Altruistic help or taking advantage of the situation? Social representations of surrogate motherhood

Concerning Europe, the lay public, mainly in Central regions, still lacks information about what surrogacy is and how the process works in practice. It is one of the most controversial methods of assisted reproduction precisely because it goes against traditional social norms and ideas about the conception of life. The main aim of our study was to map the social representations of lay people that are formed in internet discussions. We focused on discussion forums over a time span of the last 10 years, from 2013 to 2022. We were also interested in whether perceived risks or benefits formed the core of social representations. Through a reflexive thematic analysis, we identified two distinct constructions of social representations of surrogacy, finding that value settings in terms of liberalism and conservatism appear to have the greatest influence on the anchoring and objectification of surrogacy.

Sexualization of Children or Human Rights? Attitudes Toward Addressing Sexual-Orientation Diversity in School

Lesbian, gay, and bisexual (LGB) adolescents are more likely to experience mental health problems than their heterosexual peers because they are victimized more often or fear discrimination. Governmental plans to improve this situation by addressing sexual diversity in German schools have been accompanied by public resistance and misinformation, e.g., that they aim to sexualize children. The present study assessed how widespread negative attitudes toward such plans really are and how they can be explained. A random sample of 2,013 German residents was surveyed by phone. Only 10% opposed promoting acceptance of LGB in school. Approval of such plans was predominantly predicted by respondents' beliefs about sexual orientation and the plans' aim, and only marginally by societal values. Respondents who knew that the plans' aim was to promote acceptance of LGB and not to sexualize children and that children with same-sex parents are just as well off as those with heterosexual parents showed higher approval, whereas respondents who believed that homosexuality is affected by socialization showed higher opposition.

The Social Values of Nursing Staff and the Perceived Quality of Their Professional Lives

This study's main purpose involves exploring the relationship between the social values of nursing staff and the perception they have of their professional lives. A further aim is to examine how their terms of employment and tenure of service relate to the quality of their careers and their social values. The research consisted of a non-experimental quantitative approach of a descriptive nature involving 380 nursing staff at four public hospitals in Madrid (Spain). The values were appraised by means of the Schwarz Value Survey (SVS) and the quality of their careers was measured through the Quality of Professional Life (QPL-35) questionnaire. The results reveal significant correlations between the two, highlighting the significance of such values as universalism, benevolence, achievement and power depending on their terms of employment, on the one hand, and all the values in the Schwartz model according to the length of their tenure on the other. The findings suggest that terms of employment and tenure are significantly related to the axiological profile of nursing staff and the quality of their professional lives. This study provides major empirical evidence that contributes to our understanding of how social values and the quality of professional lives are interwoven within the field of nursing in Spain.

We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment

It is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsistently employed, undermining transparency and preventing proper scrutiny of the rationales on which decisions are based. This paper - developed through a cross-disciplinary collaboration of 24 researchers with expertise in healthcare priority-setting - seeks to address this problem by offering a clear definition of key terms and distinguishing between the types of normative commitment invoked during HTA, thus providing a novel conceptual framework for the articulation of reasoning. Through application to a hypothetical case, it is illustrated how this framework can operate as a practical tool through which HTA practitioners and policymakers can enhance the transparency and coherence of their decision-making, while enabling others to hold them more easily to account. The framework is offered as a starting point for further discussion amongst those with a desire to enhance the legitimacy and fairness of HTA by facilitating practical public reasoning, in which decisions are made on behalf of the public, in public view, through a chain of reasoning that withstands ethical scrutiny.

Healthcare priority-setting criteria and social values in Iran: an investigation of local evidence

INTRODUCTION

Integrating social values into health technology assessment processes is an important component of proper healthcare priority setting. This study aims to identify social values related to healthcare priority setting in Iran.

METHOD

A scoping review was conducted on original studies that investigating social values in the healthcare system in Iran. The databases of PubMed, EMBASE, and EBSCO were searched with no restrictions on time and language. The reported criteria were clustered using Sham's framework of social value analysis in health policy.

RESULTS

Twenty-one studies published between 2008 and 2022 met the inclusion criteria. Fourteen of the included studies followed a quantitative approach with different methods to identify criteria, and the remaining seven studies used a qualitative approach. A total of fifty-five criteria were extracted and clustered into necessity, quality, sustainability, and process categories. Only six studies found criteria that were related to processes. Only three studies used public opinions as a source of value identification and eleven studies investigated the weight of criteria. None of the included studies explored the interdependency of the criteria.

CONCLUSION

Evidence suggests that several criteria other than cost per health unit also need to be considered in healthcare priority setting. Previous studies have paid little attention to the social values that underlie priority setting and policy-making processes. To reach consensus on social values related to healthcare priority setting, future researches need to involve broader stakeholders' perspectives as a valuable source of social values in a fair process.

Alternatives to the quality-adjusted life year: How well do they address common criticisms?

OBJECTIVE

To analyze whether other outcome measures used in health technology assessment (HTA) address the criticisms of quality-adjusted life years (QALYs).

DATA SOURCES AND STUDY SETTING

HTA methods guidance from 11 US comparator countries (the G10 and Australia) and six value frameworks from US organizations were reviewed to identify health outcome measures currently used to evaluate the benefits of a drug.

STUDY DESIGN

The study involved a documentary analysis of guidelines to identify outcome measures used by the sampled HTA organizations. Similar outcomes were grouped together into outcome types. Each type was analyzed to determine the extent to which it replicates key advantages and responds to criticisms of QALYs extracted from the literature.

EXTRACTION METHODS

Outcomes were included if guidance from at least one HTA organization identified the outcome as acceptable for HTA. Outcomes measuring or evaluating the benefit, clinical effect, or impact of a drug or health technology was included; methods of calculating costs were excluded.

PRINCIPAL FINDINGS

Seven types of outcome measures were identified falling into three groups: preference-based, single-dimension outcomes, and outcomes using non-health perspectives. Among the seven QALY alternative outcome measures currently used for HTA by the sampled countries, no one outcome measure addresses all the QALY criticisms while retaining the advantageous features of the QALY.

CONCLUSIONS

Proposals to adopt health technology assessment (HTA) to support value-based pricing of prescription drugs in the US have faced pushback over the use of the QALY. There is no single "right" outcome measure, and the criticisms of QALYs apply to other outcome measures used to evaluate health. The measures identified have different features and strengths, which may be appropriate for specific decision making goals, but the QALY remains the best option for decision making that requires comparisons of the overall societal value of health gains.

The 12 Rs Framework as a Comprehensive, Unifying Construct for Principles Guiding Animal Research Ethics

Animal research ethics and animal welfare in science have become progressively tightly regulated, and ethical integrity and scientific quality, as well as social responsiveness and responsibility have become key requirements for research to be approved, funded, published, and accepted. The multitude of factors to contemplate has in some instances not only become complex, requiring a team approach, but often perceived as confusing and overwhelming. To facilitate a process of simplistic yet comprehensive conceptualization, we developed the 12 Rs Framework to act as a mind map to guide scientists, oversight structures, and other stakeholders through the myriad of ethical considerations. It unfolds into three domains of twelve encompassing ethical principles, values, and other considerations, including the animal welfare, social values, and scientific integrity domains, whilst also recognizing the diversity of local context, legal requirements, values, and cultures around the globe. In the end, it can be seen as a unifying ethical framework to foster and promote animal research ethics.

