Eliciting consent from patients with dementia in general X-ray departments: Law, ethics and interpretation of context

Background: While the numbers of individuals suffering from dementia syndromes in the UK steadily increase, many practitioners in the allied healthcare professions, and particularly junior staff, still feel ill-equipped for face-to-face communicative encounters with such individuals (Miller et al., 2019; Tullo et al., 2016). An elemental feature of effective communication in healthcare contexts is the seeking of proper consent to perform given procedures. The propositions above, however, raise questions regarding how ‘properly’ consent is being acquired when dementia is at stake. This paper, thus, reports findings from a qualitative study of general radiographers’ experiences of acquiring consent from patients with dementia, specifically exploring participants’ interpretations of correct legal and ethical practice therein. Methods: With institutional ethical approval, N=6 general radiographers with less than ten years of clinical experience were recruited to sit for extended interviews. Verbatim transcripts were analysed using the domain-established techniques of Interpretative Phenomenological Analysis (Miller et al., 2017). Results: Four key areas of extremely variable interpretation and practice were identified. (1) How to assess capacity for informed consent; (2) How to effectively modify communication when gaining consent; (3) Managing carer involvement during consent-acquisition and; (4) Constituting the ‘best interest’ of the patient. Conclusion: Participants’ own accounts often indicated that they were often not lawfully implementing the Mental Capacity Act (MCA) when acquiring consent. Moreover, as previously identified by Miller et al. (2019), the situational confusion did little for participants’ confidence, with prospectively damaging import for future encounters. Stronger training in practical application of the MCA is recommended

Systematic scoping review of frameworks used to develop rehabilitation interventions for older adults

Objectives: Rehabilitation interventions for older adults are complex as they involve a number of interacting components, have multiple outcomes of interest and are influenced by a number of contextual factors. The importance of rigorous intervention development prior to formal evaluation has been acknowledged and a number of frameworks have been developed. This review explored which frameworks have been used to guide the development of rehabilitation interventions for older adults.Design: Systematic scoping review.Setting: Studies were not limited for inclusion based on setting.Participants: Studies were included that featured older adults (>65 years of age).Interventions: Studies were included that reported the development of a rehabilitation intervention.Primary and secondary outcome measures: Data was extracted on study population, setting, type of intervention developed and frameworks used. The primary outcome of interest was the type of intervention development framework.Results: Thirty-five studies were included. There was a range of underlying medical conditions including mild cognitive impairment and dementia (n=5), cardiac (n=4), stroke (n=3), falls (n=3), hip fracture (n=2), diabetes (n=2), breast cancer (n=1), Parkinson’s disease (n=1), depression (n=1), chronic health problems (n=1), osteoarthritis (n=1), leg ulcer (n=1), neck pain (n=1) and foot problems (n=1). The intervention types being developed included multicomponent, support-based, cognitive, physical activities, nursing-led, falls prevention and occupational therapy-led. Twelve studies (34%) did not report using a framework. Five frameworks were reported with the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions being the most frequently cited(77%, n=17).Conclusion: At present the MRC Framework is the most popular for developing rehabilitation interventions for older adults. Many studies do not report using a framework. Further, specific guidance to assist this complex field of rehabilitation research is required

The Physical Activity Resource Assessment (PARA) instrument: Evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods

Background: Neighborhood environment factors may influence physical activity (PA). The purpose of this study was to develop and test a brief instrument to systematically document and describe the type, features, amenities, quality and incivilities of a variety of PA resources. Method: The one-page Physical Activity Resource Assessment (PARA) instrument was developed to assess all publicly available PA resources in thirteen urban lower income, high ethnic minority concentration neighborhoods that surrounded public housing developments (HDs) and four higher income, low ethnic minority concentration comparison neighborhoods. Neighborhoods had similar population density and connectivity. Trained field coders rated 97 PA resources (including parks, churches, schools, sports facilities, fitness centers, community centers, and trails) on location, type, cost, features, amenities, quality and incivilities. Assessments typically took about 10 minutes to complete. Results: HD neighborhoods had a mean of 4.9 PA resources (n = 73) with considerable variability in the type of resources available for each neighborhood. Comparison neighborhoods had a mean of 6 resources (n = 24). Most resources were accessible at no cost (82%). Resources in both types of neighborhoods typically had about 2 to 3 PA features and amenities, and the quality was usually mediocre to good in both types of neighborhoods. Incivilities at PA resources in HD neighborhoods were significantly more common than in comparison neighborhoods. Conclusion: Although PA resources were similar in number, features and amenities, the overall appearance of the resources in HD neighborhoods was much worse as indicated by substantially worse incivilities ratings in HD neighborhoods. The more comprehensive assessment, including features, amenities and incivilities, provided by the PARA may be important to distinguish between PA resources in lower and higher deprivation areas

The Physical Activity Resource Assessment (PARA) instrument: Evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods

BACKGROUND: Neighborhood environment factors may influence physical activity (PA). The purpose of this study was to develop and test a brief instrument to systematically document and describe the type, features, amenities, quality and incivilities of a variety of PA resources. METHOD: The one-page Physical Activity Resource Assessment (PARA) instrument was developed to assess all publicly available PA resources in thirteen urban lower income, high ethnic minority concentration neighborhoods that surrounded public housing developments (HDs) and four higher income, low ethnic minority concentration comparison neighborhoods. Neighborhoods had similar population density and connectivity. Trained field coders rated 97 PA resources (including parks, churches, schools, sports facilities, fitness centers, community centers, and trails) on location, type, cost, features, amenities, quality and incivilities. Assessments typically took about 10 minutes to complete. RESULTS: HD neighborhoods had a mean of 4.9 PA resources (n = 73) with considerable variability in the type of resources available for each neighborhood. Comparison neighborhoods had a mean of 6 resources (n = 24). Most resources were accessible at no cost (82%). Resources in both types of neighborhoods typically had about 2 to 3 PA features and amenities, and the quality was usually mediocre to good in both types of neighborhoods. Incivilities at PA resources in HD neighborhoods were significantly more common than in comparison neighborhoods. CONCLUSION: Although PA resources were similar in number, features and amenities, the overall appearance of the resources in HD neighborhoods was much worse as indicated by substantially worse incivilities ratings in HD neighborhoods. The more comprehensive assessment, including features, amenities and incivilities, provided by the PARA may be important to distinguish between PA resources in lower and higher deprivation areas

