Methods of coping with social desirability bias: A review

A systematic review of 'equity-focused' game-based learning in the teaching of health staff

Background

An unequal distribution of the social determinants of health drives health inequalities. Existing training fails to communicate the impossible circumstances that disadvantaged groups face. Game-based learning is increasingly used as an innovative method with the potential to enhance health staff's ability to address health inequalities, but its effectiveness is unknown. Therefore, the aim of this systematic review was to evaluate the effectiveness of 'equity-focused' game-based learning in training health staff.

Study design

Systematic Review.

Methods

Three databases (Ovid Medline, Embase, Web of Science) and a citation search were systematically searched for articles from January 2010 to July 2023, reporting on effectiveness of 'equity-focused' game-based learning. Titles and abstracts were screened using eligibility criteria to identify relevant studies. Data was extracted and the ROBINS-I tool was used to assess quality.

Results

The search identified 7615 articles, of which thirteen were included involving 2412 healthcare workers. A variety of game-based learning tools were found to have an overall positive effect on motivation, knowledge, attitudes, and engagement of health staff. However, the significance of the results varied depending on specific game context. All included studies were judged to have serious to critical risk of bias.

Conclusions

Game-based learning has the potential to improve the effectiveness of 'equity-focused' training for health staff. Educators and researchers should further collaborate to expand the tools available and evaluate their effectiveness on long-term clinical practice.

Delirium care in hospitals in Ireland on World Delirium Awareness Day 2023

BACKGROUND

Acute, transient, but sometimes persistent, delirium is characterized by a sharp disruption in attention, consciousness, and cognitive function, and can be caused by many medications and disorders. Delirium occurrence and negative consequences, such as falls and functional decline, can be decreased with multifactorial prevention and timely detection.

AIMS

To describe current clinical practice in relation to the prevention, assessment, and management of delirium in Irish hospitals; awareness-raising and educational activities; and barriers to good practice.

METHODS

On World Delirium Awareness Day (15th March 2023), a global survey was conducted of delirium prevalence and care. A senior clinical staff member on each participating ward reported on delirium prevalence at 8AM and 8PM, and on usual ward practice; this data was entered into an online survey by a data collector (typically a clinician from the site, visiting several wards to record data). This study reports data from Irish hospitals.

RESULTS

In total, 132 wards from 15 hospitals across Ireland participated. Almost 60% of wards used 'personal judgment' for delirium assessment. Having at least one delirium training session in the preceding year was associated with greater use of a formal assessment tool (60.3% versus 18.8%; p < 0.001). Wards reported staff training/education as the main priority to improve care, but 72.7% of wards identified insufficient time to train staff as a key barrier.

CONCLUSIONS

Clinical practice related to delirium care requires improvement. Awareness raising and staff training require more focus and time in busy clinical settings.

Using Hypothetical Scenarios to Address Social Desirability Bias: Investigating Student Perceptions, Evaluations, and Motivations of Cheating and Academic Integrity in the General Chemistry Laboratory

Supporting students with upholding the principles of academic integrity is an important aspect of teaching. Academic integrity is especially important in chemistry laboratory classrooms, where students gain hands-on experience related to research and scientific practices. Prior literature on academic integrity largely focuses on catching and preventing cheating, describing various factors commonly associated with cheating behaviors. This body of literature assumes that students neutralize their feelings about cheating to engage in unethical behavior. In contrast, for this study, we began with the assumption that students intend to act ethically; to this end, we sought to investigate students' perceptions, evaluations, and motivations related to cheating and academic integrity. We interviewed 24 students enrolled in general chemistry laboratories and asked questions related to cheating and academic integrity. Additionally, to address concerns about social desirability bias affecting students' responses, we asked students questions involving hypothetical scenarios related to academic integrity that were contextualized within the chemistry laboratory classroom. In our analysis, we found that students held common views about cheating and academic integrity in general but diverged in their responses to the hypothetical scenarios. Our findings suggest the importance of providing clearer, more direct instruction regarding what counts as cheating and how to engage in academically honest behavior within the chemistry laboratory classroom.

Investigating the role of green behavior and perceived benefits in shaping green car buying behavior with environmental awareness as a moderator

As the planet faces the challenge of global warming, every individual and organization must adopt green practices to protect nature. The automobile industry is one of the primary industries which can contribute significantly towards sustainability. This study aims to examine the impact of green behavior and green perceived benefits on the green buying behaviors of automobiles. The research also explores the moderating influence of environmental awareness on the mechanism. The research is based on a quantitative method for which primary data was gathered from 406 respondents across Pakistan, China and Saudi Arabia via Quota-based purposive sampling. The gathered data was analyzed via SmartPLS. The results show that green behavior and perceived benefits positively and significantly influence green buying behavior. The findings also show the moderating role of environmental awareness on green behavior towards green buying and show no impact on the perceived benefits towards buying behavior. The study has practical and theoretical implications for managers, researchers, policymakers and institutions in the context of green automobile development and businesses. The study also contributes to the attainment of sustainable development goals.

Evaluating the Usability of the Wellness School Assessment Tool Whole School, Whole Community, Whole Child (WellSAT WSCC): A School Wellness Policy Assessment Tool

BACKGROUND

Adoption of the Whole School, Whole Community, Whole Child (WSCC) model has been slowed by a lack of available tools to support implementation. The Wellness School Assessment Tool (WellSAT) WSCC is an online assessment tool that allows schools to evaluate the alignment of their policies with the WSCC model. This study assesses the usability of the WellSAT WSCC.

METHODS

Using a convergent mixed methods design, we collected qualitative and quantitative data from 5 school-based participants with roles in development and evaluation of policy. Participants explored the platform while engaging in a think-aloud procedure and scored a sample policy using the platform. They also completed the System Usability Scale and responded to open-ended questions about the usability of the platform.

RESULTS

Participants rated the WellSAT WSCC as an above-average user experience, but data suggested several areas for improvement, including improved instructions, enhanced visual design of the platform, and guidance for subsequent policy changes.

CONCLUSION

The WellSAT WSCC provides an above-average user experience but can be improved to increase user experience. These improvements increase the potential for greater use to facilitate integration of the WSCC model into school policy.

The perspectives of hospital doctors about end-of-life care in people with mental illness: an observational pilot study

BACKGROUND

Negative attitudes towards people living with mental illness (PLWMI), defined here as mentalism, are a major contribution to health care inequity, which may extend into end-of-life care. There is a clear need for investigation of the attitudes of doctors towards PLWMI at the end of life as doctors may lead processes of care that contribute to this inequity.

AIMS

The aim of this pilot study is to examine the perspectives of hospital-based doctors regarding end-of-life care and medical decision-making in PLWMI.

METHODS

A survey was created to explore whether mentalism is present in the perspectives of hospital doctors regarding end-of-life care for PLWMI. The survey included demographic characteristics of participants and questions comprising statements and vignettes that required agree/disagree responses. Descriptive statistics were used to summarise responses, and chi-square tests examined associations with demographic variables.

RESULTS

The survey was commenced by 48 hospital-based doctors and completed by 45. Descriptive statistics indicated that mentalism is present in the attitudes of hospital doctors regarding end-of-life care of PWLMI, with 47 of 48 participants (98%) endorsing at least one mentalist response. One significant association found that psychiatrists and psychiatry trainees were less likely to endorse a stereotype response in one vignette.

CONCLUSIONS

This preliminary study addresses a gap within the literature on the potential contribution of mentalist attitudes in doctors to the poorer end-of-life care outcomes for PLWMI. The findings highlight the need for further study of this topic and suggest a role for targeted medical education in the pursuit of health care equality for PLWMI.

How traditional Norwegian outdoor activities are changing; a 10-year follow up in relation to sociodemographic factors

Introduction

The study aims to evaluate the relationship between sociodemographic factors and changes in Norwegian outdoor activities between 2008 and 2018. Traditional outdoor activities, such as family trips in nature, the gathering of mushrooms and wild berries, and growing one's own plants to eat, are believed to have a positive impact on physical activity levels and health in general.

Method

This study includes repeated cross-sectional surveys conducted in 38 randomly selected schools across two Norwegian counties. In 2008, 1,012 parents of 6th and 7th grade students from 27 schools completed a questionnaire. In 2018, 609 new parents from 25 schools participated. Variables were dichotomized. Descriptive analyses between groups were conducted using chi-square statistics. Binary logistic regression analyses were performed with the three outdoor activities as dependent variables, including year only (model 1), and then also gender, age (continuous), education (own and partners), and household income as independent variables (model 2).

