Factors influencing hepatitis B vaccination intention and behavior among college students in Tibet: Insights from the expanded theory of planned behavior

Hepatitis B (Hep B) remains a critical public health issue globally, particularly in Tibet, where vaccination rates and influencing factors among college students are yet understudied. This study applies a cross-sectional design to investigate the Hep B vaccination rate among 1,126 college students in Tibet and utilizes the expanded theory of planned behavior (ETPB) to identify vaccination behavior intention (BI) and vaccination behavior (VB). Stratified cluster sampling across three universities was used to assess behavioral attitudes (BA), subjective norms (SN), perceived behavioral control (PBC), past vaccination history (PVH) and vaccination knowledge (VK), and used structural equation modeling (SEM) for model validation and multi-group comparison. Results indicated that 16.3% of students had received the Hep B vaccine. VK notably improved BA toward vaccination (β = 0.518, p < .001). BA (β = 0.232, p < .001), PBC (β = 0.239, p < .001), SN (β = 0.385, p < .001) positively influenced BI. However, PVH failed to predict BI. BI (β = 0.448, p < .001) and PVH (β = 0.127, p < .001) were significant predictors of VB. Significant ethnic variations were noted. The positive effect of PVH on VB (β = 0.151, p < .001) and the mediating role of PBC in VB (β = 0.076, p < .05) were significant among Tibetan students. The effect of VK on BA was stronger among Tibetans (β = 0.503, p < .05),while the impact of attitude on BI was more pronounced among Han students (β = 0.366, p < .05). The vaccination rate for Hep B among college students in Tibet is relatively low, and the ETPB model effectively explains their vaccination intentions and behaviors. Tailored intervention strategies for Tibetan and Han students are recommended to boost vaccination rates effectively.

"It's about wanting to disappear from the world… " - an interpretative phenomenological analysis on the meaning of music and hearing-related risks

PURPOSE

To explore the role and meaning of music in adolescents' lives and the adolescents' ways of understanding how music listening can impact hearing-health.

METHODS

Open-ended interviews and Interpretative Phenomenological Analysis (IPA). The analysis involves both individual and more generalized investigations based on the contributions from seven participants.

FINDINGS

The findings show that music is an integrated and habitual aspect of the adolescents' daily lives, used as a tool for emotion regulation, cognitive enhancement, and creating personal space where one can be free from outside criticisms and distractions. There is a preference for music listening in headphones which creates a more intense and private experience. There are varying levels of awareness of the potential hearing-health risks, but the profound meaning of music for their well-being often overshadows any concerns.

CONCLUSIONS

Despite awareness of potential hearing-health risks, the adolescents prioritize the immediate emotional and cognitive benefits of music. Technological advancements and increased social media interactions contribute to a trend towards more personalized music listening. These insights call for more complex intervention strategies and models for health promotion which account for the positive aspects of music listening, instead of merely focusing on the potential risks of loud music.

Health behavioural change - the influence of social-ecological factors and health identity

Health behaviour is crucial for influencing health, making it a key component in health promotion. However, changing behaviours is complex, as many factors interact to determine health behaviours. Information, awareness, and knowledge are important but not enough. It is essential to move beyond focusing solely on individual psychological and cognitive factors to an understanding of the complex processes involved in health behaviour change. Social-ecological models account for these complex processes but risk being overly broad and all-encompassing. This qualitative grounded theory study explores how individual, interpersonal, and environmental factors interplay to influence health behaviour, and examines how social-ecological models in health promotion can be tailored to address different ecological needs. Participants were recruited from a community-based cardiovascular disease-prevention program in Northern Sweden. Data was collected through in-depth interviews about health and health behaviours throughout the life course among middle-aged men and women. The results illustrate how factors obstructing or enabling health behaviours vary in patterned ways for individuals with different health identities. Social-ecological interventions could be more effective if adapted to the specific needs of people with different health identities. In addition to screening for various risk factors, screening for health identities could be helpful in designing social-ecological health-promoting interventions.

Psychometric properties of the revised Ukrainian version of the Continuous Traumatic Stress Response scale (CTSR) in the context of the Russo-Ukrainian war

Background: The Continuous Traumatic Stress Response scale (CTSR) was designed to measure symptoms associated with multiple ongoing security threats in the context of Israeli-Palestinian conflict. Since 2014, Ukraine has faced armed invasion and war, with nationwide insecurity since February 2022.Objective: This study aimed to adapt the CTSR scale into Ukrainian and evaluate its psychometric properties within a Ukrainian sample during the ongoing war.Method: The Ukrainian adaptation of the CTSR followed the procedure used in creating the original instrument (Goral, A., Feder-Bubis, P., Lahad, M., Galea, S., O'Rourke, N., & Aharonson-Daniel, L. (2021). Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats. PLoS One, 16(5), e0251724). To identify a unique context-specific factor structure relevant to the Ukrainian experience, the initial 25 items were tested in a sample of 584 Ukrainians using exploratory and confirmatory factor analyses. Subsequently, the established scale structure was assessed for homogeneity, and convergent validity using measures of depression (PHQ-9), anxiety (GAD-7), perceived stress (PSS-4), resilience (BRS), and PTSD symptoms (PCL-5).Results: A three-factor, 9-item solution, representing the constructs of exhaustion, alienation, and helplessness, demonstrated the most acceptable fit among all the alternative CTSR models, including the original: χ2 = 72.84, df = 24, p < .001, χ2/ (df) = 3.04, CFI = 0.94, TLI = 0.91, SRMR = 0.05, RMSEA = 0.08. Cronbach's α for internal consistency ranged from 0.68 to 0.84 for total score, and subscales. Significant positive correlations ranging from 0.41 to 0.67 with symptom severity of depression, anxiety, perceived stress, and PTSD established the convergent validity of the Ukrainian CTSR, indicating that it measures related yet distinctive psychological phenomena of reactions to continuous traumatic stress.Conclusions: The revised Ukrainian version of the CTSR scale is a reliable and valid measure of continuous traumatic stress response, accurately reflecting its manifestation in the Ukrainian context. These findings are crucial for guiding clinical interventions and research in prolonged war environments, where understanding the nuances of ongoing trauma is essential.

Acceptance and attitudes towards COVID-19 vaccination during pregnancy in Canada

The COVID-19 pandemic posed a unique set of risks to pregnant women and pregnant people. SARS-CoV-2 infection in pregnancy is associated with increased risk of severe illness and adverse perinatal outcomes. However, evidence regarding the use of COVID-19 vaccines in pregnancy shows safety and efficacy. Despite eligibility and recommendations for COVID-19 vaccination among pregnant women and pregnant people in Canada, uptake remains lower compared to the general population, warranting exploration of influencing factors. The COVERED study, a national prospective cohort, utilized web-based surveys to collect data from pregnant women and pregnant people across Canada on COVID-19 vaccine attitudes, uptake, and hesitancy factors from July 2021 to December 2023. Survey questions were informed by validated tools including the WHO Vaccine Hesitancy Scale (VHS) and the Theory of Planned Behavior (TPB). Of 1093 respondents who were pregnant at the time of the survey, 87.7% received or intended to receive a COVID-19 vaccine during pregnancy. TPB variables such as positive attitudes toward COVID-19 vaccines (OR = 1.11, 95% CI = 1.08-1.14), direct social norms, and indirect social norms were significantly associated with vaccine acceptance. Perceived vaccine risks, assessed by the WHO VHS, were greater in those not accepting of the vaccine. Our study identified several key factors that play a role in vaccine uptake: perceived vaccine risks and safety and social norms. These findings may guide public health recommendations and prenatal vaccine counseling strategies.

"The big topic is COVID": A qualitative study about changes in HPV vaccine conversations between parents and primary care team members throughout the COVID-19 pandemic

Pandemic-related disruptions in primary care delayed important discussions between providers and parents about routine vaccinations. Conversations have become even more challenging since the COVID-19 pandemic due to increased vaccine hesitancy. This qualitative study explored changes in human papillomavirus (HPV) vaccine conversations within the context of the pandemic from the perspective of primary care team members (PCTMs). Twenty-five PCTMs serving children between 9 and 17 y old in Pennsylvania during the pandemic were conveniently sampled. PCTMs rated their confidence and agreement related to HPV vaccine conversations and pandemic impact. Semi-structured interview questions assessed changes in their HPV vaccine conversations throughout the pandemic. Open-ended questions inquired about PCTMs' thoughts on the COVID-19 pandemic and if or how it impacted HPV vaccination uptake in their practice. Data were collected from May to July 2024. Verbatim transcriptions were analyzed using both inductive and deductive approaches to thematic analysis. Participants were 44% pediatricians, 50% had ≥20 y experience, and 68% were White. Six themes emerged: (1) parents show a range of reactions about HPV vaccination; (2) disruptions in healthcare visits and heightened parental concerns impede vaccination; (3) PCTMs notice clear changes in vaccine acceptance rates; (4) reasons for vaccination refusal have not substantially changed as a result of the pandemic; (5) importance of interpersonal relationships with parents; and (6) PCTM burnout impacts conversations. The pandemic added challenges to HPV vaccine conversations with parents. Findings from this study can be used to refine existing communication approaches to improve HPV vaccine conversations in primary care.

Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder

INTRODUCTION

Perinatal opioid use disorder (OUD) remains a public health epidemic. Stress, anxiety and depression are disproportionately high among this population and are associated with poor recovery outcomes. Mindfulness interventions show promise for supporting recovery for women. This paper reports results of a pilot study to evaluate initial efficacy and acceptability of digitally delivered mindfulness meditation videos to reduce stress and promote mindfulness among women in recovery.

METHODS

Women with lived experience of OUD were recruited from three outpatient programs that provided care to pregnant and parenting women with a history of opioid use in rural northern New England (2 maternity care settings that offered buprenorphine as part of their service menu and 1 academic substance use treatment setting). In a pre-post study design, participants were randomly assigned to receive four of 16 short meditation videos, each delivered by email in a survey link over a 2-week period (2 per week) Videos were co-designed in earlier work with representative end-users, guided by evidence-based mindfulness interventions. Assessment included the Perceived Stress Scale and the Mindfulness Attention Awareness Scale. Participants rated each video on usefulness, enjoyability, ability to lower anxiety, and intention to use in the future. Participants also provided open-ended feedback about the videos. Data were analyzed using descriptive statistics, paired t-tests, and generalized linear modeling.

RESULTS

A total of 20 women, ages 24-36 years, completed the pilot study. Most participants (95%) were white and non-Hispanic, reflecting the rural region. Marginal mean perceived stress scores decreased significantly from 21.49 to 19.85 [p = 0.05, d = 0.43] and mean mindfulness scores increased significantly from 3.47 to 3.76 [p = 0.04, d = 0.45]. Overall, the meditation videos were rated as highly acceptable and useful and a majority (80%) indicated intention to use the meditations in the future.

CONCLUSION

Digitally delivered meditation videos were highly acceptable and useful to participants and the low dose intervention reduced stress and improved mindfulness. Findings inform directions for future research with larger samples to evaluate the effectiveness of this accessible digital intervention to support women in recovery and strategies for broadly implementing the intervention.

Creatine in women's health: bridging the gap from menstruation through pregnancy to menopause

BACKGROUND

Creatine supplementation in women has gained attention for its potential benefits beyond muscle growth, including reproductive health, cognitive health and aging. Women exhibit distinct physiological differences from men, influenced by hormonal fluctuations during pre-menopause, pregnancy, and menopause, and these factors should be considered for their influence on creatine metabolism.

OBJECTIVE

This review aims to provide a historical evaluation of creatine supplementation in women, its potential applications across female-specific life stages, recent research highlights, and targets for future research. The review also considers the impact of hormonal changes on creatine metabolism and effectiveness as a dietary supplementation.

METHODS

This is a narrative overview of historical and recent research evaluating the effects of creatine in women.

RESULTS

Early studies demonstrated the benefits of creatine on exercise performance in women, though they often overlooked menstrual cycle variability. Recent research has begun to account for these hormonal fluctuations, enhancing the understanding of creatine's applications. Creatine supplementation has shown positive effects on muscle strength, exercise performance, and body composition, particularly when combined with resistance training. Additionally, creatine may improve mood and cognitive function, potentially alleviating symptoms of depression. Emerging evidence suggests creatine's benefits during pregnancy and post-menopause, though data on perimenopausal women remains limited.

CONCLUSION

Creatine supplementation presents a promising strategy for enhancing various aspects of women's health across the lifespan. Future research should focus on optimizing dosing strategies, understanding long-term health implications, and exploring creatine's effects during pregnancy and perimenopause.

From error to insight: Removing non-systematic responding data in the delay discounting task may introduce systematic bias

Delay discounting (DD), which reflects a tendency to devalue rewards as the time to their receipt increases, is associated with health behaviors such as sleep disturbances, obesity, and externalizing behavior among adolescents. Response patterns characterized by inconsistent or unexpected reward valuation, called non-systematic responding (NSR), may also predict health outcomes. Many researchers flag and exclude NSR trials prior to analysis, which could lead to systematic bias if NSR (a) varies by demographic characteristics or (b) predicts health outcomes. Thus, in this study we characterized NSR and examined its potential beyond error by comparing it against DD with a secondary data analysis of the Adolescent Brain Cognitive Development (ABCD) Study-a population-based study that tracked youths (N = 11,948) annually from 8 to 11 years of age over 4 years. We assessed DD and NSR using the Adjusting Delay Discounting Task when youths were approximately 9.48 years old (SD = 0.51). We also examined three maladaptive health outcomes annually: sleep disturbances, obesity, and externalizing psychopathology. Our analysis revealed variations in NSR across races, ethnicities, and body mass index categories, with no significant differences observed by sex or gender. Notably, NSR was a stronger predictor of obesity and externalizing psychopathology than DD and inversely predicted the growth trajectory of obesity. These findings suggest that removing NSR patterns could systematically bias analyses given that NSR may capture unexplored response variability. This study demonstrates the significance of NSR and underscores the necessity for further research on how to manage NSR in future DD studies.

The role of visual attention in opportunity cost neglect and consideration

Choices necessitate opportunity costs: choosing one option means foregoing another. Despite their critical role in decision making, people often neglect opportunity costs and are less likely to make purchases when reminded of them. Here, we seek to understand whether and how opportunity-cost neglect can be explained by attention, a relationship that has been proposed but not explicitly tested. Participants made eye-tracked, incentivized purchase decisions in two conditions: one with implicit opportunity costs (e.g., "Buy" vs. "Do Not Buy") and one with explicit opportunity costs (e.g., "Buy" vs. "Keep Money"). Across two studies (approximately 30,000 choices), we find lower purchase rates when opportunity costs are explicit. More importantly, we show that the relationship between attention and opportunity cost considerations is two-fold. First, the amount of attention to the outside option is greater when opportunity costs are explicit, which partly accounts for the effect of opportunity cost salience on choice. Second, for some framings, the predictive power of attention to opportunity costs is greater when opportunity costs are explicit. Using the attentional drift-diffusion model, we model the effect of opportunity cost salience on choice via attention. These findings help explain why people are more likely to purchase when explicit opportunity cost reminders are absent.

Children's and adults' social partner choices are differently affected by statistical information

The current study investigated how U.S. adults (N = 99) and 5- and 6-year-old children (N = 112) use statistical information in their social partner choices. We found that children integrated base rate information (the distribution of traits within groups) and individual-level statistical information (the frequency of an individual's past behaviors) in their partner choices, but adults only relied on the individual-level statistical information and neglected base rate information. In addition, adults and children were affected by non-statistical information: Adults showed risk-seeking and risk-averse tendencies, and children showed only risk-seeking tendencies in their partner choices. These findings provide evidence that both statistical and non-statistical information affect social decisions, and adults and children are influenced by each type of information in distinct ways. The current study suggests future directions to further investigate the role of statistical learning in our social cognition and to develop a unifying account of how non-statistical information interacts with statistical information in our social decisions.

Dynamic modulation of confidence based on the metacognitive skills of collaborators

In collaborative decision-making contexts, people typically share their metacognitive experience of confidence to convey the degree of certainty in their decisions. To reach collective decisions, collaborators' individual beliefs can be aggregated and weighted according to their respective confidence, thereby enhancing group accuracy beyond individual capabilities. Previous joint decision-making studies have shown that individuals tend to adopt the same scale for communicating their levels of confidence. However, confidence judgments vary not only in terms of metacognitive bias, that is whether individuals tend to report generally low or high confidence, but also in terms of metacognitive accuracy, or how well the confidence judgments align with choice accuracy. In the first two experiments, where the metacognitive accuracy of the collaborator was manipulated and explicitly communicated to participants, individuals increased their average confidence levels as the metacognitive accuracy of the collaborator decreased, while their own metacognitive accuracy remained unaffected. Trial-wise analyses showed that participants differentially adapted their confidence after a collaborator made a wrong group decision, depending on the metacognitive accuracy of the collaborator. In two follow up studies, we showed that both manipulations (i.e. manipulating objective differences in the metacognitive accuracies of the collaborators and explicitly communicating these differences) were necessary for these effects to emerge. Our findings shed light on how collaborative decision-making contexts can dynamically affect metacognitive processes.

