Evidence Based Practice Quotes

Science seeks the truth. And it does not discriminate. For better or worse it finds things out. Science is humble. It knows what it knows and it knows what it doesn’t know. It bases its conclusions and beliefs on hard evidence -­- evidence that is constantly updated and upgraded. It doesn’t get offended when new facts come along. It embraces the body of knowledge. It doesn’t hold on to medieval practices because they are tradition.

Science is often expensive, and who pays for it can influence the outcome and whether or not the results are published. As enthusiastic as we are about evidence-based practices, it’s important to remember where that evidence comes from and why we might not see contrary evidence.

As long as people think poverty is the problem,” Ganz explained, “they’re missing the whole point. Poverty is evidence of a problem; it’s not the source of the problem. They’re all based on the weakening of collective institutions—the decline of labor, of common interests. The core question is not about poverty, it’s really about democracy. The galloping poverty in the United States is evidence of a retreat from democratic beliefs and practices.

If doctors practiced medicine the way many companies practice management, there would be far more sick and dead patients, and many more doctors would be in jail.

If evidence-based policy is to do its job then, it is best to construe evidence widely enough to cover all the facts without which you will not have a good argument.

The unique stigma of PTSD. The stigma of PTSD remains one of the most formidable barriers to effective care.

Things that look like they were designed, probably were... If intelligence is an operative component of the universe, a science that methodologically excludes its existence will be susceptible to being trapped in an endless chase for materialistic causes that do not exist... Where there are sufficient grounds for inferring intelligent causation, based on evidence of "specified complexity," it should be considered as a component of scientific theories. Inclusion of intelligent causation in the scientific equation is not novel and has not impeded the practice of science in the past, e.g. Newton and Kepler, in an age when science was not constrained by a philosophical materialism, and by many current scientists who have remained open to following the evidence where it leads.

The nine in our list are based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders. For more on CBT—how it works, and how to practice it—please see Appendix 1.) EMOTIONAL REASONING: Letting your feelings guide your interpretation of reality. “I feel depressed; therefore, my marriage is not working out.” CATASTROPHIZING: Focusing on the worst possible outcome and seeing it as most likely. “It would be terrible if I failed.” OVERGENERALIZING: Perceiving a global pattern of negatives on the basis of a single incident. “This generally happens to me. I seem to fail at a lot of things.” DICHOTOMOUS THINKING (also known variously as “black-and-white thinking,” “all-or-nothing thinking,” and “binary thinking”): Viewing events or people in all-or-nothing terms. “I get rejected by everyone,” or “It was a complete waste of time.” MIND READING: Assuming that you know what people think without having sufficient evidence of their thoughts. “He thinks I’m a loser.” LABELING: Assigning global negative traits to yourself or others (often in the service of dichotomous thinking). “I’m undesirable,” or “He’s a rotten person.” NEGATIVE FILTERING: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all of the people who don’t like me.” DISCOUNTING POSITIVES: Claiming that the positive things you or others do are trivial, so that you can maintain a negative judgment. “That’s what wives are supposed to do—so it doesn’t count when she’s nice to me,” or “Those successes were easy, so they don’t matter.” BLAMING: Focusing on the other person as the source of your negative feelings; you refuse to take responsibility for changing yourself. “She’s to blame for the way I feel now,” or “My parents caused all my problems.”11

Science seeks the truth. And it does not discriminate. For better or worse it finds things out. Science is humble. It knows what it knows and it knows what it doesn’t know. It bases its conclusions and beliefs on hard evidence—evidence that is constantly updated and upgraded. It doesn’t get offended when new facts come along. It embraces the body of knowledge. It doesn’t hold on to medieval practices because they are tradition. If it did, you wouldn’t get a shot of penicillin, you’d pop a leech down your trousers and pray.

A modern fad which has gained widespread acceptance amongst the semi-educated who wish to appear secular is the practice of meditation. They proclaim with an air of smug superiority, ‘Main mandir-vandir nahin jaata, meditate karta hoon (I don’t go to temples or other such places, I meditate).’ The exercise involves sitting lotus-pose (padma asana), regulating one’s breathing and making your mind go blank to prevent it from ‘jumping about like monkeys’ from one (thought) branch to another. This intense concentration awakens the kundalini serpent coiled at the base of the spine. It travels upwards through chakras (circles) till it reaches its destination in the cranium. Then the kundalini is fully jaagrit (roused) and the person is assured to have reached his goal. What does meditation achieve? The usual answer is ‘peace of mind’. If you probe further, ‘and what does peace of mind achieve?’, you will get no answer because there is none. Peace of mind is a sterile concept which achieves nothing. The exercise may be justified as therapy for those with disturbed minds or those suffering from hypertension, but there is no evidence to prove that it enhances creativity. On the contrary it can be established by statistical data that all the great works of art, literature, science and music were works of highly agitated minds, at times minds on the verge of collapse. Allama Iqbal’s short prayer is pertinent: Khuda tujhey kisee toofaan say aashna kar dey Keh terey beher kee maujon mein iztiraab naheen (May God bring a storm in your life, There is no agitation in the waves of your life’s ocean.)

pervasiveness of patterns and repetitions from the past.

We’ve done the research. The shadows are an evidence-based practice. People behave better when they are reminded of their mistakes, said the president, as he was making a very big mistake.

In order to be an executive coach with a thriving practice, you need to have been a leader, be fluent in psychology, and have a evidence-based methodology." My book can't help you with #1, but it can help you with the rest.

Here we will see that pharmaceutical companies spend tens of billions of pounds every year trying to change the treatment decisions of doctors: in fact, they spend twice as much on marketing and advertising as they do on the research and development of new drugs. Since we all want doctors to prescribe medicine based on evidence, and evidence is universal, there is only one possible reason for such huge spends: to distort evidence-based practice.

There are two reasons why I currently teach within the framework of mindfulness. The first is that mindfulness is the least culture-bound of the three Buddhist practice traditions. It is relatively easy to extract it from the cultural and doctrinal matrix within which it arose and to present it as an evidence-based, secular, and culturally neutral process. The second reason is that the general method of mindfulness shares some features with the general method of modern science. I

Broken payment models. Because we rely on insurance companies to pay for care, the treatments offered are not necessarily the most effective or those supported by the most current evidence—they’re simply the treatments that insurance companies have agreed to reimburse. This is not evidence-based medicine, it’s reimbursement-based medicine.

Gratitude practices as they’re generally presented in pop culture—usually some form of grateful-for-what-you-have exercise, like “Every day, write a list of ten things you’re grateful for”—don’t cut it, empirically speaking. When Emily tried this, it always made her feel worse because it just reminded her of how many people don’t have those things, which made her feel helpless and inadequate. Then she read the research herself and followed the instructions of the evidence-based interventions…and it worked like a charm. There are two techniques that really get the job done, and neither involves gratitude-for-what-you-have. The key is practicing gratitude-for-who-you-have and gratitude-for-how-things-happen. A Short-Term Quick-Fix Gratitude Boost is gratitude-for-who-you-have. Mr. Rogers, accepting a Lifetime Achievement Award, asked everyone in the audience to take ten seconds to remember some of the people who have “helped you love the good that grows within you, some of those people who have loved us and wanted what was best for us, […] those who have encouraged us to become who we are.” That’s how to gratitude-for-who-you-have.

The new black conservatives assume that without affirmative action programs, white Americans will make choices on merit rather than on race. Yet they have adduced no evidence for this. Most Americans realize that job-hiring choices are made both on reasons of merit and on personal grounds. And it is this personal dimension that is often influenced by racist perceptions. Therefore the pertinent debate regarding black hiring is never "merit vs. race" but whether hiring decisions will be based on merit, influenced by race-bias against blacks, or on merit, influenced by race-bias, but with special consideration for minorities and women, as mandated by law. In light of actual employment practices, the black conservative rhetoric about race-free hiring criteria (usually coupled with a call for dismantling affirmative action mechanisms) does no more than justify actual practices of racial discrimination.

Why science? Many people, with the best intentions, like to give parents advice about raising a child, including parents, non-parents, health visitors, friends, celebrities, bloggers and next-door neighbours. Unfortunately, much of this advice can be completely wrong or based on archaic ideas and practices that have since been disproved or debunked. Some of this advice can even be damaging. In addition, some parents say that they advocate using ‘common sense’ or ‘intuition’ in raising their children, but what do those things mean? How is intuition classified, when it differs so greatly from one person to another? Some people do the ‘common sense’ thing only to find out it was wrong later in life, which is why it is altogether better to be guided by the latest scientific research. In order to learn how to filter the good advice from the bad, I believe that new parents need science-based evidence in their corner. You’ll find it in this book.

