Risky business: medical students' feedback-seeking behaviours: a mixed methods study

There are differing views on how learners' feedback-seeking behaviours (FSB) develop during training. With globalisation has come medical student migration and programme internationalisation. Western-derived educational practices may prove challenging for diverse learner populations. Exploring undergraduate activity using a model of FSB may give insight into how FSB evolves and the influence of situational factors, such as nationality and site of study. Our findings seek to inform medical school processes that support feedback literacy. Using a mixed methods approach, we collected questionnaire and interview data from final-year medical students in Ireland, Bahrain, and Malaysia. A validated questionnaire investigated relationships with FSB and goal orientation, leadership style preference, and perceived costs and benefits. Interviews with the same student population explored their FSB experiences in clinical practice, qualitatively, enriching this data. The data were integrated using the 'following the thread' technique. Three hundred and twenty-five of a total of 514 completed questionnaires and 57 interviews were analysed. Learning goal orientation (LGO), instrumental leadership and supportive leadership related positively to perceived feedback benefits (0.23, 0.2, and 0.31, respectively, p < 0.05). Perceived feedback benefits are related positively to feedback monitoring and inquiry (0.13 and 0.38, respectively, p < 0.05). The personal cost of feedback is unsupported in quantitative data, but was a strong theme in interviews, as was feedback avoidance, peer feedback, and unsupportive learning environment. No differences were observed across sub-groups based on gender, study site, or student nationality. Integrated analysis describes FSB: avoiding 'unsafe' feedback (first, do no harm) and overcoming barriers (beat the system) and goal-centred curation (shop around) to optimise benefits. Diverse medical students across three continents undertake FSB with careful navigation, as a valued but risky business, that is highly contextualised. Promoting a constructive FSB is complex. Overcoming outdated theory and practices on the wards remains a challenge to psychologically safe, learner-centred feedback.

Predictors of parental acceptance to live attenuated influenza vaccine for children

To determine the influencing factors of Chinese parents' intention and behavior for children to receive live attenuated influenza vaccine during the 2022-2023 influenza season. A theoretical model was developed and included seven constructs, and structural equation modeling was used to test 11 hypotheses. From October 2022 to December 2023, a survey was conducted across 38 medical institutions in four Chinese cities and their subordinate districts, counties, and rural areas. Parents who accompanied their children for vaccinations were selected through a randomization process based on their child's medical card numbers. Measures were taken to minimize method bias, including a diverse geographical representation and random sampling. The survey resulted in the collection of 936 valid responses, exceeding the recommended sample size for structural equation model analysis and providing robust statistical inferences. During the study period, 936 respondents were included in the study. Perceived ease of use was verified to be a predictor of perceived usefulness and perceived value. Perceived usefulness was verified as a predictor of perceived value and behavioral intention. Knowledge was a significant antecedent of perceived value and risk perception of influenza disease. Risk perception of influenza disease was proved to be a significant predictor of perceived value and self-reported vaccination behavior. Perceived value significantly affected behavioral intention, and behavioral intention significantly affected self-reported vaccination behavior. Six demographic variables significantly moderate the theoretical models. The low vaccination coverage of live attenuated influenza vaccine (LAIV) among children in China suggests a need for a deeper understanding of the factors that influence vaccination rates. Particularly, effective strategies are necessary from policymakers and practitioners to elevate childhood LAIV coverage.

The relationship between challenge-hindrance stressors and innovative behavior among medical postgraduates in China: the mediation role of academic engagement and the moderating effect of relaxation

This study investigated the relationship between challenge-hindrance stressors and innovative behavior of medical postgraduates in China, examining the mediating role of academic engagement and the moderating effect of relaxation. Drawing from a sample of 437 medical postgraduates from three Chinese universities, our findings revealed that challenge stressors positively correlated with innovative behavior, while the direct relationship between hindrance stressors and innovative behavior was not statistically significant. Furthermore, academic engagement mediated the relationship between two types of stressors and innovative behavior. Challenge stressors enhanced academic engagement, which in turn fostered innovative behavior. Conversely, hindrance stressors were found to diminish academic engagement, which in turn indirectly limited innovative behavior. Additionally, relaxation was identified as a moderating factor that helped mitigate the negative effects of hindrance stressors on academic engagement and indirectly on innovative behavior. These results suggested that academic engagement as a mechanism played a pivotal role in determining how different stressors influenced innovative behavior, underscoring the need for stress management, particularly through relaxation techniques, to maintain high levels of academic engagement and innovative behavior. This study offers practical insights for medical education policymakers and educators in China, emphasizing the importance of balancing stressors and incorporating relaxation practices to enhance the innovative capabilities of medical postgraduates in demanding academic environments.

Self-compassion and psychological well-being of radiographers at work

OBJECTIVES

The aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work.

METHODS

An online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion.

RESULTS

A total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive.

CONCLUSION

Particular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

Latent class analysis of health lifestyle among older adults living alone and associations with life satisfaction and depressive symptoms

BACKGROUND

Little is known about the collective patterns of health-related behaviors of older adults living alone. We aimed to identify subgroups of older adults living alone based on their health lifestyle and examine the relationship between these subgroups and sociodemographic characteristics, life satisfaction, and depressive symptoms.

METHODS

A total of 3137 older adults living alone were sampled from the 2020 National Survey of Older Koreans. Latent class analysis was performed using 11 health-related behaviors: smoking; alcohol consumption; fruit, vegetable, and dairy product consumption; exercise; cultural leisure; social groups; educational activities; health check-ups; and dementia screening. Multinomial logistic and multiple linear regression analyses were performed.

RESULTS

Three classes were identified: Consistently Healthy (CH), Moderately Healthy but Inactive (MHI), and Unhealthy but Active (UA). Compared to the CH, members of the MHI tend to have no formal education and rarely meet relatives. Members of the UA were more likely to be male and employed. The MHI and UA were more likely to have lower incomes, meet with children less frequently or have no children, and rarely meet friends, neighbors, and acquaintances when compared to the CH. Members of the UA group had the highest risk of reduced life satisfaction and increased depressive symptoms.

LIMITATIONS

The cross-sectional design precluded causal inferences.

CONCLUSION

Our study sheds light on the heterogeneity of health lifestyles among older adults living alone and highlights the need for tailored interventions to promote healthy aging in this population.

The association between proactive personality and interprofessional learning readiness in nursing students: The chain medication effects of perceived social support and professional identity

BACKGROUND

Interprofessional education (IPE) has been advocated for all healthcare students, and readiness for interprofessional learning significantly influences its effectiveness. It is essential to explore the antecedent factors of readiness for interprofessional learning among nursing students to promote IPE. While a proactive personality might impact readiness for interprofessional learning, its specific role has remained unspecified.

OBJECTIVE

To examine the mediation effects of perceived social support and professional identity on the association between proactive personality and readiness for interprofessional learning among nursing students.

DESIGN

The study utilised a cross-sectional design.

SETTINGS

Research was conducted at two universities and two vocational schools in Hainan Province, China.

PARTICIPANTS

On-campus nursing students were invited to participate between March and May 2023.

