How Do Molecular Systems Engineering Scientists Frame the Ethics of Their Research?

BACKGROUND

There are intense discussions about the ethical and societal implications of biomedical engineering, but little data to suggest how scientists think about the ethics of their work. The aim of this study is to describe how scientists frame the ethics of their research, with a focus on the field of molecular systems engineering.

METHODS

Semi-structured qualitative interviews were conducted during 2021-2022, as part of a larger study. This analysis includes a broad question about how participants view ethics as related to their work, with follow up probes about the topics they consider most important. Interviews were transcribed, inductively coded by two researchers to consensus, and analyzed thematically.

RESULTS

Twenty-four scientists participated in the study. Interviewees hold positions as professors, principal investigators, and senior staff researchers in universities or research institutes in the United States and Europe. Among those scientists who reported reflecting on ethical considerations in their work, many equated ethics with research ethics topics (e.g., safety, replicability), or with regulation and guidelines. Participants expressed the view that ethical issues are primarily relevant for clinical trials of bioengineered products, or for those working with animal or human subjects. Scientists described their research as "too early" or "not examining anything living" with regard to ethical reflection. Finally, many felt that ethics is seen as territory for experts and therefore beyond scientists' competencies.

CONCLUSIONS

Molecular systems engineering scientists currently focus on regulatory aspects as the framework for their ethical analyses. They describe using a framework to define when life arises, as a means to determine when further ethical engagement is warranted. Further research is needed to investigate how scientists relate to the ethics of their scientific work, and build consensus around concepts of life, autonomous behavior, and physiological relevance of bioengineered systems.

Ethics of care in technology-mediated healthcare practices: A scoping review

BACKGROUND

Introducing new technologies into healthcare practices may challenge professionals' traditional care cultures. The aim of this review was to map how the 'ethics of care' theoretical framework informs empirical studies of technology-mediated healthcare.

METHOD

A scoping review was performed using eight electronic databases: CINAHL with full text, Academic Search Premier, MEDLINE, the Philosopher's Index, SocINDEX with Full Text, SCOPUS, APA PsycInfo and Web of Science. This was followed by citation tracking, and articles were assessed against the inclusion criteria.

RESULTS

Of the 443 initial articles, 18 met the criteria and were included. We found that nine of the articles used the concept of 'ethics of care' (herein used interchangeably with the terms 'feminist ethics' or 'relational ethics') insubstantially. The remaining nine articles deployed care ethics (or its equivalent) substantially as an integrated theoretical framework and analytical tool. We found that several articles suggested an expansion of ethics of care to encompass technologies as part of contemporary care. Furthermore, ethics of care contributed to the empirical research by recognising both new relationships between patients and healthcare professionals as well as new ethical challenges.

CONCLUSION

Ethics of care is sparsely used as a theoretical framework in empirical studies of technology-mediated healthcare practices. The use of ethics of care in technology-mediated care brings new dilemmas, relational tensions and vulnerabilities to the foreground. For ethics of care to be used more explicit in empirical studies, it is important that it is recognised by research community as an adequate, universal ethical theory.

Seeking utopia: Psychologies' waves toward decoloniality

This paper provides a review of empirical studies published with a decolonial epistemic approach in psychology. Our goal was to better understand how decolonial approaches are being practiced empirically in psychology, with an emphasis on community-social psychology. We first discuss the context of colonization and coloniality in the research process as orienting information. We identified 17 peer-reviewed empirical articles with a decolonial approach to psychology scholarship and discerned four waves that characterize the articles: relationally-based research to transgress fixed hierarchies and unsettle power, research from the heart, sociohistorical intersectional consciousness, and desire-based future-oriented research to rehumanize and seek utopia. Community-social psychology research with a decolonial approach has the potential to remember grassroots efforts, decolonizing our world.

Agreements and differences between psychoanalysts with regard to changes observed during a treatment. A quantitative exploration using the Three-Level Model (3-LM)

The aim of this paper is to report the partial results of an exploratory investigation into how twelve psychoanalysts of different theoretical-clinical orientations perceive and use hypotheses about the phenomena of change in connection with selected material from a psychoanalytic treatment. The Three-Level Model (3-LM) was used for the observation of patient transformations and for the collection of data. This was followed by the statistical analysis of the behaviour and relationship of a set of variables relating to the type and degree of change perceived in the patient's mental functioning during the course of her treatment. The results reported here show that there was significant agreement among the participants, irrespective of their theoretical-clinical orientation, as regards the following: 1) the positive impact of the application of psychoanalytic treatment in diverse areas of the patient's mental functioning; 2) the explanatory hypotheses of the changes observed in the patient under consideration; 3) the usefulness of the experience of group exchange using the 3-LM in observing and understanding the changes in the patient.

Evaluating education innovations rapidly with build-measure-learn: Applying lean startup to health professions education

PURPOSE

The Lean Startup approach allows innovators (including innovative educators) to rapidly identify and refine promising ideas into models that actually work. Our aim is to outline key principles of Lean Startup, apply these to health professions education, and illustrate these using personal experience.

METHODS AND RESULTS

All innovations are grounded in numerous assumptions; these assumptions should be explicitly identified, prioritized, and empirically tested ('validated learning'). To identify and test assumptions, innovators need to get out of the office and interact with customers (learners, teachers, administrators, etc). Assumptions are tested using multiple quick cycles of Build (a 'minimal viable product' [MVP]), Measure (using metrics that relate meaningfully to the assumption), and Learn (interpret data and decide to persevere with further refinements, or pivot to a new direction). The MVP is a product version that allows testing of one or more key assumptions with the least effort. We describe a novel 'Lean Education Canvas' that synopsizes an innovation and its business model on one page, to help identify assumptions and monitor progress. We illustrate these principles using three cases from health professions education.

CONCLUSIONS

Lean Startup has tremendous potential for rapid, robust innovation and evaluation in education.[Box: see text].

Consumer loneliness: A systematic review and research agenda

Treading on the heels of the spread of the coronavirus, the "loneliness virus" has been capturing territories globally. Consumers are not immune to loneliness. Although academics and the general public have recognized the devastating effects of loneliness, the academic attention given to consumer loneliness (CL) is scattered and fragmentary. The purpose of this article is to systematically review the antecedents (predictors and alleviators) and consequences (consumer behaviors, emotions, preferences, attitudes, and cognition) of CL in various consumption contexts. This review also presents findings on CL as a mediator and moderator in consumer studies. This work adds to the growing body of CL literature by synthesizing the existing findings and knowledge. More importantly, we present a future research agenda by linking CL to significant research lines and detailed implications for practitioners in the marketplace.

