Assessing the ability of people with a learning disability to give informed consent to treatment

1999 ◽  
Vol 29 (6) ◽  
pp. 1367-1375 ◽  
Author(s):  
K. ARSCOTT ◽  
D. DAGNAN ◽  
B. STENFERT KROESE
Keyword(s):  
Learning Disability ◽  
Surgical Intervention ◽  
Verbal Ability ◽  
Active Role ◽  
Decision Making Process ◽  
Memory Ability ◽  
Risks And Benefits ◽  
Ability To Consent ◽  
Consent To Treatment ◽  
The Impact

Background. People with a learning disability are increasingly being encouraged to take a more active role in decisions about their psychological and medical treatment, raising complex questions concerning their ability to consent. This study investigates the capacity of people with a learning disability to consent in the context of three treatment vignettes, and the influence of verbal and memory ability on this capacity.Methods. Measures of verbal ability, memory ability and ability to consent to treatment (ACQ) were administered to 40 people with a learning disability. The ACQ consisted of three vignettes depicting a restraint, psychiatric or surgical intervention. These were followed by questions addressing people's ability to understand the presenting problem; the nature of the proposed intervention; the alternatives, risks and benefits; their involvement in the decision-making process; and their ability to express a clear decision with a rationale for treatment.Results. Five people (12·5%) could be construed as able to consent to all three vignettes; 26 (65%) could be construed as able to consent to at least one. The questions that were most difficult to answer concerned a participants' rights, options and the impact of their choices. Verbal and memory ability both influenced ability to consent.Conclusions. This study introduces a measure that may enable clinicians to make more systematic assessments of people's capacity to consent. A number of issues surrounding the complex area of consent to treatment are also raised.

The impact of laser Doppler imaging on the early decision-making process for surgical intervention in adults with indeterminate burns

Burns ◽  
2013 ◽  
Vol 39 (4) ◽  
pp. 655-661 ◽  
Author(s):  
Yoo Seok Park ◽  
Young Hwan Choi ◽  
Hye Sun Lee ◽  
Duk Ju Moon ◽  
Seon Gyu Kim ◽  
...  
Keyword(s):  
Decision Making ◽  
Surgical Intervention ◽  
Laser Doppler ◽  
Doppler Imaging ◽  
Decision Making Process ◽  
Laser Doppler Imaging ◽  
Early Decision ◽  
The Impact

The Impact of BRICS in Reconstructing the International Order

2020 ◽  
pp. 87
Author(s):  
Tareq Mohammed Dhannoon AL Taie
Keyword(s):  
International System ◽  
Political Influence ◽  
Active Role ◽  
International Order ◽  
First Century ◽  
International Affairs ◽  
Strategic Action ◽  
Brics Countries ◽  
Future Work ◽  
The Impact

The BRICS countries have a historical aspiration for global leadership, especially Russia and China, and other countries trying to have a position in the pyramid of international powers in the twenty-first century, especially Brazil, India and South Africa, they worked to unify their efforts, in order to achieve integration in the strategic action, activate its role in International affairs, ending American domination , and restructuring an international system that have an active role in its interactions.       The research hypothesis is based on the idea that the BRICS group, despite the nature of its economic composition and its long-term goals, but its political influence as a bloc, is greater than the proportion of its economic influence in restructuring the new international order. The BRICS group has the capabilities to reshape the international order, but disputes among some of its members represent a challenge to its future work. Its goals will not be achieved without teamwork. Third world countries, especially those that reject unipolarism, have regarded one of the pillars supporting multi-polarity, aiming of giving them freedom of movement in international relations. The ultimate goal of the BRICS is a political nature, as economic mechanisms are used to achieve political goals.

scholarly journals The Impact of Social Media Use on Consumers’ Restaurant Consumption Experiences: A Qualitative Study

