BACKGROUND: Hallucinations and delusions that complicate Parkinson’s disease could lead to nursing home placement and are linked to increased mortality. Cognitive impairments are typically associated with the presence of hallucinations but there are no data regarding whether such a relationship exists with delusions. OBJECTIVE: We hypothesized that hallucinations would be associated with executive and visuospatial disturbance. An exploratory examination of cognitive correlates of delusions was also completed to address the question of whether they differ from hallucinations. METHODS: 144 PD subjects (...) completed a neuropsychological battery to assess cognition and the SAPS to examine psychosis. Correlational analyses assessed associations between hallucinations and delusions with cognitive domains. RESULTS: 48 subjects reported psychotic symptoms: 25 experienced hallucinations without delusions, 23 had symptoms dominated by delusions. Severity and/or number of hallucination subtypes were significantly correlated with lower scores in language, memory, attention, executive functioning, and visuospatial ability. Correlations with delusions were non-significant. Tests of differences in the size of the correlations between groups revealed a significant relationship between language and visuospatial performance with hallucinations. CONCLUSIONS: Cognitive correlates of hallucinations and delusions appear to be different in PD, suggesting distinct pathogenic mechanisms and possibly anatomical substrates. Hence, delusions may not share the same associations with dementia as hallucinations. Since this is a new finding, further studies will be needed to confirm our results. (shrink)

Leg rigidity is associated with frequent falls in people with Parkinson’s disease, suggesting a potential role in functional balance and gait impairments. Changes in the neural state due to secondary tasks, e.g., activation maneuvers, can exacerbate rigidity, possibly increasing the risk of falls. However, the subjective interpretation and coarse classification of the standard clinical rigidity scale has prohibited the systematic, objective assessment of resting and activated leg rigidity. The pendulum test is an objective diagnostic method that we hypothesized would (...) be sensitive enough to characterize resting and activated leg rigidity. We recorded kinematic data and electromyographic signals from rectus femoris and biceps femoris during the pendulum test in 15 individuals with PD, spanning a range of leg rigidity severity. From the recorded data of leg swing kinematics, we measured biomechanical outcomes including first swing excursion, first extension peak, number and duration of the oscillations, resting angle, relaxation index, maximum and minimum angular velocity. We examined associations between biomechanical outcomes and clinical leg rigidity score. We evaluated the effect of increasing rigidity through activation maneuvers on biomechanical outcomes. Finally, we assessed whether either biomechanical outcomes or changes in outcomes with activation were associated with a fall history. Our results suggest that the biomechanical assessment of the pendulum test can objectively quantify parkinsonian leg rigidity. We found that the presence of high rigidity during clinical exam significantly impacted biomechanical outcomes, i.e., first extension peak, number of oscillations, relaxation index, and maximum angular velocity. No differences in the effect of activation maneuvers between groups with clinically assessed low rigidity were observed, suggesting that activated rigidity may be independent of resting rigidity and should be scored as independent variables. Moreover, we found that fall history was more common among people whose rigidity was increased with a secondary task, as measured by biomechanical outcomes. We conclude that different mechanisms contributing to resting and activated rigidity may play an important yet unexplored functional role in balance impairments. The pendulum test may contribute to a better understanding of fundamental mechanisms underlying motor symptoms in PD, evaluating the efficacy of treatments, and predicting the risk of falls. (shrink)

One method for uncovering the subprocesses of mental processes is the “Additive Factors Method” (AFM). The AFM uses reaction time data from factorial experiments to infer the presence of separate processing stages. This paper investigates the conceptual status of the AFM. It argues that one of the AFM’s underlying assumptions is problematic in light of recent developments in cognitive neuroscience. Discussion begins by laying out the basic logic of the AFM, followed by an analysis of the challenge presented (...) by neural reuse. Following this, implications are analysed and avenues of response considered. (shrink)

Background: Infectious disease outbreaks such as COVID-19 and MERS pose a major threat to healthcare workers' physical and mental health. Studies exploring the positive changes gained from adapting to traumatic events, known as post-traumatic growth, have attracted much attention. However, it is unclear which factors or experiences lead to PTG among HCWs. The purpose of this mixed-method study was to investigate factors associated with PTG among HCWs who experienced the MERS outbreak in South Korea, and fully describe their experience (...) of developing PTG.Methods: Quantitative data from 78 participants were collected using psychometric tools for Psychological distress, Resilience, and Support for coping, and Post-traumatic growth. Qualitative interviews were conducted with seven nurses. Data were analyzed using the qualitative content analysis method according to the sub-themes of resilience, which was the main factor associated with PTG.Results: We found resilience to have a significant impact on PTG. Thus the qualitative interviews were analyzed using the core concepts of resilience. Qualitative interviews with nurses illustrated how participants experienced the development of resilience in terms of its sub-factors: hardiness, persistence, optimism, and support.Conclusion: HCWs who endured the MERS outbreak showed high levels of PTG, and the analysis of the interview data provided a fuller understanding on the experience of remaining resilient and developing PTG. These results provide practical and pragmatic information helpful for developing intervention strategies and protocols that can help HCWs transform adversity into growth and development. (shrink)

