Comparing the delirium objective structured clinical examination (OSCE) education package to standard education for post-registration nurses: A randomised controlled trial

BACKGROUND

A recent pilot study demonstrated that an interactive delirium educational intervention, The Delirium OSCE Education Package, had a positive impact on self-perceptions of confidence and competence in the use of delirium assessment tools and delirium knowledge; delirium knowledge scores; clinical practice; and planned practice change for participants. However, it is not known if The Delirium OSCE Education Package is superior to standard methods of professional development education.

OBJECTIVE

To determine if The Delirium OSCE Education Package is superior to standard methods of professional development education on observations of delirium care in practice scores for post-registration nurses.

DESIGN

Clustered randomised, controlled, and observer-blinded, multisite superiority trial with two parallel groups at each site.

SETTINGS

Three private hospitals across New South Wales, Australia.

PARTICIPANTS

Registered nurses (RNs) (n = 153) or enrolled nurses (ENs) (n = 37) working in the eligible inpatient medical or surgical wards at each site.

METHODS

Within each hospital site wards were clusters, with wards rather than individuals being randomised for The Delirium OSCE Education Package or standard professional development education at a ratio of 1:1. The primary outcome was observations of delirium care in practice, 6-weeks post (T1) allocated intervention. Secondary outcomes were self-perceived confidence and competence (self-efficacy) in delirium assessment tools and delirium knowledge; and delirium knowledge scores.

RESULTS

A total of 51.3 % (n = 20) in the intervention group obtained a satisfactory observation of delirium care in practice score, compared to 34.9 % (n = 15) in the control group (p = 0.134, χ2). The odds of a satisfactory observation of delirium care in practice score for the intervention group was 10.1 times higher than the control (p = 0.009). The mean MCQ score and perceptions of confidence and competence in the intervention and control group increased from baseline to six-weeks post-intervention, however, there was no significant difference between the groups.

CONCLUSION

The Delirium OSCE Education Package provides the foundation for facilitating change in delirium care. It is recommended that The Delirium OSCE Education Package is implemented as part of a multicomponent strategy involving a validation delirium screening and assessment tool, hospital-specific policy, interprofessional education, and delirium champions. Future studies are needed to evaluate the sustainability of the intervention and if there is a positive impact on patient-level outcomes.

Positive autobiographical memory recall does not influence temporal discounting: an internal meta-analysis of experimental studies

People tend to discount the value of future rewards as the delay to receiving them increases. This phenomenon, known as temporal discounting, may underlie many impulsive behaviors, such as drug abuse and overeating. Given the potential role of temporal discounting in maladaptive behaviors, many efforts have been made to find experimental manipulations that reduce temporal discounting. One class of manipulations that has held some promise involves recalling positive autobiographical memories prior to making intertemporal choices. Just as imagining positive future events has been shown to reduce temporal discounting, a few studies have shown that recalling positive past events reduces temporal discounting, especially if memory retrieval evokes positive affective states, such as gratitude and nostalgia. However, we failed to replicate these findings. Here we present an internal meta-analysis combining data from 14 studies (n = 758) that involved within-subjects positive memory recall-based manipulations. In each study, temporal discounting was assessed using a monetary intertemporal choice task. The average effect size was not significantly different from zero. This finding helps elucidate the neurocognitive mechanisms of temporal discounting; whereas engaging the episodic memory system to imagine future events might promote more patience, engaging the episodic memory system to imagine past events does not.

Association of Smoking Media Literacy with Vietnamese and South Korean Adolescents' Susceptibility to Smoking

Studies on how smoking media literacy (SML) is associated with susceptibility to smoking among adolescents in South Korea and Vietnam are scarce. Thus, we examined the association of SML with susceptibility to smoking among adolescents in these countries to initiate a collaborative global health program. In total, 460 adolescents (Vietnam: 277, South Korea: 183) aged 15-18 completed an online cross-sectional survey. SML was measured using the 15-item SML scale. Susceptibility to smoking was measured by three questions on future smoking and if offered a cigarette by a friend. A multiple logistic regression model explored the association of SML with susceptibility to smoking. The study revealed that higher SML was significantly associated with lower susceptibility to smoking among Vietnamese, but not South Korean adolescents. Further studies to identify pathways between other factors associated with SML and susceptibility to smoking are needed to develop culture-specific intervention strategies for smoking prevention.

An Integrative Scoping Review of Behavioral Economics Applications in Higher Education: Opportunities for Academic Pharmacy

OBJECTIVES

This integrative scoping review explores the applications of behavioral economics within higher education, particularly, through the lens of nudging (a concept that leverages insights from economics and psychology to guide individuals' decisions subtly). The primary objective is to provide a broad overview of interventions that use behavioral economics principles and, secondarily, discuss their potential to improve pharmacy education and create a foundation for future research in this area.

FINDINGS

The review analyzed 89 studies that applied behavioral economics principles in higher education settings. Reminders and prompts were the most frequently used principles, with generally positive outcomes, especially in enrollment management. Framing, incentives, and salience also demonstrated effectiveness, depending on the context. Social norms and simplification showed mixed results, whereas priming, loss aversion, feedback, comparison, and commitment had varying degrees of success in influencing behavior.

SUMMARY

Behavioral economics principles offer valuable insights and tools for enhancing various aspects of education. The review highlights the potential for using these principles to improve student engagement, enrollment processes, and health and well-being initiatives. However, it emphasizes the importance of context-specific design and careful implementation when applying these interventions. Future research opportunities exist to further explore the applications of behavioral economics in pharmacy education and beyond.

Examining the Effect of Depicting a Patient Affected by a Negative Reimbursement Decision in Healthcare on Public Disagreement with the Decision

BACKGROUND

The availability of increasingly advanced and expensive new health technologies puts considerable pressure on publicly financed healthcare systems. Decisions to not-or no longer-reimburse a health technology from public funding may become inevitable. Nonetheless, policymakers are often pressured to amend or revoke negative reimbursement decisions due to the public disagreement that typically follows such decisions. Public disagreement may be reinforced by the publication of pictures of individual patients in the media. Our aim was to assess the effect of depicting a patient affected by a negative reimbursement decision on public disagreement with the decision.

METHODS

We conducted a discrete choice experiment in a representative sample of the public (n = 1008) in the Netherlands and assessed the likelihood of respondents' disagreement with policymakers' decision to not reimburse a new pharmaceutical for one of two patient groups. We presented a picture of one of the patients affected by the decision for one patient group and "no picture available" for the other group. The groups were described on the basis of patients' age, health-related quality of life (HRQOL) and life expectancy (LE) before treatment, and HRQOL and LE gains from treatment. We applied random-intercept logit regression models to analyze the data.

RESULTS

Our results indicate that respondents were more likely to disagree with the negative reimbursement decision when a picture of an affected patient was presented. Consistent with findings from other empirical studies, respondents were also more likely to disagree with the decision when patients were relatively young, had high levels of HRQOL and LE before treatment, and large LE gains from treatment.

CONCLUSIONS

This study provides evidence for the effect of depicting individual, affected patients on public disagreement with negative reimbursement decisions in healthcare. Policymakers would do well to be aware of this effect so that they can anticipate it and implement policies to mitigate associated risks.

