What constitutes globalised evidence? Cultural tensions and critical reflections of the evidence-based movement in New Zealand

The evidence-based movement (EBM) is grounded in a well-intentioned desire to ensure resources are invested in high quality initiatives that generate the intended impact. Nevertheless, recent critiques contest the appropriateness of translating an approach rooted in a medical model to socially complex initiatives. Globalised notions of evidence can also be damaging for programs operating in small, culturally diverse countries with limited resources. Given these polemic views, our aim was to examine local perceptions of the EBM in New Zealand, a small, vibrant, bicultural society with a mix of homegrown and imported programs. Using a snowball sampling approach, 79 professionals working in the education and social sectors completed an anonymous online survey that contained a series of closed and open-ended questions. The results show that although participants positively endorsed a variety of quality evidence markers, traditionally positivist methodological leanings received lower and more varied endorsements compared to more inclusive and pluralistic approaches. Many also expressed concern that the EBM emphasises a narrow and colonised view of evidence that does not align with Māori and Pacific worldviews, and undermines innovation. We discuss the implications as an avenue for advancing intervention and social programming research in an increasingly multicultural and globalised world.     

Computerized assessment in neuropsychology: A review of tests and test batteries

This article contains detailed reviews of 13 computerized neuropsychological and performance test batteries and six stand-alone computer tests. Tasks found on these instruments are described and tables illustrate which batteries employ which measures. In addition to issues of reliability and validity, special considerations apply to computerized assessment. These issues are discussed and readers are provided information to help them assess computerized tests in relation to their particular clinical and research needs. Since many computerized tests were developed as performance assessment tools, the relationship between performance and neuropsychological assessment is examined.     

The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.     

On the time course of negative priming: Another look

In two experiments, the pattern of persistence of negative priming effects across delay intervals of 500 and 2,500 msec was assessed using a within-subjects, random sequencing of delays. Neill and Valdes (1992; Neill, Valdes, Terry, & Gorfein, 1992) have argued that a within-subject experimental design is required for decay of negative priming to be seen, in contrast to results reported elsewhere (e.g., Tipper, Weaver, Cameron, Brehaut, & Bastedo, 1991) showing stable negative priming effects across delays. In neither experiment was substantial evidence of decay detected, raising questions for the notion that suppression necessarily declines across brief temporal intervals and for the assertion that episodic retrieval is the sole source of negative priming.     

Lump detection in simulated human breasts

Sixteen observers palpated silicone models of human breasts containing lumps 1.6-12.1 mm in diameter. Detectability depended on the size of the lump, producing a systematic psychometric function. In eight observers who participated in three or more sessions, performance improved with practice, with most improvement occurring within one or two 26-trial sessions. Three-week retention measures disclosed no appreciable decrease in performance, but a significant correlation was found between the number of lumps detected and duration of trial (p < .01). There was no difference in performance between four observers who used their preferred hands and four observers who used their nonpreferred hands. These data establish that examination of breast models for the detection of lumps simulating cancer is a task amenable to experimental analysis.     

The longitudinal effects of early behavior problems in the dementia caregiving career

Using multiregional, 3-year data from early career dementia caregivers, this study determines how behavior problems that occur early in the caregiving career influence time to nursing home placement and change in burden and depression over time. A Cox proportional hazards model indicated that caregivers who managed frequent behavior problems earlier are more likely to institutionalize. After controlling for important time-varying covariates in a series of growth-curve models, caregivers who were faced with severe, early behavior problems reported greater increases in burden and depression over the 3-year study period. The findings suggest the need to consider experiences early in the dementia caregiving career when accounting for key longitudinal outcomes and also emphasize the importance of attrition when attempting to model the health implications of informal long-term care over time.