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1.
BMJ Open ; 13(1): e069115, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36690402

RESUMO

OBJECTIVE: To evaluate the prevalence and accuracy of industry-related financial conflict of interest (COI) disclosures among US physician guideline authors. DESIGN: Cross-sectional study. SETTING: Clinical practice guidelines published by the Council of Medical Specialty Societies in 2020. PARTICIPANTS: US physician guideline authors. MAIN OUTCOME MEASURES: Financial COI disclosures, both self-reported and determined using Open Payments data. RESULTS: Among 270 US physician authors of 20 clinical practice guidelines, 101 (37.4%) disclosed industry-related financial COIs, whereas 199 (73.7%) were found to have received payments from industry when accounting for payments disclosed through Open Payments. The median payments received by authors during the 3-year period was US$27 451 (IQR, US$1385-US$254 677). Comparing authors' self-disclosures with Open Payments, 72 (26.7%) of the authors accurately disclosed their financial COIs, including 68 (25.2%) accurately disclosing no financial COIs and 4 (1.5%) accurately disclosing a financial COI. In contrast, 101 (37.4%) disclosed no financial COIs and were found to have received payments from industry, 23 (8.5%) disclosed a financial COI but had under-reported payments received from industry, 14 (5.2%) disclosed a financial COI but had over-reported payments received from industry and 60 (22.2%) disclosed a financial COI but were found to have both under-reported and over-reported payments received from industry. We found that inaccurate COI disclosure was more frequent among professors compared with non-professors (81.9% vs 63.5%; p<0.001) and among males compared with females (77.7% vs 64.8%; p=0.02). The accuracy of disclosures also varied among medical professional societies (p<0.001). CONCLUSIONS: Financial relationships with industry are common among US physician authors of clinical practice guidelines and are often not accurately disclosed. To ensure high-quality guidelines and unbiased recommendations, more effort is needed to minimise existing COIs and improve disclosure accuracy among panel members.


Assuntos
Conflito de Interesses , Médicos , Feminino , Humanos , Estudos Transversais , Revelação , Indústrias
2.
PLoS One ; 18(1): e0279904, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36652406

RESUMO

With the increasing attention of the capital market to environmental, social and governance information, sustainability reporting has become an important carrier for stakeholders to gain insight into sustainability of companies. But the emerged "greenwashing" problem has also brought haze to the value creation of capital market. To study the consequences of the pseudo-social responsibility behavior of "greenwashing", this paper takes China's listed companies as the research sample to empirically examine the relationship between sustainability reporting "greenwashing" and "shared value" creation. It is found that the "greenwashing" behavior of corporate sustainability reporting significantly reduces the "shared value" creation, while the degree of sustainability information asymmetry and the quality of information disclosure play a partial mediation role between them. Further analysis shows that the more effective internal control of a company and the greater pressure of external media supervision, the more conducive to weaken the negative impact of "greenwashing" on "shared value" creation. This paper enriches the literature on the economic consequences of "greenwashing" in sustainability disclosure and the influencing factors of "shared value" creation, extends the research on information disclosure and "shared value" from financial information to non-financial information. The results call for the state to promote legislative work, formulate unified standards and compress the "greenwashing" gray space; Governments could implement mandatory disclosure, implement independent authentication and strengthen "greenwashing" social supervision; Companies should strengthen capacity building and improve the "greenwashing" governance mechanism with the help of digital empowerment.


Assuntos
Organizações , Responsabilidade Social , Comportamento Social , Governo , Revelação , China
3.
JAMA Netw Open ; 6(1): e2250921, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36637820

