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BMC Medical Education Jun 2024Medical students and doctors face various challenges in clinical practice. Some of these challenges are related to ethical issues. Therefore, teaching ethics...
BACKGROUND
Medical students and doctors face various challenges in clinical practice. Some of these challenges are related to ethical issues. Therefore, teaching ethics respectively building moral competences has become an integral part of the medical curriculum in Germany and many other countries. To date, there is little evidence on moral competence of medical students.
METHODS
Self-administered survey among medical students from one German medical school in the first (cohort 1) and fifth semester (cohort 2) in the winter term 2019/20 (T0). Both cohorts received the same questionnaire one year later in winter term 2020/21 (T1). Assessment was performed with Lind's Moral Competence Test. We performed convenience sampling. We analyzed the data with descriptive statistics and C-Scores as a measure of moral competence (higher scores = higher competence, ≥ 30 points = high competence).
RESULTS
A total of 613 students participated in the study (response rate 67.5%, n = 288 with data on both time points). 69.6% of the participants were female, the mean age was 21.3 years. Mean C-Score for both cohorts for T0 (first and fifth semester) is 32.5 ± 18.0 and for T1 (third and seventh semester) is 30.4 ± 17.9. Overall, 6.6% (T0) and 6.7% (T1) of respondents showed some but very low moral competence. 3.3% (T0) and 3.0% (T1) showed no moral competence. Additionally, students without prior experience in the healthcare system scored 3.0 points higher.
CONCLUSIONS
Improvement of assessment of moral competence as well effective interventions are particular needed for supporting those students which have been identified to demonstrate little moral competences.
Topics: Humans; Germany; Female; Students, Medical; Male; Morals; Longitudinal Studies; Young Adult; Schools, Medical; Surveys and Questionnaires; Education, Medical, Undergraduate; Curriculum; Ethics, Medical; Adult
PubMed: 38918781
DOI: 10.1186/s12909-024-05674-x -
BMC Public Health Jun 2024This study examines factors associated with symptoms of loneliness among a sample (n = 213) of mostly Mexican-origin adults at risk of chronic diseases in Southern...
This study examines factors associated with symptoms of loneliness among a sample (n = 213) of mostly Mexican-origin adults at risk of chronic diseases in Southern Arizona's Pima, Yuma, and Santa Cruz counties. It uses baseline data from a community-based participatory research partnership and multinominal logistic regression models. Controlling for chronic diseases and sociodemographic characteristics, perceived social support and hope exhibit negative main effects on loneliness when comparing individuals who experienced loneliness for 5-7 days in the preceding week with those who did not encounter such feelings during the same period (adjusted odds ratio, AOR = 0.49 and 0.47; 95% confidence interval, CI = 0.34-0.73 and 0.29-0.75, respectively). However, when considered together, perceived social support and hope display a positive and statistically significant combined effect on loneliness (AOR = 1.03; 95% CI = 1.01-1.06). Holding all covariates constant, individuals reporting loneliness for 5-7 days exhibit a relative risk ratio of 1.24 (95% CI = 1.06-1.46) for a one-unit increase in physical problem severity compared to those who do not experience loneliness. Moreover, being 65 years old or older (AOR = 0.16, 95% CI = 0.03-0.84), and having been born in Mexico and lived in the US for less than 30 years (AOR = 0.12, 95% CI = 0.02-0.74) are associated with negative main effects on loneliness when comparing individuals who experienced loneliness 1-2, and 5-7 days in the preceding week with those who did not feel loneliness during the same timeframe, respectively. Recognizing the crucial role of loneliness in shaping health outcomes for Mexican-origin adults, our findings underscore the significance of fostering supportive environments that not only enhance well-being but also cultivate robust community bonds within the US-Mexico border region.
Topics: Humans; Loneliness; Arizona; Female; Male; Adult; Risk Factors; Middle Aged; Mexican Americans; Social Support; Aged; Young Adult; Chronic Disease; Community-Based Participatory Research; Logistic Models
PubMed: 38918747
DOI: 10.1186/s12889-024-19199-x -
PloS One 2024Fulfilling corporate social responsibility (CSR) is crucial for society's sustainable development. Executives' academic experience significantly affects their awareness...
Fulfilling corporate social responsibility (CSR) is crucial for society's sustainable development. Executives' academic experience significantly affects their awareness of social responsibility, value orientation, professional ability, and network resources. Thus, it is critical in CSR-related corporate decision-making. This paper explores the impact of executives' academic experience on the fulfillment of CSR. It focuses on non-financial, Special treatment enterprises (ST), and ST* enterprises listed in the A-share market from 2012 to 2021. It utilizes a fixed-effects analysis model to examine the relationship between executives' academic experience and CSR fulfillment. The CSR score and executives' academic experience were positively correlated. This paper also explores the intermediary role of compensation incentives and the moderating effect of marketization level. Both compensation incentives and the level of marketization positively moderated the relationship between executives' academic experience and CSR fulfillment. Meanwhile, the robustness results showed that the experimental findings still held after replacing the explained and explanatory variables. This paper contributes to the advancement of the Upper Echelons Theory and provides empirical evidence for the society's sustainable development.