Determinants of physical activity during cancer treatment: a longitudinal exploration of psycho-cognitive variables and physician counseling

Individuals with cancer are recommended to engage in regular physical activity (PA) even during cancer therapy. The aim of this study was to explore how patient-reported physician PA counseling influences their PA intention and behavior in addition to psycho-cognitive determinants derived from the theory of planned behavior (TPB). A longitudinal study during cancer treatment was conducted among N = 115 patients with breast, prostate, or colorectal cancer (Mage = 58.0, SD = 11.5; 55.7% female). The median time since diagnosis was 2 months, and 19.1% were diagnosed with metastases. Participants provided information on PA counseling by their physicians and on psycho-cognitive variables of the TPB at three measurement points. Additionally, they wore accelerometers for seven days at baseline and three months later. Nearly half of participants (48%) reported basic PA counseling and 30% reported in-depth PA counseling. Patients in poorer health and with lower education reported significantly less in-depth counseling. In addition to patient self-efficacy in performing PA, only in-depth physician PA counseling, but not basic physician counseling, predicted intention for PA four weeks later. Patients' PA three months after baseline was predicted by patients' PA at baseline and their intention for PA. Overall, the PA level at baseline was identified as the most important predictor of PA three months later. Nevertheless, physicians seem to have the ability to increase their cancer patients' intention for PA by in-depth counseling.

HIV Activist Identity, Commitment, and Orientation Scale (HAICOS): Psychometric Evaluation to Assess Clinician's Propensity Towards HIV Activism in Malaysia

HIV activism has a long history of advancing HIV treatment and is critical in dismantling HIV-related stigma. This study evaluated the psychometric quality of the HIV Activist Identity, Commitment, and Orientation Scale (HAICOS) to assess clinicians' propensity towards HIV activism in Malaysia. From November 2022 to March 2023, 74 general practitioners and primary care physicians in Malaysia participated in the study. The exploratory factor analysis (EFA) extracted an internally consistent three-factor solution with 13 items: (1) HIV activist identity and commitment, orientation towards (2) day-to-day, and (3) structural activism. The Cronbach's alpha value was 0.91, and intra-class correlation coefficient for test-retest reliability was 0.86. Stigma-related (prejudice and discrimination intent) and clinical practice (comfort in performing clinical tasks with key populations and knowledge about HIV pre-exposure prophylaxis) measures supported the construct validity of the scale. The study provided concise, structurally valid, and reliable measures to evaluate HIV activism among clinicians.

Ecotourism and mangrove conservation in Southeast Asia: Current trends and perspectives

Mangroves in Southeast Asia provide numerous supporting, provisioning, regulating, and cultural services that are crucial to the environment and local livelihoods since they support biodiversity conservation and climate change resilience. However, Southeast Asia mangroves face deforestation threats from the expansion of commercial aquaculture, agriculture, and urban development, along with climate change-related natural processes. Ecotourism has gained prominence as a financial incentive tool to support mangrove conservation and restoration. Through a systematic literature review approach, we examined the relationships between ecotourism and mangrove conservation in Southeast Asia based on scientific papers published from 2010 to 2022. Most of the studies were reported in Indonesia, Malaysia, Philippines, Thailand, and Vietnam, respectively, which were associated with the highest number of vibrant mangrove ecotourism sites and largest mangrove areas compared to the other countries of Southeast Asia. Mangrove-related ecotourism activities in the above countries mainly include boat tours, bird and wildlife watching, mangrove planting, kayaking, eating seafood, and snorkeling. The economic benefits, such as an increase in income associated with mangrove ecotourism, have stimulated infrastructural development in ecotourism destinations. Local communities benefited from increased access to social amenities such as clean water, electricity, transportation networks, schools, and health services that are intended to make destinations more attractive to tourists. Economic benefits from mangrove ecotourism motivated the implementation of several community-based mangrove conservation and restoration initiatives, which attracted international financial incentives and public-private partnerships. Since mangroves are mostly located on the land occupied by indigenous people and local communities, ensuring respect for their land rights and equity in economic benefit sharing may increase their intrinsic motivation and participation in mangrove restoration and conservation initiatives. Remote sensing tools for mangrove monitoring, evaluation, and reporting, and integrated education and awareness campaigns can ensure the long-term conservation of mangroves while sustaining ecotourism's economic infrastructure and social amenities benefits.

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.

Looks and longevity: Do prettier people live longer?

Social scientists have given relatively scant attention to the association between attractiveness and longevity. But attractiveness may convey underlying health, and it systematically structures critical social stratification processes. We evaluated these issues using the Wisconsin Longitudinal Study (WLS, N = 8386), a survey of Wisconsin high school graduates from 1957 which provided large samples of women and men observed until their death (or through their early 80s). In doing so, we utilized a meticulously constructed measure of facial attractiveness based on the independent ratings of high-school yearbook photographs. We used linked death information from the National Death Index-plus through 2022 and Cox proportional hazard models as well as standard life-table techniques. We found that the least attractive rated sextile of the sample had significantly higher hazards of mortality (HR: 1.168, p < 0.01) compared to the middle rated four sextiles of attractiveness. This finding remained robust to the inclusion of covariates describing high-school achievement, intelligence, family background, earnings as adults, as well as mental and physical health in middle adulthood. We also found that different specifications of the attractiveness measure consistently indicated no significant differences in the mortality hazard between highly attractive and average-looking people. Using life-table techniques, we next illustrated that among women in the least attractive sextile, at age 20 their life expectancy was nearly 2 years less than others'; among men in the least attractive sextile, it was nearly 1 year less at age 20.

Athletic Trainers' Experiences With and Perceptions of Salary Negotiation Decision-Making During the Hiring Process

CONTEXT

Appropriate salaries for athletic trainers (ATs) have been a contentious topic for decades. Although professional advocacy efforts to increase ATs' salaries have gained traction, little is known about ATs' experiences with negotiation during the hiring process.

OBJECTIVE

To explore the reasons, influences, and factors influencing ATs' negotiation decisions.

DESIGN

Qualitative study.

SETTING

Individual video interviews.

PATIENTS OR OTHER PARTICIPANTS

Twenty-eight ATs who participated in a previous study and indicated a willingness to participate in the qualitative follow-up were interviewed (17 women, 10 men, 1 nonbinary individual; age = 37.8 ± 8.9 years, athletic training experience = 15.1 ± 8.3 years). Of the 28 participants, 18 did negotiate, whereas 10 did not.

DATA COLLECTION AND ANALYSIS

An individual video conference interview was conducted with each participant. After transcription, data were analyzed into themes and categories following the consensual qualitative research tradition. To ensure trustworthiness of the findings, we confirmed accuracy through member checks, triangulated the data using multianalyst research teams, and confirmed representativeness by including an external auditor.

RESULTS

Four parallel themes emerged during data analysis: factors for determining salary negotiation, reasons for negotiating/not negotiating, negotiation influencers/deterrents, and experiences with negotiation/impact of not negotiating.

CONCLUSIONS

Negotiators used a variety of data sources to support their requests, and their decisions were motivated by their own known value, the area's cost of living, and their current financial or employment situations. Negotiators relied on previous experiences to guide negotiations and provided successes and regrets from their negotiation experience. Nonnegotiators also used a variety of data types but were deterred by fear of not knowing how to negotiate, of losing the offer, or of offending those involved. Nonnegotiators highlighted a lack of confidence in their ability to negotiate and provided the financial consequences and personal regrets from not negotiating. More training, education, and publicly available data are needed to assist ATs in future negotiation attempts.

The antecedents, drivers and outcomes of employee family incivility in the workplace: A systematic review and future research avenues

Family Incivility has emerged as an important construct that may impact the employee's mental wellbeing and thus affect various organizational outcomes including financial and market related outcomes. The construct however is nascent stage of scholarly research. Thus through a systematic literature review we organise the scholarship till date on the theories, contexts and methods used to explore the construct We also propose a unique framework for employee family incivility and its impact on workplace that identifies and maps the antecedents, drivers and outcomes of family incivility. These two contributions would help both scholars and practitioners in further development of theory and practice. The study follows the PRISMA method for literature review which is an established and rigorous protocol to minimise the errors and biases. That identified 34 articles for the review that were analysed and synthesised for the findings. The third unique and novel contribution of the study is the identification of specific future research questions with reference to employee family incivility and workplace, based on the analysis done in the review.

