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Patients’ Responsibilities in Medical Ethics

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Community studies documenting gender-based violence (GBV) experienced by trans and gender diverse (TGD) people often find differences in prevalence across TGD subgroups. In contrast, studies with university students tend to treat TGD students as a homogenous group, leaving differences across subgroups unknown. Using data from TGD Ontario university students, we examined the prevalence and impacts of GBV across the spectrum of nonbinary and gender queer, trans women and trans feminine (TWTF), and trans men and trans masculine (TMTM) students. Specifically, we explored the frequency of subtle and overt forms of GBV (trans environmental microaggressions, trans interpersonal microaggressions, victimization) and their relationship with psychological (positive mental health, psychological distress, perceived stress) and social (campus belonging) well-being among each subgroup. TMTM students reported experiencing both microaggression types significantly more frequently than TWTF; no other differences in prevalence were found. Consistent with minority stress theory, all but one statistically significant result suggested that experiences of GBV are associated with poorer outcomes. Specifically, GBV can negatively impact TGD students’ well-being, although its impacts are not identical across TGD subgroups. The findings highlight the importance of considering TGD students as a heterogeneous group when examining GBV and its consequences. Implications for research, policy, practice, and the training of practitioners are offered.
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James Borton, Dispatches from the South China Sea: Navigating to Common Ground. Universal-Publishers, 2022, 270 pp. (eBook). ISBN: 978-1627343701.
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Cross-sectional research has identified robust correlations between prosocial behavior in economic games and political views, but this research is limited in its ability to draw causal inferences. Here, we conducted a longitudinal cross-lagged panel study of prosociality and political views with a New Zealand sample ( n = 631). Across two waves separated by 18 months, we measured self-reported political views and employed a battery of economic games to estimate people’s general preferences for prosociality. We found that this “prosocial phenotype” predicted future variation in some of our measures of political views, including Social Dominance Orientation and support for income redistribution. Income attribution beliefs and political party support were not consistently related to the prosocial phenotype over time. None of these variables predicted future variation in the prosocial phenotype. These results suggest that prosocial predispositions may play a causal role in the expression of certain political views.
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Objective: Research concerning the relationship between transgender and gender nonconforming (TGNC) youth and religion and spirituality is sparse with mixed findings. The research that has been done focuses on spirituality and religion as both a source of joy and a stressor for TGNC youth. Method: The current study uses qualitative data collected from 141 TGNC youth and 103 caregivers to capture the experiences of TGNC youth and their families in relation to their spiritual and religious communities and commitments. Results: Findings revealed the majority of TGNC youth reported having a religious or spiritual affiliation. Approximately one-third of youth responses discussed their affiliations positively with many feeling affirmed in their place of worship. Two-thirds of respondents reported neutral or negative experiences related to their affiliation. The majority of youth and guardian dyads reported alignment in their religious or spiritual affiliation. Conclusions: This study is the first to showcase TGNC youth and their guardians’ views about religious and spiritual affiliation. Findings highlight the need for religious/spiritual interventions and programming such as chaplaincy as a part of an interdisciplinary care team and revised intake questions that seek to understand both the spiritual and religious elements of patients’ lives. Implications for Impact Statement Religious and spirituality among transgender and gender nonconforming (TGNC) youth may be an important point of intervention for youth and families. Cross-disciplinary interventions and programming, such as chaplaincy, affirming religious communities, interdisciplinary clinics, and specific inquiry about religious and spiritual beliefs may help to support TGNC youth and their families.
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Environmental issues are becoming increasingly politically polarized, making common ground essential. This research investigated the political common ground of environmental motives—the reasons why nature is worth preserving. Natural language processing of liberals’ and conservatives’ open text responses (Study 1: N = 1,544) identified 12 central motives. Political common ground was shared on the most cited motives: Human survival, moral obligations to future generations, and appreciation for nature’s beauty. Political differences emerged on motives related to climate change risks and religious stewardship. Study 2 ( N = 796) replicated these findings using a validated self-report questionnaire based on participant responses in Study 1. Factor analysis indicated motives belonged to four categories: Responsibility to nature, instrumental benefits, childhood experiences, and religious stewardship. These motives explained substantial variance in environmental attitudes and partially accounted for political differences in attitudes. The studies used mixed methods and direct/conceptual replication to build confidence in key findings and longstanding theoretical frameworks.