Evaluating the impact of an educational intervention with cognitive rehearsal training on preparing pre-registration nursing students to respond to workplace incivility

BACKGROUND

Workplace incivility can cause distress to nursing students and adversely affect team cohesiveness which can then negatively affect the quality of patient care. Preparing students to foster healthy work environments and deal with acts of incivility that threaten teamwork and patient safety becomes increasingly important as nursing students progress through their academic careers.

OBJECTIVES

This study aimed to assess the impact of structured education based on cognitive rehearsal response training on pre-registration nursing students' self-efficacy perceptions in dealing with workplace incivility.

DESIGN

A single-group pre - and post - intervention study design.

SETTINGS & PARTICIPANTS

A consecutive sample of 91 third-year pre-registration Bachelor of Nursing students across three campuses of a single university participated in the study between August and October 2022.

METHODS

A concurrent nested mixed method design comprising a structured educational intervention and a 'before and after' survey (open-ended and closed-ended questions) was conducted to evaluate the efficacy of the intervention on nursing students' perceived self-efficacy in handling workplace incivility. The quantitative component was supplemented by qualitative insights from free-text comments on the quality and effectiveness of, and satisfaction with the educational intervention.

RESULTS

Participants reported an increase in perceived self-efficacy of 4.8 (SD = 4.5) points, 95 % CI [3.8, 5.8], during the post-intervention phase compared to the pre-intervention stage. This difference was statistically significant, t (90) = 10.2, p < .001, and large, d = 0.84. Additionally, the overall effectiveness of the educational intervention was rated highly, with a mean score of 8.51 and SD of 1.71. Qualitative content analysis revealed five categories: knowledge is power, the cue card method, simple and clear, role-playing realism, and the road to improvement and change. Qualitative content analysis revealed five categories: knowledge is power, the cue card method, simple and clear explanation, role-playing realism, and the road to improvement and change.

CONCLUSION

Cognitive rehearsal response training significantly enhanced nursing students' perceived self-efficacy in handling workplace incivility. Larger-scale randomised controlled trials are warranted in order to validate these findings and support broader scale implementation.

Unfamiliar familiarity: A scoping review on the role of familiarity in consumer acceptance of cultivated meat

The potential introduction of cultivated meat products to the market, framed as sustainable alternative to conventional animal-source foods, underscores the need to examine psychological barriers and predisposing factors influencing consumer acceptance. Familiarity is often considered a facilitating factor, based on the premise that higher familiarity with cultivated meat is associated with greater acceptance. However, evidence remains contradictory and poorly integrated. This review examines and organizes the literature on familiarity with cultivated meat and its influence on consumer acceptance. A scoping review of peer-reviewed and grey literature was conducted on June 7, 2024, following PRISMA-ScR and Joanna Briggs Institute guidelines. Comprehensive searches across Scopus, Web of Science, PubMed, and PsycInfo included no restrictions on participant type, geographic location, social and cultural contexts, language, or publication time. 63 articles were analyzed to examine (i) definitions of familiarity, (ii) methodologies measuring familiarity with cultivated meat, and (iii) evidence regarding its influence on consumer acceptance of cultivated meat. Results indicate that current research on familiarity is largely based on non-representative samples, with data recency limitations, and inconsistent operationalization. Familiarity is often conflated with the related yet distinct constructs of awareness and knowledge, revealing a lack of clarity in literature. The review also identified various approaches for assessing familiarity, all lacking psychometric rigor, hindering replicability and comparability of findings. This review highlights the need for further research to clarify the theoretical and operational definition of familiarity and its role in consumer acceptance of cultivated meat.

Perceived vs. actual multitasking abilities: Predicting texting while driving efficacy and behavior from overconfidence

Whereas numerous studies have reported drivers' overconfidence in their driving ability, this study examines overconfidence in one's multitasking abilities operationalized as overestimation (perception relative to one's actual performance) and overplacement (perception relative to others' abilities) as predictors of texting while driving (TWD). This study also examines TWD self-efficacy as an explanatory mechanism for the relationship between overconfidence and TWD. A sample of 611 undergraduate students (34 % male, mean age of 19.52 years) from a southwestern US university completed an online task-switching paradigm to assess their multitasking ability and multiple self-report measures of TWD-related constructs. TWD was also measured using phone application data. Results indicated that overconfidence (both overestimation and overplacement) was more strongly related to TWD self-efficacy than self-efficacy to resist TWD. TWD self-efficacy explained the relationships between overconfidence and TWD. Additionally, TWD self-efficacy predicted self-reported and actual TWD above and beyond self-efficacy to resist TWD and vice versa. Actual multitasking ability was not significantly related to actual or self-reported TWD. Overall, these findings provide evidence for the influence of overconfidence in multitasking and two forms of self-efficacy on TWD. Implications as well as future directions for research are discussed.

Stop, think, buy: An online randomised controlled experiment comparing the effects of traffic light nutritional labelling and price promotion on steering consumer food choice

Diet-related diseases are a global health concern, prompting governments to implement population-wide dietary improvements. In the UK, the traffic light system (TLS) of nutritional labelling aims to guide healthier food choices. However, concerns have arisen about whether retailer price promotions may counteract positive effects of the TLS on diet. To address these concerns, in the present research we investigated the effects of the TLS and price promotions on the healthiness of food choice, both individually and in combination. A pre-registered online randomised controlled trial (RCT) was conducted using a 2x3 factorial between-subjects design with TLS (control vs. TLS) and price promotion (no promotion vs. healthiest product promotion vs. unhealthiest product promotion) as interventions. A total of 1582 UK participants were randomised across the experimental conditions and asked to make a hypothetical purchase choice amongst four unbranded snack bars of varying healthiness. Price promotions were found to effectively increase the likelihood of choosing a promoted product, whether healthy or unhealthy. Price promotions on the unhealthiest food item were found to decrease the likelihood of the healthiest product being chosen. TLS labelling did not significantly impact food choice relative to the control. However, there was a tendency for the labelling to amplify the effect of price promotions on healthy products and dampen the effect on unhealthy products. Overall, our research offers new insights into how different forces may interact when multiple policy interventions are implemented in the retail environment and highlights the need to examine them in combination.

Social Influence in Australian University Institutional Eating: A Qualitative Content Analysis

INTRODUCTION

Social influence has been recognised as a primary determinant of eating behaviour, and an effective behavioural change mechanism. Institutional settings offer a conducive environment for eating behaviour research, and few have examined multiple social influences interacting within an Australian institutional eating setting. Responding to calls to improve the use and reporting of theory within social marketing research, this study aimed to explore which social influences within the Consumer Socialisation Theory (CST) were evident in an institutional eating environment, to determine if the use of the CST could advance theory use within social marketing and behavioural change research.

METHODS

Semi-structured interviews (n = 16) were conducted with students residing in university college accommodation with provided meals. A deductive content analysis method was used to identify the CST social influences of interaction, modelling, social norms and reinforcement.

RESULTS

All theory defined social influences were evident. While all four social influences were present, participants identified interaction, modelling and social norms as having a greater influence within this context. The CST was successfully applied and helped to identify the different social influences within this study.

CONCLUSIONS

These findings show that not all social influences were relevant within this setting. SO WHAT?: This study informs future research and interventions by indicating the social influences that exist within an Australian university institutional context, and therefore which may be used to change eating behaviour. Additionally, it provides evidence for the successful use of the CST as a theory to identify social influences and inform intervention development and planning.

Alcohol and Aquatic Activity: Young Males' Perceptions of Risk and Social Identity Through the Lived Experience

INTRODUCTION

This research explored the lived experiences, risk perceptions and social identity beliefs related to alcohol consumption around water among young Australian males.

METHODS

Purposive sampling was used to recruit 23 Australian males aged 18-30 who had previously consumed alcohol around water. An online survey collected demographics, eligibility and swimming ability, followed by qualitative telephone interviews. An interview guide developed based on extant literature and team member expertise gathered data on lived experience of alcohol consumption around water, risk perception and social identity. Interviews were recorded, transcribed verbatim and analysed using a reflexive hybrid thematic approach in NVivo.