Survey dataset of factors affecting Islamic donation intention in Malaysia

The present dataset investigates the factors that influence Malaysian Muslims' Islamic donation intentions. The research model was developed based on the integration of the theory of planned behavior (TPB) and social capital theory with six latent variables. A self-administrated survey of 400 Muslims with various demographic characteristics yielded the dataset in February 2024. The dataset was the basis for identifying factors that influence Muslims' Islamic donation intentions, thereby helping scholars and Islamic non-profit organisations understand how Malaysian Muslims participated in donation activities by interacting with religious commitment, institutional trust, attitude, subjective norms, and perceived behavioral control.

The effect of therapeutic and deterrent messages on Internet users attempting to access 'barely legal' pornography

Online child sexual abuse material (CSAM) is a growing problem. Prevention charities, such as Stop It Now! UK, use online messaging to dissuade users from viewing CSAM and to encourage them to consider anonymous therapeutic interventions. This experiment used a honeypot website that purported to contain barely legal pornography, which we treated as a proxy for CSAM. We examined whether warnings would dissuade males (18-30 years) from visiting the website. Participants (n = 474) who attempted to access the site were randomly allocated to one of four conditions. The control group went straight to the landing page (control; n = 100). The experimental groups encountered different warning messages: deterrence-themed with an image (D3; n = 117); therapeutic-themed (T1; n = 120); and therapeutic-themed with an image (T3; n = 137). We measured the click through to the site. Three quarters of the control group attempted to enter the pornography site, compared with 35 % to 47 % of the experimental groups. All messages were effective: D3 (odds ratio [OR] = 5.02), T1 (OR = 4.06) and T2 (OR = 3.05). Images did not enhance warning effectiveness. We argue that therapeutic and deterrent warnings are useful for CSAM-prevention.

Do mturkers collude in interactive online experiments?

One of the issues that can potentially affect the internal validity of interactive online experiments that recruit participants using crowdsourcing platforms is collusion: participants could act upon information shared through channels that are external to the experimental design. Using two experiments, I measure how prevalent collusion is among MTurk workers and whether collusion depends on experimental design choices. Despite having incentives to collude, I find no evidence that MTurk workers collude in the treatments that resembled the design of most other interactive online experiments. This suggests collusion is not a concern for data quality in typical interactive online experiments that recruit participants using crowdsourcing platforms. However, I find that approximately 3% of MTurk workers collude when the payoff of collusion is unusually high. Therefore, collusion should not be overlooked as a possible danger to data validity in interactive experiments that recruit participants using crowdsourcing platforms when participants have strong incentives to engage in such behavior.

Identifying Behavior Change Techniques in an Artificial Intelligence-Based Fitness App: A Content Analysis

In the field of artificial intelligence-based fitness apps, the effective integration of behavior change techniques (BCTs) is critical for promoting physical activity and improving health outcomes. However, the specific BCTs employed by apps and their impact on user engagement and behavior change are not explored sufficiently. This study investigates the Freeletics fitness app through a mixed-methods approach to evaluate the use of BCTs. In the quantitative analysis, fifteen unique BCTs were identified based on the Behavior Change Technique Taxonomy (V1). In the qualitative analysis, user reviews (n=400) were examined to understand perspectives on the app's effectiveness in promoting behavior change. Goal setting, action planning, self-monitoring of behavior, and social support were among the most prevalent BCTs identified in the Freeletics app, and their effectiveness in enhancing user engagement and promoting behavior change was also highlighted by user reviews. Among the areas of improvement identified in the study were the need for simplifying personalization options and addressing user concerns regarding the specificity of feedback. The study underscores the importance of integrating BCTs effectively within AI-based fitness apps to drive user engagement and facilitate behavior change. It contributes valuable insights into the design and implementation of BCTs in fitness apps and offers recommendations for developers, emphasizing the significance of goal setting, feedback mechanisms, self-monitoring, and social support. By understanding the impact of specific BCTs on user behavior and addressing user concerns, developers can create more effective fitness apps, ultimately promoting healthier lifestyles and positive behavior change.

The effectiveness of taught, self-help mindfulness-based interventions on Chinese adolescents' well-being, mental health, prosocial and difficult behavior, and coping strategy

Despite China's enduring historical connection with mindfulness and the growing recognition of mindfulness-based interventions (MBIs) in Western education, mindfulness remains relatively underexplored in the Chinese education system. This study addresses the scarcity of resources and certified instructors in China by assessing the effectiveness of MBIs in both taught and self-help forms in improving well-being and prosocial behavior and regulating negative emotions and behaviors among Chinese adolescents. The analysis included 362 Chinese students (mean age = 13.03, SD = 0.50, 47.5% girls) from 12 classes, assigned to the taught MBI group (N = 129, post), self-help MBI group (N = 116, post), or control group (N = 117, post). Paired-sample t-tests and multi-level modeling were used, accounting for data nesting and incorporating gender, whether students live in school, and age as covariates. Results revealed a significantly greater improvement in well-being in the taught group compared with the control, with both MBI groups demonstrating increased prosocial behavior. While the taught group showed a significant decrease in loneliness, it was accompanied by an increase in internalizing problems. Coping strategies varied across the groups, with no significant changes in depression, anxiety, and stress levels. These findings imply the potential value of integrating MBIs into the Chinese educational system, especially given the self-help approach's favorable outcomes.

Does a person's body size and the application type influence healthcare students' perceptions of technologies to promote physical activity? Findings from a cross-sectional study

BACKGROUND

Recent evidence suggests that weight bias may be pervasive, even among health professionals specialized in obesity, including healthcare students. Technology-based physical activity interventions are promising for people with obesity, specifically when they are theory-driven (e.g., autonomy-supportive as described by self-determination theory). However, perceptions of these technologies have been understudied among healthcare students and professionals.

OBJECTIVE

The purpose of this study was to examine the influence of a person's body size based on body mass index and technology type on healthcare students' perceptions.

DESIGN

This is a cross-sectional, experimental study.

PARTICIPANTS AND METHODS

Five hundred and two healthcare students (360 females, 142 males; mean age = 23.3, SD = 5.0) were randomly exposed to one of four scenarios that manipulated a hypothetical person's body mass index (22 kg/m2 vs. 42 kg/m2) and a technology-based physical activity type based on self-determination theory (autonomy-supportive app vs. controlling app). They then completed measures of their perceptions of the person's app acceptability and self-efficacy and of their intention to recommend the app. Multivariate and univariate analyses of covariance were performed.

RESULTS

Students exposed to the larger-bodied people (42 kg/m2) versus the smaller-bodied people (22 kg/m2) perceived a lower level of person's app acceptability (i.e., higher social influence and less enjoyment in using the app), as well as a lower level of self-efficacy to use the technology. Students exposed to the controlling app were more likely to recommend it compared to those exposed to the autonomy-supportive app.

CONCLUSIONS

These results suggest that healthcare students' attitudes may be negatively influenced by explicit weight bias. Also, in contrast to self-determination theory precepts, a controlling app may be more frequently recommended. Further study of healthcare students' implicit attitudes toward technology is needed.

