Predictors of refusal to participate: a longitudinal health survey of the elderly in Australia

BACKGROUND: The loss of participants in longitudinal studies due to non-contact, refusal or death can introduce bias into the results of such studies. The study described here examines reasons for refusal over three waves of a survey of persons aged ≥ 70 years. METHODS: In a longitudinal study involving three waves, participants were compared to those who refused to participate but allowed an informant to be interviewed and to those who refused any participation. RESULTS: At Wave 1 both groups of Wave 2 non-participants had reported lower occupational status and fewer years of education, had achieved lower verbal IQ scores and cognitive performance scores and experienced some distress from the interview. Those with an informant interview only were in poorer physical health than those who participated and those who refused. Depression and anxiety symptoms were not associated with non-participation. Multivariate analyses found that verbal IQ and cognitive impairment predicted refusal. Results were very similar for refusers at both Waves 2 and 3. CONCLUSIONS: Longitudinal studies of the elderly may over estimate cognitive performance because of the greater refusal rate of those with poorer performance. However, there is no evidence of bias with respect to anxiety or depression

Studies in bovine vibriosis

Vibrio fetus causes infertility and abortion in cattle, the carrier bull being the main agent of transmission. The work done in this thesis studied different methods of detecting V.fetus and where possible compared their results. In the first section V.fetus was added to preputial washings from vibrio-free bulls. After treatment in the laboratory the following procedures were carried out: 1. The material was cultured on to a solid medium containing antibioties. 2. The material was passed through a Millipore filter of 0.65 micron diameter porosity and the filtrate cultured. 3. The material was placed on a slide and treated with a fluorescein conjugated anti-V.fetus serum to detect the presence of V.Fetus cells. The fluorescent antibody technique (FAT) was found to be specific and of comparable sensitivity to the culture method following millipore filtration. The later method was found to be more successful than direct culture on to a medium containing antibioties. The second section dealth with the insemination of heifers with preputial washings (PPW) containing known numbers of V.fetus cells and the subsequent reisolation of V.fetus from vaginal mucus taken from these animals. It was found that when approximately 104 viable vibrios were inseminated, 4 out of 12 helfers gave at least one vaginal mucus sample from which V.fetus was isolated. When approximately 108 vibrios were inseminated, 6 out of 8 heifers gave isolates of V.fetus. The third section was a bull survey in which 89 bulls were examined, 54 using the FAT only and 35 using the FAT and culture following millipore filtration. The results showed that 8 out of the 54 bulls and 10 out of the 35 bulls were vibrio carriers. Only 4 out of the 10 FAT positive bulls gave successful isolation using the millipore filtration culture method. Because of its speed and accuracy the FAT was considered to be a good screening method but isolation was considered essential if further identification of the isolates were required

New Zealand athletes' attitudes towards seeking sport psychology consultation

The aim of this study was to use the Sport Psychology Attitudes-Revised (SPA-R) questionnaire (Martin, Kellman, Lavallee & Page, 2002) to develop an understanding of the attitudes elite New Zealand athletes (N = 112) hold towards sport psychology so that services can be tailored to accommodate these views. The influence of athlete characteristics such as nationality, gender, age, level of competition achieved, and previous use of sport psychology on attitudes was explored. Further, the SPA-R was used as a measure of attitudes within the Theory of Reasoned Action (TRA; Ajzen & Fishbein, 1980) and Theory Planned Behaviour (TPB; Ajzen, 1985, 1991), and integrated with measures of subjective norm and perceived behavioural control to investigate the influence of these variables on predicting athletes' intention to use sport psychology. Results suggested that New Zealand athletes generally held positive attitudes regarding sport psychology, with gender and previous experience of sport psychology significantly influencing attitudes. Regression analyses indicated that the TPB was a better model than the TRA for predicting intention, and the variables predicted 39.7% of variance in intention to use sport psychology. The only SPA-R subscale that contributed significantly was confidence in sport psychology, and perceived behavioural control and subjective norm also contributed significantly. These findings suggest the SPA-R may have limited value in predicting intentions, although the TPB could provide a useful theoretical framework to direct interventions aimed at increasing athletes' intention to use sport psychology

Reflections on offering a therapeutic creative arts intervention with cult survivors:A collective biography

A new, evidence-based, multimodal, and creative psychological therapy, Arts for the Blues, was piloted with survivors of cultic abuse in a workshop within a conference setting. The five facilitators, who occupied diverse roles and perspectives within the workshop and research project, reflected on heir experiences of introducing this novel intervention to the cult-survivor population. In this underreported territory of using structured, arts-based, psychological therapy with those who have survived cultic abuse, the authors used a process of collective biography to compile a first person, combined narrative based on those reflections. This approach allows for a visceral insight into the dynamics and obstacles encountered, and the counter transference responses of the facilitators. This reflexive process shined a light into aspects of research and practice that were not all visible to the individual researchers previously, with implications for research ethics, psychological therapy, and creative arts within the cult-survivor field

Competency-based assessment of practice-based experiential learning in undergraduate pharmacy programmes.

