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Background: We explore cognitive and behavioural biases that influence individual’s willingness to engage advance care planning (ACP). Because contexts for the initiation of ACP discussions can be so different, our objective in this study was to identify specific groups, particular preferences or uniform behaviours, that may be prone to cognitive bias in the ACP decision process. Method: We collected data from the Australian general public (n=1253), as well as general practitioners (GPs) and nurses (n=117) including demographics, stated preference for ACP decision-making; six cognitive bias tests commonly used in Behavioural Economics; and a framing experiment in the context of ACP. Results: Compared to GPs (M=57.6 years, SD=17.2) and the general public (58.1 years, SD=14.56), nurses on average recommend ACP discussions with patients occur approximately 15 years earlier (M=42.9 years, SD=23.1; p<0.0001 in both cases). There is a positive correlation between the age of the general population and the preferred age for the initial ACP discussion (ρ=0.368, p<0.001). Our shared decision-making analysis shows the mean share of doctor’s ACP input is viewed to be approximately 40% by the general public, significantly higher than health professionals (GPs and nurses), who believe doctors should only contribute approximately 20% input. The general public show varying relationships (all p<0.05) for both first ACP discussion, and shared decision-making for five of six cognitive tests. However, for health professionals, only those who exhibit confirmation bias show differences (8.4% higher; p=0.035) of patient’s input. Our framing experiment results show that positive versus negative framing can result in as much as 4.9–7.0% shift in preference for factors most relevant to ACP uptake. Conclusion: Understanding how GPs, nurses and patients perceive, engage and choose to communicate ACP and how specific groups, particular preferences or uniform behaviours, may be prone to cognitive bias in the decision process is of critical importance for increasing future uptake and efficient future healthcare provision. [ABSTRACT FROM AUTHOR]

Background: Successful return to sports activity after surgery requires both physical and psychological readiness. The Hip–Return to Sport After Injury (Short Form) has been developed to assess psychological readiness to return to sports after hip injury and hip surgery, including hip arthroscopy. Purpose: To evaluate the reliability, validity, responsiveness, and interpretability of the scale for a cohort of patients after hip arthroscopy with a range of sports participation levels. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Invitations to participate were sent to 145 patients from 3 specialist surgeons. The study included 77 participants 1 to 24 months after hip arthroscopy (mean ± SD age, 35 ± 9 years; 62% women) and 33 healthy age-matched controls (age, 37 ± 7 years; 52% women). The scale was administered electronically on 3 occasions to patients: baseline (≥1 month postarthroscopy), 1 week later, and 6 months later. In addition to the scale, participants were asked about sports participation status and their global rating of postsurgical change. The scale was administered to healthy controls on 1 occasion. The minimal detectable difference, discriminant validity, floor and ceiling effects, responsiveness, and interpretability (minimally important change) were determined for the scale. Results: Among the postarthroscopy group, excellent test-retest reliability was found (intraclass correlation coefficient = 0.869; 95% CI, 0.756-0.932) with a minimal detectable difference of 26 points out of 100 at the individual level and 4 points out of 100 at the group level. At baseline discriminant validity was evident between those who had returned to sports (median = 69, n = 35) and those who had not returned to sports (median = 30, n = 42; Mann-Whitney U score = 232.5, z = −5.141, P <.001) and between the returned-to-sports postarthroscopy group and healthy controls (median = 96, n = 33; Mann-Whitney U score = 165.500, z = 5.666, P <.001). No floor or ceiling effects were evident. Responsiveness was demonstrated for the scale in relation to sports status. With sports status as an anchor, a minimally important change of 26 points was identified. Conclusion: Assessment of the Hip–Return to Sport After Injury (Short Form) supports its use as a reliable and valid measure of psychological readiness to return to sports in patients after hip arthroscopy. [ABSTRACT FROM AUTHOR]

Background: Achieving preinjury levels of athletic performance has been challenging for elite athletes after anterior cruciate ligament (ACL) reconstruction. Although a recent study found that 77% of Australian Football League (AFL) players who underwent ACL reconstruction from 1999 to 2013 returned to play at the highest level, the study did not indicate how consistently or well they were able to play. Purpose: To identify the number of AFL players who returned to play consistently over 2 seasons after ACL reconstruction, compare their playing performance in these seasons with preinjury performance, and evaluate factors associated with returning to preinjury levels of performance. Study Design: Case series; Level of evidence, 4. Methods: Analysis included 104 AFL players who underwent ACL reconstruction between 1999 and 2013. All had played at least 10 AFL matches in 1 season before ACL injury. Ranking points, as devised by AFL statisticians, were used to measure individual playing performance. Results: Of the 104 players who played at least 10 matches in 1 season before ACL injury, 53 (51%) returned to play at least 10 matches in 2 seasons after surgery. Of these 53 players, 36 (68%) returned to their preinjury levels of performance. The 17 remaining players who did not return to their preinjury performance still performed comparably to the AFL average level after surgery. Players <25 years old (odds ratio = 2.9, P =.01) or <90 kg (odds ratio = 2.7, P =.03) had greater odds of returning to their preinjury levels of performance. Conclusion: Returning to play on a consistent basis was a substantial challenge for AFL players after ACL reconstruction. However, among players who did return to play consistently over 2 seasons, their postsurgery average performance was comparable with the AFL average level of performance, and two-thirds returned to their preinjury levels of performance. Younger and lighter players were more likely to return to their preinjury levels of performance, possibly given the nature of AFL club playing list management decisions. [ABSTRACT FROM AUTHOR]

Because women are in the minority in masculine fields like finance and banking, women in these fields may experience stereotype threat or the concern about being negatively stereotyped in their workplace. Research demonstrates that stereotype threat among women in management and accounting leads to negative job attitudes and intentions to quit via its effects on identity separation, or the perception that one’s gender identity is incompatible with one’s work identity. The current work extends this research to related outcomes among women in finance. In this study, 512 women working in finance completed a survey about their work environment, their well-being at work, and whether they would recommend the field of finance to younger women. Results showed that, to the extent women experienced stereotype threat in their work environment, they reported diminished well-being at work and were less likely to recommend their field to other women, and these outcomes were mediated by identity separation. Recruitment and retention of women into fields where they have been historically underrepresented is key to achieving the “critical mass” of women necessary to reduce perceptions of tokenism as well as stereotyping and devaluing of women. The current work sheds light on psychological factors that affect these outcomes. [ABSTRACT FROM AUTHOR]