People living with dementia may experience difficulties when making decisions for themselves in the later stages of the condition. While there are mechanisms in England and Wales for appointing an attorney to make decisions about welfare and finances on their behalf, there are no provisions for appointing an attorney to make future decisions about research participation. This is despite a growing focus on Advanced Care Planning and other processes that provide opportunities to discuss future preferences and ensure that decisions are made in line with those preferences. This qualitative study with 15 family caregivers who had acted as research proxies explored the role of Power of Attorney in their decisions about research, and their views about extending current legal arrangements to include research. Five themes were identified: the holistic nature of decision-making; the 'power' of attorney; making decisions by putting yourself in their shoes; support for bringing research under the umbrella of attorney arrangements and a unifying theme of trusting relationships. Legal provisions for prospectively appointing a research proxy may encourage discussion about future wishes and so enable decisions about research to be made that are in accordance with the person's preferences and wishes. However, further consultation with the public including people living with dementia and their families, and a range of stakeholders is needed. Providing guidance to families, people living with dementia and the wider research community may provide greater clarity and improve decision-making in the meantime.
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http://dx.doi.org/10.1177/1471301219884426 | DOI Listing |
Hum Brain Mapp
January 2025
Department of Psychology, Concordia University, Montreal, Quebec, Canada.
The cortex and cerebellum are densely connected through reciprocal input/output projections that form segregated circuits. These circuits are shown to differentially connect anterior lobules of the cerebellum to sensorimotor regions, and lobules Crus I and II to prefrontal regions. This differential connectivity pattern leads to the hypothesis that individual differences in structure should be related, especially for connected regions.
View Article and Find Full Text PDFJMIR Public Health Surveill
January 2025
School of Public Health, Imperial College London, London, United Kingdom.
Background: High response rates are needed in population-based studies, as nonresponse reduces effective sample size and bias affects accuracy and decreases the generalizability of the study findings.
Objective: We tested different strategies to improve response rate and reduce nonresponse bias in a national population-based COVID-19 surveillance program in England, United Kingdom.
Methods: Over 19 rounds, a random sample of individuals aged 5 years and older from the general population in England were invited by mail to complete a web-based questionnaire and return a swab for SARS-CoV-2 testing.
J Integr Complement Med
January 2025
Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Naturopathic practitioners consult an estimated 6.2% of Australian adults, equating to 1,550,000 people receiving their care each year. Sleep is now recognized as a key pillar of health; however, nearly half of all Australian adults report inadequate sleep.
View Article and Find Full Text PDFUnlabelled: Policy Points A redirection of measurement in health care from a narrow focus on diseases and care processes towards assessing whole person health, as perceived by the person themself, may provide a galvanizing view of how health care can best meet the needs of people and help patients feel heard, seen, and understood by their care team. This review identifies key tensions to navigate as well as four overarching categories of whole person health for consideration in developing an instrument optimized for clinical practice. The categories (body and mind, relationships, living environment and finances, and engagement in daily life) include nine constituent domains.
View Article and Find Full Text PDFSSM Popul Health
March 2025
School of Foreign Languages, Chongqing Technology and Business University, Chongqing, 400067, China.
The digital infrastructure has profoundly changed people's daily lives and health outcomes. However, the causal effect of digital infrastructure on cognitive health remains unclear. The study employs the "Broadband China" policy as a reliable proxy for digital infrastructure, using the China Health and Retirement Longitudinal Study (CHARLS) five waves panel data from 2011 to 2020 and a staggered difference-in-differences (DID) method to investigate the causal impact of digital infrastructure construction on the cognitive health in Chinese older adults.
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