Exploring the effects of fitbit incentive on treatment outcomes in veterans undergoing intensive pain rehabilitation program.

OBJECTIVE: This study compares clinical pain outcomes between patients in a pain treatment program that received a Fitbit, to patients that did not. We also explored: (1) cognitive, emotional, and psychological factors that may have impacted the decision to opt in to receiving a Fitbit; and (2) whether the choice to receive a Fitbit impacted changes in cognitive, emotional, and psychological factors following treatment. METHODS: Among 58 patients in a multidisciplinary pain treatment program at a Veterans Affairs Healthcare System hospital, 31 patients opted to receive a Fitbit as adjunct treatment, while 27 did not. This study utilized patient-reported and practitioner-collected data from the pain treatment program. RESULTS: Compared to the non-Fitbit group, the Fitbit group displayed a significant decrease in average pain intensity, however showed no correlation between Fitbit activity and average pain intensity. Additionally, treatment satisfaction was the only predictor of treatment group, when modeling pre- and post-treatment outcomes changes. CONCLUSION: The implementation of a Fitbit may lead to improved pain intensity. Initial evidence suggests that opting to receive a Fitbit during a pain treatment program indicates treatment engagement leading to greater treatment satisfaction. Future work is needed to verify and expand upon this potential mechanism.

Final-year nursing students' perceptions of humanistic education in nursing: a cross-sectional descriptive study.

BACKGROUND: Humanistic education is an important part of nursing education. Final-year nursing students' perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students' perceptions of nursing humanistic education in both school and hospital. METHODS: This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire. RESULTS: Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1-5 scale, while their initiative to enhance humanistic qualities was relatively low. Students' satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The "monotonous teaching format" (63.6%) and "teaching methods" (64.5%) have emerged as focal points that students identified as needing attention and improvement. CONCLUSIONS: In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students' learning motivation, and strengthening the construction of humanistic environment.

Factors affecting motivation for receiving a booster dose of the COVID-19 vaccine among Japanese university students and staff: a cross-sectional questionnaire survey.

Understanding the factors that influence people's decisions regarding vaccination is essential to promote vaccination. We aimed to clarify the motivations for receiving booster vaccines. We conducted a paper-based questionnaire distributed during January-February 2022 involving students and faculty staff who received the first COVID-19 vaccination at the mass vaccination program during June-September 2021 at Keio University. A total of 1725 participants were enrolled, and all completed the survey. Among these, 64.9% reported a significant adverse event (AEs) affecting daily life after the second vaccine. "Fear of severe COVID-19 illness" (72.6%) was the most common reason for getting vaccinated, followed by "concern of infecting others" (68.4%) and "fear of COVID-19 infection itself" (68.3%). Television emerged as the most influential source of information (80%), followed by university information (50.2%) and social networking sites (42.8%). Multivariate analysis revealed "fear of severe COVID-19 illness", "fear of COVID-19 infection itself", and "trust in the efficacy and safety of the vaccines in general" were significantly correlated with willingness to receive paid vaccinations. The severity of AEs and source of information were not related to participants' willingness to receive booster vaccinations. Participants with positive reasons for vaccination were more likely to accept a third dose.

Elements of successful NIH grant applications.

Is there a formula for a competitive NIH grant application? The Serenity Prayer may provide one: "Grant me the serenity to accept the things I cannot change, the ability to change the things I can, and the wisdom to know the difference." But how to tell the difference? In this Perspective, we provide an inclusive roadmap-elements of NIH funding. Collectively, we have over 30 y of peer review experience as NIH Scientific Review Officers in addition to over 30 y of program experience as NIH Program Officers. This article distills our NIH experience. We use Euclid's 13-book landmark, The Elements, as our template to humbly share what we learned. We have three specific aims: inform, guide, and motivate prospective applicants. We also address ways that support diversity and inclusion among applicants and young investigators in biomedical research. The elements we describe come from a wide range of sources. Some themes will be general. Some will be specific. All will be candid. The ultimate goal is a competitive application, serenity, and hopefully both.

People see more of their biases in algorithms.