METHODS

A flyer was distributed to the participants with a QR code to scan to voluntarily complete the online survey, including the Readiness for Interprofessional Learning Scale (RIPLS), Proactive Personality Scale, Perceived Social Support Scale and Professional Identity Status Questionnaire Scale 5d. Descriptive analysis, Pearson associations and mediation analysis were conducted using SPSS software version 26.0 and PROCESS version 4.2 for SPSS.

RESULTS

The participants' average RIPLS score was 66.93 ± 9.28. Proactive personality (r = 0.633, p < 0.01), perceived social support (r = 0.605, p < 0.01) and professional identity (r = 0.549, p < 0.01) were all positively related to readiness for interprofessional learning. Meanwhile, the relationship between proactive personality and readiness for interprofessional learning was partly mediated by perceived social support (25.15 %), professional identity (13.35 %) and the chain effects (9.48 %) of perceived social support and professional identity.

CONCLUSIONS

The nursing students in Hainan, China demonstrated a medium level of readiness for interprofessional learning. Compound strategies that foster proactive personality, provide social support and boost positive professional identity are warranted to improve nursing students' readiness for interprofessional learning.

Decoding medical jargon: The use of AI language models (ChatGPT-4, BARD, microsoft copilot) in radiology reports

OBJECTIVE

Evaluate Artificial Intelligence (AI) language models (ChatGPT-4, BARD, Microsoft Copilot) in simplifying radiology reports, assessing readability, understandability, actionability, and urgency classification.

METHODS

This study evaluated the effectiveness of these AI models in translating radiology reports into patient-friendly language and providing understandable and actionable suggestions and urgency classifications. Thirty radiology reports were processed using AI tools, and their outputs were assessed for readability (Flesch Reading Ease, Flesch-Kincaid Grade Level), understandability (PEMAT), and the accuracy of urgency classification. ANOVA and Chi-Square tests were performed to compare the models' performances.

RESULTS

All three AI models successfully transformed medical jargon into more accessible language, with BARD showing superior readability scores. In terms of understandability, all models achieved scores above 70%, with ChatGPT-4 and BARD leading (p < 0.001, both). However, the AI models varied in accuracy of urgency recommendations, with no significant statistical difference (p = 0.284).

CONCLUSION

AI language models have proven effective in simplifying radiology reports, thereby potentially improving patient comprehension and engagement in their health decisions. However, their accuracy in assessing the urgency of medical conditions based on radiology reports suggests a need for further refinement.

PRACTICE IMPLICATIONS

Incorporating AI in radiology communication can empower patients, but further development is crucial for comprehensive and actionable patient support.

Student Perspectives of Success and Failure in Biology Lecture: Multifaceted Definitions and Misalignments

Investigating definitions of success and failure among introductory biology students is essential for understanding what underlies their self-efficacy; a student who gets a B on an exam may lose self-efficacy if they define failure as anything less than an A. Yet, whether students have the same definitions for success as they have for failure in these classes is unknown, nor how those definitions relate to course performance. To better understand student definitions for success and failure and their implications, this mixed-methods study collected survey data from students in two introductory biology courses about their definitions of success and failure and their self-reported grades. Coding of open-ended responses revealed four broad themes related to both success and failure: Performance, Content, Preparation, and Attitude. Although there were common themes in how students defined success and failure overall, individual students often (65%) described success or failure in relation to different standards. We also found some definitions of success and failure were predicted by grades. These results highlight the complexity of building self-efficacy in introductory biology and suggest the need for greater awareness and acknowledgment of the different standards students use to judge their success and failure.

Effects of outdoor recreational physical challenges on general self-efficacy: A randomized controlled trial

Outdoor programs involving recreational physical challenges are becoming increasingly popular for training and development purposes among adults, but rigorous studies investigating their effectiveness remain scarce. A randomized controlled trial was conducted to evaluate the effects of an outdoor adventure-based program on measures of self-efficacy, resilience, risk-taking propensity, and perceived stress. Participants were randomly assigned either to an intervention condition (half-day high ropes course) or a wait-list control group. Measures were taken at baseline and four days post-intervention and on the day to measure intervention perceptions. Significant increases in self-efficacy and risk-taking propensity were observed for the intervention arm compared to the control arm. Greater intervention engagement and affective valence ratings were associated with self-efficacy change. These findings highlight the practical relevance of adventure-based experiences for organizations and educational institutions seeking to enhance young adults' self-confidence. Additionally, they emphasize the importance of tailoring interventions to individual needs and ensuring positive participant experiences to achieve desired outcomes.

Associations between restrictive feeding practices and children's dietary intake: Systematic review and meta-analyses

BACKGROUND

Parents' attempt to limit or restrict children's intake of 'unhealthy' or discretionary foods has been widely considered as a counterproductive feeding practice associated with poorer dietary outcomes, but empirical evidence is varied.

AIM

The present systematic literature review aimed to investigate the association between parental restriction and children's dietary intake.

METHOD

Studies were identified through PsycInfo, MEDLINE, CINAHL, Web of Science, and Scopus databases on April 29th, 2022. Included were peer-reviewed, English-language articles published between 2001 and 2022, with an effect size between restriction and children's intake of foods that are 'healthy' (i.e., fruit, vegetables, other general healthy foods) or 'discretionary' (i.e., sweet or savoury energy-dense/nutrient poor foods, high-sugar foods, high-salt/fat foods, and high-energy/sugar-sweetened beverages), or overall diet quality. Risk of bias was assessed using a quality assessment checklist designed to evaluate survey studies.

RESULTS

Included studies (n = 44) were most often conducted in the USA, cross-sectional, and participants were mothers. Effect sizes (k = 59) from 21 studies were used in nine meta-analyses investigating various healthy and discretionary dietary intake variables. No meta-analytic effects were statistically significant. Qualitative synthesis of effect sizes ineligible for meta-analysis (k = 91) identified patterns of associations between restriction and increased intake of healthy foods, and decreased intake of discretionary foods.

CONCLUSIONS

Studies used a diverse selection of measures of restriction and dietary intake, limiting the ability of this review to make accurate cross-study comparisons. However, results suggest that instead of restriction being detrimental for children's dietary outcomes, it may be unrelated, or associated with more beneficial dietary outcomes. Research that utilises validated measures of restriction and dietary outcomes and a longitudinal design is needed to clarify this association.

Objectively quantifying subjective phenomena: Measuring the flashed face distortion effect

Objectively quantifying subjective phenomena like visual illusions is challenging. We address this issue in the context of the Flashed Face Distortion Effect (FFDE), where faces presented in succession appear distorted and grotesque. We first show that the traditional method of quantifying FFDE - via subjective ratings of the level of distortion - is subject to substantial biases. Motivated by this finding, we develop an objective method for quantifying FFDE by introducing two design innovations. First, we create artificially distorted faces and ask subjects to discriminate between undistorted and objectively distorted faces. Second, we employ both an illusion condition, which includes a succession of 15 face flashes, and a control condition, which includes a single face flash and does not induce an illusion. Using these innovations, we quantify the strength of the face distortion illusion by comparing the response bias for identifying distorted faces between the illusion and control conditions. We find that our method successfully quantifies the face distortion, with subjects exhibiting a more liberal response bias in the illusion condition. Finally, we apply our new method to evaluate how the face distortion illusion is modulated by face eccentricity, face inversion, the temporal frequency of the face flashes, and presence of temporal gaps between consecutive faces. Our results demonstrate the utility of our objective method in quantifying the subjective illusion of face distortion. Critically, the method is general and can be applied to other phenomena that are inherently subjective.

