Self‐rated preparedness of Australian prevocational hospital doctors for emergencies

Objective: To determine perceived preparedness of Australian hospital‐based prevocational doctors for resuscitation skills and management of emergencies, and to identify differences between doctors who perceive themselves well prepared and those who perceive themselves poorly prepared for emergencies, in demographics and exposure to desired learning methods. Methods: Questionnaire consisting of a mix of graded Likert scales and free‐text answers distributed to 36 Australian hospitals for secondary distribution to hospital medical officers. Results: From 2607 questionnaires posted, 470 (18.1%) were returned. Thirty‐one per cent (95% confidence interval [CI] 26–35%) felt well prepared for resuscitation and management of emergencies, 41% (CI 37–45%) felt adequately prepared and 28% (CI 24–32%) felt they were not well prepared. Those who felt well prepared reported that they had experienced more exposure to a range of educational methods, including consultant contact, supervisor feedback, clinical skills, high fidelity simulator sessions and unit meetings. Well‐prepared and poorly prepared doctors had similar opinions of the usefulness of various learning methods, but the poorly prepared group more frequently expressed a desire for increased exposure to contact with registrars and consultants, clinical skills sessions and hospital and unit meetings. There were no differences in gender, age or country of origin (Australia vs international medical graduates) between those who felt well or poorly prepared. Conclusions: Many prevocational hospital doctors feel inadequately prepared for the management of emergencies. Perceived preparedness is associated with more exposure to particular educational activities. Increasing exposure to learning of emergencies in undergraduate and prevocational years could reduce the number of junior doctors who feel poorly prepared for emergencies.     

Patient Education and Engagement through Social Media

This review addresses the demographics of social media users and their relative health literacy. Means of overcoming health inequities via social media and the role of social media in patient education and engagement are explored. This review discusses forms of appropriate patient engagement, including the pitfalls of social media use.     

Years of good life is a well-being indicator designed to serve research on sustainability

Sustainable development (SD) as popularized by the Brundtland Commission and politically enshrined in the Sustainable Development Goals has been the explicit focus of sustainability science. While there is broad agreement that the trend of human well-being (W) over time should serve as a sustainability criterion, the literature so far has mostly addressed this in terms of its determinants rather than focusing on W itself. There is broad agreement that an indicator for W should have multiple constituents, clearly going beyond gross domestic product. Here, we propose a tailor-made indicator to serve precisely this purpose following a set of specified desiderata, including its applicability to flexibly defined subnational populations by gender, place of residence, ethnicity, and other relevant characteristics. The indicator, years of good life (YoGL), reflects the evident fact that in order to be able to enjoy any quality of life, one has to be alive and thus is primarily based on life expectancy. However, since mere survival is not considered good enough, life years are counted conditional on meeting minimum standards in two dimensions: the objective dimension of capable longevity (consisting of being out of absolute poverty and enjoying minimal levels of physical and cognitive health) and the subjective dimension of overall life satisfaction. We illustrate the calculation of this indicator for countries and subpopulations at different stages of development and with different degrees of data availability.

Sustainability science refers to the most comprehensive scholarly effort to understand the interactions between natural and social systems in order to assess whether certain developmental pathways can be considered sustainable. This should also include the possible negative effects of environmental changes, such as climate change and biodiversity loss, on future human well-being. In this paper, we propose a tailor-made indicator to assess long-term human well-being as the ultimate end of sustainable development. This indicator, called “years of good life” (YoGL), is designed in such a way that it can be both empirically measured—which is the focus of this paper—and modeled in its long-term future trends—which will be the focus of future work.When assessing changes over time in the well-being of certain human populations (or subpopulations, as defined, e.g., by gender, ethnicity, urban/rural place of residence, or other social groupings), one can focus on the determinants or the constituents of well-being. In sustainability science, thus far, empirical and theoretical research has placed more emphasis on studying the determinants, including environmental services (1), whereas specifying its constituents has received less systematic attention, often leaving us with nothing but the unspecific notion of “utility.” The focus on determinants has led to the concept of “inclusive wealth” (IW) which can be used to assess whether a society is on a sustainable development trajectory in terms of the productive base necessary to maintain a high standard of living in the future (2). However, empirically measuring the values and relative effects of the different capitals determining human well-being remains extremely challenging and “no current attempt to date can be said to be fully inclusive” (3).The idea behind YoGL, on the other hand, is to study sustainability by focusing explicitly on the constituents of well-being and its change over time. In doing so, YoGL avoids several of the pitfalls by which the IW approach is plagued (3, 4). For example, rather than making contestable quantitative assessments of the relative contributions of the different determinants of well-being, the demographic approach underlying YoGL provides numerical values of human well-being directly, expressed as the average number of years of good life a person can expect to live as part of a given subpopulation under the conditions of a specified point in time. Based on the assumed universal nature of its unit of measurement—YoGL lived today in one specific population has the same meaning as YoGL lived in the future or in another population—the indicator has a time-independent meaning. This also avoids the pitfalls of specifying a rate at which to discount future well-being, which have become apparent at least since the debates around the Stern report (5). YoGL allows us to directly compare human well-being across different subpopulations and generations. Moreover, while all estimates of the different determinants of future human well-being are highly sensitive to population growth, as a measure referring to per-person well-being the derivation of YoGL is not directly affected by assumptions about the future trajectory of population size. Finally, as stressed by Dasgupta (6), the nature of determinants can change over time and across places depending on different commodities and technological regimes, whereas the constituents of well-being—as used in YoGL—are arguably shared across space and time.In the following, we will first present the proposed design of the indicator. We will then provide a step-by-step user’s guide for empirically deriving YoGL based on the most appropriate available data source, before offering examples of how it can be calculated based on auxiliary information on populations for which the necessary data are not yet fully available. We will close with a discussion and brief outlook as to what is still needed to use this indicator for the assessment of sustainability.     

