Journal of evaluation in clinical practice
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Recent controversies about dietary advice concerning meat demonstrate that aggregating the available evidence to assess a putative causal link between food and cancer is a challenging enterprise. ⋯ We find that E-Synthesis is a tool well-suited for food carcinogenicity assessments, as it enables a graphical representation of lines and weights of evidence, offers the possibility to make a great number of judgements explicit and transparent, outputs a probability of causality suitable for decision making and is flexible to aggregate different kinds of evidence.
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Exercise interventions and policies are widely prescribed in both sport and healthcare. Research investigating exercise interventions and policies is generally conducted using an Evidence-Based framework, placing an emphasis on evidence gathered from randomised controlled trials (RCTs). ⋯ The article argues that evidence from mechanistic studies ought to be considered alongside evidence from RCTs because: as RCTs investigating exercise interventions tend to be of low quality, mechanistic studies ought to be used to reinforce the evidence base; further, evidence from mechanistic studies is highly useful for both questions of extrapolation and implementation. This article argues for this on theoretical grounds, and also draws on a number of case studies.
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The most important advance of precision medicine (PM) has been a specific way to define and understand disease. However, PM may fail to be therapeutically effective if diseases are natural kinds. ⋯ Need for improved design of future interventions that better acknowledge problematic epistemology of PM.
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When we face an equation with an unknown variable, we 'solve for x', using methods that allow us to isolate and identify the unknown. Stigma is a known variable in health care equations, but remains impactful in a variety of ways that are not fully mapped or understood. In other words, stigma is a known unknown: it presents potential obstacles to the delivery of effective health care, but what kind of obstacles, of what size and significance, and for whom is often unclear. ⋯ The present paper begins by demonstrating that stigma in mental health care remains an obstacle worthy of sustained attention. It then discusses typical methods taken in efforts to destigmatize mental illness, and suggests that additional work is needed in the clinical context of mental health care. The pervasiveness and complexity of stigma requires diligence in clinical settings to integrate the experience of mental health care service users and work towards an adequate model of recovery.
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Substance use disorder (SUD) is often understood as a chronic illness. ⋯ The paper concludes that the delivery of treatment services is inequitable as SUD is not treated as a chronic illness.