knowledge and skills were mixed with strong…

  1. The Evidence-Based Manifesto for School Librarians

    ERIC Educational Resources Information Center

    Todd, Ross

    2008-01-01

    School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

  2. Teaching Evidence-based Medical Care: Description and Evaluation.

    ERIC Educational Resources Information Center

    Grad, Roland; Macaulay, Ann C.; Warner, Michelle

    2001-01-01

    Describes and evaluates a teaching initiative in evidence-based medical care in McGill University's family practice residency program. Discusses results of pre- and post-course self-assessments by students, which indicated significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews,…

  3. Personalizing Research: Special Educators' Awareness of Evidence-Based Practice

    ERIC Educational Resources Information Center

    Guckert, Mary; Mastropieri, Margo A.; Scruggs, Thomas E.

    2016-01-01

    Although evidence-based practices are considered critical to student success, a research-to-practice gap exists. This qualitative study examined practicing special education teachers' perceptions of their use of evidence-based practices. Special education teachers were interviewed and their classroom practices examined. Major themes emerged and…

  4. Teaching Evidence-Based Physical Diagnosis: Six Bedside Lessons.

    PubMed

    McGee, Steven

    2016-12-01

    Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.

  5. Evidence-Based Treatment and Stuttering--Historical Perspective

    ERIC Educational Resources Information Center

    Prins, David; Ingham, Roger J.

    2009-01-01

    Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

  6. Behavioral Activation Is an Evidence-Based Treatment for Depression

    ERIC Educational Resources Information Center

    Sturmey, Peter

    2009-01-01

    Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier…

  7. Evidence-based gene predictions in plant genomes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Automated evidence-based gene building is a rapid and cost-effective way to provide reliable gene annotations on newly sequenced genomes. One of the limitations of evidence-based gene builders, however, is their requirement for gene expression evidence—known proteins, full-length cDNAs, or expressed...

  8. Mental health clinicians' experiences of implementing evidence-based treatments.

    PubMed

    Powell, Byron J; Hausmann-Stabile, Carolina; McMillen, J Curtis

    2013-10-01

    Implementation research has tremendous potential to bridge the research-practice gap; however, we know more about barriers to evidence-based care than the factors that contribute to the adoption and sustainability of evidence-based treatments. In this qualitative study the authors explore the experiences of clinicians (N = 11) who were implementing evidence-based treatments, highlighting the factors that they perceived to be most critical to successful implementation. The clinicians' narratives reveal many leverage points that can inform administrators, clinical supervisors, and clinicians who wish to implement evidence-based treatments, as well as other stakeholders who wish to develop and test strategies for moving evidence-based treatments into routine care.

  9. Merging Evidence-Based Psychosocial Interventions in Schizophrenia

    PubMed Central

    Lecomte, Tania; Corbière, Marc; Simard, Stéphanie; Leclerc, Claude

    2014-01-01

    Psychosocial interventions are an essential part of the treatment for people with severe mental illness such as schizophrenia. The criteria regarding what makes an intervention “evidence-based” along with a current list of evidence-based interventions are presented. Although many evidence-based interventions exist, implementation studies reveal that few, if any, are ever implemented in a given setting. Various theories and approaches have been developed to better understand and overcome implementation obstacles. Among these, merging two evidence-based interventions, or offering an evidence-based intervention within an evidence-based service, are increasingly being reported and studied in the literature. Five such merges are presented, along with their empirical support: cognitive behavior therapy (CBT) with skills training; CBT and family psychoeducation; supported employment (SE) and skills training; SE and cognitive remediation; and SE and CBT. PMID:25431447

  10. Hospital readiness for undertaking evidence-based practice: A survey.

    PubMed

    Nguyen, Thi Ngoc Minh; Wilson, Anne

    2016-12-01

    Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association.

  11. [Forensic evidence-based medicine in computer communication networks].

    PubMed

    Qiu, Yun-Liang; Peng, Ming-Qi

    2013-12-01

    As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks.

  12. The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

    PubMed

    Sheppard, Maria K

    2015-10-01

    Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries.

  13. The process of adoption of evidence-based tobacco use prevention programs in California schools.

    PubMed

    Little, Melissa A; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

    2015-01-01

    Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community and organizational variables on the adoption of prevention programs via school administrators' beliefs and the organization's receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts' use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools.

  14. Iconoclastic ethics.

    PubMed

    Black, D

    1984-12-01

    Arguments are advanced, on a pragmatic basis, for preferring a 'situational' approach to medical ethical problems, rather than an approach based on any one of the dogmatic formulations on offer. The consequences of such a preference are exemplified in relation to confidentiality; and in relation to the ethical dilemmas which surround the beginning and the end of terrestrial human life.

  15. "Ethics Shock."

    ERIC Educational Resources Information Center

    Knefelkamp, L. Lee

    1990-01-01

    Four books focusing on ethical issues in collegiate sports are reviewed: "Paterno by the Book,""Personal Fouls,""Never Too Young to Die: The Death of Len Bias," and "Rules of the Game: Ethics in College Sport." The themes of academic standards, student responsibility, the coach's role and responsibilities,…

  16. Research ethics in the context of humanitarian emergencies.

    PubMed

    O'Mathúna, Dónal

    2015-02-01

    Research is needed to make responses to disasters and humanitarian emergencies more evidence-based. Such research must also adhere to the generally accepted principles of research ethics. While research into health interventions used in disasters raises distinctive ethical concerns, seven ethical principles developed for clinical research are applied here to disaster research. Practical examples from disaster settings are used to demonstrate how these ethical principles can be applied. This reveals that research ethics needs to be seen as much more than a mechanism to obtain ethical approval for research. Research ethics involves ethical principles and governance frameworks, but must also consider the role of ethical virtues in research. Virtues are essential to ensure that researchers do what they believe is ethically right and resist what is unethical. Research ethics that truly protects participants and promotes respect needs to include training in ethical virtues to ensure disaster research is carried out to the highest ethical standards. This article is based on a presentation at the Evidence Aid Symposium on 20 September 2014, in Hyderabad, India.

  17. A moment in human development: legal protection, ethical standards and social policy on the selective non-treatment of handicapped neonates.

    PubMed

    Gostin, L

    1985-01-01

    Selective non-treatment decisions involving severely handicapped neonates have recently come under renewed judicial and legislative scrutiny. In this Article, the Author examines the legal, ethical and social considerations attendant to the non-treatment decision. In Part II of this Article the Author discusses the predominant ethical viewpoints relating to this issue and proposes a new moral standard based on personal interests. Part III presents a survey of the jurisprudence relating to selective non-treatment decisions. Parts IV and V of this Article provide a critical examination of the recently enacted Child Abuse Amendments of 1984, a federal legislative initiative designed to regulate treatment decisions relating to handicapped infants. The Author suggests that the ethical standards and treatment criteria proposed in this Article may prove useful to courts seeking to balance the handicapped neonate's constitutional right to privacy with the requirements of the new federal law.

  18. Business ethics: the materiel/manufacturing perspective.

    PubMed

    Marucheck, A S; Robbins, L B

    1990-08-01

    The discussion of purchasing practices and product integrity, which have ethical implications for materiel/manufacturing management, serves to illustrate how routine decisions can have larger implications for the firm as a whole. Management needs to take a proactive role in confronting ethical issues by (1) demonstrating a corporate commitment to sound ethics in business practices, (2) providing written policies where appropriate to provide a basis for sound ethical conducts, (3) educating various functional areas to understand their responsibility in seeming unrelated ethical problems, (4) delegating authority in ethical issues where such issues are considered in decision making, and (5) fostering interfunctional communication as a means in establishing corporatewide responsibility. The basic philosophical principles of JIT serve as a blueprint for recognizing and managing ethical responsibility. The unexpected by-products of a JIT implementation may be vendor/customer good will and an excellent reputation for the firm.

