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The quality of public decision making depends significantly on the quality of analysis and advice provided through public organizations. Champions of \"evidence-informed\" policy making claim that rigorous evaluation practices can significantly improve attainment of cost-effective outcomes. After decades of experience, performance information is more sophisticated, but evaluation practices and capabilities vary enormously. Public agencies gather and process vast amounts of information, but there has been little analysis of how this information is actually utilized for policy and program improvement. This article examines how government agencies use evidence about policy and program effectiveness, with attention to four themes: (1) the prospects for improving \"evidence-informed\" policy making, (2) the diversity of practices concerning evidence utilization and evaluation across types of public agencies and policy arenas, (3) recent attempts to \"institutionalize\" evaluation as a core feature of policy development and budget approval, and (4) the relationships between public agencies and nongovernmental sources of expertise.

There is, in the twenty-first century, an intense interest in the nature of wicked problems and the complex tasks of identifying their scope, viable responses, and appropriate mechanisms and pathways towards achieving improvement. This preoccupation is timeless, but the discussion over several decades has benefited from Rittel and Webber’s (Policy Sci 4(2):155–169, 1973) path breaking conceptualisation of wicked problems and the political argumentation needed to resolve them. This review revisits Rittel and Webber’s work and its enduring significance, reflecting upon its broad uptake and impact in the policy sciences, an impact that continues to grow over time. We revisit how the classic 1973 paper came to be published in Policy Sciences, its innovative depiction of social problems, its rejection of rationalistic design, its acknowledgement of the subjectivities involved in problem identification and resolutions, and the consequent need for argumentative-based solution processes. We find great resonance in the paper with contemporary problem solving preoccupations, not least that the political context is crucial, that argumentation must be transparent and robust, and that policy interventions may have consequences that cannot be easily controlled in open and highly pluralised social systems.

Academics and policy makers in many Western countries are perceived as occupying separate communities, with distinct languages, values, and reward systems. However, data from a survey of more than 2,000 policy officials and 126 in-depth interviews with public servants in Australia suggest that the \"two communities\" conceptualization may be misleading and flawed. More realistically, there is a range of interaction between policy and academia, with some individuals valuing and using academic research more than others. Furthermore, this relationship is complicated by the internal division between the political and administrative components of the public policy process.

In this case study, I examine the quality of decision-making under conditions of rapidly evolving urban water crises, and the adaptive policy challenges of building regional resilience in response to both drought and flood. Like other regions of Australia, Southeast Queensland has been subject to substantial cycles of drought and flood. I draw on resilience literature concerning sustainability, together with governance literature on policy change, to explain the changing awareness of urban water crises and the strategic options available for addressing these crises in this case study. The problem of resilience thinking opens up a number of important questions about the efficacy and adaptability of the policy system. The case provides insights into the interplay between the ways in which problems are framed, the knowledge bases required for planning and decision-making, the collaborative governance processes required for managing complex and rapidly evolving issues, and the overall capacity for policy learning over time. Regional resilience was proclaimed as a policy goal by government, but the practices remained largely anchored in traditional technical frameworks. Centralized investment decisions and governance restructures provoked conflict between levels of government, undermining the capacity of stakeholders to create more consensual approaches to problem-solving and limiting the collective learning that could have emerged.

Behavioural and experimental projects have become increasingly popular with policymakers. Behavioural insights teams have used several policy design and implementation tools drawn from behavioural sciences, especially randomised controlled trials, to test the design of ‘nudge’ interventions. This approach has attained discursive legitimacy in government agencies seeking to use the best available evidence for behaviourally informed, evidence-based policy innovation. We examine the practices of governmental behavioural insights teams in Australia, drawing on two research projects that included interviews with key personnel. We find that teams make strong commitments to using and promoting randomised controlled trials in government policy innovation. Nevertheless, some members of these teams are beginning to appreciate the constraints of relying solely on randomised controlled trials in the development of behavioural public policy. We conclude that while an initial focus on rigorous trials helped behavioural insights teams establish themselves in policymaking, strict adherence may represent a risk to their long-term growth and relevance.

Traumatic brain injury (TBI) is one of the leading causes of death of young people in the developed world. In the United States alone, 1.7 million traumatic events occur annually accounting for 50,000 deaths. The etiology of TBI includes traffic accidents, falls, gunshot wounds, sports, and combat-related events. TBI severity ranges from mild to severe. TBI can induce subtle changes in molecular signaling, alterations in cellular structure and function, and/or primary tissue injury, such as contusion, hemorrhage, and diffuse axonal injury. TBI results in blood–brain barrier (BBB) damage and leakage, which allows for increased extravasation of immune cells (i.e., increased neuroinflammation). BBB dysfunction and impaired homeostasis contribute to secondary injury that occurs from hours to days to months after the initial trauma. This delayed nature of the secondary injury suggests a potential therapeutic window. The focus of this article is on the (1) pathophysiology of TBI and (2) potential therapies that include biologics (stem cells, gene therapy, peptides), pharmacological (anti-inflammatory, antiepileptic, progrowth), and noninvasive (exercise, transcranial magnetic stimulation). In final, the review briefly discusses membrane/lipid rafts (MLR) and the MLR-associated protein caveolin (Cav). Interventions that increase Cav-1, MLR formation, and MLR recruitment of growth-promoting signaling components may augment the efficacy of pharmacologic agents or already existing endogenous neurotransmitters and neurotrophins that converge upon progrowth signaling cascades resulting in improved neuronal function after injury.