Objective: To obtain feedback from experiential leaning (EL) leads about how competency-based assessments could be undertaken by EL facilitators, and to scope existing EL assessment structures in undergraduate Masters in Pharmacy (MPharm) programmes across the United Kingdom (UK). Methods: A cross-sectional survey was conducted utilizing a nine-item on-line survey, consisting of five open-ended and four closed-ended question. All UK universities with MPharm programmes (n=30) were invited to participate in the survey. Variables of interest were perceptions on activities and competencies that could be assessed by EL facilitators. The survey utilised a 5-point Likert-type response ranging from strongly disagree to strongly agree. Other variables of interest were tools/methods that could be used to assess competency, and perceived advantages and disadvantages of the proposed methods, the latter two captured via open-ended questions. Results: Of the 21 universities that responded (Response rate: 70%), 17 were included in the final analysis. Fourteen of the 17 (82.4%) offered the 4-year programme, while 3 (17.6%) offered both the 4-year and 5-year integrated programme. Assessments were mainly undertaken by university staff (59%), with minimal amounts undertaken during EL (39%). There was unanimous agreement (100%) that facilitators could assess students’ communication skills and professionalism during EL. No consensus, however, was achieved with regard to the tool(s) or method(s) to be used to assess student’s competencies. There were 13 responses to the open-ended comments. An advantage noted was that EL facilitator assessment of students would allow for more accurate evaluation of students in the practice setting, while acknowledging barriers such as the burden of time and the lack of consistency in marking. To address this lack of consistency, the majority highlighted the need for facilitator training. Conclusion: Minimal assessments are currently undertaken during EL, with students predominantly assessed on return to the university. No consensus could be achieved with regard to the tool(s) or method(s) to be used to assess students’ competencies, suggesting that perhaps there is no one-size-fits-all, and that the tools and methods used should be informed by the competencies being assessed

A cross-sectional study examining the nature and extent of interprofessional education in schools of pharmacy in the United Kingdom.

Interprofessional education can prepare the workforce for collaborative practice in complex health and social care systems. The aim of this study was to examine the nature and extent of interprofessional education in schools of pharmacy in the United Kingdom. An online questionnaire was developed using systems theory, published literature and input from an interprofessional expert panel. It included closed and open-ended questions and a demographic section. Following piloting, it was distributed to 31 schools of pharmacy. Descriptive statistics were used for quantitative data, a content analysis approach for qualitative data. Ten schools of pharmacy responded. All reported delivering compulsory interprofessional education. Most (80%) reported an interprofessional steering group overseeing development. Formative and/or summative assessment varied depending on year of study. Mechanism and purpose of evaluation varied, with respondents reporting Kirkpatrick Evaluation Model Levels 1-3 (100%;80%;70%). Two themes were identified: "Variation in Interprofessional Education Approaches and Opportunities" and "Factors Influencing Development and Implementation of Interprofessional Education". Formal teaching was mainly integrated into other modules; various pedagogic approaches and topics were used for campus-based activities. Respondents referred to planned interprofessional education during practice-based placements; some still at pilot stage. Overall, respondents agreed that practice-based placements offered opportunistic interprofessional education, but a more focused approach is needed to maximise student pharmacists' learning potential. Most interprofessional education offered in undergraduate pharmacy curricula in the United Kingdom is campus-based, the nature and extent of which varies between programmes. Very few examples of practice-based activities were reported. Results may inform future interprofessional education curricular developmen

Pharmacy students’ experience of a novel government-funded experiential learning initiative: a mixed-method study (ACTp Study).

Background: In 2018, the Scottish Government made the Pharmacy Additional Cost of Teaching (ACTp) funding available to support the development of Experiential Learning (EL) in undergraduate pharmacy education. To inform the further expansion of EL in the pharmacy degree evaluation of new EL sites was required. Aim and method: A mixed-methods study was undertaken to determine students' perceptions of four new areas included in an EL pilot: primary care, out-of-hours, specialist sites, and remote and rural. Results: There were 43 survey respondents (response rate 72%). Majority agreed the pilot had developed their clinical (n=28, 74%) and communication skills (n=31, 82%), and prepared them for future practice (n=30, 79%). One third felt the EL did not permit them to interact with patients. Focus group and interview participants were positive about their experience and the opportunity to experience new pharmacy roles in non-traditional settings. Many highlighted the lack of hands-on experience and facilitator feedback. Facilitator training and quality assurance of sites are warranted. Conclusions: Future work should focus on assessment of and feedback for students, and interprofessional opportunities within EL