Unlocking the connection between education, entrepreneurial mindset, and social values in entrepreneurial activity development

The Entrepreneurial University constitutes a phenomenon that highlights the prominent roles played by academic organizations as aggregators of capabilities, enabling the establishing of bridges between innovation and Entrepreneurial Ecosystems. This research therefore sets out to analyze the relationship between the Total Early Stage Entrepreneurial Activities of individual graduates and their entrepreneurial attitudes and social values towards entrepreneurship. This applies data sourced from the Global Entrepreneurship Monitor report on innovation-driven countries. The main research findings stem from the regression models (Study 1) and fsQCA analysis (Study 2) returning evidence that the likelihood of adult graduates setting up firms or owning young companies rises whenever such individuals deem they hold the knowledge/skills required to start a business. The results also stress the importance of devoting high levels of media attention to entrepreneurship and fostering entrepreneurial cultures capable of fostering economic growth and prosperity. This research makes substantial theoretical contributions to the literature. Firstly, the findings reinforce the applicability and suitability of fsQCA analysis of Global Entrepreneurship Monitor data. Secondly, this study strengthens the credibility of the Institutional Theory and Theory of Planned Behavior theoretical frameworks, correspondingly lending support to the importance of institutional or organizational factors as determinants of entrepreneurship and the need to focus on the linkage between entrepreneurial attitudes, entrepreneurial intentions, and entrepreneurial behaviors.

Impact of information and deliberation on the consistency of preferences for prioritization in health care - evidence from discrete choice experiments undertaken alongside citizens' juries

BACKGROUND

Public preferences are an important consideration for priority-setting. Critics suggest preferences of the public who are potentially naïve to the issue under consideration may lead to sub-optimal decisions. We assessed the impact of information and deliberation via a Citizens' Jury (CJ) or preference elicitation methods (Discrete Choice Experiment, DCE) on preferences for prioritizing access to bariatric surgery.

METHODS

Preferences for seven prioritization criteria (e.g. obesity level, obesity-related comorbidities) were elicited from three groups who completed a DCE: (i) participants from two CJs (n = 28); (ii) controls who did not participate in the jury (n = 21); (iii) population sample (n = 1,994). Participants in the jury and control groups completed the DCE pre- and post-jury. DCE data were analyzed using multinomial logit models to derive "priority weights" for criteria for access to surgery. The rank order of criteria was compared across groups, time points and CJ recommendations.

RESULTS

The extent to which the criteria were considered important were broadly consistent across groups and were similar to jury recommendations but with variation in the rank order. Preferences of jurors but not controls were more differentiated (that is, criteria were assigned a greater range of priority weights) after than before the jury. Juror preferences pre-jury were similar to that of the public but appeared to change during the course of the jury with greater priority given to a person with comorbidity. Conversely, controls appeared to give a lower priority to those with comorbidity and higher priority to treating very severe obesity after than before the jury.

CONCLUSION

Being informed and undertaking deliberation had little impact on the criteria that were considered to be relevant for prioritizing access to bariatric surgery but may have a small impact on the relative importance of criteria. CJs may clarify underlying rationale but may not provide substantially different prioritization recommendations compared to a DCE.

Value of social activities and prerequisites for continued participation of rural older adults: A qualitative study

AIMS

To explore the value of social activities and the prerequisites for continuous participation among rural older adults based on their experiences.

DESIGN

Qualitative, descriptive design.

METHODS

Individual semi-structured interviews were conducted with 14 older adults from voluntary community salons in a rural area in Japan. Participants were selected through purposeful sampling. Data were analyzed using qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used.

RESULTS

Four values of social activities were identified: "Mutual benefit connectedness," "Preventing and coping with aging," "Making life brilliant 'now'," and "Building a safety net." Three prerequisites for activities were identified: "Do not overreach," "Do not infringe on personal territory," and "Do not go against community norms." Social activities provide rural older adults with reciprocity ties, coping with aging, enhanced daily lives, and a social safety net. Continued participation in rural social activities requires adherence to cultural norms and moderation of relationship distances. Community and public health nurses are expected to promote social activities that incorporate these values and adhere to these prerequisites.

Understanding the Influence of Initial Values of College Students in Shaping Pro-Environmental Behavioral Intention

Pro-environmental behaviors are rooted in values, and understanding the initial values among college students is pivotal in developing educational strategies to improve their pro-environmental behavior. However, most pro-environmental behavior studies fail to consider the social values and personal values as different dimensional or even conflicting values. This study integrated two distinct values, namely perceived social values and perceived personal values, with the technology acceptance model (TAM) to examine how different values shape college students' pro-environmental behavioral intentions. The proposed model was then empirically validated using survey data from 245 responses from freshmen students at a University in Chongqing. The findings reveal that while perceived social values and perceived personal values are both positively related to behavioral intention, the effect sizes of the former are much larger. Our findings highlight that higher institutions and instructors should continue shaping the prosocial values among college students and create personal values from pro-environmental behavior to reduce the detrimental impact on the environment and achieve sustainability.

The value of adult orthodontics: Do the public's willingness-to-pay values reflect the profession's?

OBJECTIVE

To explore how the public and dental professionals would value an orthodontic service for adults by eliciting their willingness-to-pay (WTP), a standardised health economics technique which quantifies 'strength of preference' in monetary terms. Despite increasing demand, adults in the UK are only eligible for NHS orthodontic treatment if there is severe dental health or complex multidisciplinary need. Orthodontic services are provided to children aged under 18 years who are eligible by their Index of Orthodontic Treatment Need (IOTN) score. Consequently, many adults who may have a need for treatment as determined by IOTN are unable to access this service.

DESIGN

Cross-sectional survey.

SETTING

General dental practices in North East England and national specialists approached through the British Orthodontic Society (BOS).

PARTICIPANTS

Public participants were recruited from general dental practices. Dentists were recruited from local dental lists and members of the BOS.

METHODS

Participants were asked if they would be willing to pay to see an orthodontic service extended to all adults in England with a qualifying IOTN. Clinical photographs of three malocclusions were presented and maximum WTP in additional tax per household per year was elicited using shuffled payment cards.

RESULTS

A total of 205 dentists and 206 public participants were recruited. Pairwise tests showed a statistically significant difference in WTP between the public and professionals for all malocclusions, with the public giving higher valuations. In both groups, the Class III scenario elicited a higher WTP than the class I or II malocclusion. However, when all other factors were controlled for using a regression analysis, the group (public or profession) and the other variables did not significantly influence WTP.

CONCLUSION

The public and professionals were willing to pay for an adult orthodontic service. Due to this variability and unpredictability the allocation of healthcare resources will remain contentious.

