Professional Interviews Research Articles

Developing a toolkit to support parents’ involvement in child death review: an experience-based co-design study

BackgroundUnderstanding why children die is important for grieving parents and for informing system improvements aimed at prevention and future care. Many countries have child death review (CDR) process, but little...

Implementation of a National Prenatal Exome Sequencing Service in England: Cost-Effectiveness Analysis.

Prenatal exome sequencing (pES) for diagnosing fetal structural anomalies commenced in the English National Health Service (NHS) in 2020. We evaluated cost-effectiveness to the healthcare system, and costs to families, of pES in addition to standard testing, compared to standard testing alone. A cost-effectiveness analysis combining costs, outcomes, parent and professional interview and professional survey data. The English NHS Genomic Medicine Service. 413 families with fetal anomalies with a suspected genetic cause referred for pES from 01 October 2021 to 30 June 2022. We costed the incremental resource required to deliver the pES clinical pathway. We calculated the diagnostic yield (proportion of cases with pathogenic variants). We divided the total incremental cost by the number of cases with a diagnosis to calculate cost-effectiveness. We estimated the annual NHS budget requirement based on case numbers. We determined parental costs from interviews. Incremental costs of pES to the NHS and families, incremental cost per additional diagnosis and NHS budget impact. Of 413 referred cases, 241 were tested, at a cost of £2331 (95% credibility interval £1894-£2856) per referred case or £3592 (£2959-£4250) per case that proceeded with testing. The incremental cost per diagnosis (yield 35.3%) was £11 326 (£8582-£15 361). Based on referrals data 01 October 2022 to 30 September 2023, pES costs the NHS £1.8 m annually. Family costs could not be separated from other pregnancy-related appointments but were not considered burdensome; most appointments were concurrent or remote. pES costs the English NHS £11 326 for each additional diagnosis. Incremental costs to families are negligible.

Eyewitness memory for person, object and action information is mediated by interview environment and the presence or absence of rapport

Purpose Obtaining accurate and reliable information from witnesses and victims of crime is essential for guiding criminal investigations and for the successful prosecution of offenders and beyond. Here, the purpose of this study is to investigate the impact of prosocial rapport behaviours and retrieval environment on mock eyewitness memory with an emphasis on the qualitative nature of information recalled in terms of persons, actions, objects and surroundings. Design/methodology/approach One hundred participants from the general population took part in mock witness research using a 2 (Environment: face-to-face; virtual) × 2 (Rapport: present; absent) design. Participants individually viewed an event depicting a fight in a bar and were then interviewed 48 h later according to condition. Findings Rapport and environment variously emerged as impactful, resulting in significant improvements in correct recall of persons, actions and object information when rapport was present and in virtual environments (VEs) when communicating via avatars. In many instances, the benefits of rapport and environment were additive, but not always. Surroundings information remained consistent across all conditions. Erroneous recall was extremely susceptible to inflation in face-to-face interviews when rapport was absent, in some instances increasing by over 100%. However, virtual interview spaces appeared to dilute the negative effects on retrieval when rapport was absent. Research limitations/implications This study concurs with others who have argued that comfortable witnesses are “better” witnesses; however, understanding what “comfort” looks and feels like remains a challenge. Practical implications The results, alongside the findings of others, have implications for applied and social cognition and reveal avenues for future research centred on widening access to justice and professional interview training. Originality/value This study reveals that prosocial rapport behaviours and VEs significantly enhance the accuracy of eyewitness recall. The findings suggest that virtual interviews can mitigate errors in the absence of rapport, offering valuable insights for criminal investigators and legal professionals. This research is crucial for improving witness interviewing techniques, thereby aiding in the accurate prosecution of offenders and broadening access to justice. The paper is valuable for criminal investigators, legal professionals, forensic psychologists and researchers focused on improving the reliability of eyewitness testimonies and interview methodologies.

