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European Journal of Investigation in... Jun 2024This research aimed to contribute to the literature on internet addiction (IA) and moral development among university students. Moral potency (MP) encompasses the...
This research aimed to contribute to the literature on internet addiction (IA) and moral development among university students. Moral potency (MP) encompasses the interconnected dimensions of moral courage, moral ownership, and moral efficacy. Studies on the relationships between students' problematic behaviors (e.g., IA) and cognitive processes like MP, mindfulness (MI), and psychological capital (PsyCap) are scarce in educational research. Therefore, this study investigated the relationships among IA, MP, MI, and PsyCap in university students. This study included 868 undergraduate students from a state university in Ethiopia, with 526 male students (60.6%) and 342 female students (39.4%). Participants' ages ranged from 21 to 29 years, with a mean age of 22.31 and a standard deviation of 4.03. The findings indicated that IA was negatively correlated with MI, PsyCap, and MP. Both MI and PsyCap showed positive correlations with MP. Importantly, this study revealed that IA had a direct and negative impact on MI, PsyCap, and MP. Further, MI and PsyCap partially mediated and fully mediated the relationship between IA and MP. These findings suggest that cultivating MI and positive PsyCap among university students could be an important strategy to reduce the risks of IA and enhance their moral development. This study contributes to the limited research on the complex relationships between technology use, psychological resources, and moral functioning in emerging adulthood.
PubMed: 38921081
DOI: 10.3390/ejihpe14060115 -
Behavioral Sciences (Basel, Switzerland) May 2024The relationship between diet and health is well-researched, and there is also information regarding the effects of diet on mental health. This study aimed to...
The relationship between diet and health is well-researched, and there is also information regarding the effects of diet on mental health. This study aimed to investigate whether motivation to optimize lifestyles without regulations or restrictions could improve the health of rotating shift workers. In this pilot study, 18 male shift workers were randomly divided into two groups. All participants completed the Short Form Health Survey-36 questionnaire (SF-36) before the start and at the end of the study. Group I (n = 9, mean age 42 ± 6.6 y) received dietary and lifestyle information every other month for one year, and the other, Group II (n = 9 mean age 36 ± 7.3 y), one year later. All participants were motivated to follow the trained dietary recommendations and to engage in physical activity. Almost all scores had improved. Surprisingly, physical performance scores worsened, which was not expected. The impairment in mental health due to the change in ownership of the company could have been better explained. Nutritional advice over a longer period and the motivation to integrate more exercise into everyday life can potentially improve the health of rotating shift workers.
PubMed: 38920786
DOI: 10.3390/bs14060454 -
Frontiers in Digital Health 2024In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are...
INTRODUCTION
In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are unique digital assets on the blockchain, representing ownership of digital objects, including health data. By minting their data as NFTs, patients can track access, monetize its use, and build secure, private health information systems. However, research on NFTs in healthcare is in its infancy, warranting a comprehensive review.
METHODS
This study conducted a systematic literature review and thematic analysis of NFTs in healthcare to identify use cases, design models, and key challenges. Five multidisciplinary research databases (Scopus, Web of Science, Google Scholar, IEEE Explore, Elsevier Science Direct) were searched. The approach involved four stages: paper collection, inclusion/exclusion criteria application, screening, full-text reading, and quality assessment. A classification and coding framework was employed. Thematic analysis followed six steps: data familiarization, initial code generation, theme searching, theme review, theme definition/naming, and report production.
RESULTS
Analysis of 19 selected papers revealed three primary use cases: patient-centric data management, supply chain management for data provenance, and digital twin development. Notably, most solutions were prototypes or frameworks without real-world implementations. Four overarching themes emerged: data governance (ownership, tracking, privacy), data monetization (commercialization, incentivization, sharing), data protection, and data storage. The focus lies on user-controlled, private, and secure health data solutions. Additionally, data commodification is explored, with mechanisms proposed to incentivize data maintenance and sharing. NFTs are also suggested for tracking medical products in supply chains, ensuring data integrity and provenance. Ethereum and similar platforms dominate NFT minting, while compact NFT storage options are being explored for faster data access.
CONCLUSION
NFTs offer significant potential for secure, traceable, decentralized healthcare data exchange systems. However, challenges exist, including dependence on blockchain, interoperability issues, and associated costs. The review identified research gaps, such as developing dual ownership models and data pricing strategies. Building an open standard for interoperability and adoption is crucial. The scalability, security, and privacy of NFT-backed healthcare applications require further investigation. Thus, this study proposes a research agenda for adopting NFTs in healthcare, focusing on governance, storage models, and perceptions.
PubMed: 38919876
DOI: 10.3389/fdgth.2024.1377531 -
Frontiers in Health Services 2024Implementation and adoption of quality improvement interventions have proved difficult, even in situations where all participants recognise the relevance and benefits of...