  19. Analysis of Texas & New Mexico Hospice Organization's new Code of Ethics.

    PubMed

    Smith, M J

    1999-01-01

    Unique among professional codes of ethics is the Texas & New Mexico Hospice Organization's Code of Ethics. Where other codes concentrate only on principles-based ethics, this new code identifies five models of bioethics currently used in resolving ethical dilemmas. This report's primary purpose analyzes the code's four precepts in the context of (1) principles-based ethics, (2) casuistic-based ethics, (3) covenant-based ethics, (4) evidence-based ethics and narrative-based ethics. The second purpose is to present the practicality of these often esoteric concepts in the day-to-day work of palliative care providers. Indications are that this code of ethics, because of its broad scope, is more useful than other principles-based-only codes.

  20. USPSTF perspective on evidence-based preventive recommendations for children.

    PubMed

    Melnyk, Bernadette Mazurek; Grossman, David C; Chou, Roger; Mabry-Hernandez, Iris; Nicholson, Wanda; DeWitt, Thomas G; Cantu, Adelita G; Flores, Glenn

    2012-08-01

    The development and use of evidence-based recommendations for preventive care by primary care providers caring for children is an ongoing challenge. This issue is further complicated by the fact that a higher proportion of recommendations by the US Preventive Services Task Force (USPSTF) for pediatric preventive services in comparison with adult services have insufficient evidence to recommend for or against the service. One important root cause for this problem is the relative lack of high quality screening and counseling studies in pediatric primary care settings. The paucity of studies limits the development of additional evidence-based guidelines to enhance best practices for pediatric and adolescent conditions. In this article, we describe the following: (1) evidence-based primary care preventive services as a strategy for addressing important pediatric morbidities, (2) the process of making evidence-based screening recommendations by the USPSTF, (3) the current library of USPSTF recommendations for children and adolescents, and (4) factors influencing the use of USPSTF recommendations and other evidence-based guidelines by clinicians. Strategies to accelerate the implementation of evidence-based services and areas of need for future research to fill key gaps in evidence-based recommendations and guidelines are highlighted.

  1. Clinical Decision Support Systems for the Practice of Evidence-based Medicine

    PubMed Central

    Sim, Ida; Gorman, Paul; Greenes, Robert A.; Haynes, R. Brian; Kaplan, Bonnie; Lehmann, Harold; Tang, Paul C.

    2001-01-01

    Background: The use of clinical decision support systems to facilitate the practice of evidence-based medicine promises to substantially improve health care quality. Objective: To describe, on the basis of the proceedings of the Evidence and Decision Support track at the 2000 AMIA Spring Symposium, the research and policy challenges for capturing research and practice-based evidence in machine-interpretable repositories, and to present recommendations for accelerating the development and adoption of clinical decision support systems for evidence-based medicine. Results: The recommendations fall into five broad areas—capture literature-based and practice-based evidence in machine-interpretable knowledge bases; develop maintainable technical and methodological foundations for computer-based decision support; evaluate the clinical effects and costs of clinical decision support systems and the ways clinical decision support systems affect and are affected by professional and organizational practices; identify and disseminate best practices for work flow–sensitive implementations of clinical decision support systems; and establish public policies that provide incentives for implementing clinical decision support systems to improve health care quality. Conclusions: Although the promise of clinical decision support system–facilitated evidence-based medicine is strong, substantial work remains to be done to realize the potential benefits. PMID:11687560

  2. A Socio-Cultural Analysis of Practitioner Perspectives on Implementation of Evidence-Based Practice in Special Education

    ERIC Educational Resources Information Center

    Hudson, Roxanne F.; Davis, Carol A.; Blum, Grace; Greenway, Rosanne; Hackett, Jacob; Kidwell, James; Liberty, Lisa; McCollow, Megan; Patish, Yelena; Pierce, Jennifer; Schulze, Maggie; Smith, Maya M.; Peck, Charles A.

    2016-01-01

    Despite the central role "evidence-based practice" (EBP) plays in special education agendas for both research and policy, it is widely recognized that achieving "implementation" of EBPs remains an elusive goal. In an effort to better understand this problem, we interviewed special education practitioners in four school…

  3. A Comparison of Evidence-Based Practice and the ACRL Information Literacy Standards: Implications for Information Literacy Practice

    ERIC Educational Resources Information Center

    Adams, Nancy E.

    2014-01-01

    Evidence-based practice (EBP), like information literacy, is concerned with an individual's knowledge, skills, and attitudes relating to using information. EBP is now a professional competency in fields as diverse as social work, nursing and allied health fields, and public policy. A comparison of the Association of College and Research Libraries'…

  4. Ethical Liberalism, Education and the "New Right."

    ERIC Educational Resources Information Center

    Olssen, Mark

    2000-01-01

    Examines the philosophical tradition of ethical liberalism from its emergence as a coherent response to 19th century classical liberal individualism through contemporary formulations. Pursues origins in John Stuart Mills's writings and assesses ethical liberalism's relevance for understanding current neo-liberal policy restructuring in education.…

  5. Personal Ethics versus Professional Ethics

    DTIC Science & Technology

    1996-01-01

    Colorado Springs, Colo.: Navpress, 1978). 2. Quoted in Andrew Stark, “What’s the Matter with Business Ethics?” Harvard Business Review , May–June 1993...39. 3. Ibid., 40. 4. Kenneth R. Andrews, “Ethics in Practice,” Harvard Business Review , September–October 1989, 99. 5. Quoted in Perspective: A

  6. The perceptions of danish physiotherapists on the ethical issues related to the physiotherapist-patient relationship during the first session: a phenomenological approach

    PubMed Central

    2011-01-01

    Background In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical

  7. Research ethics consultation: ethical and professional practice challenges and recommendations.

    PubMed

    Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

    2015-05-01

    The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

  8. Organizational change tactics: the evidence base in the literature.

    PubMed

    Packard, Thomas; Shih, Amber

    2014-01-01

    Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.

  9. The Outcomes Movement and Evidence Based Medicine in Plastic Surgery

    PubMed Central

    Kowalski, Evan.; Chung, Kevin C.

    2012-01-01

    Synopsis Evidence based medicine is analyzed from its inception. The authors take the reader through the early formation of ‘scientific medicine’ that has evolved into the multi-purpose tool it has become today. Early proponents and their intentions that sparked evidence base and outcomes are presented: the work of David Sackett, Brian Haynes, Peter Tugwell, and Victor Neufeld is discussed - how they perceived the need for better clinical outcomes that led to a more formalized evidence based practice. The fundamentals are discussed objectively in detail and potential flaws are presented that guide the reader to deeper comprehension. PMID:23506764

  10. NCLEX-RN success: evidence-based strategies.

    PubMed

    Thomas, Marie H; Baker, Susan Scott

    2011-01-01

    Evidence-based nursing requires that students think reflectively and use clinical inquiry to develop clinical reasoning and decision-making skills. Likewise, nursing students need a strategy to be successful in passing the NCLEX-RN. The authors identify strategies based on nursing research to facilitate student success. While learning the evidence-based nursing process, the student must begin to think like a nurse while answering clinical practice questions. Using the skills taught for evidence-based nursing can be a powerful tool to approach the NCLEX-RN and succeed.

