Implementing living evidence to inform health decisions: A strategy for building capacity in health sector (Protocol)

Every day important healthcare decisions are made with incomplete or outdated information about the effects of the different health care interventions available, what delivers the best value for the health system and where more research is needed. It is necessary to invest in strategies that allow access to reliable and updated evidence on which to base health decisions. The objective is to develop and evaluate a strategy for building the capacity among different actors of a country’s health system to implement the model known as “Living Evidence” [LE] in the evidence synthesis and dissemination of knowledge transfer [KT] products to inform health decisions. The study will involve professional members of health system organizations in charge of developing KT-products to inform health decisions. The project will be developed in three complementary phases: 1) LE-implementation framework development through review of the literature, brainstorming meetings, user testing and expert consultation; 2) training in LE tools and strategies; 3) developing LE synthesis for KT-products by applying the framework to real-life diverse situations. To achieve the capacity building strategy assessment goal, several surveys and interviews will take place during the process to assess: 1) the LE-implementation framework for the incorporation of LE synthesis in the development of KT-products; 2) the training workshops; 3) the whole capacity-building strategy used for health system organizations be able of implementing the LE as part of the KT-products they regularly produce. The expected results are an effective capacity building strategy for health system organizations to implement the living evidence model in different KT products; a LE-implementation framework to be applicable to any country or region for incorporate LE in the KT-products; LE synthesis for KT-products directly applicable to the real-setting situations; integration of Epistemonikos-L.OVE platform for keeping the LE process in the development and updating of KT-products.

Modelling visibility judgments using models of decision confidence

How can we explain the regularities in subjective reports of human observers about their subjective visual experience of a stimulus? The present study tests whether a recent model of confidence in perceptual decisions, the weighted evidence and visibility model, can be generalized from confidence to subjective visibility. In a postmasked orientation identification task, observers reported the subjective visibility of the stimulus after each single identification response. Cognitive modelling revealed that the weighted evidence and visibility model provided a superior fit to the data compared with the standard signal detection model, the signal detection model with unsystematic noise superimposed on ratings, the postdecisional accumulation model, the two-channel model, the response-congruent evidence model, the two-dimensional Bayesian model, and the constant noise and decay model. A comparison between subjective visibility and decisional confidence revealed that visibility relied more on the strength of sensory evidence about features of the stimulus irrelevant to the identification judgment and less on evidence for the identification judgment. It is argued that at least two types of evidence are required to account for subjective visibility, one related to the identification judgment, and one related to the strength of stimulation.

Enhanced humidity in SW Iberia driven by the combination of insolation and ice-sheet forcing during MIS 13 interglacial

<p>Marine Isotope Stage (MIS) 13, ~500 ky ago, represents a Quaternary interglacial of primary interest due to the unexpected enhancement of monsoon systems under a cool climate characterised by low atmospheric CO<sub>2</sub> and larger ice volume than the present interglacial. Yet, key questions remain about its regional expression (intensity, climate variability, length) and underlying forcing factors. Here we examine the SW Iberian vegetation and terrestrial climate during MIS 13 directly compared with the sea surface temperatures using sediments from IODP Site U1385, and combine those terrestrial-marine profiles with climate-model experiments. We show for the first time that MIS 13 stands out for its large forest expansions with a reduced Mediterranean character alternating with muted forest contractions, indicating that this stage is marked by a cool-temperate climate regime with high levels of humidity. Results of our data-model approach reveal that that the dominant effect of MIS 13 insolation forcing on the regional vegetation and precipitation regime in SW Iberia is amplified by the relatively large extent of the ice-sheets in high northern latitudes. In qualitative agreement with the pollen-based evidence, model results show that ice-sheet forcing triggers an increase in the SW Iberian tree fraction along with both intensified winter and summer rainfall. We propose that the interactions between ice-sheets and major atmospheric circulation systems may have resulted in the persistent influence of the mid-latitude cells over the SW Iberian region, which led to intensified moisture availability and reduced seasonality, and, in turn, to a pronounced expansion of the temperate forest.</p>

GIS-Based Weights-of-Evidence Model for Landslide Susceptibility Mapping and Assessment in the Hillslopes of Bujumbura, Burundi

The aim of this research is the modelling of landslide susceptibility in the hillslopes of Bujumbura using the Weights-of-Evidence model, a probabilistic data modelling approach relevant for predicting future landslides at a regional scale. Initially, characteristics and spatial mapping of different landslides type were identified (fall, flow, slide, complex) by thorough interpretation of high-resolution remote sensing data (mountainous areas with difficult access) and intensive fieldwork. Subsequently, the main landslides controlling factors were selected (lithology, fault density, land use, drainage density, slope aspect, curvature, slope angle, and elevation) using in-depth field knowledge and relevant literature. A landslide inventory map with a total of 569 landslide sites was constructed using the data from various sources. Out of those 569 landslide sites, 285 (50.1%) of the data taken before the 2000s was used for training and the remaining 284 (49.9%) sites (post-2000 events) were used for the accuracy assessment purpose. Thereafter, a prediction map of future landslides was generated with an accuracy of 73.7%. The main geo-environmental landslides factors retained are the high density of drainage networks, the lithology often made with weathered gneiss, the high fault density, the steep topography and the convex slope curvature. The landslide susceptibility map validated was reclassified into very high, high, moderate, low and very low zones. The established susceptibility map will allow with the interaction of the real terrain to locate roads, dwellings, urban extension areas, dams located in high landslides risk zones. These infrastructures will require intervention to address their vulnerability with new facilities, slope stabilization, creation of bypass roads, etc. The susceptibility map produced will be a powerful decision-making tool for drawing up appropriate development plans. Such an approach will make it possible to mitigate the socio-economic impacts due to slope instabilities.

Inner Conviction of a Judge and Objective Standards of Proof: Integral Elements of the Single System? (the final part)

This paper presents theoretical analysis of the fundamental possibility of introduction the standards of proof institution in the assessment of evidence model of Romano-German legal family countries.