Helping patients and physicians reach individualized medical decisions: theory and application to prenatal diagnostic testing

This paper presents a procedure designed to aid physicians and patients in the process of making medical decisions, and illustrates its implementation to aid pregnant women, who decided to undergo prenatal diagnostic test choose a physician to administer it. The procedure is based on a medical decision-making model of Karni (J Risk Uncertain 39: 1–16, 2009). This model accommodates the possibility that the decision maker’s risk attitudes may vary with her state of health and incorporates other costs, such as pain and inconvenience, associated with alternative treatments. The medical decision problem was chosen for its relative simplicity and the transparency it affords.     

Gearing Up for Personalisation: Training Activities Commissioned in the English Pilot Individual Budgets Sites 2006–2008

The transformation of social care in England is taking place though changes affording greater choice and control for people using services. Individual budgets were one key element of these changes and were piloted in 13 local authorities in 2006–2008. This article reports on interviews with training leads in these local authorities that took place in 2008 as part of an independent evaluation of the individual budget pilots. The aims of the interviews were to explore the role of training as part of the processes of transformation, the use of resources and establishment of training strategies within the local authority. Participants revealed that the subject of training was acquiring higher profile within their authorities, although uncertainties remain about the extent of local authority responsibilities for training. Within local authorities, training resources were yet to be determined and models of training were not fully developed. The article concludes that training will remain a central issue when implementing personalised social care services and that models of training for such changes should be shared and evaluated over the long term.     

Social care stakeholders' perceptions of the recruitment of international practitioners in the United Kingdom—a qualitative study

Mobility of labour is common within Europe and globally, particularly in social and health care. This article examines the findings from a qualitative study of 15 expert or stakeholder views that explored supply and demand factors in international social care staff recruitment to the United Kingdom (UK). Findings are that international social care workers have a better reputation and are perceived as being harder workers, more productive, more reliable, more focused and more likely to stay in a post longer than local workers. However, there is also the perception that employment in social care is a stepping-stone into other forms of employment both in the UK and when returning to home countries, through access to training, experience and improved job opportunities. The impact of migration policies on the composition of international workers is further noted because greater numbers of social care staff are coming to the UK from the European Union and fewer from Commonwealth states. Changes in the profile of international workers are discussed, with a need identified to address cultural and language differences to ensure good outcomes for service users.     

“Capacity Is Key”: Investigating New Legal Provisions in England and Wales for Adult Safeguarding

This study aimed to investigate the views and experiences of local Safeguarding Adults Coordinators of the newly implemented Mental Capacity Act 2005. This legislation in England and Wales has both protection and empowerment as its dual goals. Fifteen Safeguarding Adults Coordinators (SACs) employed by local authorities in the London area were interviewed in 2008, and again 2 years later. A total of 12 SACs participated in the 2010 follow-up interviews. The findings are reported here, covering experiences and views on the implementation and uses of the Act. There was overwhelming support for the Act as enhancing people's rights to a life free from abuse, of providing a framework for the assessment of decision-making capacity, and of assisting practitioners in reducing risks and responding to abusive situations. Participants urged better publicity about the Act, more detailed guidance on the new offenses, and greater attention to the interactions with other government policy goals.     

“Bad Things Happened”: How Children of the Digital Age Make Sense of Violent Current Events

Digital technologies collapse distance and accelerate the speed at which information travels. This has made it easier for children to encounter violent clashes from across the globe. Thus, the digital era has raised new questions for educators about how to teach current events in an increasingly globalized world. When children have easy access to information, how do they make sense of what they see and hear? When world events take a violent turn, what cognitive and emotional sense-making strategies do children employ? And, in light of children’s developing thoughts and feelings about global affairs, what role should educators play in helping children make sense of violent current events? This research explores these questions by examining one particular case of children’s understanding of violent current events. Through interviews and storytelling exercises it investigates how a group of Jewish children in the United States attempted to make sense of the 2014 war between Israel and Hamas, interrogating the cognitive and emotional sense-making strategies that the children employed. In doing so it highlights the opportunities and challenges of current events education at a time of unprecedented global connectivity.