[The social human health as a complex interdisciplinary problem]

The preservation and promotion of population social health is one of actual global problems worldwide. The various phenomena currently associated with coronavirus pandemic, threats to individual human physical and mental health put the whole world on dangerous brink of self-destruction that actualize studying of human vital forces and human social health. The versatility of this problem is based on unity of personal vital forces, social health and social values where human is to be the highest value of state social policy. The article represents analysis of scientific publications, proposes genuine concept of harmonious personality modeling and substantiates need in studying human social health and individual vitality as complex interdisciplinary problem.

Patient perspectives on states worse than death: A qualitative study with implications for patient-centered outcomes and values elicitation

BACKGROUND

Seriously ill patients rate several health outcomes as states worse than death. It is unclear what factors underlie such valuations, and whether consideration of such states is useful when making medical decisions.

AIM

We sought to (1) use qualitative approaches to identify states worse than death, (2) identify attributes common to such undesirable health states, and (3) determine how participants might use information on these states in making medical decisions.

DESIGN

Qualitative study of semi-structured interviews utilizing content analysis with constant comparison techniques.

SETTING, PARTICIPANTS

We interviewed adults age 65 or older with serious illnesses after discharge home from one of two urban, academic hospitals. Eligible patients were purposively sampled to achieve balance in gender and race.

RESULTS

Of 29 participants, 15 (52%) were female, and 15 were white (52%), with a median age of 72 (interquartile range 69, 75). Various physical, cognitive, and social impairments were identified as states worse than death. The most commonly reported attributes underlying states worse than death were perceived burden on loved ones and inability to maintain human connection. Patients believed information on states worse than death must be individualized, and were concerned their opinions could change with time and fluctuations in health status.

CONCLUSIONS

Common factors underlying undesirable states suggest that for care to be patient-centered it must also be family-centered. Patients' views on using states worse than death in decision making highlight barriers to using avoidance of such states as a quality measure, but also suggest opportunities for eliciting patients' values.

Older adult life in COVID-19 pandemic: Focus on social isolation, loneliness, and minimization of risks

At the moment of worldwide lockdown with the outbreak of coronavirus disease 2019 (COVID-19), older adult life bangs up with lots of changes such as stagnation in life, abuses, or violence (e.g., physical, emotional, sexual, and neglect). Older adults are feeling and experiencing more deprivation of social connectedness in a self-isolating environment. When there is a need for solidarity worldwide, COVID-19 is escalating stigmatization and discrimination against older adult populations. For this reason, we are particularly interested/accentuated more on the isolation life and loneliness lifestyles of older adults residing inside the four walls of their houses. In addition, emphasis is also given on different approaches of 4 R's such as reinoculate, remove, restore, and resilience for minimization of impact of COVID-19 among older adults. However, the cultural differences and societal values also played a major role in minimization of mental health challenges and illnesses during lockdown in Western and Eastern societies. The "We-ness" of collectivistic culture of Eastern societies brings more "Wellness" for older adult mental health. On the other hand, the "I-ness" of individualistic culture of Western societies brings only "Illness" for the older adult population. Still, many countries are facing a second or third wave of COVID-19, which are worsening the situation more for the older adult population. With aging and social isolation in pandemic, older adults' well-being can be restored by developing healthy habits, involvement in religious activities, adopting natural healing techniques, and positive thinking toward the life.

Using social values in the prioritization of research: Quantitative examples and generalizations

Identifying critical uncertainties about ecological systems can help prioritize research efforts intended to inform management decisions. However, exclusively focusing on the ecological system neglects the objectives of natural resource managers and the associated social values tied to risks and rewards of actions.I demonstrate how to prioritize research efforts for a harvested population by applying expected value of perfect information (EVPI) to harvest decisions made with a density-independent matrix population model. Research priorities identified by EVPI diverge from priorities identified by matrix elasticity analyses that ignore social utility.Using a density-dependent harvest model, the value of information about the intrinsic productivity of a population is shown to be sensitive to the socially determined penalty for implementing a harvest rate that deviates from the goal because of imperfection in estimation. Synthesis and applications. The effect of including social values into harvest decision-making depends on the assumed population model, uncertainty in population vital rates, and the particular form of the utility function used to represent risk/reward of harvest. EVPI analyses that include perceived utility of different outcomes can be used by managers seeking to optimize monitoring and research spending. Collaboration between applied ecologists and social scientists that quantitatively measure peoples' values is needed in many structured decision-making processes.

Alcohol Consumption During Pregnancy in Brazil: Elements of an Interpretive Approach

With this research, we aimed to raise elements to enhance the understanding of alcohol consumption among pregnant women in Brazil. Fourteen women identified as alcohol consumers during pregnancy were interviewed. Alcohol consumption during pregnancy seemed to be associated with three groups of interconnected issues: subjective and individual issues (such as expectations, motivations, and women's difficulty in identifying their own consumption as risky); sociocultural and environmental issues (such as alcohol cultural value, easy access, and influence from relatives, friends, and partners); misinformation, inconsistent opinions publicized through media and lack of technically addressing the subject during prenatal care. Collective and individual health educative actions seem necessary to decrease alcohol consumption among Brazilian women with similar sociocultural characteristics. Media campaigns and explicit information about negative alcohol effects, articulated with individualized actions, such as a systematic approach of this theme during prenatal care, could allow earlier and more appropriate identification and intervention of women at risk.

Professional and ethical values in Nursing practice: An Indian Perspective

OBJECTIVES

This study was carried out to examine professional and ethical values related to the profession from nurses' perspectives.

METHODS

This was a cross-sectional survey carried out among 124 randomly selected nurses working at a tertiary care hospital in South India. The data was collected using Nursing Professional Values scale (NPVS-3). This tool consisted of 28 items to assess nurses' professional values in three domains namely; Caring (10 items), activism(10items), and professionalism (8items). The maximum range of scores is 28-140. The higher the score, the stronger the nurse's professional value orientation.

RESULTS

The mean total score of the Professional Value scale was high (121.07±15.32). The mean score of the participants was higher in the caring domain (44.02±5.75) than activism (42.19±6.33) and professionalism domains (34.86±4.27). Pearson correlational analysis revealed that nurses with less experience had greater mean professional values score than nurses with higher experience (p<0.01).

CONCLUSIONS

The present study showed that nurses have high professional and ethical values, although they perceive that the most important values are those related to direct patient care. Continuing education programs should be designed so that nurses understand that nonclinical professional values are also equally important in promoting the nursing profession.

Societal religiosity and the gender gap in political interest, 1990-2014

This manuscript examines the structural causes of the gender gap in political interest. In many countries, men are more interested in politics than women. Yet, in others, men and women prove equally interested. We explain this cross-national variation by focusing on the effects of societal religiosity. Since religion sustains the traditional gender order, contexts where societal religiosity is low undermine the taken-for-grantedness of this order, subjecting it to debate. Men then become especially interested in politics to try to reassert their traditional gender dominance, or to compensate for their increasingly uncertain social status. A secular environment thus increases political interest more among men than among women, expanding this gender gap. Using the World and European Values Survey, we estimate three-level regression models and test our religiosity-based approach in 96 countries. The results are consistent with our hypothesis.

