The WWW is increasingly used as a tool and platform for survey research. Several principles have been developed to deal with the new challenges posed to researchers conducting online surveys. In this paper, we discuss some of the challenges we encountered in all phases of our Web based survey conducted in 2004/2005 among nearly 10,000 respondents in six European countries. We argue how and to what extent we applied the principles and methodologies of online surveys to meet the (...) challenges, ranging from composing sampling frames, questionnaire construction, addressing potential respondents, questionnaire distribution, response rate improvement, to data cleaning and data processing. When relevant, we discuss the differences between the six countries involved. It is concluded that many if not most of the problems encountered in online surveys are solved when taking into account the principles that guide the conduct of conventional surveys. (shrink)

Simple Reduction and Beyond Traditional and New Wave models of reduction in science have not lacked for ambition. Philosophers have presented single models to account for the full range of interesting intertheoretic relations, for scientific progress, and for the unity of science (Nagel, 1961; Oppenheim and Putnam, 1958). Early critics attacked the logical empiricists' proposals about the character of intertheoretic connections (Feyerabend, 1962; Kuhn, 1970). New Wave reductionists have similarly argued that various intertheoretic relations fall at different points on a (...) continuum of goodness-of-intertheoretic-mapping. Still, whatever their differences with the logical empiricists, New Wave reductionists have retained traditional aspirations for a single, comprehensive model of reduction that will make sense of the wide range of intertheoretic relations, of progressive scientific change, and of how the various sciences hang together (Hooker, 1981; Churchland and Churchland, 1990; Bickle, 1998). Both logical empiricists and their New Wave successors proffer such unified, multi-purpose models. Regardless of the field, multi-purpose tools typically sacrifice precision for versatility. Recent analyses of mechanistic explanation have helped to reveal that these models of scientific reduction are no exceptions to this rule, and the cost of sacrificing precision is one that the mechanists are unwilling to pay. Traditional and New Wave reductionists manifest allegiances (1) to the (virtually exclusive) analysis of theories and intertheoretic relations and (2) to conceptions of explanatory levels in science rooted in considerations pertaining to the size of and the mereological relations between the sciences' objects of study. (Discussions of both explanatory levels and mereological relations follow in subsequent sections.) By contrast, advocates of mechanistic analysis offer detailed accounts of particular systems' functioning that survey their components, their operations, and the larger systems to which they contribute (Bechtel and Richardson, 1993; Glennan, 1996; Machamer, Darden and Craver, 2000; Craver, 2001; Bechtel, 2006).. (shrink)

In March 2020, the World Health Organization announced the Covid-19 outbreak a pandemic and restrictive measures were enacted by the Governments to fight the spread of the virus. In Italy, these measures included a nationwide lockdown, with limited exceptions including grocery shopping, certain work activities, and healthcare. Consistently with findings from previous studies investigating the psychological impact of similar pandemics [e.g., Severe Acute Respiratory Syndrome ], there is evidence that Covid-19 is associated with negative mental health outcomes. Given this background, (...) we conducted a cross-sectional study aimed at investigating the impact of the Covid-19 pandemic and the subsequent restrictive measures imposed by the Government on the psychological health of Italian men and women aged = 18 years and living in Lombardy, one of the worst-hit regions. The study also aimed at identifying what factors are associated with specific psychological outcomes. Thus, we developed an online survey that included a researcher-made questionnaire to collect sociodemographic, household, general health, and pandemic-related information. The Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9 and the Perceived Stress Scale were used to assess anxiety, depression, and perceived stress, respectively. We found that younger age, greater concerns about the pandemic, female gender, being unmarried, not having children, and being a student were associated with worse psychological health. These findings may provide further insight into the risk factors associated with negative psychological outcomes during the current pandemic, with identification of vulnerable groups. This body of evidence may help professionals implement targeted psychosocial treatment and prevention programs. (shrink)