Validation of the Coach Behavior in Sports Questionnaire: Towards dynamic assessments using the circumplex model for coach behavior

The development of the circumplex model for coach behavior recently provided researchers an integrative model to assess coach behavior. While the circumplex model has currently only been deployed in cross-sectional research designs using the Situations in Sports questionnaire (SISQ), it has clear potential within research on dynamics of coach behavior. However, the SISQ consists of vignette-based situations and is too extensive for such frequent administrations. Within the present study we therefore developed the Coach Behavior in Sports Questionnaire (CBSQ), a 32-item alternative for the SISQ which consists of general items rather than vignette-based situations. First, content validity of 54 initial pilot CBSQ items was tested in a sample of 34 expert coaches. Second, construct validity, predictive validity, and reliability of the 32-item CBSQ was tested in a sample of 689 athletes and 420 coaches. Third, within-person variability of coach behavior was longitudinally assessed using the 32-item CBSQ during a five-week training and game period in a sample of 31 coach-athlete dyads. The 32-item CBSQ showed to be a valid and reliable alternative for the SISQ. Also, coach behavior showed considerable within-person variability over the five-week period in all coaching styles and approaches. Additionally, a 24, 16, and 12-item version were tested to provide even shorter alternatives. The CBSQ opens new horizons for future longitudinal research and coach reflection programs based on the circumplex model for coach behavior.

The effects of coaches' pride and shame expressions on field hockey players' emotions and performance

In this study, we examined the effects of female coaches' nonverbal pride and shame expressions on female field hockey players' emotions and performance and considered the role of two potential moderating factors. Across two experiments, a between (emotional expression manipulation) within (pre- and post-manipulation) subjects design was employed. A female hockey coach was scripted to deliver performance feedback randomly displaying pride or shame to skilled players (Experiment 1, n = 38; Experiment 2, n = 44) after they had performed a passing test. Players then performed the passing test for a second time. In both experiments, players reported their emotions, perceptions of the coach, and connection with the coach. In Experiment 2, players also rated their emotion regulation ability. The results showed that displayed pride elicited pride in players while displayed shame elicited shame in players. Further, coaches' pride and shame expressions had differential effects on players' performance. Displayed pride consistently improved players' performance. Displayed shame mainly worsened performance, but players' ability to regulate their own emotions seemed to buffer these negative effects. There was further evidence that players' emotions could underpin the performance effects, particularly when players knew the coach. These findings advance the literature by providing further experimental evidence for when and how coaches' pride and shame expressions influence players' emotions and performance and have important practical implications for coaches aiming to optimize performance.

Depression and emotional eating in children and adolescents: A systematic review and meta-analysis

Major Depressive Disorder in youth is associated with obesity and adult cardiovascular disease (CVD) risk. Eating in response to emotions (emotional eating) is a potential contributing factor to this association. Although emotional eating is associated with Major Depressive Disorder in adults, findings in children and adolescents are mixed. This systematic review and meta-analysis aims to determine the association between depression and emotional eating in children and adolescents. Systematic searches were conducted in seven databases. Studies were included if the study population had a mean age of ≤18 years and assessed both depression and emotional eating using validated measures. The search generated 12,241 unique studies, of which 37 met inclusion criteria. Random-effects meta-analyses of study outcomes were performed. Thirty-seven studies (26,026 participants; mean age = 12.4 years, SD = 3.1) were included. The mean effect size was significant for both cross-sectional and longitudinal data (Hedges' g = 0.48, p < 0.0001; g = 0.37, p = 0.002, respectively), revealing a positive moderately strong association between depressive symptoms and emotional eating in youth. Among longitudinal studies, the association was stronger when depressive symptoms and emotional eating were assessed using child and adolescent self-report versus parent-report. No studies examined youth with a clinical diagnosis of depression. Meta-analyses revealed that depressive symptoms and emotional eating are positively associated in children and adolescents. However, further research in clinical samples is needed. Results raise the possibility for the importance of emotional eating in the link between depression and early CVD risk, though further examination is required to determine whether emotional eating is a potential treatment target to decrease CVD risk among adolescents with increased depression symptoms.

Exploring athletes' gendered views of coaches and their impact of coach competency ratings

This study draws on social role theory, role congruity theory, and the black sheep effect to explore athletes' gendered perceptions of coach competence. The study relied on a sample of 308 New Zealand athletes across sports levels and modalities who completed an online survey. Participants were randomly assigned to one of four vignettes, in which coach gender (female vs. male) and coaching style (communal vs. agentic) were manipulated, and athlete gender was considered. The results show that male and female coaches did not receive significantly different coach competency scores (relational and strategic competencies), that a communal coaching style was linked to higher ratings in both relational and strategic competencies, and that the interplay of athlete gender, coach gender, and gender conforming/non-conforming coaching style did not significantly affect coach competence scores. However, participants' comments to the open-ended question presented at the end of the survey suggest that athletes still hold gendered views of coaching competence at the elite level. We discuss the research and practical implications of our findings.

Effects of noise exposure on stress hormone changes during task performance in young Korean men: quasi-experimental study

Numerous studies have suggested that noise exposure might be associated with changes in stress hormone levels. However, quantitative evidence for these effects in humans is rare and remains controversial. This study aimed to investigate the acute effects of exposure to noise and its different levels on stress hormone changes in task performance. Quasi-experimental noise exposure environment was established for 90 male university student volunteers in their twenties, and each was exposed to different noise levels during task performance. The stress hormones tested included cortisol, adrenocorticotropic hormone (ACTH), adrenaline, and noradrenaline. A one-way ANOVA was performed to investigate differences in hormone levels measured in the three groups according to the noise exposure levels (35, 45, or 75 dB). Analysis of covariance (ANCOVA) was used to adjust for confounding factors that might affect hormone levels. After adjusting for confounders, significant exposure-dependent differences were found in hormone levels in salivary cortisol, serum cortisol, serum ACTH, and serum adrenaline. The amount of hormonal increase in 75 dB exposure group compared to 35 or 45 dB groups was detected. Similar results were also seen in the rate of change analysis. Our findings indicate that short-term noise exposure during task performance elevates stress hormone levels. Further, the extent of stress hormone alterations varies with noise exposure levels. Changes in hormone levels are an objective measure that may be used to identify health effects and stress responses in various noise environments.

The association of stress perception on anxiety, depression and sleep quality in parents of children with burns: The moderating effect of social support

OBJECTIVE

Few studies have explored the mental health status of parents of children with burns and the moderating effect of social support on them.

METHODS

A survey was performed with parents of 112 burn-injured children at a burn center in China. Their perceived stress, anxiety, depression, sleep quality, and social support were measured by the Chinese Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale.

RESULTS

➀ The prevalence of anxiety (46.43%), depression (52.67%) and poor sleep quality (43.75%) of parents indicated that they experienced emotional and sleep disorders;➁ The perceived stress was positively correlated with sleep quality, anxiety and depression（P＜0.01), and negatively correlated with perceived social support (p＜0.05); ➂ Social support had a significant moderating effect on their perceived stress and anxiety, depression, but not on their sleep quality. With high social support, parental perceived stress had a significant positive association on anxiety and depression, while with low perceived social support, parental perceived stress had no significant association on anxiety and depression.