RESUMO

Importance: Individuals who are amyloid-positive with subjective cognitive decline and clinical features increasing the likelihood of preclinical Alzheimer disease (SCD+) are at higher risk of developing dementia. Some individuals with SCD+ undergo amyloid-positron emission tomography (PET) as part of research studies and frequently wish to know their amyloid status; however, the disclosure of a positive amyloid-PET result might have psychological risks. Objective: To assess the psychological outcomes of the amyloid-PET result disclosure in individuals with SCD+ and explore which variables are associated with a safer disclosure in individuals who are amyloid positive. Design, Setting, and Participants: This prospective, multicenter study was conducted as part of The Amyloid Imaging to Prevent Alzheimer Disease Diagnostic and Patient Management Study (AMYPAD-DPMS) (recruitment period: from April 2018 to October 2020). The setting was 5 European memory clinics, and participants included patients with SCD+ who underwent amyloid-PET. Statistical analysis was performed from July to October 2022. Exposures: Disclosure of amyloid-PET result. Main Outcomes and Measures: Psychological outcomes were defined as (1) disclosure related distress, assessed using the Impact of Event Scale-Revised (IES-R; scores of at least 33 indicate probable presence of posttraumatic stress disorder [PTSD]); and (2) anxiety and depression, assessed using the Hospital Anxiety and Depression scale (HADS; scores of at least 15 indicate probable presence of severe mood disorder symptoms). Results: After disclosure, 27 patients with amyloid-positive SCD+ (median [IQR] age, 70 [66-74] years; gender: 14 men [52%]; median [IQR] education: 15 [13 to 17] years, median [IQR] Mini-Mental State Examination [MMSE] score, 29 [28 to 30]) had higher median (IQR) IES-R total score (10 [2 to 14] vs 0 [0 to 2]; P < .001), IES-R avoidance (0.00 [0.00 to 0.69] vs 0.00 [0.00 to 0.00]; P < .001), IES-R intrusions (0.50 [0.13 to 0.75] vs 0.00 [0.00 to 0.25]; P < .001), and IES-R hyperarousal (0.33 [0.00 to 0.67] vs 0.00 [0.00 to 0.00]; P < .001) scores than the 78 patients who were amyloid-negative (median [IQR], age, 67 [64 to 74] years, 45 men [58%], median [IQR] education: 15 [12 to 17] years, median [IQR] MMSE score: 29 [28 to 30]). There were no observed differences between amyloid-positive and amyloid-negative patients in the median (IQR) HADS Anxiety (-1.0 [-3.0 to 1.8] vs -2.0 [-4.8 to 1.0]; P = .06) and Depression (-1.0 [-2.0 to 0.0] vs -1.0 [-3.0 to 0.0]; P = .46) deltas (score after disclosure - scores at baseline). In patients with amyloid-positive SCD+, despite the small sample size, higher education was associated with lower disclosure-related distress (ρ = -0.43; P = .02) whereas the presence of study partner was associated with higher disclosure-related distress (W = 7.5; P = .03). No participants with amyloid-positive SCD+ showed probable presence of PTSD or severe anxiety or depression symptoms at follow-up. Conclusions and Relevance: The disclosure of a positive amyloid-PET result to patients with SCD+ was associated with a bigger psychological change, yet such change did not reach the threshold for clinical concern.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Masculino , Humanos , Adulto , Idoso , Doença de Alzheimer/diagnóstico , Encéfalo/metabolismo , Peptídeos beta-Amiloides/metabolismo , Estudos Prospectivos , Revelação , Tomografia por Emissão de Pósitrons , Disfunção Cognitiva/diagnóstico por imagem
4.
J Interpers Violence ; 38(1-2): NP1343-NP1366, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35466757

RESUMO

Children exposed to domestic violence (DV) disclose their experiences to a variety of people, including informal (e.g., peers), formal (e.g., doctors), and legal (e.g., police) support systems. Legal system disclosure is more common than formal system disclosure yet remains understudied leaving unanswered questions about the nature of those who choose to disclose and factors that influence their disclosure decision. Guided by communication privacy management theory and Johnson's typology of domestic violence (DV), this study addressed gaps in the CEDV literature through a theoretical thematic analysis of the DV exposure and legal system disclosure experiences of 25 young adults exposed to father-mother-perpetrated DV during their childhood. Findings from this study show that half of the participants had no legal system disclosure (n = 12; nondisclosers) and half had at least some legal system disclosure (n = 13; disclosers). Varying types of violence exposure and levels of exposure were factors that impacted youths' decisions to disclose to legal systems. Escalation of violence was a key factor that drove legal system disclosure, but other factors including how the young adults and their communities perceived their fathers, the match between the youth's goals for disclosure and the outcomes upon disclosing, along with family privacy norms and family boundaries were influential in guiding decision making over time. This study has implications for practitioners working with DV-exposed youth, as our findings unpack the conditions under which youth choose to (not) disclose, the factors influencing these decisions, and how the responses and reactions from legal support systems inform future disclosure decisions.