Background and ObjectivesAnxiety plays an important role in psychology. An exploration of anxiety and its associated reactions may provide insight into measures for addressing mental health problems caused by the coronavirus disease 2019 pandemic. Data from this study provide potential correlational responses to anxiety.MethodsA cross-sectional study using data collected via an online self-reported questionnaire was conducted in Japan during the COVID-19 pandemic. Using the State-Trait Anxiety Inventory, we assessed anxiety levels and explored the relationship between anxiety STAI-6 score, sources of (...) COVID-19 information, the influences of COVID-19, social anxiety symptoms, discrimination, and evaluation of the government.ResultsA total of 4,127 participants were included in the analysis. The level of anxiety was not equally distributed across the general population with respect to age, gender, educational level, occupation, income, presence of underlying disease, and location. The number of sources of information on COVID-19 had a positive correlation with the STAI-6 score. The influence of the pandemic was correlated with moderate–severe anxiety. A high level of anxiety added to social anxiety and discriminatory behavior. Being female and from a non-emergency area was related to higher STAI scores, and higher education, and income decreased the STAI score. The respondents who had a lower evaluative score of the preventive activities undertaken by the national and local governments had higher STAI-6 scores.ConclusionOur findings provide statistical evidence for the associated reaction of anxiety and that anxiety reactions may vary in predictable ways. Further studies should focus on the strategic interventions that may decrease the associated responses to anxiety, to address mental health issues due to the pandemic. (shrink)

This article surveys and analyses the reflections on medical ethics teaching by colleagues teaching in United Kingdom (UK) medical schools in the early 2020s. Participants were recruited mainly by using the worldwide web to identify 64 people from 41 UK medical schools who were thought to contribute to teaching medical ethics based on their internet profiles. Twenty-three people responded. The survey data reveals that many staff are happy with the provision of medical ethics teaching, but also that some are (...) concerned about the quality of provision due to concerns with staff expertise and teaching time. In spite of the fact that the General Medical Council (GMC) and other organisations are perceived to have contributed to raising the profile of medical ethics, there is significant concern with how it is embedded within local UK medical curricula. Some participants contributed hardly or not at all to research in medical ethics, where one attributed this decline in research to the pandemic. Future work will need to address what can be done to improve the provision of medical ethics teaching to address some of these findings and to survey and analyse how perceptions might have changed in light of recent challenges and developments. (shrink)

As an informational technology, the World Wide Web has enjoyed spectacular success. In just ten years it has transformed the way information is produced, stored, and shared in arenas as diverse as shopping, family photo albums, and high-level academic research. The “Semantic Web” was touted by its developers as equally revolutionary but has not yet achieved anything like the Web’s exponential uptake. This 17 000 word survey article explores why this might be so, from a perspective that bridges both (...) philosophy and IT. (*Also translated into Croatian and republished in Vjesnik bibliotekara Hrvatske 53, 1(2010), 155-206: See external link #2). (shrink)

The Survey of Organizational Research Climate (SORC) is a validated tool to facilitate promotion of research integrity and research best practices. This work uses the SORC to assess shared and individual perceptions of the research climate in universities and academic departments and relate these perceptions to desirable and undesirable research practices. An anonymous web- and mail-based survey was administered to randomly selected biomedical and social science faculty and postdoctoral fellows in the United States. Respondents reported their perceptions of (...) the research climates at their universities and primary departments, and the frequency with which they engaged in desirable and undesirable research practices. More positive individual perceptions of the research climate in one’s university or department were associated with higher likelihoods of desirable, and lower likelihoods of undesirable, research practices. Shared perceptions of the research climate tended to be similarly predictive of both desirable and undesirable research practices as individuals’ deviations from these shared perceptions. Study results supported the central prediction that more positive SORC-measured perceptions of the research climate were associated with more positive reports of research practices. There were differences with respect to whether shared or individual climate perceptions were related to desirable or undesirable practices but the general pattern of results provide empirical evidence that the SORC is predictive of self-reported research behavior. (shrink)

The paper is an introduction to geometric algebra and geometric calculus for those with a knowledge of undergraduate mathematics. No knowledge of physics is required. The section Further Study lists many papers available on the web.

Nowadays, higher education worldwide is affected by the COVID-19 pandemic. It has affected students’ attendance in the universities and causes universities to close down in more than 190 countries. On the other hand, novice engineers studied only a few lectures related to highway engineering. Their lectures have included very little knowledge about asphalt pavement construction as highway engineering consists of many areas that are not studied in detail during their studying years subject to their traditional education. Due to all mentioned, (...) a new drive to promote online learning paves the way to evaluate our future approach to curriculum development and delivery of educational materials for engineering courses. However, experts can offer solutions to these problems using their past experience. Hence, a system that allows experts to share their experience with other engineers after completing a project is needed. Nevertheless, the web-based expert system for maintaining flexible pavement problems in tropical regions designed in this study is a novel concept. Prior to developing this system, the need for such a system was determined through literature review and validated through a questionnaire survey. Experts were interviewed, and a questionnaire survey was conducted to construct the knowledge base of the system. Knowledge was presented as rules and coded in software through PHP programming. Web pages that support the user interface were designed using a framework that consists of CSS, HTML, and J-Query. Furthermore, the system was tested by an array of users engaged in highway engineering, namely, experts, teaching experts, novice engineers, and students. The mean values of the overall system evaluation performed by 20 users using a five-point Likert scale were 4, 4.5, 3.75, 4.25, 5, 4, and 3.5. Expert and user satisfaction prove the effectiveness of the proposed system. (shrink)

