Older people and research partnerships

Increasing consumer consultation is a priority for those involved in health and social care research and practice, with promoting greater public participation being widely accepted as 'a good thing' (Reason, 1994: 3). However, whilst such consultation may improve the quality of research and practice, there is a need to recognise the considerable investment of time and energy that is required for success (Baxter et al., 2001). Given the extra resources needed, it is important to understand how consultation and user involvement can work to benefit all parties. This paper describes our experiences of working together on a research project exploring people's involvement in decision-making processes when using care services in later life. When we started the project in March 2001 each of us could draw on a range of experiences that we hoped would make a valuable contribution. We have now worked together for over two years and this paper describes how our combined efforts have not only enhanced the overall quality of the research but also had personal benefits that we did not anticipate when we started ou

Dying at home: A qualitative study of the perspectives of older South Asians living in East London

South Asians constitute the single largest ethnic minority group in the United Kingdom, yet little is known about their perspectives and experiences on end-of-life care. Aim: To explore beliefs, attitudes and expectations expressed by older South Asians living in East London about dying at home. Methodology and methods: Five focus groups and 29 in-depth semi-structured interviews were conducted with a total of 55 older adults (24 men and 31 women) aged between 52 to 78 years. Participants from six South Asian ethnic groups were recruited via 11 local community organisations. Data were analysed using a constructive grounded theory approach. Findings: Two key themes were identified. The theme of ‘reconsidering the homeland’ draws on the notion of ‘diaspora’ to help understand why for many participants the physical place of death was perceived by many as less important than the opportunity to carry out cultural and religious practices surrounding death. The second theme ‘home as a haven’ describes participants’ accounts of how their home is a place in which it is possible to perform various cultural and religious rituals. Cultural and religious practices were often seen as essential to achieving a peaceful death and honouring religious and filial duties. Conclusion: Older people of South Asian ethnicity living in East London perceive home as more than a physical location for dying relatives. They make efforts to adhere, but also adapt, to important social and cultural values relating to death and dying as part of the wider challenge of living in an emigrant society

Doing research with children and young people who do not use speech for communication

Despite emphasis in policy on participation of disabled children, we still know relatively little about how to obtain the views of disabled children with significant communication impairment and their views are often overlooked in planning and service provision. This article describes how the views of children who do not use speech were accessed in research aiming to identify disabled children and young people's priorities regarding outcomes of social care and support services. The main challenge was to develop a method that was reliable, non-threatening, enjoyable and relevant to individual children, as well as enabling children to think beyond their everyday life and express what they aspire to

Interprofessional learning in practice: The student experience

Interprofessional learning and the development of teamworking skills are recognised as essential for patient care and are also a government priority for undergraduate education. Sixteen occupational therapy students worked on an interprofessional training ward as part of their practice placement and three of them participated in an evaluation using the nominal group technique. Despite this small number, the evaluation identifies the value of this learning experience in giving the students an opportunity to appreciate the importance of interpersonal skills; to learn about other team members’ roles; and to experience the challenges of working on a busy rehabilitation ward for older people

Community pharmacy type 2 diabetes risk assessment: demographics and risk results

Objectives: To determine the demographics and risk results of patients accessing a community pharmacy diabetes risk assessment service. Method: Participating patients underwent an assessment using a validated questionnaire to determine their 10-year risk of developing type 2 diabetes. Patients were given appropriate lifestyle advice or referred to their general practitioner if necessary. Key findings: In total, 21 302 risk assessments were performed. Nearly one-third (29%) of 3427 risk assessments analysed yielded a result of moderate or high chance of developing the condition. Conclusions: Community pharmacies can identify a significant number of patients at risk of developing type 2 diabetes in the next 10 years. Further follow-up work needs to be done to determine the cost-effectiveness of such a service and the consequences of receiving a risk assessment

Feeling Safe in the Dark : Examining the Effect of Entrapment, Lighting Levels, and Gender on Feelings of Safety and Lighting Policy Acceptability

This research examined to what extent physical factors, notably lighting and entrapment (blocked escape), and individual factors, notably gender, affect feelings of safety and the acceptability of reduced lighting levels. The authors reasoned that acceptability of reduced street lighting depends on perceived safety, which in turn depends on entrapment, lighting, and gender. Virtual representations of a residential street were used, systematically manipulating entrapment and lighting levels. As expected, people felt less safe in lower lighting and higher entrapment settings, and these settings were evaluated as less acceptable. Although women perceived a situation as less safe compared with men, the authors found no gender differences in acceptability, which extends previous research. Importantly, as hypothesized, perceived safety mediated the effect of lighting on acceptability levels, suggesting that people can accept lower lighting levels when social safety is not threatened

Is acting prosocially beneficial for the credit market?

This article argues that behaving prosocially implies more transparent information during the negotiation process of a financial contract and more cooperation among the parties to respect the terms of the contract. For this reason this work considers interest rate on loans and insolvency rate functions of prosocial behaviour along with the traditional socio-economic and financial collaterals. The context of study is Italy and the analysis is developed at a cross-regional level. We collect data from the two reports on “Relatives and Safety Net” produced by the Italian Centre Bureau of Statistics (ISTAT) in 1998 and 2003 and from the reports on “Regional Economics” produced by the Bank of Italy in the same years. A two-period panel model shows two interesting outcomes. Firstly, regions with a higher proportion of prosocial individuals report lower interest rates on loans and insolvency rates. Secondly, when we include the efficiency of legal enforcement, evidence supports the idea that a more efficient legal framework can act as a more reliable transmission mechanism of institutional norms and facilitate the internalisation of social norms

Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia

<b>Background:</b> To investigate variation in rates of cataract surgery in New South Wales (NSW), Australia by area of residence for Aboriginal and non-Aboriginal adults.<p></p> <b>Design:</b> Observational data linkage study of hospital admissions.<p></p> <b>Participants:</b> 289 646 NSW residents aged 30 years and over admitted to NSW hospitals for 444 551 cataract surgery procedures between 2001 and 2008.<p></p> <b>Methods:</b> Analysis of linked routinely collected hospital data using direct standardisation and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas (SLAs).<p></p> <b>Main outcome measures:</b> Age-standardised cataract surgery rates and adjusted rate ratios (ARRs).<p></p> <b>Results:</b> Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same SLA (ARR 0.71, 95% CI 0.68-0.75). There was significant variation in cataract surgery rates across SLAs for both Aboriginal and non-Aboriginal people, with the disparity higher in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most SLAs, but in a few, the rates were similar or higher for Aboriginal people.<p></p> <b>Conclusions:</b> Aboriginal people in NSW received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations.<p></p&gt