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BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

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Inspired by, and in close relation with, the contributions of this special issue, Kuperberg elegantly links event comprehension, production, and learning. She proposes an overarching hierarchical generative framework of processing events enabling us to make sense of the world around us and to interact with it in a competent manner.

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El desarrollo creciente de la novela negra neo-detectivesca en Chile es una prueba más de que atravesamos por un cambio artístico fundamental. Tecnológica y estéticamente impecables, las variantes de esta novela suelen ser producidas por escritores rigurosamente profesionales. Sin embargo y a pesar de los factores mencionados, ésta no está exenta de popularidad y éxito de ventas. Elalemán de Atacama de Roberto Ampuero es la segunda de la saga de su detective ficcional Cayetano Brulet. Como otras de sus novelas, ésta (...) conlleva una reflexión sobre el entreguismo de la nación-estado, los efectos devastadores de la economía global, la precariedad de los grupos étnicos y la destrucción ecológica. (shrink)

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Autistic children with sensory processing differences successfully navigate and engage in meaningful family daily occupations within home and community environments through the support of their family. To date however, much of the research on autistic children with sensory processing differences, has primarily been deficit focused, while much of the caregiver research has focused on issues of distress, burden, effort, and emotional trauma in coping with their child's diagnosis. This study aimed to conduct a qualitative evidence synthesis, using a meta-ethnographic approach (...) to explore the gap identified in understanding successful occupational experiences of family participation and daily family routines when supporting an autistic child with sensory processing differences and to offer an alternative strengths-based perspective. Inclusion criteria were studies which were peer-reviewed qualitative design, published from 2000 to 2021, and that concerned parents/caregivers' perspectives of family occupations of children diagnosed with autism spectrum disorder. Studies were electronically searched in eight databases from October to December 2021 and 23 studies were identified which met the inclusion criteria. Noblit and Hare's seven step approach for conducting analysis in meta-ethnography was used, and three themes identified: sensory processing differences in daily life, what is hard about hard, and orchestrating family life. Results identified the centrality of sensory experiences in understanding family life. Living with unpredictability while orchestrating certainty through routines was core to successful participation. This review provides insights into how parents negotiate the complexities of constructing family life when living with an autistic child. The results can inform the design of future interventions that specifically address the relationship between meaningful participation in family occupations and daily routines and sensory processing in autistic children.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298938, identifier: CRD42022298938. (shrink)

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The primary question my dissertation aims to answer is: how might eudaimonic virtue ethics be reimagined to respond to contemporary criticisms from disability scholars, feminists, and empirical psychology? To answer this, I introduce the Eudaimonic View of Virtue, or EV, and propose a Mengzian adaptation of the EV (EV-M) in response to these criticisms. The EV captures the four core claims to which eudaimonic virtue ethical theories are committed: (i) virtues, in the sense of excellent character traits or dispositions, are (...) the foundation of ethics or ethical action (i.e., aretaicism); (ii) virtue is at least partially constitutive of human well-being/flourishing (i.e., eudaimonism); (iii) virtue or virtuous activity consists in the good performance of human function or fulfilling human nature (i.e., naturalism); and (iv) practical wisdom, in the sense of understanding how to live well, is required for achieving full virtue. For the EV, reason and emotions are both pivotal parts of virtue. However, there is disagreement among contemporary and historic eudaimonic virtue ethicists about what specific roles reason and emotion play—whether for Aristotle (the founder of the Western eudaimonic virtue ethics tradition) or in virtue ethical theory more broadly. The EV can be divided into (broadly) rational and emotional versions. I critically evaluate contemporary EV-based accounts in light of critiques from disability scholars, feminists, and psychologists, revealing rational versions’ vulnerability to the first two avenues of critique and emotional versions’ susceptibility to the third. In contrast to Aristotelian virtue ethics, which defines human nature through rational activity, Mengzi defines human nature through its potential for moral goodness; moreover, his moral psychology does not contain a rigid rational-emotional divide. This helps the Mengzian version of the EV evade criticisms from feminist and disability perspectives. Additionally, the EV-M’s emphasis on the interdependence of society and individuals—through its focus on rituals and social roles—provides an avenue of response to the psychology critique. The EV-M thus serves as a resilient foundation for an improved EV. (shrink)