Exploring the Ethical Considerations of Direct Contact in Pediatric Organ Transplantation: A Qualitative Study

BACKGROUND

Nonanonymized direct contact between organ recipients and donor families is a topic of international interest in the adult context. However, there is limited discussion about whether direct contact should be extended to pediatric settings due to clinician and researcher concerns of the potential harms to pediatric patients.

METHODS

We interviewed pediatric organ recipients, their families, and donorfamilies in British Columbia, Canada, to determine their views on direct contact. Interviews were conducted in two stages, with those who were further removed from the transplant process informing the approach to interviews with those who more recently went throughthe transplant process.

RESULTS

Twenty-nine individuals participated in twenty in-depth interviews. The study included participants from three major organ systems: kidney, heart, and liver. Only five participants expressed that direct contact might cause harm or discomfort, while twenty-three indicated they saw significant potential for benefits. Nearly half focused on the harms to others rather than themselves, and nearly two-thirds focused on the benefits for others rather than themselves.

CONCLUSION

There appears to be a community desire for direct contact in pediatric organ transplant programs among those living in British Columbia, Canada. These results suggest a need to revisit the medical community's assumptions around protection and paternalism in our practice as clinicians and researchers.

Underrepresentation of Respiratory Therapists as Experts in Delphi Studies on Respiratory Practices and Research Priorities

Delphi survey techniques are a common consensus method used to collect feedback from an expert panel to inform practices, establish guidelines, and identify research priorities. Collecting respiratory therapists' (RT) expertise and experiences as part of consensus-building methodologies is one way to ensure that they align with RT practices and to better influence respiratory care practice. This narrative review aimed to report the RT representation in expert panels of Delphi studies focused on respiratory therapy practices and research priorities. The research question that guided this review is: to what extent are RTs included as expert participants among published Delphi studies relate to respiratory therapy and research topics? We conducted a structured search of the literature and identified 23 papers that reported Delphi studies related to respiratory care practices and 15 that reported on respiratory-related research priorities. Delphi studies that focused on reporting consensus on respiratory care practices included the following: (1) mechanical ventilation, (2) high-flow nasal cannula therapy, (3) COVID-19 respiratory management, (4) home oxygen therapy, (5) cardiopulmonary monitoring, and (6) disease-specific guidelines. Delphi studies that focused on establishing respiratory research priorities included the following: (1) theory and practice-orientated knowledge gaps, and (2) priority research topics for empirical investigation. The results of this review suggest that RTs were rarely included as expert participants and, when involved, were minimally represented (5% to 33%). Given RTs' diverse and relevant experience in respiratory care, incorporating their perspectives to inform future education, respiratory care practices, and research priorities would allow evidence to better align with knowledge gaps deemed important for the respiratory therapy profession.

Psychoanalytic paradigms for "internal" change in the institutions

This article reflects on the transmission of clinical practices based on psychoanalytic theories and methods in care institutions. It examines the issues raised by these practices and the impact on therapists in the French social, scientific, and economic context. We attempt to identify the factors that promote the implementation of a process of reflection on established practices and their evolution.Our hypothesis is that any process of transmission of psychoanalytic practices in institutions implies thinking about the institution as an object of psychic reality, and grappling with potentially persecuting elements of change; these include the upheaval of values and ideals underlying the practices, as well as generational transmissions and their potential for conflict. The possibility of working on these internal objects raises the question of the institutional capacity for containing conflict; it also involves thinking about the nature and function of institutional spaces.Three points in particular are developed: the organizational modes of structures and their impact; the history of the structure and its intergenerational transmission; and the place of third parties in the process of historicization and transmission. These three points define the objects that are collectively elaborated, and the method that promotes the evolution and creativity of psychoanalytic practices in institutions.

Towards a cooperative urbanism? An alternative conceptualization of urban development for Johannesburg's mining belt

This paper explores the multidimensional aspects of inequality that shape urban areas and imagines an alternative future for one such space in Johannesburg, South Africa. It builds on literature from urban studies and planning theory to explore planning practices that politicize inequality, valorize difference and promote the shared management of collective resources. Then, drawing on a decade of qualitative research, the paper imagines how cooperative urbanism could be applied in the factious context of Johannesburg, describing the potential for developing the former mining belt of the Witwatersrand as a series of multi-scalar interventions, networking sites of cooperative action to incrementally address the entrenched inequality of the region. Thus, the paper brings together interdisciplinary conversations on theory with empirical research, discussing concrete ways to continue shifting urban planning and development towards increased environmental and social justice.

Shifting the focus inward: Israeli social workers' participation in decision-making and their inclusion of service-users in intervention-related decisions

Service-users' inclusion (SUI) in decision-making regarding services provided by public social services has numerous benefits for both users and providers. However, studies show a gap between the evolution of inclusive discourse and policy, and the implementation of SUI in social services' daily practice. Focusing on the organisational context, the present study is the first to empirically test the relationship between social workers' perception of the services' participative organisational culture (POC), their actual participation in organisational decision-making (SWAP) and their inclusive praxes with service-users (SUI). Data were collected between January and March of 2019 via an online survey of 317 Israeli social workers from 173 public departments of social services. Findings show that social workers who find the organisational culture at their workplace to be more participative, do in fact take a significantly greater part in decision-making at the organisational level, and include service-users more in decision-making throughout the intervention. Furthermore, SWAP mediates the connection between services' POC and SUI. Findings suggest that establishing a POC is not enough to increase users' inclusion, as social workers' active participation in decision-making is vital for their ability to include their marginalised users.

Founders' Creativity, Business Model Innovation, and Business Growth

Given the existing studies on the role of different founders’ personalities in the growth of new ventures, we take the digital technology start-ups as the research object and focus on the role of founders’ creativity. In this study, we assess the relationship between founders’ creativity and business growth. According to the framework of upper echelons theory, we propose several hypotheses. Based on the investigation of 153 new ventures in China’s transition economy, we find that: (1) founders’ creativity has a positive impact on the growth of enterprises; (2) business model innovation positively mediates the relationship between founders’ creativity and enterprise growth; (3) work experience is found to be a moderator of the relationship between founders’ creativity and business model innovation. The conclusion of our analysis not only helps to further deepen the research on the growth process of start-ups but also helps to further expand the important role of business model innovation and founders’ work experience in the growth of new firms.

Nurse Migration in Australia, Germany, and the UK: A Rapid Evidence Assessment of Empirical Research Involving Migrant Nurses

Forecasts predict a growing shortage of skilled nursing staff in countries worldwide. Nurse migration is already a common strategy used to address nursing workforce needs. Germany, the UK, and Australia are reviewed here as examples of destination countries for nurse migrants. Agreements exist between countries to facilitate nurse migration; however, it is not evident how nurse migrants have contributed to data on which these arrangements are based. We examined existing primary research on nurse migration, including educational needs and initiatives to support policymakers’, stakeholders’, and health professions educators’ decisions on measures for ethical and sustainable nurse migration. We conducted a rapid evidence assessment to review available empirical research data which involved, was developed with, or considered migrant nurses to address the research question: what are the findings of research that directly involves migrant nurses in producing primary research data? A total of 56 papers were included. Four main themes were identified in this research data: Research does not clearly define what is meant by the term migrant nurses; discrimination is often reported by migrant nurses; language and communication competencies are important; and structured integration programs are highly valued by migrant nurses and destination healthcare employers.

