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published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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No description available.

In the literature on doxastic evidence, the phenomenon is regarded as either internal (Plantinga 1993, Feldman and Conee 2001, Turri 2009) or external (Armstrong 1973, Collins 1997, BonJour 2008). Though the specifics of these views tend to vary, the two main categories are prominent. However, these views face various criticisms. Internalists claim that external evidence ignores relevant mental processes. Externalists claim that internal evidence is weak given its subjective nature. I will propose a remedy for both of these criticisms. I will argue that evidence is internal, external, and social. That is to say, that there are three types of evidence: mental states, states of affairs, and that which has been produced by a rigorous social process. I will extract Helen Longino’s method for establishing social knowledge (2002) and apply it to evidence; I will argue that her method produces social evidence as well. The social component of evidence is aimed towards strengthening internal and external theories of evidence by responding to the worries raised by the internalists and externalists. First, I will argue that a theory that accommodates both internal and external evidence can absolves the worries raised to either theory alone. Moreover, a theory that can accommodate social evidence will be stronger insofar as a rigorous social process will add a further qualification which can only strengthen our evidence. Second, I will argue that social evidence is not reducible to either external or internal evidence. The external view cannot account for the mental processes that are evidently a part of the justification process and is therefore weak. Finally, though the internal view is compelling, it does not account for evidence which supports our usage of automatic, non-conscious mental processes (Bargh and Chartrand 1999; Aarts and Dijksterhuis 2000).

This essay deals with problematic of evidence-efficiency. It is based on analysis of not only national, but also international law sources of different legal power. It further deals with this issue not only from theoretical, but also practical side of the Czech and as well another countries criminal procedure. It closer devotes to the conception of ineffective evidence in Czech criminal-legal theory. The question of efficiency of evidence obtained from inefficient evidence is considered one of the most complicated ones. The legal regulation itself does not reflect on that and jurisprudence as well as opinions of criminal law authorities are not uniform. Reasoning " de lege ferenda" lead to demand of a better legal regulation. Namely the addition of the legislation on General Conditions clause enshrining the ineffectiveness of the evidence exhaustively with significant defects in individual cases based on the prohibitions that were included in the adjustment of individual evidence.

Evidence based practice (EBP) is an educational paradigm that espouses that clinical decision making should be made through the judicious and conscientious use of best evidence. EBP is predicated on a fundamental principle that therapeutic knowledge is appraised and applied into practice with the ethical imperative to use such knowledge for the good of patient care. Despite the ubiquitous nature of EBP in health care little is known about how physiotherapists use this clinical decision making process and it is not clear as to which theoretical frameworks of practice and knowledge paradigms underpin physiotherapists application of EBP. Phenomenology seeks to uncover the internal consciousness of phenomena by describing and exploring the lived experience and explores the relationship between what exists in one’s consciousness and what exists in the objective world. Descriptive phenomenology was used in this thesis to gain an in depth understanding of how twelve physiotherapists applied EBP in the real and complex world of clinical practice with the objective to explore their experiences and to understand the essence of its practice. The findings in this study revealed a complex picture comprising of three separate but interrelated themes. Physiotherapists had developed a personal theory of EBP (Theme 1) that guided their behaviour and comprised of an ontological, epistemological and methodological structure. This theoretical and practice framework was uniquely individual and required a complex set of cognitive processes that included knowledge identification, transformation, translation and implementation in specific client situations and practice contexts (Theme 2: translation into practice). To add to this complexity this framework took place within intrapersonal, social and cultural milieus which influenced behaviour (Theme 3). The study concludes by conceptualising the findings and experiences of physiotherapists into models that could be used to assist educationalists, practitioners and researchers to promote evidence based practice in a pragmatic way.