  11. 12 CFR 367.16 - Ethics Counselor decisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Ethics Counselor decisions. 367.16 Section 367... POLICY SUSPENSION AND EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.16 Ethics Counselor... disputed material facts, the Ethics Counselor shall base the decision on the facts as found, together...

  12. 12 CFR 367.16 - Ethics Counselor decisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Ethics Counselor decisions. 367.16 Section 367... POLICY SUSPENSION AND EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.16 Ethics Counselor... disputed material facts, the Ethics Counselor shall base the decision on the facts as found, together...

  13. 12 CFR 367.16 - Ethics Counselor decisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Ethics Counselor decisions. 367.16 Section 367... POLICY SUSPENSION AND EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.16 Ethics Counselor... disputed material facts, the Ethics Counselor shall base the decision on the facts as found, together...

  14. 12 CFR 367.16 - Ethics Counselor decisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Ethics Counselor decisions. 367.16 Section 367... POLICY SUSPENSION AND EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.16 Ethics Counselor... disputed material facts, the Ethics Counselor shall base the decision on the facts as found, together...

  15. Quality focus shining on corporate ethics.

    PubMed

    2003-01-01

    Compliance just scratches the surface of a comprehensive ethics policy. Being true to your mission is a critical component of governance responsibilities. Quality managers play an important role in feedback, implementation.

  16. An Ethical Justification and Policy for Making Commitments during Computerized Residency Application Processes: The US Matching Program as a Laboratory for Needed Reform

    ERIC Educational Resources Information Center

    Chervenak, Frank A.; McCullough, Laurence B.; Cefalo, Robert

    2011-01-01

    The US National Residency Matching Program (NRMP) is a computerized, national system for matching residency applicants to programs. Similar systems exist in Canada, Australia, and New Zealand, and the need for such a program will probably make itself felt in the European Union soon. NRMP is an important laboratory for the ethical challenges that…

  17. Ethics and Corruption in Education. Results from the Expert Workshop (Paris, France, November 28-29, 2001). Policy Forum on Education.

    ERIC Educational Resources Information Center

    Hallak, Jacques; Poisson, Muriel

    This book summarizes the findings of a research workshop organized by the International Institute for Educational Planning on ethics and corruption in education. It makes a case for addressing the issue of corruption in education based on the experiences of the various participants of the workshop, representatives of various countries and…

  18. Evidence that consumers are skeptical about evidence-based health care.

    PubMed

    Carman, Kristin L; Maurer, Maureen; Yegian, Jill Mathews; Dardess, Pamela; McGee, Jeanne; Evers, Mark; Marlo, Karen O

    2010-07-01

    We undertook focus groups, interviews, and an online survey with health care consumers as part of a recent project to assist purchasers in communicating more effectively about health care evidence and quality. Most of the consumers were ages 18-64; had health insurance through a current employer; and had taken part in making decisions about health insurance coverage for themselves, their spouse, or someone else. We found many of these consumers' beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as "medical evidence" or "quality guidelines." Most believed that more care meant higher-quality, better care. The gaps in knowledge and misconceptions point to serious challenges in engaging consumers in evidence-based decision making.

  19. Dissemination and implementation of evidence based, mental health interventions in post conflict, low resource settings

    PubMed Central

    Tol, Wietse; Jordans, Mark; Zangana, Goran Sabir; Amin, Ahmed Mohammed; Bolton, Paul; Bass, Judith; Bonilla-Escobar, Fransisco Javier; Thornicroft, Graham

    2014-01-01

    The burden of mental health problems in (post)conflict low- and middle-income countries (LMIC) is substantial. Despite growing evidence for the effectiveness of selected mental health programs in conflict-affected LMIC and growing policy support, actual uptake and implementation have been slow. A key direction for future research, and a new frontier within science and practice, is Dissemination and Implementation (DI) which directly addresses the movement of evidence-based, effective health care approaches from experimental settings into routine use. This paper outlines some key implementation challenges, and strategies to address these, while implementing evidence-based treatments in conflict-affected LMIC based on the authors’ collective experiences. Dissemination and implementation evaluation and research in conflict settings is an essential new research direction. Future DI work in LMIC should include: 1) defining concepts and developing measurement tools, 2) the measurement of DI outcomes for all programming, and 3) the systematic evaluation of specific implementation strategies. PMID:28316559

  20. Evidence-based community pediatrics: building a bridge from bedside to neighborhood.

    PubMed

    Sanders, Lee M; Robinson, Thomas N; Forster, Lourdes Q; Plax, Katie; Brosco, Jeffrey P; Brito, Arturo

    2005-04-01

    The American Academy of Pediatrics policy statement "The Pediatrician's Role in Community Pediatrics" encourages all pediatricians to partner with their communities to create and disseminate innovative programs that improve child health. This article describes 4 pillars of a bridge to evidence-based community pediatrics for pediatricians interested in pursuing effective community action: (1) collaborate with the community to establish a specific, short-term, health-related goal; (2) identify evidence-based best practice(s) for achieving the shared goal; (3) collaborate with the community to adapt this best practice to the community's unique assets and constraints; and (4) evaluate the project by using appropriate expertise. Practical elements of each pillar are described and illustrated by specific examples from community-based efforts of pediatricians and are accompanied by specific resources to aid pediatricians in their future community health work.

  1. Adherence of preventive oral care products in the Syrian market to evidence-based international recommendations.

    PubMed

    Habes, D; Mahzia, R; Nakhleh, K; Joury, E

    2016-09-25

    No study has investigated the availability and adherence of preventive oral care products on the Syrian market to evidence-based international recommendations. Data were collected in 2012, and updated in 2016, in terms of availability, characteristics and adherence to evidence-based international recommendations. Few preventive products adhered to the recommendations. Despite the large decrease in the number of oral care products on the Syrian market, due to the Syrian crisis, nonadherence of some of the available products is still present. A multisectorial approach at a policy level is needed to address such important limitations. The Syrian Ministry of Health should reform regulations for fluoride products to become subject to drug monitoring systems; the Syrian Arab Committee for Measurements and Standards needs to update its standards; and the Syrian General Dental Association should distribute a preventive booklet to dental practitioners.

  2. Towards an ethics of authentic practice.

    PubMed

    Murray, Stuart J; Holmes, Dave; Perron, Amélie; Rail, Geneviève

    2008-10-01

    This essay asks how we might best elaborate an ethics of authentic practice. Will we be able to agree on a set of shared terms through which ethical practice will be understood? How will we define ethics and the subject's relation to authoritative structures of power and knowledge? We begin by further clarifying our critique of evidence-based medicine (EBM), reflecting on the intimate relation between theory and practice. We challenge the charge that our position amounts to no more than 'subjectivism' and 'antiauthoritarian' theory. We argue that an ethical practice ought to question the authority of EBM without falling into the trap of dogmatic antiauthoritarianism. In this, we take up the work of Hannah Arendt, who offers terms to help understand our difficult political relation to authority in an authentic ethical practice. We continue with a discussion of Michel Foucault's use of 'free speech' or parrhesia, which he adopts from Ancient Greek philosophy. Foucault demonstrates that authentic ethical practice demands that we 'speak truth to power.' We conclude with a consideration of recent biotechnologies, and suggest that these biomedical practices force us to re-evaluate our theoretical understanding of the ethical subject. We believe that we are at a crucial juncture: we must develop an ethics of authentic practice that will be commensurable with new and emergent biomedical subjectivities.