Topics: Social Responsibility; China; Humans; Administrative Personnel; Motivation; Sustainable Development
PubMed: 38917164
DOI: 10.1371/journal.pone.0305813 -
PloS One 2024Corporate social responsibility (CSR) is a constantly evolving concept that reflects changes in society and the expectations of stakeholders in a process that leads...
Corporate social responsibility (CSR) is a constantly evolving concept that reflects changes in society and the expectations of stakeholders in a process that leads companies to adapt to respond to new challenges and demands. Similarly, the theory and practice of CSR have moved from regulatory compliance to a more holistic approach that requires more sophisticated models that allow for a deeper understanding. Following the fact that companies now have access to a greater amount of information related to their social and environmental performance, as well as comparative data from other organizations, which is why it is necessary to have a management tool that allows collecting, process, and generating more accurate and meaningful metrics that more effectively reflect a company's impact on society. Consequently, the present work aims to identify a system of variables and dimensions representative of the management of organizations that allows the validation of a generic model of corporate social responsibility determined through factorial and structural modeling capable of reflecting more accurate and up-to-date dimensions and metrics of model variables and dimensions. To carry out the study, a sample of 667 middle and senior managers from medium and large companies in Guayas, Ecuador, were randomly contacted in their respective business contexts by trained interviewers. The data processing was carried out in stages. First, the exploratory factorial analysis method of the items was applied to form relevant factors. Then, the dimensions' structural modeling was formulated and ratified through the pertinent goodness-of-fit indices. The results determined a system of correlated factors whose items present estimators of commonality and high and significant factorial loads, excluding variables that did not exceed the sensitization criteria applied. Finally, a model made up of 15 factors and 66 variables ratified using the comparative adjustment indices, the chi-square likelihood ratio, and the mean square error of approximation is introduced, confirming the proposed corporate social responsibility model.
Topics: Social Responsibility; Humans; Models, Theoretical; Commerce
PubMed: 38917095
DOI: 10.1371/journal.pone.0296761 -
JMIR Human Factors Jun 2024In pandemic situations, digital contact tracing (DCT) can be an effective way to assess one's risk of infection and inform others in case of infection. DCT apps can...
BACKGROUND
In pandemic situations, digital contact tracing (DCT) can be an effective way to assess one's risk of infection and inform others in case of infection. DCT apps can support the information gathering and analysis processes of users aiming to trace contacts. However, users' use intention and use of DCT information may depend on the perceived benefits of contact tracing. While existing research has examined acceptance in DCT, automation-related user experience factors have been overlooked.
OBJECTIVE
We pursued three goals: (1) to analyze how automation-related user experience (ie, perceived trustworthiness, traceability, and usefulness) relates to user behavior toward a DCT app, (2) to contextualize these effects with health behavior factors (ie, threat appraisal and moral obligation), and (3) to collect qualitative data on user demands for improved DCT communication.
METHODS
Survey data were collected from 317 users of a nationwide-distributed DCT app during the COVID-19 pandemic after it had been in app stores for >1 year using a web-based convenience sample. We assessed automation-related user experience. In addition, we assessed threat appraisal and moral obligation regarding DCT use to estimate a partial least squares structural equation model predicting use intention. To provide practical steps to improve the user experience, we surveyed users' needs for improved communication of information via the app and analyzed their responses using thematic analysis.
RESULTS
Data validity and perceived usefulness showed a significant correlation of r=0.38 (P<.001), goal congruity and perceived usefulness correlated at r=0.47 (P<.001), and result diagnosticity and perceived usefulness had a strong correlation of r=0.56 (P<.001). In addition, a correlation of r=0.35 (P<.001) was observed between Subjective Information Processing Awareness and perceived usefulness, suggesting that automation-related changes might influence the perceived utility of DCT. Finally, a moderate positive correlation of r=0.47 (P<.001) was found between perceived usefulness and use intention, highlighting the connection between user experience variables and use intention. Partial least squares structural equation modeling explained 55.6% of the variance in use intention, with the strongest direct predictor being perceived trustworthiness (β=.54; P<.001) followed by moral obligation (β=.22; P<.001). Based on the qualitative data, users mainly demanded more detailed information about contacts (eg, place and time of contact). They also wanted to share information (eg, whether they wore a mask) to improve the accuracy and diagnosticity of risk calculation.