Assuntos
Violência Doméstica , Exposição à Violência , Adolescente , Humanos , Adulto Jovem , Crianças Adultas , Revelação , Grupo Associado
6.
J Psychosom Res ; 164: 111095, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36495755

RESUMO

OBJECTIVE: Illness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this population. Using a modified version of the Child Stigma Scale originally developed for youth with epilepsy, the current study investigated the factor structure and validity of this adapted measure (i.e., Stigma Scale - Child; SS-C) in youth with IBD. METHODS: Factor analyses were conducted to determine the most parsimonious factor structure for the adapted 8-item Stigma Scale - Child in a sample of 180 youth with IBD. Correlations were conducted to assess convergent validity, and a multiple regression was conducted to further evaluate the measure's predictive validity of child depressive symptoms. RESULTS: The most parsimonious model for the SS-C is a one-factor solution with an error covariance between the two items assessing concealment/disclosure of IBD diagnosis. CONCLUSIONS: The SS-C is a psychometrically sound illness stigma measure in pediatric IBD that demonstrates strong convergent validity with psychosocial adjustment factors such as thwarted belongingness, illness uncertainty, and illness intrusiveness, as well as strong predictive validity with youth depressive symptoms. The SS-C is a viable option for use as a brief screener in youth with IBD across clinical and research settings.


Assuntos
Doenças Inflamatórias Intestinais , Adolescente , Humanos , Criança , Doenças Inflamatórias Intestinais/psicologia , Estigma Social , Revelação , Psicometria , Análise Fatorial , Reprodutibilidade dos Testes , Inquéritos e Questionários
7.
J Gen Intern Med ; 37(11): 2669-2677, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34545466

RESUMO

BACKGROUND: The development of rigorous, high-quality clinical guidelines increases the need for resources and skilled personnel within guideline-producing organizations. While collaboration between organizations provides a unique opportunity to pool resources and save time and effort, the collaboration presents its own unique challenges. OBJECTIVE: To assess the perceived needs and current challenges of guideline producers worldwide related to guideline development and collaboration efforts. DESIGN: Survey questions were developed by the Guidelines International Network and the US GRADE Network, pilot-tested among attendees of a guideline development workshop, and disseminated electronically using convenience and snowball sampling methods. PARTICIPANTS: A total of 171 respondents representing 30 countries and more than 112 unique organizations were included in this analysis. MAIN MEASURES: The survey included free-response, multiple-choice, and seven-point Likert-scale questions. Questions assessed respondents' perceived value of guidelines, resource availability and needs, guideline development processes, and collaboration efforts of their organization. KEY RESULTS: Time required to develop high-quality systematic reviews and guidelines was the most relevant need (median=7; IQR=5.5-7). In-house resources to conduct literature searches (median=4; IQR=3-6) and the resources to develop rigorous guidelines rapidly (median=4; IQR=2-5) were perceived as the least available resources. Difficulties reconciling differences in guideline methodology (median=6; IQR=4-7) and the time required to establish collaborative agreements (median=6; IQR=5-6) were the most relevant barriers to collaboration between organizations. Results also indicated a general need for improvement in conflict of interest (COI) disclosure policies. CONCLUSION: The survey identified organizational challenges in supporting rigorous guideline development, including the time, resources, and personnel required. Connecting guideline developers to existing databases of high-quality systematic reviews and the use of freely available online platforms may facilitate guideline development. Guideline-producing organizations may also consider allocating resources to hiring or training personnel with expertise in systematic review methodologies or utilizing resources more effectively by establishing collaborations with other organizations.


