Patients’ intention to speak up for health care providers’ hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony,Germany*

Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs’ hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p < .001) and higher mean intention (M = 3.9 vs. 3.4 with vs. without encouragement [5-point-scales]; F(1, 434)?=?41.5, p < .001). In patients without diabetic foot syndrome, this effect was limited to those with at least medium school education (F(2, 292)?=?4.4, p = .013) and knowledge on HCPs’ hand hygiene (F(2, 294)?=?3.1, p = .047). In conclusion, a majority of T2D-patients in diabetes outpatient centres intend to speak for HCPs’ hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.     

The impact of emotions on recall: An empirical study on social ads

Emotions are a complex phenomenon that entails a tricky problem regarding the measurement. To partially overcome this question, we assess emotions both using self‐report and measures commonly used in neuromarketing. This study assesses the accuracy of the recall after 4 months regarding two social advertising videos about female genital mutilation. Forty female participants were recruited. The skin conductance trend of the participants is different when viewing the two videos. The majority of participants (94.9%) reported that the two videos elicited different emotions (sadness for the first video and anger for the second one). Furthermore, according to arousal and valence model, these data are consistent with the literature that underlines the importance of psychophysiological indexes in measuring emotions and their associations with memory performances.     

The mediating and moderating role of planning on mothers’ decisions for early childhood dietary behaviours

Objective: Examine the roles of action and coping planning on the intention–behaviour relationship for mothers’ decisions for their young children’s dietary behaviours.

Design: Prospective design with two waves of data collection, one week apart.

Main outcome measures: Mothers (N = 197, M_age = 34.39, SD = 5.65) of children aged 2–3 years completed a main questionnaire assessing planning constructs and intentions, and a one-week follow-up of the target behaviours – ‘healthy eating’ and ‘discretionary choices’.

Results: Intention was the strongest predictor of behaviour for both dietary behaviours. For healthy eating, intention moderated the indirect relationship between intention–behaviour via planning; coping planning was less important when intention was strong. Further, intention was not a direct predictor of behaviour when intention was relatively low. Action planning was not a direct predictor of either behaviour after accounting for intention and coping planning; action planning on behaviour was mediated by coping planning (only for healthy eating). Intention was not a direct predictor of coping planning; intention on coping planning was mediated by action planning. Neither type of planning predicted discretionary choices.

Conclusion: Current findings contribute novel information on the mechanisms underpinning the effect of action and coping planning on the intention–behaviour relationship.     

Commentary on Entangled Empathy by Lori Gruen

This essay explores four aspects of Gruen's theory. The first section considers her analysis of the concepts of sympathy, pity, and emotional contagion. The second section outlines the main features of her conception of empathy and highlights some worries about empathy that her theory addresses. The third section examines empathy's contributions to moral epistemology. The fourth section queries Gruen's contention that empathy is morally motivating.     

The Gettier Intuition from South America to Asia

Journal of Indian Council of Philosophical Research - This article examines whether people share the Gettier intuition (viz. that someone who has a true justified belief that p may nonetheless fail...     

A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling

With the advancements in precision medicine and health care reform, it is critical that genetic counseling practice respond to emerging evidence to maximize client benefit. The objective of this review was to synthesize evidence on outcomes from randomized controlled trials (RCTs) of genetic counseling to inform clinical practice. Seven databases were searched in conducting this review. Studies were selected for inclusion if they were: (a) RCTs published from 1990 to 2015, and (b) assessed a direct outcome of genetic counseling. Extracted data included study population, aims, and outcomes. Risk of bias was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. A review of 1654 abstracts identified 58 publications of 54 unique RCTs that met inclusion criteria, the vast majority of which were conducted in cancer genetic counseling setting. Twenty-seven publications assessed ‘enhancements’ to genetic counseling, and 31 publications compared delivery modes. The methodological rigor varied considerably, highlighting the need for attention to quality criteria in RCT design. While most studies assessed several client outcomes hypothesized to be affected by genetic counseling (e.g., psychological wellbeing, knowledge, perceived risk, patient satisfaction), disparate validated and reliable scales and other assessments were often used to evaluate the same outcome(s). This limits opportunity to compare findings across studies. While RCTs of genetic counseling demonstrate enhanced client outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.     

Emotional fitness and the movement of affective science from lab to field

Emotions provide a ubiquitous and consequential backdrop to daily life, influencing everything from physiology to interpersonal relationships in the blink of an eye. Instances of emotional experience accumulate and compound to impact overall mental and physical health. Under optimal conditions, emotions are adaptive for the successful navigation of daily life. However, situational features of military life likely amplify everyday emotions and their impact, creating the need for soldiers to have a well-oiled emotional resilience system in place from the start, to be maintained throughout their careers. Basic research in affective science has identified the active ingredients that would be required in order for such a system of skills and abilities to have maximum impact on overall emotional fitness. Results of this emotional resilience training may provide compounding benefits for the individual as well as have spreading impact for the benefit of the military unit and other social connections. The Comprehensive Soldier Fitness initiative highlights important new frontiers in affective science and presents a challenge to our field that requires taking a second look at the theory-testing process.     

Intelligent management of intelligence agencies: beyond accountability ping-pong

The intelligence community (IC) is asked to predict outcomes that may often be inherently unpredictable-and is blamed for the inevitable forecasting failures, be they false positives or false negatives. To move beyond blame games of accountability ping-pong that incentivize bureaucratic symbolism over substantive reform, it is necessary to reach bipartisan agreements on performance indicators that are transparent enough to reassure clashing elites (to whom the IC must answer) that estimates have not been politicized. Establishing such transideological credibility requires (a) developing accuracy metrics for decoupling probability and value judgments; (b) using the resulting metrics as criterion variables in validity tests of the IC's selection, training, and incentive systems; and (c) institutionalizing adversarial collaborations that conduct level-playing-field tests of clashing perspectives.