Existing methods for evaluating manufacturing process chain complexity consider the number of machines, state of machines, number of parts, operation time, and processing sequence of parts. However, such evaluation methods ignore human factors. To consider human factors, human cognitive decision-making process factors are considered in the complexity evaluation of production processes. Accordingly, a new objective evaluation method of the human factor complexity is proposed. In the proposed method, sewing operations are taken as an example, and the human factor (...) complexity is classified into perceived and cognitive complexity. Information entropy is used to measure cognitive complexity according to the type and quantity of sewing workers’ cognitive activities. The results show that various methods have significant differences in the evaluation of the complexity level of the production process chain. Specifically, the calculation results of the proposed evaluation method are much greater than those of other methods. This indicates that human cognitive and perceived complexities account for a large proportion. Therefore, human factor complexity cannot be omitted. (shrink)

The user data mining was introduced into the model construction process, and the user behavior was decomposed by analyzing various influencing factors through the factorization machine learning method. In the recommendation screening stage, the collaborative filtering recommendation is combined to screen the recommendation candidate set. The idea of user-based collaborative filtering is used for reference to obtain music works favored by similar users. On the other hand, we learn from item-based CF, which ensures that the candidate set covers (...) user preference. Firstly, the user’s interest value is predicted by using dynamic interest model. Then, the common problems such as cold start and hot items processing are fully considered. The frequent pattern growth algorithm is compared with the association rule algorithm based on the collaborative filtering recommendation algorithm and the content-based recommendation algorithm, which proves the superiority of the algorithm and its role in solving the recommendation problem after applying the recommendation. The music data in the database data conversion effectively improve the efficiency and accuracy of mining. According to the implementation of the algorithm described in this article, the accuracy of the music recommendation results used to recommend user satisfaction is proved. And the recommended music is indeed feasible and practical. (shrink)

This paper constructs a predictive model of student reading literacy based on data from students who participated in the Program for International Student Assessment from four provinces/municipalities of China, i.e., Beijing, Shanghai, Jiangsu and Zhejiang. We calculated the contribution of influencing factors in the model by using eXtreme Gradient Boosting algorithm and sHapley additive exPlanations values, and get the following findings: Factors that have the greatest impact on students’ reading literacy are from individual and family levels, with school-level factors taking (...) a relative back seat. The most important influencing factors at individual level are reading metacognition and reading interest. The most important factors at family level are ESCS and language environment, and dialect is negative for reading literacy, whereas proficiency in both a dialect and Mandarin plays a positive role. At the school level, the most important factors are time dedicated to learning and class discipline, and we found that there is an optimal value for learning time, which suggests that reasonable learning time is beneficial, but overextended learning time may make academic performance worse instead of improving it. (shrink)

To obtain effective fusion results of multi source evidences with different importance, an evidence fusion method with importance discounting factors based on neutrosopic probability analysis in DSmT framework is proposed. First, the reasonable evidence sources are selected out based on the statistical analysis of the pignistic probability functions of single focal elements. Secondly, the neutrosophic probability analysis is conducted based on the similarities of the pignistic probability functions from the prior evidence knowledge of the reasonable evidence sources. Thirdly, the (...) importance discounting factors of the reasonable evidence sources are obtained based on the neutrosophic probability analysis and the reliability discounting factors of the real-time evidences are calculated based on probabilistic-based distances. Fourthly, the real-time evidences are discounted by the importance discounting factors and then the evidences with the mass assignments of neutrosophic empty sets are discounted by the reliability discounting factors. Finally, DSmT+PCR5 of importance discounted evidences is applied. Experimental examples show that the decision results based on the proposed fusion method are different from the results based on the existed fusion methods. Simulation experiments of recognition fusion are performed and the superiority of proposed method is testified well by the simulation results. (shrink)