Results

Participation in weekly family trips in nature increased from 22% to 28% (p = 0.002), the OR for year 2018 vs. year 2008 was 1.51. Adjusted for sociodemographic factors, the OR remained stable and significant. Education was the only significant sociodemographic factor (OR = 1.60), indicating the odds of those with a higher education to be 60% higher to engage in weekly family trips in nature. Gathering of wild mushrooms and plants remained stable with time. Being female (OR = 1.44), age (OR = 1.049) and education (OR = 1.49) was related to gathering. An increase in growing plants to eat was observed with an increase from 42% to 51% (p < 0.001), OR = 1.33. However, it did not remain significant in model 2. Education was, in general, positively related to growing food (OR = 1.35).

Conclusion

We observed a positive increase in family trips in nature over the period from 2008 to 2018. Furthermore, elder parents seem to be more involved in the long-rooted traditional Norwegian grow- and gather culture, and a social gradient is apparent as those with higher education do participate more often in traditional outdoor activities.

Assessing care quality in general practice: a qualitative study of GPs in Ireland

BACKGROUND

It is estimated that each year in Ireland, approximately 29 million consultations occur in general practice with a patient satisfaction level of 90%. To date, research has been lacking on how GPs assess the quality of care.

AIM

To examine how GPs assess care quality during routine practice with respect to the following pillars of quality improvement: effectiveness, safety, timeliness, equity, efficiency, sustainability, and person-centredness.

DESIGN & SETTING

Qualitative study of GPs in Ireland.

METHOD

In this qualitative study, semi-structured interviews were conducted with 10 GPs who were recruited via a snowball sampling strategy. Interviews were recorded, transcribed, and analysed. Quality 'assessment points' were identified and themes were synthesised to produce a theoretical framework.

RESULTS

Five female and five male GPs practising in a variety of settings were interviewed. The age range was 33-68 years. In total, 122 assessment points emerged from the data and were collated into the following eight themes: the GP as a professional person factors; the patient and coproduction factors; care team factors; direct care factors; outcome factors; practice environment and organisation factors; external environment factors; and improvement approach factors.

CONCLUSION

This is the first study to examine how GPs in Ireland assess care quality as a holistic construct during daily care. The qualitative approach applied yielded rich and diverse insights into the many assessment points that GPs use to inform their approach and actions as clinicians, managers, collaborators, and leaders to maximise patient care. The theory produced is likely useful and applicable for practising GPs, healthcare administration, policymakers, and funders in planning and executing changes for quality improvement.

Can lameness prevalence in dairy herds be predicted from farmers' reports of their motivation to control lameness and barriers to doing so? An observational study from New Zealand

Understanding what motivates and prevents behavioral change in farmers is a critical step in disease control in dairy cattle. A total of 101 New Zealand dairy farmers across 8 regions were randomly enrolled into a cross-sectional study to investigate farmer barriers and motivators to lameness control for cows managed 100% at pasture and the relationship between these responses and the true lameness status on farm. Trained technicians lameness scored all lactating cows on the enrolled farms on 2 occasions during one lactation. Farm-level prevalence proportions were calculated as the mean of the 2 lameness scores. Enrolled farmers were asked their perception of lameness in the current milking season and responded to 26 ordinal Likert-type items with 5 options ranging from not important at all to extremely important. The questions were grouped under 3 categories; barriers to lameness control (n = 9), impacts of lameness (n = 10), and motivators to control lameness (n = 7). The association between farmer perception of lameness and lameness prevalence was reported using linear regression. Multiple-factor analysis was conducted to identify latent variable themes within the responses. Linear discriminant analysis was used to assess whether barriers, impacts, and motivators could be used to predict farmer perception of lameness and lameness prevalence. Lameness prevalence was 0.8% greater on farms where farmers perceived lameness as a moderate or a major problem compared with farms where the farmer perceived lameness as a minor problem or not a problem. Farmers ranked all potential motivators to lameness control as important and declared few barriers to be important at preventing them from controlling lameness. Feeling sorry for lame cows and pride in a healthy herd were the most important motivators, with lack of time and skilled labor the most important barriers. The most important effects of lameness were cow-related factors such as pain and production, with farm and industry impacts of less importance. Farmers place different weightings of importance on barriers to lameness control compared with motivators for lameness control. The impacts and motivators were strongly correlated with the first dimension from the multiple-factor analysis, with only weak correlation between barriers and the first dimension. Linear discriminant analysis identified that the importance that farmers place on barriers, motivators, and impacts of lameness were poor predictors of farmers' belief in regard to their lameness problem or actual lameness prevalence (above or below the median lameness prevalence for the study cohort). Despite relatively low lameness prevalence, many New Zealand dairy farmers believe lameness is a problem on their farm, and they rank welfare effects of lameness of high importance. To investigate how farmer behavior change can be used to manage lameness, future studies should consider theoretical social science frameworks beyond the theory of planned behavior or involve prospective interventional studies investigating farmer actions instead of beliefs.

A systematic review and meta-analysis of the effectiveness of co-designed, in-person, mental health interventions for reducing anxiety and depression symptoms

BACKGROUND

Co-design is recommended in mental health fields and has been associated with improved intervention efficacy. Despite its growing popularity, syntheses of evidence on the effectiveness of co-designed interventions are scarce, and little is known about their impact on anxiety and depression.

METHODS

The purpose of this systematic review and meta-analysis was to consolidate evidence on the effectiveness of in-person, co-designed mental health interventions for reducing anxiety and depression symptoms. An exhaustive search was conducted across six electronic databases (PubMed, PsycINFO, Embase, CINAHL, CENTRAL, and ProQuest) and grey literature. Criteria for inclusion comprised studies utilizing randomized or quasi-randomized methods, implementing non-digital/in-person, co-designed interventions for mental health enhancement, and assessing anxiety and/or depression. Intervention impacts were evaluated using random-effects meta-analyses.

RESULTS

The review identified 20 studies, with only three using the term 'co-design'. Other terminologies included 'co-developed' (n = 2), 'co-produced' (n = 2), and 'CBPR' (n = 11). Seventeen studies exhibited moderate risk of bias, while three demonstrated high risk. Meta-analyses demonstrated a moderate non-significant effect size of 0.5 (95 % CI: -0.8, 1.08; p = 0.08) on depression outcomes, and a small non-significant effect size of 0.12 (95 % CI: -0.1, 0.33; p = 0.23) on anxiety outcomes.

LIMITATIONS

The majority of studies lacked sufficient statistical power to detect between-group differences. Following GRADE criteria, confidence in estimates was low.

CONCLUSIONS

Notwithstanding widespread enthusiasm for co-design, the current evidence base is inadequate to confirm the impact of in-person, co-designed mental health interventions on anxiety and depression. More full-scale evaluation trials of higher quality are urgently needed, along with uniform terminology and measurement.

Do dyadic interventions impact biomarkers of child health? A state-of-the-science narrative review

BACKGROUND

Early life adversity is related to numerous poor health outcomes in childhood; however, dyadic interventions that promote sensitive and responsive caregiving may protect children from the negative consequences of such exposures. To date, quasi-experimental and randomized controlled trials (RCTs) have examined the impact of dyadic interventions on a range of individual biomarkers in children, which may elucidate the relation between early stress exposure and transdiagnostic risk factors for prospective poor health. However, the content of interventions, analytic strategies, and findings vary widely across studies, obscuring key themes in the science and hindering policy and research efforts.

METHODS

We use a narrative approach to review findings from methodologically rigorous (predominantly RCT) studies of dyadic interventions' impacts on different biomarkers in children, including indicators of the hypothalamic-pituitary-adrenal (HPA) axis, parasympathetic (PNS) and sympathetic nervous systems (SNS), brain development, inflammation, and intracellular DNA processes. We contribute to this important area of inquiry through integrating findings across biological systems and identifying contextual and mechanistic factors to depict the current state of the field.

RESULTS

Evidence suggests dyadic interventions improved PNS functioning and advanced brain maturation. Some studies indicated interventions reduced hair cortisol concentrations, systemic inflammation, and resulted in differences in DNA methylation patterns. Findings did not support main effect-level change in salivary measures of HPA axis activity, SNS activity, or telomere length. Importantly, reviewed studies indicated significant heterogeneity in effects across biological systems, underscoring the importance of contextual factors (e.g., adversity subtype and severity) as potential moderators of effects. Further, findings suggested enhanced parenting behaviors may be a mechanism through which dyadic interventions operate on biomarkers.