RESULTS

With respect to lived experience, participants described consuming alcohol around water primarily as a social and unplanned activity, often occurring with friends and family and in locations lacking formal safety measures. In terms of risk perception, despite recognising the dangers of consuming alcohol around water, many underestimated personal risks and overestimated their risk assessment abilities. Concerning social identity, participants identified typical individuals engaging in these activities as young, predominantly male and sensation-seeking, often viewed as socially undesirable and reckless. However, many did not see themselves as fitting this description, instead describing their behaviour as more cautious and responsible.

CONCLUSIONS

This study provides valuable insights into how lived experiences, risk perceptions and social identities influence young Australian males' decisions to consume alcohol around water. So what?: The findings underscore the need for targeted public safety campaigns and interventions that leverage lived experiences and psychological insights to effectively reduce alcohol-related risks in aquatic environments.

Does changing behavioral intentions engender actual behavior change? The context of coastal ecological engineering

Environmental communication effectively influences environmental intentions, yet its ability to translate these intentions into actual behavior changes remains understudied, especially in coastal ecological engineering contexts. This study investigates this potential inconsistency by employing the intention-behavior gap concept and examining the impact of four distinct informational interventions: social pressure, negative framing, positive framing, and emotion. Based on a between-subject experiment and the data from 5258 participants, our findings revealed that information conveying social pressure, positive framing, and emotional appeals significantly increased participants' intentions in comparison to the control group. However, none of the information interventions significantly affected actual behavior in support of ecological engineering. Consequently, social pressure, positive framing, and emotion information slightly yet significantly enlarge the intention-behavior gap. Additionally, our results suggest that positive framing surpasses negative framing in eliciting supportive intentions for ecological engineering. Finally, different types of past behaviors appear to influence subsequent actions through different mechanisms.

The longitudinal (in)stability and cognitive underpinnings of children's cheating behavior

There has been a long-standing debate about whether cheating is a stable behavior across various situations. However, there is a notable gap in our understanding about whether children's cheating behavior could exhibit stability over time. Moreover, research on the cognitive correlates of children's cheating is limited, yet exploring these cognitive factors is essential for understanding how children make (dis)honest decisions. This study aimed to test the longitudinal stability in children's cheating tendency and frequency and to explore the cognitive underpinnings of cheating behavior (theory of mind, inhibitory control, and free will belief). The study involved 100 children aged 3 to 6 years who were initially tested at Time 1, and 89 of these participants were retested at Time 2 approximately 1 year later. Cheating behavior was measured using a die-rolling game over Zoom, and three different cognitive abilities were measured. The results indicated that children's cheating tendency was stable over a year-long interval, whereas cheating frequency did not show longitudinal stability. Moreover, the study found that free will belief was related to cheating behavior, whereas theory of mind and inhibitory control were not. Specifically, children's belief in the free will to inhibit their desires, rather than their actual ability to inhibit the desires, was associated with a reduced frequency and likelihood of cheating. The findings can provide insight into the developmental origin of children's decisions to refrain from cheating.

Why waste sorting implementation remains ineffective: A theoretical analysis based on the generation process of waste sorting behavior in China

Improving waste sorting performance is a crucial measure to address urban waste siege. This study aims to enhance the performance of waste sorting by examining the influencing factors of residents' sorting behaviors. Based on the A-B-C theory of emotion, we have constructed a dual mediation model. Using data from a survey of waste sorting pilot cities in China, we tested our theoretical model through regression analysis and structural equation modeling. The results indicate that external environmental factors significantly affect residents' waste sorting behavior. Individual plasticity mediates the relationship between external environmental factors and waste sorting behavior. Individual inertia plays a mediating role in the relationship between external environmental factors and waste sorting behavior. Our study sheds light on the causes of the low performance of urban waste sorting in China from the perspective of the generation process of waste sorting behavior. It offers a nuanced understanding of the challenges in waste sorting practices in China, providing valuable insights for the government in formulating waste sorting policies.

Power asymmetry destabilizes reciprocal cooperation in social dilemmas

Direct reciprocity has been long identified as a mechanism to support the evolution of cooperation in social dilemmas. While most research on reciprocal cooperation has focused on symmetrical interactions, real world interactions often involve differences in power. Verbal theories have either claimed that power differences enhance or destabilize cooperation, indicating the need for a comprehensive theoretical model of how power asymmetries affect direct reciprocity. Here, we investigate the relationship between power and cooperation in two frequently studied social dilemmas, the prisoner's dilemma (PD) and the snowdrift game (SD). Combining evolutionary game theory and agent-based models, we demonstrate that power asymmetries are detrimental to the evolution of cooperation. Strategies that are contingent on power within an interaction provide a selective advantage in the iterated SD, but not in the iterated PD. In both games, the rate of cooperation declines as power asymmetry increases, indicating that a more egalitarian distribution of the benefits of cooperation is the prerequisite for direct reciprocity to evolve and be maintained.

Population dependent rearing modifies sleep and decision-making ability with the involvement of noradrenaline: A study conducted using zebrafish as a model

Sleep is an instinct phenomenon, which affects cognitive processes including learning, memory and decision-making. Its quality, quantity and pattern vary in species through evolution. Living in groups (compared to living individually) with an increased population (as a family and a society) is an important contributing factor influencing the evolution of many behaviours. We hypothesized that rearing (upbringing) among many individuals (as compared to in isolation) and socialization might have influenced the quality, quantity and pattern of optimum sleep (a fundamental behaviour), which in turn affected animal behaviour(s) including learning and decision-making. To confirm, using zebrafish (which expresses shoaling) as a model we evaluated their sleep pattern as well as decision-making ability when reared post-birth under isolated (individually) or populated conditions. We observed that zebrafish reared under isolation affected sleep and compromised their decision-making ability when exposed to predator, which otherwise threatens their survivability. Also, the adverse effects of isolation were improved when the zebrafish were either reared in shoal or, by α1-adrenoceptor antagonist, prazosin, suggesting the role of noradrenaline in mediating the responses. Based on our findings we propose that one of the physiological benefits of living in a society is better (optimum) sleep health, which in turn helps with quality living.

Antecedents of university students' self-leadership: The roles of teacher developmental feedback and student proactive vitality management

BACKGROUND

Self-leadership is of significant importance to the growth and development of college students. However, few studies have systematically examined how teachers and college students can work together to cultivate the self-leadership of college students.

AIMS

Based on the social cognitive theory, this paper aims to propose and teste a comprehensive model examining the comprehensive influence effects of teacher developmental feedback, student proactive vitality management, and psychological resilience on student self-leadership.

SAMPLE

Data from 807 valid respondents were collected via online questionnaire surveys administered at several universities in Southeast China.

METHODS

The validation and robustness testing of the variables were conducted using SPSS version 22.0. The discriminant validity of our measures was assessed using AMOS version 24.0. Finally, the proposed model was tested using Hayes' PROCESS macro in SPSS version 22.0.

RESULTS

Both teacher developmental feedback and student proactive vitality management were positively related to student self-leadership. Moreover, psychological resilience mediated the relationships between teacher developmental feedback and student self-leadership, as well as between student proactive vitality management and student self-leadership. Additionally, teacher developmental feedback was more strongly related to student self-leadership when student proactive vitality management was higher.

CONCLUSIONS

Our research demonstrates the potential of using social cognitive theory to understand the multifaceted drivers of students' self-leadership. Specifically, both teacher developmental feedback and student proactive vitality management contribute to enhancing student self-leadership through psychological resilience.

Characterizing Personal Clinical Cognitive Uncertainty and Its Association With Clinical Judgment

RATIONALE

Clinical uncertainty has been studied mostly in relation to clinical scenarios or as a personal characteristic. The intersection between clinical context and personal characteristics remains underexplored. Specific forms of personal and cognitive clinical uncertainty may exist at different layers of cognitive processes, and impact clinical judgment and training.

AIMS AND OBJECTIVES

We aimed to characterize and quantify facets of personal clinical cognitive uncertainty, and examine associations with clinical judgment.