Assuntos
Conflito de Interesses , Medicina Baseada em Evidências , Revelação , Medicina Baseada em Evidências/métodos , Humanos , Determinação de Necessidades de Cuidados de Saúde , Inquéritos e Questionários
8.
J Contin Educ Health Prof ; 42(4): e128-e130, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36469804

RESUMO

INTRODUCTION: YouTube is a popular source of health care information for consumers. The use of "Dr" or "Doctor" in a channel name is a way contributors establish expertise. The current study sought to understand the degree by which popular YouTube channels belonging to individuals who self-identify as doctors disclose their credentials and the nature of their disclosures. METHODS: Two raters extracted descriptive characteristics from the most viewed public YouTube channel names meeting keyword search criteria of "Doctor" and "Dr". Channel-level disclosure was captured by examining a channel's "About" section. Video-level disclosure was captured by watching the first 2 minutes of the five most viewed videos from each channel. RESULTS: Forty-eight channels (45.7%; 48/105) disclosed degree, 60 channels (57.1%; 60/105) disclosed specialty, and 26 channels (24.8%; 26/105) disclosed the level of training. Two hundred thirty-six videos (46.6%; 236/506) disclosed degree, 201 videos (39.7%; 201/506) disclosed specialty, and 81 videos (16%; 81/506) disclosed the level of training. DISCUSSION: Our findings suggest that the most viewed YouTube health channels and videos demonstrate inconsistent credential disclosure, occurring less than half of the time. Current professional guidance from licensing boards on social media encourages transparency around expertise and credential sharing. In addition, it remains unclear what guidance other health care professionals receive about disclosure practices online. Future recommendations and training to health care professionals should include explicit language for transparent disclosure of credentials.


Assuntos
Médicos , Mídias Sociais , Humanos , Gravação em Vídeo , Revelação
9.
BMC Infect Dis ; 22(1): 937, 2022 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-36514071

RESUMO

BACKGROUND: Research on the relationship between disclosure of HIV status to male sexual partners (HIV disclosure) and quality of life (QOL) revealed complex and even contradictory results. The impact of HIV disclosure on various domains of QOL and the mediation effect between them are unclear. The purposes of this study were to explore the impact of HIV disclosure on QOL among men who have sex with men (MSM), and whether HIV treatment self-efficacy mediated these relationships. METHODS: The data came from a baseline survey on the design of a randomized control trial conducted in Shandong, China. A total of 579 MSM patients were included. SPSS 24.0 was used to conduct independent samples t test, one-way analysis of variance and nonparametric tests and the PROCESS macro was used to conduct mediation analysis. RESULTS: Among 579 participants, 16.06% disclosed their HIV infection status to their male sexual partners. The effect of HIV disclosure on QOL was mediated by treatment self-efficacy. Self-efficacy played partial mediating role in social relationships, meaning that HIV disclosure had both direct and indirect effects on this factor. In the overall QOL and domains of physical, psychological, independence, and environment, HIV disclosure had an indirect effect only through self-efficacy and no significant effect on the spirituality domain. CONCLUSIONS: The results emphasize the importance of HIV disclosure and self-efficacy on the QOL of MSM patients and suggest that health care providers should assist MSM patients in deciding whether to disclose their HIV status during daily medical services.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Humanos , Masculino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Homossexualidade Masculina , Revelação , Qualidade de Vida , Autoeficácia , Parceiros Sexuais , Comportamento Sexual/psicologia
10.
Urolithiasis ; 51(1): 24, 2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36580121

RESUMO

This review examines data from stone conferences and research journals to assess whether justifiable concerns exist about possible bias in urolithiasis research and if so, how they can be minimized. Conflict of interest (COI) policies of two major urological congresses and three symposia dedicated to stone research were reviewed. Disclosure slides were viewed in webcasts and were evaluated for robustness and speaker compliance with respect to policy. Additionally, disclosure and COI policies of ten Science Citation Index (SCI)-approved journals were assessed and compared with actual declarations in published papers on urolithiasis. It was observed that disclosure and conflict declarations are frequently conflated in congresses and journals. Differences between the two ideologies appear to be ignored or unappreciated. Disclosures in the major urological meetings revealed a high percentage of financial relationships with industry. In dedicated stone conferences, more than two-thirds of speakers failed to display a declaration slide. Both scenarios generate questions about objectivity. Disclosure and COI statements in journals varied widely in format, detail and content. It is concluded that there exists a misinformed and incorrect perception in urolithiasis research that disclosure of potential COIs somehow validates a study as being objective and unbiased. Current policies and practices at conferences and in published papers create a setting in which concerns of bias prevail. Changes, including the establishment of a universal policy, insistence of independent and explicit declarations of disclosures and conflicts, implementation of sanctions for transgression and the introduction of intensive scrutiny by reviewers are required to minimize doubts.