Since the sudden outbreak of the coronavirus disease 2019 epidemic in 2020, the second language learning patterns of students in mainland China have encountered new challenges that have had a psychological impact on mainland Chinese students. The epidemic has not only inconvenienced students’ normal second language learning but also greatly affected the second language learning patterns of mainland Chinese students. In the post-epidemic era, more and more students are becoming accustomed to studying and learning a second language online. The level (...) of informatization of second language learning patterns of students in mainland China has increased significantly. This study first analyses the mechanisms of change in second language learning patterns and further analyses the influence of knowledge background on the perception of second language learning patterns on this basis. To design the influencing factors of second language learning patterns, a questionnaire was used to investigate the influence of knowledge background on the perception of second language learning patterns. The survey was conducted on students who were learning a second language in mainland China. Then, the survey data were statistically analyzed. In analyzing the influence of effect on second language learning behaviors of students in mainland China, observed variables were designed, including observed variables of affective factors and learning behaviors. After that, the findings of the experiment were summarized based on the results of the questionnaire survey, and the positive influence of emotional factors on second language learning behaviors of mainland Chinese students in the post-development era was concluded. (shrink)

Though largely ignored by educators and researchers, boredom, an aversive emotion, is the hurdle for many translation learners to be professional. It is all the more important to unpack the boredom factors of Chinese foreign language major students in translation classes, which will serve in promoting students’ engagement in L2 classes and translator cultivation. By using a sequential mixed approach, this study conducted a thematic analysis and built a structural equation model. Quantitative data were gleaned from 483 foreign major college (...) students in China and qualitative data were selected from students of 7 universities through snowball sampling. Initially, the first-order confirmatory factor analysis verified the adapted questionnaire and the second-order CFA finds each factor’s contribution. Then, the thematic analysis gives support to the empirical findings. Both quantitative and qualitative analyses revealed that task-based boredom is the most routinely experienced boredom. Moreover, two major sources of boredom in translation classes are found, including task-based boredom and teacher-related boredom. It is suggested that teachers should improve their classes and use more interesting and engaging materials and tasks with the proper level of difficulty. The finding can help educators to identify the major boredom in the translation class and help potential professional translators to grow. Future studies will also be facilitated by the present study to find approaches to tackle these boredom sources. (shrink)

BackgroundEthics is the science of moral and ethical rules recognised in human life and attempts to verify what is morally right and wrong. Healthcare ethics is seen as an integrated part of the daily activities of health facilities. Healthcare professionals’ standardisation and uniformity in healthcare ethics are urgent and basic requirements. Therefore, this study aimed to assess the practice of the code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021.MethodsA facility-based cross-sectional (...) study design with a mixed method was conducted on 631 health professionals from Central Gondar Zone public hospitals. For the quantitative part, pre-tested self-administered questionnaires were used, and for the qualitative part, key informant interviews with a semi-structured questionnaire were used. Variables with a p value of < 0.2 in binary logistic regression entered into a multivariable logistic regression, then p value < 0.05 and AOR were used to declare statistically significant variables in quantitative data. A thematic content analysis was used for qualitative data analysis.ResultsThis study revealed that only 286 health professionals had good practice of the code of ethics. Good ethical knowledge, favourable attitude, and satisfaction of health professionals with their jobs were significantly associated with the practice of health care ethics.ConclusionsHealth professionals' overall level of practice of health care ethics in the Central Gondar Zone public hospitals was poor. This necessitates practical training, ongoing follow-up, availing of necessary medical equipment, a smooth working environment, and modification of the recognition system for health professionals. (shrink)

Positive spillover occurs when changes in one behaviour influence changes in subsequent behaviours. Evidence for such spillover and an understanding of when and how it may occur is still limited. This paper presents findings of a one year longitudinal behaviour change project led by a commercial retailer in the UK & Ireland to examine behaviour change and potential spillover of pro-environmental behaviour, and how this may be associated with changes in environmental identity and perceptions of ease and affordability as well (...) as perceptions of how participation in the project has helped support behaviour change. We draw on both quantitative and qualitative. Study 1 examines quantitative data from the experimental and a matched control group. Study 2 reports qualitative findings from a follow up interview study with participants of the experimental group. As expected, we found significant changes in reported pro-environmental behaviour and identity in the experimental group as well as some indications of behavioural spillover. These changes were not significantly associated with changes in environmental identity. The interviews suggested that group dynamics played an important role in facilitating a sense of efficacy and promote sustained behaviour change and spillover. Moreover, the support by a trusted entity was deemed to be of crucial importance. (shrink)