CONCLUSION

Parents of burned children had increased stress, obvious symptoms of anxiety and depression, and poor sleep quality. Social support had a significant buffering effect on them under low pressure, and high pressure will hinder the buffering effect of social support on stress. Therefore, the ideal services to improve mental health should be provided for them to face different levels of stress.

Conceptualizing Fit in Surgical Residency Selection: The Experience in Otolaryngology-Head and Neck Surgery

OBJECTIVE

Fit is a crucial factor in surgical residency selection, but how this abstract concept is applied in practice is poorly understood. Person-environment (PE) fit theory suggests that there are multiple fit domains that can clarify usage: person-job, person-organization, and person-workgroup fit. We used PE fit theory to explore how otolaryngology residency selection committee (RSC) members operationalize the concept of fit.

DESIGN

One-hour focus groups were conducted in November 2022. Interview questions explored participants' definitions and uses of fit in the resident selection process. Transcripts were analyzed using directed qualitative content analysis to generate themes and evaluate how these align with PE fit domains.

SETTING

Society of University Otolaryngologists Annual Meeting breakout session in November 2022.

PARTICIPANTS

21 RSC members from 20 different otolaryngology-head and neck surgery departments participated in three seven-person focus groups.

RESULTS

Participants described aspects of fit that aligned with PE fit domains. Person-job included how applicants fit as both surgeons and residents. Person-organization included how applicants fit with the program's characteristics, program's mission, and the local community. Person-workgroup emphasized how applicants fit with current residents. Various challenges in the selection process limited the extent to which PE fit was operationalized, including 1) ambiguous uses of fit, 2) unique features of the match process, 3) lack of outcomes data for selection decisions, and 4) interactions with diversity, equity, and inclusion goals.

CONCLUSIONS

Fit manifests in various ways during the surgical residency selection process that parallel domains of PE fit theory. Recommendations are made to assist programs in using fit in resident selection, including clearly articulating definitions of fit to increase transparency in conversations. Further work on selection challenges is needed to maximize the utility of fit in practice.

An investigation of antecedents and consequences of green value internalisation among sampled UK enterprises

Despite the growing popularity of the concept of green value internalisation, research on how this concept is being accomplished at the enterprise level is still limited. The purpose of this study is to address this knowledge gap by drawing from previously known concepts of green value and value internalisation. It examines the antecedents and consequences of green value internalisation and evaluates how these environment-leaning approaches impact competitive advantage. This study uses the resource-based view and the stakeholder theory as theoretical lenses in linking green value internalisation to its antecedents and how these impact competitive advantage. A two-step approach involving a measurement model and a structural model was used to analyse survey data from 213 UK enterprises to validate the research hypotheses. Hypotheses testing shows that green value internalisation has a positive and significant impact on green criteria development. The results also show that external pressure positively and significantly affects green value internalisation. These findings extend prior knowledge by establishing the level of significance in the relationship among the antecedents and consequences in the research model. The research design for this study draws from a systematic literature review. The study offers rigorous empirical insights for implementing green value internalisation as a value-creating strategy. However, the antecedents and consequences examined in this study may not capture in detail all underlying constructs. Hence future studies should proffer valid and reliable instruments for these constructs. The findings provide managers from enterprises across a broad industry size range seeking to implement green value internalisation with resources for embedding an enterprise-level pro-environmental strategy.

Association Between Family History of Diabetes, Irrational Beliefs, and Health Anxiety with 10-Year Risk of Type 2 Diabetes Mellitus: the ATTICA Epidemiological Study (2002-2012)

BACKGROUND

This study aimed to examine the relationship between family history of diabetes, irrational beliefs, and health anxiety in the development of type 2 diabetes mellitus (T2DM).

METHOD

ATTICA is a prospective, cohort study (2002-2012). The working sample included 845 participants (18-89 years), free of diabetes at baseline. Α detailed biochemical, clinical, and lifestyle evaluation was performed, while participants' irrational beliefs and health anxiety were assessed through the Irrational Beliefs Inventory and the Whiteley index scale, respectively. We evaluated the association between the participants' family history of diabetes mellitus with the 10-year risk of diabetes mellitus, both in the total study's sample and separately according to their levels of health anxiety and irrational beliefs.

RESULTS

The crude 10-year risk of T2DM was 12.9% (95%CI: 10.4, 15.4), with 191 cases of T2DM. Family history of diabetes was associated with 2.5 times higher odds (2.53, 95%CI 1.71, 3.75) of T2DM compared to those without family history. Among participants with family history of diabetes, the highest likelihood of developing T2DM, regarding their tested psychological features (i.e., low/high irrational beliefs in the entire group, low/high health anxiety in the entire group, and low/high irrational beliefs, low/high healthy anxiety), had people with high irrational beliefs, low health anxiety (OR 3.70, 95%CI 1.83, 7.48).

CONCLUSIONS

The findings underline the important moderating role of irrational beliefs and health anxiety in the prevention of T2DM, among participants at increased risk of T2DM.

Investigating the Psychological Impact of Cyber-Sexual Harassment

The impact of cyber sexual harassment (CSH) on adult women and the factors influencing this impact are largely under-researched. Communication technologies provide novel means for people to threaten, communicate, and harass others. Victims of in-person sexual harassment (ISH) can experience negative symptoms of depression, anxiety, trauma, and negative body image. The current study explored the psychological impact of CSH in adult women to determine whether CSH predicts psychological difficulties. Adult female participants (N = 136) took part in an online, cross-sectional study; 44% of participants had experienced CSH and this was associated with higher levels of depression, anxiety, trauma, and body image dissatisfaction. Younger victims, those who had been in a relationship for a shorter amount of time, those who had previously experienced of ISH, and those who had a higher number of social media followers were more likely to have experienced CSH. When controlling for demographic variables, CSH predicted anxiety, depression, trauma, and body image dissatisfaction; however, experience of ISH impacted upon body-image dissatisfaction over and above CSH. There is a need to routinely ask individuals accessing mental health services whether online interactions cause harm. Future research should examine these phenomena in more ethnically diverse samples.

Putting Oneself Ahead of the Group: The Liability of Narcissistic Leadership

Integrating insights from interdependence theory with the narcissistic admiration and rivalry concept, we propose that a pivotal obstacle for narcissistic leaders is their inability to sustain benevolent perceptions over time. As people strive to interpret social behavior in terms of self- or other-interest, the narcissistic tendency of prioritizing self-interests over the collective may become apparent and eventually taint their reputation as a leader. We examined how interpersonal motive perceptions-based on attributions of self- and other-interest-would clarify the leadership paradox of narcissism. We tracked 472 participants in 119 teams across four time-points. Narcissistic rivalry (but not admiration) corresponded to increasingly negative leader effectiveness ratings. The extent to which individuals were perceived as self-maximizing and lacking concern for other interests was tightly connected to declines in leader effectiveness across time. Altogether, these results offer insight into how perceived interpersonal motives may explain the downfall of narcissistic leadership.

