Approaches to motivate physicians and nurses in low- and middle-income countries: a systematic literature review.

Poor health worker motivation, and the resultant shortages and geographic imbalances of providers, impedes the provision of quality care in low- and middle-income countries (LMICs). This systematic review summarizes the evidence on interventions used to motivate health workers in LMICs. A standardized keyword search strategy was employed across five databases from September 2007 -September 2017. Studies had to meet the following criteria: original study; doctors and/or nurses as target population for intervention(s); work motivation as study outcome; study design with clearly defined comparison group; categorized as either a supervision, compensation, systems support, or lifelong learning intervention; and conducted in a LMIC setting. Two independent reviewers screened 3845 titles and abstracts and, subsequently, reviewed 269 full articles. Seven studies were retained from China (n = 1), Ghana (n = 2), Iran (n = 1), Mozambique (n = 1), and Zambia (n = 2). Study data and risk of bias were extracted using a standardized form. Though work motivation was the primary study outcome, four studies did not provide an outcome definition and five studies did not describe use of a theoretical framework in the ascertainment. Four studies used a randomized trial-group design, one used a non-randomized trial-group design, one used a cross-sectional design, and one used a pretest-posttest design. All three studies that found a significant positive effect on motivational outcomes had a supervision component. Of the three studies that found no effects on motivation, two were primarily compensation interventions and the third was a systems support intervention. One study found a significant negative effect of a compensation intervention on health worker motivation. In conducting this systematic review, we found there is limited evidence on successful interventions to motivate health workers in LMICs. True effects on select categories of health workers may have been obscured given that studies included health workers with a wide range of social and professional characteristics. Robust studies that use validated and culturally appropriate tools to assess worker motivation are greatly needed in the Sustainable Development Goals era.

Looking at the past through a telescope: adults postdated their earliest childhood memories.

Our previous studies have consistently shown a telescoping error in children's dating of earliest childhood memories. Preschool children through adolescents systematically date their earliest memories at older ages, in comparison with the age estimates provided by their parents or by themselves previously. In the current study, we examined the dating of earliest childhood memories in two samples of college adults and collected independent age estimates from their parents. Consistent with our findings with children, adults significantly postdated their earlier memories by approximately 12 months (Study 1) and 6 months (Study 2). The actual age of earliest memories was 2.5 years after adjusted for telescoping errors, 1 year earlier than what is commonly believed at 3.5 years. These findings challenge commonly held theoretical assumptions about childhood amnesia and highlight critical methodological issues in the study of childhood memory.

The self online: When meaning-making is outsourced to the cyber audience.

This study examines the cyber audience's perception of social media users' persona based on their online posts from a cognitive meaning-making perspective. Participants (N = 158) answered questions about their personal characteristics and provided their 20 most recent Facebook status updates. Two groups of viewers, who viewed either the text-only or multimedia version of the status updates, answered questions about the Facebook users' personal characteristics. The viewers' perceptions of Facebook users deviated from the users' self-perceptions, although user characteristics that serve social motives were more accurately perceived. Multimedia viewers were more accurate than text viewers, whereas the latter showed a greater consensus. Gender and ethnic differences of Facebook users also emerged in online person perceptions, in line with gendered and cultured characteristics. These findings shed critical light on the dynamic interplay between social media users and the cyber audience in the co-construction of a digitally extended self.