Development and Preliminary Validation of a Screener for Digital Health Readiness

While telehealth use has grown, patient uptake is variable, which has the potential to increase health disparities. Identifying and understanding individuals' barriers to digital health readiness can help health systems efficiently deploy resources to provide personalized patient-centered support. To develop and validate an instrument to evaluate digital health readiness to identify and quantify barriers to digital readiness. In this qualitative mixed-methods study conducted from April 26, 2022, to June 8, 2023, the instrument was created in 4 phases. Patients and health care professionals were interviewed to explore barriers to telehealth use, scale items were developed for the screener, cognitive interviews were conducted to refine scale items, and psychometric properties of the screener were evaluated. The study was conducted in an urban, multisite academic health system and the surrounding community. Participants were older than 18 years, English-speaking, and able to provide informed consent. Professionals worked within the Jefferson Health system and were involved in telehealth services. Participants completed a semistructured interview (duration: 6-19 minutes), a cognitive interview (duration: 13-137 minutes), or the draft screener survey (duration: 5-10 minutes). Development and validation of a screener for digital health readiness. Of 519 patients approached, 19 were ineligible, 122 declined, and 11 were excluded from analysis, resulting in inclusion of 367 participants (32 patient interviews, 16 professional interviews, 15 cognitive interviews, 304 psychometric survey testing). All 16 professionals who were approached participated. Most patient participants were Black (46.7%) or White (37.9%), male (56.4%), and had a high school degree or some college (49.6%); mean (SD) age was 45 (23) years for participants in cognitive interviews, 53 (18) years for survey respondents, and 57 (14) years for patient interviews. The structured interviews uncovered 21 concepts, leading to 48 items that were refined through cognitive interviews. Psychometric analyses of the 29 items that emerged from the cognitive interviews resulted in a final screener with 24 items across 2 factors: technical readiness (18 items; factor loading range, 0.488-0.968) and quality-of-care concerns (6 items; factor loading range, 0.619-0.942). In this qualitative study of digital health readiness, the findings suggest that the screener items may be valid to assess the complexity of factors influencing digital health uptake and highlight several areas for potential intervention.

Healthcare Professionals' Perspectives on the Use of Standing Frames for Children Diagnosed With Cerebral Palsy: An Explanatory Mixed Methods Study.

Standing frames are commonly used by healthcare professionals in their practice with children with cerebral palsy (CP) who do not have an independent standing function. A better understanding of healthcare professionals' attitudes and experiences with standing frames may impact practice and rehabilitation. Therefore, this study aimed to investigate the standing frame practice among healthcare professionals and expand their attitude and experience with the use of standing frames for children with CP. This is an explanatory sequential mixed methods study. A cross-sectional survey was conducted, providing quantitative data on 210 healthcare professionals' use of standing frames. The quantitative data were descriptively analysed. Subsequently, the results from the survey were followed up with five focus group interviews of healthcare professionals (n = 14). The qualitative data were analysed using thematic analysis, enabling integration between the quantitative and qualitative data. When quantitative and qualitative data are integrated, expansion between the two datasets occurred. The quantitative dataset emphasised the use of GMFCS levels as a guideline for recommending standing frames, whereas the qualitative data showed that the healthcare professionals' recommendations were based on individual needs. Furthermore, the healthcare professionals expanded the quantitative data, showing that the healthcare professionals' considerations regarding age and dosage were based on clinical experience, and saw the standing frame as having many benefits. The healthcare professionals had a child-centred approach, where the child's need for using a standing frame was assessed based on the functional level, stage of development, cognitive level and clinical assessment. All of these considerations showed that the use of standing frames for children with CP was individualised, thereby making it difficult to make unified descriptions.

Development and early implementation of telemonitoring of complicated pregnancies – A qualitative study with the perspectives of health professionals