Assuntos
Políticas Editoriais , Urolitíase , Humanos , Conflito de Interesses , Estudos Transversais , Revelação
11.
Afr J AIDS Res ; 21(4): 373-384, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36538541

RESUMO

Background: Reaching all people with HIV services, including traders in the informal economy, is critical to meeting UNAIDS' 95-95-95 goals. However, traders prioritise their business over attendance at health facilities. This limits their access to health services. This study explores market traders' preferences for the potential type and delivery methods of HIV services at Lilongwe Central market.Method: The study used an exploratory qualitative study design in Lilongwe, Malawi. Sixteen in-depth interviews were conducted among traders at Lilongwe Central Market between June and September 2022. In the same period, we also conducted four key informant interviews involving three officers responsible for HIV services at the district and council levels, and the market chairman.Results: HIV services preferred by market traders include HIV testing, antiretroviral therapy, condom dispensation, voluntary medical male circumcision and HIV awareness campaigns. These services should be offered daily or when the market is less crowded, and they could be delivered in the market. These services can be provided by both lay and health workers, depending on traders' preferences, and must be integrated with other health services to mitigate unintended HIV status disclosure concerns.Conclusion: The achievement of UNAIDS' 95-95-95 goals by 2030 requires that HIV services should be available to all those who require them at times and locations that are convenient for them, through providers they have chosen either as integrated or standalone, depending on the target group perception of the role of these two models in mitigating stigma. This will necessitate the development of new approaches targeting underserved groups, such as traders in markets.


Assuntos
Infecções por HIV , Humanos , Masculino , Malaui , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Pesquisa Qualitativa , Serviços de Saúde , Revelação
12.
Gan To Kagaku Ryoho ; 49(12): 1291-1294, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36539236

RESUMO

A series of research frauds, including data manipulation in clinical trials of pharmaceuticals represented by the hypertension drugs Diovan and Blopress and the leukemia treatment Tasigna, as well as violation of conflict of interest disclosure in relation to pharmaceutical companies, were uncovered from 2013 to 2014. In response, the Clinical Trials Act(Act No. 16 of 2017)was enacted by the ordinary Diet session on April 7, 2017(promulgated on April 14 of the same year)to ensure confidence in clinical research. In addition to requiring researchers to comply with the Standards for Conducting Clinical Research and to conclude and disclose contracts related to funding to pharmaceutical companies and other parties, the act also stipulates that the quality of reviews should be ensured by establishing an accredited certified review board, thereby promoting high-quality social and academic clinical research that is transparent, safe, and the purpose of the Act is to promote high-quality, socially and academically significant clinical research that ensures transparency and safety. The Act came into effect on April 1, 2018, but when it first came into effect, there was atrophy in clinical research, which is essential for drug development, due to a lack of understanding among researchers, delays in response by medical institutions, and complicated procedures and high implementation costs as typified by the enormous amount of paperwork. Now, several years after the enactment of the Act, the number of specified clinical research projects stipulated in the Act is on the increase, thanks to the Q and A issued by the Ministry of Health, Labour and Welfare regarding the implementation of the Clinical Trials Act and other administrative information, as well as to the ingenious implementation of the Act. In addition, various advantages of conducting research under the Clinical Trials Act have also become apparent. This article outlines the operation and points to keep in mind regarding the specified clinical research stipulated in the Clinical Trials Act.