CONCLUSIONS

We close with future policy and research directions, emphasizing the promise of biologically-informed dyadic interventions for understanding and ameliorating the effects of early adversity on transdiagnostic biomarkers of health.

Safety Climate in the Utility Industry: Perceptual Discrepancies Across Organizational Hierarchy

OBJECTIVES

This study aims to extend safety climate research by considering perceptions across the following three hierarchical levels within a workplace: (1) senior leaders/executives, (2) field leaders/supervisors, and (3) front-line employees.

METHODS

We conducted a quantitative survey study at a US utility company where we collected data related to safety climate perceptions and employee-reported safety behaviors across the different levels of organizational hierarchy.

RESULTS

The findings revealed the highest safety climate scores among senior leaders/executives, followed by field leaders/supervisors, and then employees, suggesting potential discrepancies between espoused and enacted safety values in the workplace.

CONCLUSIONS

These results suggest that supervisors and top managers may have different mental models of workplace safety compared with employees. Consequently, assessing perceptions at different organizational levels provides a fuller picture of safety in the workplace.

Exploring the motivation of health professionals to engage with research at various career stages

BACKGROUND

Research is crucial for improved healthcare and better patient outcomes, but there is a current shortage of clinician-researchers who can connect research and practice in the health professions field. This study aimed to investigate the effect of career stage, previous training and involvement in research on health professionals' (HPs) motivations to engage in research while in public hospital clinical roles. HPs' perceived motivation concerning the importance, value, and barriers attributed to research during different career stages were examined.

METHODS

A mixed methods study design was adopted for this research. An online survey developed based on the Expectancy-Value-Cost (EVC) theory was distributed to HPs (doctors, nurses, midwives, and allied health professionals) in three North Queensland Public Hospitals. Data analysis included descriptive and inferential statistics for the quantitative data and content analysis for the qualitative text responses.

RESULTS

Three hundred and fifty-five responses were received. Prior research training and involvement in research influenced respondents' perceptions about the importance, attitude, motivators, and barriers to research. Attainment value was the overarching motivation for involvement in research and research training for all career stages and all professional HP groups. Positive attitude to research was significantly higher (P = 0.003) for the allied health group (27.45 ± 4.05), followed by the medical (26.30 ± 4.12) and then the nursing and midwifery group (25.62 ± 4.21). Perceived importance and attitude attributed to research were significantly higher (P < 0.05) for those who had research training (26.66 ± 3.26 and 28.21 ± 3.73) compared to those who did not have research training (25.77 ± 3.77 and 23.97 ± 3.53). Significantly higher (P < 0.05) perceptions of organisational and individual barriers were reported among early career (50.52 ± 7.30) respondents compared to their mid-career (48.49 ± 8.14) and late career (47.71 ± 8.36) counterparts.

CONCLUSION

The findings from this study provide valuable insights into the factors that influence HPs' motivation for research. The results underscore the importance of professional group, involvement in research, exposure to research training, career stage, gender, and organisational support in shaping HPs' attitudes, values, and perceived barriers to research. Understanding these factors can inform the development of targeted strategies to enhance research engagement among HPs and promote evidence-based practice in healthcare.

Willingness to provide a hair sample for drug testing: results from an anonymous multi-city intercept survey

Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual's drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods.Objective: To identify demographic and drug-related correlates of providing hair samples in a multi-site venue-intercept study.Methods: We utilized venue-intercept sampling for our Rapid Street Reporting study across 12 US cities between January and November 2022. Participants reported past 12-month drug use and were asked if they would provide a hair sample. We conducted multivariable (generalized linear model with logit link) analyses on demographics and drug use characteristics correlated to hair provision for drug testing.Results: Among 3,045 participants, 55.8% were male, 13.6% provided hair samples. Compared to males, those identifying as "other gender" had higher odds of hair collection (adjusted odds ratio = 2.24, 95% confidence interval: 1.28-3.80). Participants identifying as Black (aOR = 0.32, CI: 0.23-0.45) or "other race" (aOR = 0.50, 95% CI: 0.29-0.80) had lower odds of providing hair than those identifying as White. All levels of reported drug use - one drug (aOR=1.50, 95% CI: 1.15-1.96), two-three drugs (aOR=1.51, 95% CI: 1.11-2.05), four or more (aOR = 2.13, 95% CI: 1.50-3.01) - had higher odds of providing hair samples than those reporting no drug use. Similar associations applied to reporting cannabis use with or without another drug (aOR = 1.52-1.81, 95% CI: 1.15-2.38).Conclusion: Differential hair provision based on participant sex, race/ethnicity, and drug use may introduce biases in drug testing, limiting generalizability to individuals from minority backgrounds.

Why are some countries rich and others poor? development and validation of the attributions for Cross-Country Inequality Scale (ACIS)

Understanding lay theories on the causes of economic inequality is the first step to comprehending why people tolerate, justify, or react against it. Accordingly, this paper aims to develop and validate with two cross-sectional studies the Attributions for Cross-Country Inequality Scale (ACIS), which assesses how people explain cross-country economic inequality-namely, the uneven distribution of income and wealth between poor and rich countries. After selecting and adapting items from existing scales of attributions for poverty and wealth, in Study 1, we tested the factorial structure of this initial pool of items in three countries with different levels of economic development and inequality, namely, Italy (n = 246), the UK (n = 248), and South Africa (n = 228). Three causal dimensions emerged from the Exploratory Factor Analysis: "rich countries" (blaming the systematic advantage of and exploitation by rich countries), "poor countries" (blaming the dispositional inadequacy and faults of poor countries), and "fate" (blaming destiny and luck). The retained items were administered in Study 2 to three new samples from Italy (n = 239), the UK (n = 249), and South Africa (n = 248). Confirmatory Factor Analysis (CFA) corroborated the factorial structure of the ACIS, and Multi-Group CFA supported configural and metric invariances of the scale across countries. In addition, we show internal consistency and construct validity of the scale: the scale correlates with relevant constructs (e.g., beliefs about cross-country inequality and ideological orientation) and attitudes toward relevant policies related to international redistribution and migration. Overall, the scale is a valid instrument to assess causal attribution for cross-national inequality and is reliable across countries. By focusing on resource distribution from an international perspective, this scale will allow researchers to broaden the discussion on economic inequality to a global level.

Validation of a German version of the Boredom Proneness Scale and the Multidimensional State Boredom Scale

The scientific interest in boredom is growing over the past decades. Boredom has not only been linked to symptoms of psychopathology, but also shows a remarkable effect on individual behavior under healthy conditions. Current characterizations of boredom in humans mostly rely on self-report assessments which proved to faithfully reflect boredom in a vast range of experimental environments. Two of the most commonly used and prominent self-report scales in order to assess boredom are the Multidimensional State Boredom Scale (MSBS) and the Boredom Proneness Scale (BPS). Here, we present the German translations of both questionnaires and their validation. We obtained and analyzed psychometric data from more than 800 healthy individuals. We find that the German MSBS and BPS show vast congruence with their originals in respect to item statistics, internal reliability and validity. In particular, we find remarkable associations of state boredom and trait boredom with indicators of mental burden. Testing the factor structure of both questionnaires, we find supporting evidence for a 5-factor model of the MSBS, whereas the BPS in line with its original shows an irregular, inconsistent factor structure. Thus, we validate the German versions of MSBS and BPS and set a starting point for further studies of boredom in German-speaking collectives.

Observed face mask use outside retail chain stores during the COVID-19 pandemic in two cities in the state of Idaho, USA

During the COVID-19 pandemic, public health authorities have encouraged the use of face masks to minimize transmission within the community. To assess mask wear during a COVID-19 surge and guide public health response efforts, including public messaging on mask recommendations, we compared observed mask use in the largest city in each of Idaho's 2 most populous counties, both without a current mask mandate. We recorded mask usage by every third person exiting stores of 5 retail chains in Boise and Nampa during November 8-December 5, 2021. Observations were conducted during three time periods (morning, afternoon, and evening) on weekday and weekend days. A multivariable model with city, retail chain, and city-chain interaction was used to assess mask wear differences by city for each chain. Of 3021 observed persons, 22.0% wore masks. In Boise, 31.3% (430/1376) of observed persons wore masks; in Nampa, 14.3% (236/1645) wore masks. Among all persons wearing masks, > 94% wore masks correctly; cloth and surgical masks were most common. By retail chain, observed individuals at Boise locations were 2.3-5.7 times as likely to wear masks than persons at respective Nampa locations. This study provided a rapid, nonconfrontational assessment of public use of mitigation measures in 2 Idaho cities during a COVID-19 surge.