The Moral Foundations of Child Health and Social Policies: A Critical Interpretive Synthesis

Background: Allusions to the uniqueness and value of childhood abound in academic, lay, and policy discourse. However, little clarity exists on the values that guide child health and social policy-making. We review extant academic literature on the normative dimensions of child health and social policy to provide foundations for the development of child-focused public policies. Methods: We conducted a critical interpretive synthesis of academic literature on the normative dimensions of child health and social policy-making. We employed a social constructivist lens to interpret emergent themes. Political theory on the social construction of target populations served as a bridge between sociologies of childhood and public policy analysis. Results: Our database searches returned 14,658 unique articles; full text review yielded 72 relevant articles. Purposive sampling of relevant literature complemented our electronic searches, adding 51 original articles, for a total of 123 articles. Our analysis of the literature reveals three central themes: potential, rights, and risk. These themes retain relevance in diverse policy domains. A core set of foundational concepts also cuts across disciplines: well-being, participation, and best interests of the child inform debate on the moral and legal dimensions of a gamut of child social policies. Finally, a meta-theme of embedding encompasses the pervasive issue of a child’s place, in the family and in society, which is at the heart of much social theory and applied analysis on children and childhood. Conclusions: Foundational understanding of the moral language and dominant policy frames applied to children can enrich analyses of social policies for children. Most societies paint children as potent, vulnerable, entitled, and embedded. It is the admixture of these elements in particular policy spheres, across distinct places and times, that often determines the form of a given policy and societal reactions to it. Subsequent work in this area will need to detail the degree and impact of variance in the values mix attached to children across sociocultural contexts and investigate tensions between what are and what ought to be the values that guide social policy development for children.

Dimension reduction of subjective motivational values toward child gender tool tested in women of reproductive age from a hospital in rural area of Himachal Pradesh, India

Background

A novel subjective Motivational Value toward Child Gender (MVCG) tool was developed using the theoretical construct of 10 motivational domains described by Shalom H Schwartz.

Objective

The study aimed to summarize the pattern of correlations of (MVCG) in women of reproductive age in Himachal Pradesh, India.

Methods

A cross-sectional study was conducted from October 2018 to November 2019 among a sample of 355 women. Required data were collected through an interviewer-administered questionnaire. Maximum likelihood exploratory factor analysis (EFA) with oblique rotation was done with Bartlett's test sphericity and Kaiser-Meyer-Olkin test.

Results

A total of 28 (53.8%) questions loaded on eight factors explaining maximum variance (68.7%). Reliability analysis of these questions, with high loadings on extracted factors, of the questionnaire, observed with poor Cronbach's alpha of 0.61 and intraclass cluster coefficient (ICC) 0.49. However, selected domains such as tradition, power, achievement, self-direction, and benevolence were observed with a good Cronbach's alpha and ICC.

Conclusion

MCVG is novel tool in its kind with well scalable properties in measuring subjective motivational values towards child gender. After EFA, total questions across 10 domains reduced from 52 to 28, across 8 domains, loaded on 8 factors with good reliability and agreement.

Disposition toward privacy and information disclosure in the context of emerging health technologies

Objective

We sought to present a model of privacy disposition and its development based on qualitative research on privacy considerations in the context of emerging health technologies.

Materials and Methods

We spoke to 108 participants across 44 interviews and 9 focus groups to understand the range of ways in which individuals value (or do not value) control over their health information. Transcripts of interviews and focus groups were systematically coded and analyzed in ATLAS.ti for privacy considerations expressed by respondents.

Results

Three key findings from the qualitative data suggest a model of privacy disposition. First, participants described privacy related behavior as both contextual and habitual. Second, there are motivations for and deterrents to sharing personal information that do not fit into the analytical categories of risks and benefits. Third, philosophies of privacy, often described as attitudes toward privacy, should be classified as a subtype of motivation or deterrent.

Discussion

This qualitative analysis suggests a simple but potentially powerful conceptual model of privacy disposition, or what makes a person more or less private. Components of privacy disposition are identifiable and measurable through self-report and therefore amenable to operationalization and further quantitative inquiry.

Conclusions

We propose this model as the basis for a psychometric instrument that can be used to identify types of privacy dispositions, with potential applications in research, clinical practice, system design, and policy.

Relationship Between Basic Human Values and Decision-Making Styles in Adolescents

This paper examines the relationship between decision-making styles and values of Spanish adolescents and analyses the role of age and gender on their use of adaptive and maladaptive decision-making styles. The scientific literature suggests that decision-making consists of different stages through which individuals reach a solution to their dilemmas. An ex post facto quantitative, non-experimental research design was used and applied to a sample of adolescents of Madrid (España). The Flinders Adolescents Decision-Making Questionnaire (FADMQ) by Mann as well as the Schwartz Values Scale (SVS) were also used. Correlation analysis was used to analyze the decision-making styles and values of adolescents using the variables gender and age to classify the sample. The study concludes that adolescents who use an adaptive decision-making style tend to pursue mastery of the values Self-direction, Stimulation, Achievement, and Power, whereas adolescents who use a maladaptive style tend to shy away from the value Self-direction and are more conservative. In terms of gender, the results for both females and males coincide in the significant correlations found between their decision-making styles and values. In terms of age, the correlations between values and decision-making styles are higher and numerous in younger adolescents. We conclude that the relationships verified could help educators to engage and act on the development of specific decision-making training programs based on the values of adolescents.

Domineering Dispositions and Hierarchy Preferences: Differentiating the Impact of Traits and Social Values in Economic Games

In this article, we examined the relation between valuing hierarchies (dominant value orientations) and personally wanting to get ahead, without regard for others' welfare (domineering dispositions). Survey data from five studies (total N > 1,500) indicated differences between being domineering and endorsing dominant value orientations. This distinction was also evident in different strategies in economic games. Domineering individuals typically gave less to a powerless player (dictator game) but changed behaviors when the other party possessed bargaining power (ultimatum game). Individuals endorsing dominant value orientations did not show such "exploitative opportunism." In a third-party punishment task, in contrast, individuals with dominant value orientations were more likely to intervene against fair decisions (i.e., upholding inequalities between others). Correcting behaviors of others were not predicted by domineering dispositions. We discuss implications for distinguishing between traits and social values more broadly.

Understanding Human-Nature Connections Through Landscape Socialization

Understanding the landscape socialization underpinning the human–nature relationship is essential because it can contribute to assisting us to reconnect with nature. Reconnecting to nature is increasingly recognized as positively contributing to health and well-being. This study aimed to understand people’s connections with nature through landscape socialization under different land use policies. The study assumed that social values, as perceived by residents, facilitates their landscape socialization. Using a questionnaire measuring sense of community and the Social Values for Ecosystem Services application as analytical tools, the study assessed how residents with varying educational attainment, sense of community, and grounded occupation differ in identifying with conservation- and recreation-oriented policy interventions. The results demonstrated the role of landscape socialization in how people connect with nature, and the landscape socialization as a result of long-term policy interventions may exert substantial effects on residents’ social values across various spatial scales. The results deepen the general understanding of system leverage points for creating inner connections to nature which can aid sustainability transformation.

Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non-remunerated blood donors?

BACKGROUND

We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, São Paulo and Belo Horizonte.

MATERIAL AND METHODS

A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed.