Migrant nurses continue to experience discrimination and reduced career opportunities and therefore should be included in research about them to better inform policy. Structured integration programs can improve the experience of migrant nurses by providing language support (if necessary), a country-specific bridging program and help with organisational hurdles. Not only researching migrant nurses but making them active partners in research is of great importance for successful, ethical, and sustainable migration policies. A broader evidence base, especially with regard to the views and experiences of migrant nurses and their educational support needs, should be promoted to make future immigration policy more needs-based, sustainable and ethically acceptable.

Ethics Consultation in U.S. Hospitals: A National Follow-Up Study

A 1999-2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to "best informants" in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC.

Ethics Consultation in U.S. Hospitals: Determinants of Consultation Volume

The annual volume of ethics consultations (ECs) has been a topic of interest in the bioethics literature, in part because of its presumed relationship to quality. To better understand factors associated with EC volume, we used multiple linear regression to model the number of case consultations performed in the last year based on a national survey. We found that hospital bed size, academic affiliation, and urban/rural location were all associated with EC volume, but were not the primary drivers. Instead, these variables affected EC volume through three other variables, all of which relate to ethics staffing: the percentage of case consultations performed by a single individual; whether the survey respondent's main role at the hospital contained the word "ethics"; and especially, the number of full-time ethics program staff. We conclude that EC is an example of supply-sensitive care, and further research is needed to determine the optimal level of EC activity.

Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners' opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted.

Mining the Data: Exploring Rural Patients' Attitudes about the Use of Their Personal Information in Research

BACKGROUND

This study examines rural patients' perceived importance of knowing or being consulted about researchers' access and use of their personal data (identifiable and de-identified health information, and identifiable and de-identified non-health information) across five scenarios. This study also examines their views on stewardship or governance of their personal information by researchers in their healthcare systems.

METHODS

We conducted a survey by mail. Data were analyzed using descriptive statistics. Multivariable regression analyses were conducted across each scenario and type of personal data with the same variables included in each model.

RESULTS

The majority of participants said it was "very important/absolutely essential" to know the purpose of the study, to be asked every time, and to know the policies governing researcher access and use of their identifiable health information. Just over two-thirds of respondents thought it "very important/absolutely essential" to know who serves on the data governance committee and to have a community member serve. Distrust in healthcare organizations was positively correlated with the scenarios while willingness to give permission to donate leftover biological specimens was negatively correlated.

CONCLUSION

Our study findings indicate that the type of personal information being accessed and used generally matters to 1,407 patients living in rural Pennsylvania. We also demonstrate that knowing their healthcare organizations' governance policies and practices for managing their personal data is important to many rural Pennsylvania patients. Biomedical researchers need to recognize and attend to those differences as much as possible in order to expand opportunities for and participation in research by residents of these rural communities.

Supplemental data for this article is available online at.

Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China

This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.

Treatment for perpetrators of intimate partner violence: What is the evidence?

Intimate partner violence (IPV) is recognized as a worldwide health issue that calls for urgent interventions to prevent the significant physical and mental harm it poses to the individuals involved and to reduce its wider deleterious impacts on society. Despite 40 years of research in the field, incidence rates of IPV have not significantly declined and treatment services for perpetrators of IPV are scarce. Empirical research has been hindered by ideological disputes, and the most commonly used treatment approaches-the feminist-oriented Duluth approach and cognitive-behavioral treatments-lack evidence for their efficacy. This introduction to this issue of In Session reviews these ideological controversies and the current state of empirical evidence for the treatment of perpetrators of IPV; and summarizes the five papers, commissioned from different countries in Europe, North America, and Africa, comprising this issue, each of which presents a novel therapeutic intervention for this heterogeneous population.

Ethics Consultation in U.S. Hospitals: Adherence to National Practice Standards

BACKGROUND

Adherence to widely accepted practice standards is a frequently used measure of healthcare quality. In the U.S., the most widely recognized authoritative source of practice standards for ethics consultation (EC) is the second edition of the American Society for Bioethics and Humanities' Core Competencies for Healthcare Ethics Consultation report.

METHODS

To determine the extent to which EC practices in U.S. hospitals adhere to these practice standards, we developed and analyzed 12 evaluative measures from a national survey.

RESULTS

Only three of the 12 standards achieved over 75% adherence with reported EC practices: allowing anyone involved in a case to request an EC (100%), not requiring an attending physician's permission to conduct an EC (97.6%), and having at least one person on the ethics consultation service (ECS) with advanced level EC proficiency (79.3%).

CONCLUSIONS

Implications are discussed for achieving consensus on EC standards as they continue to evolve.

Ethics Consultation in U.S. Hospitals: New Findings about Consultation Practices

BACKGROUND

While previous research has examined various aspects of ethics consultation (EC) in U.S. hospitals, certain EC practices have never been systematically studied.

METHODS

To address this gap, we surveyed a random stratified sample of 600 hospitals about aspects of EC that had not been previously explored.

RESULTS

New findings include: in 26.0% of hospitals, the EC service performs EC for more than one hospital; 72.4% of hospitals performed at least one non-case consultation; in 56% of hospitals, ECs are never requested by patients or families; 59.0% of case consultations involve conflict; the usual practice is to visit the patient in all formal EC cases in 32.5% of hospitals; 56.6% of hospitals do not include a formal meeting in most EC cases; 61.1% of hospitals do not routinely assess ethics consultants' competencies; and 31.6% of hospitals belong to a bioethics network. We estimate the total number of non-case consultations performed in U.S. hospitals to be approximately one half the number of case consultations; we estimate the total number of ECs performed in U.S. hospitals, including both case and non-case consultations, to be just over 100,000 per year.

CONCLUSIONS

These findings expand our current understanding of EC in U.S. hospitals, and raise several concerns that suggest a need for further research.

Variation in COVID-19 Resource Allocation Protocols and Potential Implementation in the Chicago Metropolitan Area

BACKGROUND

Scarce resource allocation policies vary across the United States. Little is known about regional variation in resource allocation protocols and variation in their application. We sought to evaluate how Covid-19 scarce resource allocation policies vary throughout the Chicago metropolitan area and whether there are differences in policy application within hospitals when prioritizing hypothetical patients who need critical care resources.