The internal structure of ability emotional intelligence tests at item level has been hardly studied, and if studied often the predicted structure did not show. In the present study, an a priori model for responses to EI ability items using Likert response scales with a Situational Judgement Test format is investigated with confirmatory factor analysis. The model consists of a target EI ability factor, an acquiescence factor, which is a method factor induced by the Likert response scales, and design-based (...) error covariances, which are induced by the SJT format. It is investigated whether this a priori model can account for the observed associations between the raw item responses of the Components of Emotion Understanding Test-24. The CEUT-24 is a new test developed to assess emotion understanding, a key aspect of the EI ability construct, based on the componential emotion framework. The sample consisted of 1184 participants from four European countries speaking four different languages. Findings showed that the a priori model fitted the data well in all four languages. Furthermore, measurement invariance testing gave evidence for a well-fitting configural, metric, and partial scalar invariance model. The conclusion is that within a regular CFA framework using raw observed items responses, method factors can be disentangled from the targeted EI ability factor. (shrink)

This paper shows how an efficient and parallel algorithm for inference in Bayesian Networks (BNs) can be built and implemented combining sparse matrix factorization methods with variable elimination algorithms for BNs. This entails a complete separation between a first symbolic phase, and a second numerical phase.

Background Moral distress is a major issue in intensive care units that requires immediate attention since it can cause nurses to burnout. Given the special conditions of patients in intensive care units and the importance of the mental health of nurses, the present study was designed to systematically review the factors affecting moral distress in nurses working in intensive care units. Methods PubMed, EMBASE, Web of Science, Scopus, and Science Direct were systematically searched for papers published between 2009 and 2019. (...) Original articles from quantitative and qualitative studies were reviewed. The CONSORT and STROBE checklists were used to assess the quality of the quantitative papers. The JBI checklist was applied for qualitative studies. Results Factors affecting moral distress in nurses include lack of nursing staff, nurses with inadequate experience, lack of support from organizations and colleagues, inadequate education and lack of knowledge of nurses, poor collaboration of physicians with nurses, ethical insensitivity and lack of teamwork, heavy workload, poor quality of care and moral violence and they are considered as risk factors for moral distress. Conclusion Many of the related causes are due to the nature of nurses’ work and it is necessary to manage the underlying conditions of this phenomenon so that it can be effectively prevented from spreading. Levels of moral distress require more attention of authorities in the use of prevention strategies and the reduction of effective factors in distress. (shrink)

Dengue fever is a debilitating and infectious disease that could be life-threatening. It is caused by the dengue virus which affects millions of people in the tropical area. Currently, there is no cure for the disease as there is no vaccine available. Thus, prevention of the vector population using conventional methods is by far the main strategy but has been found ineffective. A genetically modified mosquito is among the favoured alternatives to curb dengue fever in Malaysia. Past studies have shown (...) that development and diffusion of gene technology products depends heavily upon public acceptance. The purpose of this study is to identify the relevant factors influencing stakeholders’ attitudes toward the GM Aedes mosquito and to analyse the relationships between all the factors using the structural equation model. A survey was carried out on 509 respondents from various stakeholder groups in the Klang Valley region of Malaysia. Results of the survey have confirmed that public perception towards complex issues such as gene technology should be seen as a multi-faceted process. The perceived benefit-perceived risk balance is very important in determining the most predominant predictor of attitudes toward a GM mosquito. In this study the stakeholders perceived the benefit of the GM mosquito as outweighing its risk, translating perceived benefit as the most important direct predictor of attitudes toward the GM mosquito. Trust in key players has a direct influence on attitudes toward the GM mosquito while moral concern exhibited an indirect influence through perceived benefits. Other factors such as attitudes toward technology and nature were also indirect predictors of attitudes toward the GM mosquito while religiosity and engagement did not exhibited any significant roles. The research findings serve as a useful database to understand public acceptance and the social construct of public attitudes towards the GM mosquito to combat dengue. (shrink)

Social mobility is influenced by many factors. Studies show that Lithuania is among the countries with the same number of upward and downward social mobility. This shows that there is social inequality in the country, which especially affects people from the lower socio-economic strata. Considering the fact that previous studies of social mobility did not analyse the factors of this phenomenon based on the qualitative approach of data collection and analysis, this article, based on the Delphi method, seeks a (...) consensus of views expressed by experts – the most important barriers and factors of social mobility. The results show that a family and neighbourhood environment that does not form positive social skills is one of the main obstacles to social mobility, moreover, opportunities are limited due to insufficient funding for social protection, high levels of inequality, the fragmentation of complex assistance and the lack of other social services. (shrink)

