Using evidence in policy: The importance of mediating beliefs and practices

This article argues that to understand the use of evidence in policy, we need to examine how meanings and practices in the civil service shape what is accepted as knowledge, and how differences between the beliefs and values of the academy and the polity can impede the flow and transfer of knowledge. It considers the importance of social context and shared meanings in legitimating knowledge. Who counts as legitimate knowledge providers has expanded and here the role of stakeholder groups and experiential knowledge is of particular interest. How hierarchy, anonymity, and generalist knowledge within the civil service mediate the use of evidence in policy is examined. The difference in values and ideology of the civil service and the academy has implications for how academic research is interpreted and used to formulate policy and for its position in knowledge power struggles. There are particular issues about the social science nature of evidence to inform rural policy being mediated in a government department more used to dealing with natural science knowledge. This article is based on participant observation carried out in a UK Department of Agriculture and Rural Development. © 2013 The Author. Sociologia Ruralis © 2013 European Society for Rural Sociology.

Preface Writers Are Consistent

The preface paradox does not show that it can be rational to have inconsistent beliefs, because preface writers do not have inconsistent beliefs. I argue, first, that a fully satisfactory solution to the preface paradox would have it that the preface writer's beliefs are consistent. The case here is on basic intuitive grounds, not the consequence of a theory of rationality or of belief. Second, I point out that there is an independently motivated theory of belief--sensitivism--which allows such a solution. I sketch a sensitivist account of the preface writer's (consistent) doxastic state.

Adherence to treatment in children and adolescents with cystic fibrosis: a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

BACKGROUND: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence.

METHODS: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.

RESULTS: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence.

CONCLUSIONS: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.