Algorithmic bias occurs when algorithms incorporate biases in the human decisions on which they are trained. We find that people see more of their biases (e.g., age, gender, race) in the decisions of algorithms than in their own decisions. Research participants saw more bias in the decisions of algorithms trained on their decisions than in their own decisions, even when those decisions were the same and participants were incentivized to reveal their true beliefs. By contrast, participants saw as much bias in the decisions of algorithms trained on their decisions as in the decisions of other participants and algorithms trained on the decisions of other participants. Cognitive psychological processes and motivated reasoning help explain why people see more of their biases in algorithms. Research participants most susceptible to bias blind spot were most likely to see more bias in algorithms than self. Participants were also more likely to perceive algorithms than themselves to have been influenced by irrelevant biasing attributes (e.g., race) but not by relevant attributes (e.g., user reviews). Because participants saw more of their biases in algorithms than themselves, they were more likely to make debiasing corrections to decisions attributed to an algorithm than to themselves. Our findings show that bias is more readily perceived in algorithms than in self and suggest how to use algorithms to reveal and correct biased human decisions.

Understanding effective post-test linkage strategies for HIV prevention and care: a scoping review.

INTRODUCTION: Following HIV testing services (HTS), the World Health Organization recommends prompt linkage to prevention and treatment. Scale-up of effective linkage strategies is essential to achieving the global 95-95-95 goals for maintaining low HIV incidence by 2030 and reducing HIV-related morbidity and mortality. Whereas linkage to care including same-day antiretroviral therapy (ART) initiation for all people with HIV is now routinely implemented in testing programmes, linkage to HIV prevention interventions including behavioural or biomedical strategies, for HIV-negative individuals remains sub-optimal. This review aims to evaluate effective post-HTS linkage strategies for HIV overall, and highlight gaps specifically in linkage to prevention. METHODS: Using the five-step Arksey and O'Malley framework, we conducted a scoping review searching existing published and grey literature. We searched PubMed, Cochrane Library, CINAHL, Web of Science and EMBASE databases for English-language studies published between 1 January 2010 and 30 November 2023. Linkage interventions included as streamlined interventions-involving same-day HIV testing, ART initiation and point-of-care CD4 cell count/viral load, case management-involving linkage coordinators developing personalized HIV care and risk reduction plans, incentives-financial and non-financial, partner services-including contact tracing, virtual-like social media, quality improvement-like use of score cards, and peer-based interventions. Outcomes of interest were linkage to any form of HIV prevention and/or care including ART initiation. RESULTS: Of 2358 articles screened, 66 research studies met the inclusion criteria. Only nine linkage to prevention studies were identified (n = 9/66, 14%)-involving pre-exposure prophylaxis, voluntary medical male circumcision, sexually transmitted infection and cervical cancer screening. Linkage to care studies (n = 57/66, 86%) focused on streamlined interventions in the general population and on case management among key populations. DISCUSSION: Despite a wide range of HIV prevention interventions available, there was a dearth of literature on HIV prevention programmes and on the use of messaging on treatment as prevention strategy. Linkage to care studies were comparatively numerous except those evaluating virtual interventions, incentives and quality improvement. CONCLUSIONS: The findings give insights into linkage strategies but more understanding of how to provide these effectively for maximum prevention impact is needed.

[Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study]. / Investire sul personale sanitario: motivi di iscrizione al corso di laurea in Infermieristica. Risultati dello studio pilota.

. Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study. INTRODUCTION: Understanding the reasons for enrolling in a Bachelor of Science in Nursing (BSc Nursing) is crucial for devising strategies to stimulate enrollment and counteract the current decline in applications. A multi-center longitudinal study was initiated to explore motivations for enrollment and dropout rates. The results of the pilot study focusing on enrollment motives are presented. OBJECTIVE: To identify the reasons for enrolling in BSc Nursing programs at five Italian universities. METHODS: First-year BSc Nursing students enrolled in the academic year 2022-2023 completed an online questionnaire exploring socio-demographic and personal information, priority criteria for their choice, information sources, and the following reasons for enrolling (Likert scale 1-5): altruistic motivations, personal interests, preferences, past experiences, job security, advice, fallback options, and the social image of nursing. RESULTS: 759 questionnaires were analyzed (78% of those involved). 64.7% of the students indicated nursing as their first choice, while one-third enrolled as a fallback option, by chance, or because they were uncertain. Altruism was the primary motivation for enrollment (91.8%), but 74.2% of students enrolled to secure a good job or to pursue a career (52.3%), or due to curriculum counseling sessions (13.7%). Some differences were observed between geographical areas. CONCLUSIONS: Students primarily enroll in BSc Nursing programs due to altruism, personal experience, and job prospect. These findings may be valuable for guiding and tailoring information campaigns, and for enhancing the appeal of nursing courses.