A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

Circadian markers as a predictor of response in the treatment of depression-A systematic review

Despite many available treatment options for depression, response rates remain suboptimal. To improve outcome, circadian markers may be suitable as markers of treatment response. This systematic review provides an overview of circadian markers that have been studied as predictors of response in treatment of depression. A search was performed (EMBASE, PUBMED, PSYCHINFO) for research studies or articles, randomized controlled trials and case report/series with no time boundaries on March 2, 2024 (PROSPERO: CRD42021252333). Other criteria were; an antidepressant treatment as intervention, treatment response measured by depression symptom severity and/or occurrence of a clinical diagnosis of depression and assessment of a circadian marker at baseline. 44 articles, encompassing 8,772 participants were included in the analysis. Although additional research is needed with less variation in types of markers and treatments to provide definitive recommendations, circadian markers, especially diurnal mood variation and chronotype, show potential to implement as response markers in the clinic.

Parental psychological control and depression, anxiety among adolescents: The mediating role of bedtime procrastination and moderating role of neuroticism

Studies have shown that maladaptive parenting styles, particularly parental psychological control may be an important risk factor for emotional problems in adolescence. However, the potential mechanisms behind this association are still not fully understood. To fill the research gap, this study investigated the relationship between parental psychological control and depression and anxiety among adolescents. It also explored the mediating effect of bedtime procrastination and the moderating effect of neuroticism through a moderated mediation analysis. A sample of 665 adolescents (331 girls) were recruited from two secondary schools in southern China. All participants completed standardized self-report questionnaires measuring the severity of parental psychological control, bedtime procrastination, depression, anxiety, and neuroticism. Data were analyzed using SPSS 25.0 and PROCESS macros. The results indicated that parental psychological control had a positive predictive effect on depression and anxiety among adolescents. Bedtime procrastination partially mediated the relationship between parental psychological control and depression, as well as parental psychological control and anxiety. Neuroticism was found to play a moderating role in the path from bedtime procrastination to depression and from bedtime procrastination to anxiety, with these effects being stronger for adolescents with higher levels of neuroticism. This study advances a deeper understanding of how and when or for whom parental psychological control is related to adolescents' severe depression and anxiety. Our findings suggest that intervention programs or strategies aimed at reducing parental psychological control and assisting adolescents in establishing healthy sleep hygiene practices should be developed to decrease the risk of depression and anxiety in adolescents.

Area measure of skin conductance in the Concealed Information Test

Skin conductance (SC) is one of the indices commonly used in the autonomic Concealed Information Test (CIT), but SC amplitude is sometimes difficult to quantify. This study investigated the applicability of SC area to the CIT as an unambiguous measure of SC. Secondary analyses of an existing dataset indicated that SC area could be used to classify examinees according to their knowledge status, although the equivalence of its performance with the SC amplitude was inconclusive. Classification performance was best when the SC signal was converted to the difference from question onset and summed over 10 s after question onset. SC area produced relatively consistent evaluations of differential responses based on the amplitude for inter-item comparisons. In addition, the classification performance of SC area exceeded the chance level even for participants who showed few measurable amplitudes (low-responsive participants). A possible implication is that a tonic increase in SC occurred in response to the relevant question even in low-responsive participants, who are traditionally excluded from analysis. The use of SC area might contribute to more impartial data evaluation and broader application of the CIT. These results indicate that SC area can be used as an alternative measure of SC in the CIT.

The Role of Leader-Member Exchange Relations and Individual Differences on Counterproductive Work Behavior

Although researchers have documented relations between abusive supervision and subordinate counterproductive work behavior (CWB), might CWB result from non-abusive treatment? We address the question by examining the relation between leader-member relations (LMX) and CWB as well as potential mediators and moderators of that relation. One hundred and eighty subordinates completed surveys assessing their LMX quality, entitlement, negative emotions, self-control, and CWB. Twenty-six supervisors also provided CWB data on 88 of those subordinates. We found that subordinates reporting lower quality relations with their supervisors were more likely to experience CWB than other subordinates and that anger mediated that relation. There was some support for the moderating effect of self-control on the negative emotion - CWB relation. Entitlement did not moderate the LMX - anger relation as hypothesized. One implication is that supervisors do not have to treat their subordinates poorly for the subordinates to react negatively and engage in behavior detrimental to their organization.

An Examination of the Inverse Relationship Between Dimensions of Political Skill and Interpersonal Conflict at Work: Exploring Perceived Control as a Mediating Factor

Political skill has been established as an antidote to workplace stress and strain. However, despite the scholarly attention it has attracted, we still know very little about mediating mechanisms that explain this relationship and the role of political skill dimensions in mitigating workplace stressors. Thus, in this study, we investigate the impact of perceived control as a mediating mechanism between the political skill dimensions (i.e., social astuteness, interpersonal influence, networking ability, apparent sincerity) and interpersonal conflict (i.e., stress arising due to social interactions). Structural equation modeling was applied to analyze the data collected from 370 employees in a textile organization. The study found that perceived control mediated the relationship of social astuteness, interpersonal influence, and networking ability with interpersonal conflict. It, however, did not mediate the link between apparent sincerity and interpersonal conflict. Limitations, implications, and directions for future research are also discussed.

The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations

Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r = .16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design.

Effects of adding adjuvants to propofol on the post-anesthesia cognitive function in patients undergoing gastroscopy/colonoscopy: a systematic review and meta-analysis

OBJECTIVES

This study aimed to elucidate the effects of propofol plus adjuvants on postoperative cognitive dysfunction (POCD) and patient satisfaction.

METHODS

Studies published up to September 2023 on the Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, Sinomed, PubMed, Embase, Cochrane Library, Web of Science, and Clinictrials.gov websites were searched. Binary summary of results was used for meta-analyses.

RESULTS

We included 18 studies (2691 patients). The combined sedation did not affect the processing speed (ES = 0.02, 95%CI: -0.01, 0.04; I2 = 79.3%, p < 0.001), attention (ES = 0.02, 95%CI: -0.02, 0.05; I2 = 95.0%, p < 0.001), nor working memory (ES = 0.02, 95%CI: -0.03, 0.06; I2 = 94.4%, p < 0.001) in CogState brief battery tool. A significant effect of combined sedation was observed in the domain of visual learning in CogState tool (ES = -0.03, 95%CI: -0.04, -0.02; I2 = 15.8%, p = 0.306). The TDT (ES = 4.96, 95%CI: 2.92, 7.00) indicates that combined sedation would increase error rates in the tests of cognitive function. The DSST (ES = 0.16, 95% CI: -0.44, 0.75) shown that combined sedation does not affect cognitive function. In addition, an insignificant difference in patient satisfaction between combined sedation and propofol alone was observed (ES = -0.03, 95%CI: -0.09, 0.02).

CONCLUSION

The available evidence suggests that propofol combined with adjuvants may affect POCD but not patient satisfaction.

REGISTRATION NUMBER

INPLASY2023110092.

Meta-analysis of the relationship between the number and location of perivascular spaces in the brain and cognitive function

BACKGROUND

Cerebral perivascular spaces are part of the cerebral microvascular structure and play a role in lymphatic drainage and the removal of waste products from the brain. Relationships of the number and location of such spaces with cognition are unclear.

OBJECTIVE

To meta-analyze available data on potential associations of severity and location of perivascular spaces with cognitive performance.