Implementation of a strengths-based approach in a traumatic brain injury community service; perspectives of community workers

Background The strengths-based approach (SBA) was initially developed for people living with mental health issues but may represent a promising support option for community participation of people living with a traumatic brain injury (TBI). A community-based organisation working with people living with TBI is in the process of adapting this approach to implement it in their organisation. No studies explored an SBA implementation with this population. This study explores the implementation of key components of the SBA in a community-based organisation dedicated to people living with TBI. Methods A qualitative descriptive design using semi-structured interviews (n  = 10) with community workers, before and during implementation, was used. Transcripts were analysed inductively and deductively. Deductive coding was informed by the SBA fidelity scale. Results Group supervision and mobilisation of personal strengths are key SBA components that were reported as being integrated within practice. These changes led to improved team communication and cohesiveness in and across services, more structured interventions, and greater engagement of clients. No changes were reported regarding the mobilisation of environmental strengths and the provision of individual supervision. Conclusion The implementation of the SBA had positive impacts on the community-based organisation. This suggests that it is valuable to implement an adaptation of the SBA for people living with TBI.

Transformational leadership and employability among support staff workers with long tenure

BACKGROUND

In the changing world of work, there is an urgency to gain insight into determinants of the employability among support staff workers with long tenure whose functions may become outdated as their competencies may no longer match the requirements of future jobs.

OBJECTIVE

The specific aim of this study was to investigate the relationship between transformational leadership and employability.

METHODS

Support staff (n = 236) from a university participated in an online questionnaire focusing on five dimensions of employability (occupational expertise, anticipation and optimization, personal flexibility, corporate sense, and balance) and transformational leadership (identifying and articulating a vision, providing an appropriate model, fostering the acceptance of group goals, providing individual support, and intellectual stimulation.

RESULTS

Identifying and articulating a vision (β= 0.247, p <  0.001), providing an appropriate model (β= 0.196, p = 0.002), fostering the acceptance of group goals (β= 0.298, p <  0.001) and providing individual support (β= 0.258, p <  0.001) were associated with higher balance scores. No significant associations were found between the transformational leadership subscales and the other dimensions of employability.

CONCLUSION

The current study found that just one specific dimension of transformational leadership was associated with only one aspect of employability for our target group of long-term employed support staff workers with a high level of job security.

Crafting impactful papers: Expectations and recommendations for Business and management articles

This paper introduces Heliyon's Business and Management Section, established in 2023 as a platform committed to maintaining rigorous ethical and scientific publishing standards within the field. Prioritizing scientific correctness and technical soundness over mere novelty, it encompasses a wide range of research domains, encouraging contributions from scholars across diverse backgrounds. Within this guide, we provide insights into the process of preparing effective papers and offer constructive guidelines for the reviewing process. Authors will find valuable tools to align their work with the journal's expectations, incorporating current literature to enhance the probability of successful publication. Both aspiring authors and reviewers will benefit from this resource, which emphasizes academic and professional growth. By promoting collaboration and upholding high-quality standards, we aim to fortify the scholarly publishing community and advance knowledge in the field of business and management.

Long-Term Retention of Advanced Cardiovascular Life Support Knowledge and Confidence in Doctor of Pharmacy Students

OBJECTIVE

This study aimed to evaluate the impact of American Heart Association (AHA) advanced cardiovascular life support (ACLS) education and training on long-term retention of ACLS knowledge and confidence in Doctor of Pharmacy (PharmD) students.

METHODS

This multicenter study included PharmD students who received ACLS training through different means: 1-hour didactic lecture (didactic), 1-hour didactic lecture with 2-hour skills practice (didactic + skills), and comprehensive AHA ACLS certification through an elective course (elective-certification). Students completed a survey before training, immediately after training, and at least 6-12 months after training to assess demographics and ACLS confidence and knowledge. The primary outcome was a passing score, defined as ≥ 84% on the long-term knowledge assessment. Secondary outcomes included overall knowledge score and perceived confidence, assessed using the Dreyfus model.

RESULTS

The long-term assessment was completed by 160 students in the didactic group, 66 in the didactic + skills group, and 62 in the elective-certification group. Six (4%), 8 (12%), and 14 (23%) received a passing score on the long-term knowledge assessment in the didactic, didactic + skills, and elective-certification groups, respectively. The median (IQR) scores on the long-term knowledge assessment were 50% (40-60), 60% (50-70), and 65% (40-80) in the 3 groups. On the long-term assessment, confidence was higher in the elective-certification group, demonstrated by more self-ratings of competent, proficient, and expert, and fewer self-ratings of novice and advanced beginner.

CONCLUSION

Long-term retention of ACLS knowledge was low in all groups, but was higher in students who received AHA ACLS certification through an ACLS elective course.

Survey Uses May Influence Survey Responses

Traditional validation processes for psychological surveys tend to focus on analyzing item responses instead of the cognitive processes that participants use to generate these responses. When screening for invalid responses, researchers typically focus on participants who manipulate their answers for personal gain or respond carelessly. In this paper, we introduce a new invalid response process, discordant responding, that arises when participants disagree with the use of the survey and discuss similarities and differences between this response style and protective responding. Results show that nearly all participants reflect on the intended uses of an assessment when responding to items and may decline to respond or modify their responses if they are not comfortable with the way the results will be used. Incidentally, we also find that participants may misread survey instructions if they are not interactive. We introduce a short screener to detect invalid responses, the discordant response identifiers (DRI), which provides researchers with a simple validity tool to use when validating surveys. Finally, we provide recommendations about how researchers may use these findings to design surveys that reduce this response manipulation in the first place.

Assessing antibiotic usage data capture accuracy on dairy farms in England and Wales

BACKGROUND

Accurate farm-level data on antibiotic usage (ABU) are needed for the surveillance of antibiotic resistance. Therefore, this study aimed to determine the accuracy of ABU data capture by dairy farmers in South West England and Wales.

METHODS

Through a cross-sectional survey of 48 dairy farmers, the accuracy of ABU recording was measured by farmers' assessment of the completeness and timeliness of ABU recording ('perceived accuracy') and the completeness and correctness of on-farm ABU records ('actual accuracy'). Completeness and correctness were compared for paper and software recording methods.

RESULTS

Perceived accuracy was higher than actual accuracy. Antibiotic names, withdrawal periods and dates that products were fit for human consumption were often incomplete or incorrect. More inaccuracies were seen with paper than software. In some software platforms, the date that milk would be fit for human consumption was frequently rounded down by half a day, increasing the risk of residue failures.

LIMITATION

The small number of on-farm records assessed limits the generalisability of the results.

CONCLUSIONS

Electronic recording of ABU should be encouraged. However, functionality needs improvement, alongside consultation with dairy farmers to increase awareness of inaccuracies.

Rebels with a cause? How norm violations shape dominance, prestige, and influence granting

Norms play an important role in upholding orderly and well-functioning societies. Indeed, violations of norms can undermine social coordination and stability. Much is known about the antecedents of norm violations, but their social consequences are poorly understood. In particular, it remains unclear when and how norm violators gain or lose influence in groups. Some studies found that norm violators elicit negative responses that curtail their influence in groups, whereas other studies documented positive consequences that enhance violators' influence. We propose that the complex relationship between norm violation and influence can be understood by considering that norm violations differentially shape perceptions of dominance and prestige, which tend to have opposite effects on voluntary influence granting, depending on the type of norm that is violated. We first provide correlational (Study 1) and causal (Study 2) evidence that norm violations are associated with dominance, and norm abidance with prestige. We then examine how dominance, prestige, and resultant influence granting are shaped by whether local group norms and/or global community norms are violated. In Study 3, protagonists who violated global (university) norms but followed local (sorority/fraternity) norms were more strongly endorsed as leaders than protagonists who followed global norms but violated local norms, because the former were perceived not only as high on dominance but also on prestige. In Study 4, popular high-school students were remembered as violating global (school) norms while abiding by local (peer) norms. In Study 5, individuals who violated global (organizational) norms while abiding by local (team) norms were assigned more leadership tasks when global and local norms conflicted (making violators "rebels with a cause") than when norms did not conflict, because the former situation inspired greater prestige. We discuss implications for the social dynamics of norms, hierarchy development, and leader emergence.

