An Exploratory Qualitative Study of Computer Screening to Support Decision-Making about Use of Palliative Care Registers in Primary Care:GP Think Aloud and Patient and Carer Interviews

Objectives: This study aimed to understand factors that influence general practitioner (GP) use of automated computer screening to identify patients for the palliative care register (PCR) and the experiences of palliative care and this emerging technology from patients’ and carers’ perspectives. Methods: A computer screening program electronically searches primary care records in routine clinical practice to identify patients with advanced illness who are not already on a PCR. Five GPs were asked to “think aloud” about adding patients identified by computer screening to the PCR. Key informant interviews with 6 patients on the PCR and 4 carers about their experiences of palliative care while on the PCR and their views of this technology. Data were analyzed thematically. Results and Conclusions: Using computer screening, 29% additional patients were added by GPs to the PCR. GP decision-making for the PCR was informed by clinical factors such as: if being treated with curative intent; having stable or unstable disease; end-stage disease, frailty; the likelihood of dying within the next 12 months; and psychosocial factors such as, age, personality, patient preference and social support. Six (60%) patients/carers did not know that they/their relative was on the PCR. From a patient/carer perspective, having a non-curative illness was not in and of itself sufficient reason for being on the PCR; other factors such as, unstable disease and avoiding pain and suffering were equally if not more, important. Patients and carers considered that computer screening should support but not replace, GP decision-making about the PCR. Computer screening merits ongoing development as a tool to aid clinical decision-making around entry to a PCR, but should not be used as a sole criterion. Care need, irrespective of diagnosis, disease trajectory or prognosis, should determine care.</p

New media and the circuit of cyber-culture: Conceptualizing Napster

Media studies scholars have employed the cultural circuit model to analyze media in the context of capitalist political economy. This model identifies interrelated moments\u27 in which the meanings of cultural products are determined, negotiated, and subverted in interaction between producers and audiences. The turbulent evolution of new media, however, requires continuous reflection on the adequacy of conceptual tools. Analysis of recent controversy surrounding the Internet music-exchange service Napster indicates that the cultural circuit model must be modified to accommodate the emerging media of cyber-culture

New media and the circuit of cyber-culture: Conceptualizing Napster

Media studies scholars have employed the cultural circuit model to analyze media in the context of capitalist political economy. This model identifies interrelated moments\u27 in which the meanings of cultural products are determined, negotiated, and subverted in interaction between producers and audiences. The turbulent evolution of new media, however, requires continuous reflection on the adequacy of conceptual tools. Analysis of recent controversy surrounding the Internet music-exchange service Napster indicates that the cultural circuit model must be modified to accommodate the emerging media of cyber-culture

Last Aid Training online:Participants’ and facilitators’ perceptions from a mixed-methods study in rural Scotland

(1) Background: Palliative and end-of-life care services are increasingly gaining centre stage in health and social care contexts in the UK and globally. Death and dying need are relational processes. Building personal and community capacity along with resilience is vital to support families and communities to normalise death and dying. Last Aid Training (LAT) is one such innovative educational initiative which teaches the general public about the fundamentals of palliative care and promotes public discussion about death and dying. The Highland Hospice [HH] in Scotland has pioneered delivery of LAT in face-to-face settings since March 2019 and online since March 2020 to accommodate pandemic restrictions. (2) Methods: This study used a mixed-methods approach, combining an online survey with LAT participants followed by individual semi-structured qualitative interviews with both LAT participants and facilitators. The primary aim of this study was to investigate the impacts of LAT for participants at the individual, family, and community levels, as well as explore participant and facilitator experiences and perspectives of LAT in an online environment. (3) Results: Overall, this evaluation demonstrates that provision of foundational death literacy education in social contexts enhances the personal knowledge, skills, and confidence of individual community members and supports the notion that this personal growth could lead to strengthened community action. (4) Conclusions: Findings from this study concluded that there is potential to include LAT as the foundational core training to promote death literacy in communities with further exploration to integrate/align LAT with other national/global end-of-life care frameworks

The burden of managing medicines for older people with sensory impairment : an ethnographic-informed study

Background: Older age is associated with increased prevalence of sensory impairment and use of medicines. Objectives: To explore the daily ‘medicine journey’ of older people with sensory impairment. Methods: The study used ethnographic-informed methods (using audio-, photo- and video-recordings, diary notes and semi-structured interviews with researchers) and involved community-dwelling adults (aged > 65) in Scotland, with visual and/or hearing impairment and using > 4 medicines. Data analysis used the constant comparative method. Results: Fourteen older people with sensory impairment participated and used a mean of 11.0 (SD 5.0) medicines (range 5 to 22). Participants reported difficulties with medicine ordering, obtaining, storage, administration and disposal. They used elaborate strategies to manage their medicines including bespoke storage systems, fixed routines, simple aids, communication, and assistive technologies. Conclusion: Older people with sensory impairment experience substantial burden, challenges and risk with medicines management. Tailored medicine regimens and assistive technologies could provide greater support to older people with sensory impairment