This paper is a survey of standards being used in the domain of digital cultural heritage with focus on the Metadata Encoding and Transmission Standard created by the Library of Congress in the United States of America. The process of digitization of cultural heritage requires silo breaking in a number of areas—one area is that of academic disciplines to enable the performance of rich interdisciplinary work. This lays the foundation for the emancipation of the second form of silo which (...) are the silos of knowledge, both traditional and born digital, held in individual institutions, such as galleries, libraries, archives and museums. Disciplinary silo breaking is the key to unlocking these institutional knowledge silos. Interdisciplinary teams, such as developers and librarians, work together to make the data accessible as open data on the “semantic web”. Description logic is the area of mathematics which underpins many ontology building applications today. Creating these ontologies requires a human–machine symbiosis. Currently in the cultural heritage domain, the institutions’ role is that of provider of this open data to the national aggregator which in turn can make the data available to the trans-European aggregator known as Europeana. Current ingests to the aggregators are in the form of machine readable cataloguing metadata which is limited in the richness it provides to disparate object descriptions. METS can provide this richness. (shrink)

PurposeThis paper attempts to recognize the informational needs of women who suffer from intimate partner violence. It then presents a model of a web site that may answer to these needs.Design/methodology/approachFirst, the paper defines the phases women suffering from IPV go through. This is done by surveying the literature that describes the stages these women experience. In order to clarify the proposed model, the paper then describe our own set of phases based on the above literature. Once the phases mentioned (...) above are understood, the needs of these women become evident, thus allowing us to define and specify them. The model of the web site is then described and the paper shows how it relates to the various aforementioned needs.FindingsThe web site would offer a variety of information, such as: names of organizations that offer support, chats, and forums that provide emotional support and advice from women who experienced abuse in the past as well as from professionals.Research limitations/implicationsSecurity issues of this model need to be researched before applying it to use, as they are beyond the scope of this paper. Such issues should include techniques for erasing the user's traces and for keeping out “unwelcome visitors.”Originality/valueThis model, if applied, may greatly aid women suffering from IPV, as it would provide them with the emotional support and technical information they need in order to make important decisions regarding their situation. Information, if utilized, may give these women the ability to control their fate and actively improve their quality of life. (shrink)

A comprehensive understanding of participants’ motives to complete web-based surveys has the potential to improve data quality. In this study we tested the construct validity of a scale developed to measure motivation to participate in webbased surveys. We expected that 7 different motivations observed in our previous study will form a 3-factor structure, as predicted by Self-Determination Theory. This web-based questionnaire study comprised 257 participants completing the Voluntary Participation in Online Studies Scale. Their responses to 21 items underwent a principal (...) component analysis and confi rmatory factor analysis. As we expected, three factors were identifi ed: intrinsic motivation, extrinsic motivation and amotivation. In line with Self-Determination Theory there are three distinct groups of motives among web-surveys participants with amotivation as an understudied motivational state. We discuss the results suggesting which types of motivation might lead to higher quality of data with an emphasis on possible negative effects of amotivation. (shrink)

Objectives -/- Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown. Methods -/- We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected (...) viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. Results -/- We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances. Conclusion and implications -/- Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions. (shrink)

Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at (...) 40 academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

