Assessing and managing concurrent hearing, vision and cognitive impairments in older people: an international perspective from healthcare professionals

Background: there is a significant gap in the understanding, assessment and management of people with dementia and concurrent hearing and vision impairments. / Objective: from the perspective of professionals in dementia, hearing and vision care, we aimed to: (1) explore the perceptions of gaps in assessment and service provision in ageing-related hearing, vision and cognitive impairment; (2) consider potential solutions regarding this overlap and (3) ascertain the attitudes, awareness and practice, with a view to implementing change. / Methods: our two-part investigation with hearing, vision, and dementia care professionals involved: (1) an in-depth, interdisciplinary, international Expert Reference Group (ERG; n = 17) and (2) a wide-scale knowledge, attitudes and practice survey (n = 653). The ERG involved consensus discussions around prototypic clinical vignettes drawn from a memory centre, an audiology clinic, and an optometry clinic, analysed using an applied content approach. / Results: the ERG revealed several gaps in assessment and service provision, including a lack of validated assessment tools for concurrent impairments, poor interdisciplinary communication and care pathways, and a lack of evidence-based interventions. Consensus centred on the need for flexible, individualised, patient-centred solutions, using an interdisciplinary approach. The survey data validated these findings, highlighting the need for clear guidelines for assessing and managing concurrent impairments. / Conclusions: this is the first international study exploring professionals’ views of the assessment and care of individuals with age-related hearing, vision and hearing impairment. The findings will inform the adaptation of assessments, the development of supportive interventions, and the new provision of services

Fleeting Perceptual Experience and the Possibility of Recalling Without Seeing

We explore an intensely debated problem in neuroscience, psychology and philosophy: the degree to which the “phenomenological consciousness” of the experience of a stimulus is separable from the “access consciousness” of its reportability. Specifically, it has been proposed that these two measures are dissociated from one another in one, or both directions. However, even if it was agreed that reportability and experience were doubly dissociated, the limits of dissociation logic mean we would not be able to conclusively separate the cognitive processes underlying the two. We take advantage of computational modelling and recent advances in state-trace analysis to assess this dissociation in an attentional/experiential blink paradigm. These advances in state-trace analysis make use of Bayesian statistics to quantify the evidence for and against a dissociation. Further evidence is obtained by linking our finding to a prominent model of the attentional blink – the Simultaneous Type/Serial Token model. Our results show evidence for a dissociation between experience and reportability, whereby participants appear able to encode stimuli into working memory with little, if any, conscious experience of them. This raises the possibility of a phenomenon that might be called sight-blind recall, which we discuss in the context of the current experience/reportability debate

Studying Evidence Use for Health Policymaking from a Policy Perspective

Individuals working within the health sector widely embrace the idea of using evidence to achieve their goals of improving individual and population health. Yet while these actors embrace an ideal form of rational-instrumental evidence use under the banner of ‘evidence based policymaking’, they often struggle to understand when, why, or how evidence is used in policy processes. This chapter sets out the conceptual framework employed in this volume to study the use of evidence within policymaking from a public policy perspective. It explores the importance of both political contestation and institutional context to understand when and how evidence will be used within policy processes. The chapter then outlines the structure of this book and the focus of subsequent chapters, highlighting how each of these talks to these themes

Published in The Physics Teacher, January 1999 p.1

this paper is part of an iterative cycle of research, curriculum development, delivery, and evaluation. We do our evaluation using a variety of probes, including videotaped individual demonstration interviews, pretests (short, ungraded quizzes that accompany tutorials) , examination questions, and specially designed diagnostic tests. In interviews, individual students answer questions about a simple physical problem in a context where the researcher has the opportunity to probe their responses more deeply. Students who volunteer for these interviews are typically doing well in the clas