  3. Informatics and evidence-based medicine: prescription for success.

    PubMed

    Starmer, John M; Wright Pinson, C; Lorenzi, Nancy M

    2010-01-01

    This article reports on the experience of one organization between 2004 and 2009 to develop an effective people-process-technology system to better manage the quality of health care. The creation of this system started with creating a strategic plan for quality and then establishing a structure to implement the plan. The next phase consisted of establishing a number of simultaneous steps that ranged from identifying and leveraging the appropriate informatics tools to the oversight process, and from the implementation team to strategies for working with clinical groups. The outcome as of 2009 is a well established evidence-based quality process and team in place. There are over 450 evidence-based medicine quality sets. More than 52% of all patients are admitted on quality evidence-based medicine pathways and protocols. This article reflects a successful prescription for combining informatics and evidence-based medicine to improve the quality of health care.

  4. Ethical challenges in the management of multiple pregnancies: the professional responsibility model of perinatal ethics.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2013-01-01

    Abstract Ethics is an essential component for the responsible clinical management of multiple gestation and decision-making about such pregnancies with pregnant women. The ethical concept of the fetus as a patient is presented as the basis for identifying a professionally responsible approach to selective termination, twin-to-twin transfusion syndrome, and to discordant beneficence-based obligations that exist when one or more fetuses are adversely affected by a fetal anomaly or complication of pregnancy. The roles for directive counseling, i.e., making evidence-based recommendations, and for non-directive counseling, i.e., offering evidence-based alternatives but making no recommendations, are described. The professional responsibility model of perinatal ethics creates a practical framework to guide the clinical judgment of perinatologists and the informed process about the clinical management of multiple pregnancies.

  5. Teaching evidence-based practice: implications for psychology.

    PubMed

    Collins, Frank L; Leffingwell, Thad R; Belar, Cynthia D

    2007-07-01

    A movement advocating the use of evidence-based practice (EBP) is increasingly influencing health care and the practice of psychology. Thus, teaching evidence-based practice in psychology (EBPP) is critical to the preparation of future health service psychologists. In this article, the authors address common myths associated with EBP, propose core components involved in teaching EBPP, and describe an example of how such training can be incorporated into a professional psychology education and training curriculum.

  6. How to Reach Evidence-Based Usability Evaluation Methods.

    PubMed

    Marcilly, Romaric; Peute, Linda

    2017-01-01

    This paper discusses how and why to build evidence-based knowledge on usability evaluation methods. At each step of building evidence, requisites and difficulties to achieve it are highlighted. Specifically, the paper presents how usability evaluation studies should be designed to allow capitalizing evidence. Reciprocally, it presents how evidence-based usability knowledge will help improve usability practice. Finally, it underlines that evaluation and evidence participate in a virtuous circle that will help improve scientific knowledge and evaluation practice.

  7. Organizational change strategies for evidence-based practice.

    PubMed

    Newhouse, Robin P; Dearholt, Sandi; Poe, Stephanie; Pugh, Linda C; White, Kathleen M

    2007-12-01

    Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university.

  8. Antibiotic resistance: An ethical challenge.

    PubMed

    Littmann, Jasper; Buyx, Alena; Cars, Otto

    2015-10-01

    In this paper, we argue that antibiotic resistance (ABR) raises a number of ethical problems that have not yet been sufficiently addressed. We outline four areas in which ethical issues that arise in relation to ABR are particularly pressing. First, the emergence of multidrug-resistant and extensively drug-resistant infections exacerbates traditional ethical challenges of infectious disease control, such as the restriction of individual liberty for the protection of the public's health. Second, ABR raises issues of global distributive justice, both with regard to the overuse and lack of access to antibiotics. Third, the use of antibiotics in veterinary medicine raises serious concerns for animal welfare and sustainable farming practices. Finally, the diminishing effectiveness of antibiotics leads to questions about intergenerational justice and our responsibility for the wellbeing of future generations. We suggest that current policy discussions should take ethical conflicts into account and engage openly with the challenges that we outline in this paper.

  9. [Public health, genetics and ethics].

    PubMed

    Kottow, Miguel H

    2002-10-01

    Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the requirements of citizenry, consideration of common assets, and definition of public policies in regulating genetic endeavors and protecting the society as a whole Bioethics has privileged the approach to individual ethical issues derived from genetic intervention, thereby neglecting the more salient aspects of genetics and social ethics.

  10. Legal briefing: Healthcare ethics committees.

    PubMed

    Pope, Thaddeus Mason

    2011-01-01

    This issue's "Legal Briefing" column covers recent legal developments involving institutional healthcare ethics committees. This topic has been the subject of recent articles in JCE. Healthcare ethics committees have also recently been the subject of significant public policy attention. Disturbingly, Bobby Schindler and others have described ethics committees as "death panels." But most of the recent attention has been positive. Over the past several months, legislatures and courts have expanded the use of ethics committees and clarified their roles concerning both end-of-life treatment and other issues. These developments are usefully grouped into the following eight categories: 1. Existence and availability. 2. Membership and composition. 3. Operating procedures. 4. Advisory roles. 5. Decision-making and gate-keeping roles. 6. Confidentiality. 7. Immunity. 8. Litigation and court cases.

  11. Deinstitutionalization in Greece: Ethical problems.

    PubMed

    Ploumpidis, D; Garanis-Papadatos, T; Economou, M

    2008-10-01

    The following paper is based on a Concerted Action which focused on the "Ethical aspects of deistinstutionalisation in mental health care" in 2001. It investigates the development and the ethical dilemmas posed by deinstitutionalization in Greece. This movement has recently undergone a very active phase but the transition from the traditional model of psychiatric care to the community based system unavoidably creates many ethical problems related to the professionals' attitude towards individual liberties, dignity and other fundamental rights of mentally ill persons. These problems exist not only in the level of the therapist-patient relationship but in the level of policy making as well as its implementation. Moreover, the paper deals with specific ethical problems such as stigmatisation and isolation in the community context, as well as the role of the family.

  12. Feminism and public health ethics.

    PubMed

    Rogers, W A

    2006-06-01

    This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

  13. The business of ethics. Hospitals need to focus on managerial ethics as much as clinical ethics.

    PubMed

    Weber, L J

    1990-01-01

    Business ethics begins with the recognition of the various values and "goods" involved in judgements of what to do. Four key values are individual rights, individual self-interest, the company's best interest, and the public good. Often a company has to choose which of these goals or values should be subordinated to another. Business ethics, then, must clarify priorities among these values and establish priority principles to resolve conflicts. One approach to contemporary business ethics emphasizes personal integrity, focusing on conflicts of interest; another approach stresses social responsibility, focusing on the effect of company policy on groups and individuals in society. In business, most of the attention to conflicts of interest focuses on the conflict between employee self-interest and the firm's interest. Healthcare organizations may need to focus on potential conflicts between the patient's interest and the institution's or physician's interest. Physician referrals and pharmaceutical companies' marketing practices are two areas with potential conflicts. Not-for-profit organizations have been quicker than the business world to acknowledge social responsibility. In many ways, however, the social impact of healthcare policies and decisions has not been as carefully considered as it should be. Institutionalizing deliberation about clinical ethical issues has helped to raise awareness about the ethical dimensions of medical care. It would also be useful to institutionalize attention to business ethics in healthcare.