Emotional disorder symptoms are highly prevalent and a common cause of disability among children and adolescents. Screening and early detection are needed to identify those who need help and to improve treatment outcomes. Nowadays, especially with the arrival of the COVID-19 outbreak, assessment is increasingly conducted online, resulting in the need for brief online screening measures. The aim of the current study was to examine the reliability and different sources of validity evidence of a new web-based screening questionnaire for emotional (...) disorder symptoms, the DetectaWeb-Distress Scale, which assesses mood, anxiety, obsessive–compulsive disorder, post-traumatic stress disorder, suicidality, and global distress. A total of 1,499 participants completed the DetectaWeb-Distress Scale and specific questionnaires for emotional disorder symptoms, suicidal behaviors, and well-being through a web-based survey. Results indicated that a structural model of 10 correlated factors fits reasonably better in comparison to the remaining models; measurement invariance for age and gender; good internal consistency ; and significant positive correlation with other measures of anxiety, depression, PTSD, or distress, and negative correlation with well-being measures, displaying support for convergent-discriminant validity. We also found that girls scored higher than boys on most of the subscales, and children had higher scores for social anxiety, specific phobia, panic disorder, and obsessive–compulsive symptoms, whereas adolescents scored higher on depressive symptoms, suicidality, and generalized anxiety, but the effect sizes were small to medium for all comparisons. The DetectaWeb-Distress Scale is a valid, innovative, and useful online tool for the screening and evaluation of preventive programs for mental health in children and adolescents. (shrink)

An evaluation of a health condition-specific hope scale adapted from the more general dispositional Hope Scale (Snyder et al., 1991) is provided. Participants (N = 202) with a rare, debilitating, and potentially stigmatising health condition were recruited from readers of the Anal Fissure Self Help Page. Data were gathered anonymously using an online survey linked to the website. Consistent with hope theory, this new measure yielded a pathways factor (perceived capacity to find ways to achieve desired goals) and an (...) agency factor (perceived motivation to pursue goals energetically). Respondents with stronger pathways thoughts reported greater benefits from website information for understanding and generating strategies for managing anal fissures. Stronger agency beliefs were related to more frequent website visits, more rereading of first-hand patient accounts, and shorter duration of fissure symptoms. Results offer preliminary support for validity of this scale and for using web-based methodologies to study conditions, such as anal fissure. (shrink)

An evaluation of a health condition-specific hope scale adapted from the more general dispositional Hope Scale (Snyder et al., 1991) is provided. Participants (N = 202) with a rare, debilitating, and potentially stigmatising health condition were recruited from readers of the Anal Fissure Self Help Page. Data were gathered anonymously using an online survey linked to the website. Consistent with hope theory, this new measure yielded a pathways factor (perceived capacity to find ways to achieve desired goals) and an (...) agency factor (perceived motivation to pursue goals energetically). Respondents with stronger pathways thoughts reported greater benefits from website information for understanding and generating strategies for managing anal fissures. Stronger agency beliefs were related to more frequent website visits, more rereading of first-hand patient accounts, and shorter duration of fissure symptoms. Results offer preliminary support for validity of this scale and for using web-based methodologies to study conditions, such as anal fissure. (shrink)

Ontology languages for the Semantic Web have their strengths and weaknesses, in particular in the light of deploying them for biological and medical information systems. We survey and compare the Description Logics-based OWL languages, and the DL-Lite and DLR families of languages. Language choices that an ontology developer has to make are, among others, expressivity with n-ary relations (where n > 2) and more role properties versus ontology usage for data-intensive tasks. Guidelines are suggested to facilitate choosing the language (...) best fitted for a task. (shrink)

Objective: To assess the psychological distress of healthcare providers working in the field of obstetrics during the coronavirus disease 2019 pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in (...) May 2020 via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2%, and that for GHQ-12 was 84.4%. Just over half of the GHQ-12 respondents reported a clinically significant level of psychological distress. Psychological distress was associated with either individual, interpersonal, and organizational factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress. (shrink)

Little is known about the mechanisms by which psychology graduate programs transmit responsible conduct of research (RCR) values. A national sample of 968 current students and recent graduates of mission-diverse doctoral psychology programs completed a Web-based survey on their research ethics challenges, perceptions of RCR mentoring and department climate, whether they were prepared to conduct research responsibly, and whether they believed psychology as a discipline promotes scientific integrity. Research experience, mentor RCR instruction and modeling, and department RCR policies predicted (...) student RCR preparedness. Mentor RCR instruction, department RCR policies, and faculty modeling of RCR behaviors predicted confidence in the RCR integrity of the discipline. Implications for training are discussed. (shrink)

BackgroundSurveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents’ stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects.MethodsSurvey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording (...) as well as two variations of question order were employed. Respondents were randomized to receive one of four questionnaire versions.ResultsThree thousand and fifty responses were received. There were moderate to large question wording and question order effects. A majority of Norwegian citizens favour the legalization of assisted dying for patients with terminal or chronic disease.ConclusionsStakeholders in the assisted dying debate need to acknowledge potential framing effects, and accordingly should interpret survey results with caution. The same holds for researchers who conduct attitude surveys in the field of bioethics. (shrink)