2021 ◽  
Vol 13 (12) ◽  
pp. 6581
Author(s):  
Jooyoung Hwang ◽  
Anita Eves ◽  
Jason L. Stienmetz
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Selection Process ◽  
Decision Making Process ◽  
Structured Interviews ◽  
High Standards ◽  
Tourism And Hospitality Industry ◽  
Tourism And Hospitality ◽  
Search For Information ◽  
The Impact

Travellers have high standards and regard restaurants as important travel attributes. In the tourism and hospitality industry, the use of developed tools (e.g., smartphones and location-based tablets) has been popularised as a way for travellers to easily search for information and to book venues. Qualitative research using semi-structured interviews based on the face-to-face approach was adopted for this study to examine how consumers’ restaurant selection processes are performed with the utilisation of social media on smartphones. Then, thematic analysis was adopted. The findings of this research show that the adoption of social media on smartphones is positively related with consumers’ gratification. More specifically, when consumers regard that process, content and social gratification are satisfied, their intention to adopt social media is fulfilled. It is suggested by this study that consumers’ restaurant decision-making process needs to be understood, as each stage of the decision-making process is not independent; all the stages of the restaurant selection process are organically connected and influence one another.

scholarly journals Environmental Sensitivity and Awareness as Differentiating Factors in the Purchase Decision-Making Process in the Smartphone Industry—Case of Polish Consumers

2021 ◽  
Vol 13 (1) ◽  
pp. 348
Author(s):  
Lukasz Skowron ◽  
Monika Sak-Skowron
Keyword(s):  
Expectation Maximization ◽  
Cross Validation ◽  
Expectation Maximization Algorithm ◽  
Decision Making Process ◽  
Environmental Sensitivity ◽  
Significance Level ◽  
On Line ◽  
Purchase Process ◽  
The Impact ◽  
Fold Cross Validation

The first of the research objectives discussed in this article was to analyze the differences related to the valuation of particular factors influencing the purchase process in the smartphone industry, expressed by respondents with different sensitivity and environmental awareness, as well as the assessment of their knowledge about the impact of smartphones on the natural environment. The second objective of the research was to determine whether the level of environmental sensitivity, awareness and knowledge about the impact of smartphones on the environment has a statistically significant influence on the respondents’ choice of smartphone brand. The survey was conducted using an on-line questionnaire, distributed by a specialized research agency on a representative sample of over 1000 Polish residents. In order to identify the various customers clusters, the expectation-maximization algorithm and the v-fold cross-validation were used. Additionally, in order to analyze the significance level of differences between clusters the nonparametric Mann-Whitney U-test was carried out. The results show unequivocally that people with a different approach to ecological issues demonstrate statistically significant differences in their purchasing behaviors in the smartphone industry. Furthermore, it was noticed that in the case of comparing some smartphones brands, there is a statistically confirmed difference in the environmental sensitivity and awareness of the customers who use them. Moreover, the research has shown that in Polish customers’ consciousness smartphones are mistakenly considered to be relatively safe and environmentally friendly products.

scholarly journals Modulation of Differentiation of Embryonic Stem Cells by Polypyrrole: The Impact on Neurogenesis

2021 ◽  
Vol 22 (2) ◽  
pp. 501
Author(s):  
Kateřina Skopalová ◽  
Katarzyna Anna Radaszkiewicz ◽  
Věra Kašpárková ◽  
Jaroslav Stejskal ◽  
Patrycja Bober ◽  
...  
Keyword(s):  
Stem Cells ◽  
Embryonic Stem Cells ◽  
Embryonic Stem ◽  
Stem Cell Differentiation ◽  
Active Role ◽  
Low Molecular Weight ◽  
Conducting Materials ◽  
The Impact ◽  
Erk Kinase

The active role of biomaterials in the regeneration of tissues and their ability to modulate the behavior of stem cells in terms of their differentiation is highly advantageous. Here, polypyrrole, as a representantive of electro-conducting materials, is found to modulate the behavior of embryonic stem cells. Concretely, the aqueous extracts of polypyrrole induce neurogenesis within embryonic bodies formed from embryonic stem cells. This finding ledto an effort to determine the physiological cascade which is responsible for this effect. The polypyrrole modulates signaling pathways of Akt and ERK kinase through their phosphorylation. These effects are related to the presence of low-molecular-weight compounds present in aqueous polypyrrole extracts, determined by mass spectroscopy. The results show that consequences related to the modulation of stem cell differentiation must also be taken into account when polypyrrole is considered as a biomaterial.

scholarly journals Custody and Care of Children in Spain: Can the Two Rights be Reconciled?