It is evident that most of what we think of as our medieval ancestors’ barbaric practices were based on mistaken beliefs about how the laws of nature actually operate. If you—and everyone around you, including ecclesiastical and political authorities—truly believe that witches cause disease, crop failures, sickness, catastrophes, and accidents, then it is not only a rational act to burn witches, it is also a moral duty. This is what Voltaire meant when he wrote that people who believe absurdities are more likely to commit atrocities.

Research shows that practices like yoga and meditation that help us to focus our attention on the present moment, are especially powerful in restructuring the brain. When new neural pathways are forged, we are able to break free of our default patterns and live more actively in a conscious state. In fact, functional MRI (fMRI) brain scans confirm this,23 showing tangible evidence that consistent consciousness practices actually thicken the prefrontal lobes, the area where our conscious awareness actually lives. Other forms of compassion-based meditation (or just closing your eyes and thinking about someone you love) help strengthen an area called the limbic system, which is the emotional center of the brain. All of this work helps to rewire our brain, disrupt our default thought patterns, and wake us up out of our subconscious-driven autopilot. From this foundation of consciousness we can then begin to witness the conditioned patterns in our thoughts, beliefs, and relationships. This honest self awareness shows us our pathway towards change and ultimately healing.

Today the causes of suicide are similarly unknown, but evidence from multiple sources suggests that certain types of treatments and interventions can reduce suicidal behaviors better than status quo practices, which often conceptualizes suicide as a symptom or outcome of mental illness. Consistent with this perspective, status quo practices target a patients diagnosed mental illness based on the assumption that reducing these symptoms or eliminating the psychological or behavioral disorder also will reduce or eliminate the risk of suicide.

I would here observe that very much of what is rejected as evidence by a court, is the best of evidence to the intellect. For the court, guiding itself by the general principles of evidence- the recognized and booked principles- is averse from swerving at particular instances. And this steadfast adherence to principle, with rigorous disregard of the conflicting exception, is a sure mode of attaining the maximum of attainable truth, in any long sequence of time. The practice, in mass, is therefore philosophical; but it is not the less certain that it engenders vast individual error ("A theory based on the qualities of an object, will prevent its being unfolded according to its objects; and he who arranges topics in reference to their causes, will cease to value them according to their results. Thus the jurisprudence of every nation will show that, when law becomes a science and a system, it ceases to be justice. The errors into which a blind devotion to principles of classification has led the common law, will be seen by observing how often the legislature has been obliged to come forward to restore the equity its scheme had lost."- Landor.)

My point is that bias is not advertised by a glowing sign worn around jurors’ necks; we are all guilty of it, because the brain is wired for us to see what we believe, and it usually happens outside of everyone’s awareness. Affective realism decimates the ideal of the impartial juror. Want to increase the likelihood of a conviction in a murder trial? Show the jury some gruesome photographic evidence. Tip their body budgets out of balance and chances are they’ll attribute their unpleasant affect to the defendant: “I feel bad, therefore you must have done something bad. You are a bad person.” Or permit family members of the deceased to describe how the crime has hurt them, a practice known as a victim impact statement, and the jury will tend to recommend more severe punishments. Crank up the emotional impact of a victim impact statement by recording it professionally on video and adding music and narration like a dramatic film, and you’ve got the makings of a jury-swaying masterpiece.45 Affective realism intertwines with the law outside the courtroom as well. Imagine that you are enjoying a quiet evening at home when suddenly you hear loud banging outside. You look out the window and see an African American man attempting to force open the door of a nearby house. Being a dutiful citizen, you call 911, and the police arrive and arrest the perpetrator. Congratulations, you have just brought about the arrest of Harvard professor Henry Louis Gates, Jr., as it happened on July 16, 2009. Gates was trying to force open the front door of his own home, which had become stuck while he was traveling. Affective realism strikes again. The real-life eyewitness in this incident had an affective feeling, presumably based on her concepts about crime and skin color, and made a mental inference that the man outside the window had intent to commit a crime.

Only accurate information has practical application, so it doesn't matter what you wanna believe. All that matters is why we should believe it too, and how accurate your perception can be shown to be. You can't just make up stuff in science like you can in religion because you have to substantiate everything, and you have to be able to defend it—even against peers who may not want to believe as you do. Be prepared to convince them anyway. It's possible to do that in science because science is based on evidence and reason. That means you must be ready to reject or correct whatever you hold true should you discover evidence against it.

Some have estimated that the pharmaceutical industry overall spends about twice as much on marketing and promotion as it does on research and development. Regardless of how those two figures compare to each other, the fact that they are in the same ballpark gives one pause, and this is worth mulling over in various contexts. For example, when a drug company refuses to let a developing country have affordable access to a new AIDS drug it’s because – the company says – it needs the money from sales to fund research and development on other new AIDS drugs for the future. If R&D is a fraction of the company’s outgoings, and it spends a similar amount on promotion, then this moral and practical argument doesn’t hold water quite so well. The scale of this spend is fascinating in itself, when you put it in the context of what we all expect from evidence-based medicine, which is that people will simply use the best treatment for the patient. Because when you pull away from the industry’s carefully fostered belief that this marketing activity is all completely normal, and stop thinking of drugs as being a consumer product like clothes or cosmetics, you suddenly realise that medicines marketing only exists for one reason. In medicine, brand identities are irrelevant, and there’s a factual, objective answer to whether one drug is the most likely to improve a patient’s pain, suffering and longevity. Marketing, therefore, one might argue, exists for no reason other than to pervert evidence-based decision-making in medicine.

The Japanese word seiki is also a way of pointing to this vitality of presence. Carl Whitaker hinted at it when he said therapy was as good as the goodness of the therapist. Though his words are easy to misunderstand, they imply a truth: “I found seiki at the heart of most healing traditions.” Keeney is referring to his decade-long journey around the world, studying with the most accomplished healers in southern Africa, Latin America, South Asia, among the aborigines of Australia, and to many other far-flung places that hold ancient practices. He finds it more than a little amusing that in the culture of therapy we are so obsessed with things that matter so little to others around the world. “I have learned that one’s model or protocols matter not at all and that evidence-based therapy is a gambler’s way of pulling the authority card. If you have seiki, or a powerful life force, then any model will come to life. Without it, the session will be dead and incapable of transformation.” Keeney finds it challenging, if not frustrating, to try to explain this idea to those who don’t speak this language. “I guess if you have seiki or n/om, you feel what I am talking about; if you don’t, no words will matter. The extent to which you feel, smell, taste, hear, and see this vitality is a measure of how much mastery there is in your practice and everyday life.” We believe it is an illusion that master therapists truly understand what therapy is all about and how it works. The reality is that the process has many different dimensions and nuances that we never really grasp. There are aspects that appear both mysterious and magical.

I drew a long breath so I could point out to her all the fallacies in her argument, but then I thought; why? Out of an overwhelming duty to the truth? Fuck, as I may have observed before, the truth. If it was here, would it go out of its way to defend me? Unlikely. The truth is utterly selfish and doesn’t give a damn about anyone else. Serving the truth is like serving the empire. Nobody thanks you for it and you die poor. Besides, what is the truth, anyway? In a court of law, it’s the testimony of credible witnesses corroborating each other. She’d been a witness and she knew what she saw. So was I, but even my mother wouldn’t say I was credible. And there’d been hundreds of people there, all rock-solid upright pillars of Dejauzi society. And when I stabbed myself, there were loads of people watching, and they saw what happened with their own eyes. And, come to that, Alyattes was now the nephew of the old emperor and the rightful heir to the throne. He hadn’t been until quite recently, but pretty soon anyone who could testify against his claim would be dead or singing a very different tune, and what was once a lie would become the truth, official, carved on the lintels of triumphal arches; and if you can’t believe what you read on a government arch, what can you believe? All the books would tell it that way, and in a thousand years’ time it will be the truth, just as what was once the bottom of the sea is now a mountaintop. Ask the wise men at the university what truth is and they’ll tell you it’s the consensus of informed and qualified scholars, based on the best evidence available. Availability is governed by what gets burned in the meanwhile, but I see no real problem with that. All living things change or else they die, and why should the truth be any different?