INTRODUCTION
Implementation and adoption of quality improvement interventions have proved difficult, even in situations where all participants recognise the relevance and benefits of the intervention. One way to describe difficulties in implementing new quality improvement interventions is to explore different types of knowledge boundaries, more specifically the syntactic, semantic and pragmatic boundaries, influencing the implementation process. As such, this study aims to identify and understand knowledge boundaries for implementation processes in nursing homes and homecare services.
METHODS
An exploratory qualitative methodology was used for this study. The empirical data, including individual interviews ( = 10) and focus group interviews ( = 10) with leaders and development nurses, stem from an externally driven leadership intervention and a supplementary tracer project entailing an internally driven intervention. Both implementations took place in Norwegian nursing homes and homecare services. The empirical data was inductively analysed in accordance with grounded theory.
RESULTS
The findings showed that the syntactic boundary included boundaries like the lack of meeting arenas, and lack of knowledge transfer and continuity in learning. Furthermore, the syntactic boundary was mostly related to the dissemination and training of staff across the organisation. The semantic boundary consisted of boundaries such as ambiguity, lack of perceived impact for practice and lack of appropriate knowledge. This boundary mostly related to uncertainty of the facilitator role. The pragmatic boundary included boundaries related to a lack of ownership, resistance, feeling unsecure, workload, different perspectives and a lack of support and focus, reflecting a change of practices.
DISCUSSION
This study provides potential solutions for traversing different knowledge boundaries and a framework for understanding knowledge boundaries related to the implementation of quality interventions.
PubMed: 38919829
DOI: 10.3389/frhs.2024.1294299 -
Plastic and Reconstructive Surgery.... Jun 2024The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical...
BACKGROUND
The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical challenges. This review discusses the ethical dimensions of medical aesthetics, exploring the implications of consumer demand, societal influences, and technological advancements on patient care and well-being.
METHODS
Drawing upon a comprehensive analysis of existing literature, this review synthesizes evidence regarding the rise of aesthetic medicine, ethical challenges encountered in practice, and the implications of social media and marketing in shaping patient perceptions and decision-making.
RESULTS
Aesthetic medicine confronts unique ethical challenges stemming from its elective nature and the pervasive influence of societal beauty standards. Concerns include the commodification of beauty, conflicts of interest, limited evidence-base of treatments, and the rise of nonphysician providers. Moreover, the evolving role of social media influencers and medical marketing raises ethical dilemmas regarding transparency, patient autonomy, and professional integrity.
CONCLUSIONS
The ethical landscape of aesthetic medicine necessitates a proactive approach to address emerging challenges and safeguard patient well-being. Guided by principles of autonomy, beneficence, nonmaleficence, and justice, recommendations are proposed to enhance informed consent practices, mitigate appearance anxiety, facilitate shared decision-making, and promote responsible use of social media. Professional societies are urged to establish clear ethical guidelines and standards to uphold professionalism and patient trust in the field of aesthetic medicine.
PubMed: 38919517
DOI: 10.1097/GOX.0000000000005935 -
Frontiers in Nutrition 2024Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of... (Review)
Review
Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of bovine milk osteopontin (bmOPN) to formula may replicate OPN's concentration and function in human milk. To address safety concerns, we convened an expert panel to assess the adequacy of safety data and physiological roles of dietary bmOPN in infancy. The exposure of breastfed infants to human milk OPN (hmOPN) has been well-characterized and decreases markedly over the first 6 months of lactation. Dietary bmOPN is resistant to gastric and intestinal digestion, absorbed and cleared from circulation within 8-24 h, and represents a small portion (<5%) of total plasma OPN. Label studies on hmOPN suggest that after 3 h, intact or digested OPN is absorbed into carcass (62%), small intestine (23%), stomach (5%), and small intestinal perfusate (4%), with <2% each found in the cecum, liver, brain, heart, and spleen. Although the results are heterogenous with respect to bmOPN's physiologic impact, no adverse impacts have been reported across growth, gastrointestinal, immune, or brain-related outcomes. Recombinant bovine and human forms demonstrate similar absorption in plasma as bmOPN, as well as effects on cognition and immunity. The panel recommended prioritization of trials measuring a comprehensive set of clinically relevant outcomes on immunity and cognition to confirm the safety of bmOPN over that of further research on its absorption, distribution, metabolism, and excretion. This review offers expert consensus on the adequacy of data available to assess the safety of bmOPN for use in infant formula, aiding evidence-based decisions on the formulation of infant formula.
PubMed: 38919388
DOI: 10.3389/fnut.2024.1404303 -
PloS One 2024The inefficiency observed in investment within state-owned enterprises presents a significant practical challenge that can affect the sustainable development of China's...
