Ethical Justifications for Access to Unapproved Medical Interventions : An Argument for (Limited) Patient Obligations

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The ethical and epistemic roles of narrative in person-centred healthcare

Acknowledgements The first author was supported by the Australian Research Council (CE140100012). The third author was part supported by the Wellcome Trust (209811). Our thanks to participants at the European Society for Philosophy of Medicine and Health Care 32nd annual conference for comments and questions on an earlier version of some of the paperPeer reviewedPostprin

Risk, Overdiagnosis and Ethical Justifications

Wendy Rogers was supported by Future Fellowship (FT130100346) from the Australian Research Council and a 2018 Residency from the Brocher Foundation. Stacy Carter was supported by National Health and Medical Research Council Centre for Research Excellence 1104136 and a 2018 Residence from the Brocher Foundation. This study was funded by FT130100346 from the Australian Research Council (Rogers) and CRE 1104136 from the National Health and Medical Research Council (Carter), and Rogers and Carter both received support in the form of a 2018 month-long residency at the Brocher Foundation, Switzerland.Peer reviewedPublisher PD

Revisiting the equity debate in COVID-19 : ICU is no panacea

Copyright information No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usagePeer reviewedPostprin

An analysis of automatic teller machine usage by older adults : a structured interview approach.

It is often assumed that automatic teller machines (ATMs) are inherently easy to use and require no training. However, there is evidence to suggest that ATM users do experience difficulty when learning to use the system. The purpose of the present study was to conduct an in-depth analysis of ATM usage by older adults. Our approach consisted of telephone interviews followed by structured individual interviews. The goals were to understand the problems encountered by ATM users, to determine how ATMs might be better designed and to assess the training needs of older individuals. The phone interview data provide information about the relationships between age, sex and ATM usage within the adult sample, as well as information about why some people choose not to use ATMs. The structured interview data provide a more in-depth view of the concerns of both users and non-users, and information about training needs. The training and design implications of the results are discussed

Refining a pedagogical approach for employing design thinking as a catalyst

There is an increasing interest in design and creative thinking processes in the Sciences, Technology, Engineering, and Mathematics (STEM) and health education disciplines. Many new degree programs are integrating design thinking into their syllabi, with the intention of bringing creative problem-solving methods to these disciplines. In reality, the exposure these students get is minimal, and it does not provide enough foundation for them to use the knowledge and apply the process(es) in real-life situations. There is an increased awareness of the importance of design thinking in the innovative process. More and more STEM, business, and health establishments are embedding trained designers into their research teams – yet many designers are not equipped to work on interdisciplinary teams. Design students tend to approach problems more intuitively, opportunistically, and build on creative leaps of imagination whereas, STEM and health disciplines are often more algorithmic, systematic, and rationale. This can often generate tension in interdisciplinary teams, especially when traditional disciplines (e.g., Engineering, Sciences) are integrating relatively newer thinking (e.g., design thinking).In this paper, we share the outcome of a phenomenological study on a high-functioning interdisciplinary team working on a health innovation project focused on aging with a disability. This case study illustrates the skill set needed for designers, health and technology professionals to make a significant contribution to its overall outcome. We identified key attributes that contribute towards being an effective member of interdisciplinary teams. Based on this study, we propose a pedagogical approach to better equip design, STEM, and Health students to be more competitive in changing economic expectations and ensure more impactful design outcomes