BackgroundTelemonitoring may offer promising opportunities in health care. In obstetric health care, there is a need to expand and improve digitalization. Nevertheless, there is limited knowledge based on healthcare professionals' perspectives regarding the use of telemedicine and remote cardiotocography during pregnancy, as well as its implementation. AimTo explore the perspectives of health-care professionals who manage telemonitoring of complicated pregnancies. Design and settingA qualitative interview study undertaken in a hospital with a tertiary obstetric unit in Northen Denmark. MethodsBased on a purposive sample strategy, 11 semi-structured interviews of health-care professionals involved in the management of telemonitoring in women with complicated pregnancies were conducted and analyzed using a reflexive thematic analytical approach. FindingsThe findings are assembled into two main themes. The experience of relevance to own practice: included the embedded potentials in telemonitoring providing women-centred care, but also challenges related to the implementation of a new technology. Experience of challenges and potential in day-to-day operation: included frustrations regarding the technological devices and software, working experiences increasing confidence in telemonitoring, and perspectives on the required interdependence across departments. ConclusionThis study adds important knowledge to support awareness and reflection on how challenges impact the successful implementation of telemonitoring in obstetric and midwifery care. This includes knowledge of important processes and resources to ensure ongoing implementation and evaluation. Implementation strategies and collaborations to support a multiple-level system change, such as an interdisciplinary team, seem crucial to minimize challenges, build shared visions, and engage staff.

Qualitative Research: An Interview with Margaret Roller

In this edition of “Interview the Expert,” we are joined by our Associate Editor Margaret Roller, a renowned expert in qualitative methodology and passionate supporter of mixed-methods research. Margaret is the lead author of the book she co-wrote with Paul Lavrakas “Applied Qualitative Research Design: A Total Quality Framework Approach,” which received the AAPOR Book Award in 2021. Margaret is a professional moderator and interviewer with a 40-plus-year career in qualitative research. She shares her expertise and knowledge on the many aspects of quality research design in her blog “Research Design Review” and delivers training in qualitative methods.

Barriers to accessing care among rural women veterans: A qualitative study with veterans, peer specialists, and primary care professionals.

Rural women veterans are less likely than men and nonrural veterans to access Veterans Health Administration (VHA) care. This qualitative study describes rural women veterans' barriers to accessing care and explores whether participants viewed a peer specialist intervention as having the potential to facilitate access to care. We recruited rural veterans who identified as women with psychological distress and social needs, women peer specialists, and VHA primary care professionals working with rural veterans. We conducted two veteran focus groups, two peer specialist focus groups, and 11 individual Patient Aligned Care Team professional interviews using semistructured interview questions. One of the veteran focus groups was exclusive to veterans of color. We used a rapid qualitative data analysis approach to analyze the results. Data analysis revealed barriers affecting perceived access to services for rural women veterans, especially veterans of color, including transportation, finances, childcare, long travel distance to clinics, lack of access to gender-specific services, ineligibility for services, and lacking information about available resources. Participants also reported challenges accessing community services outside of the VHA. The rural women veterans reported a strong preference for gender-specific services. Leveraging existing VHA resources with rural women veterans may mitigate some of the identified barriers. In particular, participants agreed that increasing availability of peer specialists who are both women and veterans could bridge some perceived barriers to accessing care among rural women veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adapting scientific modeling practice for promoting elementary students’ productive disciplinary engagement

ABSTRACT This study explores the adaptations made by elementary school teachers to promote student Productive Disciplinary Engagement (PDE) during modeling activities within an online learning context. PDE means students make collective intellectual progress by using disciplinary practices and ideas to formulate possible solutions or answers. Given the abrupt transition to remote education instigated by the COVID-19 pandemic, student engagement and hands-on learning opportunities have faced significant challenges. This study adopts a collective case study design with an interpretivist perspective, investigating three fourth-grade teachers over the 2020–2021 school year. We collected multiple data sources, including professional learnings, observations, teacher interviews, and student artifacts. The study identified four significant themes pertaining to teacher adaptations that corresponded with increased students’ PDE: leverage technology tools for constructing models; maximise student-centered choice and position students as epistemic agents in modeling; incorporate family and community resources for modeling; and utilise students’ diverse knowledge and expertise in modeling. These findings contribute to our understanding of effective strategies for promoting student engagement and the practical application of scientific modeling in online learning environments.