The Link between the Perception of Animal Welfare and the Emotional Response to Pictures of Farm Animals Kept in Intensive and Extensive Husbandry Systems: An Italian Survey

As livestock production grows to satisfy the global demand for animal products, understanding public attitudes towards different husbandry systems becomes essential for both animal welfare and socio-economic reasons. This study aimed to investigate people's emotional responses toward pictures of farm animals kept in intensive and extensive husbandry systems, their perception of animal welfare, and their choices as animal product consumers. A questionnaire that included demographic questions and photos of cows, pigs, chickens, and rabbits in both intensive and extensive systems was distributed electronically and physically and completed by 835 respondents. Photos of animals in intensive systems elicited more negative emotions, especially for pigs and rabbits (p < 0.05), as opposed to extensive systems, which elicited more positive emotions, especially for chickens (p < 0.001). Higher welfare levels were perceived for extensively farmed animals (p < 0.001) and for cattle compared to all other species, regardless of the husbandry system (p < 0.001). The quality of the emotional response was positively associated with welfare perception (p < 0.001) and negatively associated with the importance given to welfare when purchasing animal products (p < 0.001). Finally, the emotional response was found to be affected by gender, education, household composition, living area, pet ownership, and eating habits. The implications and limitations of these findings are discussed.

Perceptions of Racism Among Graduate Students of Color in Audiology and Speech-Language Pathology

PURPOSE

Audiology (AUD) and speech-language pathology (SLP) are White-dominated fields that operate within racist systems. Systemic racism has profoundly negative impacts on students and professionals who identify as Black, Indigenous, and people of color (BIPOC). This study explored the perceptions and experiences of systemic racism in BIPOC AUD and SLP graduate students as a means to promote antiracism efforts in the fields.

METHOD

A national web-based survey was used to collect information from 46 graduate students. The survey included quantitative questions about systemic racism in the AUD and SLP fields as well as open-ended questions regarding the personal, professional, and client-related impacts of racism. Analyses aimed to characterize patterns first within the overall BIPOC sample and then within three disaggregated racial-ethnic groups (Asian, Black, and Latino/a) to characterize potential differences within the heterogeneous BIPOC category.

RESULTS

On quantitative questions, a substantial majority of BIPOC students selected options consistent with perceptions of systemic racism and White privilege. Qualitative questions yielded several themes related to the personal, professional, and client-related impacts of systemic racism from the perspective of BIPOC students, including reduced access to educational opportunities as well as clinical services, experiences with appearance-based discrimination as well as overt racism, and persistent underrepresentation with accompanying feelings of otherness. Disaggregation of responses suggested some differences in response patterns across racial-ethnic groups, which may warrant further investigation.

CONCLUSIONS

The perspectives of AUD and SLP graduate students reinforce other reports of systemic racism in the fields. Multiple actions are warranted to instigate systemic change that supports graduate students, professionals, and clients of color.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24171513.

Coping resources and stress due to demands in parents to children with autism spectrum disorder

Introduction

Parents to children with autism spectrum disorder (ASD) are exposed to numerous demands in their daily lives and exhibit high levels of stress. The present study aims to find out which coping resources are mediators that help parents cope with these demands and which of those coping resources amplify or reduce stress arising from the demands. Studies often only focus on the connection between coping resources and stress without taking the demands into account at the same time.

Methods

For this reason, a mediation model was set up to answer the research question. Data from a German questionnaire survey with N = 266 parents who have children with ASD (two to 23 years old) were used. Subjectively perceived demands in everyday life (scale "Parental demands in everyday life"), parental stress ("Parental Stress Inventory", based on Abidin's parenting stress model) and the following coping resources were collected: parental self-efficacy beliefs ("Parents' sense of competence questionnaire"), available social support of parents (scale "Availability of social support") and parental coping strategies (German version of the Brief COPE).

Results

An exploratory factor analysis revealed four mediators: dysfunctional coping, functional coping, social support, and self-efficacy. The use of dysfunctional behavior and parental self-efficacy were found to be significant mediators that mediated between daily demands and parental stress. A direct effect of demands on parental stress was also found, implying partial mediation. The two factors of functional coping and support were not found to be significant mediators.

Discussion

Key findings indicate that parental stress resulting from the daily demands of parenting children with ASD can be reduced by high parental self-efficacy and increased by dysfunctional coping. For practice, it can be deduced that dysfunctional coping strategies of parents to children with ASD should be reduced and parental self-efficacy should be strengthened in order to reduce stress which arises from the multiple demands in everyday life.

Assessment of implementation of the caries management by risk assessment philosophy in a dental school

OBJECTIVE

This cross-sectional study assessed the implementation of documenting a baseline caries risk assessment (CRA) of patients seen by predoctoral dental students and its association with the presence of caries risk management (CRM) treatment.

METHODS

A convenience sample of 10,000 electronic axiUm patient records at Tufts University School of Dental Medicine was retrospectively assessed for the presence or absence of a completed CRA and CRM after IRB approval following predetermined inclusion and exclusion criteria. The CRM variables (nutrition counseling, sealant, fluoride) were identified by procedure codes that were completed by the student. Associations were assessed via the chi-square test, Kruskal-Wallis test (with Dunn's test and the Bonferroni correction used in post-hoc tests) and Mann-Whitney U test.

RESULTS

Most patients (70.5%) had a CRA completed. However, only 24.9% (out of the 7045 patients with a completed CRA) received CRM, while 22.9% of the 2,955 patients without a CRA received CRM. The difference between the groups with and without a completed CRA in terms of the percentage receiving CRM was not clinically significant. Significant associations were found between a completed CRA and in-house fluoride treatment (p = .034) and between a completed CRA and sealant treatment (p = .001). Patients with higher baseline CRA levels (i.e., greater risk) were more likely to have CRM (16.9% of the 785 patients at low risk, 21.1% of the 1282 patients at moderate risk, 26.3% of the 4347 patients at high risk, and 32.6% of the 631 patients at extreme risk). The association between these two variables was significant (p < .001).

CONCLUSION

There is evidence that students were mostly compliant with completing a CRA for most patients; however, there is a deficiency in implementation of CRM approach to help support dental caries management, and there is still much room for improvement.

Online grocery shopping intention: Elderly's perspective in Malaysia

Purpose

This study investigates the factors associated with the elderly's intention to use OGS. Building on the Technology Acceptance Model, we propose several elderly-specific and functional-ageing constructs related to the perceived ease of use and usefulness of OGS.

Methods

The questionnaire was distributed physically and digitally to non-OGS users aged above 60, living in the Klang Valley, Malaysia, using a non-probability sampling approach. A total of 302 data were analysed using PLS structural equation modelling.

Results

The findings indicate that perceived ease of use, functional ability, life-course events, and digital literacy are associated with the elderly's perception of OGS's usefulness, while life-course events, digital literacy, technology anxiety, and facilitating conditions are associated with the perceived ease of use.

Conclusion

This study contributes to the OGS literature by addressing ageing complexities with OGS adoption among the elderly population, thereby offering insights for marketers and the government to tailor services and provide relevant support.

Health Care Provider Stigma Toward Patients With Substance Use Disorders: Protocol for a Nationally Representative Survey

BACKGROUND

The US overdose epidemic is an escalating public health emergency, accounting for over 100,000 deaths annually. Despite the availability of medications for opioid use disorders, provider-level barriers, such as negative attitudes, exacerbate the treatment gap in clinical care settings. Assessing the prevalence and intensity of provider stigma, defined as the negative perceptions and behaviors that providers embody and enact toward patients with substance use disorders, across providers with different specialties, is critical to expanding the delivery of substance use treatment.

OBJECTIVE

To thoroughly understand provider stigma toward patients with substance use disorders, we conducted a nationwide survey of emergency medicine and primary care physicians and dentists using a questionnaire designed to reveal how widely and intensely provider attitudes and stigma can impact these providers' clinical practices in caring for their patients. The survey also queried providers' stigma and clinical practices toward other chronic conditions, which can then be compared with their stigma and practices related to substance use disorders.

METHODS

Our cross-sectional survey was mailed to a nationally representative sample of primary care physicians, emergency medicine physicians, and dentists (N=3011), obtained by American Medical Association and American Dental Association licensees based on specified selection criteria. We oversampled nonmetropolitan practice areas, given the potential differences in provider stigma and available resources in these regions compared with metropolitan areas. Data collection followed a recommended series of contacts with participants per the Dillman Total Design Method, with mixed-modality options offered (email, mail, fax, and phone). A gradually increasing compensation scale (maximum US$250) was implemented to recruit chronic nonresponders and assess the association between requiring higher incentives to participate and providers stigma. The primary outcome, provider stigma, was measured using the Medical Condition Regard Scale, which inquired about participants' views on substance use and other chronic conditions. Additional survey measures included familiarity and social engagement with people with substance use disorders; clinical practices (screening, treating, and referring for a range of chronic conditions); subjective norms and social desirability; knowledge and prior education; and descriptions of their patient populations.