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Many high school students access dual enrollment at 2-year colleges, but the credits associated with their college-level courses may not transfer if they later matriculate to 4-year institutions as first-year undergraduates. In this study, we ask whether statewide articulation agreements can support the postsecondary success of participants by preserving the credits earned and facilitating academic momentum. Employing the administrative data of students in Georgia, we use a difference-in-differences approach to investigate the effect of the state’s 2012 policy on 4-year college undergraduates who participated in dual enrollment at 2-year colleges. We find a positive impact of the policy on timely degree completion, but the effect is conditional, as it applied only to students who completed the coursework identified by the articulation agreement.
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The aim of the study was to investigate mathematics anxiety in autistic school-aged boys compared with non-autistic peers, by considering the distinction between trait and state components of mathematics anxiety. The study involved 110 boys aged between 8 and 16 years old: 50 autistic participants without intellectual disability and 60 non-autistic peers. The two groups were matched for age and full-scale intelligence quotient. Trait mathematics anxiety was assessed with a self-report measure, whereas state components of mathematics anxiety were measured in the context of a real-time assessment, in which participants had to report their emotional (valence, arousal) and cognitive (perception of competence, worries) responses before and after completing a math task with time pressure. Findings revealed no significant group differences for trait mathematics anxiety. However, autistic participants performed worse in the timed math test than non-autistic peers. After controlling for age and trait mathematics anxiety, lower valence, higher pre-test emotional arousal, and higher worries were reported by the autistic boys compared with the non-autistic counterparts. No group differences emerged for perception of competence. This study emphasizes the importance of considering the distinction between trait and state mathematics anxiety, in addition to acknowledging the impact that emotional aspects, thoughts, and worries may have on the school experience of autistic students. Lay abstract Autistic children and adolescents may encounter difficulties at school, especially in mathematics, experiencing a pattern of negative feelings, distress, and concerns, which has been called mathematics anxiety. We asked 110 boys (50 autistic, 60 non-autistic) aged between 8 and 16 years old to report their feelings toward mathematics. Specifically, we asked them to fill in a questionnaire on their levels of mathematics anxiety at school and to report their emotional (valence, arousal) and cognitive (perception of competence, worries) responses before and after completing a mathematical task with time pressure. Mathematics anxiety might be an important factor to consider when assessing academic functioning of autistic children and adolescents, to understand whether it can interfere with their school success and well-being. In our sample, no significant group differences emerged for mathematics anxiety experienced at school. However, autistic children and adolescents performed worse in the timed math test than non-autistic peers. Regarding emotional and cognitive factors, lower valence, higher arousal, and higher worries were reported by the autistic participants compared with non-autistic peers. No group differences emerged for perception of competence. Teachers and clinicians should be aware that time pressure could be a negative factor in terms of proficiency and worries in autistic children and adolescents. Furthermore, it is essential to discourage the development of resignation toward academic learning and to improve positive feelings, self-esteem, and self-awareness for a more supportive learning environment.
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A study using a multiple-baseline across participants design was conducted in an alternative education setting to examine the functional relation between students’ use of a technology-based graphic organizer (TBGO) with embedded self-regulated learning strategies on the quantity and quality of their persuasive essay writing. Three third- to fifth-grade students with writing difficulties and complex behavioral needs receiving services in an alternative special education program participated in the study. The dependent variables included the number of words, number of transition words, and writing quality scores across (a) baseline (writing on the computer without the TBGO), (b) TBGO-use phase (writing on a computer with the TBGO), and (c) maintenance (writing on the computer without the TBGO). The visual and statistical analyses of data indicated all participants improved the quality of their writing, and two students also increased the quantity of their writing across phases. Students’ self-efficacy for self-regulated learning in writing ratings were also monitored throughout the study. Results indicated an overall increase in their perceived self-efficacy for writing.
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This article describes the experience of five high school seniors in a discussion-based, Advanced Placement Government course, in which the teacher of the course frequently implemented controversial public issues (CPI) discussions. By analyzing the ways in which students experienced CPI discussion in their government classroom, the author seeks to better understand the ways in which discussion strategies support the aims of disciplinary literacy in civics. Overall, the discussion-based strategies were successful in supporting the development of disciplinary literacy in civics; however, more intentional connections between CPI discussion and the aims of disciplinary literacy may further enhance the effectiveness of this practice.
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Despite advances in inclusion and access to the general curriculum for students with disabilities at large, students with extensive support needs (ESN) continue to receive instruction that is disconnected from the general curriculum and general education peers. One area of the general curriculum that students with ESN have historically lacked access to is science. However, ongoing research in this area has identified several evidence-based and promising practices that support the science learning of students with ESN. This project used a convergent mixed-methods single-case research design, specifically a single case adapted alternating treatments design paired with qualitative methods, to explore how an intervention to support comprehension of science content supported student learning and engagement for four middle school students with ESN. Implications of the study findings, as well as the value added from the mixed-methods approach, will be discussed.