METHODS

Two cross-sectional surveys were distributed to Chicago metropolitan area hospital representatives and triage officers. Survey responses and categorical variables are described by frequency of occurrence. Intra- and interhospital variation in ranking of hypothetical patients was assessed using Fleiss's Kappa coefficients.

RESULTS

Eight Chicago-area hospitals responded to the survey assessing scarce resource allocation protocols (N = 8/18, response rate 44%). For hospitals willing to describe their ventilator allocation protocol (N = 7), most used the sequential organ failure assessment (SOFA) score (N = 6/7, 86%) and medical comorbidities (N = 4/7, 57%) for initial scoring of patients. A majority gave priority in initial scoring to pre-defined groups (N = 5/7, 71%), all discussed withdrawal of mechanical ventilation for adult patients (N = 7/7, 100%), and a minority had exclusion criteria (N = 3/7, 43%). Forty-nine triage officers from nine hospitals responded to the second survey (N = 9/10 hospitals, response rate 90%). Their rankings of hypothetical patients showed only slight agreement amongst all hospitals (Kappa 0.158) and fair agreement within two hospitals with the most respondents (Kappa 0.21 and 0.25). Almost half used tiebreakers to rank patients (N = 23/49, 47%).

CONCLUSIONS

Although most respondents from Chicago-area hospitals described policies for resource allocation during the COVID-19 pandemic, the substance and application of these protocols varied. There was little agreement when prioritizing hypothetical patients to receive scarce resources, even among people from the same hospital. Variations in resource allocation protocols and their application could lead to inequitable distribution of resources, further exacerbating community distrust and disparities in health.

Supplemental data for this article is available online at https://doi.org/10.1080/23294515.2021.1983667.

Are Founders More Socially Responsible? -An Empirical Research on Private Listed Companies in China

Personal factors such as the founder's values and psychological characteristics will influence founder's vision, his perception and interpretation of the decision-making environment, and his strategic choice and decision-making. Based on the theory of entrepreneurial characteristics, combined with the founder's unique psychological characteristics, this paper takes Chinese private listed companies between 2010 and 2018 as a research sample to study the effect of the founder of private enterprises on corporate social responsibility. Furthermore, this study analyzes the impact of different management roles of the founder on corporate social responsibility. We demonstrate that the private enterprises have better social responsibility performance when there are founders; the founders have different management roles, and their corporate social responsibility performance has certain differences, and the higher the management level of the founders, the better the corporate social responsibility performance. This paper studies the issue of corporate social responsibility from the perspective of the characteristics of founders, which expands the current framework of corporate social responsibility research and provides an empirical basis for founders to effectively participate in corporate management in practice.

How Chinese Web Users Value Their Personal Information: An Empirical Study on WeChat Users

Purpose

The purpose of the study is to investigate Chinese web users' monetary valuation of their personal information (PI) and its psychological driving factors, and thereby promote the establishment of the PI market in China.

Methods

In this study, a survey was conducted with 710 Chinese WeChat users to determine how they perceive the monetary value of their PI.

Results

The survey results demonstrate that the "endowment effect" exists among Chinese web users, indicating different allocations of PI property rights may elicit distinct outcomes. The results also reveal that Chinese web users' willingness-to-pay (WTP) is mainly driven by privacy concern and intimacy of disclosure, and their willingness-to-accept (WTA) is mainly driven by privacy concern, intimacy of disclosure and psychological ownership.

Conclusion

The results imply that market players in China can use these driving factors to increase consumers' valuation of their PI to maintain a stable user base, and a portion of users will choose paid but privacy-guaranteed services to protect their PI. Furthermore, our findings indicate that when there is a formal monetary PI market, a privacy class may emerge.

Incentives to promote the US pharmaceutical innovation: empirical research based on the case of Epogen

OBJECTIVE

This study aims at emphasizing the significant impact of the incentives to promote the United States (US) pharmaceutical innovation.

METHODS

We carried out a retrospective single-case study. We analyzed the innovation process of Epogen: basic research, applied research, regulatory, and marketing.

RESULTS

Incentives and policies of pharmaceutical innovation significantly facilitates the entire life cycle of Epogen. The transfer of patent presented by the Bayh-Dole Act allowed Amgen to purchase the research results of Epogen. Relying on the intellectual property mechanisms and financing incentives, Amgen raised the funds needed for Epogen in applied research. Special review shortened the regulatory of Epogen. Epogen obtained orphan drug designation twice and 8 years of market exclusivity. Tax deduction and research funding provided direct economic compensation. The patent system enabled Epogen to obtain 32 years of patent protection (1983-2015). Monopoly pricing was a significant determinant to increase the sales of Epogen through pricing strategies.

CONCLUSION

We pointed out that Amgen has developed the successful innovation of Epogen taking advantages of the incentives. Effective and flexible incentives and policies are essential to support the entire life cycle of new drugs, ultimately forming a sustainable driver for the long-run pharmaceutical innovation.

Report Quality of Generalized Linear Mixed Models in Psychology: A Systematic Review

Generalized linear mixed models (GLMMs) estimate fixed and random effects and are especially useful when the dependent variable is binary, ordinal, count or quantitative but not normally distributed. They are also useful when the dependent variable involves repeated measures, since GLMMs can model autocorrelation. This study aimed to determine how and how often GLMMs are used in psychology and to summarize how the information about them is presented in published articles. Our focus in this respect was mainly on frequentist models. In order to review studies applying GLMMs in psychology we searched the Web of Science for articles published over the period 2014–2018. A total of 316 empirical articles were selected for trend study from 2014 to 2018. We then conducted a systematic review of 118 GLMM analyses from 80 empirical articles indexed in Journal Citation Reports during 2018 in order to evaluate report quality. Results showed that the use of GLMMs increased over time and that 86.4% of articles were published in first- or second-quartile journals. Although GLMMs have, in recent years, been increasingly used in psychology, most of the important information about them was not stated in the majority of articles. Report quality needs to be improved in line with current recommendations for the use of GLMMs.

Becoming a Training and Supervising Analyst: Interviews from the Columbia Postgraduate Analytic Practice Study

Although much has been written about the training and supervising analyst system (TSA), its role in analysts' professional development has not been empirically studied. The Columbia Psychoanalytic Practice Study (CPAPS) is a longitudinal study of the careers of graduates from the Columbia Center for Psychoanalytic Training and Research. Interviews with 29/37 (78%) analysts graduating from 2003-2009 were analyzed using grounded theory. Our research question was: Are Columbia Center graduates interested in becoming TSAs and what factors influence their success in reaching this goal?Many analysts express interest in pursuing TSA appointment (22/29, 76%), however, a vast majority (26/29, 90%) experience challenges with finding cases, finances, and the work involved at a life stage with competing priorities. Fewer graduates become TSAs than express initial interest, suggesting that graduates find alternate pathways for professional development. While it is vital that institutes mentor graduates to take on a variety of postgraduate roles as educators, researchers, clinicians and scholars, our findings suggest that if the TSA qualification process were more user-friendly (less time-consuming, financially viable, and in step with current practice norms) more graduate analysts would sustain their interest in this career path.