RESULTS

Data collection was facilitated through collaboration with the National Opinion Research Center between October 2020 and October 2022. The overall Council of American Survey Research Organizations completion rate was 53.62% (1240/2312.7; physicians overall: 855/1681.9, 50.83% [primary care physicians: 506/1081.3, 46.79%; emergency medicine physicians: 349/599.8, 58.2%]; dentists: 385/627.1, 61.4%). The ineligibility rate among those screened is applied to those not screened, causing denominators to include fractional numbers.

CONCLUSIONS

Using systematically quantified data on the prevalence and intensity of provider stigma toward substance use disorders in health care, we can provide evidence-based improvement strategies and policies to inform the development and implementation of stigma-reduction interventions for providers to address their perceptions and treatment of substance use.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/47548.

Human Papillomavirus Vaccine Acceptance (HPV-VA) and Vaccine Uptake (HPV-VU): assessing the impact of theory, culture, and trusted sources of information in a Hispanic community

BACKGROUND

Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with many types of cancers that disproportionately impact Hispanics. An HPV vaccine is available for individuals ages 9-45 that can prevent up to 90% of HPV-associated cancers. The current study investigates factors associated with accepting the HPV vaccine in a predominately Hispanic community.

METHODS

A cross-sectional study design with an online questionnaire was used to collect data from a community sample of adults between the ages 18-65 residing in a U.S./Mexico border city, El Paso, Texas. Theory-based factors (e.g., the Health Belief Model), culture-based factors (e.g., familism), and trusted sources of information were examined as predictors of HPV-vaccine acceptance (HPV-VA) and HPV-vaccine uptake (HPV-VU).

RESULTS

Community members (N = 602, Mage = 34.65, SD = 9.79) who were predominately Hispanic (89.4%) and female (79.6%) participated in the study. Linear regression models revealed that HPV-VA was associated with household size, primary language, engagement in organizational activities, health-related community stigma, government trust, and the HBM theory-based factors: perceived benefits, perceived harm, and perceived severity. Logistic regression analyses revealed that HPV-VU was associated with household size, engagement in non-organizational activities, HPV trusted sources of information, and perceived safety.

CONCLUSIONS

Adequate HPV vaccination uptake among all vaccine-eligible Hispanics is an important step to lessen the HPV-attributed cancer burden. Our hypothesis that theory-based factors would be associated with HPV-VA and HPV-VU was supported. Our findings have implications for designing trusted, theory-based, and culturally sensitive health communications and interventions to promote vaccines in minority underrepresented communities.

Intermediate levels of scientific knowledge are associated with overconfidence and negative attitudes towards science

Overconfidence is a prevalent problem and it is particularly consequential in its relation with scientific knowledge: being unaware of one's own ignorance can affect behaviours and threaten public policies and health. However, it is not clear how confidence varies with knowledge. Here, we examine four large surveys, spanning 30 years in Europe and the United States and propose a new confidence metric. This metric does not rely on self-reporting or peer comparison, operationalizing (over)confidence as the tendency to give incorrect answers rather than 'don't know' responses to questions on scientific facts. We find a nonlinear relationship between knowledge and confidence, with overconfidence (the confidence gap) peaking at intermediate levels of actual scientific knowledge. These high-confidence/intermediate-knowledge groups also display the least positive attitudes towards science. These results differ from current models and, by identifying specific audiences, can help inform science communication strategies.

The trauma and learning policy initiative (TLPI)'s inquiry-based process: Mapping systems change toward resilience

Trauma is much more than our individual experiences. Fundamentally, trauma is rooted in our social conditions, interrelated with the oppression and violence in our communities and in societies at large. Trauma is knotted within cycles of harm in our relationships and in our communities and institutions. Not only are our communities and institutions sites of trauma, however, but they can also be sites of great healing, restoration, and resilience. Educational institutions hold the potential for contributing to resilient change toward the creation of transformative communities for children to feel safe and to thrive, even in the face of accumulating adversities that are endemic in the United States and beyond. This study investigated the impact of an initiative that strives to support K-12 schools in transforming towards greater trauma-sensitivity: trauma and learning policy initiative (TLPI). We share findings from our qualitative, situational analysis of the impact of TLPI's support to three schools in Massachusetts, USA. Although TLPI's framework on trauma does not explicitly include an antiracism lens, when engaging in data analysis, with the aim to shed light on possible schoolwide approaches to promote equity, our team of researchers specifically attended to ways intersecting systems of oppression may have impacted student education. A visual diagram, "Map of Educational Systems Change Towards Resilience," emerged from our data analysis, with four themes that represent how educators understood the shifts in their schools. These were: (1) facilitating empowerment and collaboration; (2) integrating whole-child approaches; (3) affirming cultural identity and promoting a sense of belonging; and (4) re-envisioning discipline toward relational accountability. We discuss pathways that educational communities and institutions can take to create trauma-sensitive learning environments for the promotion of greater resilience.

Lower limb hyperthermia augments functional hyperaemia during small muscle mass exercise similarly in trained elderly and young humans

NEW FINDINGS

What is the central question of the study? Ageing is postulated to lead to underperfusion of human limb tissues during passive and exertional hyperthermia, but findings to date have been equivocal. Thus, does age have an independent adverse effect on local haemodynamics during passive single-leg hyperthermia, single-leg knee-extensor exercise and their combination? What is the main finding and its importance? Local hyperthermia increased leg blood flow over three-fold and had an additive effect during knee-extensor exercise with no absolute differences in leg perfusion between the healthy, exercise-trained elderly and the young groups. Our findings indicate that age per se does not compromise lower limb hyperaemia during local hyperthermia and/or small muscle mass exercise.

ABSTRACT

Heat and exercise therapies are recommended to improve vascular health across the lifespan. However, the haemodynamic effects of hyperthermia, exercise and their combination are inconsistent in young and elderly people. Here we investigated the acute effects of local-limb hyperthermia and exercise on limb haemodynamics in nine healthy, trained elderly (69 ± 5 years) and 10 young (26 ± 7 years) adults, hypothesising that the combination of local hyperthermia and exercise interact to increase leg perfusion, albeit to a lesser extent in the elderly. Participants underwent 90 min of single whole-leg heating, with the contralateral leg remaining as control, followed by 10 min of low-intensity incremental single-leg knee-extensor exercise with both the heated and control legs. Temperature profiles and leg haemodynamics at the femoral and popliteal arteries were measured. In both groups, heating increased whole-leg skin temperature and blood flow by 9.5 ± 1.2°C and 0.7 ± 0.2 L min-1 (>3-fold), respectively (P < 0.0001). Blood flow in the heated leg remained 0.7 ± 0.6 and 1.0 ± 0.8 L min-1 higher during exercise at 6 and 12 W, respectively (P < 0.0001). However, there were no differences in limb haemodynamics between cohorts, other than the elderly group exhibiting a 16 ± 6% larger arterial diameter and a 51 ± 6% lower blood velocity following heating (P < 0.0001). In conclusion, local hyperthermia-induced limb hyperperfusion and/or small muscle mass exercise hyperaemia are preserved in trained older people despite evident age-related structural and functional alterations in their leg conduit arteries.

Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015-2016

INTRODUCTION

Adherence to healthy lifestyle recommendations has positive effects on cancer outcomes yet adherence is low among cancer survivors. Differences in adherence between women and men, phase of survivorship, and other factors that might increase adherence, like the use of traditional and complementary medicine (T&CM), need to be explored. We aimed to study the adherence to national recommendations for a healthy diet (daily intake of ≥ 5 portions of fruit/vegetables), physical activity (150 min of moderate-intensity or 75 min of high-intensity/week), normal body mass index (BMI) (18.5-24.9 kg/m2), non-smoking, and low-risk alcohol consumption (women ≤ 10 g/day, men ≤ 20 g/day) among Norwegian cancer survivors and their associations with sex, the use of T&CM, and survivorship phase.