The studies reviewed above provide evidence to support the intuitions of teachers and learners that instruction based on the ‘Get it right from the beginning’ proposal has important limitations. Learners receiving audiolingual or grammar-translation instruction are often unable to communicate their messages and intentions effectively in a second language. Experience has also shown that primarily or exclusively structure-based approaches to teaching do not guarantee that learners develop high levels of accuracy and linguistic knowledge. In fact, it is often very difficult to determine what students know about the target language. The classroom emphasis on accuracy often leads learners to feel inhibited and reluctant to take chances in using their knowledge for communication. The results from these studies provide evidence that learners benefit from opportunities for communicative practice in contexts where the emphasis is on understanding and expressing meaning.

Like many biblical terms we see in scripture, the word "holy" and the call to be holy have often been co-opted by various tribes and adjusted to suit their particular agendas. In my experience, and perhaps this is true for you, too, the call to be holy has been a call to conform. Preachers...then prescribe for us all of the changes we need to make in our lives so that we'll conform to the image and likeness of their particular brand of Christianity. "Holy living," then, becomes a call to conform to the beliefs and practices of a particular group or tribe as evidence that we are truly walking with God. Although we are called to be imitators of Christ, and to conform to his image and likeness, we must remember that his image and likeness do not conform to any of the various paradigms we like to use to box God in. Holy living, then, becomes conformity with Christ, but radical nonconformity with all those Christian tribes or labels that try to neatly create a limited space where God supposedly lives and works.

In 2011 in Swansea, Wales, Colin Batley was found guilty of 35 charges relating to his role as the leader of a 'satanic cult' that sexually abused children and women, manufactured child abuse images and forced children and women into prostitution (de Bruxelles 2011). His partner and two other women were also convicted on related charges, with one man convicted of paying to abuse a victim of the group. The groups' ritualistic activities were based on the doctrine of Aleister Crowley, an occult figure whose writing includes references to ritual sex with children. Crowley's literature has been widely linked to the practice of ritualistic abuse by survivors and their advocates, who in turn have been accused by occult groups of religious persecution. During Batley's trial, the prosecution claimed that Crowley's writings formed the basis of Batley's organisation and he read from a copy of it during sexually abusive incidents. It seems that alternative as well as mainstream religious traditions can be misused by sexually abusive groups. p38

Here it is necessary to bring to the fore a major and highly revealing difference, at least in the common sense pervading our historical conjuncture, between the idea of communism and that of democracy. It is sometimes said of communism that it was, in fact, a good idea on paper, but that the reality was a veritable catastrophe. One thereby highlights a discrepancy between political theory and historical reality by insisting on the fact that the idea of communism is perhaps quite simply not realizable. One sometimes adds for good measure that it was precisely faith in the communist idea—a faith that lies beyond the reach of the manifest evidence of concrete experience—that led to the totalitarian turn of actually existing communism. Yet on the other hand, when one speaks of democracy, this type of criticism is no longer operative. One frequently admits that contemporary institutions are not perfect, that actually existing democracy has insufficiencies, that there is still progress to be made, that there is a democratic deficit, or that democracy quite simply remains to come. But despite all the setbacks and all the limitations of contemporary practices, people shout themselves hoarse proclaiming that it is a good idea, or even that it is the sole and unique Idea. In one instance, reality takes precedence over the idea; in the other, the idea gains the upper hand over reality. At base, the same operation is at work, which is a comparison between an ideal system and its historical institution. Yet a revealing discrepancy manifests itself in the criteria of evaluation. In the case of communism, history is capable of refuting the idea, whereas for democracy the idea transcends historical reality and orients it toward something that is perhaps always to come. Whatever the case may be, it is impossible to call into question the democratic idea, for it hovers well above concrete practices. Towering over the real, democratic discourse thereby functions as a pseudo-science, which is to say a discourse that is beyond the reach of material refutations. Illustrating another surreptitious recuperation of vulgar Marxism, faith in the idea—this time democratic—can never be refuted by experience. If this sort of belief was what sustained the misdeeds of Soviet bureaucracy, should not one expect that the liberal recuperation would come full circle and that the icon of democracy would come to allow innumerable “anti-democratic abuses,” and even the development of what Sheldon Wolin has called “inverted totalitarianism”?

Andrei Yanuaryevich (one longs to blurt out, “Jaguaryevich”) Vyshinsky, availing himself of the most flexible dialectics (of a sort nowadays not permitted either Soviet citizens or electronic calculators, since to them yes is yes and no is no), pointed out in a report which became famous in certain circles that it is never possible for mortal men to establish absolute truth, but relative truth only. He then proceeded to a further step, which jurists of the last two thousand years had not been willing to take: that the truth established by interrogation and trial could not be absolute, but only, so to speak, relative. Therefore, when we sign a sentence ordering someone to be shot we can never be absolutely certain, but only approximately, in view of certain hypotheses, and in a certain sense, that we are punishing a guilty person. Thence arose the most practical conclusion: that it was useless to seek absolute evidence-for evidence is always relative-or unchallengeable witnesses-for they can say different things at different times. The proofs of guilt were relative, approximate, and the interrogator could find them, even when there was no evidence and no witness, without leaving his office, “basing his conclusions not only on his own intellect but also on his Party sensitivity, his moral forces” (in other words, the superiority of someone who has slept well, has been well fed, and has not been beaten up) “and on his character” (i.e., his willingness to apply cruelty!)… In only one respect did Vyshinsky fail to be consistent and retreat from dialectical logic: for some reason, the executioner’s bullet which he allowed was not relative but absolute…

A soup dumpling is a little marvel of engineering. Called xiao long bao in Chinese, shōronpō in Japanese, and "soupies" by Iris, soup dumplings consist of silky dough wrapped around a minced pork or crab filling. The filling is mixed with chilled gelatinous broth which turns back into soup when the dumplings are steamed. Eating a soup dumpling requires practice. Pop the whole thing in your mouth and fry your tongue; bite it in the wrong place and watch the soup dribble onto your lap. The reason I thought about chocolate baklava is because Mago-chan pan-fries its soup dumplings. A steamed soup dumpling is perfect just the way it is. Must we pan-fry everything? Based on the available evidence, the answer is yes. Pan-fried soup dumplings are bigger and heartier than the steamed variety and more plump with hot soup. No, that's too understated. I'm exploding with love and soup and I have to tell the world: pan-fried soupies are amazing. The dumplings are served in groups of four, just enough for lunch for one adult or a growing eight-year-old. They're topped with a sprinkle of sesame and scallion. You can mix up a dipping sauce from the dispensers of soy sauce, black vinegar, and chile oil at the table, but I found it unnecessary. Like a slice of pizza, a pan-fried soup dumpling is a complete experience wrapped in dough. Lift a dumpling with your spoon, poke it with a chopstick, press your lips to the puncture wound, and slurp out the soup. (This will come in handy if I'm ever bitten by a soup snake.) No matter how much you extract, there always seems to be a little more broth pooling within as you eat your way through the meaty filling and crispy underside. Then you get to start again, until, too soon, your dumplings are gone.

It turns out that in that terrible year Andrei Yanuaryevich (one longs to blurt out, “Jaguaryevich”) Vyshinsky, availing himself of the most flexible dialectics (of a sort nowadays not permitted either Soviet citizens or electronic calculators, since to them yes is yes and no is no), pointed out in a report which became famous in certain circles that it is never possible for mortal men to establish absolute truth, but relative truth only. He then proceeded to a further step, which jurists of the last two thousand years had not been willing to take: that the truth established by interrogation and trial could not be absolute, but only, so to speak, relative. Therefore, when we sign a sentence ordering someone to be shot we can never be absolutely certain, but only approximately, in view of certain hypotheses, and in a certain sense, that we are punishing a guilty person. Thence arose the most practical conclusion: that it was useless to seek absolute evidence—for evidence is always relative—or unchallengeable witnesses—for they can say different things at different times. The proofs of guilt were relative, approximate, and the interrogator could find them, even when there was no evidence and no witness, without leaving his office, “basing his conclusions not only on his own intellect but also on his Party sensitivity, his moral forces” (in other words, the superiority of someone who has slept well, has been well fed, and has not been beaten up) “and on his character” (i.e., his willingness to apply cruelty!). In only one respect did Vyshinsky fail to be consistent and retreat from dialectical logic: for some reason, the executioner’s bullet which he allowed was not relative but absolute. . . . Thus it was that the conclusions of advanced Soviet jurisprudence, proceeding in a spiral, returned to barbaric or medieval standards. Like medieval torturers, our interrogators, prosecutors, and judges agreed to accept the confession of the accused as the chief proof of guilt.