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Latent variable modeling as a lens for psychometric theory is a popular tool for social scientists to examine measurement of constructs. Journals, such as Assessment regularly publish articles supporting measures of latent constructs wherein a measurement model is established. Confirmatory factor analysis can be used to investigate the replicability and generalizability of the measurement model in new samples, while multigroup confirmatory factor analysis is used to examine the measurement model across groups within samples. With the rise of the replication crisis and “psychology’s renaissance,” interest in divergence in measurement has increased, often focused on small parameter differences within the latent model. This article presents visualizemi, an R package that provides functionality to calculate multigroup models, partial invariance, visualizations for (non)-invariance, effect sizes for models and parameters, and potential replication rates compared with random models. Readers will learn how to interpret the impact and size of the proposed non-invariance in models with a focus on potential replication and how to plan for registered reports.
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Technological innovation is a double-edged sword. It can help solve major problems, such as how to treat cancer, and can be an engine of economic growth, but it can also cost jobs, such as when automation replaces people Both aspects raise issues that have major but so far little-recognized policy implications. One such issue is that new technologies are now taking the place not just of routinized jobs but of more complex positions. Another is that many government policies meant to foster needed innovation are based on an outmoded understanding of how innovation occurs and thus are not as effective as they could be. As behavioral scientists who study technology and innovation, we offer insights into addressing both issues.
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More U.S. community college students are enrolling without the requisite reading skills to be successful. Deaf and hard of hearing (DHH) students are following a similar pattern with a little less than half requiring remedial instruction when entering college. College-age readers were the first population that we studied to learn about reading and reading instruction. The present study revisits this notion with DHH students at the forefront. We wanted to know what skills DHH readers have when they enroll in community college and what skills secondary teachers could focus on to prepare them. Based on the Degrees of Reading Power assessment given to DHH first year students prior entering community college (N = 409 participants), DHH readers would benefit from instruction in three important areas of reading comprehension: key ideas and details, craft and structure, and integration of knowledge and ideas. We discuss instructional ideas and future directions.
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The present study investigated spousal interdependencies in well-being and the sources of these interdependencies among Americans and Japanese. We collected high-powered three-wave longitudinal and cross-sectional data from a wide age range of participants ( Ns = 3,012 American couples aged 26–96 and 2,307 Japanese couples aged 24–76) and assessed a variety of well-being measures. Study 1 replicated previous findings that American spouses’ well-being was positively associated with each other. Studies 2a and 2b generalized the findings of Study 1 to Japanese spouses. Both Studies 1 and 2b showed conflicting results: There were effects of mutual influence and shared environmental factors’ influences on American and Japanese spouses’ well-being in a longitudinal actor-partner interdependence model when using the cross-lagged panel model, but not when using the random intercept cross-lagged panel model. These findings illustrate that the interdependent nature of well-being is an essential feature of American and Japanese married couples.
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Aircraft carrier flight decks present high-risk mission-critical environments that need to be both efficient and safe. The concept of optimal manning, having just enough people to do the job safely and efficiently, is paramount in order to put the least amount of people at risk while not sacrificing mission effectiveness. To this end, an agent-based model, the optimal manning simulation (OMS) was developed, which specifically looks at the launch process of the flight deck in order to quantify the risk and efficiency of people working on the flight deck. OMS models different classes of crew members on the flight deck, aircraft, and resources like catapults. OMS measures safety through collisions or near-collisions of people and aircraft, as well as how long it takes to execute a launch cycle, the primary efficiency metric. Validation and sensitivity analyses provide confidence in OMS results. To demonstrate its utility, OMS is also used to predict how the future introduction of unmanned aerial vehicles could impact staffing and performance measures.