METHODS

We searched PubMed, EMBASE, Web of Science and the Cochrane Central Registry of Controlled Trials for relevant studies published between January 2000 and July 2023. Performance on different cognitive domains was compared to the severity of perivascular spaces in different brain regions using comprehensive meta-analysis. When studies report unadjusted and adjusted means, we use adjusted means for meta-analysis. The study protocol is registered in the PROSPERO database (CRD42023443460).

RESULTS

We meta-analyzed data from 26 cross-sectional studies and two longitudinal studies involving 7908 participants. In most studies perivascular spaces was using a visual rating scale. A higher number of basal ganglia perivascular spaces was linked to lower general intelligence and attention. Moreover, increased centrum semiovale perivascular spaces were associated with worse general intelligence, executive function, language, and memory. Conversely, higher hippocampus perivascular spaces were associated with enhanced memory and executive function. Subgroup analyses revealed variations in associations among different disease conditions.

CONCLUSIONS

A higher quantity of perivascular spaces in the brain is correlated with impaired cognitive function. The location of these perivascular spaces and the underlying disease conditions may influence the specific cognitive domains that are affected.

SYSTEMATIC REVIEW REGISTRATION

The study protocol has been registered in the PROSPERO database (CRD42023443460).

Connor Davidson resilience scores, perceived organizational support and workplace violence among emergency nurses

BACKGROUND

Workplace violence can threaten the physical and mental health of emergency nurses, increasing their mobility and burnout rates. However, little research has focused on how to mitigate the negative effects of workplace violence.

OBJECTIVES

To investigate the relationships among resilience scores, perceived organizational support, and workplace violence and to explore the mediating role of perceived organizational support in the relationship between resilience scores and workplace violence among emergency nurses.

RESEARCH DESIGN

A quantitative, cross-sectional study.

METHODS

From June to July 2023, 466 valid questionnaires were collected via the WeChat app Credamo Seeing Numbers. Participants were assessed using the Connor-Davidson Resilience Scale, the Perceived Organizational Support Scale, and the Fear of Future Violence at Work Scale.

ETHICAL CONSIDERATION

The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-389).

FINDINGS

The Connor-Davidson resilience scores of emergency nurses were negatively associated with workplace violence and positively associated with emergency nurses' perceived organizational support. Emergency nurses' perceived organizational support was negatively associated with workplace violence. Perceived organizational support moderated the relationship between Connor-Davidson resilience scores and workplace violence among emergency nurses to some extent.

DISCUSSION

High levels of Connor-Davidson resilience scores can mitigate the negative effects of workplace violence. Perceived organizational support can increase with increasing levels of Connor-Davidson resilience scores. When nurses face workplace violence, support from the organization can, on the one hand, reduce the negative impacts of stress and, on the other hand, elicit positive emotions.

CONCLUSION

To mitigate the effects of workplace violence on emergency nurses, interventions aimed at both internal and external organizational conditions must be developed to establish a supportive environment that can increase emergency nurses' Connor-Davidson resilience scores and sense of perceived organizational support, and decrease workplace violence.

Social Support and Physical Activity in College and University Students: A Meta-Analysis

Although physical activity (PA) has a profound impact on health, many college and university students are still physically inactive. There is some evidence to suggest that social support (SS) could impact the PA levels of students, but the internal relationship and specific effects are not very clear. The purpose of this review was to determine the strength of the relationship between SS and PA and examine whether any potential associations differed in terms of age, gender, and region among college and university students. Studies were identified using the following electronic databases: PubMed, SPORTDiscus, Web of Science, and Sociological Abstracts. Moderator analyses investigating the effects of students' age, gender, and region (nation) were performed. This review included 19 articles. The results showed total SS was significantly associated with PA (r = 0.30, 95% confidence interval [CI]: [0.22, 0.37], p < .001). With respect to different types of support, friend support was more strongly associated with PA than family support. Gender factors had a significant moderating effect on the correlation between SS and PA (QM = 17.433, p < .001). Separate analyses examining the moderating effects of gender (percentage of females) found that the association between SS and PA was stronger with the increase in female percentage. In conclusion, SS is an important factor associated with PA levels and should foster SS within intervention programs according to types of SS and gender differences to increase PA levels among college and university students.

Satisfied on our own, yet ready to leave together: An actor-partner interdependence mediation model on job satisfaction and turnover intentions in leader-follower dyads

Drawing on conservation of resources theory and job embeddedness, this study aims to investigate crossovers of positivity and negativiy between leaders and their followers with respect to work-related variables (i.e. work engagement, emotional exhaustion, job satisfaction and turnover intentions). Two waves of multisource data were collected from 244 leader-follower dyads. An actor-partner interdependence model extended to mediation (APIMeM) was used to test two mediation models and examine crossovers between leaders and their followers. Findings show that negative events are positively associated with emotional exhaustion of leaders (followers), which in turn is positively associated with leaders' (followers') own turnover intention as well as that of their followers (leaders). Positive events are positively associated with work engagement of leaders, which in turn is positively associated with leaders' own job satisfaction, but not with the job satisfaction of their followers. In other words, negative events have cross-over effects, while positive events do not. In essence, we found evidence of a crossovered negativity bias. This study is unique in using a dyadic approach to analyse leader-follower crossovers with respect to job satisfaction and turnover intention. This study reveals the mediating and cross-over effects of work engagement and emotional exhaustion on the links between positive (negative) events and work outcomes.

How to … grow a team in clinical education research

The Incubator for Clinical Education Research (ClinEdR) is a UK-wide network, established with support from the National Institute for Health and Care Research (NIHR), to lead initiatives to build capacity in the field. Our lived experiences as members of the NIHR ClinEdR Incubator and wider literature are woven into this 'How to …' paper, which outlines what to consider as you seek to grow and develop a ClinEdR team. This paper sets out pragmatic steps to grow an effective ClinEdR team that has a wider impact and mutual benefits for its members and their institution(s). Growing a ClinEdR team requires more than a dynamic character to bring people together. In our view, you can grow a ClinEdR team with other people through a structured, well-thought-out approach, in which its members develop through collaborative work to achieve a shared objective.

Trust and quality of life: A study in organizations for individuals with intellectual disability

BACKGROUND

Based on social exchange within organizations for individuals with intellectual disability, we explore trust between supervisors and team members and its association with organizational performance oriented to the quality of life of service users.

AIMS

We examine the mediating role of teams' trust in supervisors in the relationship between supervisors' trust in teams and performance focused on improving the quality of life of service users. We expect teams to reciprocate supervisors' trust by reporting greater levels of trust in supervisors and better performance.

METHOD AND PROCEDURES

We tested this trust-mediated model with a sample of 139 supervisors (reporting trust in their teams), 1101 team members (reporting trust in their supervisors), and 1468 family members (reporting performance focused on quality of life).

OUTCOMES AND RESULTS

Our findings confirmed a cross-level mediation process. Supervisors' trust in their teams leads to teams' trust in their supervisors. This trust at the team level in turn is positively associated with organizational performance oriented to improving the quality of life of individuals with intellectual disability, reported by family members.

CONCLUSIONS AND IMPLICATIONS

Our study builds on and extends an established stream of research on trust theory by considering trust and its association with performance focused on quality of life.