The research in Human Computer Interaction (HCI) has nowadays extended its attention to the study of persuasive technologies. Following this line of research, in this paper we focus on websites and mobile applications in the e-commerce domain. In particular, we take them as an evident example of persuasive technologies. Starting from the hypothesis that there is a strong connection between logical fallacies, i.e., forms of reasoning which are logically invalid but psychologically persuasive, and some common persuasion strategies adopted within these (...) technological artifacts, we carried out a survey on a sample of 175 websites and 101 mobile applications. This survey was aimed at empirically evaluating the significance of this connection by detecting the use of persuasion techniques, based on logical fallacies, in existing websites and mobile apps. In addition, with the goal of assessing the effectiveness of different fallacy-based persuasion techniques, we performed an empirical evaluation where participants interacted with a persuasive (fallacy-based) and with a non-persuasive version of an e-commerce website. Our results show that fallacy-based persuasion strategies are extensively used in existing digital artifacts, and that they are actually effective in influencing users’ behavior, with strategies based on visual salience manipulation (accent fallacy) being both the most popular and the most effective ones. (shrink)

Background There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. Methods In January 2018, following the successful implementation of a peer-led, grassroots medical ethics curriculum, (...) student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/ MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. Results The majority of respondents were female, white and mid-20s in age. Almost half of respondents reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos. (shrink)

This paper marks the launch of a new accounting and business ethics Web project called Tender Nation. The objective of the site is to provide an emotionally supportive resource and community for the discussion of accounting and business ethics issues by accounting practitioners and accounting students. The paper explains the rationale behind the development of the site and is split into five sections. Section one develops a short critique of the development of the Web and discusses the extent to which (...) it provides an opportunity for critical engagement in the economic sphere. Section two reviews the Web based accounting and business ethics resources currently available and draws on some well established ethical theory to explain how the objectives of Tender Nation differ from other Web based attempts to critically and ethically engage with the economic sphere. Section three provides an outline of the structure and content of the site. Section four presents a survey of students'' initial responses to the Web site and the concluding section discusses plans to develop the project further. (shrink)

Background Little is known about the attitudes and practices of intensivists working in Lebanon regarding withholding and withdrawing life-sustaining treatments. The objectives of the study were to assess the points of view and practices of intensivists in Lebanon along with the opinions of medical, legal and religious leaders regarding withholding withdrawal of life-sustaining treatments in Lebanese intensive care units. Methods A web-based survey was conducted among intensivists working in Lebanese adult ICUs. Interviews were also done with Lebanese medical, legal (...) and religious leaders. Results Of the 229 survey recipients, 83 intensivists completed it, i.e. a response rate of. Most respondents were between 30 and 49 years old, Catholic Christians, anesthesiologists, working in Beirut. Ninety-two percent of them were familiar with the withholding and withdrawal concepts and 80% applied them. Poor prognosis of the acute and chronic disease and futile therapy were the main reasons to consider withholding and withdrawal of treatments. Ninety-five percent of intensivists agreed with the “Principle of Double Effect”. The main withheld therapies were vasopressors, respiratory assistance and CPR. Most of the respondents reported the decision was often to always multidisciplinary, involving the family, and the patient, or his advance directives or his surrogate and the nurses. The interviewees agreed there was a law governing withholding and withdrawal decisions/practices in Lebanon. Christians and Muslim Sunni leaders declared accepting those practices. Conclusion Withholding and withdrawal of LSTs in the ICU are known concepts among intensivists working in Lebanon and are being practiced. Our results could be used to inform and optimize therapeutic limitation in ICUs in the country. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients (...) who differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Background Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered (...) questions concerning attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding and respirator attachment. Results Of the 304 responses analyzed, a majority felt that tube feeding should be initiated in these scenarios. Only 18% felt that a respirator should be attached when the patient had severe pneumonia and respiratory failure. Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months. Only 11% responded that they actually withdrew tube feeding. Half the respondents perceived tube feeding in such a patient as a "life-sustaining treatment," whereas the other half disagreed. Physicians seeking clinical ethics consultation supported the withdrawal of tube feeding (OR, 6.4; 95% CI, 2.5–16.3; P < 0.001). Conclusion Physicians tend to harbor greater negative attitudes toward the withdrawal of life-support care than its withholding. On the other hand, they favor withholding invasive life-sustaining treatments such as the attachment of a respirator over less invasive and long-term treatments such as tube feeding. Discrepancies were demonstrated between attitudes and actual behaviors. Physicians may need systematic support for appropriate decision-making for end-of-life care. (shrink)

