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Living and Researching the COVID-19 Pandemic: Autoethnographic Reflections from a Co-Research Team of Older People and Academics
Get PDFThis article describes and reflects upon the work of a co-research team on the Healthy Ageing in Scotland (HAGIS) ‘COVID-19 Impact and Recovery’ study (January 2021 to November 2022). The co-research team (seven older adults and three academics) was constituted near the start of this project; the team contributed to the development of recruitment materials and research tools and undertook qualitative research and analysis with older adults living across Scotland. This article provides a collaborative autoethnography about the activities undertaken by the team, the impact of the co-research process on the individuals involved, and the research findings and reflects the realities of co-research during the COVID-19 pandemic. Team members describe benefits, including increased confidence, new skills, and social connections, and reflect on the increased validity of the findings through their close involvement in the co-creation of knowledge. The process of team building and the adoption of an ‘ethics of care’ in our practice underpinned the success of this project and the sustainability of the group during and after the challenging circumstances of the pandemic
Assessing Decision Fatigue in General Practitioners’ Prescribing Decisions Using the Australian BEACH Data Set
Get PDFBackground General practitioners (GPs) make numerous care decisions throughout their workdays. Extended periods of decision making can result in decision fatigue, a gradual shift toward decisions that are less cognitively effortful. This study examines whether observed patterns in GPs’ prescribing decisions are consistent with the decision fatigue phenomenon. We hypothesized that the likelihood of prescribing frequently overprescribed medications (antibiotics, benzodiazepines, opioids; less effortful to prescribe) will increase and the likelihood of prescribing frequently underprescribed medications (statins, osteoporosis medications; more effortful to prescribe) will decrease over the workday. Methods This study used nationally representative primary care data on GP-patient encounters from the Bettering the Evaluation and Care of Health program from Australia. The association between prescribing decisions and order of patient encounters over a GP’s workday was assessed with generalized linear mixed models accounting for clustering and adjusting for patient, provider, and encounter characteristics. Results Among 262,456 encounters recorded by 2,909 GPs, the odds of prescribing antibiotics significantly increased by 8.7% with 15 additional patient encounters (odds ratio [OR] = 1.087; confidence interval [CI] = 1.059–1.116). The odds of prescribing decreased significantly with 15 additional patient encounters by 6.3% for benzodiazepines (OR = 0.937; CI = 0.893–0.983), 21.9% for statins (OR = 0.791; CI = 0.753–0.831), and 25.0% for osteoporosis medications (OR = 0.750; CI = 0.690–0.814). No significant effects were observed for opioids. All findings were replicated in confirmatory analyses except the effect of benzodiazepines. Conclusions GPs were increasingly likely to prescribe antibiotics and were less likely to prescribe statins and osteoporosis medications as the workday wore on, which was consistent with decision fatigue. There was no convincing evidence of decision fatigue effects in the prescribing of opioids or benzodiazepines. These findings establish decision fatigue as a promising target for optimizing prescribing behavior
Teaching team competencies within resuscitation training: A systematic review
Get PDFObjectives: To evaluate the effectiveness of life support training with specific emphasis on team competencies on clinical and educational outcomes. Methods: This systematic review was prospectively registered (PROSPERO CRD42023473154) and followed the PICOST (population, intervention, comparison, outcome, study design, timeframe) format. All randomized controlled trials and non-randomized studies evaluating learners undertaking life support training with specific emphasis on team competencies in any setting (actual and simulated resuscitations) were included. Unpublished studies were excluded. Medline, Embase and Cochrane databases as well as trial registries were searched from inception to August 2023 (updated January 18, 2024). Two researchers performed title and abstract screening, full-text screening, data extraction, assessment of risk of bias (using RoB2 and ROBINS-I) and certainty of evidence (using GRADE). PRISMA reporting checklist was used to report the results. No funding was obtained to perform this systematic review. Results: The literature search identified 5470 manuscripts. After the removal of 2073 duplicates, reviewing the remaining articles' titles and abstracts yielded 31 articles for full-text review. Of these, 17 studies were finally included. The studies involved the following training levels: basic life support, adult advanced life support, paediatric and neonatal resuscitations. Most studies (n = 16) evaluated outcomes in simulated, and only one study in actual resuscitations. Studies included in all training contexts showed either neutrality and/or benefits of life support training with specific emphasis on team competencies. Team competencies training improved CPR skill performance and CPR quality. Specific team competencies that improved included leadership, communication, decision-making and task management. No