Microstates in complex and dynamical environments: Unraveling situational awareness in critical helicopter landing maneuvers

Understanding decision-making in complex and dynamic environments is relevant for designing strategies targeting safety improvements and error rate reductions. However, studies evaluating brain dynamics in realistic situations are scarce in the literature. Given the evidence that specific microstates may be associated with perception and attention, in this work we explored for the first time the application of the microstate model in an ecological, dynamic and complex scenario. More specifically, we evaluated elite helicopter pilots during engine-failure missions in the vicinity of the so called "dead man's curve," which establishes the operational limits for a safe landing after the execution of a recovery maneuver (autorotation). Pilots from the Brazilian Air Force flew a AS-350 helicopter in a certified aerodrome and physiological sensor data were synchronized with the aircraft's flight test instrumentation. We assessed these neural correlates during maneuver execution, by comparing their modulations and source reconstructed activity with baseline epochs before and after flights. We show that the topographies of our microstate templates with 4, 5, and 6 classes resemble the literature, and that a distinct modulation characterizes decision-making intervals. Moreover, the source reconstruction result points to a differential activity in the medial prefrontal cortex, which is associated to emotional regulation circuits in the brain. Our results suggest that microstates are promising neural correlates to evaluate realistic situations, even in a challenging and intrinsically noisy environment. Furthermore, it strengthens their usage and expands their application for studying cognition under more realistic conditions.

Experiences in responders and non-responders to pulmonary rehabilitation among people with chronic obstructive pulmonary disease: a clinical study with convergent mixed analysis

PURPOSE

This study aims to investigate the experienced and measured development in physical capacity in people with Chronic Obstructive Pulmonary Disease (COPD) undergoing a standard pulmonary rehabilitation programme with a focus on the diverging experiences of responders and non-responders.

METHODS

Twenty-one participants in standard pulmonary rehabilitation were included in the study. We measured the participants' change in the six-minute walk test (6MWT) during rehabilitation participation. We investigated their experiences of the changes in their physical capacity by combined participant observations and interviews. A convergent mixed analysis was conducted of the coherent data.

RESULTS

Standard pulmonary rehabilitation had a different physical impact on people with COPD. Responders were delighted by a positive physical change, which improved their daily functioning and capability of fulfilling personal priorities. However, non-responders experienced decreased capacity and a lack of trust in their future. All participants found it challenging to exercise and achieve sustainable exercise habits.

CONCLUSION

In this qualitative study, we found that absence of expected improvement to pulmonary rehabilitation seems to confer distress and feelings of hopelessness. The achievement of sustainable change in daily exercise behaviour appears yet to be insufficient. Thus, new and more individualized models of physiotherapists' guidance in exercise are imperative.Implications for rehabilitationIt is vital to acknowledge differential response to people with the chronic obstructive pulmonary disease following eight-week standard pulmonary rehabilitation.Especially noteworthy feelings of distress and hopelessness are prominent to non-responders because of the absence of the promised improvements.Both responders and non-responders require intensive physiotherapist guidance to exercise.It is recommended to ensure individualised support to people with chronic obstructive pulmonary disease in rehabilitation programmes.

'Do language and culture really matter?': A trans-disciplinary investigation of cultural diversity in genetic counseling in Hong Kong

In this paper, we present evidence that in counseling culturally diverse patients, differences in spoken language and cultural beliefs of the patients and genetic counseling professionals do not necessarily impede successful counseling. We also highlight sociocultural factors, including socioeconomic background and genetic literacy, that may impact communication in multicultural/ multilingual contexts or when languages other than English are used. While genetic counseling is not short of insights and practical guidelines on sociocultural and language issues, and increasingly, research that employs interviews and surveys, empirical research that draws on authentic interactional data (in the form of video- and audio-recorded interactions and their transcripts) is limited. Our goal here is to assess how needs are communicated among a diverse population using an innovative empirical approach that builds on the analysis of transcribed interactions as the primary data and optimizes trans-disciplinary expertise in linguistics, genetics and genetic counseling. We present data from 42 genetic counseling encounters addressing Sudden Arrhythmic Death Syndrome (SADS) in Hong Kong. We demonstrate the value of the situated analysis of genetic counseling, which focuses on those junctures in the interaction where participants orient to their different linguistic and/or cultural backgrounds as relevant to the ongoing interaction. We further show that participants draw on various interactional resources to negotiate and resolve possible differences or misunderstandings. We highlight the advantages of incorporating authentic (i.e., non-simulated) data into the training of genetic counselors to increase cultural awareness and to provide communication tools (i.e., interactional strategies) they can draw on in their counseling practice.

How to measure the effects and potential adverse events of palliative sedation? An integrative review

BACKGROUND

Palliative sedation is the monitored use of medications intended to relieve refractory suffering. The assessment of palliative sedation has been focused on the assess of the level of consciousness but a more comprehensive approach to assessment is needed.

AIM

To understand how the potential effects and possible adverse events of palliative sedation in Palliative Care patients are measured.

DESIGN

Integrative review of most recent empirical research.

DATA SOURCES

Cochrane Library, Embase, Medline, PubMed, and CINAHL were searched (2010-2020) using the terms sedation, palliative care, terminal care, assessment. Limits included studies in English and adults. Inclusion criteria were: scientific assessment papers, effects and complications of palliative sedation; patients with incurable illness.

RESULTS

Out of 588 titles, 26 fulfilled inclusion criteria. The Discomfort Scale-Dementia of Alzheimer Type and Patient Comfort Score were used to assess comfort. The Richmond Agitation-Sedation Scale and The Ramsay Sedation Scale are the most used to measure its effect. Refractory symptoms were assessed through multi-symptom or specific scales; except for psychological or existential distress. Delirium was assessed using the Memorial Delirium Assessment Scale and pain through the Critical Care Pain Observation Tool. The use of technical approaches to monitor effects is upcoming. There is lack of measurement of possible adverse events and variability in timing measurement.

CONCLUSIONS

There are palliative care validated instruments to assess the sedation effect but this review shows the need for a more standardized approach when assessing it. Instruments should be used within an experienced and trained expert, providing a holistic assessment.

Effectiveness of communication skill training on cancer truth-telling for advanced practice nurses in Taiwan: A pilot study

OBJECTIVE

Advanced practice nurses (APNs) can best support physicians in improving the quality of truth-telling. However, the effectiveness of communication skill training (CST), based on the Japanese SHARE model exclusive to APNs, has not been tested from APNs' and recipients' viewpoints, motivating the author to conduct the present study.