Teaching caregivers to implement an augmentative and alternative communication intervention to an adult with ASD

Many researchers have investigated the effectiveness of augmentative and alternative communication (AAC) systems on improving communication skills of children with autism spectrum disorder (ASD) and communication complex needs (CCN); however, few studies included adults with ASD. Also, there is a lack of research on primary caregiver implemented interventions with high treatment fidelity although primary caregiver-implemented interventions have been used effectively with adults with ASD and their families. This study investigated the accuracy of primary caregivers’ implementation of a tablet-computer based AAC system while they were providing instruction to an adult with ASD. Also, independent use of AAC system of the participant was examined. We implemented a multiple probe design across three instructional coaching steps to examine the accuracy of the caregivers’ AAC implementation. One adult with autism and CCN and his four primary caregivers participated in this study, twice a week for seven weeks. Both visual and statistical analyses were utilized. Results indicated that, with instructional coaching, all of the caregivers were able to implement the procedures of the AAC mode with the participant accurately, as demonstrated via visual inspection and statistical analyses. Nevertheless, there was little improvement in the participant's independent use of the AAC mode. Limitations and suggestions for future researchers are discussed.     

Change in basic need frustration in relation to perfectionism,anxiety, and performance in elite junior performers

The present study examined whether there were different growth profiles in basic need frustration in elite junior performers over a nine-month period. Subsequently, we examined whether the identified growth profiles differed in their levels of perfectionistic strivings and evaluative concerns measured at baseline and, additionally, whether they were associated with higher or lower levels of anxiety and perceived performance level in the end of the period. A sample of 259 (M_age = 17.31; SD_age = 0.97) elite junior performers from sports and performing arts completed an online questionnaire to report their self-ratings of the study variables. The analyses were conducted using growth mixture modeling in Mplus 8.0. Two main contrasting growth profiles were identified in each of the basic need frustration. Perfectionistic strivings were overall higher than evaluative concerns, but did not differ between the growth profiles. Conversely, evaluative concerns differed significantly between the identified growth profiles. Higher levels of evaluative concerns were associated with the most maladaptive growth profiles. Indeed, elite junior performers, who experienced moderate and increasing levels of competence and autonomy frustration, reported higher levels of anxiety and lower levels of perceived performance level than those who reported low and decreasing levels of competence and autonomy frustration. Based on these findings, evaluative concerns and basic need frustration appear to play key roles in the development of maladaptive motivational processes over time.     

Utilisation des services d’aide et de soins à domicile pour les personnes âgées en situations complexes : comparaison entre trois types de coordination gérontologique

BackgroundOlder people with complex needs live mainly at home. Several types of gerontological coordinations have been established on the French territory to meet their needs and to implement social and primary health care services. But we do not have any information on the use of these services at home as a function of the coordination method used.MethodsWe compared the use of home care services for older people with complex needs in three types of coordination with 12 months’ follow-up. The three coordinations regrouped a gerontological network with case management (n = 105 persons), a nursing home service (SSIAD) with a nurse coordination (n = 206 persons) and an informal coordination with a non-professional caregiver (n = 117 persons).ResultsAt t0, the older people addressed to the gerontological network had less access to the services offered at home; those followed by the SSIAD had the highest number of services and of weekly interventions. Hours of weekly services were two-fold higher in those with the informal coordination. At t12, there was an improvement in access to services for the network group with case management and an overall increase in the use of professional services at home with no significant difference between the three groups.ConclusionThe use of social and primary health care services showed differences between the three gerontological coordinations. The one-year evolution in the use of home services was comparable between the groups without an explosion in the number of services in the network group with case management.