Advance requests for MAiD in dementia: Policy recommendations emerging from a mixed-methods study of the views of the Canadian public and MAiD practitioners

BackgroundThe Canadian public has repeatedly expressed its desire for advance requests for Medical Assistance in Dying (MAiD) after dementia diagnosis, yet MAiD practitioners’ willingness to accede to such advance requests is unknown. This study explores the extent and nature of any gap between the public’s desire for, and practitioners’ willingness to provide MAiD, and identifies policies to ameliorate such a gap.MethodsTwo complementary mixed-method surveys gathered data from convenience samples of 83 Canadian adults and 103 MAiD practitioners. The public survey asked participants which of five specific circumstances commonly encountered in dementia they would include in their advance requests. The practitioner survey queried the validation level participants would require before providing MAiD in each specific circumstance. Participants’ reasons were probed using thematic analysis of open-ended questions.ResultsOn average, 77% of public participants indicated they definitely or probably would include each of the five specific circumstances in their advance requests for MAiD. As validation level decreased from patient consent to patient assent, family assent, or advance request alone, the magnitude of the gap between the public’s desire and practitioners’ willingness increased. The practitioners’ qualitative data contained many practical insights from which emerged seven policy recommendations to ameliorate this gap and increase the likelihood of honouring patient requests.InterpretationThe study provides evidence of a gap between public desire for, and practitioner willingness to provide MAiD in dementia. The policy recommendations are relevant to consideration of legislation for advance requests for MAiD.

Adherence to the Internal Audit Core Principles and Threats to Internal Audit Function Effectiveness

I investigate the impact that adherence to the Institute of Internal Auditors' Core Principles has on the likelihood that an internal auditor's effectiveness is threatened through pressure to modify valid audit findings. I use responses from the Institute of Internal Auditors' 2015 Common Body of Knowledge Practitioner Survey to show that higher adherence to the Core Principles by both internal audit staff and CAEs is associated with a lower likelihood of being pressured to modify audit findings. I also explore which of the ten Core Principles are dominant in explaining these associations to inform the future development of the internal audit profession. Finally, I investigate the sources of pressure to modify audit findings and explore the effect the Core Principles have in mitigating pressure from each source. My findings are relevant to the Institute of Internal Auditors, internal audit practitioners, and academics interested in internal audit or corporate governance.

The Practice of Character Strengths: Unifying Definitions, Principles, and Exploration of What’s Soaring, Emerging, and Ripe With Potential in Science and in Practice

What does it mean to be “strengths-based” or to be a “strengths-based practitioner?” These are diffuse areas that are generic and ill-defined. Part of the confusion arises from the customary default of practitioners and leaders across many cultures to label anything positive or complimentary as “strengths-based,” whether that be an approach, a theoretical orientation, an intervention, or a company. Additional muddle is created by many researchers and practitioners not making distinctions between very different categories of “strength” in human beings – strengths of character, of talent/ability, of interest/passion, of skill/competency, to name a few. To add clarity and unification across professions, we offer seven characteristics and a comprehensive definition for a character strengths-based practitioner. We center on the type of strength referred to as character strengths and explore six guiding principles for understanding character strengths (e.g., character is plural; character is being and doing) and their practical corollaries. Reflecting this foundation and based on character strengths research, our longstanding work with strengths, discussions with practitioners across the globe, and a practitioner survey asking about strength practices (N = 113), we point out several character strengths practices or approaches we describe as soaring (e.g., explore and encourage signature strengths; practice strengths-spotting), emerging (e.g., the integration of mindfulness and character strengths), or ripe with potential (e.g., phasic strengths; the tempering effect; the towing effect). We use the same framework for describing general research domains. Some areas of research in character strengths are soaring with more than 25 studies (e.g., workplace/organizations), some are emerging with a handful of studies (e.g., health/medicine), and others are ripe with potential that have none or few studies yet opportunity looms large for integrating character science (e.g., peace/conflict studies). Using this framework, we seek to advance the exchange and collaboration between researcher and practitioner, as well as to advance the science and practice of character strengths.

Cheating, culture and incentives: who deserves a bonus?

PurposeThe purpose of this research is to examine the relationship of perceptions of organizational justice on the ranking of candidates for incentive bonuses and the impact of organizational culture on these perceptions.Design/methodology/approachA questionnaire was developed which asked respondents to rank a set of seven candidates for a sales bonus based on deservingness for the bonus. Descriptions of the candidates included information not only on whether they achieved a pre-established metric for the bonus, but on how they achieved (or failed to achieve) the metric. Hypotheses related compliance with norms of organizational justice, both by candidates and the organization, to candidate rank. The survey was administered to a sample of 204 employees of business organizations at all levels obtained through a survey research firm, as well as a sample of 52 employees of organizations in the Christian publishing industry. Nonparametric statistics were used to analyze the results. A comparison was made between the respondents sourced through the research firm, seen as representing the general population and those from the Christian-oriented group.FindingsHypotheses that respondents will seek to punish violators of justice norms, reward compliers and compensate victims of organizational unfairness were generally supported. More interesting were differences between the groups of respondents from the general population and the group representing Christian-based firms.Originality/valueThis article reveals the impact of organizational culture on the acceptance of incentive systems. The research employed a practitioner survey, rather than more common experimental approach.

Juvenile Probation Supervision Contacts in a Reforming State: Rise of the Street-Level Expert?

We examined juvenile probation officers’ use of evidence-based principles in routine supervision contacts in five counties of a reforming state, focusing on relationship quality, attention to criminogenic needs, and the use of structuring activities. We did this using ethnographic observations of 112 routine supervision contacts, supplemented by qualitative interviews and a practitioner survey. Analysis showed officers typically applied some evidence-based principles in supervision meetings, though encounters varied in their focus on rehabilitation, and whether rehabilitative work used specialized techniques. Variations were shaped by client circumstances and meeting contexts. They also reflected officers’ affinity for specialized approaches, with evidence suggesting the existence of a group of “experts” within the officer population committed to using specialized techniques. The presence of experts was related, in part, to offices’ leadership, organizational practices, and history with evidence-based reforms. Findings offer cautious optimism about the prospects for mainstreaming these evidence-based principles within community corrections agencies.