  14. Promoting networks between evidence-based medicine and values-based medicine in continuing medical education

    PubMed Central

    2013-01-01

    Background In recent years, medical practice has followed two different paradigms: evidence-based medicine (EBM) and values-based medicine (VBM). There is an urgent need to promote medical education that strengthens the relationship between these two paradigms. This work is designed to establish the foundations for a continuing medical education (CME) program aimed at encouraging the dialogue between EBM and VBM by determining the values relevant to everyday medical activities. Methods A quasi-experimental, observational, comparative, prospective and qualitative study was conducted by analyzing through a concurrent triangulation strategy the correlation between healthcare personnel-patient relationship, healthcare personnel's life history, and ethical judgments regarding dilemmas that arise in daily clinical practice. In 2009, healthcare personnel working in Mexico were invited to participate in a free, online clinical ethics course. Each participant responded to a set of online survey instruments before and after the CME program. Face-to-face semi-structured interviews were conducted with healthcare personnel, focusing on their views and representations of clinical practice. Results The healthcare personnel's core values were honesty and respect. There were significant differences in the clinical practice axiology before and after the course (P <0.001); notably, autonomy climbed from the 10th (order mean (OM) = 8.00) to the 3rd position (OM = 5.86). In ethical discernment, the CME program had an impact on autonomy (P ≤0.0001). Utilitarian autonomy was reinforced in the participants (P ≤0.0001). Regarding work values, significant differences due to the CME intervention were found in openness to change (OC) (P <0.000), self-transcendence (ST) (P <0.001), and self-enhancement (SE) (P <0.019). Predominant values in life history, ethical discernment and healthcare personnel-patient relation were beneficence, respect and compassion, respectively. Conclusions The

  15. Using spiritual interventions in practice: developing some guidelines from evidence-based practice.

    PubMed

    Hodge, David R

    2011-04-01

    Research indicates that many social work practitioners are interested in using spiritual interventions in clinical settings. Unfortunately, studies also indicate that practitioners have frequently received minimal training on the topic during their graduate education. Drawing from the evidence-based practice movement, this article develops some guidelines to assist practitioners in using spiritual interventions in an ethical, professional manner that fosters client well-being. These guidelines can be summarized under the following four rubrics: (1) client preference, (2) evaluation of relevant research, (3) clinical expertise, and (4) cultural competency. The article concludes by emphasizing that these overlapping guidelines should be considered concurrently, in a manner that privileges clients' needs and desires in the decision-making process.

  16. Protocol for developing the evidence base for a national salt reduction programme for India

    PubMed Central

    Johnson, Claire; Mohan, Sailesh; Praveen, Deversetty; Woodward, Mark; Maulik, Pallab K; Shivashankar, Roopa; Amarchand, Ritvik; Webster, Jacqui; Dunford, Elizabeth; Thout, Sudhir Raj; MacGregor, Graham; He, Feng; Reddy, K Srinath; Krishnan, Anand; Prabhakaran, Dorairaj; Neal, Bruce

    2014-01-01

    Introduction The scientific evidence base in support of salt reduction is strong but the data required to translate these insights into reduced population salt intake are mostly absent. The aim of this research project is to develop the evidence base required to formulate and implement a national salt reduction programme for India. Methods and analysis The research will comprise three components: a stakeholder analysis involving government, industry, consumers and civil society organisations; a population survey using an age-stratified and sex-stratified random samples drawn from urban (slum and non-slum) and rural areas of North and South India; and a systematic quantitative evaluation of the nutritional components of processed and restaurant foods. The stakeholder interviews will be analysed using qualitative methods to summarise the main themes and define the broad range of factors influencing the food environment in India. The population survey will estimate the mean daily salt consumption through the collection of 24 h urine samples with concurrent dietary surveys identifying the main sources of dietary sodium/salt. The survey of foods will record the nutritional composition of the chief elements of food supply. The findings from this research will be synthesised and proposals for a national salt reduction strategy for India will be developed in collaboration with key stakeholders. Ethics and dissemination This study has been approved by the Human Research Ethics Committees of the University of Sydney and the Centre for Chronic Disease Control in New Delhi, and also by the Indian Health Ministry's Screening Committee. The project began fieldwork in February 2014 and will report the main results in 2016. The findings will be targeted primarily at public health policymakers and advocates, but will be disseminated widely through other mechanisms including conference presentations and peer-reviewed publications, as well as to the participating communities. PMID

  17. Ethical Practices for College Presidents.

    ERIC Educational Resources Information Center

    American Association of State Colleges and Universities, Washington, DC.

    A policy statement on ethical practices for college presidents developed by the Committee on Governance of the American Association of State Colleges and Universities (AASCU) is presented. Presidents of AASCU member institutions recognize the special responsibilities that pertain to them by virtue of the public trust they hold. To fulfill that…

  18. Ethics in E-Learning

    ERIC Educational Resources Information Center

    Toprak, Elif; Ozkanal, Berrin; Aydin, Sinan; Kaya, Secil

    2010-01-01

    E-Learning environments require policies balancing different expectations of participants and considering how the users perceive ethics during online learning. As in the case of face-to-face classes; learners must show respect and tolerance among each other, and conduct civil relations and interaction based on pre-determined rules. Starting with a…

  19. Surgical innovation: the ethical agenda

    PubMed Central

    Broekman, Marike L.; Carrière, Michelle E.; Bredenoord, Annelien L.

    2016-01-01

    Abstract The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges. To answer the question “What are the main ethical aspects of surgical innovation?”, we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers. We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure. We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health

  20. The Ethical Significance of Antimicrobial Resistance

    PubMed Central

    Littmann, Jasper

    2015-01-01

    In this paper, we provide a state-of-the-art overview of the ethical challenges that arise in the context of antimicrobial resistance (AMR), which includes an introduction to the contributions to the symposium in this issue. We begin by discussing why AMR is a distinct ethical issue, and should not be viewed purely as a technical or medical problem. In the second section, we expand on some of these arguments and argue that AMR presents us with a broad range of ethical problems that must be addressed as part of a successful policy response to emerging drug resistance. In the third section, we discuss how some of these ethical challenges should be addressed, and we argue that this requires contributions from citizens, ethicists, policy makers, practitioners and industry. We conclude with an overview of steps that should be taken in moving forward and addressing the ethical problems of AMR. PMID:26566395

  1. Alternate light sources in sexual assault examinations: an evidence-based practice project.

    PubMed

    Eldredge, Kelli; Huggins, Emily; Pugh, Linda C

    2012-03-01

    The ability of sexual assault nurse examiners to correctly identify and collect DNA evidence improves patient outcomes and prosecution rates. The purpose of this paper is to present findings from a collaborative evidence-based practice (EBP) project between forensic nurses and baccalaureate nursing students. The goal of the project was to determine best practice using an alternate light source (ALS) to identify trace DNA evidence in sexual assault forensic examinations. Using the Johns Hopkins Nursing Evidence-based Practice model, the team searched several databases to summarize the limited amount of evidence available regarding this topic. Recommendations from the EBP project include: elimination of the Wood's lamp in sexual assault examinations; use of an ALS that provides appropriate wavelengths to detect DNA; education of forensic nurses about the advantages and limitations of an ALS; and additional research related to use of an ALS. By participating in similar collaborative efforts, practicing forensic nurses have the opportunity to collaborate with local colleges and universities to make complex projects more manageable while fulfilling the International Association of Forensic Nurses vision for ethical practice.

  2. Tips for teaching evidence-based medicine in a clinical setting: lessons from adult learning theory. Part one.

    PubMed

    Das, Kausik; Malick, Sadia; Khan, Khalid S

    2008-10-01

    Evidence-based medicine (EBM) is an indispensable tool in clinical practice. Teaching and training of EBM to trainee clinicians is patchy and fragmented at its best. Clinically integrated teaching of EBM is more likely to bring about changes in skills, attitudes and behaviour. Provision of evidence-based health care is the most ethical way to practice, as it integrates up-to-date, patient-oriented research into the clinical decision making process, thus improving patients' outcomes. In this article, we aim to dispel the myth that EBM is an academic and statistical exercise removed from practice by providing practical tips for teaching the minimum skills required to ask questions and critically identify and appraise the evidence and presenting an approach to teaching EBM within the existing clinical and educational training infrastructure.