METHODS

We recruited 120 learners and 24 supervisors at the Centre hospitalier de l'Université de Montréal. Learners completed 15 multiple-choice vignettes and recorded their level of uncertainty for each. Learners' characteristics and supervisor-rated clinical judgment were compiled. We quantified five uncertainty measures: self-reported general uncertainty, degree of clinical uncertainty, relative, absolute, and objective calibrations of uncertainty. Correlations between demographic characteristics, test scores, and uncertainty measures were computed. We examined adjusted linear regressions of clinical judgment on uncertainty measures.

RESULTS

Mean age of learners was 24.9 years (SD = 3.5), 80 (68%) were women, 52 (44%) had undergraduate education. Mean test score was 61% (13) and supervisor-rated clinical judgment was 40 (10) over 60. Higher degree of clinical uncertainty correlated with lower scores, lower training levels, and being a woman. Higher self-reported general uncertainty was associated with higher degree of clinical uncertainty but lower relative and absolute calibrations. Higher test score was correlated with higher absolute and objective calibrations. Lower self-reported general uncertainty (standardized β = -0.27, p = 0.003), lower degree of uncertainty (β = -0.27, p = 0.01), higher relative (β = 0.16, p = 0.09) and absolute calibrations (β = 0.18, p = 0.06) were associated with clinical judgment.

CONCLUSION

We identified five measures of personal clinical cognitive uncertainty with differential associations with clinical judgment and knowledge. Greater focus on understanding and teaching of personal clinical cognitive uncertainty may enhance clinicians' tolerance to uncertainty and improve clinical judgment and outcomes.

A design science approach to mixed-methods evaluation in serious game research

For a serious game to be effective, it must undergo rigorous validation process. A Design Science approach advocates the use of quantitative or qualitative research methodologies within the creation and validation of artifacts, an approach suitable for evaluating serious games as educational tools. This study presents a methodological framework that integrates quantitative measurement and qualitative inquiry to assess the effectiveness of a serious game designed for ethics education. We provide access to the quantitative questionnaire, its codebook, and the dataset generated during the validation of the authors' approach using a serious game for teaching business ethics. The integration of both methods allowed us to validate the game as a relevant and effective strategy for promoting ethical reflection among university students. These findings support the consistency and reliability of the method used for validating serious games. Methodological Highlights•The quantitative assessment is based on the Technology Acceptance Model III (TAM III) and the Theory of Planned Behavior (TPB).•Qualitative inquiry analyzes students' group work to understand their perceptions of ethical phenomena after gameplay.•Professors can use insights from students' perceptions as a starting point or framework for takeaways in future game applications.

Automating the Detection of Linguistic Intergroup Bias Through Computerized Language Analysis

Linguistic bias is the differential use of abstraction, or other linguistic mechanisms, for the same behavior by members of different groups. Abstraction is defined by the Linguistic Category Model (LCM), which defines a continuum of words from concrete to abstract. Linguistic Intergroup Bias (LIB) characterizes the tendency for people to use abstract words for undesirable outgroup and desirable ingroup behavior and concrete words for desirable outgroup and undesirable ingroup behavior. Thus, by examining abstraction in a text, we can understand the implicit attitudes of the author. Yet, research is currently stifled by the time-consuming and resource-intensive method of manual coding. In this study, we aim to develop an automated method to code for LIB. We compiled various techniques, including forms of sentence tokenization, sentiment analysis, and abstraction coding. All methods provided scores that were a good approximation of manually coded scores, which is promising and suggests that more complex methods for LIB coding may be unnecessary. We recommend automated approaches using CoreNLP sentiment analysis and LCM Dictionary abstraction coding.

Unveiling training effectiveness through behavior and performance evaluations: A case from developing country

This study investigates the effects of training on behavioral changes and overall performance at both the employee and organizational levels within the private banking sector of Bangladesh. Using the Theory of Planned Behavior (TPB) and Goal-Setting Theory (GST) as the theoretical framework, the research explores the underexamined third and fourth levels of Kirkpatrick's training evaluation model, focusing specifically on behavioral outcomes and their subsequent influence on performance. Data collected from employees through structured questionnaires were analyzed using the Paired sample t-test. Findings reveal that training positively impacts employee behavior and enhances individual and organizational performance, particularly in effective teamwork, job satisfaction, work quality, task efficiency, and retaining existing clients while attracting new ones. This study represents one of the first empirical investigations in the banking sector of Bangladesh to link behavioral change evaluation to performance outcomes evaluation following training interventions. The research provides valuable insights for policymakers and organizational leaders, emphasizing the need for comprehensive training programs to promote skill development and behavioral and performance improvements. Future research should incorporate a larger sample size, adopt a longitudinal design, use advanced statistical methods like structural equation modeling (SEM), and investigate moderating variables to better understand the complex relationships between training interventions, employee behavior, and performance outcomes.

How the Approaches of Managing Conflict With Patients Affect Nurse Emotional Exhaustion and Life Satisfaction: A Time-Lagged Three-Wave Survey

AIM(S)

To explore whether nurses' use of different approaches to manage patient mistreatment can exert distinctive effects on their emotional exhaustion and life satisfaction, and to examine whether supervisor support can mitigate the negative effects of emotional exhaustion on nurses' life satisfaction.

DESIGN

A time-lagged three-wave survey study with a 2-week time interval was conducted in 2022.

METHODS

A total of 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022 completed three-wave surveys. Descriptive analyses, confirmatory factor analyses and mediation and moderated mediation analyses were performed.

DATA SOURCES

Data were collected by using three-wave self-reported questionnaires from 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022.

RESULTS

Nurses who managed patient mistreatment more cooperatively experienced lower levels of emotional exhaustion, whereas those who managed patient mistreatment more competitively experienced higher levels of emotional exhaustion. Emotional exhaustion was negatively related to life satisfaction. Moreover, emotional exhaustion mediated the positive and negative relationships between cooperative and competitive conflict management approaches and overall life satisfaction. Additionally, supervisor support mitigated the negative impact of emotional exhaustion on life satisfaction and the indirect effects of conflict management approaches on life satisfaction.

CONCLUSION

To effectively manage the negative impact of patient mistreatment on nurses, both nurses themselves and their supervisors play an important role. Nurses who adopt a cooperative conflict management approach experience lower levels of emotional exhaustion and higher levels of life satisfaction. Supervisor support can alleviate the negative effect of emotional exhaustion on life satisfaction.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The findings provide a better understanding for nurses on how to mitigate the detrimental effects of patient mistreatment on nurses and highlight the role of both nurses themselves and their supervisors in protecting nurses' well-being.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

Drivers of environmental debris in metropolitan areas: A continental scale assessment

Plastic pollution is rapidly increasing, with land-based sources being the major contributors. Understanding the factors driving waste movement from land to sea is crucial for reducing leakage to the environment and its subsequent impact. In 2023 we conducted a stratified survey of mismanaged waste in the environment across six Australian metropolitan regions, covering inland, riverine, and coastal habitats, to determine a national baseline of debris in the environment. We completed 1907 transects, and found average debris density was 0.15 items m-2. Debris quantity was patchy and typically higher in areas with intensive land use, such as urban and agricultural zones, and socio-economically disadvantaged regions. Polystyrene (24 % of fragments) and cigarette butts (20 % of whole items) were the most common debris types. Most items could be identified by material type but not by specific use (e.g. unknown hard plastic fragments were found in 28 % of all transects). Comparing our coastal results to a survey from 10 years prior, we found a significant 39 % decrease in the national mean coastal debris density, and a 16 % increase in transects where no debris was found. Our study finds evidence to support how historical policies, practices, outreach campaigns, clean-up efforts and local custodianship have contributed to reducing debris in metropolitan coastal habitats. This national baseline study offers a benchmark to evaluate the effectiveness of new policies, practices, and awareness campaigns.

Which educational environment is better for college students' social-emotional competency development, public or private? An investigation of 100 Chinese universities

Individuals' success or happiness is influenced by their noncognitive skills. Social-emotional competency (SEC) is the essential noncognitive factor for individual development in the 21st century. The different higher education environments would affect students' SEC development differently, but the difference in college students' SEC development is unclear between Chinese public and private universities. Based on the data through online questionnaires, this study conducted propensity score matching analysis on 120,344 student samples from 100 universities. The results show that, whether interference factors such as individual characteristics, family background, and academic performance are controlled or not, the progress level of private undergraduates' SEC is higher than that of public undergraduates. Private university educational environment is relatively more beneficial for undergraduates' social-emotional competency development. For improving talent cultivation quality, public universities are advised to learn from private universities' school-running experience and carry on systematic social-emotional learning programs.