METHODS

A two-group before-after model design was adopted, and 61 APNs from two hospitals were randomly assigned to either an experimental group (EG; N = 28) or an control group (CG; N = 33). APNs in the EG received 6 h of CST under the guidance of qualified facilitators and simulated patients. This study used APNs' subjective assessment (N = 61) (self-confidence and perceptions on truth-telling) and recipients' opinions (N = 480) (cancer patients' and their caregivers' satisfaction with truth-telling and emotional status) to assess the effectiveness of the SHARE CST. Data were collected before CST (baseline, T0), immediately after (T1), and 2 weeks after (T2).

RESULTS

APNs in the EG had more confidence (p < 0.05) and better perceptions of cancer truth-telling (p < 0.01) than APNs in the CG at both T1 and T2. No group differences were found in patients' or their caregivers' satisfaction with truth-telling, emotional distress, and anxiety (p > 0.05). In addition, patients in the EG had higher depression than patients in the CG (β = 1.65, p = 0.01).

CONCLUSIONS

SHARE CST can improve APNs' confidence and perceptions of cancer truth-telling. However, more rigorous studies are required to test the effectiveness of CST from recipients' viewpoint.

Breeding brains? Patients' and laymen's perspectives on cerebral organoids

Aim: To explore the perspectives of patients and laymen with regard to the development, use and storage of cerebral organoids, in order to contribute to the ethical debate about this technology. Materials & methods: In depth semi-structured interviews with 28 patients and laymen were conducted. A qualitative thematic analysis was undertaken using a constant comparative method. Results: Three interrelated themes emerged from the empirical material: moral value; willingness to donate; and elements of good governance. Conclusion: Patients and laymen are most concerned about cerebral organoids potentially developing consciousness and potential misuse. They support the use of cerebral organoids under the conditions that donors are adequately informed and that there will be good governance. Perspectives of patients and laymen are helpful to enable responsible development and use of cerebral organoids in practice.

Managing Conflicts and Maximizing Transparency in Industry-Funded Research

BACKGROUND

Industry funding of research comes with important conflicts of interest, especially when research findings have financial implications for funders. When considering industry funding, academic investigators seek ways to mitigate and manage conflict to ensure integrity of research design, analysis, interpretation, and to protect researchers' and their institutions' credibility. This qualitative study's purpose was to conduct semi-structured interviews with expert stakeholders to gain insight into industry funding of research focused on nutrition and obesity, and determine the feasibility of developing a transparent process using an advisory board to help govern industry funding and manage conflict.

METHODS

We conducted seven semi-structured interviews with a purposive group of expert stakeholders representing varied perspectives. We distributed a summary of the advisory board concept to interviewees; developed and used a 16-question interview guide; and analyzed the interviews using open coding, manifest content analysis, axial coding, and code list reviews to identify and refine themes.

RESULTS

Most interviewees agreed that managing conflicts between industry funders and researchers was possible but difficult. They believed a carefully constructed advisory board empowered with specific responsibilities could help facilitate this process. They posited that strict guidelines are required to protect research quality and reporting, researcher(s)' and research institution(s)' reputations, and subsequent policy influenced by the research findings. They recommended specific guidelines and a framework for developing and administering the advisory board.

CONCLUSIONS

A carefully constructed advisory board empowered with specific responsibilities could be useful to manage actual and perceived conflicts of interest, and increase transparency of research processes, funding, and results for industry-funded research. Stricter guidelines than those previously proposed in existing frameworks are needed to instill confidence in industry-funded nutrition and obesity research. A possible next step could include a pilot study of the advisory board concept to determine specific requirements for execution and to develop rigorous guidelines.

How Biomedical Citizen Scientists Define What They Do: It's All in the Name

BACKGROUND

As citizen science continues to grow in popularity, there remains disagreement about what terms should be used to describe citizen science activities and participants. The question of how to self-identify has important ethical, political, and practical implications to the extent that shared language reflects a common ethos and goals and shapes behavior. Biomedical citizen science in particular has come to be associated with terms that reflect its unique activities, concerns, and priorities. To date, however, there is scant evidence regarding how biomedical citizen scientists prefer to describe themselves, their work, and the values that they attach to these terms.

METHODS

In 2018, we conducted semi-structured interviews with 35 biomedical citizen scientists in connection with a larger study to understand ownership preferences. Interview data were analyzed to identify the terms that interviewees used and avoided to describe themselves and their work, as well as the reasons for their preferences.

RESULTS

Biomedical citizen scientists self-identified using three main terms: citizen scientist, biohacker, and community scientist. However, there was a lack of consensus among interviewees on the appropriateness of each term, two of which prompted conflicting responses. Self-identification preferences were based on personal judgments about whether specific terms convey respect, are provocative, or are broad and inclusive, as well as the desirability of each of these messages.

CONCLUSIONS

The lack of consensus about self-identification preferences in biomedical citizen science reflects the diversity of experiences and goals of individuals participating in this field, as well as different perceptions of the values signaled by and implications of using each term. Heterogeneity of preferences also may signal the parallel development of multiple communities in biomedical citizen science.

An empirical study on the index system of rational drug use in children with primary nephrotic syndrome: A cross-sectional study

In the study's early stage, the research group had established an evaluation index system for the rational drug use of primary nephrotic syndrome in children. To assess the feasibility of the established index system, we conducted this empirical study.The cross-sectional study was conducted by using the Hospital Information System to extract some general clinical data of hospitalized children with primary nephrotic syndrome, which included registration number, age, sex, diagnosis and medication, etc. Utilize the SPSS23.0 software and Excel 2016 to descriptively analyze information.224 hospitalized children with primary nephrotic syndrome who met the inclusion criteria were included, ranging from 18 years old and 10 months to 11 months and 23 days, with an average age of 8.40, plus or minus 4.30 years. 148 males (66.07%) and 76 females (33.93%). The duration of hospitalization was 1-57 days, with an average hospitalization time of 10.59 days. The most common is respiratory infections, such as the bronchopneumonia, the mycoplasma pneumonia, etc. This study had successfully completed the measurement of the evaluation index system for the rational drug use of primary nephrotic syndrome in children.All indicators are feasible, but the operability and applicability need further research and improvement.