  3. Medical ethics in pediatric critical care.

    PubMed

    Orioles, Alberto; Morrison, Wynne E

    2013-04-01

    Ethically charged situations are common in pediatric critical care. Most situations can be managed with minimal controversy within the medical team or between the team and patients/families. Familiarity with institutional resources, such as hospital ethics committees, and national guidelines, such as publications from the American Academy of Pediatrics, American Medical Association, or Society of Critical Care Medicine, are an essential part of the toolkit of any intensivist. Open discussion with colleagues and within the multidisciplinary team can also ensure that when difficult situations arise, they are addressed in a proactive, evidence-based, and collegial manner.

  4. Professional Ethics for Climate Scientists

    NASA Astrophysics Data System (ADS)

    Peacock, K.; Mann, M. E.

    2014-12-01

    Several authors have warned that climate scientists sometimes exhibit a tendency to "err on the side of least drama" in reporting the risks associated with fossil fuel emissions. Scientists are often reluctant to comment on the implications of their work for public policy, despite the fact that because of their expertise they may be among those best placed to make recommendations about such matters as mitigation and preparedness. Scientists often have little or no training in ethics or philosophy, and consequently they may feel that they lack clear guidelines for balancing the imperative to avoid error against the need to speak out when it may be ethically required to do so. This dilemma becomes acute in cases such as abrupt ice sheet collapse where it is easier to identify a risk than to assess its probability. We will argue that long-established codes of ethics in the learned professions such as medicine and engineering offer a model that can guide research scientists in cases like this, and we suggest that ethical training could be regularly incorporated into graduate curricula in fields such as climate science and geology. We recognize that there are disanalogies between professional and scientific ethics, the most important of which is that codes of ethics are typically written into the laws that govern licensed professions such as engineering. Presently, no one can legally compel a research scientist to be ethical, although legal precedent may evolve such that scientists are increasingly expected to communicate their knowledge of risks. We will show that the principles of professional ethics can be readily adapted to define an ethical code that could be voluntarily adopted by scientists who seek clearer guidelines in an era of rapid climate change.

  5. The Therapist's Role in Effective Marriage and Family Therapy Practice: The Case for Evidence Based Therapists.

    PubMed

    Blow, Adrian J; Karam, Eli A

    2016-09-30

    In this paper we argue that the therapist is a crucial change variable in psychotherapy as a whole and in couple, marital, and family therapy specifically. Therapists who work with complex systems require more skills to negotiate demanding therapy contexts. Yet, little is known about what differentiates effective couple, marital, and family therapists from those who are less effective, what innate therapy skills they possess, how they learn, and how they operationalize their knowledge in the therapy room. We discuss the need to emphasize evidence based therapists (as opposed to therapies), and implications of the importance of the role therapists for training, practice, research priorities, and policy.

  6. Using Evidence-Based Design to Improve Pharmacy Department Efficiency.

    PubMed

    Greenroyd, Fraser L; Hayward, Rebecca; Price, Andrew; Demian, Peter; Sharma, Shrikant

    2016-10-01

    Using a case study of a pharmacy department rebuild in the South West of England, this article examines the use of evidence-based design to improve the efficiency and staff well-being with a new design. This article compares three designs, the current design, an anecdotal design, and an evidence-based design, to identify how evidence-based design can improve efficiency and staff well-being by reducing walking time and distance. Data were collected from the existing building and used to measure the efficiency of the department in its current state. These data were then mapped onto an anecdotal design, produced by architects from interviews and workshops with the end users, and an evidence-based design, produced by highlighting functions with high adjacencies. This changed the view on the working processes within the department, shifting away from a focus on the existing robotic dispensing system. Using evidence-based design was found to decrease the walking time and distance for staff by 24%, as opposed to the anecdotal design, which increased these parameters by 9%, and is predicted to save the department 248 min across 2 days in staff time spent walking.

  7. Evidence-based curriculum reform: the Kentucky Experience.

    PubMed

    Thomas, Mark V; Robinson, Fonda G; Nihill, Patricia

    2009-01-01

    Evidence-based health care seeks to base clinical practice and decision-making on best evidence, while allowing for modifications because of patient preferences and individual clinical situations. Dentistry has been slow to embrace this discipline, but this is changing. In the Graduate Periodontology Program (GPP) of the University of Kentucky, an evidence-based clinical curriculum was implemented in 2004. The tools of evidence-based health care (EBHC) were used to create evidence-based protocols to guide clinical decision-making by faculty and residents. The program was largely successful, although certain challenges were encountered. As a result of the positive experience with the GPP, the college is implementing a wider program in which evidence-based protocols will form the basis for all patient care and clinical education in the predoctoral clinics. A primary component of this is a computerized risk assessment tool that will aid in clinical decision-making. Surveys of alumni of the periodontal graduate program show that the EBHC program has been effective in changing practice patterns, and similar follow-up studies are planned to assess the effectiveness of the predoctoral EBHC program.

  8. How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments

    PubMed Central

    Drinkwater, Michael J.; Matthews, Kelly E.; Seiler, Jacob

    2017-01-01

    While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. PMID:28232589

  9. Tools for implementing an evidence-based approach in public health practice.

    PubMed

    Jacobs, Julie A; Jones, Ellen; Gabella, Barbara A; Spring, Bonnie; Brownson, Ross C

    2012-01-01

    Increasing disease rates, limited funding, and the ever-growing scientific basis for intervention demand the use of proven strategies to improve population health. Public health practitioners must be ready to implement an evidence-based approach in their work to meet health goals and sustain necessary resources. We researched easily accessible and time-efficient tools for implementing an evidence-based public health (EBPH) approach to improve population health. Several tools have been developed to meet EBPH needs, including free online resources in the following topic areas: training and planning tools, US health surveillance, policy tracking and surveillance, systematic reviews and evidence-based guidelines, economic evaluation, and gray literature. Key elements of EBPH are engaging the community in assessment and decision making; using data and information systems systematically; making decisions on the basis of the best available peer-reviewed evidence (both quantitative and qualitative); applying program-planning frameworks (often based in health-behavior theory); conducting sound evaluation; and disseminating what is learned.

  10. Improving the Evidence Base for Treating Older Adults With Cancer: American Society of Clinical Oncology Statement.

    PubMed

    Hurria, Arti; Levit, Laura A; Dale, William; Mohile, Supriya G; Muss, Hyman B; Fehrenbacher, Louis; Magnuson, Allison; Lichtman, Stuart M; Bruinooge, Suanna S; Soto-Perez-de-Celis, Enrique; Tew, William P; Postow, Michael A; Cohen, Harvey J

    2015-11-10

    The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response to a critical need identified by the Institute of Medicine. Older adults experience the majority of cancer diagnoses and deaths and make up the majority of cancer survivors. Older adults are also the fastest growing segment of the US population. However, the evidence base for treating this population is sparse, because older adults are underrepresented in clinical trials, and trials designed specifically for older adults are rare. The result is that clinicians have less evidence on how to treat older adults, who represent the majority of patients with cancer. Clinicians and patients are forced to extrapolate from trials conducted in younger, healthier populations when developing treatment plans. This has created a dearth of knowledge regarding the risk of toxicity in the average older patient and about key end points of importance to older adults. ASCO makes five recommendations to improve evidence generation in this population: (1) Use clinical trials to improve the evidence base for treating older adults with cancer, (2) leverage research designs and infrastructure for generating evidence on older adults with cancer, (3) increase US Food and Drug Administration authority to incentivize and require research involving older adults with cancer, (4) increase clinicians' recruitment of older adults with cancer to clinical trials, and (5) use journal policies to improve researchers' reporting on the age distribution and health risk profiles of research participants.

