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Introduction: The goal of medical education is to develop clinicians who have sufficient agency (capacity to act) to practise effectively in clinical workplaces and to learn from work throughout their careers. Little research has focused on experiences of organisational structures and the role of these in constraining or affording agency. The aim of this study was to identify priorities for organisational change, by identifying and analysing key moments of agency described by doctors‐in‐training. Methods: This was a secondary qualitative analysis of data from a large national mixed methods research programme, which examined the work and wellbeing of UK doctors‐in‐training. Using a dialogical approach, we identified 56 key moments of agency within the transcripts of 22 semi‐structured interviews with doctors based across the UK in their first year after graduation. By analysing action within the key moments from a sociocultural theoretical perspective, we identified tangible changes that healthcare organisations can make to afford agency. Results: When talking about team working, participants gave specific descriptions of agency (or lack thereof) and used adversarial metaphors, but when talking about the wider healthcare system, their dialogue was disengaged and they appeared resigned to having no agency to shape the agenda. Organisational changes that could afford greater agency to doctors‐in‐training were improving induction, smoothing peaks and troughs of responsibility and providing a means of timely feedback on patient care. Conclusions: Our findings identified some organisational changes needed for doctors‐in‐training to practise effectively and learn from work. The findings also highlight a need to improve workplace‐based team dynamics and empower trainees to influence policy. By targeting change, healthcare organisations can better support doctors‐in‐training, which will ultimately benefit patients. Using a dialogical approach, Mattick and colleagues analysed 56 key moments of agency from 22 interviews with UK doctors and make recommendations for workplace changes that could increase agency. [ABSTRACT FROM AUTHOR]

This article addresses how older people understand and engage with contemporary art in the gallery context--whether there is something unique to the art, the format of the visits, the pedagogical approaches used by gallery educators, the social contact, or a combination of all these factors. It also addresses the psychosocial barriers to engagement. It draws from "Contemporary visual art and identity construction--wellbeing amongst older people", a two-year research project funded by the cross-research council New Dynamic of Ageing Programme. Over 21 months, 43 participants aged 60-92 made three visits to contemporary art galleries in north-east England. The potential for art galleries to develop lifelong learning opportunities for post-retirement people has implications for the cultural, health and voluntary sector. (Contains 2 tables.)

This paper reports the initial findings from Contemporary Visual Art and Identity Construction--Wellbeing Amongst Older People: a two-year research project that aims to understand how the lives of older people can be improved by examining their use of contemporary visual art in the art gallery and museum. It will focus on data relating to lifelong learning for postretirement people. The paper investigates the impact of engaging with contemporary art on a sample of 43 participants aged 64+. (Contains 4 tables.)

The International Centre for Cultural and Heritage Studies at Newcastle University has been investigating the impact of artists working with young people in cultural sites and schools. This paper focuses on "Transfer" by the artist Wolfgang Weileder; the construction and de-construction of a full-scale replica of Milton Keynes Gallery at Station Square, Milton Keynes by construction students. The art project involved collaboration between the artist, two Further Education colleges and a construction company involved in the training of construction students. This paper will investigate how the different cultures interacted during the creative learning experience, concentrating on the impact upon the construction students. "Transfer" provided training opportunities for the students, who simultaneously developed an understanding of contemporary artistic practice and began to take on ownership of the piece. Insights from this project will be presented in order to draw out implications for future collaborations. (Contains 6 figures.)

The concept of intergenerational fairness has taken hold across Europe since the 2008 financial crisis. In the United Kingdom (UK), focus on intergenerational conflict has been further sharpened by the 2016 'Brexit' vote to take the UK out of the European Union. However, current debates around intergenerational fairness are taking place among policy makers, the media and in think-tanks. In this way, they are conversations about, but not with, people. This article draws on qualitative interviews with 40 people aged 19–85 years and living in North-East England and Edinburgh, Scotland's capital city, to explore whether macro-level intergenerational equity discourses resonate in people's everyday lives. We find widespread pessimism around young people's prospects and evidence of a fracturing social contract, with little faith in the principles of intergenerational equity, equality and reciprocity upon which welfare states depend. Although often strong, the kin contract was not fully ameliorating resentment and frustration among participants observing societal-level intergenerational unfairness mirrored within families. However, blame for intergenerational inequity was placed on a remote state rather than on older generations. Despite the precariousness of the welfare state, participants of all ages strongly supported the principle of state support, rejecting a system based on family wealth and inherited privilege. Rather than increased individualism, participants desired strengthened communities that encouraged greater intergenerational mixing. [ABSTRACT FROM AUTHOR]