Background: For many years, studies have shown that the results of clinical trials are often published or reported selectively with a statistically significant bias in favour of positive trial results. Trial registration as a precondition for publication had only limited effects on current practice. Results of trials which were approved by research ethics committees are often published only partially, with a substantial time lag or not at all. This study examined existing procedures of RECs in the European Union to monitor (...) and prevent incomplete registration of trials and selective reporting of trial results. It further investigated opinions of REC members about the need to update current legislation on this matter. Methods: Web-based survey on members of RECs in 22 European countries. Results: Over 90 percent of respondents agreed that the incomplete publication of trial results had a strong or somewhat negative impact on public health and on healthcare professionals’ trust in the validity of clinical research, yet only 30 percent reported that their REC had some mechanism in place to check that findings of approved studies are published in some form. Less than 10 percent stated that their REC has further specific procedures in place to prevent or minimize selective reporting of study results. Respondents stated variously that their REC did not have the resources to follow up on this matter. Conclusions: The existing legislation to regulate trial registration and encourage complete publication of trial results leaves room for improvement. REC members welcome guidelines to adequately address both problems. The new Regulation EU No. 536/2014 as well as the FDA Amendment Act from 2007 require the reporting of summary results within 1 year after study end. As recent reviews demonstrated, without any systematic approach to monitor the adherence to these regulations, publication rates remain rather low. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using (...) a stratified purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients (...) who differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Background: Long working hours and mental health problems among teachers are a concern in Japan. More specifically, it has been reported that junior high school teachers tend to work overtime. In this study, examined the working hours of junior high school teachers in public schools and investigated the association between overtime work and stress responses across job titles.Methods: From June to December 2018, 54,772 teachers in public junior high schools completed a web-based nationwide survey regarding occupational stress and submitted (...) self-evaluated working hours per day of the previous month. Psychological and physical stress responses were assessed using the Brief Job Stress Questionnaire.Results: Results showed that 59.6% of the participants worked 11 h or more per day. Additionally, the length of working hours significantly differed across job titles = 5295.8, p < 0.001, Cramér’s V = 0.14). With respect to tenured teachers, sex, age, taking charge of the class, number of working years in the same school, working hours of 10 to 11 h, 11 to 12 h, 12 to 13 h, and 13 h or more were significantly associated with high stress, compared to those who worked less than 9 h per day. Moreover, for fixed-term teachers, sex, age, working hours of 9 to 10 h, 10 to 11 h, 11 to 12 h, 12 to 13 h, and 13 h or more were related with more stress as compared to those who worked less than 9 h per day. On the other hand, there was no significant relationship between long working hours and stress response among vice-principals, even though they tended to work the longest hours.Conclusion: We verified that Japanese junior high school teachers work long hours. Long working hours were associated with stress responses in both tenured and fixed-term teachers, but not in vice-principals. However, vice-principals work the longest hours among teachers, and we suggest that these long working hours may be a hidden problem that is often overlooked. (shrink)

This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. Home care physicians (...) and nurses face ethical issues, some of which are that “the patient’s wishes cannot be reliably understood owing to their impaired decision-making capacity” and “there is disagreement between the patient and their family members over the necessary healthcare.” The respondents sought “experience with, and insight into, healthcare ethics” and “home care” from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have “multidisciplinary discussions in the community,” “participation of healthcare ethics experts at meetings,” and “meetings held by healthcare ethics experts” to discuss specific cases. Given these results and the history of healthcare ethics education in Japan—which has been implemented mostly for healthcare providers—we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community. (shrink)