Rather than measuring results and rewarding excellent providers with more patients, the focus has been on lifting all boats by attempting to raise all providers of a service to an acceptable level. The principal tools have been practice guidelines and standards of care that every provider is expected to meet. Evidence-based medicine is another term for practicing based on accepted standards of care.

EFM certainly seems like a good idea. A machine that measures and records a baby’s response to contractions provides scientific data about a particular woman’s labor. Logic says—and many people assume—that EFM improves birth outcomes. Actually, three decades of research shows that EFM doesn’t improve birth outcomes. When EFM is used during labor, no fewer babies die and no fewer have problems at birth. However, more women have cesareans when EFM is used.21 If EFM doesn’t help babies and puts mothers at higher risk of surgical intervention, it is not safer care. In 1988, a Harvard Medical School report described EFM as a “failed technology” but also predicted that doctors wouldn’t stop using it because they fear being sued. Fear of malpractice litigation is pervasive in obstetrics. Doctors too often make patient-care decisions based on their fear of a lawsuit rather than on evidence-based standards of practice established by their profession.

Yet where this idea really hits home is with the breath, the one response over which we have control and which, in turn, exerts control through the alarm system that is the autonomic nervous system. Porges says he realized a long time ago—because he is a musician, specifically a horn player—that the act of controlling the breath to control the rhythm of music and at the same time engaging the brain to execute the mechanics of music works like a mental therapy. To his mind, it has all the elements of pranayama yoga, a form of yoga that stresses breath control. Breath control is common in most of yoga but also in meditation, and even in modern-day “evidence-based practices” like cognitive behavioral therapy. Relax. Take a deep breath. This

I’ve argued that the good data that effective metrics provide are essential to advancing the science at the heart of evidence-based medicine. But I’ve also argued that not all metrics or standards are created equal, and we should not equate metric-tracking with trust-building, because to do so misses a crucial point: What looks good on paper and what drives the best outcomes in practice can be two very different things. Too often, what looks good on paper is what is possible to measure, not necessarily what is actually the best approach to caring for patients. And when we consider the costs of abiding by and tracking and reporting all of these metrics—the four hours of physician time, the eight hours of care team time, the $8 billion we spend as a nation every year—it’s pretty clear that we’re interfering with those best, relationship-building approaches. Instead of spending so much more of our national time, resources, and attention in medicine on creating artificial metrics designed to incentivize good physician and provider behavior while unwittingly reinforcing bad behavior, let’s give the art of medicine the room it needs to build trusting relationships in the way that the best doctors and medical practices have always done so: honestly, naturally, compassionately, and with the best outcomes for the patient squarely in mind.

Your laptop is a note in a symphony currently being played by an orchestra of incalculable size. It’s a very small part of a much greater whole. Most of its capacity resides beyond its hard shell. It maintains its function only because a vast array of other technologies are currently and harmoniously at play. It is fed, for example, by a power grid whose function is invisibly dependent on the stability of a myriad of complex physical, biological, economic and interpersonal systems. The factories that make its parts are still in operation. The operating system that enables its function is based on those parts, and not on others yet to be created. Its video hardware runs the technology expected by the creative people who post their content on the web. Your laptop is in communication with a certain, specified ecosystem of other devices and web servers. And, finally, all this is made possible by an even less visible element: the social contract of trust—the interconnected and fundamentally honest political and economic systems that make the reliable electrical grid a reality. This interdependency of part on whole, invisible in systems that work, becomes starkly evident in systems that don’t. The higher-order, surrounding systems that enable personal computing hardly exist at all in corrupt, third-world countries, so that the power lines, electrical switches, outlets, and all the other entities so hopefully and concretely indicative of such a grid are absent or compromised, and in fact make little contribution to the practical delivery of electricity to people’s homes and factories. This makes perceiving the electronic and other devices that electricity theoretically enables as separate, functional units frustrating, at minimum, and impossible, at worst. This is partly because of technical insufficiency: the systems simply don’t work. But it is also in no small part because of the lack of trust characteristic of systemically corrupt societies. To put it another way: What you perceive as your computer is like a single leaf, on a tree, in a forest—or, even more accurately, like your fingers rubbing briefly across that leaf. A single leaf can be plucked from a branch. It can be perceived, briefly, as a single, self-contained entity—but that perception misleads more than clarifies. In a few weeks, the leaf will crumble and dissolve. It would not have been there at all, without the tree. It cannot continue to exist, in the absence of the tree. This is the position of our laptops in relation to the world. So much of what they are resides outside their boundaries that the screened devices we hold on our laps can only maintain their computer-like façade for a few short years. Almost everything we see and hold is like that, although often not so evidently

Another significant study that was based on the practices of millennials rather than their claims was conducted by sociologists Leslie Picca and Joe Feagin.13 They asked 626 white college students at twenty-eight colleges across the United States to keep journals and record every instance of racial issues, racial images, and racial understanding that they observed or were part of for six to eight weeks. The students recorded more than seventy-five hundred accounts of blatantly racist comments and actions by the white people in their lives (friends, families, acquaintances, strangers). These accounts come from the generation most likely to claim they were taught to see everyone as equal—those who grew up in the age of color-blind ideology after the civil rights movement. Picca and Feagin’s study provides empirical evidence that racism continues to be explicitly expressed by whites, even those who are young and profess to be progressive.

we do not know the physics of climate system responses to warming well enough to blame most of the warming on human activities. Human causation is simply assumed. The models are designed with the assumption that the climate system was in natural balance before the Industrial Revolution, despite historical evidence to the contrary. They only produce human-caused climate change because that is the way they are designed. This is in spite of abundant evidence of past warm episodes, such as 1,000- to 2,000-year-old tree stumps being uncovered by receding glaciers; temperature proxy evidence for the Roman and Medieval Warm Periods covering that same time frame; and Arctic sea ice proxy evidence for a natural decrease in sea ice starting well before humans could be blamed. Natural warming since the Little Ice Age of a few hundred years ago is simply ignored in the design of climate models, since we do not know what caused it. Simply put, the computerized climate models support human causation of climate change because that’s what they assume from the outset. They are an example of circular reasoning. There is little to no evidence of long-term increases in heat waves, droughts, or floods. Wildfire activity has, if anything, decreased, even though poor land management practices are now making some areas more vulnerable to wildfires even without climate change. Contrary to popular perception and new reports, there is little to no evidence of increased storminess resulting from climate change. This includes tornadoes and hurricanes. Long-term increases in monetary storm damages have indeed occurred, but are due to increasing development, not worsening weather. Sea level has been rising naturally since at least the mid-1800s, well before humans could be blamed. Land subsidence in some areas (e.g. Norfolk, Miami, Galveston-Houston, New Orleans) would result in increasing flooding problems even without any sea-level rise, let alone human-induced sea-level rise causing thermal expansion of the oceans. Some evidence for recent acceleration of sea-level rise might support human causation, but the magnitude of the human component since 1950 has been only 1 inch every 30 years. Ocean acidification is now looking like a non-problem, as the evidence builds that sea life prefers somewhat more CO2, just as vegetation on land does. Given that CO2 is necessary for life on Earth, yet had been at dangerously low levels for thousands of years, the scientific community needs to stop accepting the premise that more CO2 in the atmosphere is necessarily a bad thing. Global greening has been observed by satellites over the last few decades, which is during the period of most rapid rises in atmospheric CO2. The benefits of increasing CO2 to agriculture have been calculated to be in the trillions of dollars. Crop yields continue to break records around the world, due to a combination of human ingenuity and the direct effects of CO2 on plant growth and water use efficiency. Much of this evidence is not known by our citizens, who are largely misinformed by a news media that favors alarmist stories. The scientific community is, in general, biased toward alarmism in order to maintain careers and support desired governmental energy policies. Only when the public becomes informed based upon evidence from both sides of the debate can we expect to make rational policy decisions. I hope my brief treatment of these subjects provides a step in that direction. THE END

Still, the volume on climate change keeps getting turned up. Many activists, convinced it is the only important global issue, have made it a practice to blame everything on the climate, to make it the single cause of all other global problems. They grab at the immediate shocking concerns of the day—the war in Syria, ISIS, Ebola, HIV, shark attacks, almost anything you can imagine—to increase the feeling of urgency about the long-term problem. Sometimes the claims are based on strong scientific evidence, but in many cases they are far-fetched, unproven hypotheses.