Similarities and differences of lung cancer (LC) multidisciplinary teams (MDTs) in China compared to Europe and Canada.

e13562 Background: LC MDTs involve a collaborative approach where specialists work together to analyze individual cases, discuss treatment options, and tailor comprehensive care plans for patients. Implementing MDTs can be challenging, especially for developing countries with limited resources and high disease burden. China, with approximately 820,000 new patients with lung cancer in 2020 accounting for 37% of the total number in the world, bears the responsibility of treating the largest lung cancer patient population worldwide. The global MDT Aid Program (MAP) in LC has been including China to gather insights on the challenges, best practices, similarities, and differences of China LC MDT processes compared to other countries, so as to improve the outcome and cost-efficiency of global MDTs. Methods: In this study, we learned about the status, best practices, challenges of LC MDT development in China through virtual semi-structured healthcare professional (HCP) interviews, on-site masterclasses, and internal data sharing with 3 Chinese leading hospitals in LC - Guangdong Provincial People’s Hospital, West China Hospital and Xiangya Hospital. Similarities and differences were gathered based on previous MAP experience and insights from HCP discussions in LC across the Netherlands, Italy, Spain, Switzerland, Denmark, Norway, and Canada. To build a global collaboration on LC MDTs, three international knowledge exchange (IKE) sessions were organised to include China and all participating countries. Results: We identified seven main differences between China, Europe and Canada, including the enrolment criteria of patients in MDT that China MDTs focus on challenging cases such as resistance to multi-lines of therapy, multiple primary lung cancer and stage III lung cancer, while Europe and Canada MDTs mainly for routine patients. Other differences include setup and composition of MDT teams, digitalization of MDTs, incentives and reimbursement for MDT attendance, cross-institutional patient referral to the MDT, time spent per patient, patient follow-up after MDT discussion. Similarities identified include the MDT development model from both hospital and national level, experience sharing to educate junior physicians, hospital willingness to learn at global level, and challenges of high pressure with limited medical resources. Best practices of leveraging innovative digital capabilities to improve MDT efficiency and to support decision-making have been shared by China participants during the IKEs. Conclusions: Global collaboration to identify synergies within LC MDT communities can help China and other regions learn from each other and share China expertise in large-volume data-based practices globally. Alongside China’s rapid development of digital health, the digitalization of MDTs is likely to follow.

Взаємозв’язок емоційного інтелекту та характеристик лідерського потенціалу менеджерів

The authors consider the interpretation of the essence of “leadership” and “emotional intelligence”. The purpose of the study is to form a set of knowledge and skills for the disclosure of emotional intelligence and the formation of socio-economic qualities of a leader. Among the tasks are the study of theories on determining the level of leadership potential, determining the level of leadership in managers of enterprise “A”, assessing the management of the enterprise on the basis of a questionnaire and determining the level of leadership potential of managers. The following methods of leadership research are used: analysis of indicators, comparison of characteristics, scoring, and surveys. The leadership positions of managers in the teams of a particular organizational structure of an enterprise are studied. This can be done in different ways: through a professional and personal survey, a motivational survey, a dynamic aptitude test, a survey of colleagues, assessment centers, assessment of goals, results and leadership skills. The leadership potential of three people at the enterprise was determined on a 100-point scale. A questionnaire was created and administered to survey the company’s employees. The entire methodology of the leadership potential study was conducted on the basis of a specific enterprise, and the owner was offered unique methods for determining the characteristics of emotional intelligence and developing the leadership potential of employees. In this study, the method of determining leadership potential through a 360 survey was chosen because it provides a comprehensive assessment of employees, taking into account the opinion of the manager and the employees themselves. After analyzing the emotional intelligence (EI or EQ) and character of the managers of Company A, we can conclude that there are many ways to assess the potential of managers. The most optimal and objective is the 360-degree method used in employee surveys. Based on our definition of the leadership potential of employees, various methods can be used to select a candidate for the position of leader from among the managers of an on-call company, such as professional and personal interviews, motivational interviews, dynamic aptitude tests, comparative interviews, assessment centers, evaluation of goals and performance, and assessment of leadership competencies. The list of competencies that a team leader should possess includes: sales professionalism; leadership skills; communication skills; planning and organizational skills; analytical skills; strategic thinking; ability to learn and develop oneself and the team; emotional intelligence. Signs of a developed EQ: the ability to identify and describe people’s feelings; awareness of one’s own strengths and weaknesses; ability to forgive mistakes to oneself and others; ability to accept change; keen interest in other people; attention to the feelings of others; empathy as a care for employees; acceptance of responsibility for the result of one’s behavior; ability to manage emotions in difficult situations. The performance appraisal of company “A” employees and the survey to determine the potential of the company’s managers show that Company is working effectively. There is always a goal to strive for. An analysis of the effectiveness of the social performance indicators of enterprise A and the creation of a questionnaire to determine the level of leadership potential of the company’s employees are carried out. When developing the questions for the 360-degree questionnaire, we use the list of competencies, character elements, and commitments described in the study. Therefore, according to the results of the 360 surveys, the sales department will select the leader who best meets the requirements for the necessary competencies, character traits, and commitment. As a result, the sales department, as well as the entire enterprise, will function even more efficiently and further improve financial reporting performance. Specific measures that can be implemented to increase the level of leadership potential of the enterprise: leadership trainings and seminars, role-playing and case studies, involvement of potential leaders in projects where they can demonstrate their leadership skills, regular assessment of leadership potential and adjustment of development plans.