Assuntos
Revelação , Humanos , Preparações Farmacêuticas
13.
J Clin Ethics ; 33(4): 303-313, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36548234

RESUMO

The OpenNotes (ON) mandate in the 21st Century Cures Act requires that patients or their legally authorized representatives be able to access their medical information in their electronic medical record (EMR) in real time. Ethics notes fall under the domain of this policy. We argue that ethics notes are unique from other clinical documentation in a number of ways: they lack best-practice guidelines, are written in the context of common misconceptions surrounding the purpose of ethics consultation, and often answer questions of a different nature than other documentation. Thus, we believe the clinical ethics community would benefit from clarification on when the withholding of ethics notes is justified. We provide recommendations for excluding information from ethics documentation based on the likelihood and magnitude of harm that may occur with particular disclosures and suggest approaches to decrease the potential harms that may occur. We define and explain six types of reasons to exclude information from ethics notes based on significant harms that are not addressed in the ON policy: (1) harmful revelations from a protected chart note; (2) negative emotional effects on patients or families; (3) the purpose of the consultation is undermined by harmful consequences; (4) avoidable negative impact on interpersonal dynamics; (5) inappropriate labeling or disclosure of medical, social, or financial information; and (6) inclusion of biasing or otherwise unfair information. We also suggest approaches to mitigate harm when excluding, including, reframing, or delaying release of information that is perceived to be relevant to an ethics case. Overall, we hope our analysis and recommendations will initiate a much-needed discussion about the impact of the ON mandate on clinical ethics documentation.


Assuntos
Consultoria Ética , Ética Clínica , Humanos , Registros Eletrônicos de Saúde , Revelação , Documentação
14.
PLoS One ; 17(12): e0275926, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36477719

RESUMO

INTRODUCTION: Genetic testing for hereditary cancers can improve long-term health outcomes through identifying high-risk individuals and facilitating targeted prevention and screening/surveillance. The rising demand for genetic testing exceeds the clinical genetic workforce capacity. Therefore, non-genetic specialists need to be empowered to offer genetic testing. However, it is unknown whether patient outcomes differ depending on whether genetic testing is offered by a genetics specialist or a trained non-genetics clinician. This paper describes a protocol for upskilling non-genetics clinicians to provide genetic testing, randomise high-risk individuals to receive testing from a trained clinician or a genetic counsellor, and then determine whether patient outcomes differed depending on provider-type. METHODS: An experiential training program to upskill dermatologically-trained clinicians to offer genetic testing for familial melanoma is being piloted on 10-15 clinicians, prior to wider implementation. Training involves a workshop, comprised of a didactic learning presentation, case studies, simulated sessions, and provision of supporting documentation. Clinicians later observe a genetic counsellor led consultation before being observed leading a consultation. Both sessions are followed by debriefing with a genetic counsellor. Thereafter, clinicians independently offer genetic testing in the clinical trial. Individuals with a strong personal and/or family history of melanoma are recruited to a parallel-group trial and allocated to receive pre- and post- genetic testing consultation from a genetic counsellor, or a dermatologically-trained clinician. A mixed method approach measures psychosocial and behavioural outcomes. Longitudinal online surveys are administered at five timepoints from baseline to one year post-test disclosure. Semi-structured interviews with both patients and clinicians are qualitatively analysed. SIGNIFICANCE: This is the first program to upskill dermatologically-trained clinicians to provide genetic testing for familial melanoma. This protocol describes the first clinical trial to compare patient-reported outcomes of genetic testing based on provider type (genetic counsellors vs trained non-genetic clinicians).


Assuntos
Revelação , Melanoma , Humanos , Testes Genéticos , Melanoma/diagnóstico , Melanoma/genética , Projetos Piloto
15.
PLoS One ; 17(12): e0273491, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36520927

RESUMO

BACKGROUND: While there is growing support for screening for Adverse Childhood Experiences (ACEs), rigorous evidence on the efficacy and preference of screening methods is needed. OBJECTIVE: To examine caregiver: (1) rates of disclosure of their child's exposure to ACEs using item-level response (each item can be endorsed) versus aggregate-level response (only total score reported) screening format, (2) associations between family demographic factors and disclosure by screening format, and (3) emotional reaction and experience of screening formats in a diverse, low-income pediatric population. METHODS: Caregiver participants (n = 367) were randomized to complete the Pediatric ACEs and Related Life Events Screener (PEARLS) tool, in an aggregate-level response vs item-level response format from 2016-2019. Select caregivers (n = 182) participated in debriefing interviews. T-test and chi-square analyses in 2019 compared PEARLS disclosure rates and reactions between the screening modalities. Regression models explored interactions with child characteristics. Thematic analysis of interview notes captured caregiver screening experience. RESULTS: PEARLS disclosure rates were significantly higher in the aggregate-level response compared to the item-level response screening arm (p <0.05). This difference was accentuated for children identified as black and/or male (p <0.05). Caregiver reactions to PEARLS screening were rarely negative in either screening format. Qualitative data demonstrated strong caregiver preference for the item-level response format; additional themes include provider relationship, fear with disclosure, and screening outcome expectations. CONCLUSION: While caregivers reported a preference for the item-level response format, the aggregate-level response screening format elicited higher disclosures rates particularly for children who are black or ma. TRIAL REGISTRATION: Clinical trial registry: NCT04182906.


