designed the review, supervised its conduct, performed reliability checks, identified additional papers, extracted data from primary sources, methodologically rated the studies and wrote the review. Gareth Owen wrote much of chapter 2 and was responsible for performing the searches and conducting the initial systematic review, identifying relevant papers, extracting information, quality assessing studies and summarising their findings. Matthew Hotopf and Swaran Singh contributed to the design of the review and commented on drafts. This work was undertaken by the Institute of Psychiatry who received funding from the Department of Health. This publication presents the findings from a systematic review of existing studies on Community Treatment Orders. The conclusions are based on a thorough analysis of this literature and do not necessarily express the views of the Department of Health.
Mental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio-demographic variables do not have a major impact but clinical ones do.
Integrated reporting (IR) is a major development in a number of sustainability-related accounting initiatives and, if widely adopted, will require significant developments in professional and university accounting curricula. These will include: a strategic rather than operational or transactional focus; longer-rather than short-term outlook; prospective rather than retrospective analysis; qualitative commentary as well as quantitative information; and reports on wider business performance metrics rather than on narrower external financial reporting data or audit compliance. This paper reports on ACCA's support of and response to the latest initiatives in IR, in particular the impact this will have on the education and training of accountants in order to reflect these new principles to prepare the twenty-first-century accountant for a much more challenging role in the near future. These developments can only be in the wider public interest of improving the relevance of information for decision-making, for all stakeholders, and allow greater efficiency in the allocation of financial and other resources and in adding public value.
BackgroundPsychiatric disorders can pose problems in the assessment of decision-making capacity (DMC). This is so particularly where psychopathology is seen as the extreme end of a dimension that includes normality. Depression is an example of such a psychiatric disorder. Four abilities (understanding, appreciating, reasoning and ability to express a choice) are commonly assessed when determining DMC in psychiatry and uncertainty exists about the extent to which depression impacts capacity to make treatment or research participation decisions.MethodsA systematic review of the medical ethical and empirical literature concerning depression and DMC was conducted. Medline, EMBASE and PsycInfo databases were searched for studies of depression and consent and DMC. Empirical studies and papers containing ethical analysis were extracted and analysed.Results17 publications were identified. The clinical ethics studies highlighted appreciation of information as the ability that can be impaired in depression, indicating that emotional factors can impact on DMC. The empirical studies reporting decision-making ability scores also highlighted impairment of appreciation but without evidence of strong impact. Measurement problems, however, looked likely. The frequency of clinical judgements of lack of DMC in people with depression varied greatly according to acuity of illness and whether judgements are structured or unstructured.ConclusionsDepression can impair DMC especially if severe. Most evidence indicates appreciation as the ability primarily impaired by depressive illness. Understanding and measuring the appreciation ability in depression remains a problem in need of further research.
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