Rights-based social work as a practice. The role of child welfare social work in the repatriations of Finnish children from the camps in north-eastern Syria

ABSTRACT In this article, we present an interdisciplinary analysis that combines perspectives of law and social work on the role of child welfare social work in Finnish repatriations of children from camps in north-eastern Syria after the territorial losses of the terrorist organisation ISIS in 2019. We used qualitative data that consists of interviews of professionals, which we analysed using thematic analysis. The findings show how a rights-based approach to the issue of repatriation helped to decrease tension in a highly politicised situation, making children’s rights the starting point of the decision making process followed by a professionally led bureaucratic process in which several children were repatriated from the camps in Syria. Social workers’ decisions in individual cases both affected the legal obligations of the state to repatriate and the repatriation processes. The actions taken by the social workers emerge as practices of rights-based social work. Importantly, the role of social workers has been essential in how rights of the children were negotiated and understood in an evolving process between authorities.

Barriers to diverse clinical trial participation in Duchenne muscular dystrophy: Engaging Hispanic/Latina caregivers and health professionals

BackgroundDespite the increasing availability of clinical trials in Duchenne muscular dystrophy, racial/ethnic minorities and other populations facing health disparities remain underrepresented in clinical trials evaluating products for Duchenne. We sought to understand the barriers faced by Hispanic/Latino families specifically and underrepresented groups more generally to clinical trial participation in Duchenne.MethodsWe engaged two participant groups: Hispanic/Latino caregivers of children with Duchenne in the US, including Puerto Rico, and health professionals within the broader US Duchenne community. Caregiver interviews explored attitudes towards and experiences with clinical trials, while professional interviews explored barriers to clinical trial participation among socio-demographically underrepresented families (e.g., low income, rural, racial/ethnic minority, etc.). Interviews were analyzed aggregately and using a thematic analysis approach. An advisory group was engaged throughout the course of the study to inform design, conduct, and interpretation of findings generated from interviews.ResultsThirty interviews were conducted, including with 12 Hispanic/Latina caregivers and 18 professionals. We identified barriers to clinical trial participation at various stages of the enrollment process. In the initial identification of patients, barriers included lack of awareness about trials and clinical trial locations at clinics that were less likely to serve diverse patients. In the prescreening process, barriers included ineligibility, anticipated non-compliance in clinical trial protocols, and language discrimination. In screening, barriers included concerns about characteristics of the trial, as well as mistrust/lack of trust. In consent and recruitment, barriers included lack of timely decision support, logistical factors (distance, time, money), and lack of translated study materials.ConclusionsNumerous barriers hinder participation in Duchenne clinical trials for Hispanic/Latino families and other populations experiencing health disparities. Addressing these barriers necessitates interventions across multiple stages of the clinical trial enrollment process. Recommendations to enhance participation opportunities include developing clinical trial decision support tools, translating prominent clinical trials educational resources such as ClinicalTrials.gov, fostering trusting family-provider relationships, engaging families in clinical trial design, and establishing ethical guidelines for pre-screening potentially non-compliant patients.