Randomized Controlled Trial Evaluating the Effectiveness of a Direct-to-Consumer Marketing Video About Patients' Right to Evidence-Based Mental Health Care

ABSTRACT

This study evaluated the impact of a direct-to-consumer (DTC) marketing video designed to educate the public about patients' rights to evidence-based mental health care (EBMHC). Participants ( N = 632) were randomly assigned to an active DTC video condition, a control video condition, or a control condition without a video. Participants who watched the DTC video ( vs . both control conditions) had significantly greater knowledge of patients' rights to EBMHC. Further, individuals who watched the DTC ( vs . control) video reported significantly greater comfort with accessing care and perceived their assigned video as significantly more culturally sensitive. However, participants who watched the DTC video were not significantly different from both control conditions on self-report measures of self-efficacy in working with a provider, likelihood of asking a provider about one's rights, treatment-seeking intentions, and self-stigma. Findings suggest the potential for a DTC video to promote knowledge of EBMHC, though its impact on help-seeking perceptions and intentions was less promising.

A Bayesian approach to reveal the role of psychological factors on turnover intention among nurses during the COVID-19 pandemic

BACKGROUND

Turnover intention is considered a significant challenge for healthcare and treatment organizations. The challenging conditions of treating COVID-19 patients and the physical and mental stress imposed on nurses during the pandemic may lead them to leave their jobs. The present study aimed to determine the role of psychological factors (general health, mental workload, work-family conflicts, and resilience) on turnover intention using a Bayesian approach during the COVID-19 pandemic.

METHODS

The present cross-sectional study was carried out during the winter of 2021 at three hospitals in Khuzestan Province, Iran. To collect data for this investigation, 300 nurses were chosen based on Cochran's formula and random sampling technique. Seven questionnaires, including General Health, Mental Workload, Work-Family Conflict, Resilience, Job Stress, Fear of COVID-19, and Turnover Intention Questionnaires. Bayesian Networks (BNs) were used to draw probabilistic and graphical models. A sensitivity analysis also was performed to study the effects of the variables. The GeNIe academic software, version 2.3, facilitated the examination of the Bayesian network.

RESULTS

The statistically significant associations occurred between the variables of fear of COVID-19 and job stress (0.313), job stress and turnover intention (0.302), and resilience and job stress (0.298), respectively. Job stress had the highest association with the fear of COVID-19 (0.313), and resilience had the greatest association with the work-family conflict (0.296). Also, the association between turnover intention and job stress (0.302) was higher than the association between this variable and resilience (0.219). At the low resilience and high job stress with the probability of 100%, the turnover intention variable increased by 20%, while at high resilience and low job stress with the probability of 100%, turnover intention was found to decrease by 32%.

CONCLUSION

In general, the results showed that four psychological factors affect job turnover intention. However, the greatest impact was related to job stress and resilience. These results can be used to manage job turnover intention in medical environments, especially in critical situations such as COVID-19.

Social decision-making in major depressive disorder: A three-level meta-analysis

Major Depressive Disorder (MDD) is frequently associated with social dysfunction and impaired decision-making, but its impact on social decisions remains unclear. Thus, we conducted a series of meta-analyses to examine the effects of MDD on key social decision phenomena, including trust, altruistic punishment, and cooperation. We searched Web of Science, PubMed, PsycINFO, and Embase up to December 2023, using Hedges' g to compare social decision-making between MDD patients and healthy controls (HCs). Meta-analytic results showed that MDD patients exhibited a significant reduction in trust (Hedges' g = -0.347, p < 0.001), no significant difference in altruistic punishment (Hedges' g = 0.232, p = 0.149), and an increase in cooperative behaviors (Hedges' g = 0.361, p = 0.002) compared to HCs. The moderation analysis revealed that age (p = 0.039) and region (p = 0.007) significantly moderated altruistic punishment, with older MDD patients and those from Asian and European regions having larger MDD-HC contrast than others. Regarding cooperation, moderation analysis indicated that age (p = 0.028), years of education (p = 0.054), and treatment coverage (p = 0.042) were significant moderators, indicating larger MDD-HC contrast in older, less-educated and better-treated people. These findings suggest MDD has different impacts on different social decisions, highlighting the need for fine-tuned therapeutic interventions that address these differences. The data also underscores the importance of considering demographic and treatment-related variables in managing MDD, which could inform personalized treatment strategies and improve social functionality and patient outcomes.

How does a school-based intervention impact students' social cognitions on reducing sedentary behavior over 14 months?

Despite sedentary behavior being ubiquitous in students and detrimental to health, interventions specifically targeting it are mostly restricted to leisure time screen time reduction. With six weekly sessions alongside a poster campaign and an additional teacher intervention, the Let's Move It trial delivered environmental and psychological strategies to increase physical activity (PA) and reduce sedentary behavior (SB) in vocational schools, an understudied environment for behavioral interventions. Participants in the intervention arm considerably reduced sedentary time post-intervention. To investigate how social cognitions about restricting SB, as defined by the Reasoned Action Approach, change in intervention and control arms, self-reported data on social cognitions was collected as part of a cluster-randomized controlled trial from 1166 students (59% female, mage = 18.7 years, range: 16-49) in six vocational schools before, post-intervention, and 14 months post-baseline. Data were analyzed using mixed between-within repeated measures ANOVA. We found greater improvements in intention (F(1, 833) = 9.69; η2p = 0.01; p = .018) and descriptive norms (F(1, 831) = 13.25; η2p = 0.016; p < .001) in the intervention than control arm, but these effects depended on the included control variables. Generally, intervention effects leveled off from post-intervention to follow-up. The Let's Move It intervention for SB reduction showed modest, short-lived effects on social cognitions, indicating that changes in behavior are likely due to other factors like changes to the classroom environment. Optimally, SB reduction interventions should not only change behavior but produce robust changes in conscious intentions to restrict one's sitting, so that positive effects generalize to other contexts.

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.

Judgement and Decision Making in Clinical and Return-to-Sports Decision Making: A Narrative Review

Making return-to-sport decisions can be complex and multi-faceted, as it requires an evaluation of an individual's physical, psychological, and social well-being. Specifically, the timing of progression, regression, or return to sport can be difficult to determine due to the multitude of information that needs to be considered by clinicians. With the advent of new sports technology, the increasing volume of data poses a challenge to clinicians in effectively processing and utilising it to enhance the quality of their decisions. To gain a deeper understanding of the mechanisms underlying human decision making and associated biases, this narrative review provides a brief overview of different decision-making models that are relevant to sports rehabilitation settings. Accordingly, decisions can be made intuitively, analytically, and/or with heuristics. This narrative review demonstrates how the decision-making models can be applied in the context of return-to-sport decisions and shed light on strategies that may help clinicians improve decision quality.

Connecting through touch: Attitudes toward touch in pregnancy are associated with couples' sexual and affectionate behaviors across the transition to parenthood

Touch is a universal nonverbal action often used by romantic partners to demonstrate affection and care for each other. Attitudes toward touch might be particularly relevant across periods of relational strain-such as the transition to parenthood-when couples face many novel stressors and shifting priorities which can interfere with their sexual and affectionate experiences. New parent couples (N = 203) completed self-report measures online across six time-points (two prenatal). We tested whether couples' attitudes toward touch (touch aversion, touch for affection, touch for emotion regulation) at baseline (20 weeks mid-pregnancy) predicted their frequency of sexual and affectionate behaviors from mid-pregnancy through 12-month postpartum. Both partners' more positive attitudes toward touch (i.e., for affection and emotion regulation) and lower aversive attitudes toward touch, as measured in mid-pregnancy, predicted couples' higher frequency and variety of sexual and affectionate behaviors at 3-month postpartum. Touch attitudes generally did not predict the degree of change in the frequency or variety of sexual or affectionate behaviors, with one exception: non-birthing parents' more positive attitudes toward touch for emotion regulation in mid-pregnancy predicted a slower decline in couples' affectionate behaviors across pregnancy. Findings underscore a link between new parents' attitudes toward touch and their subsequent sexual and affectionate behaviors, particularly in the early postpartum period. New parents need to navigate novel sexual changes and a nonverbal strategy such as touch might be useful to promote intimacy and care.