undesirable effects were observed. Meta-analysis was not possible due to significant methodological heterogeneity. Sub-group analysis was impossible due to lack of data. Risk of bias assessment ranged from some concerns to serious. Overall certainty of evidence was rated as low to very low due to risk of bias and imprecision. Conclusion: This systematic review identified very low and low certainty evidence, almost entirely derived from simulation studies. The studies and their findings were heterogenous but suggest that teaching team competencies can improve resuscitation skills performance and CPR quality, as well as improve team competencies, specifically leadership, communication, decision-making, and task management. Further research is required to understand optimal configuration of team competencies training interventions and to understand the effect on clinical outcomes and cost-effectiveness
Optimising species detection probability and sampling effort in lake fish eDNA surveys
Get PDFEnvironmental DNA (eDNA) metabarcoding is transforming biodiversity monitoring in aquatic environments. Such an approach has been developed and deployed for monitoring lake fish communities in Great Britain, where the method has repeatedly shown a comparable or better performance than conventional approaches. Previous analyses indicated that 20 water samples per lake are sufficient to reliably estimate fish species richness, but it is unclear how reduced eDNA sampling effort affects richness, or other biodiversity estimates and metrics. As the number of samples strongly influences the cost of monitoring programmes, it is essential that sampling effort is optimised for a specific monitoring objective. The aim of this project was to explore the effect of reduced eDNA sampling effort on biodiversity metrics (namely species richness and community composition) using algorithmic and statistical resampling techniques of a data set from 101 lakes, covering a wide spectrum of lake types and ecological quality. The results showed that reliable estimation of lake fish species richness could, in fact, usually be achieved with a much lower number of samples. For example, in almost 90% of lakes, 95% of complete fish richness could be detected with only 10 water samples, regardless of lake area. Similarly, other measures of alpha and beta-diversity were not greatly affected by a reduction in sample size from 20 to 10 samples. We also found that there is no significant difference in detected species richness between shoreline and offshore sampling transects, allowing for simplified field logistics. This could potentially allow the effective sampling of a larger number of lakes within a given monitoring budget. However, rare species were more often missed with fewer samples, with potential implications for monitoring of invasive or endangered species. These results should inform the design of eDNA sampling strategies, so that these can be optimised to achieve specific monitoring goals.Additional authors: Ian J. Winfield, Daniel S. Read, Lori Lawson Handley, Bernd Hänflin
Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page: Qualitative Interview Process Evaluation
Get PDFBackground: The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy. Objective: In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app. Methods: A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews. The interview questions were mapped on to the 7 facets of acceptability according to the Theoretical Framework of Acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs, we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken. Results: The Drink Less app was perceived as being ethical, easy, user-friendly, and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app, which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice web page was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as being personally relevant or effective in changing drinking behavior. Most participants reported neutral or negative affect, most participants thought the alcohol advice web page was accessible, and some participants reported ethical concerns around the availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns, which influenced their perceived self-efficacy regardless of their assigned intervention. Conclusions: Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice web page was generally considered unacceptable as a stand-alone intervention among the recruited sample, although it may signpost and help people access other resources and interventions.Additional co-authors: Claire Garnett
Nature-based therapy in Botswana and Scotland: Re-imagining social work for the climate crisis
Get PDFThis article discusses nature-based therapeutic interventions for young people and their families in Scotland and Botswana, to explore how green social work practice might tackle deepening inequalities in the context of the climate crisis. Both countries struggle with long-standing inequalities, and both face similar threats as the climate crisis advances-complicated by the legacies of other shared crises, from pandemics to poverty. With similar modes of governance and a shared entanglement in the British colonial project, social work practice encounters similar challenges in addressing the intersecting crises both countries face. Co-written by two social workers and a social anthropologist with personal, professional and research experience in these countries, the article draws on autoethnography to make comparisons that enable imagining new possibilities for social work practice in a time of accumulating crisis