Such creativity with statistics is by no means an isolated incident, as revealed by The Climate Change Performance Index[20] published by Germanwatch and Climate Action Network Europe in 2014. Again, the wrong countries were at risk of becoming the top performers, and again, the situation was fixed with creative carbon accounting for nuclear. This particular index went even further than WWF did and declared nuclear electricity to have the same emissions as the dirtiest mainstream electricity, coal power. Given that this was an especially climate oriented index, it is interesting to note that a country could improve its score by replacing nearly emission-free nuclear with practically any mix of fossil fuels. One really cannot make this stuff up. We are sure that similar creative ”indices” are already in preparation somewhere. Using deliberately falsified indices and reports for actual, sensible real world policy is of course impossible, as they simply seek to distort the reality to conform to an ideologically preconceived position. We believe that environmental organizations are in fact never going to tell us which countries have historically cut their carbon emissions the fastest and the most. The leaders in this game are those countries that built a lot of nuclear in the 1980s, like France and Sweden. It is worth noting that these cuts were accomplished with technology from the 1970s, and were achieved completely by accident, as a by-product of energy policy enacted for completely different reasons. There was no active climate policy, but the results were many times better than what Germany has managed with its Energiewende since the early 2000s. It is worth imagining what an active and evidence-based climate policy that pushed aggressively for renewables, energy savings and nuclear could therefore achieve. Image 10 - The best ten years of emissions reductions in four countries. A major part of Germany’s reductions, called “Wallfall”, are due to the country’s unification and the following closure of many of ineffective power plants and industry in eastern Germany. In addition to these countries, also Belgium and Finland have cut their emissions markedly with nuclear power.

The best approach to teaching procedural skills is a directive design. Direct instruction includes three core elements: explanations, as summarized in the previous chapter; demonstrations of skills; and student practice with feedback.

Pilot test your training to determine an optimal amount of practice to reach acceptable job competence. As you plan your practice activities, find ways to spread them over a lesson or course. Spaced practice results in better long-term learning with a high effect size of 0.71.

To qualify as practice, the learner must make some kind of behavioral response. For the purposes of formal training, that response usually generates a visible product—one that can be evaluated by the instructional environment.

Practice Guideline 5 Assign comparison practice exercises to build relevant prior knowledge, to correct flawed or incomplete mental models, or to reflect on decisions made in a training scenario.

At the same time, in my reading, I discovered some evidence that traditional talk therapy might not actually be particularly effective for C-PTSD. In The Body Keeps the Score, Bessel van der Kolk writes about how talk therapy can be useless for those for whom “traumatic events are almost impossible to put into words.” Some people are too dissociated and distanced from these traumatic experiences for talk therapy to work well. They might not be able to access their feelings, let alone convey them. For others, they’re in such an activated state that they have a hard time reaching into difficult memories, and the very act of recalling them could be retraumatizing. One study showed that about 10 percent of people might experience worsening symptoms after being forced to talk about their trauma. Between 40 percent and 60 percent of people drop out of therapy at some point. Most drop out within the first two sessions. And plenty of statistics show that even pointed, skills-based talk therapy is ineffective for PTSD. Cognitive behavioral therapy (CBT), a form of talk therapy where patients unlearn negative patterns of behavior and try to practice strategically positive patterns, is widely accepted as a treatment for PTSD. But it has abysmal statistics. In one study of seventy-four patients, eight got better with CBT, compared with four who received no therapy at all.

In sum, the Indian tradition shows no evidence for the kind of posture-based practices that dominate transnational anglophone yoga today. We should except from this assertion, of course, seated postures such as padmāsana and siddhāasana, which have played an enormously important practical and symbolic role throughout the history of yoga. And today, largely thanks to modern advertising, cross-legged yoga postures such as these have become powerful and universally recognized signifiers of relaxation, self-control, self-cultivation, a balanced lifestyle, good health, fitness, and spiritual urban cool.

Based on this evidence, the NQF endorsed bar coding , and it has since been adopted as standard practice in hospitals nationwide.

The most effective evidence-based discipleship happens when we combine the wisdom of God's Word with the insights of research and practice.

The Major Attributes of Leadership. The following are important factors of leadership:— 1.   Unwavering courage based upon knowledge of self, and of one’s occupation. No follower wishes to be dominated by a leader who lacks self-confidence and courage. No intelligent follower will be dominated by such a leader very long. 2.   Self-control. The man who cannot control himself can never control others. Self-control sets a mighty example for one’s followers, which the more intelligent will emulate. 3.   A keen sense of justice. Without a sense of fairness and justice, no leader can command and retain the respect of his followers. 4.   Definiteness of decision. The man who wavers in his decisions, shows that he is not sure of himself, cannot lead others successfully. 5.   Definiteness of plans. The successful leader must plan his work, and work his plan. A leader who moves by guesswork, without practical, definite plans, is comparable to a ship without a rudder. Sooner or later he will land on the rocks. 6.   The habit of doing more than paid for. One of the penalties of leadership is the necessity of willingness, upon the part of the leader, to do more than he requires of his followers. 7.   A pleasing personality. No slovenly, careless person can become a successful leader. Leadership calls for respect. Followers will not respect a leader who does not grade high on all of the factors of a pleasing personality. 8. Sympathy and understanding. The successful leader must be in sympathy with his followers. Moreover, he must understand them and their problems. 9. Mastery of detail. Successful leadership calls for mastery of the details of the leader’s position. 10. Willingness to assume full responsibility. The successful leader must be willing to assume responsibility for the mistakes and the shortcomings of his followers. If he tries to shift this responsibility, he will not remain the leader. If one of his followers makes a mistake, and shows himself incompetent, the leader must consider that it is he who failed. 11. Cooperation. The successful leader must understand and apply the principle of cooperative effort and be able to induce his followers to do the same. Leadership calls for power, and power calls for cooperation. There are two forms of leadership. The first, and by far the most effective, is leadership by consent of, and with the sympathy of the followers. The second is leadership by force, without the consent and sympathy of the followers. History is filled with evidences that leadership by force cannot endure. The downfall and disappearance of dictators and kings is significant. It means that people will not follow forced leadership indefinitely. Napoleon, Mussolini, Hitler, were examples of leadership by force. Their leadership passed. Leadership-by-consent of the followers is the only brand which can endure! Men may follow the forced leadership temporarily, but they will not do so willingly.

One of Clark’s earliest statements on the proper nature of economics argued that economics should be “based on a foundation of terms, conceptions, standards of measurement, and assumptions which is sufficiently realistic, comprehensive, and unbiased” to provide a basis for the analysis and discussion of practical issues (Clark 1919, p. 280). Relevance to practical issues, accuracy of data, and comprehensiveness, in the sense of not excluding any evidence relevant to the problem at hand, were the characteristics of a scientific approach to economics that Clark most frequently stressed (Clark 1924, p. 74).

Stress reduces sexual interest in 80–90 percent of people and reduces sexual pleasure in everyone—even the 10–20 percent of people for whom it increases interest. The way to deal with stress is to allow your body to complete the stress response cycle. Trauma survivors’ brains sometimes learn to treat “sex-related” stimuli as threats, so that whenever the accelerator is activated, the brakes are hit, too. Practicing mindfulness is an evidence-based strategy for decoupling the brakes and accelerator. In the right context, sex can attach us emotionally to new partners or reinforce emotional bonds in unstable relationships. In other words, sex and love are closely linked in our brains—but only in the right context. Sex that brings you closer to your partner “advances the plot,” as opposed to gratuitous sex, for no reason other than that you can. To have more and better sex, give yourself a compelling reason to have sex, something important to move toward.

Some leaders keep repeating or mentioning that there was some study conducted in Harvard or Yale that only 3 percent of people had set goals and written down these goals and they made more money than 97 percent of people! Well first of all, statements containing precise statistics, particularly ones with little empirical evidence, are often based on cooked up or questionable data. And secondly, there was no such study at either Harvard or Yale. It has just been repeated from one inspirational dude to another until it become a part of folklore. It has also been incorrectly repeated in another inspirational dude, Sir Anubhav Srivastava’s film Carve Your Destiny ten years ago. On a sidenote, I have no connections whatsoever with this gentleman. Who is he?!

Borrowing from the philosopher of science Robert Merton, I wanted to know if what we thought we knew was really so. I applied a historical perspective to this controversy because I believe that understanding that context is essential for evaluating and understanding the competing arguments and beliefs. Doesn’t the concept of “knowing what you’re talking about” literally require, after all, that you know the history of what you believe, of your assumptions, and of the competing belief systems and so the evidence on which they’re based?