2021 ◽  
Author(s):  
Marcela Jabbaz Churba
Keyword(s):  
Gender Gap ◽  
Gender Stereotypes ◽  
Parental Authority ◽  
Decision Making Process ◽  
Gender Based Violence ◽  
Judicial Process ◽  
Gender Based ◽  
And Gender ◽  
Children’S Voices ◽  
The Impact

AbstractThis study aims to analyse the legal decision-making process in the Community of Valencia (Spain) regarding contentious divorces particularly with respect to parental authority (patria potestas), custody and visiting arrangements for children, and the opinions of mothers and fathers on the impact these judicial measures have had on their lives. It also considers the biases in these decisions produced by privileging the rights of the adults over those of the children. Three particular moments are studied: (1) the situation before the break-up, focusing on the invisible gender gap in care; (2) the judicial process, where we observe the impact of hidden gender-based violence and gender stereotypes; and (3) the situation post-decision, showing how any existing violence continues after divorce, by means of parental authority. The concept of ‘motherhood under threat’ is placed at the centre of these issues, where children’s voices are given the least attention.

Superior verbal ability and nonverbal learning disability in a child with a novel 17p12p13.1 deletion

2005 ◽  
Vol 134B (1) ◽  
pp. 104-109 ◽  
Author(s):  
D.L. Steele ◽  
A.K. Chisholm ◽  
J.D.R. McGhie ◽  
R.J.M. Gardner ◽  
I.E. Scheffer ◽  
...  
Keyword(s):  
Learning Disability ◽  
Verbal Ability ◽  
Nonverbal Learning Disability ◽  
Nonverbal Learning

scholarly journals Change in Functional Impairment, Disability, and Quality of Life Following Operative Treatment for Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 53S-69S ◽  
Author(s):  
Michael G. Fehlings ◽  
Lindsay A. Tetreault ◽  
Shekar Kurpad ◽  
Darrel S. Brodke ◽  
Jefferson R. Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Functional Impairment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Duration Of Symptoms ◽  
Degenerative Cervical Myelopathy ◽  
The Impact

Study Design: Systematic review. Objectives: The primary objective of this systematic review was to define the change in impairment, disability, and pain following surgical intervention in patients with degenerative cervical myelopathy (DCM). Secondary objectives included to assess the impact of preoperative disease severity and duration of symptoms on outcomes and to summarize complications associated with surgery. Methods: A systematic literature search was conducted to identify prospective studies evaluating the effectiveness and safety of operative treatment in patients with DCM. Outcomes of interest were functional status, disability, pain, and complications. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and the strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Results: Of the 385 retrieved citations, 32 met inclusion criteria and are summarized in this review. Based on our results, pooled standard mean differences showed a large effect for improvement in Japanese Orthopaedic Association or modified Japanese Orthopaedic Association score from baseline at short-, medium-, and long-term follow-up: 6 to 12 months (1.92; 95% confidence interval [CI] = 1.41 to 2.43), 13 to 36 months (1.40; 95% CI = 1.12 to 1.67), and ≥36 months (1.92; 95% CI = 1.14 to 2.69) (moderate evidence). Surgery also resulted in significant improvements in Nurick, Neck Disability Index, and Visual Analogue Scale scores (low to very low evidence). The cumulative incidence of complications was low (14.1%; 95% CI = 10.1% to 18.2%). Conclusion: Surgical intervention for DCM results in significant improvements in functional impairment, disability, and pain and is associated with an acceptably low rate of complications.

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