Adult safeguarding legislation: Navigating the borderlands between mental capacity, mental health and social care law and practice
Get PDFAdult safeguarding legislation is contentious because it seeks to protect ‘vulnerable’ adults who fall between the borderlands of social care, mental health and mental capacity law. As a new and complex area of law and practice, further research on adult safeguarding legislation is required, in particular to consider it efficacy and human rights implications. Utilising a narrative literature review approach this article explores current research evidence on the Adult Support and Protection (Scotland) Act 2007 to consider whether safeguarding powers and duties can achieve a proportionate balance between individual autonomy and the state’s duties to protect adults at risk of harm and, if so, how. The findings demonstrate there are a wide range of people who can fall into these borderland areas. For a majority, the use of the Act has made significant positive differences to their lives. However, while supported decision-making was identified it was not found consistently applied. In addition, concerns emerged around the adequacy of some professionals’ legal knowledge, the consistent upholding of adults’ will and preferences, and the commitment to and resourcing of supported decision-making. Notwithstanding these drawbacks, it is concluded that this Act provides vital functions but amendments would enhance alignment with the CRPD
Is the perception of odour pleasantness shared across cultures and ecological conditions? Evidence from Amazonia, East Africa, New Guinea, Malaysia and Poland
Get PDFWhat makes an odour pleasant or unpleasant? The inherent properties of the constituent chemical compounds, or the nose of the beholder, driven by idiosyncratic differences and culture-specific learning? Here, 582 individuals, including Tanzanian Hadza hunter–gatherers, Amazonian Tsimane’ horticulturalists, Yali from the Papuan highlands and two industrialized populations (Poles, Malaysians), rated the pleasantness of 15 odour samples. We find considerable similarities in odour assessments across cultures, but our data do not fully support a claim regarding the universality of smell preferences. Despite cross-cultural similarities in olfactory assessments, probably driven by odour properties, we suggest that odour availability in ecological and cultural niches bears an undeniable effect on human odour preferences
Participation in a prison-based training programme is beneficial for rescue dogs
Get PDFDogs are often relinquished because of behavioural issues which may be exacerbated in rehoming centres. Prison-based dog training programmes (DTPs) may enhance outcomes for rescue dogs by providing socialisation and training opportunities to improve behaviour, welfare and likelihood of rehoming. We assessed whether dogs benefitted from participation, 1-3 times per week, in a prison-based DTP in which male young offenders learn how to train and care for dogs waiting to be rehomed. Within DTP sessions, there was significant improvement on a range of training tasks (n=42 dogs). Analyses of videos (n=17 dogs) in the kennels and a training barn pre- and post-DTP participation showed improvement in some positive behaviours, but no significant change in other behaviours. Subjective ratings by staff of the dogs’ behaviour were made (n=20 dogs). Desirable behaviours (e.g. playful/friendly) increased, and most undesirable behaviours (e.g. frustrated and noisy) decreased. Participation in the DTP did not mitigate all negative behaviours. However, improvements are consistent with enhanced welfare and likelihood of successful rehoming. Prison-based DTPs can be effective in supporting the work of animal rescue organisations to improve outcomes for dogs, while offering people in custody an opportunity to engage in purposeful activity and provide a community service
Biodiversity responses to insular fragmentation in Amazonia: two decades of research in the Balbina Hydroelectric Reservoir
Get PDFAs hydropower development expands across lowland tropical forests, flooding and concomitant insular fragmentation have become important threats to biodiversity. Newly created insular landscapes serve as natural laboratories to investigate biodiversity responses to fragmentation. One of these most iconic landscapes is the Balbina Hydroelectric Reservoir in Brazilian Amazonia, occupying >400 000 ha and comprising >3 500 forest islands. Here, we synthesise the current knowledge on responses of a wide range of biological groups to insular fragmentation at Balbina. Sampling has largely concentrated on a set of 22 islands and three mainland sites. In total, 39 studies were conducted over nearly two decades, covering 17 vertebrate, invertebrate, and plant taxa. Although species responses varied according to taxonomic group, island area was consistently included and played a pivotal role in 66.7% of all studies examining patterns of species diversity. Species persistence was further affected by species traits, mostly related to species capacity to use/traverse the aquatic matrix or tolerate habitat degradation, as noted for species of vertebrates and orchid bees. Further research is needed to improve our understanding of such effects on wider ecosystem functioning. Environmental Impact Assessments must account for changes in both the remaining habitat amount and configuration, and subsequent long-term species losses
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