Objectives: Changes in the prevalence of faecal occult blood test positivity over time have not been previously reported, but could have important implications. This study examined the positivity of the initial guaiac faecal occult blood test, a surrogate marker for colorectal bleeding, in participants aged 50 in a national bowel screening programme. Methods: Data from the Scottish Bowel Screening Programme were used to study the initial positivity of the guaiac faecal occult blood test between 2007 and 2017. Positive predictive values of the testing process for colorectal cancer and adenoma were assessed over the same time period. Results: Across Scotland, the initial guaiac faecal occult blood test positivity increased from 4.1 to 10.8%. In NHS Grampian and NHS Fife, two of the three NHS Boards which began roll-out of screening in 2007, it increased from 4.0 to 10.9%. In the Scottish Bowel Screening Programme, the positive predictive value declined from 11.0 to 6.6% for colorectal cancer and increased from 31.6 to 39.8% for adenoma. Conclusions: In the Scottish programme over a decade, initial guaiac faecal occult blood test positivity increased in participants aged 50. This may be associated with changes in lifestyle and might have implications for screening clinical outcomes, including positive predictive value. [ABSTRACT FROM AUTHOR]

This study responds to a gap in the literature relating to the resilience of people living with dementia in care homes. We applied an ecopsychosocial framework of resilience, theorising that sources of resilience may be personal, social and structural. Visual arts enrichment activities were examined to see how they might provide opportunities for resilience. The data used for this study were qualitative and originated from people with dementia aged between 70 and 99 years old (N = 48) living in four care homes in North East England, United Kingdom and staff/carers/family members (N = 37). The results showed that visual arts enrichment activities supported the resilience of those with dementia through creative expression, increased communication, improved self-esteem, and influenced relationships with carers and family members. It is concluded that even those with advanced dementia are capable of demonstrating resilience which can be supported by, and explored through, visual arts enrichment activities. [ABSTRACT FROM AUTHOR]

This study explores the degree to which cultural engagement contributes to older people’s lives using qualitative interview data with 40 participants aged 64–98 years. It makes an original contribution to the fields of cultural class analysis and policy-related literature on participation and ageing by unravelling how class – especially cultural capital acquired throughout the life course – shapes the meanings and contexts of cultural participation in later life. This article shows how ageing creates material, physical and relational barriers to cultural participation, particularly for older-old participants, and how these interact with inequalities of cultural capital and taste. Findings highlight how cultural participation both reflects and creates inequality of opportunity in older age, by revealing the influence of class, gender and ethnicity on the contexts and subsequent outcomes of engagement. The article examines the intellectual dimension of engagement in order to understand the experience of the aesthetic encounter specific to older populations. The patterns of participation and social contexts in which engagement occurs reinforce social hierarchies and define identities in older age. [ABSTRACT FROM AUTHOR]

Despite the growing international innovations for visual arts interventions in dementia care, limited attention has been paid to their theoretical basis. In response, this paper explores how and why visual art interventions in dementia care influence changes in outcomes. The theory building process consists of a realist review of primary research on visual art programmes. This aims to uncover what works, for whom, how, why and in what circumstances. We undertook a qualitative exploration of stakeholder perspectives of art programmes, and then synthesised these two pieces of work alongside broader theory to produce a conceptual framework for intervention development, further research and practice. This suggests effective programmes are realised through essential attributes of two key conditions (provocative and stimulating aesthetic experience; dynamic and responsive artistic practice). These conditions are important for cognitive, social and individual responses, leading to benefits for people with early to more advanced dementia. This work represents a starting point at identifying theories of change for arts interventions, and for further research to critically examine, refine and strengthen the evidence base for the arts in dementia care. Understanding the theoretical basis of interventions is important for service development, evaluation and implementation. [ABSTRACT FROM AUTHOR]

This paper analyses how the methodological approach for a major Arts and Humanities Research Council and Economic and Social Research Council-funded project entitled Dementia and Imagination1 was formulated. This multidisciplinary project brings together the arts and humanities with the social sciences with their different epistemological philosophies and subsequent understandings of research methods. The main objective was to determine how visual arts activities may change, sustain and catalyse community cultures, beliefs, attitudes and behaviours to create dementia-friendly communities. This project involves 6 different UK universities, 14 researchers, 10 formal partners, 7 project artists, 3 research artists and a large number of civil society organisations. The analysis presents a series of themes that have been identified as influencing the approach taken to develop methods which aimed to speak to different audiences in the social sciences, arts and humanities, policy/practice and public domains. It is concluded that a research project of this type needs to embrace a wide variety of epistemological positions if it is to successfully achieve its objectives. This paper contributes to knowledge about how the methodology of large-scale multidisciplinary projects may be constructed which will be of value to those building research consortia across different universities and between universities and community partners. [ABSTRACT FROM AUTHOR]

Slowing is a common feature of ageing, yet a direct relationship between neural slowing and brain atrophy is yet to be established in healthy humans. We combine magnetoencephalographic (MEG) measures of neural processing speed with magnetic resonance imaging (MRI) measures of white and grey matter in a large population-derived cohort to investigate the relationship between age-related structural differences and visual evoked field (VEF) and auditory evoked field (AEF) delay across two different tasks. Here we use a novel technique to show that VEFs exhibit a constant delay, whereas AEFs exhibit delay that accumulates over time. White-matter (WM) microstructure in the optic radiation partially mediates visual delay, suggesting increased transmission time, whereas grey matter (GM) in auditory cortex partially mediates auditory delay, suggesting less efficient local processing. Our results demonstrate that age has dissociable effects on neural processing speed, and that these effects relate to different types of brain atrophy.