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Este artigo tem como objetivo apresentar, como Introdução, a definição de Lógica como o estudo das formas válidas de raciocínio. Raciocinar é inferir conclusões de proposições tidas ou dadas por verdadeiros, denominadas premissas. Como estudo das formas válidas não é escopo da Lógica determinar se as premissas são verdadeiras ou falsa. Apenas considera as premissas como tidas por verdadeiras. A seguir trata-se da filosofia da ciência que estuda, entre outras questões, em que consiste a natureza da ciência, quais são suas (...) características, o que a diferencia do senso comum. Entre seus objetivos está em determinar em que consiste a explicação científica em especial o modelo da explicação dedutivo nomológico, sobretudo. Em terceiro lugar, trata-se deste modelo específico, que o tema central destas reflexões, sua estrutura um conjunto de proposições que constituem o Explanans no qual figuram 1. As condições iniciais em que se produz o fenômeno a ser explicado (denominado de Explanandum) e 2. As leis universais que estimadas como explicações do fenômeno a ser explicado. Do Explanans por meio de regras lógicas deduz-se o Explanandum. Este modelo é também denominado modelo de Hempel-Openheim considerado clássico e vigente até a década de 1960. A dedução lógica acarreta necessidade da ocorrência do Explanandum. A quarta secção do capítulo examina em que consiste esta necessidade, sobretudo quando é notório que em ciência tudo é revisível e sujeito ao princípio de incerteza de Heisenberg. Segue finalmente a conclusão. (shrink)

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Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments. DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system. Trial RegistrationISRCTN89993391. (shrink)

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In this paper, we offer a conceptualization of leadership as contemplative. Drawing on MacIntyre’s perspective on virtue ethics and Levinas’ and Gilligan’s work on the ethics of responsibility and care, we propose contemplative leadership as virtuous activity; reflexive, engaged, relational, and embodied practice that requires knowledge from within context and practical wisdom. More than simply offering another way to conceptualize the ethics of leadership, this research contributes to understanding the ethics of leadership in practice. Empirically, we analyze the narratives of (...) those in positions of formal authority and other organizational members in churches. We illustrate contemplative leadership as driven by a good purpose, derived from the unique organizational and broader societal context in which leadership occurs, and grounded in an ethical concern for the other. Contemplative leadership accounts for the complexity of experience and is discerned in mundane and everyday practices. We conclude with the implications for leadership theory, practice, and education. (shrink)

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This volume defends a particular set of progressive political interventions on the basis of their being legitimate exercises of coercive political power, specifically focusing on the gendered division of labour, which is widely regarded as the predominant form of gender injustice.

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Embodying Asian/American Sexualities is an accessible reader designed for use in undergraduate and graduate American studies, ethnic studies, gender and sexuality studies, and performance studies classes as well as for a general public interested in related issues. It contains both overviews of the field and scholarly interventions into a range of topics, including history, literature, performance, and sociology.

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As the grandchild of Italian immigrants, photographerGina J. Grillo has a personal impetus in her photographic studies of ethnic and immigrant life in the United States. In Between Cultures, Grillo explores the struggles immigrant children face as they develop their cultural identity in an environment completely new and foreign to them. Following the tradition of the pioneering photographers Jacob Riis and Lewis Hine, Grillo portrays the immigrant experience through children's eyes, unearthing a complex and poignant world. She begins (...) with images of newly arrived immigrant families at O'Hare International Airport during their first few hours in the United States, and then follows them through the gates and into Chicago's urban life: through her chronicle of citizenship ceremonies, cultural celebrations, weddings and dances, and other everyday scenes of immigrant life, Grillo captures the crucial elements that shape not only the characters of the children, but also the neighborhoods in which they reside. For adults, emigration to America is filled with both hope and fear, yet it is tempered by a mature understanding. For children, however, this same journey unfolds in the unrelenting present as they must constantly negotiate their individual identities and allegiances to culture, country, and kin. With moving quotations and drawings by immigrant children woven into Grillo's visual sequence, Between Cultures is a unique meditation on the development of individual identity through the reconciliation of multiple cultural heritages. (shrink)