RESULTS

Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3-1.9, for replacement and AOR = 1.3, 1.2-1.6, for community donors), previous donation (AOR = 2.7, 2.3-3.3, for replacement and AOR = 2.9, 2.5-3.5, for community donors) and high altruism (AOR = 1.3, 1.1-1.7, for replacement and AOR = 1.2, 1.0-1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and São Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour.

CONCLUSION

The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.

Parenting Styles, Internalization of Values and Self-Esteem: A Cross-Cultural Study in Spain, Portugal and Brazil

The present study analyzes the impact of parenting styles on adolescents' self-esteem and internalization of social values in three countries, Spain, Portugal and Brazil. The sample of the study was comprised of 2091 adolescents from Spain (n = 793), Portugal (n = 675), and Brazil (n = 623) from 12-18 years old (52.1% females). The four types of parenting styles, authoritative, indulgent, authoritarian and neglectful, were measured through the warmth and strictness dimensions of the Scale of Parental Socialization ESPA29. The two criteria variables were captured with the five dimensions of the AF5, Five-Factor Self-Concept Questionnaire, and with self-transcendence and conservation Schwartz values. Results confirm emergent research in parenting socialization: the use of parental warmth is evidenced as key for adolescent self-esteem and internalization of social values in the three countries analyzed. Indulgent and authoritative parenting (both characterized by parental warmth) are associated with the highest value internalization in the three countries. Furthermore, indulgent parenting (use of warmth) is associated with the highest adolescent self-esteem, overcoming authoritative parenting (use of warmth and strictness). The influence of parenting over adolescent self-esteem and values internalization is maintained independent of the differences in self-esteem and value priorities observed in the cultural context, the sex and age of the participants.

Qualitative Research for One Health: From Methodological Principles to Impactful Applications

The One Health concept has inspired a rich vein of applied research and scholarly reflection over the past decade, yet with little influence from qualitative methodologists. With this overview, we describe the underpinning assumptions, purposes, and potential pitfalls of data collection techniques and methods of data analysis in key qualitative research methodologies. Our aim is to enhance One Health collaborations involving qualitative researchers, veterinary epidemiologists, and veterinary economists. There exist several distinct traditions of qualitative research, from which we draw selectively for illustrative purposes. Notwithstanding important distinctions, we emphasize commonalities and the potential for collaborative impact. The most important commonality is a shared focus on contextualizing human behavior and experience–culturally, economically, historically, and socially. We demonstrate that in-depth attention to context can assist veterinary economists and epidemiologists in drawing lessons from the implementation of policies and programs. In other words, qualitative researchers can assist One Health teams in distilling insights from “success stories,” but also from adverse events and unintended consequences. As a result, qualitative researchers can contribute to One Health research and policy discussions by formulating more accurate and contextually-relevant parameters for future quantitative studies. When performed well, qualitative methodologies can help veterinary economists and epidemiologists to develop impactful research questions, to create more accurate and contextually-relevant parameters for quantitative studies, and to develop policy recommendations and interventions that are attuned to the political and socio-cultural context of their implementation. In sketching out the properties and features of influential methodologies, we underscore the value of working with seasoned qualitative researchers to incorporate questions about “what,” “how,” and “why” in mixed-methods research designs.

Do Social Values and Institutional Context Shape the Use of Economic Evaluation in Reimbursement Decisions? An Empirical Analysis

OBJECTIVES

To investigate whether the use of economic evaluation (EE) in healthcare decision making is influenced by the social values and institutional context in a given country.

METHODS

We developed and tested a conceptual framework for the 36 Organisation for Economic Co-operation and Development (OECD) countries. The countries were divided into two groups based on the extent of their use of EE in drug reimbursement. The key social values were efficiency, equity, and personal responsibility, measured in an international survey. Countries were classified based on their institutional context in terms of their general welfare paradigm/type of healthcare system and the administrative tradition to which they belong. We performed correlation tests and ran path analysis regression models to test our hypotheses.

RESULTS

EE high users included significantly more Beveridge-type systems (50% vs 31%) and fewer Bismarck-type (15% vs 56%). Napoleonic tradition countries seemed to reject personal responsibility in health (r = -0.511, P = .009), whereas Germanic tradition countries embraced it (r = 0.572, P = .003); Anglo-American tradition countries exhibited a significant association with efficiency (r = 0.444, P = .026), whereas Scandinavian tradition countries appeared to reject it as a criterion for rationing in healthcare (r = -0.454, P = .023). No significant direct association was found between social values and use of EE.

CONCLUSION

Our exploratory analysis suggests that institutional context and, indirectly, social values may play a role in shaping the use of EE in healthcare decision making. Because of the differences among countries in terms of institutional context, which may in part be influenced by social values, it is unlikely that there will ever be a single, harmonious approach to the use of EE.

Common, nonsexual masochistic preferences are positively associated with antisocial personality traits

Objective

Based on prior research linking masochism and antisocial behavior to sensation seeking, we hypothesized that masochistic and antisocial preferences are positively correlated. Besides sensation seeking, we tested whether disgust sensitivity (due to its inhibitory function) and shared social values (e.g., stimulation) accounted for the masochistic‐antisocial link. We additionally examined the link in relation to broad personality factors.

Method

Six online and laboratory studies (N = 2,999) with US‐American and European samples.

Results

We consistently found positive correlations between masochistic enjoyment (e.g., enjoying the burn of spicy food, disgusting jokes, pounding heart, painful massage) and antisocial traits such as subclinical psychopathy, everyday sadism, and low Honesty‐Humility. We observed behavioral correlations in that experienced pleasure of a painful event was positively related to causing another person to feel pain. Shared sensation seeking, low disgust sensitivity, and endorsement of social values such as social power, hedonism, and a stimulating life partially accounted for the masochistic‐antisocial link.

Conclusion

The extent to which a person enjoys threatening stimuli on the self is reliably related to how much a person enjoys and evokes others' suffering. Future research could explore the common core that underlies common masochistic and antisocial preferences beyond the mediators tested here.

Standing out and not fitting in: The Dark Triad traits and social values

We replicated and extended (N = 207) work on the social values (i.e., obedience, tradition, security, benevolence, universalism, self-direction, stimulation, hedonism, achievement, and power) linked to the Dark Triad traits (i.e., narcissism, psychopathy, and Machiavellianism). Each of the traits was positively associated with values of achievement and power. Psychopathy and narcissism were both negatively correlated with benevolence, and psychopathy and Machiavellianism were negatively correlated with obedience. Psychopathy was also negatively correlated with tradition. Sex differences in the values of tradition, benevolence, and power were mediated by psychopathy. We suggest that high rates of the Dark Triad traits facilitate, for men, holding social values that emphasize standing out whereas low rates facilitate, for women, fitting in.