Bringing Creative Psychotherapies to Primary NHS Mental Health Services in the UK:A Feasibility Study on Patient and Staff Experiences of Arts for the Blues Workshops Delivered at Improving Access to Psychological Therapies (IAPT) services

There have been several arguments for the need to generate evidence-based creative forms of psychological interventions in Improving Access to Psychological Services (IAPT), the main primary mental health provider in hospitals in England, UK. In this feasibility study, we sought to identify helpful and unhelpful factors of a new creative group psychotherapy, titled Arts for the Blues. We also wanted to find out whether the research tools used were acceptable and sensitive. We therefore engaged a group of seven patients attending an IAPT service in the North West of England, and a group of six staff working in the same service, to attend one creative workshop each, followed by a focus group. The two focus groups were transcribed and analysed using thematic analysis. We also collected pre- and post-measures of depression (PHQ-9) and anxiety (GAD-7), measures commonly used in IAPT services, plus measures of well-being (WHO-5), the PANAS, and goal-setting, which were considered for acceptability and sensitivity. We received largely positive responses from service users and staff in the use of creative methods in psychotherapy. Although the measures used had limitations due to the short duration of one-off creative workshops, we found that they were sensitive enough, easy to complete and, thus, were acceptable. We concluded that Arts for the Blues is a promising intervention in IAPT, especially since it is shaped by service users and staff working in these services. Further work is needed to establish the effectiveness of this new intervention

Understanding the combined effects of multiple stressors : a new perspective on a longstanding challenge

This work was supported by the Office of Naval Research [grant numbers N000142012697, N000142112096]; and the Strategic Environmental Research and Development Program [grant numbers RC20-1097, RC20-7188, RC21-3091].Wildlife populations and their habitats are exposed to an expanding diversity and intensity of stressors caused by human activities, within the broader context of natural processes and increasing pressure from climate change. Estimating how these multiple stressors affect individuals, populations, and ecosystems is thus of growing importance. However, their combined effects often cannot be predicted reliably from the individual effects of each stressor, and we lack the mechanistic understanding and analytical tools to predict their joint outcomes. We review the science of multiple stressors and present a conceptual framework that captures and reconciles the variety of existing approaches for assessing combined effects. Specifically, we show that all approaches lie along a spectrum, reflecting increasing assumptions about the mechanisms that regulate the action of single stressors and their combined effects. An emphasis on mechanisms improves analytical precision and predictive power but could introduce bias if the underlying assumptions are incorrect. A purely empirical approach has less risk of bias but requires adequate data on the effects of the full range of anticipated combinations of stressor types and magnitudes. We illustrate how this spectrum can be formalised into specific analytical methods, using an example of North Atlantic right whales feeding on limited prey resources while simultaneously being affected by entanglement in fishing gear. In practice, case-specific management needs and data availability will guide the exploration of the stressor combinations of interest and the selection of a suitable trade-off between precision and bias. We argue that the primary goal for adaptive management should be to identify the most practical and effective ways to remove or reduce specific combinations of stressors, bringing the risk of adverse impacts on populations and ecosystems below acceptable thresholds.Publisher PDFPeer reviewe

Overcoming the challenges of studying conservation physiology in large whales : a review of available methods

Large whales are subjected to a variety of conservation pressures that could be better monitored and managed if physiological information could be gathered readily from free-swimming whales. However, traditional approaches to studying physiology have been impractical for large whales, because there is no routine method for capture of the largest species and there is presently no practical method of obtaining blood samples from free-swimming whales. We review the currently available techniques for gathering physiological information on large whales using a variety of non-lethal and minimally invasive (or non-invasive) sample matrices. We focus on methods that should produce information relevant to conservation physiology, e.g. measures relevant to stress physiology, reproductive status, nutritional status, immune response, health, and disease. The following four types of samples are discussed: faecal samples, respiratory samples (‘blow’), skin/blubber samples, and photographs. Faecal samples have historically been used for diet analysis but increasingly are also used for hormonal analyses, as well as for assessment of exposure to toxins, pollutants, and parasites. Blow samples contain many hormones as well as respiratory microbes, a diverse array of metabolites, and a variety of immune-related substances. Biopsy dart samples are widely used for genetic, contaminant, and fatty-acid analyses and are now being used for endocrine studies along with proteomic and transcriptomic approaches. Photographic analyses have benefited from recently developed quantitative techniques allowing assessment of skin condition, ectoparasite load, and nutritional status, along with wounds and scars from ship strikes and fishing gear entanglement. Field application of these techniques has the potential to improve our understanding of the physiology of large whales greatly, better enabling assessment of the relative impacts of many anthropogenic and ecological pressures.Publisher PDFPeer reviewe