How experts and novices judge other people's knowledgeability from language use

How accurate are people in judging someone else's knowledge based on their language use, and do more knowledgeable people use different cues to make these judgments? We address this by recruiting a group of participants ("informants") to answer general knowledge questions and describe various images belonging to different categories (e.g., cartoons, basketball). A second group of participants ("evaluators") also answer general knowledge questions and decide who is more knowledgeable within pairs of informants, based on these descriptions. Evaluators perform above chance at identifying the most knowledgeable informants (65% with only one description available). The less knowledgeable evaluators base their decisions on the number of specific statements, regardless of whether the statements are true or false. The more knowledgeable evaluators treat true and false statements differently and penalize the knowledge they attribute to informants who produce specific yet false statements. Our findings demonstrate the power of a few words when assessing others' knowledge and have implications for how misinformation is processed differently between experts and novices.

Effects of portraying an innocent versus non-innocent identified victim on intentions to donate organs post-mortem

The need for more people to register as organ donors is a pressing concern. This preregistered experiment examined whether portraying a patient in need of an organ transplant as leading a healthy lifestyle (an "innocent victim") can serve to increase people's intentions to register as post-mortem organ donors. Participants not previously registered as organ donors (N = 348) were randomly assigned to an innocent identified victim, non-innocent identified victim, or statistical victims condition. The identified victim was a 42 year-old woman in need of a liver transplant. The experimental manipulation produced marginally significant effects on self-reported intentions to register as an organ donor. Moreover, participants in the innocent victim condition were more likely relative to those in the non-innocent victim condition to sign up on an e-mail list to receive additional information about organ donation.

Recruitment of magnitude representations to understand graded words

Language understanding and mathematics understanding are two fundamental forms of human thinking. Prior research has largely focused on the question of how language shapes mathematical thinking. The current study considers the converse question. Specifically, it investigates whether the magnitude representations that are thought to anchor understanding of number are also recruited to understand the meanings of graded words. These are words that come in scales (e.g., Anger) whose members can be ordered by the degree to which they possess the defining property (e.g., calm, annoyed, angry, furious). Experiment 1 uses the comparison paradigm to find evidence that the distance, ratio, and boundary effects that are taken as evidence of the recruitment of magnitude representations extend from numbers to words. Experiment 2 uses a similarity rating paradigm and multi-dimensional scaling to find converging evidence for these effects in graded word understanding. Experiment 3 evaluates an alternative hypothesis - that these effects for graded words simply reflect the statistical structure of the linguistic environment - by using machine learning models of distributional word semantics: LSA, word2vec, GloVe, counterfitted word vectors, BERT, RoBERTa, and GPT-2. These models fail to show the full pattern of effects observed of humans in Experiment 2, suggesting that more is needed than mere statistics. This research paves the way for further investigations of the role of magnitude representations in sentence and text comprehension, and of the question of whether language understanding and number understanding draw on shared or independent magnitude representations. It also informs the role of machine learning models in cognitive psychology research.

Moral decision-making in context: Behavioral and neural processes underlying allocations based on need, merit, and equality

How to fairly allocate goods is a key issue of social decision-making. Extensive research demonstrates that people do not selfishly maximize their own benefits, but instead also consider how others are affected. However, most accounts of the psychological processes underlying fairness-related behavior implicitly assume that assessments of fairness are somewhat stable. In this paper, we present results of a novel task, the Re-Allocation Game, in which two players receive an allocation determined by the computer and, on half of the trials, one player has the subsequent possibility to change this allocation. Importantly, prior to the receipt of the allocation, players were shown either their respective financial situations, their respective performance on a previous simple task, or random information, while being scanned using functional neuroimaging. As expected, our results demonstrate when given the opportunity, participants allocated on average almost half the money to anonymous others. However, our findings further show that participants used the provided information in a dynamic manner, revealing the underlying principle based on which people re-allocate money - namely based on merit, need, or equality - switches dynamically. On the neural level, we identified activity in the right and left dorsolateral prefrontal cortices related to context-independent inequity and context-dependent fairness information respectively when viewing the computer-generated allocations. At the same time, activity in the temporoparietal and precuneus represented these different types of fairness-related information in adjacent and partially overlapping clusters. Finally, we observed that the activity pattern in the precuneus and putamen was most clearly related to participants' subsequent re-allocation decisions. Together, our findings suggest that participants judge an allocation as fair or unfair using a network associated with cognitive control and theory-of-mind, while dynamically switching between what might constitute a fair allocation in a particular context.

A randomized trial of 'fresh start' text messaging to improve return to care in people with HIV who missed appointments in South Africa

OBJECTIVE

Treatment interruptions are a barrier to successful antiretroviral therapy (ART). 'Fresh start messages', which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the potential to encourage people with HIV (PWH) to return to care. We evaluated a 'fresh start' intervention (text messages) to increase return to care in PWH who had missed their last appointment.

DESIGN

A three arm 1 : 1:1 individual randomised controlled trial.

METHODS

We randomized adults in Capricorn District who had missed ART appointments by >28 days to: no text message; unframed messages (fresh start not mentioned); or framed messages (fresh start mentioned). Randomization was stratified by treatment interruption duration and across two holidays (Youth Day, Mandela Day). The primary outcome was an ART-related clinic visit at ≤45 days of the first message.

RESULTS

9143 participants were randomised. For Youth Day, 1474 and 1468 were sent unframed and framed messages respectively, with 13.4% sent these messages having an ART visit vs. 11.9% not sent a message [adjusted odds ratio (aOR) 1.2; 95% confidence interval (CI): 1.0-1.4, P -value = 0.075]. For Mandela Day, 1336 and 1334 were sent unframed and framed messages respectively, with 6.7% sent these messages having an ART-related clinic visit vs. 5.4% not sent a message (aOR 1.2; 95% CI: 1.0-1.6; P -value = 0.100).

CONCLUSIONS

Low-cost text messages sent around a 'fresh start' date may increase the likelihood that patients who miss appointments return to care. This study suggests the potential of text messaging for motivating return to care.

'Let's talk about sleep health' within primary care: a qualitative study of patients' willingness to engage in psychological interventions for insomnia

BACKGROUND

Cognitive behavioural therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia yet remains underutilised in general practice. Understanding patient motivations and barriers to engaging in psychological interventions for insomnia is critical. Theoretical frameworks, such as the theory of planned behaviour, are needed to identify variables related to intentions and behaviour change.

AIM

To explore key influences that motivate individuals' intention to engage with psychological interventions for insomnia.

DESIGN AND SETTING

Qualitative study consisting of an online survey and interviews with 20 community-dwelling participants with insomnia aged 26-75 years residing in Victoria, Australia.

METHOD

Guided by the theory of planned behaviour, reflexive thematic analysis was used to identify factors influencing participants' intention to engage with psychological interventions for insomnia.

RESULTS

Participants reported positive attitudes towards psychological interventions for insomnia, stemming from negative beliefs about pharmacological sleep aids and the perceived benefits of a structured and evidence-based intervention. Important others positively influenced participants' intention to engage; however, the GP influence was less consistent and often indirect. Participants believed in the efficacy of psychological interventions, but several barriers hampered their ability to benefit from them. Accessibility was identified as a key facilitator, whereas lack of knowledge and clear referral pathways were the main barriers having an impact on uptake.