Haptic and deep sensing in ballet class

ABSTRACT Different cultural traditions about the sensory domain of tactility can lead groups of people to categorize the senses differently. This research explores how professional dancers in their social relations learn sensorially through touch at three London institutions and offers new perspectives on how touch compose part of the dancers’ shifting sensoria and the epistemology of the culture of their ballet class. Drawing on de Sousa Santos (2018) development of the concept of corazonar and Borda’s (2015, 10) notion of “sentipensar” (feeling-thinking) I discuss how dancers feel touch, how other sensorial modalities intersect with touch and how the variants of touch/being touched influence learning. In my study the dancer’s ways of knowing are inscribed in social relations by combining the feeling/thinking, reason, and love in emotions/affects indicating a deeper understanding of the confluence of various senses. The methodology involved four years of ethnographic observations, my active participation in professional ballet classes and interviews with dancers.

Cancer in prison: barriers and enablers to diagnosis and treatment

Approximately 82,000 people are in prison annually in England and Wales. Limited research has investigated cancer in this population and none has explored experiences of imprisoned people with cancer. This study aimed to address this gap. We conducted 55 semi-structured, qualitative, audio-recorded interviews with: imprisoned people with cancer (n=24), custodial staff (n=6), prison healthcare staff (n=16) and oncology specialists (n=9). Data were collected 07/10/2019-20/03/2020. Patients were recruited by prison healthcare staff and interviews were conducted face-to-face. Professionals were recruited via professional networks and interviews were conducted face-to-face or via telephone. Transcribed interviews were analysed using reflexive thematic analysis. We also analysed relevant National Cancer Patient Experience Survey (NCPES) questions for those diagnosed in prison (n=78) and in the general population (n=390). Our findings highlight the complexities of cancer care for imprisoned people. We identified three core themes: control and choice, communication, and care and custody. Whilst people in prison follow a similar diagnostic pathway to those in the community, additional barriers to diagnosis exist including health literacy, the General Practitioner appointment booking system and communication between prison and oncology staff. Tensions between control and choice in prison impacted aspects of cancer care experience such as symptom management and accessing cancer information. NCPES results supported the qualitative findings and showed people in prison reported significantly poorer experiences than in the general population. Our findings demonstrate the complexity of cancer care in custodial settings, identifying barriers and enablers to equitable cancer care provision and offering insights on how to improve care for this population. National Institute for Health and Social Care Research Delivery Research Programme 16/52/53 and Strategic Priorities Fund 2019/20 Research England via University of Surrey.

Digital Social Connectedness as a Lifeline for Older People: Use and Non-use of VinclesBCN During the Pandemic

AbstractThis article presents the results of a study that evaluated VinclesBCN during COVID-19. This digital-based public social service aims to prevent loneliness and isolation in +65-year-old adults living in Barcelona. Through service user (N = 12) and professional (N = 6) interviews and a questionnaire with service users (N = 255), we demonstrate the pivotal role of digital connectedness in transforming VinclesBCN into a lifeline during the pandemic. The analysis revealed the importance of sociability, social support, and, especially, entertainment in coping with pandemic fatigue and facilitating social connectivity and support among users. Users engaged in activities such as sharing images, songs, memes, and daily greetings to provide proximity, sociability, and care among users, whether they belonged to preexisting groups or were newly introduced to the platform. It also facilitated the identification of individuals who needed companionship, comfort, or more specialized support. The findings emphasize the significance of entertainment as a resilience-building strategy during times of uncertainty. Despite the positive impact, not all users equally used the platform. Non-use was strongly associated with being a woman, having a low educational level, having preexisting social relationships, less time of enrolment in the platform, as well as a high perception of loneliness, poor self-reported health, and low mood. The article underscores the need for further research into older adults’ digital engagement during crises, its role in building resilience, and advocating for inclusive digital interventions that take into account diverse older adults’ needs and experiences in crisis contexts.

Insights from Health and Social Care Professionals Supporting Children and Young Adults with a Parent Diagnosed with Dementia: An Interview Study

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals’ experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals’ experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way.