Community members trusted by African American parents for vaccine advice

Exposure to pro-vaccination messages from nonmedical peers and others perceived to share a similar value system for society (referred to as worldview outlook) improves vaccination attitudes. Nonetheless, a minority of African American parents have friends and family members who provide them with vaccine advice. The aims of the current study were to identify the presumed worldview outlook of eight types of community figures as perceived by African American parents, and determine parents' trust in these figures for vaccine advice, and whether trust varied according to the figures' racial concordance. A cross-sectional survey was administered to 110 African American parents in 2015. Parents perceived the community figures to represent a spectrum of worldview outlooks. Although levels of trust in the community figures differed overall (p < .001), it was high in the school nurse, pediatrician, mother, father, disease survivor, and vaccine scientist. All trusted figures except the father were perceived to hold a communitarian outlook. Parents shown race-concordant figures had higher levels of trust in them than those who were shown race-discordant equivalents (p < .01). These findings suggest that vaccination campaigns geared toward African American parents may be strengthened by including other nonmedical, African American spokespersons who convey their community contributions in messages.

Using Values Affirmation to Reduce the Effects of Stereotype Threat on Hypertension Disparities: Protocol for the Multicenter Randomized Hypertension and Values (HYVALUE) Trial

Background

Medication nonadherence is a significant, modifiable contributor to uncontrolled hypertension. Stereotype threat may contribute to racial disparities in adherence by hindering a patient’s ability to actively engage during a clinical encounter, resulting in reduced activation to adhere to prescribed therapies.

Objective

The Hypertension and Values (HYVALUE) trial aims to examine whether a values-affirmation intervention improves medication adherence (primary outcome) by targeting racial stereotype threat.

Methods

The HYVALUE trial is a patient-level, blinded randomized controlled trial comparing a brief values-affirmation writing exercise with a control writing exercise among black and white patients with uncontrolled hypertension. We are recruiting patients from 3 large health systems in the United States. The primary outcome is patients’ adherence to antihypertensive medications, with secondary outcomes of systolic and diastolic blood pressure over time, time for which blood pressure is under control, and treatment intensification. We are comparing the effects of the intervention among blacks and whites, exploring possible moderators (ie, patients’ prior experiences of discrimination and clinician racial bias) and mediators (ie, patient activation) of intervention effects on outcomes.

Results

This study was funded by the National Heart, Lung, and Blood Institute. Enrollment and follow-up are ongoing and data analysis is expected to begin in late 2020. Planned enrollment is 1130 patients. On the basis of evidence supporting the effectiveness of values affirmation in educational settings and our pilot work demonstrating improved patient-clinician communication, we hypothesize that values affirmation disrupts the negative effects of stereotype threat on the clinical interaction and can reduce racial disparities in medication adherence and subsequent health outcomes.

Conclusions

The HYVALUE study moves beyond documentation of race-based health disparities toward testing an intervention. We focus on a medical condition—hypertension, which is arguably the greatest contributor to mortality disparities for black patients. If successful, this study will be the first to provide evidence for a low-resource intervention that has the potential to substantially reduce health care disparities across a wide range of health care conditions and populations.

Trial Registration

ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB).

International Registered Report Identifier (IRRID)

DERR1-10.2196/12498

Ethics and Floods: A Systematic Review

Disaster ethics is a developing field of inquiry recognizing the wide variety of ethical issues confronting various professionals involved in planning for and responding to different types of disasters. This article explores how ethical issues related to floods are addressed in academic literature. The review involved analysis of publications on ethics and floods identified in a systematic literature search of electronic databases that included sociological, biomedical, and geophysical sources. The review methods were guided by the PRISMA Statement on systematic reviews, adapted to this topic area, and followed by a qualitative analysis of the included publications. All articles were analyzed using NVivo software version 11. The qualitative analysis showed that further research is needed on the ethical issues involved in flood disasters. Ethical guidelines are needed for flood planners and responders that are based on the consistent application of well-established ethical principles, values, and virtues to the specific circumstances arising with each flood. Flexibility is required in applying such approaches. The results suggest that interdisciplinary collaboration (sociological, biomedical, geophysical, engineering, and ethical) could contribute significantly to the development of ethics in floods. (Disaster Med Public Health Preparedness. 2019;13:817-828).

Exploration of Māori household experiences of food insecurity

AIM

Researchers explored how food insecurity was experienced in Māori households and how this can affect hauora (well-being).

METHODS

This Māori-centred research was conducted in New Zealand by Māori dietetic students with Māori supervision. Kaupapa Māori methodology guided the inductive thematic analysis of observational and discussion data (40+ hours per household) from four Māori households (18 individuals) that participated in a 3-month ethnographic-style investigation in 2011.

RESULTS

Four themes were identified. 'Overcoming socioeconomic hardship' was most clearly observed within the low-income whānau (family), however, all whānau had experienced food insecurity. This experience had short- and long-term impacts on well-being. Other themes identified strategies whānau developed to reduce the severity of food insecurity: sharing food, gardening food, and teaching food and nutrition skills. Selected text for themes revealed expressed Māori values and/or hauora influences. The values of manaakitanga (sharing food/hospitality), whānaungatanga (family relationships) and kaitiakitanga (caring for the environment) were observed and analysed deductively.

CONCLUSIONS

All households had experienced income-related food insecurity, and its short- and long-term impacts on well-being were observed. Whānau had developed many strategies to reduce the severity of food insecurity, relying on support from extended whānau and the wider community, but households remained food insecure. Health and other professionals should advocate for social justice and policy solutions that change systems perpetuating social and health inequity. All households need sufficient income to afford basic needs including food. When basic needs are met, households and individuals can thrive and make meaningful contributions to society.

What Would It Take to Get You into an Electric Car? Consumer Perceptions and Decision Making about Electric Vehicles

Americans buy millions of vehicles every year, but research on how those decisions are made, including personality and individual difference factors, has rarely taken full advantage of psychological insights. This is an increasingly important topic because, for instance, decisions to buy electric vehicles (EVs) rather than gasoline-powered vehicles have environmental and geopolitical consequences. A series of studies reveal the very different perceptions of EVs and gas vehicles. Although vehicle choices at the aggregate level were strongly correlated with economic considerations, individual consumer choices were correlated with delay discounting rates in Study 1 but not Study 2. These studies also did not find significant correlations between EV purchase decisions and a number of other individual difference traits often thought to be factors in such decisions (i.e., social value orientation, political attitudes, environmental attitudes, preference for novel products, or an array of core social values). Regression models indicate that factors which did predict vehicle choices concerns were about the performance and range of EVs, EV prevalence in general, and beliefs about what statements different vehicle types made about their owners and the owners' values. More attention to the vehicle-associated values and immediate performance/use issues can help to promote EV purchase decisions and subsequent improvements in environmental and political stability.

Factors Associated with Not Drinking Alcoholic Beverages in Dependent Individuals on Recovery

OBJECTIVES

This work sought to determine the association between personal factors and not drinking alcoholic beverages in alcohol-dependent individuals on recovery process.

METHODS

This was a cross-sectional quantitative study. The sample was comprised by 119 adult belonging to 50 Alcoholics Anonymous groups in Saltillo, Coahuila (Mexico). The sampling was simple random, by conglomerates (AA groups). To gather the information, a Personal Data Card was used along with a history on alcohol consumption and the instruments Scale on Social Readjustment Classification, Spiritual Perspective Scale, Schwartz Values Survey, and the Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

The time without alcohol consumption was related positively with age (r=0.59) and spirituality (r=0.29) and negatively with stressful events (r=-0.31). The Multiple Linear Regression Model explained 32.5% of the variance, with age being the variable remaining in the model and which affected not drinking alcoholic beverages.