Identifying the determinants of human behavior is useful to adjust interventions and lead the civil society toward a stronger commitment to climate change mitigation and adaptation objectives, achieving greater support for successfully implementing environmental policies. Existing research has largely focused on case studies of pro-environmental behaviors in developed economies but there is very little evidence for developing countries. This study provides estimations of the effect of internal factors, such as sociodemographic variables, and four psychological dimensions on PEBs. Data were obtained (...) through a survey applied with future decision makers – university students – from Colombia and Nicaragua. Indices were generated for PEBs and the psychological dimensions using z-scores and Principal Component Analysis. Partial correlations were evaluated through the Ordinary Least Squares method. Our results suggest that, in order to reach the planned emission reduction targets, policy approaches should more strongly focus on educating and motivating citizens and prepare them for contributing to the environmental cause, as well as provide individual solutions to combat CC, rather than providing only information on its causes and consequences. (shrink)

The present study aimed at investigating the motivational factors affecting Iranian learners’ learning of English as a Foreign Language across differing levels of language proficiency. To this end, 110 males and 70 females with an age range of 18–31 took part in the study and a mixed-methods approach was adopted. First, the researchers administered Oxford Placement Test to determine the proficiency level of the participants and placed them into three levels of language proficiency. Elementary, intermediate, and advanced. Next, as for (...) the quantitative part of the study, the Attitude/Motivation Test Battery questionnaire was distributed among all the participants to delve into the motivational factors. Finally, a semi-structured interview was conducted to qualitatively probe into EFL learners’ motivational factors affecting their learning of English. It was found that the motivational factors which encouraged EFL learners resulted from either intrinsic or extrinsic tendencies. The recognized intrinsically-based motivational factors were personal enjoyment, social prestige, and being challenged. The extrinsically-oriented factors as the source of motivation to learn English were getting a job, pursuing education, earning more money, traveling to foreign countries, pursuing academic careers, making efficient use of technology, and effectively interacting with native speakers. It was concluded that beginner and intermediate English language learners tended to learn English more based on extrinsic factors whereas advanced learners were found to be more intrinsically motivated. (shrink)

Purpose To examine process factors that either facilitate or inhibit learning medical ethics during case-based learning. Methods A qualitative research approach using microanalysis of transcribed videotaped discussions of three consecutive small-group learning sessions on medical ethics teaching for three groups, each with 10 students. Results This research effort revealed 12 themes of learning strategies, divided into 6 coping and 6 evasive strategies. Cognitive-based strategies were found to relate to Kamin's model of critical thinking in medical education, thereby supporting our distinction (...) between the themes of coping and evasive strategies. The findings also showed that cognitive efforts as well as emotional strategies are involved in discussions of ethical dilemmas. Based on Kamin's model and the constructivist learning theory, an examination of the different themes within the two learning strategies—coping and evasive—revealed that these strategies may be understood as corresponding to process factors either facilitating or inhibiting MET in SGL, respectively. Conclusions Our classification offers a more nuanced observation, specifically geared to pinpointing the desired and less desired process factors in the learning involved in MET in the SGL environment. Two key advantages of this observation are: it brings to the forefront process factors that may inhibit and not merely facilitate MET in SGL and it acknowledges the existence of emotional and not just cognitive process factors. Further enhancement of MET in SGL may thus be achieved based on these observations. (shrink)

The commercialization of microfinance brings formal financial institutions into the microfinance landscape, yet little is known about the forces that lead to this phenomenon. This paper is the first dedicated to this topic using a hand-collected dataset of 112 institutions from 34 countries covering the period from 2008 to 2012. Based on institutional theory and resource-based argument, we empirically assess the effects of institutional environment factors, including regulative, normative, and cognitive elements, as well as resource-based factors, including practice model and (...) multinational diversity, on the intensity of engagements. To do so, we define the roles as capital-related, product-related, and service delivery, and calculate engagement intensity using a scoring method which reflects an organization’s extent of presence in the microfinance value chain. The analysis takes the engaging location and engaging model into account. We find that the two logics together can explain such involvement. Legal compliance is identified as most relevant for domestic players, while resource-based factors are more relevant for overseas players. In addition to regression analysis, many cases are identified to support the arguments. (shrink)

Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal.Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk factors, such (...) as sociodemographic, physical, hereditary, and adverse childhood experiences. Depressive symptoms and personality functioning were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis.Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology.Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression. (shrink)