Growing evidence attests to the efficacy of e-mental health services. There is less evidence on how to facilitate the safe, effective, and sustainable implementation of these services. We conducted a systematic review on e-mental health service use for depressive and anxiety disorders to inform policy development and identify policy-relevant gaps in the evidence base. Following the PRISMA protocol, we identified research (1) conducted in Australia, (2) on e-mental health services, (3) for depressive or anxiety disorders, and (4) on e-mental health usage, such as barriers and facilitators to use. Databases searched included Cochrane, PubMed, PsycINFO, CINAHL, Embase, ProQuest Social Science, and Google Scholar. Sources were assessed according to area and level of policy relevance. The search yielded 1081 studies; 30 studies were included for analysis. Most reported on self-selected samples and samples of online help-seekers. Studies indicate that e-mental health services are predominantly used by females, and those who are more educated and socioeconomically advantaged. Ethnicity was infrequently reported on. Studies examining consumer preferences found a preference for face-to-face therapy over e-therapies, but not an aversion to e-therapy. Content relevant to governance was predominantly related to the organizational dimensions of e-mental health services, followed by implications for community education. Financing and payment for e-services and governance of the information communication technology were least commonly discussed. Little research focuses explicitly on policy development and implementation planning; most research provides an e-services perspective. Research is needed to provide community and policy-maker perspectives. General population studies of prospective treatment seekers that include ethnicity and socioeconomic status and quantify relative preferences for all treatment modalities are necessary.

Abstract More collaborative and human-centered approaches to tackle social problems of entrenched disadvantage have been introduced in many countries, including Australia, but with mixed results. Traditional programs that reinforce existing political and bureaucratic processes have been seen as blockers to collaborative modes of policymaking, governance, and delivery. Drawing on collaborative governance perspectives, this paper reports new research undertaken in conjunction with a not-for-profit organization (Collaboration for Impact) involved in supporting place-based collaborative community change efforts. Research findings, based on stakeholder perspectives, highlight not only the potential benefits of a more collaborative model (i.e., placed-based and community driven) but also the significant unresolved challenges for “backbone” coordination bodies, which have recently been established to achieve more “joined-up” policy, funding, and service delivery arrangements. The paper concludes by proposing a practice-driven focus on policy and funding systems, together with implications for policy learning and program design.

The aged brain exhibits a loss in gray matter and a decrease in spines and synaptic densities that may represent a sequela for neurodegenerative diseases such as Alzheimer's. Membrane/lipid rafts (MLR), discrete regions of the plasmalemma enriched in cholesterol, glycosphingolipids, and sphingomyelin, are essential for the development and stabilization of synapses. Caveolin-1 (Cav-1), a cholesterol binding protein organizes synaptic signaling components within MLR. It is unknown whether loss of synapses is dependent on an age-related loss of Cav-1 expression and whether this has implications for neurodegenerative diseases such as Alzheimer's disease. We analyzed brains from young (Yg, 3-6 months), middle age (Md, 12 months), aged (Ag, >18 months), and young Cav-1 KO mice and show that localization of PSD-95, NR2A, NR2B, TrkBR, AMPAR, and Cav-1 to MLR is decreased in aged hippocampi. Young Cav-1 KO mice showed signs of premature neuronal aging and degeneration. Hippocampi synaptosomes from Cav-1 KO mice showed reduced PSD-95, NR2A, NR2B, and Cav-1, an inability to be protected against cerebral ischemia-reperfusion injury compared to young WT mice, increased Aβ, P-Tau, and astrogliosis, decreased cerebrovascular volume compared to young WT mice. As with aged hippocampi, Cav-1 KO brains showed significantly reduced synapses. Neuron-targeted re-expression of Cav-1 in Cav-1 KO neurons in vitro decreased Aβ expression. Therefore, Cav-1 represents a novel control point for healthy neuronal aging and loss of Cav-1 represents a non-mutational model for Alzheimer's disease.

Background In order to understand and measure the policy impact of research we need a definition of research impact that is suited to the task. This article systematically reviewed both peer-reviewed and grey literature for definitions of research impact to develop a definition of research impact that can be used to investigate how public health research influences policy. Method Keyword searches of the electronic databases Web of Science, ProQuest, PubMed, EMBASE, CINAHL, Informit, PsycINFO, The Cochrane Database of Systematic Reviews and Google Scholar were conducted between August 2015 and April 2016. Keywords included ‘definition’ and ‘policy’ and ‘research impact’ or ‘research evidence’. The search terms ‘health’, public health’ or ‘mental health’ and ‘knowledge transfer’ or ‘research translation’ were used to focus the search on relevant health discipline approaches. Studies included in the review described processes, theories or frameworks associated with public health, health services or mental health policy. Results We identified 108 definitions in 83 publications. The key findings were that literature on research impact is growing, but only 23% of peer-reviewed publications on the topic explicitly defined the term and that the majority (76%) of definitions were derived from research organisations and funding institutions. We identified four main types of definition, namely (1) definitions that conceptualise research impacts in terms of positive changes or effects that evidence can bring about when transferred into policies (example Research Excellence Framework definition), (2) definitions that interpret research impacts as measurable outcomes (Research Councils UK), and (3) bibliometric and (4) use-based definitions. We identified four constructs underpinning these definitions that related to concepts of contribution, change, avenues and levels of impact. Conclusion The dominance of bureaucratic definitions, the tendency to discuss but not define the concept of research impact, and the heterogeneity of definitions confirm the need for conceptual clarity in this area. We propose a working definition of research impact that can be used in a range of health policy contexts.