Newly qualified professional nurses' experiences providing postoperative care to children in CTICU.

BACKGROUND:  It is challenging for newly qualified professional nurses (NQPNs) to care for children with congenital heart abnormalities following cardiac surgery in cardiothoracic critical care units. This population of nurses is allocated to critically ill children in the cardiothoracic intensive care unit (CTICU) even though they lack sufficient knowledge, experience and skills to care for these patients. OBJECTIVES:  This study explored, described and made recommendations to support NQPNs who provide postoperative care to children in a CTICU. METHOD:  A qualitative, exploratory, descriptive and contextual research design was used. Purposive sampling was employed, and in-depth individual phenomenological interviews were conducted with 10 NQPNs. Data were analysed according to Giorgio's descriptive phenomenological method, and measures to ensure trustworthiness and ethical principles were followed. RESULTS:  The NQPNs cited their lack of knowledge and mentoring as the primary contributors to their perceived challenges. This population requires motivation, mentoring and empowerment to address this phenomenon. CONCLUSION:  Professional nurses in CTICUs require a supportive work environment, with encouragement from colleagues, management and doctors. A lack of support compromises patient care outcomes and safety, resulting in litigation.Contribution: Recommendations are provided for nursing education, research and practice to empower NQPNs with knowledge and skills to work with children following cardiac surgery to avoid adverse events in the CTICU.

[Preventing decline of autonomy through the promotion of mental health: a randomized clinical trial for older adults with disabilities]. / La prévention de la perte d'autonomie par le renforcement de la santé mentale : un essai clinique à répartition aléatoire auprès des personnes âgées avec incapacités.

Among older adults with disabilities, maintaining active aging can often be compromised. However, the literature highlights a positive link between mental health and autonomy on one hand, and self-determined motivation on the other. Therefore, self-determined motivation may be improved by promoting mental health and, in the end, older adults autonomy. In this context, the « pôle bien-être autonomie ¼, a mental health promotion program, has been set up to offer activities adapted to the disabilities and needs of the elderly, hence fostering active aging. The purpose of this longitudinal study is to test the hypothesis that promoting the mental health of disabled older adults would preserve their autonomy through the development of self-determined motivation. The theoretical model was tested using structural equation modelling on data of 170 participants. A RCT was conducted between 2019 and 2021 with the same cohort. Results of the structural equation modelling support the importance of promoting mental health in maintaining active aging. Evaluation of the promotion program indicates a decrease in levels of depression, an increase in the frequency of self-determined activities and in the autonomy of beneficiaries after three months of operation. The discussion focuses on the relevance of a processual analysis of the promotion program and on new directions to maintain autonomy for seniors with disabilities.

Cultivating physician empathy: a person-centered study based in self-determination theory.

While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from N = 177 (44%) students at a Canadian medical school. We then used a person-centered approach (cluster analysis) to identify medical student profiles of self-determination (based on trait autonomy and perceived competence in learning) and how the learning environment impacted empathy for those in each profile. When the learning environment was more autonomy-supportive, students experienced higher satisfaction and lower frustration of their basic psychological needs in medical school, as well as greater empathy towards patients. The translation into increased empathy, however, was only evident among the students with higher self-determination at baseline. Results from this study suggest that autonomy-supportive learning environments will generally support medical students' psychological needs for optimal motivation and well-being, but whether or not they lead to empathy towards patients will depend on individual differences in self-determination. Findings and their implications are discussed in terms of developing theory-driven approaches to cultivating empathy in medical education.

"This is how I'm going to do it, but this is not how you're going to do it": the expectation gap between student paramedics and mentors in East and Central Scotland.