MediVizor: Visual Mediation Analysis of Nominal Variables

Mediation analysis is crucial for diagnosing indirect causal relations in many scientific fields. However, mediation analysis of nominal variables requires examining and comparing multiple total effects and their corresponding direct/indirect causal effects derived from mediation models. This process is tedious and challenging to achieve with classical analysis tools such as Excel tables. In this study, we worked closely with experts from two scientific domains to design MediVizor, a visualization system that enables experts to conduct visual mediation analysis of nominal variables. The visualization design allows users to browse and compare multiple total effects together with the direct/indirect effects that compose them. The design also allows users to examine to what extent the positive and negative direct/indirect effects contribute to and reduce the total effects, respectively. We conducted two case studies separately with the experts from the two domains, sports and communication science, and a user study with common users to evaluate the system and design. The positive feedback from experts and common users demonstrates the effectiveness and generalizability of the system.

AutoTitle: An Interactive Title Generator for Visualizations

We propose AutoTitle, an interactive visualization title generator satisfying multifarious user requirements. Factors making a good title, namely, the feature importance, coverage, preciseness, general information richness, conciseness, and non-technicality, are summarized based on the feedback from user interviews. Visualization authors need to trade off among these factors to fit specific scenarios, resulting in a wide design space of visualization titles. AutoTitle generates various titles through the process of visualization facts traversing, deep learning-based fact-to-title generation, and quantitative evaluation of the six factors. AutoTitle also provides users with an interactive interface to explore the desired titles by filtering the metrics. We conduct a user study to validate the quality of generated titles as well as the rationality and helpfulness of these metrics.

Triggered by your heart: Effects of cardioafferent traffic and stress on automatic responses in a Simon task

Variations in cardioafferent traffic are relayed to the brain via arterial baroreceptors and have been shown to modulate perceptual processing. However, less is known about the cognitive-behavioral consequences of these effects and their role during stress. Here, we investigated in how far automatic responses during the Simon task were modulated by exposure to a laboratory stressor and the different phases of the cardiac cycle. In this study, 30 participants performed three blocks of a combined horizontal and vertical Simon task, which is characterized by either sensorimotor or cognitive response conflicts, respectively. Before each block, subjects were exposed to both the cold pressor test (CPT) and a control condition according to a within-subjects design. Target stimuli were presented during either systole or diastole. Behavioral and EEG-correlates of task processing were assessed along with subjective, cardiovascular, and endocrine measures of stress. The stress induction was successful yielding significant increases in all these measures compared to control. Moreover, we found the expected Simon effects: in incompatible compared to compatible trials performance was decreased and LRP latency as well as anterior N2 area increased. Importantly, accuracy was improved in compatible but reduced in incompatible trials during systole vs. diastole but only in the horizontal Simon condition. Stress dampened N2 area, however, no interactions with cardiac cycle were evident. These results indicate a faciliatory effect of cardioafferent traffic on automated sensorimotor processes.

Assessing between-officer variability in responses to a live-acted deadly force encounter as a window to the effectiveness of training and experience

We aimed to infer the effectiveness of officers' training and experience by assessing consistency of behavioural responses between them. If officers facing the same scenario respond in similar ways, this implies their use of shared cognition, through acquired in-common tactical knowledge. Officers (n = 42) responded to a live-acted scenario in which an assailant ultimately discharged his weapon. Triangulated camera positions assessed their movement patterns, final positions, and weapon responses relative to when the assailant fired his weapon. We also assessed the officers' visual search and gathered information regarding their experience and rest. Our second aim was to examine sources of variability in the officers' responses. We found extensive variability in all aspects of the response. Experience did not impact spatial or temporal behavioural responses. However, longer hours awake and lower reported rest negatively impacted officers' responses. We conclude that officers had insufficient training and experience to demonstrate in-common knowledge.Practitioner summary: Police officers showed high spatial and temporal variability in response to the same scenario. This implies inadequate tactical training, and is supported by our finding that training and experience did not impact performance. Instead, the officers' variability was constrained by their visual search, and the hours awake before being tested.

Outcomes from Individual Alpha Frequency Guided Repetitive Transcranial Magnetic Stimulation in Children with Autism Spectrum Disorder - A Retrospective Chart Review

AIMS AND OBJECTIVES

Individual alpha frequency (IAF) is a biomarker of neurophysiological functioning. The IAF-guided repetitive transcranial magnetic stimulation (α-rTMS) is increasingly explored in diverse neurological conditions. However, there is limited data on the efficacy and safety of α-rTMS in children with autism spectrum disorder (ASD).

MATERIALS AND METHODS

The IAF, childhood autism rating scale (CARS), Pediatric Quality of Life Inventory 4.0 (PedsQLTM 4.0), and semi-structured interview data of patients that received 19 α-rTMS sessions (4 weeks) were aggregated and analysed using paired student t-test and descriptive method.

RESULTS

Data were retrieved from 28 patients (26 males, aged 3-9years (mean ± SD age: 6.1 ± 1.8years)). The post-α-rTMS data shows a significant improvement in IAF (9.4 Hz; p ≤ 0.025) towards 10 Hz. The CARS and PedsQLTM 4.0 surveys indicate that patients' ASD symptoms and quality of life improved significantly. Specifically, reports from semi-structured interviews suggest improved sleep trouble - the most significant comorbidity. The experiences of minor side effects such as hyperactivity resolved within two hours following α-rTMS sessions.

CONCLUSION

This study presents evidence on the efficacy and safety of α-rTMS in improving ASD symptoms, quality of life and comorbid sleep troubles in children. However, these findings should be interpreted as preliminary pending the presentation of double-blind, randomised clinical trials.

On Personality Measures and Their Data: A Classification of Measurement Approaches and Their Recommended Uses

We employ a new approach for classifying methods of personality measurement such as self-judgment, mental ability, and lifespace measures and the data they produce. We divide these measures into two fundamental groups: personal-source data, which arise from the target person's own reports, and external-source data, which derive from the areas surrounding the person. These two broad classes are then further divided according to what they target and the response processes that produce them. We use the model to organize roughly a dozen kinds of data currently employed in the field. With this classification system in hand, we describe how much we might expect two types of measures of the same attribute to converge-and explain why methods often yield somewhat different results. Given that each measurement method has its own strengths and weaknesses, we examine the pros and cons of selecting a given type of measure to assess a specific area of personality.

Professional burnout among expert physicians, patient-focused care, and trust in top management: Moving forward

INTRODUCTION

Professional burnout in physicians is perceived as an inevitable occupational hazard inhibiting patient-focused care, the preferred approach of care, which enhances satisfaction of physicians with their work and improves clinical outcomes. Burnout jeopardizes the physical, mental, and emotional health of physicians, inhibiting high-quality care. Most individual-driven interventions and job-level interventions to reduce burnout proved inefficient or reduced burnout for only a short term. The potential of organizational processes to reduce burnout was acknowledged but is yet to be empirically tested. Drawing on social exchange theory, this study investigates the role of an organizational phenomenon, organizational trust among physicians in top management, on burnout.

METHODS

Data were collected across specialties in 10 out of 20 Israeli public general hospitals. The sample comprised 798 senior expert physicians. Measures were all previously published. Structural equation modeling was performed.