Doctor of Philosophy / Aim and significance: The aim of this research was to investigate how evidence-based practice (EBP) in nursing homes is understood in the context of Taiwan, a non-Western country. There is a growing movement towards using research evidence to inform practice in the nursing profession with variable success. To date, factors that promote or inhibit implementation of EBP in health care have been investigated through research conducted in hospital settings in Western countries. Remarkably little is known about nurses’ experience and perceptions of EBP in residential aged care facilities (RACFs), especially in non-Western countries. Method: The study adopted a mixed method approach. Subjects were recruited from six nursing homes in the Hsinchu district of Taiwan. In Stage 1, 89 registered nurses completed a comprehensive questionnaire specifically developed for this project. It was designed to elicit information about (1) their experience of and attitudes towards research and EBP; (2) the barriers they perceive to its implementation; and (3) what strategies they believe would enhance its implementation in the nursing home setting. In Stage 2, six nursing managers participated in semi-structured in-depth interviews that explored the same topic areas as those in the questionnaire but used an open-ended format which allowed for new themes to emerge. Findings: The majority of nurses and nursing managers expressed positive attitudes towards research and EBP but reported relatively little experience in its implementation. Nurses relied most heavily on knowledge derived from past experience and on interactions with nursing colleagues, medical staff and patients to inform their clinical practice. They identified the main barriers to EBP as: insufficient authority to change practice, their own lack of research knowledge and insufficient time to implement new ideas in the workplace. They believed EBP would be facilitated by: improved access to computers and internet facilities in the workplace; more effective research training; collaboration with academics; and dedicated time to search for and read research articles. As anticipated, nurses viewed the issues from a practical stance in relation to their own time, resources and lack of authority to effect change. Nursing managers expressed similar views to the nurses in relation to attitudes towards EBP implementation. However, they identified barriers which related to aspects of the organizational framework. In particular, they expressed concerns about issues such as budgetary constraints, staff quality (notably the reliance on minimally trained assistants in nursing (AINs) for direct resident care), as well as factors that reflected the wider political and economic context of health care in Taiwan. Conclusion: The findings of this study have implications for research, policy and practice in both Western and non-Western countries. Further research on EBP would be beneficial if conducted in settings other than hospitals, such as RACFs. There remains also the need to examine the potential for EBP in different social-cultural contexts, such as those in non-Western countries. Nursing managers have generally been excluded in previous research but, because of their particular role, there is a need to examine their perspectives of EBP and then compare these with those of the nurses. In Taiwan specifically, policy change is needed at both government and institutional levels to encourage and support the development of protocols and procedures for the implementation of EBP. If EBP was a government requirement for accreditation and a standard for protocols in hospitals and RACFs, it would lead to improved standards of care and cost effectiveness. This study supports the findings of a number of investigations conducted in Western countries which indicate that further education and training in research for nurses may lead to higher standards of patient care, greater job satisfaction and higher staff retention rates.

The programme of research described in this dissertation examines the potential prejudicial impact of gruesome evidence on mock juror decision making. The dissertation provides a model of the cognitive and emotional processes by which gruesome evidence can influence mock juror judgments. Five studies will be presented which have examined the influence of gruesome verbal (written) and visual evidence. Four studies utilised mock trial or simulation methodology utilising written trial transcripts and undergraduate students as mock jurors. Results suggest that gruesome evidence can cause emotional reactions in mock jurors and that mock jurors who are exposed to gruesome evidence are more likely to find the defendant culpable (in criminal cases) and liable (in civil cases). The studies evaluated a model which outlines the cognitive and affective processes by which gruesome evidence might influence juror emotion and decision making. Gruesome evidence presented verbally, such as verbal descriptions of the victim??s injuries, may bias juror decisions toward conviction. Increased estimates of the guilt of the defendant may result when gruesome information is present, especially when the inculpatory evidence is weak overall. Photographic evidence, irrespective of whether this evidence is neutral or gruesome, can increase the likelihood of conviction. Admitting gruesome photographic evidence, rather than excluding this evidence, may increase the inculpatory value that jurors ascribe to prosecutorial evidence via the influence of gruesome evidence on the emotional state of jurors. Further, although exposure to any photographs had similar effects on mock juror affect, emotional reactions to gruesome photographic evidence appeared to lead to changes in the assessment of evidence and to an increased likelihood of conviction or liability when compared with neutral and no photographs. The implications of the results for policy, practice and research are discussed.