Green entrepreneurship has a huge role in solving environmental degradation and social problems. As today’s youth are tomorrow’s entrepreneurs, enhancing their green entrepreneurial intention will contribute to the sustainable development of economy in the future. The existing literature has examined the green entrepreneurial intention of college students based on self-efficacy, entrepreneurial creativity, entrepreneurship education, financial support, sustainable development values, and other influencing factors. However, these studies focus on net effect of factors on the results of college students’ green entrepreneurial intention, (...) ignoring the combination of multiple factors, and the relationship between different configurations of factors and the results of college students’ green entrepreneurial intention. Therefore, this study aimed to understand and analyze the influence of the complex relationship between multiple antecedents on college students’ green entrepreneurial intention from a comprehensive perspective. Based on 207 questionnaires collected from colleges in the coastal cities of China, this study used the fuzzy set qualitative comparative analysis method for data analysis. The results showed three dominant paths of great significance to college students’ high green entrepreneurial intention: entrepreneurial creativity—green cognition—dominant path; entrepreneurial creativity—financial support—dominant path; and the future self-continuity—entrepreneurship culture—entrepreneurship education—dominant path. The results of this study can help college educators to plan courses on innovative thinking and green entrepreneurship to improve college students’ entrepreneurial creativity and green cognitive ability. (shrink)

We present a novel method, called graph sparse nonnegative matrix factorization, for dimensionality reduction. The affinity graph and sparse constraint are further taken into consideration in nonnegative matrix factorization and it is shown that the proposed matrix factorization method can respect the intrinsic graph structure and provide the sparse representation. Different from some existing traditional methods, the inertial neural network was developed, which can be used to optimize our proposed matrix factorization problem. By adopting (...) one parameter in the neural network, the global optimal solution can be searched. Finally, simulations on numerical examples and clustering in real-world data illustrate the effectiveness and performance of the proposed method. (shrink)

Exploratory factor analysis is a statistical method widely used in quantitative psychology for the construction of scales and measurement instruments. It aims to reduce the complexity of a data set and explain the common and unique variance using latent variables. In introductory textbooks, exploratory factor analysis is generally presented in contrast to confirmatory factor analysis as a theory- or a hypothesis-generating process that does not require prior background, theory or hypothesis to be performed. The aim of the present paper (...) is to analyze this claim and clarify in which sense exploratory factor analysis is theory-laden. We provide a careful examination of the concepts it involves and thereby establish a clear limitation of the epistemic scope of exploratory factor analysis. (shrink)

Background: Physical restraint is among the commonly used methods for ensuring patient safety in intensive care units. However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety. Aim: The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients. Design: This is a qualitative study using conventional content analysis approach, as suggested by Graneheim and Lundman, to analyze the data. (...) Methods: Seventeen critical care nurses were purposefully recruited from the four intensive care units in Tehran, Iran. Data were collected through in-depth semi-structured interviews and were concurrently analyzed through conventional content analysis as suggested by Graneheim and Lundman. Ethical consideration: This study was approved by the Ethics Committee of Iran University of Medical Sciences, Tehran, Iran with the code: IR.IUMS.REC.1397.795. Before interviews, participants were provided with explanations about the aim of the study, the confidentiality of the data, their freedom to participate, and the right to withdraw the study, and their free access to the study findings. Finally, their consents were obtained, and interviews were started. Results: Factors behind ethical dilemmas for critical care nurses over using physical restraint were categorized into three main categories, namely the outcomes of using physical restraint, the outcomes of not using physical restraint, and emotional distress for nurses. The outcomes of using physical restraint were categorized into the three subcategories of ensuring patient safety, physical damage to patients, and mental damage to the patient. The outcomes of not using physical restraint fell into two subcategories, namely the risks associated with not using physical restraint and legal problems for nurses. Finally, the two subcategories of the emotional distress for nurses main category were nurses’ negative feelings about restraint use and uncertainty over the decision on physical restraint use. Conclusion: Decision-making for restraint use is often associated with ethical dilemmas, because nurses need to weight the outcomes of its use against the outcomes of not using it and also consider patient safety and autonomy. Health authorities are recommended to develop clear evidence-based guidelines for restraint use and develop and implement educational and counseling programs for nurses on the principles of ethical nursing practice, patient rights, physical restraint guidelines and protocols, and management of emotional, ethical, and legal problems associated with physical restraint use. (shrink)