METHODS

We used logistic regression, independent sample t-test, and chi-square test to study self-reported (diet, physical activity, smoking, alcohol consumption) and measured (BMI) adherence in 1530 cancer survivors (40 years and above, participating in the population-based Tromsø Study conducted in 2015-2016 (65% attendance). We dichotomized all assessed lifestyle recommendations (adherence = 1 point, non-adherence = 0 points), and created a score for every recommendation (0-5 points). Adherence to individual lifestyle recommendations and the use of T&CM as well as the phase of survivorship was adjusted for sex, age, income, and living with a partner.

RESULTS

Adherence to recommendations was 7.5% for diet, 85.3% for physical activity, 30.5% for BMI, 89.3% for non-smoking, and 87.6% for alcohol consumption. In total 2.3% adhered to all five recommendations concurrently (mean score 2.96 [SD = 0.86]). Women adhered to more recommendations concurrently compared to men (3.03 [SD = 0.90] vs. 2.89 [SD = 0.80] points respectively, [p = .012]). In total, 31% reported the use of T&CM and there were no differences in adherence to individual lifestyle recommendations or concurrent adherence in overall T&CM use compared to non-use. Users of self-help techniques were more likely to adhere to the recommendations of diet (aOR 2.69, 95% CI 1.45-4.98) and physical activity (aOR 6.26, 95% CI 1.51-25.92). Users of traditional healers and users of more than one T&CM modality were less likely to adhere to the low-risk alcohol consumption recommendation, (aOR 0.32, 95% CI 0.13-0.77, and aOR 0.53, 95% CI 1.08-2.17, respectively) compared to T&CM non-users. Survivors with cancer previously (1162) had higher odds of adhering to the recommendation of diet (aOR 2.66, 95% CI 1.36-5.19) than survivors with cancer presently (n = 368), but not to other recommendations.

CONCLUSION

The health of cancer survivors can be improved through adherence to lifestyle recommendations, yet our study found partial adherence among survivors in Norway, in accordance with findings from other countries. Although overall T&CM use was not associated with higher adherence to lifestyle recommendations, differences in adherence were seen among individual modalities like the use of self-help techniques and traditional healers. Our results suggest the need for intensified follow-up of lifestyle with attention to male survivors and diet among all survivors throughout the cancer survivorship continuum.

Investigating the associations of the illness representations of gambling disorder with superstitious and responsible gambling

Background

As a theoretical framework for understanding illness self-management, the commonsense model of self-regulation (CSM) has been commonly used to promote health behaviors. However, its application to examining gambling disorder (GD) is still in an exploratory stage.

Objectives

Based on CSM, the current study aimed to address this knowledge gap and test whether illness representations (i.e., perceived consequences, illness coherence, and emotional representations) of GD are associated with gambling behaviors (i.e., responsible gambling [RG] and superstitious gambling). We also aimed to explore the potential mediating role of positive gambling beliefs (i.e., personal responsibility about gambling and gambling literacy) in such associations.

Methods

An online questionnaire survey with snowballing sampling method was administered to Chinese adult past-year gamblers, and 603 valid responses were collected. The structural equation modeling (SEM) analysis with a bootstrapping approach was utilized to test the associations of illness representations with gambling behaviors and the hypothesized mediation effects of positive gambling beliefs.

Results

We found that (a) perceived consequences of GD had significant, positive associations with RG and negative associations with superstitious gambling, with positive gambling beliefs acting as full mediators; (b) emotional representations for GD showed significant, negative correlations with RG and positive ones with superstitious gambling, with positive gambling beliefs acting as full and partial mediators, respectively; (c) the direct effect of illness coherence of GD on superstitious gambling behaviors was unexpectedly positive, and its indirect effects via positive gambling beliefs were nonsignificant.

Discussion

Under the framework of CSM, the current findings provided new insights in understanding both controlled and at-risk gambling patterns from a perspective of illness self-management. We suggest future GD prevention campaigns may adopt psychoeducational programs to help gamblers form a better understanding about GD as an illness, which may promote RG practices and hence lower the risk of developing GD.

Knowledge, Practice and Self-Reported Confidence Level of Croatian Dentists in the Use of Local Anesthesia: A Cross-Sectional Study

Objectives: To provide safe and effective local anesthesia, dentists must have knowledge of neuroanatomy, anesthesia agents, techniques, equipment, and proper use of local anesthetics. This study aims to explore the knowledge, practices, and confidence regarding local anesthetics and anesthetic techniques in dentistry. Material and Methods: The online cross-sectional questionnaire was conducted via social media, and yielded 441 responses from across the country (69.8% women and 30.2% men; 70.7% general dentists; and 29.3 specialists). The data collected included sociodemographic characteristics, knowledge, and practices pertaining to the usage of local anesthesia. The questionnaire also documents their self-assessed confidence level in applying different local anesthetic techniques and experiences with adverse reactions. The obtained data were processed by description and using a generalized linear model for regression. Results: The respondents had a median knowledge score of 6 out of a possible 14 points regarding local anesthetics in dental medicine, and their median self-confidence level in the successful application of various techniques of local anesthesia was 54 out of a maximum of 85 points. The results showed that a higher knowledge level was associated with the female gender (OR 1.83, CI 1.13-2.98, p = 0.014) and specialization in oral surgery (OR 7.04, CI 1.71-29.07, p = 0.007). In contrast, a lack of confidence in using various local anesthetic techniques was also associated with the female gender (OR 0.63, CI 0.41-0.99, p = 0.047) and specialization in orthodontics (OR 0.16, CI 0.03-0.88, p = 0.035). Of the respondents, 81.4% (n = 371) experienced a local complication, and 42.2% (n = 186) experienced a systemic complication during local anesthesia. The complications experienced cannot be associated with a lack of knowledge or self-confidence (p > 0.05). The majority of respondents (364 of the 441 total-82.5%) expressed interest in receiving further education on the topic of local anesthesia. Conclusions: The research results show that the dentists involved in the study have poor knowledge of local anesthetics and moderate self-reported confidence levels in using various local anesthetic techniques. Moreover, dentists' self-confidence in applying different techniques of local anesthesia is not related to their knowledge. Therefore, it would be necessary for dentists to undergo a continuing dental education program that enables them to enhance their skills and knowledge in local anesthesia.

The Relationship between Substance Use Stigma and COVID-19 Vaccine Hesitancy

Two parallel public health epidemics affecting the United States include the COVID-19 pandemic and a rise in substance use disorders (SUDs). Limited research has examined the potential relationship between these two epidemics. Our objective was therefore to perform an exploratory study in order to examine the association between public stigma toward people with a past history of opioid, methamphetamine, cocaine, and alcohol use disorder and COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 6515) completed a survey which assessed the degree of negative perceptions toward individuals with a past history of substance use disorders (referred to as substance use stigma) and COVID-19 vaccine hesitancy, along with variables such as racial prejudice, source of health news, and other demographics. We evaluated four multivariable logistic regression models to predict COVID-19 vaccine hesitancy, utilizing substance use stigma toward opioids, methamphetamine, cocaine, and alcohol use as independent variables. We found that COVID-19 vaccine hesitancy was positively associated with substance use stigma toward opioid (AOR = 1.34, p < 0.05), methamphetamine (AOR = 1.40, p < 0.01), and cocaine (AOR = 1.28, p < 0.05) use, but not alcohol use (AOR = 1.06, n.s.). Predictive models that incorporate substance use stigma may therefore improve our ability to identify individuals that may benefit from vaccine hesitancy interventions. Future research to understand the underlying reasons behind the association between substance use stigma and COVID-19 vaccine hesitancy may help us to construct combined interventions which address belief systems that promote both substance use stigma and vaccine hesitancy.

Adolescent determinants of life-course leisure-time vigorous physical activity trajectories: a 27-Year longitudinal study

BACKGROUND

Adolescence is regarded as formative years for building the foundations for life-long health and well-being, and adolescent determinants of physical activity (PA) development is particularly interesting. Novel approaches for the study of PA development, such as group-based trajectory modelling, opens for the possibility of identifying different patterns in the relationship among several known determinants of PA. This study aimed to explore how demographic, psychological and social factors in early adolescence determine membership in four distinct leisure-time vigorous physical activity (LVPA) trajectories from 13 to 40 years.

METHODS

This study is based on data from the Norwegian Longitudinal Health Behaviour Study, following a cohort born in 1977 from Western Norway. Four trajectories identified using latent class growth analysis, based on self-reposted LVPA (n = 1103, 45.5% women) measured ten times from age 13 to age 40 and 17 different adolescent determinants, were used in a multivariate multinomial logistic regression.