When laws are based on ideology and not evidence, and when public health is based on revelation rather than reality, medical care suffers. Both the privacy and sanctity of the doctor-patient relationship are compromised. As noted by U.S. medical specialty societies, intrusion of uninformed lay persons (viz., State legislators) into the practice of medicine is dangerous and unwarranted.

In 1996, the U.S. Preventive Services Task Force, the independent panel of experts that reviews screening tests, recommended against routine fetal monitoring.5 But according to their current Web site, fetal monitoring has become such an ingrained fixture of medical care that, frankly, the task force seems to have simply given up on trying to dissuade doctors from using it: Despite the lack of evidence on its positive impact on health outcomes and the 1996 USPSTF recommendation against its routine use, intrapartum electronic fetal monitoring in pregnancy has become common practice in the U.S. Based on currently available evidence, the USPSTF believes there would be limited potential impact on clinical practice in updating the 1996 recommendation. The

Gibbs (2003) and others (e.g., Straus, Richardson, Glaziou, & Haynes, 2005) have provided detailed suggestions in this regard. Some general principles for clinicians are as follows. Evidence from multiple studies is always preferred to results of a single study. Systematic reviews of research are preferable to traditional narrative reviews. Thus, clinicians should look for systematic reviews, mindful of the fact that these reviews vary in quality. The Cochrane and Campbell Collaborations are good sources of high-quality systematic reviews. Clinicians can and should assess potential sources of bias in any review. The characteristics of systematic reviews described in this chapter can be used as a yardstick that clinicians can use to judge how well specific reviews measure up. The QUOROM statement (Moher et al., 1999) provides guidance about what to look for in reports on systematic reviews, as does a recent report by Shea et al. (2007). When relevant reviews are not available, out of date, or potentially biased, clinicians can identify individual studies and assess the credibility of those studies, using one of many tools developed for this purpose (e.g., Gibbs, 2003). It would be ideal if clinicians were able to rely on others to produce valid research syntheses. Above all, clinicians should remember that critical thinking is crucial to understanding and using evidence. Authorities, expert opinion, and lists of ESTs provide insufficient evidence for sound clinical practice. Further, clinicians must determine how credible evidence relates to the particular needs, values, preferences, circumstances, and ultimately, the responses of their clients. Clinicians and researchers also need to have an effect on policy so that EBP is not interpreted in a way that unfairly restricts treatments. Policymakers and others can be educated about the nature of EBP. EBP is a process aimed at informing the choices that clinicians make. It should inform and enhance practice, “increasing, not dictating, choice” (Dickersin, Straus, & Bero, 2007, p. s10). EBP supports choices among alternative treatments that have similar effects. It supports the choice of a less effective alternative, when an effective treatment is not acceptable to a client. Policymakers and others can be educated about the nature of evidence and methods of research synthesis. Empirical evidence is tentative, and it evolves over time as new information is added to the knowledge base. At present, there is insufficient evidence about the effectiveness of most psychological and psychosocial treatments (including some so-called empirically supported treatments). Policymakers need to understand that most lists of effective treatments are not based on rigorous systematic reviews; thus, they are not necessarily based on sound evidence. It makes little sense to base policy decisions on lists of preferred treatments because this limits consumer choice. Lists of selected or preferred treatments should not restrict the use of other potentially effective treatments. Policies that restrict treatments that have been shown to be harmful or ineffective, however, are of benefit. Lists of harmful or wasteful treatments could be compiled to discourage their use.

psychodynamic psychotherapy and psychoanalysis are convergent with respect to their interest in transference, countertransference, unconscious meanings in the here and now, the importance of analyzing character, and the impact of early relationships.

The observation has been made that that only psychodynamic psychotherapy among the psychotherapies retains the ambition to cure or help patients transform themselves in a profound way (Seligman, 2002).

relationship makes it possible to understand the underlying issue better and therefore helps her solve it.

It has also clarified the continuing need for treatment of other problems such as developmental and lifecycle issues that are not symptom based, such as identity formation, intimacy and relationship problems, and loss and grieving. Common clinical scenarios include teenagers in conflict with their parents as they try to "find themselves," young adults with

Making the connection between the boyfriend and the father was frightening to her, but after discussing this several times, she began to feel some relief and an unaccustomed sense of calm.

Research on comprehension-based approaches to second language acquisition shows that learners can make considerable progress if they have sustained exposure to language they understand. The evidence also suggests, however, that comprehension-based activities may best be seen as an excellent way to begin learning and as a supplement to other kinds of learning for more advanced learners. Comprehension of meaningful language is the foundation of language acquisition. Active listening and reading for meaning are valuable components of classroom teachers’ pedagogical practices. Nevertheless, considerable research and experience challenge the hypothesis that comprehensible input is enough. VanPatten’s research showed that forcing students to rely on specific linguistic features in order to interpret meaning increased the chances that they would be able to use these features in their own second language production. Another response to comprehension-based approaches is Merrill Swain’s (1985) comprehensible output hypothesis. She argues that it is when students have to produce language that they begin to see the limitations of their interlanguage (see Chapter 4). However, as we will see in the discussion of the ‘Let’s talk’ proposal, if learners are in situations where their teachers and classmates understand them without difficulty, they may need additional help in overcoming those limitations.

Scheffe tests also produce “homogeneous subsets,” that is, groups that have statistically identical means. Both the three largest and the three smallest populations have identical means. The Tukey levels of statistical significance are, respectively, .725 and .165 (both > .05). This is shown in Table 13.3. Figure 13.2 Group Boxplots Table 13.2 ANOVA Table Third, is the increase in means linear? This test is an option on many statistical software packages that produces an additional line of output in the ANOVA table, called the “linear term for unweighted sum of squares,” with the appropriate F-test. Here, that F-test statistic is 7.85, p = .006 < .01, and so we conclude that the apparent linear increase is indeed significant: wetland loss is linearly associated with the increased surrounding population of watersheds.8 Figure 13.2 does not clearly show this, but the enlarged Y-axis in Figure 13.3 does. Fourth, are our findings robust? One concern is that the statistical validity is affected by observations that statistically (although not substantively) are outliers. Removing the seven outliers identified earlier does not affect our conclusions. The resulting variable remains normally distributed, and there are no (new) outliers for any group. The resulting variable has equal variances across the groups (Levene’s test = 1.03, p = .38 > .05). The global F-test is 3.44 (p = .019 < .05), and the Bonferroni post-hoc test similarly finds that only the differences between the “Small” and “Large” group means are significant (p = .031). The increase remains linear (F = 6.74, p = .011 < .05). Thus, we conclude that the presence of observations with large values does not alter our conclusions. Table 13.3 Homogeneous Subsets Figure 13.3 Watershed Loss, by Population We also test the robustness of conclusions for different variable transformations. The extreme skewness of the untransformed variable allows for only a limited range of root transformations that produce normality. Within this range (power 0.222 through 0.275), the preceding conclusions are replicated fully. Natural log and base-10 log transformations also result in normality and replicate these results, except that the post-hoc tests fail to identify that the means of the “Large” and “Small” groups are significantly different. However, the global F-test is (marginally) significant (F = 2.80, p = .043 < .05), which suggests that this difference is too small to detect with this transformation. A single, independent-samples t-test for this difference is significant (t = 2.47, p = .017 < .05), suggesting that this problem may have been exacerbated by the limited number of observations. In sum, we find converging evidence for our conclusions. As this example also shows, when using statistics, analysts frequently must exercise judgment and justify their decisions.9 Finally, what is the practical significance of this analysis? The wetland loss among watersheds with large surrounding populations is [(3.21 – 2.52)/2.52 =] 27.4 percent greater than among those surrounded by small populations. It is up to managers and elected officials to determine whether a difference of this magnitude warrants intervention in watersheds with large surrounding populations.10

in order to understand how they relate to the past, the search for recurring patterns, and a focus on the therapeutic relationship to see how conflicts are repeated.

the essence of dynamic psychotherapy-exploration of current conflicts and relationships

Students need the opportunity to process these gut reactions.

This moment is an interpersonal crisis, but also a psychodynamic opportunity. The task of the therapy is to elucidate what is going on in this moment. The patient did not come to therapy to solve her problem with the therapist, but rather to decrease her depression. However, the enactment in the therapeutic

We see the central task of psychotherapy as the rewriting of a more complex and useful narrative of the patient's life and experience.