Time perspectives and precrastination: Understanding early task completion in a time-moving perspective

This study examines the relationship between precrastination-a tendency to complete tasks early-and the time-moving perspective. Given the opposing nature of precrastination and procrastination, we hypothesize that precrastination correlates positively with a time-moving perspective, based on the finding that procrastination correlates with an ego-moving tendency. To test this, we conducted a survey with 366 participants (172 females aged 17 to 68), assessing their tendencies toward precrastination and their responses to the classic "ambiguous meeting question" (McGlone & Harding, 1998). Participants who selected "Monday" as the answer to the ambiguous time-related question displayed higher precrastination scores than those who chose "Friday," supporting the hypothesis. To address the potential subjectivity of self-reported data, we included an objective measurement by recording participants' arrival times for a scheduled test in a controlled setting involving 84 students (42 females aged 18 to 25). The results showed that participants who arrived early were more likely to choose "Monday" in a modified version of the "ambiguous meeting question," further validating our hypothesis. This study highlights the significant role of precrastination in shaping time perception.

Observational learning of exploration-exploitation strategies in bandit tasks

In decision-making scenarios, individuals often face the challenge of balancing between exploring new options and exploiting known ones-a dynamic known as the exploration-exploitation trade-off. In such situations, people frequently have the opportunity to observe others' actions. Yet little is known about when, how, and from whom individuals use observational learning in the exploration-exploitation dilemma. In two experiments, participants completed multiple nine-armed bandit tasks, either independently or while observing a fictitious agent using either an explorative or equally successful exploitative strategy. To analyze participants' behaviors, we used a reinforcement learning model (simplified Kalman Filter) to extract parameters for both copying and exploration at the individual level. Results showed that participants copied the observed agents' choices by adding a bonus to the individually estimated value of the observed action. While most participants appear to use an unconditional copying approach, a subset of participants adopted a copy-when-uncertain approach, that is copying more when uncertain about the optimal action based on their individually acquired knowledge. Further, participants adjusted their exploration strategies in alignment with those observed. We discuss, in how far this can be understood as a form of emulation. Results on participants' preferences to copy from explorative versus exploitative agents are ambiguous. Contrary to expectations, similarity or dissimilarity between participants' and agents' exploration tendencies had no impact on observational learning. These results shed light on humans' processing of social and non-social information in exploration scenarios and conditions of observational learning.

Design framework to develop sustainable innovations for addressing One Health challenges

The complexity of global health challenges requires integrated approaches that crosses traditional boundaries. One Health (OH) offers a holistic approach to address health issues at the crossroads of human, animal, and environmental domains. Antimicrobial Resistance (AMR), a prime example of a cross-sectoral issue and OH challenge, highlights the need for coordinated interventions that consider multiple stakeholders. Current approaches to improve OH challenges and AMR have limited success, often due to a lack of a structured theoretical approach that informs the design and development of solutions for long-term sustainability. Existing frameworks focus primarily on human or veterinary sectors in isolation, leaving a gap in comprehensive, integrated approaches that align with OH principles. The proposed framework addresses this gap by offering a structured approach to both implementing and evaluating interventions that consider all three sectors. This paper proposes the HEARTf of OHC (Holistic Engagement and Adaptive Responses Theoretical framework of One Health challenges), a user-centered design approach aimed at developing sustainable and innovative OHC interventions. The HEARTf of OHC integrates knowledge from social sciences, computer science, industrial design, pedagogy, and health sciences to create context specific solutions that address the specific needs of end-users in the human, animal, and environmental sectors. Additionally, this paper reviews existing frameworks addressing AMR, identifies limitations and outlines the need for a transdisciplinary approach when tackling OHC. By emphasizing the importance of the user-centered design, transdisciplinarity, and continuous evaluation, the HEARTf of OHC aims to bridge the gap between current strategies and improve the development and evaluation of innovative solutions or services. The HEARTf of OHC is a generalizable framework for the design, implementation, and evaluation of OH interventions, where we use AMR as a case study to demonstrate its application.

Should I Stay or Should I Go? Motives and Barriers for Sustained Collective Action Toward Social Change

Israel's year-long protest calling for Prime Minister Netanyahu's resignation created an opportunity to examine unique factors influencing sustained collective action (SCA; i.e., repeated participation in social movement action for the same cause). As little is known about how to explain such dedication, we compared a well-established set of predictors of one-time collective action (CA) with a new predictors set of SCA, focusing on collective instrumental and socio-emotional (CISE) motivations grounded in previous participation experience, to predict subsequent participation. In a unique longitudinal design, we tracked protestors over 6 weeks. Our findings showed that less emotional exhaustion, more subjective effort into participation, and a perceived closer timeframe for desired social change positively predicted SCA. This differentiates SCA from CA-moreover, as one-time CA predictors did not predict SCA, this suggests a need for a new model to explain SCA based on CISE motivations that reflect continuous goal pursuit.

Beliefs and Perceptions of Physical Activity Among Black Adolescents in South Florida: A Qualitative Study

INTRODUCTION

In the United States, non-Hispanic Black adolescents have a significantly higher prevalence of obesity than their peers. Though physical activity (PA) has many benefits, many adolescents fail to engage in adequate amounts of PA. Black adolescents are also more sedentary than those from other races and ethnicities. This study aimed to describe the perceptions, beliefs, and barriers to PA in South Florida Black adolescents.

METHODS

Five focus groups were conducted with self-identified non-Hispanic Black adolescents (n = 38) in South Florida. A semi-structured question guide based on the Theory of Planned Behavior was used for group discussions. The open-ended questions addressed adolescents' (1) attitudes and beliefs toward PA, (2) current PA-related behaviors, and (3) environmental, social, cultural, and racial influences on health behaviors.

RESULTS

The desire to be healthy, thoughts of the future, and self-image were among the reasons participants engaged in PA. Engagement in PA was associated with a positive social environment, including encouragement from family and friends. Race, culture, and social media were also cited as influences on PA. Perceived control beliefs, such as parental pressures and self-discipline, also impacted PA.

CONCLUSION

Adolescents recognize the importance of PA; however, their behaviors do not reflect this. Barriers and motivators for Black adolescents are multifaceted. It is critical for Public Health practitioners and local legislators to understand the complexities to serve this population. This study's findings can guide the development of tailored PA and education programs for Black adolescent populations.

Mapping vulnerability factors of chronic emotional and social loneliness: A network analysis

BACKGROUND

Chronic loneliness adversely impacts both mental and physical health. As current interventions are only moderately effective, examining vulnerability factors reflected in interpersonal behavior and their relationships with specific chronic loneliness subtypes may provide insights. The present study explored the associations between loneliness vulnerability factors and two subtypes of chronic loneliness: chronic emotional loneliness (a longing for intimate connections) and chronic social loneliness (dissatisfaction with the quantity and quality of one's social network).

METHODS

The sample consisted of 294 university students who had recently started at a new university. Participants completed surveys across three time points, separated by three-month intervals, including questionnaires on emotional and social loneliness, adult attachment styles, interpersonal behavioral styles, and features of emotional disorders. To explore relationships, we used network analysis by estimating a Mixed Graphical Model (MGM), in which chronic emotional loneliness and chronic social loneliness were dichotomized as binary variables (absence versus presence), while vulnerability factors were treated as continuous variables.

RESULTS

The network analysis demonstrated that chronic loneliness subtypes were differentially linked to vulnerability factors. Chronic emotional loneliness was predominantly linked to features of emotional disorders, whereas chronic social loneliness demonstrated a negative conditional association with secure attachment style.

LIMITATIONS

The assessment of chronic loneliness was based on three time points, which does not capture potential fluctuations between assessments.

CONCLUSIONS

These findings highlight the importance of differentiating between chronic loneliness subtypes when examining vulnerability factors. By distinguishing these subtypes, tailored interventions for loneliness can be developed to enhance prevention.

Will they stay in the teaching profession? Nexus between attitude towards teaching and retention among pre-service teachers in Egypt and the United Arab Emirates

The role of teachers in the promotion of quality education cannot be overemphasised. In teacher education, the emphasis is on training individuals who are committed to teaching. However, educational systems are facing difficulties when it comes to keeping qualified teachers in the profession. There are problems with training individuals with a positive attitude towards teaching and, at the same time, retaining qualified teachers. However, the relationship between attitudes towards teaching and teacher retention has not been explored. The present study was guided by Ajzen's concept of behavioural belief, which is a tenet of the theory of planned behaviour, and Mason and Matas' four-capital retention model. A total of 407 pre-service teachers enrolled in education programmes from one institution in Egypt (n = 275) and one in the United Arab Emirates (n = 132) were surveyed. The data were analysed using the Pearson moment correlation coefficient, multiple and hierarchical regressions, and moderation analysis. The results show a positive contribution of attitude to the variance in retention among pre-service teachers. Moreover, teacher nationality significantly moderated the relationship between attitude and teacher retention. The need to incorporate course content on changing attitudes towards teaching into teacher education programmes as part of the effort to promote retention is discussed in detail.