CONCLUSION

This study highlights key factors influencing patients' intention to engage in psychological interventions for insomnia as well as opportunities for GPs to support uptake and engagement. Routine conversations about sleep health are essential to reduce the burden of untreated insomnia in the community, and the active promotion of evidence-based psychological interventions is needed.

Promoting Erroneous Divergent Opinions Increases the Wisdom of Crowds

The aggregation of many lay judgments generates surprisingly accurate estimates. This phenomenon, called the "wisdom of crowds," has been demonstrated in domains such as medical decision-making and financial forecasting. Previous research identified two factors driving this effect: the accuracy of individual assessments and the diversity of opinions. Most available strategies to enhance the wisdom of crowds have focused on improving individual accuracy while neglecting the potential of increasing opinion diversity. Here, we study a complementary approach to reduce collective error by promoting erroneous divergent opinions. This strategy proposes to anchor half of the crowd to a small value and the other half to a large value before eliciting and averaging all estimates. Consistent with our mathematical modeling, four experiments (N = 1,362 adults) demonstrated that this method is effective for estimation and forecasting tasks. Beyond the practical implications, these findings offer new theoretical insights into the epistemic value of collective decision-making.

Factors Associated With Reporting Attitudes of Work-Related Musculoskeletal Disorders Among Direct Care Workers in South Korea

BACKGROUND

Workers' reporting of work-related injuries or illnesses is important for treatment and prevention, yet research often focuses on reporting barriers. This study aimed to identify factors related to work-related musculoskeletal disorder (WRMSD) reporting attitudes and their connection to reporting intention and behavior.

METHODS

We analyzed data from 377 direct care workers employed in 19 long-term care facilities in South Korea. A self-administered questionnaire collected demographics, job characteristics, physical and psychosocial factors, musculoskeletal symptoms, reporting attitudes, and WRMSD reporting intentions and behavior between May and August 2022. We used a generalized linear mixed model with a random intercept by employers to identify factors influencing reporting attitudes. To explore the relationship between reporting attitude and reporting intention and behavior, simple logistic regression was also conducted.

RESULTS

We achieved an 86% response rate. The majority of the study participants were female (87.2%), married (95.9%), and non-immigrant (72.8%). Of the study participants, 48.9% had no intention to report WRMSDs, and 44.3% held negative reporting attitudes. Among 200 workers with WRMSDs, 86.5% did not report them. Attitudes were associated with work duration, safety training, management safety priority, WRMSD experience, and symptom severity and frequency. Management safety priority did not moderate this relationship. Significant links existed between attitudes and reporting intention and behavior.

CONCLUSIONS/APPLICATIONS TO PRACTICE

This study highlights the vital influence of workers' attitudes on reporting work-related injuries and illnesses. Occupational health providers should employ strategies, such as tailored safety training and management commitment, with a focus on addressing the unique needs of long-tenured and musculoskeletal-exposed workers. Fostering a safety culture that promotes open and timely reporting is crucial, and implementing these strategies can significantly enhance workplace safety and health.

Averse to what: Consumer aversion to algorithmic labels, but not their outputs?

Inspired by significant technical advancements, a rapidly growing stream of research explores human lay beliefs and reactions surrounding AI tools, which employ algorithms to mimic elements of human intelligence. This literature predominantly documents negative reactions to these tools or the underlying algorithms, often referred to as algorithm aversion or, alternatively, a preference for humans. This article proposes a third interpretation: people may be averse to their labels, but appreciative of their output. This perspective offers three core insights for how we study people's reactions to algorithms. Research would benefit from (1) carefully considering the labeling of AI tools, (2) broadening the scope of study to include interactions with these tools, and (3) accounting for their technical configuration.

Danish Women Make Decisions about Participation in Breast Cancer Screening prior to Invitation Information: An Online Survey Using Experimental Methods

INTRODUCTION

At mammography screening invitation, the Danish Health Authority recommends women aged 50 to 69 y make an informed decision about whether to be screened. Previous studies have shown that women have very positive attitudes about screening participation. Therefore, we hypothesized that Danish women may already have decided to participate in breast cancer screening prior to receiving their screening invitation at age 50 y.

METHODS

We invited a random sample of 2,952 Danish women aged 44 to 49 y (prescreening age) to complete an online questionnaire about barriers to informed screening decision making using the official digital mailbox system in Denmark. We asked participants about their screening intentions using 3 different questions to which women were randomized: screening presented 1) as an opportunity, 2) as a choice, and 3) as an opportunity plus a question about women's stage of decision making. All women completed questions about background characteristics, intended participation in the screening program, use and impact of screening information, and preferences for the decision-making process. Data were linked to sociodemographic register data.

RESULTS

A total of 790 (26.8%) women participated in the study. Herein, 97% (95% confidence interval: 96%-98%) reported that they wanted to participate in breast cancer screening when invited at age 50 y. When presented with the choice compared with the opportunity framing, more women rejected screening. When asked about their stage of decision making, most (87%) had already made a decision about screening participation and were unlikely to change their mind.

CONCLUSION

In our study, almost all women of prescreening age wanted to participate in breast cancer screening, suggesting that providing information at the time of screening invitation may be too late to support informed decision making.

HIGHLIGHTS

Almost all women of prescreening age (44-49 y) in our study wanted to participate in the Danish national mammography screening program starting at age 50 y.Early decision making represents a barrier for informed decision making as women in this study had intentions to participate in breast cancer screening prior to receiving an official screening invitation, and therefore, providing information at the time of screening invitation may be too late to support informed decision making.Very few women rejected screening participation; however, more women rejected screening when the information was framed as an active choice between having or declining breast cancer screening (continue with usual care) compared with presenting only the option of screening with no description of the alternative.Two-thirds of women reading the screening information in this study had unchanged attitudes toward screening after reading the presented information.

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.

Parental decision regret after pediatric urologic surgeries compared to decisions of everyday life

INTRODUCTION

Parents are at risk of decision regret (DR) for decisions affecting their children. The Decision Regret Scale (DRS) measures medical DR but lacks context outside of healthcare.

OBJECTIVE

To compare parental DR 1) between common pediatric urologic surgeries and everyday decisions and 2) with preference to make a different choice.

METHODS

We conducted a cross-sectional online survey of randomly selected parents >1year (y) after their children underwent: orchiopexy (males ≤10y), open ureteral reimplant (OUR, females 2-6y), open pyeloplasty (OP, ≤2y), or robotic pyeloplasty (RP, 5-17y) (2017-2021). Higher DRS scores indicate increased DR (none: 0, mild: 1-25, moderate: 30-50, strong: 55-75, very strong: 80-100). Parents completed DRS on four decisions: their child's surgery, most recent/current romantic relationship, most recent leased/purchased car, and most recent purchased meal. Parents reported if they would make the same choice (yes/no). Nonparametric statistics were used.

RESULTS

We surveyed 191 parents (orchiopexy n = 52, OUR n = 50, OP n = 51, RP n = 38). The median parent age was 36y (mothers: 86%). Some DR was reported for all decisions, but with significant differences in DR severity. The lowest median DRS score was seen with surgery (orchiopexy 0 [IQR 0-10], OUR 0 [IQR 0-5], OP 0 [IQR 0-0], RP 0 [IQR 0-0]), with no difference between surgery groups (p = 0.78). This was followed by relationship (0, IQR 0-20), car (15, IQR 0-25), and meal (20, IQR 0-30, p < 0.001). Most parents did not report any DR regarding surgery (orchiopexy 69%, OUR 74%, OP 76%, RP 76%, with no difference between surgery groups p = 0.85, Summary Figure). Comparatively, 59% of parents did not have any regret about their relationship, 37% their car, and 28% their meal (p < 0.001). All surgical DR was mild or moderate. No parent (0%) would have chosen differently for their child's surgery versus 4-12% for non-surgical decisions (p < 0.001). Overall, increasing DR corresponded to increasing desire to have made a different choice (DRS≤10: 0%, DRS 45-50: 32%, DRS 55-60: 66%, DRS≥75: 100%, p < 0.001).