This article explores how older visitors use meanings created through encounters with contemporary visual art in art galleries for identity maintenance and revision processes. The analysis is based on the results of a 28-month study of the responses of older people to contemporary visual art in art galleries in north-east England, UK. The identity processes used in this study are those defined as maintenance and revision as understood by Kroger (2002) Identity processes and contents through the years of late adulthood.Identity, 2, (1), 81-99, Kroger and Adair (2008) Symbolic meanings of valued personal objects in identity transitions of late adulthood.Identity, 8, (1), 5-24. and Marcia (2002) Identity and psychosocial development in adulthood.Identity, 2, (1), 7-28. Respondents who did not have an existing identity-defining commitment towards art and who had less ability to decode the art works used the art to make symbolic links to aspects of their identity. The meanings created were then used to help satisfy current identity needs. In contrast, those with an existing commitment to art used the experience of the visits to deepen their current knowledge. Engaging with contemporary visual art facilitated identity processes that contributed to participants’ well-being. This study contributes to studies on identity by exploring how content and identity processes interact and provides new perspectives on the role of art in identity formation for older people. It also has significance for museum, gallery and heritage policy and practice. [ABSTRACT FROM PUBLISHER]

Providing evidence of health or well-being outcomes for arts on prescription (AoP) programmes for older people is problematic. A number of reports have shown that the Department of Health (DoH) supports the role of art in health (ACE 2007a; 2007b, Cayton 2007), but this has not translated into long-term, strategic funding. This article uses interviews with health, arts and voluntary sector professionals involved in five AoP programmes in England, UK, to provide an understanding of the challenges of providing evidence and o f sustaining such work. Interviewees noted the tension between arts and health requirements, arguing that quantitative evaluation fails to capture the process of participation and the impact of programmes within the context of an individual's life. However, using both qualitative and quantitative methods and demonstrating cost-savings was felt necessary. The substantial changes the National Health Service (NHS) is undergoing presents threats to embedding AoP in the light of financial cuts and opportunities through new commissioning structures. To attempt to gain policy support from the DoH and sustained funding from the NHS, the development of quantitative evaluation of health outcomes and demonstration of cost-savings alongside qualitative evaluation is recommended. Despite being in a relatively weak position in terms of influencing health policy, the article also recommends arts organizations invest energy in advocacy. [ABSTRACT FROM AUTHOR]

Memory problems are among the most common complaints as people grow older. Using structural equation modeling of commensurate scores of anterograde memory from a large (N = 315), population-derived sample (www.cam-can.org), we provide evidence for three memory factors that are supported by distinct brain regions and show differential sensitivity to age. Associative memory and item memory are dramatically affected by age, even after adjusting for education level and fluid intelligence, whereas visual priming is not. Associative memory and item memory are differentially affected by emotional valence, and the age-related decline in associative memory is faster for negative than for positive or neutral stimuli. Gray-matter volume in the hippocampus, parahippocampus and fusiform cortex, and a white-matter index for the fornix, uncinate fasciculus and inferior longitudinal fasciculus, show differential contributions to the three memory factors. Together, these data demonstrate the extent to which differential ageing of the brain leads to differential patterns of memory loss.

The aim of providing a close reading of a randomized controlled trial (RCT) of reminiscence groups for people with dementia and an evaluation of a pilot arts programme for people with dementia is to compare evidence from the paradigms of health and arts. Whilst the RCT is the gold standard of research in Health, the qualitative approach favoured by arts may be able to capture subtle shifts in participants' affect. Although RCTs are beyond the budget of small arts organizations, there are lessons to be learnt in terms of study design - the use of control groups, random allocation, the blinding of researchers to the intervention participants receive, regular data collection points and the use of validated quantitative scales. There is already considerable pressure on small arts organizations to provide effective evaluation that satisfies a range of stakeholders, and adopting the suggested methodologies would require considerable support in terms of resource and expertise. While the focus of this article is on arts and health work for older people, the principal of comparing a RCT with a general evaluation has relevance for arts programmes with health outcomes for a range of participants. [ABSTRACT FROM AUTHOR]

This paper examines the responses of older people to the British Art Show 6, which is an exhibition of recent developments in contemporary visual art in the UK. One group of respondents attended two “meet the artist talks” and a second group attended an artist-led workshop where they produced work that had been stimulated by the exhibition. The focus groups that resulted were analysed using theoretical frameworks related to identity construction. The analysis demonstrated that respondents were using the resources of the exhibition to construct identity positions in response to their social contexts. However, their ability to do this was governed by how the relationship between agency and structure played out for individuals in their engagement with contemporary visual art. It is suggested that wellbeing originates from the control such a process might give individuals over their social environment. [ABSTRACT FROM AUTHOR]