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The use of African American as a new denomination for a group previously referred to as Black has rapidly become standard practice in American society. This paper analyzes how the introduction of African American in our ordinary language marks the elaboration of a new social reality. As the concept becomes part of our social life, it is transformed into a real “phenomenon” of social representation that formalizes behaviour and orients communication. Such a transformation requires that the new term infiltrates people's (...) everyday lives sufficiently to concretize it into a common reality. The analysis presented here outlines three key processes in the emergence and formation of the social representation of African American. The first one is anchoring which familiarizes the new object by linking it with preexisting categories in our minds. The second process is objectification which assures the crystallization of the object. A figurative core is created to allow the projection of images. At this point people can talk about the object, and through communication the object takes on meaning. This naturalization is the third process to conclude the transformation of the object into a social reality. These steps have allowed African American to become the carrier for a modification of cognitions and broadening of attitudes concerning the group. (shrink)

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Moral bioenhancement presents the possibility of enhancing morally desirable emotions and dispositions. While some scholars have proposed that moral bioenhancement can produce virtue, we argue that within a virtue ethics framework moral bioenhancement cannot reliably produce virtue. Moreover, on a virtue ethics framework, the pursuit of moral bioenhancement carries moral risks. To make this argument, we consider three aspects of virtue—its motivational, rational, and behavioral components. In order to be virtuous, we argue, a person must (i) take pleasure in doing (...) the right thing and have the correct motivational attitudes; (ii) reason correctly about what is called for in a particular ethical dilemma; and (iii) intentionally and continuously practice and cultivate virtues. These dimensions of morality—in short: precisely those emphasized in a virtue ethics framework—cannot be consistently or reliably met using existing moral bioenhancement technology. (shrink)

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Fabiano argues that virtue theory offers the best “safety framework” for mitigating the risks of moral enhancement (1). He advances five desiderata for an ideal safety framework and then explains how virtue theory satisfies each. Among these desiderata is the “preservation of identity” (1). Fabiano argues that moral enhancement can safely preserve personal identity when carried out within the framework of virtue theory. We suggest Fabiano's argument for this conclusion falls short, since contra Fabiano’s claim, enhancing virtues may not preserve—and (...) could even damage—personal identity. We draw on three sources of evidence: 1) virtue theory scholarship that argues for the importance of habituation for virtue formation, 2) Focquaert and Schermer’s (2015) distinction between active and passive enhancement and attendant endorsement of more active paths to virtue enhancement, and 3) empirical research suggesting that technologies which support moral enhancements may have damaging effects on personal identity. (shrink)

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This paper explores the contemporary art landscape of the Philippines, mapping its multiplicity across local terrains and within definitions of regionality and the art market. It discusses the ruptures that have caused this landscape to shift intermittently, spawning new networks and value structures that are less defined by the frame of ‘nation-based identity’ favoured in the past, and instead locates difference within the experimentation, historiographies, and pace of this contemporary ‘art scene’. It highlights flashpoints and uses case studies across the (...) last five years in particular to illustrate that Philippine artists, art scenes and art markets are highly reflective of cross-civilizational cultural flows, alert to global trends and of their own currency within regional markets. This paper does not seek to provide a comprehensive overview but rather draws a map of some potent changes and significant players in this contemporary landscape. (shrink)

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L’avventura ultraterrena di Dante, definita divina da Boccaccio, si fa in Borges commedia di vita. È soprattutto nell’interpretazione esistenziale del viaggio ultraterreno dantesco che risiede l’irresistibile forza di attrazione dell’ateo Borges per la teologia poetica di Dante, un viaggio alla scoperta di un’umanità, di cui l’incontro con il poeta restituisce affreschi indelebili di grande intensità.