Today we denounce such practices as inhuman and reject as irrational the belief that the spilling of innocent blood literally affected the outcome of harvests and military battles. Yet we continue to offer our own children on the altar of homeland security, sending them off to die in ambiguous wars, based on the irrational belief that by being violent we can protect ourselves from violence. We refer to our children’s deaths as “sacrifices” which are necessary for the preservation of democracy and free trade. The market is our temple and it must be protected at all costs. Thus, like King Mesha, we make “sacrifices” in order to ensure the victory of capitalism over socialism, the victory of consumerism over terrorism. Our high priests tell us that it is necessary to make sacrifices if we are going to continue to have the freedom to shop. Unlike King Mesha, however, in our day it is rarely the king’s own son who is sacrificed; rather, the king sacrifices the sons and daughters of the poor in order to protect an economy whose benefits the poor do not reap. (As Shrek’s Lord Farquaad so profoundly put it, “Some of you may die, but that is a sacrifice I am willing to make.”) Like martyrs, our children are valorized because of their willingness to sacrifice their lives in yet another war waged to rid the world of war. We invest their deaths with meaning by forcing ourselves to believe, despite all evidence to the contrary, that their blood affects the productivity of the market and protects a multitude from the threat of violence.

PEOPLE GENERALLY ARE going about learning in the wrong ways. Empirical research into how we learn and remember shows that much of what we take for gospel about how to learn turns out to be largely wasted effort. Even college and medical students—whose main job is learning—rely on study techniques that are far from optimal. At the same time, this field of research, which goes back 125 years but has been particularly fruitful in recent years, has yielded a body of insights that constitute a growing science of learning: highly effective, evidence-based strategies to replace less effective but widely accepted practices that are rooted in theory, lore, and intuition. But there’s a catch: the most effective learning strategies are not intuitive.

Indeed, we recognize that a deep treatment may not be required for all patients. Much of the success of behavioral therapy is thought to reside in its focus on symptoms and in its parsimonious and directed use of therapeutic resources to decrease symptoms. It does not aim to be a therapy of depth, and this is one of its strengths. In contrast dynamic psychotherapy, which facilitates a patient's rewriting of his life narrative, his picture of himself, his past, present, and future, seems uniquely positioned to address the depth of a individual's experience.

Great doubt: great awakening. Little doubt: little awakening. No doubt: no awakening. —Zen mantra

About a quarter of the money taken by pharmaceutical companies for the drugs they sell is turned around into promotional activity which has, as we will see, a provable impact on doctors' prescribing. So we pay for products, with a huge uplift in price to cover their marketing budgets, and that money is then spent on distorting evidence-based practice, which in turn makes our decisions unnecessarily expensive, and less effective.

In recent philosophy there has been a growing awareness of the gap between the abstract principles proposed by philosophers and the ways in which people actually think. The kind of rationality admired in the theory of knowledge is idealization. In the real world people have to act on beliefs often based on fragmentary and unreliable evidence.

Individual clinicians’ practices tend to go unquestioned (current practice has been described as “eminence based,” not “evidence based”).

Collection Methods in Qualitative Studies Where was the setting of the study? What was the rationale for choosing the setting? Who were the participants and what were their roles and characteristics? Why were they chosen? What data collection methods were used? What role did the researcher adopt within the setting? Who collected the data and were they qualified for their roles? How were data collectors trained? Was the training adequate? Was the process of the fieldwork adequately reported? How did the event unfold? Was data collection continued until saturation was achieved? Were the researchers’ assumptions or biases acknowledged?

Augustus actually had his poets and scribes rewrite his mythic biography to fit his own agenda that included changing calendar years in order to substantiate his divinity." His face crinkled into a smile. "I'm not completely certain what my findings add up to yet. I can tell you I've found convincing evidence that there's a fundamental identification between Octavius Caesar Augustus and Christianity as we call it today. I've studied comparative religions all my life, but only recently come to the conclusion that the Emperor Augustus was a comparatist extraordinaire, albeit a thoroughly pragmatic one. He was a master of turning the common themes in the religions of the cultures he conquered to the service of his empire, and of his personal reputation. He based his own spiritual practices on the moral principles he encountered in all religions,

Astrophysicist Bernard Haisch, former science editor for The Astrophysical Journal and The Journal of Scientific Exploration, defines a true skeptic as “one who practices the method of suspended judgment, engages in rational and dispassionate reasoning as exemplified by the scientific method, shows willingness to consider alternative explanations without prejudice based on prior beliefs, and who seeks out evidence and carefully scrutinizes its validity.

What I offer in this book are stories of hanging in, the practice-based evidence from working with our most challenging students,

All of these models and others have been heavily criticized. In 2009, a panel commissioned by the Association for Psychological Sciences published a report that outlined a research design to properly study the effect of learning styles, and it asserted that this methodology was almost entirely absent from learning styles studies. Of the few studies utilizing this research design, all but one feature negative findings. They also doubted the value of the significant cost of attempting to identify the precise learning style of every student over other interventions such as individual tutors. They concluded that “at present, there is no adequate evidence base to justify incorporating learning styles assessments into general educational practice. Thus, limited education resources would better be devoted to adopting other educational practices that have strong evidence base, of which there are an increasing number.” Then,

These programs have been successfully integrated into schools in the US, Canada, and/or the UK; have a clearly articulated curriculum that can be easily accessed and replicated; are based in developmentally appropriate practice; and have some preliminary evidence of efficacy that has been published in a peer-reviewed journal.

pharmaceutical companies spend tens of billions of pounds every year trying to change the treatment decisions of doctors: in fact, they spend twice as much on marketing and advertising as they do on the research and development of new drugs. Since we all want doctors to prescribe medicine based on evidence, and evidence is universal, there is only one possible reason for such huge spends: to distort evidence-based practice.

Known for his heartfelt dedication to patient care, Joseph Galdun is a seasoned physician. With over two decades of experience in hospital medicine, he has earned trust and respect in Carmel, Indiana. His commitment to evidence-based practices and compassionate healthcare ensures that patients receive top-notch treatment.

Intersectionality is a popular intellectual framework on campuses today; certain versions of it teach students to see multiple axes of privilege and oppression that intersect. While there are merits to the theory, the way it is interpreted and practiced on campus can sometimes amplify tribal thinking and encourage students to endorse the Untruth of Us Versus Them: Life is a battle between good people and evil people. Common-enemy identity politics, when combined with microaggression theory, produces a call-out culture in which almost anything one says or does could result in a public shaming. This can engender a sense of “walking on eggshells,” and it teaches students habits of self-censorship. Call-out cultures are detrimental to students’ education and bad for their mental health. Call-out cultures and us-versus-them thinking are incompatible with the educational and research missions of universities, which require free inquiry, dissent, evidence-based argument, and intellectual honesty.

This model also offers each group of providers the opportunity to learn from each other. Midwives would gain more exposure to high-risk patients and complications and, thus, learn to more readily recognize and initially manage them. Obstetricians would gain exposure to alternative delivery techniques they may not have learned in their training, such as hands and knees positions or birthing stool deliveries, as well as comfort with less aggressive management styles. In an ideal integrative model, both groups would have opportunities to work together even at the training level to help build professional camaraderie and respect from the onset of practice.

affective instability, emotional dysregulation, and interpersonal sensitivity has little resemblance to classical depression. It is also the key feature of BPD

However, the benefits of spaced practice are apparent after 60 days. Since many training organizations don’t evaluate learning over time, the benefits of spaced practice are rarely documented. Based on a lot of accumulated evidence, though, spaced practice will give you a better long-term return.

When you practice self-acceptance, you learn to embrace all aspects of yourself, including both your strengths and the areas you think you need to work on.

He adds, “If someone used blind faith and bought the first house he or she saw with a For Sale sign in front of it, but made no effort to get information about the house and neighborhood, we would consider that person foolish. Why? Because when we use our reason and base decisions on the best assessment of the evidence we can make, we increase our chances that our decisions are based on true beliefs…Now if this is the case for day-to-day issues, why should we suddenly abandon the importance of reason and evidence when it comes to religion? We should not.

As recent research evidence suggests, mindfulness/attention training practices enable learners to receive a plethora of information on the matter at hand via sensory organs (most importantly in a nonjudgemental way) until clarity is enhanced (Rechtschaffen & Rechtschaffen, 2015; Hanson, 2019; Spoon, 2018; Langer, 2015; Kabat-Zinn, 2005).

research evidence shows repeatedly, learners in such disadvantaged situations/conditions could benefit from attention training/mindfulness practices so that they can continue engaging in higher-order learning activities.