Differences in Conceptual Understanding of the "Actionability" of Incidental Findings and the Resultant Difference in Ethical Responsibility: An Empirical Study in Japan

BACKGROUND

The issue of incidental findings encountered in medical researches and in clinical practices becomes controversial in recent years. In what situations should researchers and clinicians disclose incidental findings to study participants or patients? According to previous studies, the concept of "actionability" is one of most important notions in determining the management of incidental findings, however, the understanding of this concept is also inconsistent among people and the inconsistency can affect the management of incidental findings. That is why we surveyed the difference in conceptual understanding of "actionability" for incidental findings with genomic researches in Japan. Methods: We conducted focus groups with individuals conducting genomics research or genetic testing at the National Centers in Japan, all of which are expected to contribute significantly to genomics research and subsequent clinical practice in Japan. Results: As far as our survey and analysis, there exists crucial discrepancy; one might consider that an "actionable" finding should be one that would be useful in treatment or prevention; another might consider if the finding could lead to a definitive diagnosis, it should be considered "actionable," regardless of the treatment potential of the disease; moreover another might considered that a finding that would lead to the opportunity to participate in a clinical trial was "actionable". Conclusion: Based on the present study which we conducted, we have examined thus far the concept of "actionability", which may influence the management of incidental findings. The present study revealed discrepancies in the understanding of this concept among the National Centers in Japan, which all bear similar expectations from society. And this difference in "actionability" would lead to variations in management of incidental findings.

An ANP-fuzzy evaluation model of food quality safety supervision based on China's data

A government acts as the main supervisor of food quality and safety. How to quantify and improve the performance and efficiency of government supervision, respectively, is an urgent problem. This study constructs a food safety supervision performance index and utilizes an analytic network process-fuzzy comprehensive evaluation model to precisely quantify the performance of government supervision. The evaluation results show that, (a) although the overall situation of food quality and safety in China is controllable, the government does not do well in food safety risk supervision, food recall supervision, and accident summary supervision. (b) Internal supervision is the weakest link in food quality and safety supervision. (c) Grassroots supervision is weak especially in prefecture and county levels. (d) There is no positive correlation between the economy level and supervision level in one region. This paper contributes to accurately reflecting the status quo of China's food safety supervision and realizing the transparency of government regulatory information, which ultimately boosts the government's efficiency in food safety supervision and improves the regulatory situation.

Walking the middle ground between hermeneutics and science: A research proposal on psychoanalytic process

In 100 years of clinical research and 40 years of empirical research, the concept of psychoanalytic process continues to elude a consensual definition, probably because the problem and methodology must be approached in a different way. This article outlines the empirical implications of the epistemological model exposed in a previous article, by proposing a scientific, innovative, and clinically sensitive research programme for the study of psychoanalytic process. This proposal is an attempt at developing psychotherapy research that is founded on psychoanalytic hypotheses derived from a two-person psychology. The research programme focuses on the interactional nature of the analytical work, and on the relationship between the implicit (unconscious) and the explicit (conscious) levels of the analytic endeavour. The authors propose that this research programme be articulated around three methodological approaches: (1) the use of systematic case studies; (2) the adoption of the events paradigm for accessing the salient phenomena of the psychoanalytic process; and (3) a micro-analytic approach to the specific phenomena occurring within relevant sequences of interaction. These ideas are illustrated with a description of the micro-analysis of a clinical case. This article is intended to contribute to a constructive dialogue between psychoanalytic practice and psychotherapy research.

Social welfare reform in Israel: Social workers' views on change, participation and professional values

In recent years, many western welfare states have undergone reforms in their social services. These reforms are intended to influence the work of social workers in the public sector, and depend largely upon workers' ability and willingness to implement them. The research presented in this article addresses the reform in Israeli Departments of Social Services through the perspective of the social workers tasked with its implementation. Drawing on recent developments of the Knowledge-Power-Politics Triad model, the relationship between aspects of social workers' support for the reform and their perceived and actual involvement in reform policy making, general attitude towards change, and professional inclinations was examined. Our sample consisted of 180 social workers employed in departments currently implementing the reform. The study's results emphasise the vital role employee participation plays in forming support for reforms' goals, and at the same time expose the complex interplay between developing a 'sense' of participation and participation's actual realisation. They offer several insights into the way social workers' support for reform is constructed, and not less so, regarding aspects of examining such support.

An Empirical Study of the Impact of Social Interaction on Public Pro-Environmental Behavior

Public pro-environmental behavior plays a positive role in solving environmental pollution problems. In a real socioeconomic system, because public pro-environmental behavior has characteristics of externality and interactivity, a number of factors, such as external information and the behavior of others, could affect the pro-environmental behavior of individuals who optimize their own strategies by interacting with the outside world; thus, public pro-environmental behavior and social interaction are very closely related. In order to study the impact of social interaction on public pro-environmental behavior and its mechanisms, the authors of this paper conducted an empirical study based on an Ordinary Least Square (OLS) regression model and data from the Chinese General Social Survey (CGSS). The empirical results show that: (1) social interaction has a promoting effect on public environmental protection behavior, and social interaction has a more significant impact on private environmental protection behavior; (2) the public will not only adjust their own environmental protection behavior by directly observing the behavior of others, they will also obtain environmental protection knowledge through social interactions which thus have a positive impact on their behavior. It is of great practical significance to study the impact of social interactions on public pro-environmental behavior.

Heteronormative gatekeeping when enacting queer research in elementary schools: an autoethnographic perspective

Using authoethnography, the authors analyze how queerphobia and cis/heterosexism shape their research process regarding (LGBTQ)-inclusive empirical work in elementary school spaces. With examples from their own experiences, they show how queerphobic gatekeeping affects site access, negotiations required during data collection, and dissemination of the results to others. The authors argue that, taken together, these forces complicate - if not outright prevent - empirical, school-based research with young children, thereby artificially constraining the knowledge base of the field related to LGBTQ-inclusive education. They offer these analyses as affirmations to those facing similar challenges and as education to those in positions of power to change perceptions of, support of, and responses to queer, school-based educational research.

The Extent and Coverage of Current Knowledge of Connected Health: Systematic Mapping Study

Background

This study examines the development of the connected health (CH) research landscape with a view to providing an overview of the existing CH research. The research field of CH has experienced rapid growth coinciding with increasing pressure on health care systems to become more proactive and patient centered.

Objective

This study aimed to assess the extent and coverage of the current body of knowledge in CH. In doing so, we sought to identify specific topics that have drawn the attention of CH researchers and to identify research gaps, in particular those offering opportunities for further interdisciplinary research.

Methods

A systematic mapping study that combined scientific contributions from research in the disciplines of medicine, business, computer science, and engineering was used. Overall, seven classification criteria were used to analyze the papers, including publication source, publication year, research type, empirical type, contribution type, research topic, and the medical condition studied.

Results

The search resulted in 208 papers that were analyzed by a multidisciplinary group of researchers. The results indicated a slow start for CH research but showed a more recent steady upswing since 2013. The majority of papers proposed health care solutions (77/208, 37.0%) or evaluated CH approaches (49/208, 23.5%). Case studies (59/208, 28.3%) and experiments (55/208, 26.4%) were the most popular forms of scientific validation used. Diabetes, cancer, multiple sclerosis, and heart conditions were among the most prevalent medical conditions studied.