CONCLUSIONS

Values and spirituality favor not drinking alcoholic beverages in individuals in the process of recovering from the dependence, while exposure to stressful events increases vulnerability to alcohol consumption.

Attachment security, values, and prosocial attitudes

The objective of this study was to determine whether individuals with different attachment styles held different prosocial values and attitudes given their different models of self and of others. A sample of 717 university students completed the ECR-S (Experiences in Close Relationships-Spanish) and the PVQ (Portrait Values Questionnaire), and evaluated different prosocial attitudes. The results showed that secure individuals reported higher scores on self-transcendence and in the value self-directions of the dimension openness to change, whereas insecure individuals had higher scores on conservation and self-enhancement. No differences were found in the attitudes of individuals with different attachment styles. These findings show a link between the dimensions of the universal values theory, and the models of self and of others.

Understanding the effects of different social data on selecting priority conservation areas

Conservation success is contingent on assessing social and environmental factors so that cost-effective implementation of strategies and actions can be placed in a broad social-ecological context. Until now, the focus has been on how to include spatially explicit social data in conservation planning, whereas the value of different kinds of social data has received limited attention. In a regional systematic conservation planning case study in Australia, we examined the spatial concurrence of a range of spatially explicit social values and land-use preferences collected using a public participation geographic information system and biological data. We used Zonation to integrate the social data with the biological data in a series of spatial-prioritization scenarios to determine the effect of the different types of social data on spatial prioritization compared with biological data alone. The type of social data (i.e., conservation opportunities or constraints) significantly affected spatial prioritization outcomes. The integration of social values and land-use preferences under different scenarios was highly variable and generated spatial prioritizations 1.2-51% different from those based on biological data alone. The inclusion of conservation-compatible values and preferences added relatively few new areas to conservation priorities, whereas including noncompatible economic values and development preferences as costs significantly changed conservation priority areas (48.2% and 47.4%, respectively). Based on our results, a multifaceted conservation prioritization approach that combines spatially explicit social data with biological data can help conservation planners identify the type of social data to collect for more effective and feasible conservation actions.

Prediction of employer-employee relationships from sociodemographic variables and social values in Brunei public and private sector workers

The purpose of the study was to identify the sociodemographic variables and social value correlates and predictors of employer–employee relationship problems in a random sample of 860 Brunei public and private sector workers of both genders. A quantitative field survey design was used and data were analyzed by correlation and logistic regression. The rationale and justification for using this approach is explained. The main sociodemographic correlates and predictors of employer–employee relationship problems in this study were educational level and the district in which the employee resided and worked. Other correlates, but not necessarily predictors, of employer–employee relationship problems were seeking help from the Bomo (traditional healer); obtaining help from online social networking; and workers with children in the family. The two best and most significant social value correlates and predictors of employer–employee relationship problems included interpersonal communications; and self-regulation and self-direction. Low scorers on the following variables were also associated with high likelihood for possessing employer–employee relationship problems: satisfaction with work achievements; and peace and security, while low scorers on work stress had lower odds of having employer–employee relationship problems. Other significant social value correlates, but not predictors of employer–employee relationship problems were self-presentation; interpersonal trust; peace and security; and general anxiety. Consistent with findings of relevant previous studies conducted elsewhere, there were the variables that correlated with and predicted employer–employee relationship problems in Brunei public and private sector workers. Having identified these, the next step, efforts and priority should be directed at addressing the presenting issues via counseling and psychotherapy with affected employees. Further research is recommended to understand better the problem and its possible solutions.

Ecological restoration should be redefined for the twenty-first century

Forty years ago, ecological restoration was conceptualized through a natural science lens. Today, ecological restoration has evolved into a social and scientific concept. The duality of ecological restoration is acknowledged in guidance documents on the subject but is not apparent in its definition. Current definitions reflect our views about what ecological restoration does but not why we do it. This viewpoint does not give appropriate credit to contributions from social sciences, nor does it provide compelling goals for people with different motivating rationales to engage in or support restoration. In this study, I give a concise history of the conceptualization and definition of ecological restoration, and I propose an alternative definition and corresponding viewpoint on restoration goal‐setting to meet twenty‐first century scientific and public inquiry.

Assessing value-based health care delivery for haemodialysis

RATIONALE, AIMS AND OBJECTIVES

Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres.

METHOD

A nephrology quality management group identified the criteria for the assessment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity-adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year.

RESULTS

The study was conducted in five centres (1-5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10-60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simulations, when weights were varied by 60%.

CONCLUSIONS

Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions.

How Robust Are Value Judgments of Health Inequality Aversion? Testing for Framing and Cognitive Effects

BACKGROUND

Empirical studies have found that members of the public are inequality averse and value health gains for disadvantaged groups with poor health many times more highly than gains for better off groups. However, these studies typically use abstract scenarios that involve unrealistically large reductions in health inequality and face-to-face survey administration. It is not known how robust these findings are to more realistic scenarios or anonymous online survey administration.

METHODS

This study aimed to test the robustness of questionnaire estimates of inequality aversion by comparing the following: 1) small versus unrealistically large health inequality reductions, 2) population-level versus individual-level descriptions of health inequality reductions, 3) concrete versus abstract intervention scenarios, and 4) online versus face-to-face mode of administration. Fifty-two members of the public participated in face-to-face discussion groups, while 83 members of the public completed an online survey. Participants were given a questionnaire instrument with different scenario descriptions for eliciting aversion to social inequality in health.

RESULTS

The median respondent was inequality averse under all scenarios. Scenarios involving small rather than unrealistically large health gains made little difference in terms of inequality aversion, as did population-level rather than individual-level scenarios. However, the proportion expressing extreme inequality aversion fell 19 percentage points when considering a specific health intervention scenario rather than an abstract scenario and was 11 to 21 percentage points lower among online public respondents compared with the discussion group.

CONCLUSIONS

Our study suggests that both concrete scenarios and online administration reduce the proportion expressing extreme inequality aversion but still yield median responses that imply substantial health inequality aversion.

After 10 years, how do changes in asset ownership affect the Indicador Econômico Nacional?

OBJECTIVE

Our main objective was to analyse how the evolution of household assets ownership affected the Indicador Econômico Nacional (IEN - National Wealth index) and to point out the most stable assets and which lost importance more quickly.

METHODS

We analysed the trend of the ownership of each IEN variable and the distribution of the households' scores. We calculated the correlation coefficients of each variable separately with the IEN score and the household income. We also evaluated how the changes of the score distribution over time affected the validity of the published reference cut-points. We used data from consortium surveys conducted every two years from 2002 to 2014 in the city of Pelotas, Brazil.

RESULTS

An increase in the educational level of household heads and in the ownership of all IEN assets, except radio and telephone, was observed in the study period. In general, the correlation of the assets with the IEN scores decreased over time. There was an increase in the score, with a consequent increase in the quintiles cut-points, but the distance between these cut-points had no significant variation. Thus, the reference cut-points for Pelotas, quickly became outdated.