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Children and adolescents with an intellectual disability and autistic traits often attend special needs schools where they are surrounded by peers with diverse characteristics. Given the role that peers can play in social development, we examined whether autistic traits development in students with ID and high levels of such characteristics are influenced by the level of autistic traits among the schoolmates they like most. Furthermore, we investigated the degree to which this peer influence susceptibility depends on students’ gender. A longitudinal (...) design, with data collection points at the beginning and the end of a school year, was used. Staff reported on 330 students with high levels of autistic traits who attended 142 classrooms in 16 Swiss special needs schools. Results showed that students’ future individual level of autistic traits was not predicted by the autistic traits level of preferred peers, controlling for individual autistic traits at T1, level of general functioning, gender, and age. However, the peer effect was significantly moderated by students’ gender, indicating that girls but not boys were susceptible to peer influence. These findings are discussed in terms of implications for understanding autistic traits development and directions of support for children and adolescents in their peer context. (shrink)

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Cette réflexion sur le champ de recherche en communication interculturelle part du principe que les avancées théoriques s'élaborent au travers d'une dynamique ancrée autant dans le contexte des pratiques de recherche que dans l'évolution interne du champ de recherche. Tout d'abord, on tente de délimiter les moments clés qui ont présidé à l'émergence de ce nouveau domaine des deux côtés de l'Atlantique. Une fois établi que la communication interculturelle est un nouveau champ de recherche où se constituent un langage, des (...) théories et des méthodologies qui lui sont propres, la deuxième étape consistera à dresser la carte de son territoire, autrement dit, à préciser quels sont les objets, les approches et les postures méthodologiques qui coexistent dans ce champ.This reflection on the field of intercultural communication research assumes that theoretical advances are developed through a dynamic rooted both in the context of research practices in the internal evolution of the field of research. Firstly, we try to define the key moments that led to the emergence of this new field on both sides of the Atlantic. Once established as intercultural communication is a new field of research which is a language, theories and methodologies that are unique, the second step is to map its territory, ie to specify which objects are the methodological approaches and postures that exist in this field. (shrink)

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This dissertation is concerned with one of the central but most perplexing theories in Plotinus's metaphysics, namely the nature and origin of time. In contrast to those interpretations of Neoplatonism that treat time as an imperfect image and passive product of eternity, I argue for a much more subtle and multifaceted concept that makes the human observer central to Plotinus's account of how time is actualized and thus passes. His emphasis on mystical experience and the individual soul's journey toward the (...) One and the realm of eternity strengthens this account. By reading the treatise On Eternity and Time in this light, I demonstrate the importance of embodied human consciousness for the Plotinian theory of time. ;This emphasis invites comparison with the one contemporary Continental thinker who devoted countless pages in both his published work and his manuscripts to the relationship between time and consciousness. In the second part of the dissertation I argue that the Husserlian and Plotinian subjects have analogous characteristics, in accordance with their parallel roles as sources of time, and that the Husserlian notion of omnitemporality offers the best way of understanding the internal connection between Plotinus's notion of eternity and his notion of actualization through human experience. At the same time, Plotinus challenges a phenomenological account by giving the eternal ontological priority over the human realm of temporality. Nevertheless, these intriguing affinities and oppositions suggest that Plotinus's theory of time and eternity can best be understood and even expanded by uncovering its phenomenological underpinnings. (shrink)