CONCLUSION

Parental DR varied between urological surgical and non-surgical decisions. It was lowest after surgery. Some regret was reported after every decision, but the subset of parents with regret was smallest after surgical decisions. Positive DRS scores do not necessarily correspond to parents wishing they made a different choice.

Comparing experience- and description-based economic preferences across 11 countries

Recent evidence indicates that reward value encoding in humans is highly context dependent, leading to suboptimal decisions in some cases, but whether this computational constraint on valuation is a shared feature of human cognition remains unknown. Here we studied the behaviour of n = 561 individuals from 11 countries of markedly different socioeconomic and cultural makeup. Our findings show that context sensitivity was present in all 11 countries. Suboptimal decisions generated by context manipulation were not explained by risk aversion, as estimated through a separate description-based choice task (that is, lotteries) consisting of matched decision offers. Conversely, risk aversion significantly differed across countries. Overall, our findings suggest that context-dependent reward value encoding is a feature of human cognition that remains consistently present across different countries, as opposed to description-based decision-making, which is more permeable to cultural factors.

Intention to use physical restraint in paediatric intensive care units and correlated variables: A multicentre and cross-sectional study

OBJECTIVES

To determine the intention to use physical restraint (PR) and the relationship with sociodemographic and professional variables of the Paediatric Intensive Care Unit (PICU) nurses.

RESEARCH METHODOLOGY/DESIGN AND SETTING

A multicentre and correlational study was carried out from October 2021 to December 2023 in five paediatric intensive care units from five maternal and child hospitals in Spain. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire was provided. Moreover, sociodemographic and employment variables were registered.

RESULTS

A total of 230 paediatric nurses participated in the study. A total of 87.7 % were females with an average age of 35.5 ± 9.7 years and working experience of 10.5 ± 8.4 years. The mean scores obtained were 21.1 ± 3.8 for attitude, 13.1 ± 5.0 for subjective norms, 14.4 ± 4.3 for perceived behavioural control and 28.0 ± 6.0 for intention. The nurses apply more physical restraint to anxious patients, with scarce analgesics and sedation, those affected with pharmacological withdrawal symptoms and those with a high risk of accidental removal of vital support devices or fall from bed. The sex (p = 0.007) and type of employment contract (p = 0.01) are the variables that are significantly correlated with the intention to use of PR.

CONCLUSION

The paediatric nurses analysed had a moderate attitude, social pressure and perceived behavioural control towards the use of PR.

IMPLICATIONS FOR CLINICAL PRACTICE

It is important to know the factors that influence the intention to use physical restraint in order to standardise safe practice for critically ill paediatric and to ensure that patients' rights are respected by obtaining informed consent and assessing the prescription, continuation and removal of physical restraint.

Mindfulness decreases driving anger expression: The mediating effect of driving anger and anger rumination

Mindfulness is a state of being fully attentive to the current moment and is an experiential way of living in daily life. As a personal trait, mindfulness has been proven to enhance various negative emotions and behaviors. However, in the field of driving, there is still a lack of research on the mechanisms of mindfulness on anger expression behavior, specifically aggressive driving. Therefore, the purpose of this study is to reveal the impact of mindfulness on drivers' aggressive driving behaviors and the mediating effect of driving anger and anger rumination. A total of 350 (208 males and 142 females) participants in China voluntarily completed a series of questionnaires, including the Mindful Attention and Awareness Scale (MAAS), the Driving Anger Scale (DAS), the Anger Rumination Scale (ARS) and the Driving Anger Expression Inventory (DAX). The hierarchical multiple regression analysis and pathway analysis results showed that mindfulness negatively predicted driving anger, anger rumination and driving anger expression. Moreover, driving anger and anger rumination mediated the relationship between mindfulness and driving anger expression, accounting for 9.51% and 18.74% of the total effect, respectively. The chain-mediated effect of driving anger and anger rumination accounted for 8.00% of the total effect. This study has revealed some of the internal mechanisms through which mindfulness reduces aggressive driving. It fills a part of the gap in understanding the protective role of mindfulness in the driving domain. Furthermore, it suggests mindfulness interventions for drivers, which may have the potential to enhance overall road safety.

Neural correlates of static and dynamic social decision-making in real-time sibling interactions

In traditional game theory tasks, social decision-making is centered on the prediction of the intentions (i.e., mentalizing) of strangers or manipulated responses. In contrast, real-life scenarios often involve familiar individuals in dynamic environments. Further research is needed to explore neural correlates of social decision-making with changes in the available information and environmental settings. This study collected fMRI hyperscanning data (N = 100, 46 same-sex pairs were analyzed) to investigate sibling pairs engaging in an iterated Chicken Game task within a competitive context, including two decision-making phases. In the static phase, participants chose between turning (cooperate) and continuing (defect) in a fixed time window. Participants could estimate the probability of different events based on their priors (previous outcomes and representation of other's intentions) and report their decision plan. The dynamic phase mirrored real-world interactions in which information is continuously changing (replicated within a virtual environment). Individuals had to simultaneously update their beliefs, monitor the actions of the other, and adjust their decisions. Our findings revealed substantial choice consistency between the two phases and evidence for shared neural correlates in mentalizing-related brain regions, including the prefrontal cortex, temporoparietal junction (TPJ), and precuneus. Specific neural correlates were associated with each phase; increased activation of areas associated with action planning and outcome evaluation were found in the static compared with the dynamic phase. Using the opposite contrast, dynamic decision-making showed higher activation in regions related to predicting and monitoring other's actions, including the anterior cingulate cortex and insula. Cooperation (turning), compared with defection (continuing), showed increased activation in mentalizing-related regions only in the static phase, while defection, relative to cooperation, exhibited higher activation in areas associated with conflict monitoring and risk processing in the dynamic phase. Men were less cooperative and had greater TPJ activation. Sibling competitive relationship did not predict competitive behavior but showed a tendency to predict brain activity during dynamic decision-making. Only individual brain activation results are included here, and no interbrain analyses are reported. These neural correlates emphasize the significance of considering varying levels of information available and environmental settings when delving into the intricacies of mentalizing during social decision-making among familiar individuals.

Investigating the relationship between nurses' workplace behaviour and perceived levels of ethical leadership in managers

BACKGROUND

There is increasing research interest in the relationship between ethical leadership and deviant workplace behaviour. Ethical leadership encompasses altruism, courage, ethical orientation, integrity and fairness. Examples of deviant workplace behaviours include theft, fraud, sabotage, assault, abuse, manipulation and bullying. It appears that when leaders are fair and emphasise ethical conduct, followers are less inclined to engage in deviant workplace behaviour.

AIM

To investigate the relationship between nurses' self-rated levels of deviant workplace behaviour and perceived levels of ethical leadership in managers.

METHOD

For this descriptive correlational study, 355 nurses from one university hospital in Egypt responded to an online questionnaire comprising the Ethical Leadership Scale and the Workplace Deviance Behavior Scale. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables.

RESULTS

There was a statistically significant negative relationship between respondents' self-rated levels of deviant workplace behaviour and their perceptions of levels of ethical leadership in managers. The results appeared to confirm previous research. Nurses who feel that they are treated fairly by their managers tend to have positive attitudes towards work, colleagues and management.