  11. How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments.

    PubMed

    Drinkwater, Michael J; Matthews, Kelly E; Seiler, Jacob

    2017-01-01

    While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy.

  12. [Evidence-based orthodontics, still a long way to go].

    PubMed

    Kuijpers-Jagtman, A M

    2003-01-01

    Clinical performance can be kept up to date by learning how to practice evidence-based orthodontics, by seeking and appraising evidence-based summaries from the literature and by applying evidence-based strategies to change clinical behaviour. A MEDLINE search over the period 1990-2000 identified 8345 publications on clinical orthodontic subjects. Of these articles 49.5% was published in five specific orthodontic journals, while the others were published in about seventy other journals making it difficult for the clinician to stay current easily. Systematic reviews are an efficient and reliable source of information, but due to a lack of well-designed randomised clinical trials systematic reviews in orthodontics are still rare.

  13. Lost in translation: bibliotherapy and evidence-based medicine.

    PubMed

    Dysart-Gale, Deborah

    2008-03-01

    Evidence-based medicine's (EBM) quantitative methodologies reflect medical science's long-standing mistrust of the imprecision and subjectivity of ordinary descriptive language. However, EBM's attempts to replace subjectivity with precise empirical methods are problematic when clinicians must negotiate between scientific medicine and patients' experience. This problem is evident in the case of bibliotherapy (patient reading as treatment modality), a practice widespread despite its reliance on anecdotal evidence. While EBM purports to replace such flawed practice with reliable evidence-based methods, this essay argues that its aversion to subjective language prevents EBM from effectively evaluating bibliotherapy or making it amenable to clinical and research governance.

  14. Evidence-based orthopaedics or 'superstition in the pigeon'.

    PubMed

    Evans, R

    2009-01-01

    Pigeon behavioural conditioning methods are similar to the processes that orthopaedic surgeons use to evaluate new surgical procedures. Alternatively, evidence-based orthopaedics is a tool for surgeons to evaluate procedures in a systematic, patient-centred way that is less instinctive than pigeon behaviour. The objective of this article is to describe evidence-based orthopaedics, and then propose changes to surgical culture with the aim of refining the interpretation of the current literature and improving the quality of future research. The proposals are 'institutional' changes rather than calls for increased funding and more randomised controlled trials.

  15. Proposing an Evidence-Based Strategy for Software Requirements Engineering.

    PubMed

    Lindoerfer, Doris; Mansmann, Ulrich

    2016-01-01

    This paper discusses an evidence-based approach to software requirements engineering. The approach is called evidence-based, since it uses publications on the specific problem as a surrogate for stakeholder interests, to formulate risks and testing experiences. This complements the idea that agile software development models are more relevant, in which requirements and solutions evolve through collaboration between self-organizing cross-functional teams. The strategy is exemplified and applied to the development of a Software Requirements list used to develop software systems for patient registries.

  16. Strategies for searching and managing evidence-based practice resources.

    PubMed

    Robb, Meigan; Shellenbarger, Teresa

    2014-10-01

    Evidence-based nursing practice requires the use of effective search strategies to locate relevant resources to guide practice change. Continuing education and staff development professionals can assist nurses to conduct effective literature searches. This article provides suggestions for strategies to aid in identifying search terms. Strategies also are recommended for refining searches by using controlled vocabulary, truncation, Boolean operators, PICOT (Population/Patient Problem, Intervention, Comparison, Outcome, Time) searching, and search limits. Suggestions for methods of managing resources also are identified. Using these approaches will assist in more effective literature searches and may help evidence-based practice decisions.

  17. A constructivist model for teaching evidence-based practice.

    PubMed

    Rolloff, Mary

    2010-01-01

    The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education.

  18. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City–County, Colorado

    PubMed Central

    Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C.

    2015-01-01

    Background Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Community Context Administrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. Methods A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Outcome Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Interpretation Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments. PMID:26111156

  19. Evidence-based information needs of public health workers: a systematized review

    PubMed Central

    Barr-Walker, Jill

    2017-01-01

    Objective This study assessed public health workers’ evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author’s master’s in public health coursework and is considered a systematized review. Methods Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, “information” was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Results Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health–specific issues. Conclusions Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers’ information needs. PMID:28096749

  20. Engineering ethics beyond engineers' ethics.

    PubMed

    Basart, Josep M; Serra, Montse

    2013-03-01

    Engineering ethics is usually focused on engineers' ethics, engineers acting as individuals. Certainly, these professionals play a central role in the matter, but engineers are not a singularity inside engineering; they exist and operate as a part of a complex network of mutual relationships between many other people, organizations and groups. When engineering ethics and engineers' ethics are taken as one and the same thing the paradigm of the ethical engineer which prevails is that of the heroic engineer, a certain model of the ideal engineer: someone both quite individualistic and strong enough to deal with all the moral challenges that could arise. We argue that this is not the best approach, at least today in our interrelated world. We have achieved a high degree of independence from nature by means of technology. In exchange for this autonomy we have become increasingly tied up with very complex systems to which we constantly delegate new tasks and powers. Concerns about safety keep growing everywhere due to the fact that now we have a sensitive awareness of the huge amount of power we are both consuming and deploying, thus, new forms of dialogue and consensus have to be incorporated at different levels, in different forums and at different times. Within these democratic channels of participation not just the needs and interests, but also the responsibilities and mutual commitments of all parties should be taken into account.

  1. ENRICH Forum: Ethical aNd Regulatory Issues in Cancer ResearcH

    Cancer.gov

    ENRICH Forum: Ethical aNd Regulatory Issues in Cancer ResearcH, designed to stimulate dialogue on ethical and regulatory issues in cancer research and promote awareness of developing policies and best practices.

  2. Salt and public health: contested science and the challenge of evidence-based decision making.

    PubMed

    Bayer, Ronald; Johns, David Merritt; Galea, Sandro

    2012-12-01

    For more than four decades, starting in the late 1960s, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption has adverse implications for population health and contributes to deaths from stroke and cardiovascular disease. Various studies and trials have produced conflicting results. Despite this scientific controversy over the quality of the evidence implicating dietary salt in disease, public health leaders at local, national, and international levels have pressed the case for salt reduction at the population level. This article explores the development of this controversy. It concludes that the concealment of scientific uncertainty in this case has been a mistake that has served neither the ends of science nor good policy. The article poses questions that arise from this debate and frames the challenges of formulating evidence-based public health practice and policy, particularly when the evidence is contested.

  3. Pediatric facial transplantation: Ethical considerations

    PubMed Central

    Flynn, Jennifer; Shaul, Randi Zlotnik; Hanson, Mark D; Borschel, Gregory H; Zuker, Ronald

    2014-01-01

    Facial transplantation is becoming increasingly accepted as a method of reconstructing otherwise unreconstructable adult faces. As this modality is made more available, we must turn our attention to pediatric patients who may benefit from facial transplantation. In the current article, the authors present and briefly examine the most pressing ethical challenges posed by the possibility of performing facial transplantation on pediatric patients. Furthermore, they issue a call for a policy statement on pediatric facial transplantation. The present article may serve as a first step in that direction, highlighting ethical issues that would need to be considered in the creation of such a statement. PMID:25114614

  4. Ethical aspects of malaria control and research.

    PubMed

    Jamrozik, Euzebiusz; de la Fuente-Núñez, Vânia; Reis, Andreas; Ringwald, Pascal; Selgelid, Michael J

    2015-12-22

    Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria--and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy.