BACKGROUND: The role of paramedics has expanded significantly over the past two decades, requiring advanced skills and education to meet the demands of diverse healthcare settings. In 2021, the academic requirements for paramedics were raised to a bachelor's degree to align with other registered professions. The limited evidence on effective paramedic practice education necessitates a novel or new examination of unique learning methods, emphasising the need to establish effective learning relationships between mentors and learners to enhance professional respect and support achieving learning outcomes. This study aimed to investigate expectations between student paramedics and their mentors, focusing on the learning dynamics within paramedic education. METHODS: This qualitative study used purposive sampling to recruit participants from two distinct cohorts: student paramedics from the University of Stirling and Practice Educator Mentors from the Scottish Ambulance Service. Focus groups were conducted to illuminate comprehensive insights into participants' expectations regarding practice education and their respective roles in the learning process. Codebook thematic analysis was used to assess the alignment of these expectations. RESULTS: Findings illustrate important challenges within practice placement across learning paradigms and highlight the attitudes surrounding the integration of higher education and expectations of practice placements. These challenges encompass systemic barriers, including the support provided to mentors as they assume increased responsibilities and barriers that deter qualified staff from initially undertaking this role. CONCLUSION: The study aimed to assess expectations between practice educators and students within the paramedic profession in Scotland. The methodology effectively identified key themes from comprehensive data, marking the first primary research in this field. There are disparities in learning styles, expectation measurement, and attitudes toward higher education during practice placements, which could significantly impact the teaching and assessment processes. The findings suggest increased support for practice educators, educational programs addressing challenges of mentorship, and stronger links between higher education institutes and the Scottish Ambulance Service. Further research is needed to understand the extent of the expectation gap, how expectations evolve, and to develop strategies to address disparities.

Health workforce incentives and dis-incentives during the COVID-19 pandemic: experiences from Democratic Republic of Congo, Nigeria, Senegal, and Uganda.

BACKGROUND: The COVID-19 pandemic presented a myriad of challenges for the health workforce around the world due to its escalating demand on service delivery. A motivated health workforce is critical to effectual emergency response and in some settings, incentivizing health workers motivates them and ensures continuity in the provision of health services. We describe health workforce experiences with incentives and dis-incentives during the COVID-19 response in the Democratic Republic of Congo (DRC), Senegal, Nigeria, and Uganda. METHODS: This is a multi-country qualitative research study involving four African countries namely: DRC, Nigeria, Senegal, and Uganda which assessed the workplace incentives instituted in response to the COVID-19 pandemic. Key informant interviews (n = 60) were conducted with staff at ministries of health, policy makers and health workers. Interviews were virtual using the telephone or Zoom. They were audio recorded, transcribed verbatim, and analyzed thematically. Themes were identified and quotes were used to support findings. RESULTS: Health worker incentives included (i) financial rewards in the form of allowances and salary increments. These motivated health workers, sustaining the health system and the health workers' efforts during the COVID-19 response across the four countries. (ii) Non-financial incentives related to COVID-19 management such as provision of medicines/supplies, on the job trainings, medical care for health workers, social welfare including meals, transportation and housing, recognition, health insurance, psychosocial support, and supervision. Improvised determination and distribution of both financial and non-financial incentives were common across the countries. Dis-incentives included the lack of personal protective equipment, lack of transportation to health facilities during lockdown, long working hours, harassment by security forces and perceived unfairness in access to and inadequacy of financial incentives. CONCLUSION: Although important for worker motivation, financial and non-financial incentives generated some dis-incentives because of the perceived unfairness in their provision. Financial and non-financial incentives deployed during health emergencies should preferably be pre-determined, equitably and transparently provided because when arbitrarily applied, these same financial and non-financial incentives can potentially become dis-incentives. Moreover, financial incentives are useful only as far as they are administered together with non-financial incentives such as supportive and well-resourced work environments. The potential negative impacts of interventions such as service delivery re-organization and lockdown within already weakened systems need to be anticipated and due precautions exercised to reduce dis-incentives during emergencies.

Cross-cultural experiences and self-development: a psychobiographical study of Bruce Lee.

A common challenge people face in today's cross-cultural world is how to solve a series of adaptation problems caused by cultural conflict. Exploring Bruce Lee's successful cross-cultural experiences through psychobiography offers some inspiration and thoughts. How did Bruce Lee successfully integrate martial arts, symbolising the Eastern culture, with films representing the Western culture, finally propelling kung fu films onto the international stage? Numerous publicly available materials about Bruce Lee were collected for this study, and the research data were evaluated using thematic analysis. Bruce Lee's success benefitted from reconstructing cultural environment information and exercising his initiative to shape a new cultural environment. His life experiences reflect individual cognition behaviour and social and cultural environments as two aspects of a dynamic circulation system and show that the two have reached internal and spiralling harmony through mutual integration. In the context of the Oriental collectivism culture's family narrative, Chinese adults' personality development features the unique theme of 'inheritance and innovation'. Dealing with the relationship between self-actualisation and familism is another important and challenging task in developing the Chinese personality.