It is necessary to study the various dimensions of health and their affecting factors during the coronavirus disease-19 pandemic to identify the necessary interventions. The study aims to determine the relationship between spiritual health and happiness in medical students during the COVID-19 outbreak. In this analytical cross-sectional design study, 409 medical students were examined for the state of happiness and spiritual health and the relationship between them. Student information was collected through Web-based sampling by using standard tools from 20 April (...) to 20 June 2020. Medical students completed the demographic questionnaire as well as Oxford Happiness Questionnaire and Paloutzian and Ellison spiritual health questionnaire. The results showed that while the score of spiritual health and happiness was related to factors such as marriage, interest in a field of study, and socioeconomic status, the relationship between spiritual health and happiness was significant. This study showed that students’ happiness scores were not optimal during the COVID-19 pandemic. Due to the strong relationship between spiritual health and happiness scores, spiritual health promotion, in conjunction with other interventions, can be used to improve happiness in this group. (shrink)

BackgroundPrehospital delay is associated with non-modifiable factors such as age, residential region, and disease severity. However, the impact of psychosocial factors especially for job burnout on prehospital decision delay is still little understood.MethodThis internet-based survey was conducted between 14 February 2021 and 5 March 2021 in China through the Wechat platform and web page. Self-designed questionnaires about the expected and actual length of prehospital decision time and the Chinese version of Maslach Burnout Inventory-General Survey, Type D Personality Scale-14, (...) and Social Support Rating Scale were applied. A total of 1,039 general participants with a history of perceptible but tolerable body discomfort were included.ResultsThe top six reasons for prehospital decision delay were: endure until self-healing, too busy to ask for leave, process for seeing a doctor too complicated, too tired after work, worry about the expenditure, and fear of being identified as with serious problem. The univariate analyses revealed that older age, type D personality, job burnout, and worrying about expenditure were associated with prolonged prehospital decision time, while engaged in medical-related job and with more social support would shorten the delay. The multivariate analysis using logistic regression model with forward selecting method showed that age [per 10 years, odds ratio 1.19, p 7 days). Mediating effects were analyzed by using bias-corrected percentile bootstrap methods. Social support was found partially mediated the relationship between the determinants and prehospital decision time. The partial mediating effect of social support accounted for 24.0% of the total effect for job burnout and 11.6% for worrying about expenditure.ConclusionPsychosocial factors have a non-negligible impact on prehospital decision delay. The crucial part of prehospital decision delay may be the lack of motivation inside. Job burnout and lack of social support, as two commonly seen features in the modern world, should be given enough consideration in disease prevention and treatment. (shrink)

Cities and road authorities in many countries have started colouring their cycle lanes. Some road authorities choose red, some blue, and some green. The reasoning behind this choice is not clear, and it is uncertain whether some colours are superior to others. The current study aims to examine whether coloured cycle lanes are viewed more positively than uncoloured lanes, and whether one of the typically chosen colours is perceived as safer and more inviting to cyclists or more deterring to motorists. (...) Participants were invited to respond to a web survey. Respondents (N= 560) were from the four largest cities in Norway, both genders (42.1% women), and of a wide age range (79.6% between 30 and 70). Depending on cycling frequency, respondents were categorised as either motorist (n= 354) or cyclist (n= 206). All respondents rated different cycle lanes (uncoloured, blue, green, and red) on different attributes. The uncoloured lane was consistently rated least positively, with the lowest scores on visibility, perceived safety for both motorists and cyclist and how inviting it seemed to cycle in the lane. It was also estimated to be the lane that would experience the greatest degree of violation from motorists, in terms of driving or stopping in the cycle lane. The green and red lanes were consistently rated more positively than the blue lane, but whether green or red was preferred depended on whether the respondent had lived a place with coloured cycle lanes. People familiar with coloured cycle lanes, which in Norway are red, rated the red lane more positively than the green lane, while the opposite was true for people who were not used to coloured cycle lanes. The difference in ratings between different colours were similar to, or greater than, the difference from uncoloured to coloured, which implies that it not only mattersthata lane is coloured, but alsowhich colourit has. (shrink)

This study used experimental and correlational techniques to examine perceptions that university faculty hold regarding the practice of professorial selling of examination textbooks to wholesalers. Faculty members (n = 236) from 14 universities and community colleges and a wide variety of academic disciplines responded to a web-based survey. We presented hypothetical selling situations to respondents with manipulated variables consisting of solicitation status (unsolicited versus solicited) and use of money (for faculty or for student activities). Both main effects and the (...) interaction effect were significant such that respondents perceived it to be more ethical to sell an examination book when the book was unsolicited and when the money was being used to fund student activities. The variable most correlated with faculty members' beliefs that book selling is ethical and the faculty members' self-reports of whether or not they have engaged in bookselling was how widespread the practice appeared to be on campus. About 30 percent of faculty members sold textbooks over the past year at a dollar value of about $80 per professor. About 38 percent of respondents reported they believed the practice to be generally ethical. Implications for business ethics theory, students' moral development, and advancement of on-campus codes of ethics policies are discussed along with avenues for future research. (shrink)