Introduction. The fourth industrial revolution significantly changes the structure of economic relations and transforms the importance of factors in the development of territories. The purpose of the article is to identify the most significant factors in the regional development of the Ural macro region in the context of the fourth industrial revolution and to determine the directions of impacts to ensure the competitiveness and long-term growth of territories. Methods. The methodological basis of the study is based on a set of (...) scientific approaches to economic growth, concepts of regional and institutional economics. Research methods include regional, comparative and econometric factor analysis. Scientific novelty of the study. A method for identifying the significance of factors in the development of regions is proposed and the key factors for developing the subjects of the Ural macro region in the context of the fourth industrial revolution are established. The study contributes to the scientific debate on the meaning and management of institutional development factors. Results. The author presents the results of diagnosing the regulatory environment and geographic factors of the subjects of the Ural macro region. An econometric analysis of their impact on economic development has been carried out. The statistical significance for developing the volume of mining and the quality of the legal environment in the regions has been established. Informal institutions (the authors explain the phenomenon by weak differentiation of cultural characteristics and business practices of regions due to their historical connectivity) and transport and geographical location (due to a decrease in spatial influence and an increase in the role of digital technologies in production chains in Industry 4.0). Conclusions. In the Sverdlovsk and Chelyabinsk regions, it was possible to ensure higher values of GRP per capita due to a favorable regulatory environment. In general, in the Russian regions in the second decade of the 21st century, the raw material orientation remains (among the studied objects, the economies of the Orenburg region and Udmurtia are the most extractive). To ensure the country’s long-term development, it is necessary to create a favorable business climate: improving the legal environment in the areas outlined in the study, increasing the level of trust and reducing the level of corruption. (shrink)

Purpose: To analyze how individual characteristics and the social context are associated with mental distress symptoms in the Brazilian population.Method: A multilevel cross-sectional study with data from the 2013 National Health Survey. There were two dependent variables: decreased vital energy and somatic symptoms, the presence of depressive thoughts. The independent variables were biological characteristics, education and income, habits and lifestyle, and context variables. Bivariate analysis was performed, and Prevalence Ratios calculated in a Poisson Regression. A multilevel Poisson Regression was (...) performed to verify the effect of individual and contextual variables.Results: Regarding depressive thoughts, young and middle-aged individuals, low education, women, absence of partner, smokers or former smokers, and absence of health insurance were the categories at highest risk; belonging to classes D-E and living in states with lower expected years of schooling proved to be protective factors. Similar results were found for the second outcome.Conclusions: Symptoms of mental distress were associated with the individual characteristics and contextual aspects of the federation unit. These findings indicate the importance of strengthening psychosocial care aimed at vulnerable groups. (shrink)

In this article, the main factors of academic cheating and plagiarism in four countries are analyzed. Three groups of factors are investigated, namely individual, motivational, and contextual. A mixed method approach has been used, with material including student surveys, interviews with university teachers and administrators, and analysis of university documents. The survey results show that the role of individual social-demographic factors are not significant for predicting misconduct. Students are prone to neutralize their own blame in misconduct, and refer to (...) the external conditions by the proposition that it is difficult to avoid cheating and plagiarism during university studies. Students are also more likely to cheat and plagiarize in the conditions of weak teachers’ control and deterrents. Such results demonstrate the importance of an integrity policy at the national, institutional and classroom levels, and that the social and cultural environment can be important factors in cheating. Integrity systems and the level, which they have been implemented, have a significant impact on student misconduct and attitudes toward cheating. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first (...) semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

Background Mental health nurses advocate for patients through a person-centered approach because they care for people experiencing mental distress who tend to be limited to exercising their human rights and autonomy through interpersonal relationships. Therefore, it is necessary to provide high-quality person-centered care for these patients by identifying the influencing factors. Aim This study aims to identify the factors affecting mental health nurses in performing person-centered care for patients. Research design This study had a cross-sectional, descriptive-correlational survey design. Participants and (...) method Nurses ( N = 166) working at psychiatric wards in Korea completed an online questionnaire on moral sensitivity, attitudes toward people with mental illness, and person-centered care. The t-test and stepwise multiple regression analysis were used. Ethical considerations Ethical approval for the study was obtained from the relevant ethics committee. Findings Moral sensitivity was a significant factor correlating with the provision and perception of person-centered care. Attitudes toward patients had no effect on person-centered care. The predictor variables for the provision of person-centered care (R2 = 0.247) were moral sensitivity (β = 0.33), having a professional qualification (β = 0.19), marital status (β = 0.18), and closed ward (β = −0.15). The predictor variables for the perception of person-centered (R2 = 0.150) care were closed ward (β = −0.25), moral sensitivity (β = 0.23), and marital status (β = 0.18). Discussion and conclusion Mental health nurses can strengthen person-centered care by improving moral sensitivity related to the ethical aspect of nursing and professional competence to address the complex needs of patients. Person-centered care needs to be applied more carefully in closed wards where human rights issues may arise. Through these efforts, the dignity of patients can be protected. (shrink)

Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation.Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the (...) State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory.Results: Almost half of the sample declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation.Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation. (shrink)

Introduction The Defining Issues Test (DIT) aimed to measure one’s moral judgment development in terms of moral reasoning. The Neo-Kohlbergian approach, which is an elaboration of Kohlbergian theory, focuses on the continuous development of postconventional moral reasoning, which constitutes the theoretical basis of the DIT. However, very few studies have directly tested the internal structure of the DIT, which would indicate its construct validity. Objectives Using the DIT-2, a later revision of the DIT, we examined whether a bi-factor model or (...) 3-factor CFA model showed a better model fit. The Neo-Kohlbergian theory of moral judgment development, which constitutes the theoretical basis for the DIT-2, proposes that moral judgment development occurs continuously and that it can be better explained with a soft-stage model. Given these assertions, we assumed that the bi-factor model, which considers the Schema-General Moral Judgment (SGMJ), might be more consistent with Neo-Kohlbergian theory. Methods We analyzed a large dataset collected from undergraduate students. We performed confirmatory factor analysis (CFA) via weighted least squares. A 3-factor CFA based on the DIT-2 manual and a bi-factor model were compared for model fit. The three factors in the 3-factor CFA were labeled as moral development schemas in Neo-Kohlbergian theory (i.e., personal interests, maintaining norms, and postconventional schemas). The bi-factor model included the SGMJ in addition to the three factors. Results In general, the bi-factor model showed a better model fit compared with the 3-factor CFA model although both models reported acceptable model fit indices. Conclusion We found that the DIT-2 scale is a valid measure of the internal structure of moral reasoning development using both CFA and bi-factor models. In addition, we conclude that the soft-stage model, posited by the Neo-Kohlbergian approach to moral judgment development, can be better supported with the bi-factor model that was tested in the present study. (shrink)

This study explored international students’ online Chinese as a foreign language learning stickiness in a Chinese university context. A new theoretical model was designed and verified to serve the mixed-method investigation. Participants were a group of 194 international students learning CFL online in a Chinese university. Data were collected through an online questionnaire for all the students and semi-structural individual interviews with eight volunteer participants. The structural equation modeling was conducted to analyze the collected quantitative data, and content analysis (...) was used for the qualitative interview. Findings revealed that the online learning stickiness was significantly impacted by students’ learning expectancy confirmation, which was closely correlated with three key factors: academic integration, social integration, and technological factors. Moreover, social integration was found to be a direct contributor to learning stickiness. These results highlighted the importance of the high quality of the curriculum, the harmonious learning atmosphere, and the need for technical preparations and training for online Chinese language teaching and learning. The study also emphasized the need of integrating social interaction into Chinese learning in an online context. Investigation of a wider range of Chinese learners was recommended for future studies on learning stickiness and the new online approach. (shrink)

Male partners’ involvement in human immunodeficiency virus intervention programmes is crucial in the prevention of mother-to-child transmission of HIV. However, male partner involvement in PMTCT is low in most countries in Sub-Saharan Africa. Therefore, this study aimed at exploring the major factors associated with male partner involvement in PMTCT of HIV programmes in the Gokwe North District of Zimbabwe. The study utilised qualitative methods. Data was collected using a pretested interview guide. Purposive sampling methods were used to select participants of (...) focus group discussions and key informant interviews. Interviews were conducted from May to September 2015. Thematic analysis was used for data analysis. The study revealed that local traditional leaders played a role in mobilising men in communities. Awareness campaigns enhanced communities’ knowledge about PMTCT. Couple communication proved to be vital in promoting male involvement. However, stigmatisation against men utilising antenatal-care services, fear of HIV results and a lack of knowledge of the practices surrounding PMTCT of HIV programmes were hindrances to male partner involvement. Collaboration and engagement amongst stakeholders especially with traditional leadership can be essential in increasing male partner participation in PMTCT. Education has proved to be a catalyst in the de-stigmatisation of men in PMTCT programmes. Moreover, HIV counselling can illuminate an understanding on the implications of HIV test results. The significant contribution of this article is its demonstration of the role of African traditional leadership and belief systems in curbing HIV infections, particularly in terms of male partners’ involvement in PMTCT initiatives.Contribution: The significant contribution of this article is its demonstration of the role of African traditional leadership and belief systems in curbing HIV infections, particularly in terms of male partners’ involvement in PMTCT initiatives. (shrink)