Research on risk management incentive strategy based on the green financial ecosystem.

Taking the green financial ecosystem composed of innovators, green financial institutions and regulators as the object of research, it explores the issue of how to improve the level of efforts of the three types of subjects and the benefits of risk management in the green financial ecosystem. The optimal level of effort, optimal level of return, and optimal level of return on risk management of green financial ecosystems for innovators, green financial institutions, and regulators under the three modes of No-incentive Contract, Cost-sharing Contract, and Synergistic Cooperation Contract are investigated and analyzed respectively, and verified by numerical simulation analysis. The results show: (1) Compared to the No-incentive Contract, the Cost-sharing Contract and the Synergy Cooperation Contract generate more significant incentives, and returns increase over time in both models. (2) The effort level of the participating subjects under the Synergistic Cooperation Contract is the highest, which can realize the Pareto optimization of the participating subjects and the green financial ecosystem at the same time. The study's findings contribute to a deeper understanding of cooperation among innovators, green financial institutions and regulators in facilitating risk management in green financial ecosystems and provide a realistic reference for risk managers in green financial ecosystems.

A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists.

This project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded to a demographics survey and participated in one-on-one interviews using a 14-question, semi-structured interview framework modified from a previous study. Interview responses were deidentified and qualitatively analyzed for common themes by two content experts and one qualitative analysis expert. Results suggest that CRNAs entering the management field feel somewhat unprepared to perform the administrative tasks associated with their role. Qualitative analysis of interview responses elicited multiple key themes including interpersonal communication and handling crucial conversations, time and organizational management skills, team building and motivation, and financial management skills. Themes related to preferred learning methods of chief CRNAs included mentorship, peer networking, and experiential learning to obtain the required knowledge and skills for the role. The authors recommend incorporating each of the identified themes to guide development of CRNA management-specific educational programs. Establishing such a program will serve to better prepare aspiring CRNA managers and further develop the knowledge and skillset of current chief CRNAs.

Individuals' perceptions and expectations of nutrition care provided by doctors in Australia: A focus group study.

BACKGROUND AND OBJECTIVES: Doctors are well placed to facilitate nutrition care to support dietary improvements due, in part, to their regular contact with their patients. Limited literature exists which explores the perspective of patients regarding the nutrition care provided by medical professionals across the continuum of care. This article explores the perspective of patients regarding perceptions of nutrition advice and care received from doctors and expectations of this care, including key skills and attributes the patients perceive as important. METHOD: Six online focus groups were conducted with Australian service users (n=32). RESULTS: Framework analysis identified four key themes: perceptions of doctors' role in nutrition care, expectations and experiences; the importance of individualised care; barriers and enablers to nutrition care; and topics, skills and attributes perceived as important in nutrition care. DISCUSSION: Patients have a desire for individualised and collaborative nutrition care but experienced systemic barriers in practice.

A Randomized Trial to Address Food Insecurity and Promote Smoking Cessation Among Low-Income Adults.

Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke.

Exploring the factors influencing public intention for spectator sports consumption based on grounded theory.

Spectator sports consumption serves as a vital component in the development of the sports industry. However, numerous challenges exist in fostering public engagement in this domain. Therefore, in order to explore the factors that influence public participation in spectator sport consumption, this study analyzes the intention to participate in spectator sports consumption from the perspective of consumers. On this basis, Semi-structured interviews were conducted with a sample of 25 members of the public, and three levels of coding were analyzed using the qualitative research method of procedural rooting theory and establish a model on the influence of public intention to participate in spectator sports consumption, and on this basis, we reveal the influence of crucial elements. The results of the study indicate that: Firstly, personal and psychological factors are significant internal drivers, while external drivers cover product and contextual factors. Secondly, the key to filling the attitudinal and behavioral gaps is the depth of perception individually, which is of great importance in increasing public participation. Thirdly, external contextual factors impacting consumer support primarily consist of external incentives, social influences, and urban contextual variables, which also serve a moderating role in the integration model. The results suggest that guiding the public to actively participate in spectator sport consumption should be based on an understanding of individual perceptions, emotions as well as attitudes. This paper develops a model examining public motivation to engage in spectator sports locally in China, pinpoints the primary influencing factors and mechanisms, and presents novel concepts for the sustainable growth of the sports sector.