Short food supply chains have become the focus of considerable research in the last two decades. However, studies so far remain highly localized, and claims about the economic and social advantages of such channels for farmers are not backed by large-scale empirical evidence. Using a web survey of 613 direct-market farmers across Canada, this article explores the potential economic and social benefits that farmers derive from participating in short food supply chains. We used multivariate analysis to test whether a (...) farmer’s degree of involvement in direct food channels is positively correlated with levels of work enjoyment, social satisfaction, and economic satisfaction. The results indicate that, overall, direct-market farmers report high levels of occupational satisfaction, although work-related challenges persist, such as stress, excessive workloads, and competition. Farmer participation in short food chains was also a positive predictor of work enjoyment and economic satisfaction, but not of social satisfaction, as measured by the share of total farm sales attributable to direct selling. Net annual farm revenue, the share of direct food sales involving a middleman, age, and gender also correlated with one or more dimensions of occupational satisfaction. (shrink)

A democratic ethics of biological technology must engage the public. This is not easy to do in a way that satisfies the demands of democratic ethics, or meets the pace of rapidly changing, complex technology. This paper describes a solution proposed by the University of British Columbia’s Norms Evolving in Response to Dilemmas interdisciplinary research group. The solution, the NERD web survey, has three distinct advantages over other methods: it is Deep—the survey provides deep data, particularly when compared (...) to alternatives such as polls and focus groups; Cheap—our survey is cost effective, which is important for a truly democratic tool; and Improvable—the NERD survey is a work in progress, improvable by design. (shrink)

Research in the U. S. on fair trade consumption is sparse. Therefore, little is known as to what motivates U. S. consumers to buy fair trade products. This study sought to determine which values are salient to American fair trade consumption. The data were gathered via a Web-based version of the Schwartz Value Survey (SVS) and were gleaned from actual consumers who purchase fair trade products from a range of Internet-based fair trade retailers. This study established that indeed there (...) are significant interactions between personal values and fair trade consumption and that demographics proved to be useless in creating a profile of the American fair trade consumer. (shrink)

BackgroundAddictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk (...) of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.MethodsAn online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017–2018.Result10 983 complete answers were collected. 7.1% of the participants had a sexual minority status. Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior.ConclusionAn awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study. (shrink)

There is growing worldwide concern that the rampant spread of digital fake news via new media technologies is detrimentally impacting Democratic elections. However, the actual influence of this recent Internet phenomenon on electoral decisions has not been directly examined. Accordingly, this study tested the effects of attention to DFN on readers’ Presidential candidate preferences via an experimental web-survey administered to a cross-sectional American sample. Results showed no main effect of exposure to DFN on participants’ candidate evaluations or vote choice. (...) However, the perceived believability of DFN about the Democratic candidate negatively mediated evaluations of that candidate—especially amongst far-right ideologues. These results suggest that DFN may at worst reinforce the partisan dispositions of mostly politically conservative Internet users, but does not cause or induce conversions in these dispositions. Overall, this study contributes novel experimental evidence, indicating that the potential electoral impact of DFN, although concerning, is strongly conditional on a reciprocal interaction between message receptibility and a pre-existing right-wing ideological orientation. The said impact is, therefore, likely narrow in scope. (shrink)

The media have become an important arena where struggles over the symbolic legitimacy of expert authority take place and where scientific experts increasingly have to compete for public recognition. The rise of authoritarian and populist leaders in many countries and the growing importance of social media have fueled criticism against scientific institutions and individual researchers. This paper discusses the new hidden forms of suppression and self-censorship regarding scientists’ roles as public experts. It is based on two web surveys conducted among (...) Finnish researchers in 2015 and 2017. We focus on answers to the open-ended questions in these surveys, where respondents reflect upon issues of freedom of expression and the feedback they receive in public arenas. Building on previous research on suppression, “research silencing,” and the “chilling effect,” we discuss the connection between freedom of expression and freedom of inquiry. We make a distinction between four forms of suppression: political and economic control, organizational control, control between rival academics, and control from publics. Moreover, we make explicit and discuss the means, motives, and practices of suppression within each of these four forms. (shrink)