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Workplace bullying has a well-established body of research internationally, but the United States has lagged behind the rest of the world in the identification and investigation of this phenomenon. This paper presents a managerial perspective on bullying in organizations. The lack of attention to the concept of workplace dignity in American organizational structures has supported and even encouraged both casual and more severe forms of harassment that our workplace laws do not currently cover. The demoralization victims suffer can create toxic (...) working environments and impair organizational productivity. Some methods of protecting your organization from this blight of bullying are proposed. Bullying has always been part of the human condition; history is rife with references to abuse of power and unnecessary or excessive force. The classic bully story is of Joseph and his brothers, a tale of envy and hostility. The refinement of bullying to include various forms of legally defined social harassment is a relatively late phenomenon, however, dating to the Civil Rights Act of 1964. In the United States, bullying is not illegal, whereas it is illegal in many other countries. Bullying is not about benign teasing, nor does it include the off-color jokes, racial slurs, or unwelcome advances that are the hallmarks of legally defined harassment. Workplace bullying is the pattern of destructive and generally deliberate demeaning of co-workers or subordinates that reminds us of the activities of the schoolyard bully. Unlike the schoolyard bully, however, the workplace bully is an adult, usually (but not always) aware of the impact of his or her behavior on others. Bullying in the workplace, often tacitly accepted by the organizational leadership, can create an environment of psychological threat that diminishes corporate productivity and inhibits individual and group commitment. The two examples that follow will help to clarify the difference between harassment and bullying. (shrink)

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The Good Supervisor engages readers in dialogue and active reflection on the strategies of effective supervision of PhDs, postgraduate and undergraduate research. Accessibly written, it encourages supervisors to reflect on and enhance their research supervision practice with a diversity of students on a variety of research projects: Postgraduate and undergraduate levels, international and distance students practice and professional research research leading to creative process and products/creations the PhD by publication supervising your colleagues interpersonal skills managing diversity in learning styles, gender, (...) age and culture. The book is also useful for students undertaking research. There is special focus on research skills development.and on supporting students through and beyond the examination process. (shrink)

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In this paper, I urge feminists to re-center fetal moral status in their theorizing about abortion. I argue that fundamental feminist normative commitments are at odds with efforts to de-emphasize fetal moral status: The feminist commitment to ensuring care for dependents supports surprising conclusions with regard to the ethics of abortion, and the feminist commitment to politicizing the personal has surprising conclusions regarding the politics of abortion. But these feminist insights also support the conclusion that, conditional on fetal moral status, (...) care for unwanted fetuses would be a social obligation that only derivatively falls to women who are unwillingly pregnant. (shrink)

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Crediting scientific discovery for prolonging life is pervasive in biomedical histories of the genetic blood disorder, sickle cell disease. This includes the preventive strategies, such as newborn screening, that have underwritten the success of its life-extending interventions. Newborn screening is a technology that relies not only upon intact health infrastructures but also expertise and enhanced vigilance on the part of caregivers to anticipate complications while they are still open to circumvention. This paper posits that even after overcoming institutional barriers to (...) make newborn screening equitably available, care and vigilance are resources that are themselves subject to what I term anticipatory politics, where structural conditions also stratify expectations for the future, including the affective appeal of medical innovations. This paper elaborates the paradigm of anticipatory politics through an ethnographic examination of newborn screening to connect the comprehensive care practices that have improved survival for sickle cell disease, and as the burden of mortality shifts to young adulthood, to expose how those who are resourced to care for these futures preferentially stand to benefit from preventive interventions. (shrink)

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General semantics reveals ambiguities in the Bible.