Conclusions

We conclude that CH research has become an established field of research that has grown over the last five years. The results of this study indicate a focus on technology-driven research with a strong contribution from medicine, whereas the business aspects of CH have received less research attention.

Ethical Leadership and Employees' Perceptions About Raising Ethical Concerns to Managers in the Veterans Health Administration

Background: The willingness of employees to proactively give voice to their concerns, including ethical concerns (ethics voice), is critical to improving organizational performance and integrity. In health care, speaking up is vital to ensuring a delivery system centered on patient safety and quality, including ethics quality. In this study, we explored whether ethical leadership practices contribute to employees' willingness to raise ethical concerns to those in the organization who have the authority to take corrective action. Methods: We conducted a secondary analysis of 2014 IntegratedEthics Staff Survey data administered to a random sample of 50% of VA health system staff. The data we used reflected responses from 42,412 employees who were associated with 141 administratively defined medical centers that encompass more than 1,400 sites of care delivery and VHA administrative program offices. The response rate to the survey was 29.4%. Results: Employees positioned higher in the organizational hierarchy were more comfortable raising ethical concerns than lower ranked employees. Ethical leadership practices, and especially those that created an expectation of trust, follow-through, and fair treatment, made it more likely that employees would raise ethical concerns with managers. Conclusion: Speaking up about ethical concerns is essential to the delivery of high-quality patient care and is enabled by managers who embody ethical leadership practices. Ethics programs can help create favorable conditions for raising ethical concerns by providing managers and supervisors with ethical leadership coaching, recognizing power differentials, and modeling more egalitarian communication practices. More research is needed to understand how employees conceptualize ethics voice and to assess the comparative effectiveness of different methods of encouraging speaking up about ethical concerns in health care organizations.

Current Practices in Data Analysis Procedures in Psychology: What Has Changed?

This paper analyzes current practices in psychology in the use of research methods and data analysis procedures (DAP) and aims to determine whether researchers are now using more sophisticated and advanced DAP than were employed previously. We reviewed empirical research published recently in prominent journals from the USA and Europe corresponding to the main psychological categories of Journal Citation Reports and examined research methods, number of studies, number and type of DAP, and statistical package. The 288 papers reviewed used 663 different DAP. Experimental and correlational studies were the most prevalent, depending on the specific field of psychology. Two-thirds of the papers reported a single study, although those in journals with an experimental focus typically described more. The papers mainly used parametric tests for comparison and statistical techniques for analyzing relationships among variables. Regarding the former, the most frequently used procedure was ANOVA, with mixed factorial ANOVA being the most prevalent. A decline in the use of non-parametric analysis was observed in relation to previous research. Relationships among variables were most commonly examined using regression models, with hierarchical regression and mediation analysis being the most prevalent procedures. There was also a decline in the use of stepwise regression and an increase in the use of structural equation modeling, confirmatory factor analysis, and hierarchical linear modeling. Overall, the results show that recent empirical studies published in journals belonging to the main areas of psychology are employing more varied and advanced statistical techniques of greater computational complexity.

Empirical Research on Domestic Violence in Contemporary China: Continuity and Advances

Domestic violence is not uncommon in China. Myths and misconceptions about it do exist, especially in the context of rapid social changes. Compared with its Western counterparts, the study on domestic violence in China is considered rudimentary and of low priority. Empirical studies, especially those measuring the correlates and/or risk factors related to domestic violence, are still lacking. This special issue aims to advance understanding on domestic violence through much-needed empirical research. It also demonstrates joint efforts by local Chinese scholars and their Western counterparts to strengthen collaboration in this important research area. Based on relatively large sample surveys, the articles incorporated in this special issue provide relatively accurate estimates of factors related to domestic violence and responses to it in mainland China and Taiwan. Future studies should give priority to developing indigenous theories and practices in addition to adapting and testing theories and models developed in the West.

Understanding variations in secondary findings reporting practices across U.S. genome sequencing laboratories

BACKGROUND

Increasingly used for clinical purposes, genome and exome sequencing can generate clinically relevant information that is not directly related to the reason for testing (incidental or secondary findings). Debates about the ethical implications of secondary findings were sparked by the American College of Medical Genetics (ACMG) 2013 policy statement, which recommended that laboratories report pathogenic alterations in 56 genes. Although wide variation in laboratories' secondary findings policies has been reported, little is known about its causes.

METHODS

We interviewed 18 laboratory directors and genetic counselors at 10 U.S. laboratories to investigate the motivations and interests shaping secondary findings reporting policies for clinical exome sequencing. Analysis of interview transcripts and laboratory documents was informed by sociological theories of standardization.

RESULTS

Laboratories varied widely in terms of the types of secondary findings reported, consent-form language, and choices offered to patients. In explaining their adaptation of the ACMG report, our participants weighed genetic information's clinical, moral, professional, and commercial value in an attempt to maximize benefits for patients and families, minimize the costs of sequencing and analysis, adhere to professional norms, attract customers, and contend with the uncertain clinical implications of much of the genetic information generated.

CONCLUSIONS

Nearly all laboratories in our study voluntarily adopted ACMG's recommendations, but their actual practices varied considerably and were informed by laboratory-specific judgments about clinical utility and patient benefit. Our findings offer a compelling example of standardization as a complex process that rarely leads simply to uniformity of practice. As laboratories take on a more prominent role in decisions about the return of genetic information, strategies are needed to inform patients, families, and clinicians about the differences between laboratories' practices and ensure that the consent process prompts a discussion of the value of additional genetic information for patients and their families.

The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review

Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists' competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists' competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists' competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

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"Sacra à Deo in corde discenda, natura ex natura." Johann Christian Senckenberg's Observationes as a Medico-Theological Writing Method. In his early diaries, the pietist physician Johann Christian Senckenberg has taken down large amounts of observation data which mostly concentrated on his own body and soul. Earlier research has mistaken his diligent self-observation for hypochondria and unworldliness, especially since the author had never endeavoured to analyze and publish his work. The article shows that both his writing practice and his reluctance to process and share its results are due to his deeply religious and firmly anti-rationalist conviction. The main purpose of his journal keeping was the attainment of religious self-knowledge and professional self-perfection. Scientific publications he considered to be hypothetical and dogmatic, be it in theology or medicine; moreover, their authors were often enough driven by their self-love and desire for fame. In his eyes, the only godly way of knowledge acquisition was the humble, diligent and minute study of divine creation according to the Hippocratic method. The most immediate and reliable way of achieving true wisdom, however, was the observation of God's work within one's own body and mind, which were subject to the effects of God's grace and punishment as well as to atmospheric, environmental and dietetic circumstances.