Testosterone and social behavior

"Testosterone poisoning," now part of the language, is a popular explanation for excessive "manly" behaviors such as boasting, violence and pugnaciousness. Middle-aged and older men think sagging libido and fatigue stem from their declining testosterone. In fact, there is little empirical support for these popular assertions. We cannot say that they are all false because research literature is not conclusive. But it is already clear that there is no simple one-to-one relationship between testosterone and machoism or aggressiveness or sexuality (Mazur and Booth 1998). It seems wiser to view testosterone as one component in a confluence of interacting physiological, psychological and social influences that affect behavior. The focus of this research is variables of interest to sociologists. Gaining, maintaining and losing status is a theme found in a great deal of sociological research. Many testosterone studies have focused on status change under the rubric of competition. Sociologists who focus on deviance and social integration will be interested in testosterone studies that focus on problem behavior, and the nature and quality of peer and family relations. Those who work in the area of health and social behavior will find studies of testosterone's link to depression. Those who study gendered behavior will be interested in the differences and symmetries in the links between testosterone and social behavior for males and females. Finally, sociologists will be interested to learn that the social environment has a key role in defining testosterone-behavioral links. This article is dedicated to the memory of James M. Dabbs, a pioneer in the fi eld of testosterone research who greatly enriched our knowledge methodologically and substantively

Applicant Reactions to Artificial Intelligence in the Selection Process

The use of advanced technology such as artificial intelligence (AI) in the selection process has become an increasingly popular practice within organizations. However, little research has examined how applicants react to these new procedures and how those reactions may affect outcomes such as perceptions of fairness, organizational attraction, and job pursuit intentions. Previous research has suggested that the use of technology in the selection process may lead to more negative outcomes when compared to using traditional selection procedures such as face-to-face interviewing. The purpose of this study is to examine applicant reactions to the use of advanced decision-making technologies in the selection process, such as artificial intelligence systems that make hiring decisions. Determining how applicants react to the use of technology in the selection process serves to help organizations better understand how these practices affect job seekers’ perceptions of the organization. The results of this study may help organizations weigh the pros and cons of using computer information systems to select applicants instead of using a traditional selection procedure

Supporting shared decision-making and people’s understanding of medicines : An exploration of the acceptability and comprehensibility of patient information

ACKNOWLEDGEMENTS The research team would like to thank the community pharmacy management and staff for all their assistance in facilitating recruitment. Thanks also to our colleague Alyson Brown, Robert Gordon University, for her help with recruitment and to Linda Collins, Healthcare Improvement Scotland, for assisting with project materials. We are incredibly grateful to all participants who gave up their time to participate in the research and who provided such valuable feedback.Peer reviewedPublisher PD

The Physical Activity Resource Assessment (PARA) instrument: Evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods

Abstract Background Neighborhood environment factors may influence physical activity (PA). The purpose of this study was to develop and test a brief instrument to systematically document and describe the type, features, amenities, quality and incivilities of a variety of PA resources. Method The one-page Physical Activity Resource Assessment (PARA) instrument was developed to assess all publicly available PA resources in thirteen urban lower income, high ethnic minority concentration neighborhoods that surrounded public housing developments (HDs) and four higher income, low ethnic minority concentration comparison neighborhoods. Neighborhoods had similar population density and connectivity. Trained field coders rated 97 PA resources (including parks, churches, schools, sports facilities, fitness centers, community centers, and trails) on location, type, cost, features, amenities, quality and incivilities. Assessments typically took about 10 minutes to complete. Results HD neighborhoods had a mean of 4.9 PA resources (n = 73) with considerable variability in the type of resources available for each neighborhood. Comparison neighborhoods had a mean of 6 resources (n = 24). Most resources were accessible at no cost (82%). Resources in both types of neighborhoods typically had about 2 to 3 PA features and amenities, and the quality was usually mediocre to good in both types of neighborhoods. Incivilities at PA resources in HD neighborhoods were significantly more common than in comparison neighborhoods. Conclusion Although PA resources were similar in number, features and amenities, the overall appearance of the resources in HD neighborhoods was much worse as indicated by substantially worse incivilities ratings in HD neighborhoods. The more comprehensive assessment, including features, amenities and incivilities, provided by the PARA may be important to distinguish between PA resources in lower and higher deprivation areas.Peer Reviewe

The opportunities, challenges, and rewards of ‘community peer research’: reflections on research practice

This article shares reflections from a group of academic researchers at the same University on their experience of conducting “community peer research” projects involving nonacademics in social research. We review a range of literature that has influenced the development of our practice, stressing the importance of co-production and power relations. We present six case studies that represent the breadth of our different engagements with community peer research, and then go on to reflect on the challenges and benefits of this approach. We identify a number of practical challenges, ways in which we overcame them, and in particular stress the importance of providing well-designed training for community peer researchers. We conclude with some recommendations for other researchers looking to conduct similar research