Refining a pedagogical approach for employing design thinking as a catalyst

There is an increasing interest in design and creative thinking processes in the Sciences, Technology, Engineering, and Mathematics (STEM) and health education disciplines. Many new degree programs are integrating design thinking into their syllabi, with the intention of bringing creative problem-solving methods to these disciplines. In reality, the exposure these students get is minimal, and it does not provide enough foundation for them to use the knowledge and apply the process(es) in real-life situations. There is an increased awareness of the importance of design thinking in the innovative process. More and more STEM, business, and health establishments are embedding trained designers into their research teams – yet many designers are not equipped to work on interdisciplinary teams. Design students tend to approach problems more intuitively,  opportunistically, and build on creative leaps of imagination whereas, STEM and health disciplines are often more algorithmic, systematic, and rationale. This can often generate tension in interdisciplinary teams, especially when traditional disciplines (e.g., Engineering, Sciences) are integrating relatively newer thinking (e.g., design thinking). In this paper, we share the outcome of a phenomenological study on a high-functioning interdisciplinary team working on a health innovation project focused on aging with a disability. This case study illustrates the skill-set needed for designers, health and technology professionals to make a significant contribution to its overall outcome.  We identified key attributes that contribute towards being an effective member of interdisciplinary teams.  Based on this study, we propose a pedagogical approach to better equip design, STEM, and Health students to be more competitive in changing economic expectations and ensure more impactful design outcomes

Transportation challenges for persons aging with mobility disability: Qualitative insights and policy implications

Background Persons aging with mobility disability (PAwMD) experience transportation barriers, which can hinder their ability to fully participate in society. Despite a vast infrastructure of federal laws and programs designed to ensure access to transportation, PAwMD remain a transportation-disadvantaged population. Objectives This paper presents detailed insights on transportation challenges experienced by PAwMD along with recent Federal programmatic initiatives designed to enhance access and mobility for transportation for older adults and people with disabilities. To identify policy gaps and opportunities to improve transportation services, we compared individual-level challenges from PAwMD to national survey data about barriers associated with delivering transportation services at state and local levels. Methods To assess individual-level transportation challenges, we conducted in-depth, structured interviews with sixty older adult participants with self-identified mobility disabilities for at least 10 years. We also conducted a content analysis of end-user transportation challenges and agency-level transportation coordination barriers to identify correspondences. Results Participants reported challenges utilizing public and private modes of transportation, related to availability; accessibility; safety; advanced planning; as well as societal attitudes. Barriers to the availability, delivery, and coordination of access and mobility services are linked directly or indirectly to the PAwMD reports of experiencing a shortage of accessible transportation options. Conclusions Findings highlight the complexity of federal transportation policies and programmatic initiatives designed to support older adults and people with disabilities, which contribute to implementation barriers and transportation challenges. Results highlight the importance of integrating end-user and state and local provider input into transportation policy development and program implementation

Mental Health Outcomes, Parenting Skills and Family Functioning of Adult and Family Treatment Court Participants

Background: Parental substance use places children at risk for poor social, emotional, and behavioral outcomes. Many parents with substance use disorders (SUD) are treated through accountability drug courts including adult drug courts (ADC) through the criminal justice system and family drug treatment courts (FTC) through the child welfare system. Little is known about the children of parents who participate in treatment through adult drug courts, which could serve as an important treatment venue for improving child outcomes. Children treated through family treatment courts are often the center of treatment. This research compared outcomes of parents and children involved in adult drug and family treatment courts. Methods: Participants were 105 drug court clients (80 from ADC; 25 from FTC) from four Georgia based drug courts. Participants completed computerized interviews containing a variety of measures focusing on adult mental health, parenting behaviors and communication, and child mental health and behavior. Results: Parents in FTC compared to those in ADC reported greater social support (p =.05) and better family functioning (p =.03). Parents in ADC reported poorer parental involvement and poorer monitoring of children than FTC, but no differences in positive parenting (p =.13), inconsistent discipline (p =.27), or child abuse potential (total risk \u3e 9, p =.42; total risk \u3e12, p =.37). Regarding mental health, ADC parents reported a greater number of symptoms or poor mental health than FTC. No differences were found for parent-child communication skills (p =.38), post-traumatic stress symptom severity (p =.62), or child behavior problems. Conclusions: This data suggests that children of caregivers in drug treatment via ADC are at equal and perhaps greater risk than children of caregivers in FTC because of increased parental risk factors. ADC should consider offering family -based treatments that can enhance the parent-child relationship and promote recovery by reducing family conflict