Assuntos
Experiências Adversas da Infância , Pediatria , Criança , Humanos , Masculino , Cuidadores/psicologia , Revelação
16.
PLoS One ; 17(12): e0277674, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36516148

RESUMO

BACKGROUND: Excessive self-disclosure online may risk the reputations, mental health problems, and professional lives of nursing students. This study investigated nursing students' usage of social media, their attitudes towards social media, mental health problems and self-disclosures, and the relationships of these variables. METHODS: A cross-sectional study was conducted online (n = 1054) with questionnaires of Fear of Missing Out (FoMO), Social Media Fatigue (SMF), Students' Uses and Views of Social Media (SUVSM) and self-disclosure in social media which included self-information shown on social media and information viewed by others. RESULTS: Although most of them held positive attitudes towards social media, 17.4% of the participants acknowledged that they had posted inappropriate contents online and 37.6% witnessed improper posts from schoolmates or teachers online. SMF was affected by familiar with relevant regulations on the social media usage (ß = -.10, p < .001), FoMO (ß = .41, p < .001), and SUVSM (ß = .17, p < .001). Additionally, nearly 1/3 participants reported their net-friends could view following information: gender, age, occupation, education level and location. Self- disclosure in social media was positively influenced by education (ß = .10, p < .001), sharing moments or Weibo, etc. (ß = .009, P = 0.009), time spent on social media daily (ß = .11, p < .001), accepting stranger's "friend request" (ß = .06, P = 0.047), FoMO (ß = .14, p < .001) and SMF (ß = .19, p < .001). Furthermore, effect of SUVSM on self-disclosure in social media was mediated by FoMO and SMF. CONCLUSION: Inappropriate contents are posted and witnessed by appreciable proportions of nursing students. Positive attitude towards social media may strengthen FoMO and SMF, which may increase self-disclosure in social media in turn.


Assuntos
Mídias Sociais , Estudantes de Enfermagem , Humanos , Motivação , Estudos Transversais , Saúde Mental , Revelação , Atitude
17.
Artigo em Inglês | MEDLINE | ID: mdl-36554932

RESUMO

As the primary source of carbon emissions, enterprises must work hard to save energy, reduce emissions, and disclose timely carbon information to the public. As a key means of communicating carbon management performance to stakeholders, carbon information disclosure is directly tied to the future sustainability of enterprises. Based on panel data of 118 listed firms in the automotive manufacturing industry from 2017 to 2021, this study rates the sample companies' quality of carbon information disclosure. The impact of the government, creditors, media, employees, and suppliers on such disclosure is also examined from the stakeholders' standpoint. The findings reveal that: (1) Although there has been a gradual increase in the degree of disclosure, overall levels are still low, and the willingness to voluntarily disclose is insufficient. (2) When other variables are neglected, the government, creditors, media, and employees all assist enterprises in disclosing carbon information, but the influence of suppliers will inhibit such disclosure. In the context of a complex economic system, the level of carbon disclosure is positively correlated with the government, the media, and employees, while negatively correlated with creditors. The influence of suppliers is not significant. These findings may aid in formulating related policies from different dimensions, directing enterprises to publish carbon information actively and strengthening carbon management.