Mental capacity assessment in the multi-professional real world: a qualitative study of six areas of uncertainty.

The Mental Capacity Act 2005 of England and Wales is a ground-breaking piece of legislation with reach into healthcare, social care and legal settings. Professionals have needed to develop skills to assess mental capacity and handle malign influence, but it is unclear how assessments are implemented in real world settings. Our previously reported survey found professionals juggling competing resources in complex systems, often struggling to stay up to date with law.The current follow-up study uses one-to-one interviews of professionals to characterise in detail six areas of uncertainty faced when assessing mental capacity, whilst suggesting ways to make improvements. Forty-four healthcare, social care and legal professionals were interviewed, using a semi-structured topic guide. Transcripts were analysed using framework analysis: a qualitative technique built to investigate healthcare policy. Our topic guide generated 21 themes. In relation to the six areas of uncertainty: 1) Many participants stressed the importance of capturing a holistic view, adding that their own profession was best-placed for this - although a medical diagnosis was often needed. 2) The presumption of capacity was a laudable aim, though not always easy to operationalise and occasionally being open to abuse. 3) There was cautious interest in psychometric testing, providing a cognitive context for decisions. 4) Undue influence was infrequent, but remained under-emphasised in training. 5) Multi-professional assessments were common, despite doubts about fitting these within local resources and the law. 6) Remote assessment was generally acceptable, if inadequate for identifying coercion. Practical constraints and competing demands were reported by professionals working within real world systems. Assessment processes must be versatile, equally applicable in routine and emergency settings, across diverse decisional types, for both generalist and specialist assessors, and able to handle coercion. Recognising these challenges will guide development of best practices in assessment and associated policy.

Future Fertility Among Pediatric Cancer Patients: Experiences and Perspectives of Health Workers in a Low-Resource Setting.

Purpose:Although fertility preservation for patients with childhood and adolescent cancer is considered standard of care in the high-resource settings, it is rarely offered in low-resource settings. This study explores the experiences and perspectives of oncology health care professionals in Uganda to identify contextual barriers and facilitators to addressing oncofertility in low-resource settings. Methods: Using ground theory, we conducted in-depth face-to-face interviews of health care professionals managing pediatric patients at the Uganda Cancer Institute (UCI). Using a systematic, semi-structured interview guide, participants were asked open-ended questions about their understanding of fertility preservation and their perspectives on implementing this care at their institution. Although all the eligible health care providers were interviewed, interview transcripts were uploaded into NVivo version 12 and openly coded as per theoretical requirements. Codes were refined into categories and later into structured themes. Results: Twelve health care professionals were interviewed. Most participants identified as female (n = 9). Their role in the medical team varied from nurses (n = 6), medical officers (n = 3), pediatric oncologists (n = 2), and pediatric oncology fellow (n = 1). Six themes were noted as follows: (1) importance of information, (2) importance of future fertility, (3) inadequate consideration to future fertility, (4) communication barriers, (5) inadequate knowledge, and (6) resource barriers. Conclusion: Although health care providers at the UCI face contextual barriers to addressing future fertility among patients with pediatric cancer, they value preserving fertility in this population. Future initiatives that aim to introduce oncofertility care in low-resource settings should prioritize educating providers and building capacity to meet the oncofertility needs in this setting.

How does bias enter the employment interview? Identifying the riskiest applicant characteristics, interviewer characteristics, and sources of potentially biasing information

AbstractThe current study examines the riskiest forms and sources of potential bias in the employment interview. A mixed methods survey focused on interviewers' attention to various potentially biasing applicant characteristics, how interviewers learn about such characteristics, the traits of interviewers who are sensitive to such characteristics, and how knowledge of such characteristics affects interviewers' opinions of applicants. Participants were 680 professional interviewers from the U.S., U.K., and Canada. High risks of bias were associated with six applicant characteristics (as targets of bias), three interviewer characteristics (as predisposing toward bias), and three sources of information in the interview process. Interviewers commonly rationalized their judgments in job‐relevant terms. These results have implications for understanding and limiting the risk of common selection biases.