RESULTS

Response rates ranged from 17% to 77% across the 10 hospitals. Mean burnout was 4.7 (SD = 0.68), mean patient-focused care was 3.9 (SD = 0.79), and mean organizational trust was 3.7 (SD = 0.84). Mean burnout for women was 5.6 and for physicians from internal medicine was 5.5. The structural equation modeling supported the proposed study model, which explained 45% of burnout. Organizational trust reduced burnout by 14%.

DISCUSSION

Efforts to reduce burnout should integrate effective individual-level and job-level interventions with building trust among physicians in top management through implementing the paramount professional value of patient-focused care.

CONCLUSIONS

Perceiving management, among physicians, as facilitating the value of patient-focused care led to organizational trust in top management, which was negatively associated with burnout.

Enduring education and employment: Examining motivation and mechanisms of psychological resilience

Resilience, the ability to bounce back from difficult events, is critical for an individual to negotiate stressors and adversity. Despite being widely studied, little is known about the processes involved in the development of resilience. The goal of the studies are to investigate the relationship between motivation orientation, emotional intelligence, cognitive appraisals, and psychological resilience. Two studies, using self-report questionnaires were conducted with employed young adults also enrolled in post-secondary studies (pre- and during the pandemic) to test the tenability of our proposed models. Study 1 and Study 2 showed that emotional intelligence and challenge appraisals were mediators of autonomous motivation and resilience. Study 2 revealed statistically significant differences in mean scores of autonomous motivation and emotional intelligence between non-pandemic students and pandemic students. Based on the findings, it is suggested that autonomous motivation, emotional intelligence, and challenge appraisals are important aptitudes for the development of resilience. Furthermore, findings suggest that social isolation caused by the pandemic may have affected levels of emotional intelligence. Ultimately, the research expands the literature on both self-determination theory and resilience by offering a unique multiple mediation model for predicting the development of resilience within the employed undergraduate population.

Going Above and Beyond With SJTs: Impact of Applicant Characteristics on Open Response SJT Participation

BACKGROUND

Situational judgment tests (SJT) have gained popularity as a standardized assessment of nontechnical competencies for applicants to medical school and residency. SJT formats range from rating the effectiveness of potential response options to solely open response. We investigated differences in test-taking patterns between responders and nonresponders to optional open response SJT questions during the application process.

METHODS

This was a prospective multi-institutional study of general surgery applicants to seven residency programs. Applicants completed a 32-item SJT designed to measure ten core competencies: adaptability, attention to detail, communication, dependability, feedback receptivity, integrity, professionalism, resilience, self-directed learning, and team orientation. Each SJT item included an optional, nonscored, open response space for applicants to provide a behavioral response if they desired. Trends in applicant gender, race, ethnicity, medical school ranking, and USMLE scores were examined between the responder versus nonresponder group.

RESULTS

In total, 1491 general surgery applicants were invited to complete the surgery-specific SJT. Of these, 1454 (97.5%) candidates completed the assessment and 1177 (78.9%) provided additional responses to at least one of the 32 SJT scenario sets. There were no differences in overall SJT performance, USMLE scores (Step 1: 235, SD 14, Step 2: 250, SD 11), race and/or ethnicity between the responder and nonresponder groups. Responders were more likely to be from a top 25 medical school (p < 0.05) compared to the nonresponder group. Among applicants who completed any open response questions, women completed a significantly higher number of questions compared to men (7.21 vs 6.07, p = 0.003). The number of open responses provided correlated with higher scores on SJT items measuring dependability (r = 0.07, p = 0.007).

CONCLUSIONS

SJT design and format has the potential to impact test-taker response patterns. SJT developers and adopters should ensure test format and design have no unintended consequences prior to implementation.

Gratification and its associations with problematic internet use: A systematic review and meta-analysis using Use and Gratification theory

Problematic Internet Use (PIU) has been a growing issue for two decades, and many researchers have sought to explain its occurrence. Use and Gratification Theory (UGT) has guided empirical studies investigating the associations between gratification and PIU. However, their results appear equivocal. This study aimed to synthesize research findings applying UGT and pinpoint the associations between different gratifications and PIU. Effect sizes were pooled to obtain an overall effect size. Gratifications were then classified into four types (i.e., content, social, self-presentation, and process) according to the suggestions of previous studies and the measurement of included studies. Based on 216 effect sizes from 57 samples with 38,492 participants (mean age = 24.3; 55.1 % female), random effect model analyses yielded a medium effect size (r = 0.303, p <.001, 95 % CI [0.263, 0.343]), indicating a positive association between general gratification and PIU. Subgroup analyses revealed that all four gratifications were positively associated with PIU; self-presentation showed the largest effect size, followed by process gratification.This study enhances the conceptual relevance of UGT in understanding PIU and highlights the importance of process and self-presentation gratification as predictors for PIU in certain contexts, such as among university students and in Asian countries.

Investigating the Relation of Political Orientation and Vaccination Outcomes: Identifying the Roles of Political Ideology, Party Affiliation, and Vaccine Hesitancy

Popular press and academic articles alike suggest that political orientation is a primary determinant of vaccination willingness, vaccination, and vaccine word-of-mouth (i.e., sharing of information regarding vaccines). In the current article, we test the validity of these suggestions, and we also assess the differential roles of political ideology (e.g., liberal-conservative) and party affiliation (e.g., Democrat-Republican) as well as the mediating effect of vaccine hesitancy's dimensions. To do so, we perform a four-wave survey study with 223 participants that completed all waves. Our results support that political orientation indeed relates to our outcomes of interest. Our results also show that political ideology has a more pronounced effect than party affiliation, and the vaccine hesitancy dimensions of Health Risks and Healthy mediate many of these relations. From these results, we suggest many directions for future research and practice, including the integration of political discourse theories in studies on political orientations and vaccination.

Teamwork Competencies and Their Influence on Health Literacy and Other Health Variables

The ability to work in a team is a skill of special relevance for multiple facets of life, increasing performance and optimizing the process in any task. This work aimed to study whether teamwork skills were related to different health variables. The sample consisted of 671 military personnel from the Spanish Army. The instrument is composed of the Health Literacy Questionnaire-the Teamwork Skills Questionnaire, and Rosenberg's self-esteem scale. The study concludes that the level of teamwork skills of the military is high, as well as their level of health literacy and their self-perception of health. However, their self-esteem is medium. Teamwork competencies are positively associated with a higher level of health literacy, with a high self-perception of their health, with the level of physical activity and negatively with self-esteem and the number of hospital admissions.

Preserving the placebo effect after disclosure: A new perspective on non-deceptive placebos

The present study explores whether a particular style of placebo disclosure could serve as a tool to foster a renewed trust in one's own inherent resources and elicit a meaningful placebo effect. In a motor performance task, two placebo groups received inert transcutaneous electrical nerve stimulation (TENS) in each of four sessions along with information on its force-enhancing properties. Before the final session, one of the placebo groups was informed about the placebo, which was portrayed as a means to unleash an inherent potential. Along with force, we systematically monitored task-specific self-efficacy to test whether this variable would be differentially modulated in the two placebo groups. Compared to two control groups, placebo groups showed higher force and self-efficacy in the last session. No differences in self-efficacy were observed in the placebo groups even after revealing the placebo procedure, suggesting that the disclosure was effective in 'safeguarding' individuals' self-efficacy. These findings may have important implications, paving the way for the use of placebos that not only are ethically permissible but also support individuals' self-efficacy.