RESULTS

We found that gender (male), VPA intentions the next year and athletic identity associated with belonging to the two trajectories reporting the highest levels of LVPA in adolescence, while VPA intentions in ten years were associated with belonging to the active trajectory compared to the decreasingly active and low active trajectories Enjoyment increased the odds of belonging to the increasingly and decreasingly active trajectories compared to the low active trajectory. In addition, two of the social determinants, mother's PA and emotional support from father, were associated with belonging to the increasingly active trajectory when compared to the low active trajectory. Higher family income increased the odds of belonging to the increasingly active compared to the decreasingly active trajectory.

CONCLUSIONS

Both demographic, psychological, and social factors were identified as determinants of LVPA trajectory membership, and the findings support previous research related to the importance of intentions, but also indicate that enjoyment, role modelling and emotional support in PA can be of great importance to LVPA promotion among adolescents.

Training Emotional Intelligence Online: An Evaluation of WEIT 2.0

With the growing popularity of online courses, there is an increasing need for scientifically validated online interventions that can improve emotional competencies. We addressed this demand by evaluating an extended version of the Web-Based Emotional Intelligence Training (WEIT 2.0) program. Based on the four-branch model of emotional intelligence, WEIT 2.0 focuses on improving participants' emotion perception and emotion regulation skills. A total of 214 participants were randomly assigned to the training group (n = 91) or a waiting list control group (n = 123) to evaluate short-term (directly after WEIT 2.0) and long-term intervention effects (8 weeks later). Two-way MANOVAs and mixed ANOVAs showed significant treatment effects for self-reported emotion perception of the self, as well as emotion regulation of the self and others, after 8 weeks. No significant treatment effects were found for self-reported emotion perception in others or for performance-based emotion perception or emotion regulation. Moderator analyses revealed no significant effects of digital affinity on training success from the pretest to the posttest. The findings suggest that components of self-reported emotional intelligence can be enhanced through WEIT 2.0, but performance-based emotional intelligence cannot. Further research is needed on the online training of emotional intelligence and the mechanisms that underlie training success.

The reinforcement sensitivity theory affects questionnaire (RST-AQ). A validation study of a new scale targeting affects related to anxiety, approach motivation and fear

This paper presents the RST-AQ, a 22-item scale to measure the affective states related to the three motivational systems postulated by Reinforcement Sensitivity theory (RST-AQ): the Behavioral approach system (BAS), Behavioral inhibition system (BIS), and the Fight-Flight-Freeze system (FFFS). The three subscales are internally consistent. Results show an overall support for construct validity of our RST-AQ measure. The correlations of the RST-AQ subscales with other measures demonstrate a good convergent and divergent validity with regard to the subscales of BAS and BIS. The RTS-AQ Scale provides researcher with the first instrument to measures the affective states of the RST theory.

Measuring social desirability bias in a multi-ethnic cohort sample: its relationship with self-reported physical activity, dietary habits, and factor structure

BACKGROUND

Social desirability bias is one of the oldest forms of response bias studied in social sciences. While individuals may feel the need to fake good or bad answers in response to sensitive or intrusive questions, it remains unclear how rampant such a bias is in epidemiological research pertaining to self-reported lifestyle indicators in a multicultural Asian context. The main purpose of the current study is, therefore, to examine the sociodemographic correlates and impact of social desirability responding on self-reported physical activity and dietary habits at an epidemiological scale in a non-western multi-cultural Asian setting.

METHODS

Prior to the main analyses, confirmatory and exploratory factor analyses were conducted to determine the factorial validity of a western derived concept of social desirability. Multiple regression analyses were conducted on cross-sectional data (n = 2995) extracted from a nationwide survey conducted between 2019 and 2020.

RESULTS

A unique factor structure of social desirability was found and was therefore used for subsequent analyses. Multiple regression analyses revealed older age groups, the Indian ethnic group, those with past or present marriages, and having no income, had a significantly greater tendency to act on the bias.

CONCLUSION

The construct of social desirability bias was fundamentally different in a multicultural context than previously understood. Only a small proportion of variance of self-report lifestyle scores was explained by social desirability, thus providing support for data integrity.

A performance-based test to measure teachers' mathematics and science content and pedagogical knowledge

Developing an instrument to measure and compare mathematics and science content knowledge (CK) and pedagogical knowledge (PK) of teachers who graduated from Teacher Training University (TTU) with those of teachers who graduated from other universities in Iran was the primary purpose of this study. A total of 226 teachers were selected using a two-stage cluster random sampling, which included 84 teachers graduating from TTU and 142 teachers from other universities. The data were collected using mathematics, science CK, PK, and NEO tests to measure teachers' personality traits. The findings indicated a significant difference between the two groups of teachers in the CK tests, favoring TTU graduates. However, it was found that the two groups did not perform differently in the PK tests.

When workers feel like objects: A field study on self-objectification and affective organizational commitment

Objectification is a form of dehumanization that implies the perception of others as mere objects. The present study aimed to expand research on objectification in the work domain by exploring the relationships between objectifying job features, self-objectification, and affective organizational commitment within a real work setting. Building on previous literature, we hypothesized that the execution of objectifying work activities would be positively related to workers’ tendency to objectify themselves. Further, we expected a decrease in affective organizational commitment as the outcome of these perceptions. A study involving 142 Italian supermarket clerks (75 females) supported our hypotheses. Workers with a low-status job role (i.e., cashiers and salespeople vs. managers) perceived their activities as more objectifying. In turn, this perception heightened their self-objectification, which decreased workers’ commitment towards the organization. Our results enrich the understanding of workplace objectification by also providing relevant insights into the link between social-psychological and organizational processes.

Perceptions and Attitudes of Argentine Zoomers towards Sustainable Food Production

Young people are concerned about climate change. Their activism has attracted the attention of the media and politicians. Some of them are entering the market as consumers for the first time and can express their preferences without parental guidance: they are the Zoomers. Do these new consumers have enough knowledge about sustainability to be able to make choices in line with their concerns? Are they able to push the market towards change? A sample of 537 young Zoomer consumers were interviewed face-to-face in the Metropolitan Area of Buenos Aires. They were asked to indicate their level of concern for the planet and the first word they associated with sustainability, to rank in order of importance sustainability-related concepts and to indicate their willingness to buy sustainable products. The results of this study underline a high concern for the health of the planet (87.9%) and for unsustainable production methods (88.8%). However, the respondents perceived sustainability as consisting of a single main pillar, the environmental dimension (with 47% of the terms referring to sustainability), and two accessory pillars, the social (10.7%) and economic (5.2%) dimensions of sustainability. Respondents also showed a high interest in products obtained through sustainable agriculture, with a high percentage of them willing to pay for these products (74.1%). However, a substantial correlation was found between the ability to comprehend the notion of sustainability and the determination to purchase sustainable items, and vice versa, between those who reported difficulty comprehending the concept and their determination not to purchase these products. Zoomers believe that the market must support sustainable agriculture through consumer choices without paying a premium price. Clarifying the concept of sustainability, enhancing knowledge and assisting consumers in identifying sustainable products, as well as marketing them at reasonable prices, are essential actions for fostering a more ethical agricultural system.

A Three-Armed Randomized Controlled Trial to Evaluate the Effectiveness, Acceptance, and Negative Effects of StudiCare Mindfulness, an Internet- and Mobile-Based Intervention for College Students with No and "On Demand" Guidance

The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, "guidance on demand" (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (d = 0.91-1.06, 95% CI 0.66-1.32) and most other mental health outcomes (d = 0.25-0.69, 95% CI 0.00-0.94) compared with WL, with effects generally persisting after 6 months. Exploratory comparisons between UG and GoD were mostly non-significant. Adherence was low but significantly higher in GoD (39%) vs. UG (28%) at the 6-month follow-up. Across versions, 15% of participants experienced negative effects, which were mostly mild. Both versions effectively promoted mental health in college students. Overall, GoD was not associated with substantial gains in effectiveness or adherence compared with UG. Future studies should investigate persuasive design to improve adherence.

The Divergent Effects of the Public's Sense of Power on Donation Intention

Studies of the relationship between individuals' sense of power and donation intention have inconsistent findings. Classifying donor intention into two types, this study explored the mechanism through which a sense of power affects donation intention. Using a three-wave time-lagged survey of 1200 people, this study found that situational prevention focus mediates the positive effect of a sense of power on avoidance-based donation intention, and situational promotion focus mediates the positive effect of a sense of power on improvement-based donation intention. Furthermore, a strong perceived ethical climate strengthens the effects of a sense of power. These findings have practical implications for increasing charitable giving and improving the development of charitable programs.