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

Symbolic and continuous processes in the automatic selection of actions

Hybridness is a topical, if somewhat ambiguous, concept in a research environment where there is increasing acceptance of multiple co-existent research paradigms: artificial intelligence with its emphasis on reasoning with abstract symbols; the connectionist approach, with its exploration of the synergies of many interconnected simple structures; and "Nouvelle Robotics", which places a focus on the interplay between systems generating skill or behaviour in complete agents. There is scope for considerable argument about principles, research programmes, the "Nature of Things", as well as room for compromise and synthesis. This collection of papers, presented at AISB '95 (the 10th biennial conference on AI and the Simulation of Behaviour) reveals both argument and synthesis

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

Ethical challenges of conducting health research in UK school setting

This paper offers guidance for novice nurse researchers on the ethical and methodological challenges of conducting health research in high school settings. Over the course of two studies in UK high schools with students aged 11–16 years, the authors encountered common ethical and methodological challenges. This article draws on these studies to build a critique of approaches to health research in school settings. Issues of consent and assent, confidentiality and participation can highlight tensions between the expectations of schools and health researchers. In this context, feasible research designs raise complex ethical and methodological questions. Ethical and methodological norms for health research may not be suitable for high school settings. Successful school-based health research designs may need to be flexible and responsive to the social environment of schools

A systematic methodology for cognitive modelling

The development and testing of computational models of cognition is typically ad hoc: few generally agreed methodological principles guide the process. Consequently computational models often conflate empirically justified mechanisms with pragmatic implementation details, and essential theoretical aspects of theories are frequently hard to identify. We argue that attempts to construct cognitive theories would be considerably assisted by the availability of appropriate languages for specifying cognitive models. Such languages should: (1) be syntactically clear and succinct; (2) be operationally well defined; (3) be executable; and (4) explicitly support the division between theory and implementation detail. In support of our arguments we introduce Sceptic, an executable specification language which goes some way towards satisfying these requirements, Sceptic has been successfully used to implement a number of cognitive models including Soar, and details of the Sceptic specification of Soar are included in a technical appendix. The simplicity of Sceptic Soar permits the essentials of the underlying cognitive theory to be seen, and aids investigation of alternative theoretical assumptions. We demonstrate this by reporting three computational experiments involving modifications to the functioning of working memory within Soar, Although our focus is on Soar, the thrust of the work is more concerned with general methodological issues in cognitive modelling