CONCLUSIONS

Some assets showed greatly reduction on its importance for the indicator, and the reference cut-points became obsolete very quickly. It is essential for a standardized wealth (or asset) index with research purposes to be updated frequently, especially the cut-points of reference distribution.

OBJETIVO

Analisar como a evolução temporal da posse de bens domésticos afetou o Indicador Econômico Nacional e como essas mudanças afetaram o poder discriminatório do indicador.

MÉTODOS

Analisou-se a evolução temporal da posse de cada uma das variáveis do Indicador Econômico Nacional, bem como da distribuição do escore dos domicílios. Utilizamos dados de inquéritos populacionais realizados bienalmente no município de Pelotas, RS, de 2002 a 2014. Foi calculado o coeficiente de correlação de cada variável isoladamente com o escore do Indicador Econômico Nacional e com a renda familiar. Avaliamos também como a variação da distribuição do escore ao longo do tempo afetou a validade da utilização dos pontos de corte de referência publicados.

RESULTADOS

Houve aumento da escolaridade dos chefes das famílias e da posse de todos os bens, exceto rádio e linha telefônica no período. A correlação dos bens com o Indicador Econômico Nacional reduziu com o tempo. O escore aumentou, com consequente incremento nos pontos de corte dos quintis, mas a distância entre os pontos não teve variação importante. Assim, os pontos de corte de referência publicados para Pelotas rapidamente ficaram desatualizados.

CONCLUSÕES

Alguns bens perderam a capacidade discriminatória e os pontos de corte ficaram obsoletos rapidamente. É essencial um indicador de bens padronizado para uso em pesquisa, que seja atualizado com frequência, em especial os pontos de corte da distribuição de referência.

Sociodemographic variables and social values: relationship with work-attendance problems in Brunei public- and private-sector employees

OBJECTIVE

The study investigated the degree to which selected sociodemographic variables and social values were related to work-attendance problems in a random sample of 860 Brunei public- and private-sector employees and the nature of this relationship.

MATERIALS AND METHODS

This quantitative study used the field-survey approach to administer research instruments directly to participants. This enabled the researchers to help participants who needed assistance in completing the measures properly, so as to increase the number of usable returns.

RESULTS

Two sociodemographic variables (seeking help from a counselor/psychologist and marital status) correlated significantly with work attendance. Private-sector employees were more likely to have work-attendance problems than government workers. Both single and married employees and the chief wage earner in the household were more likely to have work-attendance issues to deal with compared to their counterparts. However, employees who sought help from a counselor/psychologist were far less likely to have work-attendance problems compared to those who did not get such help. The most significant social-value correlates with work-attendance problems were interpersonal communication, employer-employee relationship, work-stress problems, self-presentation, self-regulation, self-direction, and interpersonal trust. Self-regulation, self-direction, and satisfaction with work-related achievements significantly predicted work-attendance problems positively, while interpersonal communication problems and work-stress problems predicted work-attendance problems negatively. Low scorers on self-regulation and self-direction, as well as on satisfaction with work-related achievements, were more likely to have work-attendance problems compared to high scorers. However, low scorers on interpersonal communication and work-stress problems were less likely to have work-attendance problems compared to high-scoring peers.

CONCLUSION

Ample evidence from this study showed that sociodemographic variables and social values contribute to work-attendance problems in various ways, and need to be incorporated in counseling interventions for affected employees.

Perceptions of oocyte banking from women intending to circumvent age-related fertility decline

INTRODUCTION

Women can now opt to bank their oocytes with the intention of increasing their chances of achieving a pregnancy after their fertility has declined. This exploratory study aimed to gain insight into how women, considering oocyte banking to circumvent age-related fertility decline, perceive this intervention.

MATERIAL AND METHODS

We conducted a qualitative study in a Dutch university medical center and held in-depth interviews with women on the waiting list for oocyte banking. We recorded the interviews, transcribed them verbatim and used thematic analysis.

RESULTS

All women were financially independent and lived in single-person urban households. They opted for oocyte banking because they wished to share parenthood with a future partner rather than becoming a single parent. This strong desire was key in their interpretation of all aspects of the intervention. Women set aside information about the limited success rates and potential risks, as they were optimistic about their own prognosis, thought that the chances for success were equally likely as the chances it would fail, and because of "anticipatory regret". They perceived oocyte banking as a "helping hand" to achieve shared parenthood. Although women found the costs of the intervention high, they were willing to invest their money to increase their chances for shared parenthood.

CONCLUSIONS

Oocyte banking allows women to circumvent age-related fertility decline. The prospect of potential shared parenthood overrules the perceived health risks and burden. Health professionals should take this into account when informing potential users of oocyte banking.

Aristotle, Hume and the goals of medicine

Whilst medicine is now an immense global industry clinicians often appear unclear as to its goals. This paper uses two philosophical steps to clarify our conceptualization of health and thus our goals for healthcare. Firstly, clinicians need to understand the significance of Hume's fact / value distinction in medicine, for medicine relies on both facts and values. Secondly clinicians need a better specified definition of 'health' to use as a goal for healthcare. Aristotle's model of human flourishing is used as the starting point for a new conceptualization of health.

Virtues Education in Medical School: The Foundation for Professional Formation

BACKGROUND

Studies have shown that medical students have high rates of burnout accompanied by a loss of empathy as they progress through their training. This article describes a course for medical students at The University of Queensland-Ochsner Clinical School in New Orleans, LA, that focuses on the development of virtues and character strengths necessary in the practice of medicine. Staff of the Ochsner Clinical School and of the Institute of Medicine, Education, and Spirituality at Ochsner, a research and consulting group of Ochsner Health System, developed the course. It is a curricular innovation designed to explicitly teach virtues and their associated prosocial behaviors as a means of promoting professional formation among medical students. Virtues are core to the development of prosocial behaviors that are essential for appropriate professional formation.

METHODS

Fourth-year medical students receive instruction in the virtues as part of the required Medicine in Society (MIS) course. The virtues instruction consists of five 3-hour sessions during orientation week of the MIS course and a wrapup session at the end of the 8-week rotation. Six virtues-courage, wisdom, temperance, humanity, transcendence, and justice-are taught in a clinical context, using personal narratives, experiential exercises, contemplative practices, and reflective practices.

RESULTS

As of July 2015, 30 medical students had completed and evaluated the virtues course. Ninety-seven percent of students felt the course was well structured. After completing the course, 100% of students felt they understood and could explain the character strengths that improve physician engagement and patient care, 100% of students reported understanding the importance of virtues in the practice of medicine, and 83% felt the course provided a guide to help them deal with the complexities of medical practice. Ninety-three percent of students stated they would use the character strengths for their own well-being, and 90% said they would change their approach to the practice of medicine as a result of this course. Overall, 92% of students rated the course as outstanding or good.

CONCLUSION

We developed a course to teach virtues and their associated prosocial behaviors that are important for the practice of medicine. After completing the course, students self-reported improved understanding of the virtues and their importance to the practice of medicine. We plan further studies to determine if participation in the course leads to less burnout and improved resilience.