Assistive technologies and strategies to support the medication management of individuals with hearing and/or visual impairment : a scoping review

Background -- Individuals with sensory impairment (visual and/or hearing) experience health inequalities and increased risk of medication-related iatrogenic disease compared with the general population. Assistive technologies and tailored strategies could support medication management for individuals with sensory impairment to reduce harm and increase the likelihood of therapeutic benefit. Objective -- This scoping review identified assistive technologies and strategies to support medication management of /for people with hearing and/or visual impairment. Methods -- Standard scoping review methodology was used to identify studies that evaluated technologies or strategies designed to support people with sensory impairment with independent medicine management. Electronic databases were searched (MEDLINE, Embase, CINAHL, ACM, Cochrane) from inception to 18/07/22. Independent duplicate screening, selection and data extraction was undertaken. Results -- Of 1,231 publications identified 18 were included, reporting 17 studies, 16 of which evaluated technologies to assist people with visual impairment and one study to assist people with hearing impairment. The range of technologies and devices included: applications for android phones (n=6); eyedrop assistance devices (n=5); audio-prescription labelling/reading systems (n=2); touch-to-speech devices (n=2); continuous glucose monitoring system (n=1); and magnifying technology (n=1). Ten studies tested early-stage prototypes. Most participants could operate the technologies effectively and deemed them to be useful. Conclusions -- Despite the increasing number of medicine-related assistive technologies there has been limited empirical evaluation of their effectiveness for supporting individuals with sensory impairment. Prototypes appear to be useful for people with visual or hearing impairment, however wider ‘real-life’ testing is needed to confirm the benefits of these technologies

Diverse voices and alternative rationalities: Imagining forms of postcolonial organizational communication

In his exploration of nationalism and imagined communities, Anderson (1991) claims that nations are “imagined” (that is, they are constructions), insomuch that people are convinced of the comradeship of unknown fellow compatriots, often ignoring any actual inequality and exploitation that exists in such an imagined community. In a similar fashion, we argue that the subdiscipline or community of organizational communication scholars is also imagined, as much organizational communication scholarship conducted within the global context is performed and interpreted from the dominant Euro-American intellectual tradition, privileging those concepts as well as particular voices and traditions and often ignoring inequality and exploitation within the scholarly community. This forgetting and the imagined scholarly community it creates continue to reify and legitimate a particular form of rationality and, in practice, lead to further colonization, subordination, and oppression of native/indigenous/other forms of understanding and organizing within our disciplinary field. So, how do we recover alternative rationalities, worldviews, and voices on the processes of organizing in diverse contexts

COMMUNEcating in the Spaces In-Between: Creating New Understandings of Organizing and Communicative Practice Around the Globe

This essay describes the authors\u27 efforts to engage disciplinary calls for greater diversity through the construction of an international online community and conference, COMMUNEcation. They describe the commitments and goals of the community and conference, the construction of the COMMUNEcating space, and their encounters with disciplinary, geographically, and linguistically diverse scholars in their mutual exploration of global and organizing practices in their local contexts. The conference contributions and conversations prompted the authors to ask three salient questions around scholarly understandings of the Other and Othering practices of organizing and communicating across the globe—Where is the Other? Who is the Other? and What is the Other? The second half of the essay discusses these questions in detail and concludes with the authors\u27 reflections on creating “spaces inbetween” through technology and an introduction to the multiauthored collaborative essay and conference product from the Scholars of the COMMUNEcation Network that follows

COMMUNEcation: A rhizomatic tale of participatory technology, postcoloniality and professional community

This article explores the authors’ experiences in creating and participating with(in) a virtual conference organized as an experimental virtual network. These experiences demonstrate how physically co-located and virtual conferencing practices acting in tandem provide a greater opportunity for the inclusion of both diverse perspectives and participants in professional communities. Using insights from postcolonial theory, the article examines how the architecture of participation found in the technologies of Web 2.0 accentuates the potential for reclaiming some diversity of perspective and participation, facilitating a form of molecular community through conferencing practices. Finally, it provides theoretical and empirical insights and reflections on the social dynamics of conferencing in both online and offline spaces to demonstrate how online conferencing can expand the directions taken in pursuit of new collective knowledge