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Roadbed thaw settlement is a unique challenge for the durability of low-volume roads (LVRs) in permafrost regions. Air convection embankment (ACE) is an effective technique that acts as a semi-heat-transfer system to control temperature variation and reduce the thaw depth of subsoil. However, limited by the shortage of the necessary crushed rocks within a short distance, building an ACE in Alaska, U.S., is prohibitively expensive. Previous studies identified the feasibility of using cellular concrete for ACE and determined the optimized thickness of the cellular concrete aggregate interlayer for ACE. However, the economic efficiency and thermal and mechanical performance of the optimized, innovative cellular concrete aggregate ACE need further investigation. Therefore, two innovative cellular concrete ACEs with reasonable heights for cold/Arctic region LVRs were evaluated in this study. A thermal-mechanical coupling model was created using ANSYS Fluent and ANSYS Mechanical to evaluate the thermal and mechanical stability of the two optimized innovative cellular concrete aggregate ACEs by comparing them with a typical Alaskan flexible pavement, a silty sand/gravel embankment, and a conventional crushed-rock ACE. The fatigue damage was predicted using the elastic-based Alaska Flexible Pavement Design (AKFPD) program. A life-cycle cost analysis was conducted using AKFPD to evaluate the overall long-term economic efficiency of the cellular concrete ACEs. The results showed that cellular concrete ACE could achieve better thermal and mechanical performance with much lower embankment height than crushed-rock ACE. The cost analysis showed that the proposed cellular concrete ACEs had a significant cost advantage over the conventional crushed-rock ACE.
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The paper highlights the changes in cycling patterns and ridership trends across 12 years (including the COVID-19 pandemic) in Montreal, Vancouver, Ottawa, and New York. Using data from 17 bicycle counting stations, changes in the dynamics of daily and weekly profiles before and during pandemic were determined. Additionally, the ridership demand evolution across the years was explored using models that controlled for variations in the weather. All the studied bicycle facilities experienced changes in the daily and hourly patterns in 2020 (the first year of the pandemic), tending toward recreational purposes. Significant growth in bicycle activity during the first year of the pandemic has been found, but trends for the following years (2021 and 2022) have not been studied. This study found that all counting sites located on cycling facilities primarily used for utilitarian purposes experienced a growth in ridership during 2020. Ridership on utilitarian corridors in Montreal and New York City grew considerably during the pandemic before stabilizing in 2021 and 2022. The same counting sites rapidly reverted to utilitarian hourly and daily patterns in 2021. The mixed-utilitarian bicycle facilities in Ottawa and Montreal shifted toward more recreational uses during the pandemic, though ridership did not grow in 2021 and 2022. All the counting sites in Vancouver shifted toward mixed use during the first year of the pandemic and did not show any clear signs of reverting to their utilitarian patterns.
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Marital sexual intimacy (MSI), as one of the dimensions of intimacy, may decrease during the couple's life which could be a major concern for both families and psychologists. This study aimed to categorize and classify the research articles focused on the impact of interventional programs on MSI improvement. This systematic review and meta-analysis were performed on published articles reporting interventions on MSI, which focused on couples or women of reproductive age in PubMed, Scopus, EMBASE, Cochrane Library, SID, and Magiran databases till March 2022. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated. Further, the heterogeneity between studies and the quality of evidence was assessed using the I ² statistic and the Cochrane risk of bias tool, respectively. This review collected 43 articles with 2,001 participants. Findings were classified into three categories: Education/Communication skills, Cognitive behavior therapy (CBT), and Emotional therapy. The interventions for both couples (MD: 3.31, 95% CI = 2.62 to 4.00, I ² = 95.3%, p = .0001) and women (MD: 3.58, 95% CI = 2.80 to 4.35, I ² = 89.4%, p = .0001) had significant impact on improving sexual intimacy with more effect on women. The CBT had a more significant effect size on couples than women's MSI. All interventions have a large effect on both couples’ and women's MSI. However, because of the high heterogeneity of the findings and inadequacy of the studies in some subgroups, and the existence of uncertainty about MSI's true effect, further well-designed interventions are required to determine the long-term effects of MSI improvement programs.
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Over the past decade, health literacy has received increased attention as a tool for promoting health, well-being, and sustainable development. So far, educational approaches to health literacy have mainly been implemented in health sciences education and linked to the needs of health professionals in communication with patients. The main objective of this systematic scoping review was to investigate health literacy educational approaches in higher education study programs, including the covered content and the learning activities employed. Altogether, 26 studies on health literacy training in higher education study programs were included. The most frequent study programs represented were medicine and pharmacy. A wide range of health literacy content was extracted from the studies; by far the most frequently studied skill was patient communication, which was identified in 20 studies, followed by identification of patients with low literacy in 12 studies and conceptual knowledge of health literacy in 11 studies. All studies except one reported the use of student active learning as part of the educational approach, and 17 studies reported the use of educational technology. The scientific literature indicates that current health literacy educational approaches mainly focus on the individual components of health literacy and fail to address environmental components and health literacy in vulnerable population groups. Despite the rather extensive use of active learning in educational approaches, pedagogical foundations were scarcely reported. In addition, the use of educational technology was rarely pedagogically integrated.