Perceptions of Empathic and Compassionate Healthcare Encounters: An International Exploratory Qualitative Descriptive Study

BACKGROUND

Empathy and compassion are integral to person-centred care. Contemporary literature also provides evidence of the impact of empathic and compassionate care on patient outcomes, including enhanced satisfaction with care and improved patient safety. Notably, a previous scoping review identified only a limited number of studies exploring patients' experiences of empathic and compassionate care, underscoring the need for further research on patients' and their significant others' perspectives and experiences of empathic and compassionate healthcare encounters.

OBJECTIVE

The aim of this paper is to explore patients' and their significant others' perceptions of empathic and compassionate healthcare encounters.

METHODS

This qualitative descriptive international survey recruited people who were willing to report on a personal experience with a healthcare professional that demonstrated positive or negative examples of empathic and/or compassionate care. Data were analysed using Framework Analysis.

RESULTS

A total of 84 participants from the Pacific region, the United States of America, and Europe reported encounters with nurses, doctors, allied health professionals, and multidisciplinary teams. Analysis revealed four overarching themes: (1) Verbal and non-verbal communication; (2) Clinician attitudes and attributes; (3) The power of small, thoughtful gestures; and (4) Enduring impact of empathic care.

CONCLUSIONS

To promote empathic and compassionate care, there needs to be a holistic focus on practitioner communication across the bio-psycho-social-spiritual domains. When these elements are included in interactions with patients and their significant others, healthcare providers can have a powerful and long-lasting impact on people's experiences and health outcomes.

Breaking the endometriosis silence: a social norm approach to reducing menstrual stigma and policy resistance among young adults

OBJECTIVE

Endometriosis is a menstrual disorder that affects one in ten women. Diagnosis often takes several years due to low awareness and menstrual stigma. In this study, we employed a social norm approach (SNA) to investigate the effects of an educational leaflet on endometriosis knowledge, menstrual stigma, and acceptance of paid menstrual leave among women and men.

METHODS

The 3 × 2 online experiment tested the influence of either descriptive norm messages or both descriptive and injunctive norm messages (compared to a control group, factor 1) in an educational leaflet by taking the role of addressee's sex into account (quasi-experimental factor 2). The study included 796 German participants aged 16-35.

RESULTS

Men exhibited significantly poorer knowledge, stronger menstrual stigma, and weaker policy acceptance compared to women. No significant main effect of the social norm messages on menstrual stigma was found. In contrast, the combined norm messages seem to be beneficial when addressing policy acceptance. Moreover, compared to the control group, the intervention material indirectly influenced stigma and policy acceptance through increased knowledge.

CONCLUSIONS

Providing information about social norms appears to be an effective strategy for educating not only women but especially men about menstrual disorders like endometriosis.

A theory-based educational intervention to increase mothers' intention to vaccinate their daughters against human papillomavirus: A randomised controlled trial

OBJECTIVE

The current study aimed to examine the effectiveness of a web-based educational intervention based on the theory of planned behaviour (TPB) in enhancing mothers' knowledge of human papillomavirus (HPV) and its vaccine, attitudes towards the HPV vaccine, subjective norms, perceived behavioural control, and intention to vaccinate their daughters against HPV.

METHOD

A randomised controlled trial was conducted. The sample comprised 214 mothers of adolescents from 10 intermediate schools in Saudi Arabia. After collecting baseline data, the participants were randomly assigned to control and intervention groups. The TPB-based intervention was delivered online to the intervention group, and post-test data were collected from both groups. A mixed-effects model of covariance was used to test the effect of the intervention.

RESULTS

There were no significant differences between the two groups at baseline. One month after delivery, the intervention was found to have a significant effect on mothers' knowledge (F (1, 211.15) = 72.40, p < .001), attitudes (F (1, 211.11) = 110.57, p < .001), subjective norms (F (1, 211) = 34.55, p < .001), perceived control behaviour (F (1, 211.12) = 144.01, p < .001), and intention to vaccinate their daughters against HPV (F (1, 211.05) = 113.64, p < .001).

CONCLUSION

The study showed that the web-based intervention based on the TPB was effective in increasing mothers' knowledge, attitude, subjective norms, perceived control behaviour, and intention to vaccinate their daughters after 1 month.

PRACTICE IMPLICATIONS

The findings underscore the significance of popularising and implementing such interventions to boost HPV vaccine coverage among adolescents.

Understanding motorcycle crash involvement: Insights from regular motorcyclists and food delivery riders in Vietnam

Motorcycles have become a primary mode of transportation in many low- and middle-income countries, including Vietnam, where they are widely used for personal transport and commercial activities. The growing reliance on motorcycles, driven by rapid urbanization and the rise of app-based delivery platforms, has brought economic benefits but also significant public health concerns due to the high incidence of road traffic crashes. This study, based on a questionnaire survey targeting regular motorcyclists and food delivery riders in Vietnam, examines and compares the factors contributing to crash involvement between two groups, regular and delivery riders. Random parameters models with heterogeneity in means and variances were employed to capture variability in respondent behaviors. The results reveal that psychological factors, such as negative attitudes toward traffic rules and intentions to violate rules, significantly increase crash involvement for both regular and delivery riders, with the effect being more pronounced among delivery riders due to job pressures. Conversely, positive attitudes reduce crash involvement but are less effective for delivery riders due to high time pressures and frequent distractions. Perceived severity of crashes and the swiftness of sanctions also play critical roles: higher perceived severity promotes safer behavior, while the threat of sanctions deters risky actions for both groups. Rider attributes, such as age, education, and income, influence crash involvement, with younger and lower-educated riders facing higher risks among both groups due to inexperience and limited traffic knowledge, while income effects vary between regular and delivery riders. Travel characteristics, such as travel durations of more than two hours, increase crash involvement due to fatigue and exposure, particularly affecting delivery riders who navigate complex urban environments and face frequent distractions. The findings also highlight the importance of addressing heterogeneity in data analysis for more comprehensive insights. Moreover, based on these results, various policy implications are provided to reduce traffic crashes and enhance safety for motorcyclists in motorcycle-dominated countries.

The Interaction Between Job Embeddedness and Leader-Member Exchange (LMX) in Predicting Employee Altruism and Deviance

Drawing upon conservation of resources and social bonding theories, the present study examined the associations between job embeddedness and employee work behaviors (altruism and organizational deviance) by exploring the moderating role of leader-member exchange (LMX) in these associations. Using a cross-sectional research design, data were collected from a sample of 637 employees in Turkey. The data were analyzed using confirmatory factor analysis, structural equation modeling, and bootstrapping. The findings indicated that job embeddedness was positively related to employee altruism while negatively related to organizational deviance. This study also provided support for the moderating role of LMX in job embeddedness-altruism and job embeddedness-organizational deviance relationships. More specifically, job embeddedness had a stronger positive relationship with altruism and a stronger negative relationship with organizational deviance when LMX quality was high. These findings substantiate the pivotal role of focusing on both job embeddedness and the treatment by supervisors in the organization to inculcate desirable workplace behaviors and employee performance motivation. The implications are discussed as well as limitations, and directions for future research are provided.

Peer Attachment Style Moderates the Effect of Mood on Creativity

The present study investigated the moderating role of peer attachment style in the relationship between mood and creativity. An experiment was conducted with a sample of 267 undergraduate students (Mage = 19.85, range = 17-24 years). First, participants' peer attachment style was measured, following which positive, neutral, or negative mood was induced; subsequently, two creative tasks were conducted. A MANOVA revealed significant interactions between peer attachment and mood. Specifically, for secure participants, creativity was significantly higher in the positive mood state compared to the neutral and negative mood states; for insecure participants, the effect of positive mood was not pronounced. Moreover, negative mood exerted a significant beneficial effect on the originality dimension for participants with an anxious-ambivalent peer attachment style; they showed higher creativity in the negative mood state than in the neutral or positive mood states. In general, peer attachment style moderated the relationship between mood and creativity; specifically, positive mood was beneficial to creativity among secure persons, and negative mood was beneficial to creativity among anxious-ambivalent persons.