CONCLUSION

Ethical leadership on the part of managers is a significant determinant of nurses' behaviour in the workplace and should therefore be fostered by healthcare organisations.

Social Norms and Concussion Disclosure Behavior: Clarification of Terms and Measurement Recommendations

Nondisclosed sport-related concussion symptoms pose a significant risk to athletes' health and well-being. Many researchers have focused on understanding the factors affecting athletes' concussion disclosure behaviors. One of the most robust predictors of the likelihood that an athlete will disclose concussion symptoms to their coaches, athletic trainers, parents, or peers is what researchers term social norms. The extant literature regarding social norms influencing concussion disclosure behaviors is inconsistent on how the construct should be defined, conceptualized, or measured, often failing to distinguish between descriptive and injunctive social norms and their sources (direct and indirect). In this technical note, we provide an overview of these critical distinctions, their importance in assessments, and examples from the literature in which scholars have correctly operationalized these constructs in athletic populations. We conclude with a brief set of suggestions for researchers seeking to measure social norms in future research.

Understanding the impact of abusive leadership on third-party observers' turnover intentions: Insights from organizational identification and authority orientation

This study proposes and tests a conceptual model including three predictors (observed abusive leadership, workplace identification, and authority orientation) of third-party observers' turnover intentions. Analyzing responses from of 367 sales employees from Chinese hotels suggests that organizational identification partially mediates the relationship between observed abusive leadership and observer turnover intention. Also, observed abusive leadership is negatively associated with observers' workplace identification. Finally, authority orientation is negatively associated with observers' turnover intentions. This study contributes theoretically to understanding the repercussions of abusive leadership and offers managerial insights for hospitality firms to mitigate high turnover rates.

Child welfare predictive risk models and legal decision making

BACKGROUND

Child welfare agencies around the world have experimented with algorithmic predictive modeling as a method to assist in decision making regarding foster child risk, removal and placement.

OBJECTIVE

Thus far, all of the predictive risk models have been confined to the employees of the various child welfare agencies at the early removal stages and none have been used by attorneys in legal arguments or by judges in making child welfare legal decisions. This study will show the effects of a predictive model on legal decision making within a child welfare context.

PARTICIPANTS AND SETTING

Lawyers, judges and law students with experience in child welfare or juvenile law were recruited to take an online randomized vignette survey.

METHODS

The survey consisted of two vignettes describing complex foster child removal and placement legal decisions where participants were exposed to one of three randomized predictive risk model scores. They were then asked follow up questions regarding their decisions to see if the risk models changed their answers.

RESULTS

Using structural equation modeling, high predictive model risk scores showed consistent ability to change legal decisions about removal and placement across both vignettes. Medium and low scores, though less consistent, also significantly influenced legal decision making.

CONCLUSIONS

Child welfare legal decision making can be affected by the use of a predictive risk model, which has implications for the development and use of these models as well as legal education for attorneys and judges in the field.

Icon Arrays for Medical Risk Communication: Do Icon Type and Color Influence Cardiovascular Risk Perception and Recall?

BACKGROUND

Icon arrays have been shown to be an effective method for communicating medical risk information. However, in practice, icon arrays used to visualize personal risks often differ in the type and color of the icons. The aim of this study was to examine the influence of icon type and color on the perception and recall of cardiovascular risk, as little is known about how color affects the perception of icon arrays.

METHODS

A total of 866 participants aged 40 to 90 years representative of the German population in terms of gender and age completed an online experiment. Using a 2 × 2 between-subjects design, participants were randomly assigned to 1 of 4 experimental groups. They received their hypothetical 10-year cardiovascular risk using an icon array that varied by icon type (smiley v. person) and color (black/white v. red/yellow). We measured risk perception, emotional response, intentions of taking action to reduce the risk (e.g., increasing one's physical activity), risk recall, and graph evaluation/trustworthiness, as well as numeracy and graphical literacy.

RESULTS

Icon arrays using person icons were evaluated more positively. There was no effect of icons or color on risk perception, emotional response, intentions of taking action to reduce the risk, or trustworthiness of the graph. While more numerate/graphical literate participants were more likely to correctly recall the presented risk estimate, icon type and color did not influence the probability of correct recall.

CONCLUSIONS

Differences in the perception of the tested icon arrays were rather small, suggesting that they may be equally suitable for communicating medical risks. Further research on the robustness of these results across other colors, icons, and risk domains could add to guidelines on the design of visual aids.

HIGHLIGHTS

The use of different icons and colors did not influence the perception and the probability of recalling the 10-year cardiovascular risk, the emotional response, or the intentions to reduce the presented risk.Icon arrays with person icons were evaluated more positively.There was no evidence to suggest that the effectiveness of the studied icon arrays varied based on individuals' levels of numerical or graphical literacy, nor did it differ between people with or without a history of CVD or on medication for an increased CVD risk.

Ontario dairy producers' and veterinarians' perspectives: Barriers to biosecurity implementation

Implementing biosecurity protocols is necessary to reduce the spread of disease on dairy farms. In Ontario biosecurity implementation is variable among farms, and the barriers to implementing biosecurity are unknown. Thirty-five semistructured interviews were conducted between July 2022 and January 2023 with dairy producers (n = 17) and veterinarians (n = 18). Participants also completed a demographic survey. Thematic analysis was performed with constructivist and grounded theory paradigms. Thematic coding was done inductively using NVivo software. Dairy producers' understanding of the definition of biosecurity varied, with all understanding that it was to prevent the spread of disease. Furthermore, the most common perception was that biosecurity prevented the spread of disease onto the farm. Both veterinarians and producers stated that closed herds were one of the most important biosecurity protocols. Barriers to biosecurity implementation included a lack of resources, internal and external business influencers, individual perceptions of biosecurity, and a lack of industry initiative. Understanding the barriers producers face provides veterinarians with the chance to tailor their communication to ensure barriers are reduced or for other industry members to reduce the barriers.

Using distance-framed narratives to foster health communication outcomes among e-cigarette users and non-users

This study examines the effectiveness of distance-framed narratives in deterring e-cigarette use among young adults. Through an online experiment (N = 916), this study investigates how narratives with different distance cues influence participants' narrative engagement, perceived psychological distance, and compliance with the message. The findings suggest that distance-framed narratives heighten identification. Increased identification reduces perceived psychological distance, leading to more negative attitudes, decreased e-cigarette use intention, and stronger policy support. E-cigarette use status also impacts persuasive outcomes. Non-users tend to be more receptive to narratives featuring congruent distance cues in character and scenario depictions. Users are motivated by narratives that present an uncertain scenario, regardless of whether the character is portrayed as socially close or distant.

Creativity From Constraint Exploration and Exploitation

Using the frameworks of creativity as problem solving and Integrated Constraints in Creativity (IConIC), this article develops the proposal that creativity is best understood in terms of a cycle of constraint exploration and exploitation. This general thesis, which applies to varied domains and levels of creativity, is supported by three specific proposals about the role of constraints in creativity, each of which is developed and illustrated with examples. First, constraints provide the criteria for the evaluation of creative outcomes, which can vary as a function of the emphasis on novel usefulness or useful novelty. Second, constraints are critical in each step of the creative process: problem finding, problem construction, and problem solving. Third, constraints play a key role in both open-ended and closed-ended creative problems. These arguments are supported by specific predictions, concerning: (a) task differences in whether novelty or usefulness are emphasized more; (b) individual differences in the processing of constraints (some may favor flexible constraint exploration, while others may favor persistent constraint exploitation), which I hypothesize also correlate with (c) engagement in different types of creative problem-solving (more open-ended, of the sort encountered in art, vs. more closed-ended, of the sort encountered in science, business, and engineering).

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.