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Little previous research has examined attitudes about societal and ethical issues (SEI) among interns participating in research experience for undergraduate programs (REUs) in nanotechnology, thus neglecting an important population for understanding the burgeoning views of the next generation of nanotechnology researchers. This study surveyed a sample of interns (N = 85) participating in the National Nanotechnology Infrastructure Network’s (NNIN) REU program during the summer of 2012. Our questions focused on interns’ experiences with education on ethical issues, as well as their (...) attribution of responsibility for considering ethical issues, motivations to talk about ethical issues, and comfort level of discussing ethical issues with faculty, mentors, lab staff, and other REU students. Among key findings was that lab culture related to the extent to which REU interns felt comfortable discussing ethical issues. In addition, those who reported more discussions about ethical issues with their mentors were more likely to consider themselves as responsible for considering ethical issues. We conclude with recommendations and future research directions. (shrink)

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Despite women’s increased labor force participation, household divisions of labor remain highly unequal. Properly implemented, gender egalitarian political interventions such as work time regulation, dependent care provisions, and family leave initiatives can induce families to share work more equally than they currently do. But do these interventions constitute legitimate uses of political power? In this article, I defend the political legitimacy of these interventions. Using the conception of citizenship at the heart of political liberalism, I argue that citizens would accept (...) political interventions aimed at protecting the ‘genuinely available option’ to enact gender egalitarian lifestyles. More strongly still, I argue that under certain circumstances, citizens would insist on the enactment of political interventions to protect this option. According to political liberalism’s constraints on legitimacy, this insistence renders these interventions not only legitimate but positively mandatory. It is legitimate for a state to exercise power to preserve the genuinely available option to enact a gender egalitarian lifestyle, and under certain circumstances, it is illegitimate for a state to fail to do so. (shrink)

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Commodity chain analysis (Bair and Ramsay, 2003 Multinational Companies and Global Human Resource Strategies) is used to explore where economic pressure (from consumers) or socio-political pressure (from governments and NGOs) can be applied to reduce worker exploitation. Six paths are illustrated with examples of successful and unsuccessful application of pressure. Three conclusions are reached :Economic pressure on companies and brand owners is more likely to lead to improved workplace conditions than socio-political pressure; Brand owners are more likely to implement improved (...) workplace conditions than retailers; and Retailers who are under extreme consumer price pressure will resist improving workplace conditions. (shrink)

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In this interview-essay, artist Rosanna Bruno talks with the author about her illustrations of The Trojan Women, a comic-book made in collaboration with Anne Carson. Bruno’s illustrations offer the reader an oblique entry into a devastated Troy: they are translation “at a slant.” The artist speaks on going against what is visually expected or plausible, in her use of surprising imagery to convey and counterpoint suffering, and touches upon the use of humor to bring the tragedy into sharp focus. Bruno (...) explains how the comic-book format can communicate radical ideas in the interdependence of word and image. She talks through creating the feeling of live theater and the emotional tenor brought about by an almost entirely non-human cast: dogs, cows, a huge wave, a turnip-like rootling, a pair of dungarees. The illustrator elucidates the collaborative process between herself and Carson, revealing the various iterations of characters before they settled on their final forms, and the materials and methodologies Bruno employed in its rendering. (shrink)

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ObjectivesTo investigate which of two sources of information about an older adult’s wishes—choices made in an advance directive or proxy’s opinion—provides better insight into the older adult’s preferences measured in hypothetical clinical situations involving decisional incapacity.MethodsSecondary analyses of data collected from 157 community-dwelling, decisionally competent adults aged 70 years and over who attended a group information session on advance directives with their proxy. Older adults were invited to complete a directive introduced during the session, designed to express healthcare preferences. An (...) average of 3 months later, older adults were asked during an interview whether they would want to receive each of four medical interventions and what their goals of care would be should they develop one of three sudden health events, assuming that they had severe dementia. Proxies were asked to guess the older adult’s answers in each of the seven scenarios.ResultsEighty per cent of the older adults completed the directive. Choices they made in the directive were more in line with the preferences they stated during the interview than were their proxies’ guesses at their answers. However, concordance was relatively low, with percentages of agreement ranging from 43% to 83% across scenarios.ConclusionsFindings suggest that a directive might provide better insight into a person’s wishes than the person’s proxy, although neither source is perfect. A multifaceted decision-making model that includes both sources of information might better serve the interests of older adults who have lost the capacity to make decisions on their own.Trial registration numberISRCTN89993391; Post-results. (shrink)

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