An I-Change approach to understanding exercise determinants among Black individuals with hypertension

OBJECTIVE

Black populations are disproportionately affected by hypertension and are less likely to engage in blood pressure-lowering activities, such as exercise, compared to non-Hispanic White populations. There is a lack of theory-informed approaches to understand how individual and environmental racial disparities impact exercise participation among Black individuals with hypertension. The I-Change Model, an integrated behavior change framework, combines concepts from social and health psychology to explain the interaction between awareness, motivation, and action in adopting and maintaining health behaviors. This study aims to apply an augmented version of the I-Change Model to enhance our understanding of racial disparities in exercise participation.

METHODS

Individuals with self-reported doctor-diagnosed hypertension ( N  = 370), comprising Black ( n  = 142) and White ( n  = 228) adults who were recruited via an online recruitment platform, completed a survey with validated theoretical constructs at baseline and at 4 weeks. Structural equation modeling with race set as a group variable was used to among both races, intention predicted exercise behavior model path effects.

RESULTS

Among both races, intention positively influenced exercise behavior, whereas psychological barriers reduced the likelihood of engaging in the behavior. However, notable racial disparities among Black participants included environmental barriers (e.g., safety, accessibility to a gym) that hindered exercise behavior and affective attitudes that did not facilitate intention.

CONCLUSIONS

An exercise promotion program that fosters I-Change determinants and creates an accessible, supportive environment would enhance equitable exercise opportunities for Black individuals with hypertension. Additional recommendations for designing such a program are provided.

Leveraging Empowering Leadership to Improve Employees' Improvisational Behavior: The Role of Promotion Focus and Willingness to Take Risks

Improvisational behavior is an individual's spontaneous and creative behavior in the face of emergencies, using existing material and emotional resources to respond quickly and effectively to uncertain situations. Despite increasing interest in this behavior, its antecedents remain unclear, with particular ambiguity regarding the relationship between empowering leadership and employee improvisational behavior. The present article addresses this ambiguity with the theory of reasoned action to examine whether the impact of empowering leadership on employees' improvisational behavior is determined by employees' attitudes toward such behavior. In this study, a multi-source design was adopted, and data (339 valid samples) were collected from five Internet companies in China's Jiangsu and Zhejiang provinces. Hierarchical regression and bootstrapping methods were used to test the hypotheses. The results reveal that (1) employees' promotion focus moderates the relationship between empowering leadership and improvisational behavior and (2) employees' willingness to take risks mediates the moderating effect of promotion focus. Our findings demonstrate employees' attitudinal utility in explaining when improvisational behavior is most likely to occur under empowering leadership.

Emotional influences on user continuous use intention in recommended news apps: A study of algorithm appreciation and fatigue within the cognition-affect-conation framework

Based on the Cognition-Affect-Conation Model, this study explores the role of emotions in the relationship between users' perceptions and intention to continue using recommended news apps. TouTiao (recommended news application with the largest number of registered users in China) was chosen as the research object and a total of 1014 valid questionnaires were collected. The results based on mediation and moderation tests show that algorithm appreciation plays a mediating role among the perceived news value, the perceived recommendation personalization, the perceived recommendation explainability and the continuance usage intention. Algorithm fatigue plays a mediating role among users' perceived information narrowing, perceived content low quality, perceived information overload and continuance usage intention. Privacy concerns negatively moderate the positive effect of algorithm appreciation on continuance usage intention, while positively moderating the negative effect of algorithm fatigue on continuance usage intention. To enhance users' continuance usage intention recommended news apps, it is necessary to pay attention to the two emotional elements of algorithm appreciation and algorithm fatigue, thereby improving user experience, and achieving a win-win situation between the platform and users.

Evaluating the effect of computer-based education on pharmacist behaviour regarding point-of-care testing

Background

Recent regulatory changes in Ontario have enabled pharmacists to perform point-of-care testing (POCT) to manage chronic diseases. With the introduction of any new service(s), educational interventions can aid acceptance and implementation. Computer-based education (CBE) improves pharmacists' knowledge, but there is little evidence of its effect on pharmacist behaviour. This study assessed the impact of CBE on pharmacist knowledge, behaviour intention, and adoption of POCT.

Methods

A three-month, web-based, randomized controlled trial was conducted between April 2024 and Sep 2024 with community pharmacists in Ontario, Canada. The intervention group was asked to complete two POCT modules using a CBE platform, while the control group was asked to review reference materials about POCTs. The primary outcome, the difference in the number of POCTs performed, was collected using monthly reports. Secondary outcomes (knowledge gain and changes in the Theory of Planned Behaviour (TPB) constructs: attitude, subjective norm, perceived behavioural control, and behaviour intention) were assessed using selfreported surveys. Generalized linear models (GLM) with negative binomial distribution were used to analyze the number of POCTs. Knowledge gain was analyzed using repeated measure ANOVA and binomial regression. TPB constructs were analyzed within groups using paired sample t-tests and between groups using two-sample ttests.

Results

Of the 261 pharmacists recruited, 201 completed the pre-study survey, 135 completed the one-week post-test, and 104 completed the three-month post-test. There was a significant difference in knowledge test scores between the two groups at one week (P = .001) and three months (P < .00). There was no significant difference in behavioural constructs between the two groups at three months. However, attitude increased significantly for both groups (intervention group 3.6 ± 0.6 Vs. 3.95 ± 0.5 P < .001; control group 3.5 ± 0.6 Vs. 3.8 ± 0.5 P < .001). There was no significant change in the number of POCTs performed after one, two, and three months for both study groups.

Conclusion

CBE improved pharmacists' knowledge of POCT but showed a limited effect on pharmacist intention or behaviour. The study highlighted that knowledge alone does not influence behaviour change. Factors such as organizational support, adequate reimbursement, and expanded practice scope (e.g., prescribing) are critical to enhance POCT implementation.

Determinants of Pro-environmental Practices: An Analysis Using Discrete Choice Models

Responsible consumption decisions are key to achieving environmental sustainability, particularly concerning pro-environmental practices. However, adopting pro-environmental practices varies and is closely linked to the diversity of individual behaviors. Therefore, this research aims to identify the factors determining pro-environmental practices such as electricity-saving, potable water-saving, and recycling in Ecuadorian households from 2010 to 2014. Secondary data from the National Institute of Statistics and Censuses were utilized. The information was processed to evaluate the marginal propensity of pro-environmental practices using a logit model and a conditional multinomial logit model. Additionally, tests incorporating unobserved heterogeneity were conducted to assess the robustness of the model. The main findings confirm that the Theory of Planned Behavior explains the performance of environmental practices in Ecuadorian households. Specifically, environmental awareness accounts for the largest increase in pro-environmental practices, approximately 8% and 10%. Moreover, examining the marginal propensity of each pro-environmental practice reveals heterogeneous results. Additionally, labor income and education increase pro-environmental practices by 2.14% to 1.5%, while female-headed households show an increase of 5.68%. Conversely, evidence suggests that Indigenous ethnicity is associated with a lower likelihood of engaging in pro-environmental practices. Policy implications derived from the study suggest focusing public efforts on increasing household environmental awareness.

Peer influence on adolescents' physical activity: A dual-process perspective

Inadequate physical activity poses significant health threats to young people. Adolescents are at a developmental stage characterized by heightened impulsivity, which may limit the explanatory power of rational behavior theories in this population. This study developed an integrated model to explain adolescents' physical activity while examining the mechanism of peer influence from a dual-process perspective. The hypothetical model integrated the Theory of Planned Behavior with constructs from social, reactive, and habit theories and was tested using a two-wave prospective correlational survey design. Participants (n = 638) completed a baseline questionnaire assessing all psychological constructs. One week later, participants reported their time spent in physical activity over the past week in a follow-up questionnaire. Structural equation modeling was used to evaluate model fit and predictive utility. The model explained 14.6%, 7.1%, and 18.4% of the variances in averaged overall, weekday, and weekend physical activity levels, respectively. The latent variable of automaticity, representing impulsive processing, significantly explained adolescents' physical activity, while the reflective pathway through intention was not statistically significant. In addition, physical activity was statistically significantly explained by prototype favorability and prototype similarity via the impulsive pathway. Combining strategies to modify peer influence and impulsive processing is suggested for promoting adolescents' physical activity.