We are all one together : peer educators\u27 views about falls prevention education for community-dwelling older adults - a qualitative study

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators’ perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. Methods: A two-stage qualitative inductive constant comparative design was used.In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Results: Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators’ capacity to facilitate their peers’ engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following presentations, were perceived as essential because they affect successful message delivery. Conclusions: Peer educators have the potential to effectively deliver falls prevention education to older adults and influence acceptance of the message as they possess the peer-to-peer connection that facilitates optimal engagement. There is a need to consider incorporating learnings from this research into a formal large scale evaluation of the effectiveness of the peer education approach in reducing falls in older adults

‘Perceptions of non-accidental child deaths as preventable events: The impact of probability heuristics and biases on child protection work'

Anxiety about the possibility of non-accidental deaths of children has had a major influence on child care policy and practice over the last 40 years. The formal inquiry reports and media coverage of these rare events serve to maintain the perception that these are regular incidents that happen far too often and that they could have been prevented. This focus on individual events tends to distort a clear view of the actual probability of non-accidental deaths and serves to reinforce the notion that potentially all child care cases are risky and that any social work practitioner could be involved in such a case. As a result, work with children has become highly risk averse. However, in statistical terms, the probability of non-accidental child deaths is very low and recently has averaged about 55 deaths a year. Children are at considerably higher risk of being killed on the roads. This paper examines the way in which perceptions of the ‘high’ level of risk of possible child deaths are maintained despite the very low statistical probability of such incidents. It draws on thinking from behavioural psychology and, in particular the work of Kahneman and Tversky, to consider some of the biases in probability reasoning affecting people’s perception of risk and explores how inquiry reports into single past events reconfirm risk perceptions. It is suggested that recognition of the essentially unpredictable nature of future non-accidental child deaths would free up childcare professionals to work in a more positive and less risk-averse manner in the present

‘Perceptions of non-accidental child deaths as preventable events: The impact of probability heuristics and biases on child protection work'

Anxiety about the possibility of non-accidental deaths of children has had a major influence on child care policy and practice over the last 40 years. The formal inquiry reports and media coverage of these rare events serve to maintain the perception that these are regular incidents that happen far too often and that they could have been prevented. This focus on individual events tends to distort a clear view of the actual probability of non-accidental deaths and serves to reinforce the notion that potentially all child care cases are risky and that any social work practitioner could be involved in such a case. As a result, work with children has become highly risk averse. However, in statistical terms, the probability of non-accidental child deaths is very low and recently has averaged about 55 deaths a year. Children are at considerably higher risk of being killed on the roads. This paper examines the way in which perceptions of the ‘high’ level of risk of possible child deaths are maintained despite the very low statistical probability of such incidents. It draws on thinking from behavioural psychology and, in particular the work of Kahneman and Tversky, to consider some of the biases in probability reasoning affecting people’s perception of risk and explores how inquiry reports into single past events reconfirm risk perceptions. It is suggested that recognition of the essentially unpredictable nature of future non-accidental child deaths would free up childcare professionals to work in a more positive and less risk-averse manner in the present

Predicting energy expenditure of manual wheelchair users with spinal cord injury using a multisensor-based activity monitor

Objective: To develop and evaluate new energy expenditure (EE) prediction models for manual wheelchair users (MWUs) with spinal cord injury (SCI) based on a commercially available multisensor-based activity monitor. Design: Cross-sectional. Setting: Laboratory. Participants: Volunteer sample of MWUs with SCI (N=45). Intervention: Subjects were asked to perform 4 activities including resting, wheelchair propulsion, arm-ergometer exercise, and deskwork. Criterion EE using a metabolic cart and raw sensor data from a multisensor activity monitor was collected during each of these activities. Main Outcome Measures: Two new EE prediction models including a general model and an activity-specific model were developed using enhanced all-possible regressions on 36 MWUs and tested on the remaining 9 MWUs. Results: The activity-specific and general EE prediction models estimated the EE significantly better than the manufacturer's model. The average EE estimation error using the manufacturer's model and the new general and activity-specific models for all activities combined was -55.31% (overestimation), 2.30% (underestimation), and 4.85%, respectively. The average EE estimation error using the manufacturer's model, the new general model, and activity-specific models for various activities varied from -19.10% to -89.85%, -18.13% to 25.13%, and -4.31% to 9.93%, respectively. Conclusions: The predictors for the new models were based on accelerometer and demographic variables, indicating that movement and subject parameters were necessary in estimating the EE. The results indicate that the multisensor activity monitor with new prediction models can be used to estimate EE in MWUs with SCI during wheelchair-related activities mentioned in this study. © 2012 American Congress of Rehabilitation Medicine

Preliminary findings on reliability and validity of the Historical-Clinical-Risk assessment in a forensic psychiatric setting

The purpose of this study was to establish inter-rater reliability and retrospective validity of the Historical-Clinical-Risk assessment (HCR-20). HCR-20 is an instrument for assessing risk, incorporating three different approaches to the area. Six patients sentenced to Forensic psychiatric care for violent crimes were individually rated on the HCR-20 by 6 raters, trained in the assessment manual. The correlation's between raters were in the range of 0.76 to 0.96 for the full scale. The range for the Clinical evaluation was found to be somewhat weaker (0.52-0.95). Overall the results indicates that the HCR-20 has a satisfactory level of reliability provided that raters are properly trained. The HCR-20 was also compared to independent ratings of past violent crimes. The independent ratings were done by two professionals using the criminal records of the clients. These were rated in a 6 point crime-index scale, considering criminal versatility and seriousness of violent crimes. The correlate of the crime-index Scale and "HCR-19" was 0.67. The results were discussed with respect to the usefulness of HCR-20 as a risk assessment instrument with good levels of reliability and validity

Der Schutz der Vermögensrechte gegenüber dem Staat aus soziologischer Sicht

Kaufmann F-X. Der Schutz der Vermögensrechte gegenüber dem Staat aus soziologischer Sicht. In: Verfassungsrechtlicher Eigentumsschutz sozialer Rechtspositionen: 2. Sozialrechtslehrertagung Bielefeld. Schriftenreihe des Deutschen Sozialrechtsverbandes. Vol 23. Wiesbaden: Chmielorz; 1982: 132-150