CONCLUSIONS
The perceived result diagnosticity of DCT apps is crucial for perceived trustworthiness and use intention. By designing for high diagnosticity for the user, DCT apps could improve their support in the action regulation of users, resulting in higher perceived trustworthiness and use in pandemic situations. In general, automation-related user experience has greater importance for use intention than general health behavior or experience.
Topics: Humans; Contact Tracing; Mobile Applications; Cross-Sectional Studies; COVID-19; Female; Male; Adult; Surveys and Questionnaires; Middle Aged
PubMed: 38916941
DOI: 10.2196/53940 -
PNAS Nexus Jun 2024Behavioral research in traditional subsistence populations is often conducted in a non-native language. Recent studies show that non-native language-use systematically...
Behavioral research in traditional subsistence populations is often conducted in a non-native language. Recent studies show that non-native language-use systematically influences behavior, including in widely used methodologies. However, such studies are largely conducted in rich, industrialized societies, using at least one European language. This study expands sample diversity. We presented four standard tasks-a "dictator" game, two sacrificial dilemmas, a wager task, and five Likert-risk tolerance measures-to 129 Hadza participants. We randomly varied study languages-Hadzane and Kiswahili-between participants. We report a moderate impact of study language on wager decisions, alongside a substantial effect on dilemma decisions and responses to Likert-assessments of risk. As expected, non-native languages fostered utilitarian choices in sacrificial dilemmas. Unlike previous studies, non-native-language-use decreased risk preference in wager and Likert-tasks. We consider alternative explanatory mechanisms to account for this reversal, including linguistic relativity and cultural context. Given the strength of the effects reported here, we recommend, where possible, that future cross-cultural research should be conducted in participants' first language.
PubMed: 38915735
DOI: 10.1093/pnasnexus/pgae218 -
BMC Public Health Jun 2024It is well established that the tobacco industry used research funding as a deliberate tactic to subvert science. There has been little wider attention to how... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
It is well established that the tobacco industry used research funding as a deliberate tactic to subvert science. There has been little wider attention to how researchers think about accepting industry funding. We developed, then tested, hypotheses about two psychological constructs, namely, entitlement and conflict of interest contrarianism (CoI-C) among alcohol researchers who had previously received industry funding.
METHODS
A mixed-methods pilot study involved construct and instrument development, followed by an online survey and nested 3-arm randomised trial. We randomly allocated alcohol industry funding recipients to one of three conditions. In two experimental conditions we asked participants questions to remind them (and thus increase the salience) of their sense of entitlement or CoI-C. We compared these groups with a control group who did not receive any reminder. The outcome was a composite measure of openness to working with the alcohol industry.
RESULTS
133 researchers were randomised of whom 79 completed the experiment. The posterior distribution over effect estimates revealed that there was a 94.8% probability that reminding researchers of their CoI-C led them to self-report being more receptive to industry funding, whereas the probability was 68.1% that reminding them of their sense of entitlement did so. Biomedical researchers reported being more open to working with industry than did psychosocial researchers.
CONCLUSION
Holding contrarian views on conflict of interest could make researchers more open to working with industry. This study shows how it is possible to study researcher decision-making using quantitative experimental methods.
Topics: Humans; Conflict of Interest; Male; Female; Decision Making; Research Personnel; Adult; Pilot Projects; Food Industry; Middle Aged; Research Support as Topic
PubMed: 38914989
DOI: 10.1186/s12889-024-18961-5 -
Medical Decision Making : An... Jun 2024The use of policies in medical treatment reimbursement decisions, in which only future patients are affected, prompts a moral dilemma: is there an ethical difference...
BACKGROUND
The use of policies in medical treatment reimbursement decisions, in which only future patients are affected, prompts a moral dilemma: is there an ethical difference between withdrawing and withholding treatment?
DESIGN
Through a preregistered behavioral experiment involving 1,067 participants, we tested variations in public attitudes concerning withdrawing and withholding treatments at both the bedside and policy levels.
RESULTS
In line with our first hypothesis, participants were more supportive of rationing decisions presented as withholding treatments compared with withdrawing treatments. Contrary to our second prestated hypothesis, participants were more supportive of decisions to withdraw treatment made at the bedside level compared with similar decisions made at the policy level.
IMPLICATIONS
Our findings provide behavioral insights that help explain the common use of policies affecting only future patients in medical reimbursement decisions, despite normative concerns of such policies. In addition, our results may have implications for communication strategies when making decisions regarding treatment reimbursement.
HIGHLIGHTS
We explore public' attitudes toward withdrawing and withholding treatments and how the decision level (bedside or policy level) matters.People were more supportive of withholding medical treatment than of withdrawing equivalent treatment.People were more supportive of treatment withdrawal made at the bedside than at the policy level.Our findings help clarify why common-use policies, which impact only future patients in medical reimbursement decision, are implemented despite the normative concerns associted with thesepolicies.