  5. Ethical Questions

    ERIC Educational Resources Information Center

    Whiteley, John M.

    1970-01-01

    Eight key areas suggested for discussion by the APA and APGA as bases for formulation of ethical standards are: (1) leader qualifications; (2) limits on procedure; (3) confidentiality of group participants; (4) participant selection; (5) informed consent of participants; (6) freedom of client to withdraw; (7) safeguards for participants against…

  6. Ethical coding.

    PubMed

    Resnik, Barry I

    2009-01-01

    It is ethical, legal, and proper for a dermatologist to maximize income through proper coding of patient encounters and procedures. The overzealous physician can misinterpret reimbursement requirements or receive bad advice from other physicians and cross the line from aggressive coding to coding fraud. Several of the more common problem areas are discussed.

  7. Medical Ethics

    MedlinePlus

    ... donate an organ to a sick relative? Your personal health information: who has access to your records? Patient rights: Do you have the right to refuse treatment? When you talk with your doctor, is it ethical for her to withhold information from you or your family?

  8. Ethical Challenges.

    ERIC Educational Resources Information Center

    Morris, Michael; Posavac, Emil; Russ-Eft, Darlene

    1999-01-01

    The article and commentary in this special section consider the ethical implications of a remark by an employee in a business being evaluated that employees have been advised to make the program look good. Explores the implications for the evaluation and its usefulness. (SLD)

  9. Assessing implementation of evidence-based childhood obesity prevention strategies in schools

    PubMed Central

    Totura, Christine M.W.; Figueroa, Holly Lewis; Wharton, Christopher; Marsiglia, Flavio F.

    2015-01-01

    Objective Research suggests that schools can play a key role in obesity prevention by implementing evidence-based strategies promoting student health. This study explores school climate factors underlying implementation of evidence-based health and wellness policies and practices in Kindergarten–8th grade programs in the Southwestern United States. Method Utilizing a participatory research survey approach conducted in December 2011 with school health professionals (N = 62) and a multiple regression design, a moderated predictive model of implementation climate (i.e., attitudes and beliefs about prevention, school commitment to prevention, barriers, and stakeholder collaboration) was tested. Results Barriers to obesity prevention efforts, such as lack of resources, support, or strategy clarity, hinder implementation of healthy food policies despite strong school commitment to prevention. Along with the commitment to prevention, stakeholder collaboration predicts physical education strategies, specifically reducing restricted access to physical education as a punishment for student misconduct. Conclusion Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place. PMID:26844091

  10. Evidence-Based Practice: A Framework for Making Effective Decisions

    ERIC Educational Resources Information Center

    Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.

    2012-01-01

    The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…

  11. Evidence-Based Practice and Evaluation: From Insight to Impact

    ERIC Educational Resources Information Center

    Dunsmuir, Sandra; Brown, Emma; Iyadurai, Suzi; Monsen, Jeremy

    2009-01-01

    With the growing emphasis on accountability and evidence-based practice, evaluation has become increasingly important in the contexts in which educational psychologists (EPs) practice. This paper describes a Target Monitoring and Evaluation (TME) system, derived from Goal Attainment Scaling (GAS) which was developed to evaluate outcomes of a wide…

  12. Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem

    ERIC Educational Resources Information Center

    Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny

    2013-01-01

    Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

  13. Interteaching: An Evidence-Based Approach to Instruction

    ERIC Educational Resources Information Center

    Brown, Thomas Wade; Killingsworth, Kenneth; Alavosius, Mark P.

    2014-01-01

    This paper describes "interteaching" as an evidence-based method of instruction. Instructors often rely on more traditional approaches, such as lectures, as means to deliver instruction. Despite high usage, these methods are ineffective at achieving desirable academic outcomes. We discuss an innovative approach to delivering instruction…

  14. Evidence-Based Interprofessional Practice: Learning and Behaviour

    ERIC Educational Resources Information Center

    Littek, Celeste

    2013-01-01

    The purpose of this journal article is to investigate evidence-based practice (EBP) or He Ritenga Whaimohio, as one of the seven principles outlined in the "Resource Teacher: Learning and Behaviour (RTLB) Toolkit" (2011) that guides RTLB practice; and to critique the principle of EBP through practical reflection. (Contains 2 tables and 2…

  15. An Evidence-Based Course in Complementary Medicines

    PubMed Central

    Hughes, Jeff

    2012-01-01

    Objective. To evaluate the impact of an evidence-based course in complementary medicines on the attitudes, knowledge, and professional practice behavior of undergraduate pharmacy students. Design. A required 12-week evidence-based complementary medicine course was designed and introduced into the third-year undergraduate pharmacy curriculum. The course included a combination of traditional lectures, interactive tutorial sessions, and a range of formal assessments. Assessment. Pre- and post-course survey instruments were administered to assess changes in students’ attitudes, perceptions, knowledge, and the likelihood they would recommend the use of complementary medicines in a pharmacy practice environment. Conclusion. Completion of a required evidence-based complementary medicines course resulted in a positive change in pharmacy students’ perceptions of the value of various complementary medicines as well as in their willingness to recommend them, and provided students with the required knowledge to make patient-centered recommendations for use of complementary medicines in a professional pharmacy practice setting. These findings support the need for greater evidence-based complementary medicine education within pharmacy curricula to meet consumer demand and to align with pharmacists’ professional responsibilities. PMID:23275665

  16. Evidence-Based Kernels: Fundamental Units of Behavioral Influence

    ERIC Educational Resources Information Center

    Embry, Dennis D.; Biglan, Anthony

    2008-01-01

    This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior-influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of…

  17. Urticaria: an evidence-based update. Conference report.

    PubMed

    Alexandroff, A B; Harman, K E

    2010-08-01

    Summary Evidence-based update meetings are held annually by the Centre of Evidence Based Dermatology, University of Nottingham. Topics are chosen by delegates at the previous year's conference and in the past have included blistering disorders, psoriasis, hair disorders and skin cancers. Once the topic is identified, a trials database search is undertaken with the aim of including speakers who are actively involved in trials that address the subject in question. This year, the eighth Evidence Based Update meeting focused on urticaria and took place in Loughborough University on 14 May 2009. The latest data on the diagnosis and management of acute and chronic urticaria, including cold and solar urticaria, and the impact of food intolerance on chronic urticaria, were presented by an international panel of renowned speakers, who sometimes expressed different viewpoints. The highlights of the meeting included an informal atmosphere, an international perspective, and a practical question and answer session. Over 70% of the delegates stated that they would be changing their clinical practice following on from the meeting. The evidence-based update meeting in 2010 will be devoted to eczema.

  18. Evidence-Based Practice in Adapted Physical Education

    ERIC Educational Resources Information Center

    Jin, Jooyeon; Yun, Joonkoo

    2010-01-01

    Although implementation of evidence-based practice (EBP) has been strongly advocated by federal legislation as well as school districts in recent years, the concept has not been well accepted in adapted physical education (APE), perhaps due to a lack of understanding of the central notion of EBP. The purpose of this article is to discuss how APE…

  19. Evidence-Based Practices in Outpatient Treatment for Eating Disorders

    ERIC Educational Resources Information Center

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

    This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

  20. 75 FR 79455 - OPEN GOVERNMENT AND EVIDENCE-BASED REGULATION

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... providing people with information that they ``can readily find and use.'' For this reason, he has said that agencies ``should harness new technologies'' and ``solicit public feedback to identify information of... EVIDENCE-BASED REGULATION There is a close connection, even an inextricable relationship, between...