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Bollywood movies made in the Hindi language are regarded as one of the most popular Indian movies. Bollywood movies like other Indian movies are successful in retaining their characteristics, which is significantly different than Hollywood movies. Overseas earnings contribute a significant pie of Bollywood movies’ total revenue. International revenue prediction requires a new approach due to the changing release strategy by the investors. Movie investors worldwide are moving away from sequential release first in the domestic market followed by release in the international markets to simultaneous release both in the domestic and the international markets. Revenue prediction at an early stage before committing money to the project is more valuable than prediction at a later stage just before or after the movie’s release. We utilize multiple machine learning algorithms to improve the baseline prediction accuracy significantly. Extreme gradient boosting, the best algorithm, reduces the baseline prediction error by 18.05%. Adopting different algorithms to different scenarios improves prediction accuracy relative to applying one algorithm across all scenarios. As an example, robust regression generates the highest prediction accuracy for movies with higher star power, whereas extreme gradient boosting achieves the highest prediction accuracy for movies with lower star power. More accurate prediction before committing money to the movie project strengthens investors’ judgement and reduces investment risk. Our study addresses a new trend of simultaneous movie releases in domestic and international markets and predicts international revenue without knowledge of domestic performance.
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The purpose of these meta-analyses was to examine the effectiveness of home-based interventions aimed at improving literacy and mathematics outcomes for preschool-age children (mean age = 4.29 years; range = 3.07–5.32 years) and to develop an understanding of what home-based interventions work in different contexts. A total of 32 studies met the inclusion criteria for these meta-analyses; 30 studies included sufficient data for inclusion in the meta-analyses, and two studies did not contain sufficient quantitative data and instead were summarized in a narrative review. The average weighted effect size for interventions with literacy (d = 0.10; CI = [−0.17, 0.38]; n = 27) and mathematical outcomes (d = 0.18; CI = [−1.62, 1.99]; n = 8) were minimal. Hence, these meta-analyses showed that home-based interventions had minimal effect on literacy and mathematical outcomes for preschoolers. There were more home-based interventions with literacy (N = 28) than mathematical outcomes (N = 10). The heterogeneity showed no variability, indicating that all intervention impacted on children’s outcomes to similar effect. Overall, many interventions were relatively light touch (i.e., time spent engaging in parent training), and the engagement requirement of the parent in some studies was minimal (e.g., reading a short text message). More in-depth research into the components of interventions (e.g., focus, training approaches) and evaluation of interventions before they are implemented is essential for ensuring that early interventions will be effective and lead to the development of the intended skills.
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Objective The objectives of this systematic review were to assess the acceptability of self-management interventions for people with asthma and identify contributing factors. Methods A systematic literature search was conducted using PubMed, MEDLINE, EMBASE (OVIDWEB), CINAHL and Cochrane databases. Clinical trials design was included if they met specified criteria. A random-effect meta-regression analysis was conducted to estimate the overall acceptance and drop-out rates and to assess the potential factors that may influence the outcomes. Results A total of 64 studies were included and 8,092 participants were recruited and participated in the trials. The estimated acceptance rate was 51.1%, while the estimated drop-out rates in the intervention and control groups were 18.2% and 15.6%, respectively. Lack of interest was the main reported reason for refusing to participate and dropping out from the program. Study-related and program-related factors influenced the acceptance and drop-out rates statistically and clinically. Conclusion The acceptance rate of self-management programs among asthmatic people was not high and the dropout rate was somewhat low. The review suggests optimizing the design of self-management studies and modifying the implemented self-management programs to increase the acceptance rate and decrease the dropout rate.
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This article analyses the novel form of live political fact-checking, as performed by the Norwegian fact-checking organisation Faktisk.no during the Norwegian parliamentary election campaign in 2021. The aim of the study was to investigate the epistemological consequences of introducing a breaking news logic to political fact-checking. Through methods of participatory observation, interviews and textual analysis, the study finds that Faktisk.no used several strategies to bridge the ‘epistemic gap’ between the logics of breaking news and political fact-checking. Combined, these strategies pushed the live fact-checking towards a confirmative epistemology, implying that the live political fact-checking confirmed (1) knowledge already believed to be true and (2) hegemonic perspectives on what constitutes important and reliable information. The findings thereby point to a potential reorientation of political fact-checking from being a critical corrective of political elites to confirming the perspectives and knowledge base of the same elites.
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