The inefficiency observed in investment within state-owned enterprises presents a significant practical challenge that can affect the sustainable development of China's economy. To address this issue, this study comprehensively explores the intricate mechanisms underlying the governance implications of mixed ownership on the investment efficiency of listed companies. Drawing on unbalanced panel data encompassing Shanghai and Shenzhen Stock Exchange A-share listed companies in China spanning the period from 2008 to 2022, this study employs a fixed-effects model to unveil the nuanced ways in which mixed ownership influences investment efficiency through the lens of agency costs. This study transcends the boundaries of traditional agency conflicts between managers and shareholders. It delves deeper, illuminating the diverse effects of agency conflicts between significant controlling shareholders and minority shareholders. The results revealed a noteworthy positive correlation between mixed ownership and investment efficiency, and verified the intermediary role of agency costs between mixed ownership and investment efficiency, which is an important result of our research. Heterogeneity analysis indicates that the relationship between the two can be affected by external events, such as during the COVID-19 pandemic, investment efficiency is not the most concerned issue for enterprises. The findings have practical implications for practitioners and policymakers, as they offer avenues for optimizing investment strategies and fostering efficient and effective corporate governance practices.
Topics: China; Investments; Ownership; Humans; COVID-19; SARS-CoV-2; Pandemics
PubMed: 38917198
DOI: 10.1371/journal.pone.0306190 -
PloS One 2024The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private...
OBJECTIVE
The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private sector providers in Mexico remains high. In this paper, we sought to describe the characteristics of public and private healthcare users, describe recent visit quality across provider types, and to assess whether perceiving the public healthcare sector as poor quality is associated with private health sector use.
METHODS AND FINDINGS
We analyzed the cross-sectional People's Voice Survey conducted from December 2022 to January 2023. We used Chi-square tests to compare contextual, individual, and need-for-care factors and ratings of most recent visits between users of public (social security and other public providers) and private sector providers (stand-alone private providers and providers adjacent to pharmacies). We used a multivariable Poisson regression model to assess associations between low ratings of public healthcare sources and the use of private care. Among the 811 respondents with a healthcare visit in the past year, 31.2% used private sources. Private healthcare users were more educated and had higher incomes than public healthcare users. Quality of most recent visit was rated more highly in private providers (70.2% rating the visit as excellent or very good for stand-alone private providers and 54.3% for pharmacy-adjacent doctors) compared to social security (41.6%) and other public providers (46.6%). Those who perceived public health institutions as low quality had a higher probability of seeking private healthcare.
CONCLUSION
Users rated public care visits poorly relative to private care; at the population level, perceptions of poor quality care may drive private care use and hence out-of-pocket costs. Improving public healthcare quality is necessary to ensure universal health coverage.
Topics: Humans; Private Sector; Male; Female; Mexico; Adult; Middle Aged; Cross-Sectional Studies; Quality of Health Care; Surveys and Questionnaires; Public Sector; Adolescent; Young Adult; Perception; Health Expenditures; Delivery of Health Care
PubMed: 38917130
DOI: 10.1371/journal.pone.0306179 -
Health Affairs Scholar Jun 2024Insurer-provider integration is a new form of vertical integration, with increasing prominence in health care markets. While there are potential benefits from tighter...
Insurer-provider integration is a new form of vertical integration, with increasing prominence in health care markets. While there are potential benefits from tighter alignment between providers and payers, risks of perverse impacts on health care markets loom large. Yet, little is known about this new wave of consolidation, which limits options for policy or regulatory responses. We focus on a dominant insurer's acquisitions of ambulatory surgery centers (ASCs) to document the growth and geographic spread of these ownership events. We found that a diverse swathe of the United States has experienced an insurer-led ASC takeover. The acquisitions are also more frequently in areas where the insurer holds a higher enrollee market share at baseline, although a linear prediction of the likelihood of ASC acquisition shows a more nuanced picture.
PubMed: 38915811
DOI: 10.1093/haschl/qxae081 -
BioRxiv : the Preprint Server For... Jun 2024Efforts to cure BCR::ABL1 B cell acute lymphoblastic leukemia (Ph+ ALL) solely through inhibition of ABL1 kinase activity have thus far been insufficient despite the...
Efforts to cure BCR::ABL1 B cell acute lymphoblastic leukemia (Ph+ ALL) solely through inhibition of ABL1 kinase activity have thus far been insufficient despite the availability of tyrosine kinase inhibitors (TKIs) with broad activity against resistance mutants. The mechanisms that drive persistence within minimal residual disease (MRD) remain poorly understood and therefore untargeted. Utilizing 13 patient-derived xenograft (PDX) models and clinical trial specimens of Ph+ ALL, we examined how genetic and transcriptional features co-evolve to drive progression during prolonged TKI response. Our work reveals a landscape of cooperative mutational and transcriptional escape mechanisms that differ from those causing resistance to first generation TKIs. By analyzing MRD during remission, we show that the same resistance mutation can either increase or decrease cellular fitness depending on transcriptional state. We further demonstrate that directly targeting transcriptional state-associated vulnerabilities at MRD can overcome BCR::ABL1 independence, suggesting a new paradigm for rationally eradicating MRD prior to relapse. Finally, we illustrate how cell mass measurements of leukemia cells can be used to rapidly monitor dominant transcriptional features of Ph+ ALL to help rationally guide therapeutic selection from low-input samples.
PubMed: 38915726
DOI: 10.1101/2024.06.06.597767