MILF Token: What Is It and What Are the Prospects? Why MILF symbols? Whoever had actually the intense suggestion of producing a MILF token has actually located a cutting-edge means of touching into 2 distinctive yet similarly eye-catching streams. On the one hand, here's a fresh cryptocurrency including distinctively collectible characters, with evidence of possession saved in a blockchain. On the various other hand, when it concerns those characters, it likewise ventures a fixation among several songs in the very early 21st-century: fully grown, sexually knowledgeable ladies looking for daring times with their suitors. Any kind of speculator wanting to explore the idea behind these extravagant as well as attractive characters can conveniently acquaint themselves with a few of the very best sites concentrating on dating MILFs. These systems provide an algorithm-based solution, where brand-new consumers can surely join, as well as the details offered throughout this enrollment procedure - inspirations, kind of MILF they are brought in to, and so on. - can surely be as compared to the information they currently carry submit. This way, the liaison can surely be easily organized without the individual enquiring also needing to make up a candid message. The computer system software application will certainly give a shortlist of ideal dating prospects. Comparable character-driven symbols MILF symbols are top on from formerly prominent characters that have actually gripped the focus of crypto investors, such as CryptoPunks. These were a collection of 10,000 characters, each distinct, that exposed evidence of possession on the Ethereum blockchain. MILF symbols operate similarly. Due to the fact that no 2 characters are alike, each token can surely ended up being the authorities residential building of a solitary proprietor on this blockchain. Those 10,000 CryptoPunk symbols were quickly purchased, immediately providing the specific characters boosted worth. The presumption is that the MILF symbols will certainly go similarly, so any individual wanting to obtain their practical a certain MILF personality will certainly need to buy this through the market-place that's likewise installed in the Ethereum blockchain. Presently, the most affordable offered rate for MILF symbols is $0.00004078, standing for a 0.61% increase over the previous 24-hour. Shade coding Generally, these characters will certainly have actually a condition when they show up in the crypto markets. Where the CrytoPunks are worried, a blue history suggested that punk was except sale, neither exist energetic quotes. Punks that were offered offer for sale would certainly have actually a red history. Those with an energetic quote would certainly have actually a purple history. MILFs have actually built such a solid track record for desirability, their incorporation as

We also gave teams a primer on teamwork based on insights gleaned from research in group dynamics. On the one hand, we warned, groupthink is a danger. Be cooperative but not deferential. Consensus is not always good; disagreement is not always bad. If you do happen to agree, don't take the agreement—in itself—as proof that you are right. Never stop doubting. Pointed questions are as essential to a team as vitamins are to a human body. On the other hand, the opposite of groupthink—rancor and dysfunction—is also a danger. Team members must disagree without being disagreeable, we advised. Practice 'constructive confrontation' to use the phrase of Andy Grove, the former CEO of Intel. Precision questioning is one way to do that. Drawing on the work of Dennis Matthies and Monica Worline, we showed them how to tactfully dissect the vague claims people often make. Suppose someone says, 'Unfortunately, the popularity of soccer, the world's favorite pastime, is starting to decline.' You suspect [they] are wrong. ... Zero in. You might say, 'What do you mean by 'pastime?' or 'What evidence is there that soccer's popularity is declining? Over what time frame.' The answers to these precise questions won't settle the matter, but they will reveal the thinking behind the conclusion so it can be probed and tested.

Skeptical Empiricism and the a-Platonic School The Platonic Approach Interested in what lies outside the Platonic fold Focuses on the inside of the Platonic fold Respect for those who have the guts to say “I don’t know” “You keep criticizing these models. These models are all we have.” Fat Tony Dr. John Thinks of Black Swans as a dominant source of randomness Thinks of ordinary fluctuations as a dominant source of randomness, with jumps as an afterthought Bottom-up Top-down Would ordinarily not wear suits (except to funerals) Wears dark suits, white shirts; speaks in a boring tone Prefers to be broadly right Precisely wrong Minimal theory, considers theorizing as a disease to resist Everything needs to fit some grand, general socioeconomic model and “the rigor of economic theory;” frowns on the “descriptive” Does not believe that we can easily compute probabilities Built their entire apparatus on the assumptions that we can compute probabilities Model: Sextus Empiricus and the school of evidence-based, minimum-theory empirical medicine Model: Laplacian mechanics, the world and the economy like a clock Develops intuitions from practice, goes from observations to books Relies on scientific papers, goes from books to practice Not inspired by any science, uses messy mathematics and computational methods Inspired by physics, relies on abstract mathematics Ideas based on skepticism, on the unread books in the library Ideas based on beliefs, on what they think they know Assumes Extremistan as a starting point Assumes Mediocristan as a starting point Sophisticated craft Poor science Seeks to be approximately right across a broad set of eventualities Seeks to be perfectly right in a narrow model, under precise assumptions

Cixi began to revolutionise China's legal system. In May 1902, she decreed a wholesale review of 'all existing laws...with reference to the laws of other nations...to ensure that Chinese laws are compatible with those of foreign countries'. With a legal reform team headed by a remarkable mind, Shen Jiaben, who had a comprehensive knowledge of traditional laws and had studied several differentWestern codes, a brand-new legal structure based on Western models was created in the course of the decade, covering a whole range of commercial, civil, criminal laws and judicial procedures. Cixi approved the team's recommendations and personally decreed many landmark changes. On 24 April 1905, the notorious 'death by a thousand cuts' was abolished, with a somewhat defensive explanation from Ci:xi that this horrific form of execution had not been a Manchu practice in the first place. In a separate decree, torture during interrogation was prohibited. Up to that point it was universally regarded as indispensable to obtain confessions; now it was deemed 'only permissible to be used on those whom there was enough evidence to convict and sentence to death, but who still would not admit guilt'. Cixi made a point of expressing her 'loathing' for those who had a penchant for torture, and warned that they would be severely punished if they failed to observe the. new constraints. Prisons and detention centres were to be run humanely; the abuse of inmates would not be tolerated. Law schools were to be set up in the capital and provinces, and law studies were to be made a part of general education. Under her a legal framework began to be constructed.

Thus, as I have said, in innumerable cases today’s family owes its existence merely to a force of inertia, conventions, practical convenience, and weakness of character in a regime of mediocrity and compromises. Nor can one expect external measures to bring about a change. I must repeat that familial unity could only remain firm when determined by a suprapersonal way of thinking, so as to leave mere individual matters on a secondary level. Then the marriage could even lack "happiness," the "needs of the soul" could be unsatisfied, and yet the unity would persist. In the individualistic climate of present society no higher reason demands that familial unity should persist even when the man or the woman "does not agree," and sentiment or sex leads them to new choices. Therefore, the increase of so-called failed marriages and related divorces and separations is natural in contemporary society. It is also absurd to think of any efficacy in restraining measures, since the basis of the whole is by now a change of an existential order. After this evaluation, it would almost be superfluous to specify what can be the behavior of the differentiated man today. In principle, he cannot value marriage, family, or procreation as I have just described them. All that can only be alien to him; he can recognize nothing significant to merit his attention. (Later I will return to the problem of the sexes in itself, not from the social perspective.) The contaminations in marriage between sacred and profane and its bourgeois conformism are evident to him, even in the case of religious, indissoluble, Catholic marriage. This indissolubility that is supposed to safeguard the family in the Catholic area is by now little more than a facade. In fact, the indissoluble unions are often profoundly corrupted and loosened, and in that area petty morality is not concerned in the least that the marriage is actually indissoluble; it is important only to act as if it were such. That men and women, once duly married, do more or less whatever they want, that they feign, betray, or simply put up with each other, that they remain together for simple convenience, reducing the family to what I have already described, is of little importance there. Morality is saved: One can believe that the family remains the fundamental unit of society so long as one condemns divorce and accepts that social sanction or authorization—as if it had any right—for any sexually based cohabitation that corresponds to marriage. What is more, even if we are not speaking of the "indissoluble" Catholic rite of marriage, but of a society that permits divorce, the hypocrisy persists: one worships at the altar of social conformism even when men and women separate and remarry repeatedly for the most frivolous and ridiculous motives, as typically happens in the United States, so that marriage ends up being little more than a puritanical veneer for a regime of high prostitution or legalized free love.