PubMed: 38912645
DOI: 10.1177/0272989X241258195 -
PhytoKeys 2024Caesalpinioideae is the second largest subfamily of legumes (Leguminosae) with ca. 4680 species and 163 genera. It is an ecologically and economically important group...
Caesalpinioideae is the second largest subfamily of legumes (Leguminosae) with ca. 4680 species and 163 genera. It is an ecologically and economically important group formed of mostly woody perennials that range from large canopy emergent trees to functionally herbaceous geoxyles, lianas and shrubs, and which has a global distribution, occurring on every continent except Antarctica. Following the recent re-circumscription of 15 Caesalpinioideae genera as presented in Advances in Legume Systematics 14, Part 1, and using as a basis a phylogenomic analysis of 997 nuclear gene sequences for 420 species and all but five of the genera currently recognised in the subfamily, we present a new higher-level classification for the subfamily. The new classification of Caesalpinioideae comprises eleven tribes, all of which are either new, reinstated or re-circumscribed at this rank: Caesalpinieae Rchb. (27 genera / ca. 223 species), Campsiandreae LPWG (2 / 5-22), Cassieae Bronn (7 / 695), Ceratonieae Rchb. (4 / 6), Dimorphandreae Benth. (4 / 35), Erythrophleeae LPWG (2 /13), Gleditsieae Nakai (3 / 20), Mimoseae Bronn (100 / ca. 3510), Pterogyneae LPWG (1 / 1), Schizolobieae Nakai (8 / 42-43), Sclerolobieae Benth. & Hook. f. (5 / ca. 113). Although many of these lineages have been recognised and named in the past, either as tribes or informal generic groups, their circumscriptions have varied widely and changed over the past decades, such that all the tribes described here differ in generic membership from those previously recognised. Importantly, the approximately 3500 species and 100 genera of the former subfamily Mimosoideae are now placed in the reinstated, but newly circumscribed, tribe Mimoseae. Because of the large size and ecological importance of the tribe, we also provide a clade-based classification system for Mimoseae that includes 17 named lower-level clades. Fourteen of the 100 Mimoseae genera remain unplaced in these lower-level clades: eight are resolved in two grades and six are phylogenetically isolated monogeneric lineages. In addition to the new classification, we provide a key to genera, morphological descriptions and notes for all 163 genera, all tribes, and all named clades. The diversity of growth forms, foliage, flowers and fruits are illustrated for all genera, and for each genus we also provide a distribution map, based on quality-controlled herbarium specimen localities. A glossary for specialised terms used in legume morphology is provided. This new phylogenetically based classification of Caesalpinioideae provides a solid system for communication and a framework for downstream analyses of biogeography, trait evolution and diversification, as well as for taxonomic revision of still understudied genera.
PubMed: 38912426
DOI: 10.3897/phytokeys.240.101716 -
Congenital Heart Disease 2024Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States, there is a compelling need to investigate the intricate interplay...
BACKGROUND
Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States, there is a compelling need to investigate the intricate interplay among BMI, pregestational, and gestational maternal diabetes, and their potential impact on the occurrence of congenital heart defects (CHD) during neonatal development.
METHODS
Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico, we conducted a focused analysis on neonates diagnosed with CHD between 2016 and 2020. Our assessment encompassed a range of variables, including maternal age, gestational age, BMI, pregestational diabetes, gestational diabetes, hypertension, history of abortion, and presence of preeclampsia.
RESULTS
A cohort of 673 patients was included in our study. The average maternal age was 26 years, within a range of 22 to 32 years. The mean gestational age measured 39 weeks, with a median span of 38 to 39 weeks. Of the 673 patients, 274 (41%) mothers gave birth to neonates diagnosed with CHD. Within this group, 22 cases were linked to pre-gestational diabetes, while 202 were not; 20 instances were associated with gestational diabetes, compared to 200 without; and 148 cases exhibited an overweight or obese BMI, whereas 126 displayed a normal BMI.
CONCLUSION
We identified a statistically significant correlation between pre-gestational diabetes mellitus and the occurrence of CHD. However, our analysis did not show a statistically significant association between maternal BMI and the likelihood of CHD. These results may aid in developing effective strategies to prevent and manage CHD in neonates.
Topics: Humans; Female; Pregnancy; Puerto Rico; Infant, Newborn; Heart Defects, Congenital; Adult; Risk Factors; Maternal Health; Young Adult; Diabetes, Gestational; Body Mass Index; Gestational Age; Retrospective Studies; Incidence; Male; Maternal Age
PubMed: 38912385
DOI: 10.32604/chd.2024.046339