Assuntos
Carbono , Revelação , Humanos , Automóveis , Indústria Manufatureira , Governo , China
18.
Artigo em Inglês | MEDLINE | ID: mdl-36498296

RESUMO

Compared with developed countries, emerging economy countries are facing more severe environmental challenges. Therefore, effective disclosure of corporate environmental information is an important concern for emerging economies to cope with environmental issues. There is a growing volume of literature documenting that analyst site visits can urge corporations to provide high-quality financial information to investors. However, whether analyst site visits can also improve the quality of environmental information is still unclear. In the Chinese setting, where environmental information has attracted much attention, we explore the interaction between analyst site visits and environmental information disclosure. With three regression methods of the ordinary least squares model, two-stage least square model, and difference-in-difference model, we establish regressions to verify the relationships between them by using empirical data from 2012 to 2019 in China. The results show that analyst site visits are significantly positively correlated with corporate environmental information disclosure. This positive relation is more pronounced when corporations are in economically developed and highly market-oriented areas, in poor air quality areas, and for corporations with good, reasonable internal governance. In addition, we find that analyst site visits affect the quality of environmental information disclosure through the intermediary effect of media attention. In the robustness test, further evidence also indicates that the interaction between analyst site visits and corporate environmental information disclosure was more significant before the COVID-19 lockdown policy was implemented in Wuhan. Our findings suggest that governments should provide support for analysts to conduct site visits and formulate regulations on mandatory disclosure of environmental information by different regions as soon as possible.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Organizações , Revelação , China
19.
Artigo em Inglês | MEDLINE | ID: mdl-36498344

RESUMO

This study investigates the relationship between industry competition and managers' voluntary disclosure policies and examined how the corporate governance structure affects this relationship in South Korean companies. The fiercer the competition within the industry to which the company belongs, the higher the incentive for managers to perform strategic actions to improve their competition status. This increase in the strategic incentives of managers can be seen through voluntary disclosure policies. The empirical results of this study are as follows. First, it was found that there was a negative relationship between the degree of industry competition and the level of voluntary disclosure of greenhouse gas emissions information. This means that managers perform less disclosure to maximize the value of the company because the more competition within the industry intensifies, the higher the proprietary cost of disclosing information on greenhouse gas emissions information. Second, it was found that the corporate governance structure weakened the relationship between the degree of industry competition and the level of corporate voluntary disclosure. These results can be interpreted as that a good governance structure supports such managers' disclosure decisions because managers are more likely to choose disclosure policies to maximize the value of the company than personal benefits even in the fierce industry competition.


Assuntos
Gases de Efeito Estufa , Revelação , Indústrias , Organizações , República da Coreia
20.
Int J Cardiovasc Imaging ; 38(12): 2743-2751, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36445671

RESUMO

PURPOSE: Visual assessment of Rubidium (Rb-82) PET myocardial perfusion images is usually combined with global myocardial flow reserve (MFR) measurements. However, small regional blood flow deficits may go unnoticed. Our aim was to compare the diagnostic value of regional with global MFR in the detection of obstructive coronary artery disease (oCAD). METHODS: We retrospectively included 1519 patients referred for rest and regadenoson-induced stress Rb-82 PET/CT without prior history of oCAD. MFR was determined globally, per vessel territory and per myocardial segment and compared using receiver-operating characteristic analysis. Vessel MFR was defined as the lowest MFR of the coronary territories and segmental MFR as the lowest MFR of the 17-segments. The primary endpoint was oCAD on invasive coronary angiography. RESULTS: The 148 patients classified as having oCAD had a lower global MFR (median 1.9, interquartile range [1.5-2.4] vs. 2.4 [2.0-2.9]), lower vessel MFR (1.6 [1.2-2.1] vs. 2.2 [1.9-2.6]) and lower segmental MFR (1.3 [ 0.9-1.6] vs. 1.8 [1.5-2.2]) as compared to the non-oCAD patients (p < 0.001). The area under the curve for segmental MFR (0.81) was larger (p ≤ 0.005) than of global MFR (0.74) and vessel MFR (0.78). CONCLUSIONS: The use of regional MFR instead of global MFR is recommended as it improves the diagnostic value of Rb-82 PET in the detection of oCAD.


Assuntos
Doença da Artéria Coronariana , Revelação , Humanos , Radioisótopos de Rubídio , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Valor Preditivo dos Testes , Doença da Artéria Coronariana/diagnóstico por imagem
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