Validation of the Comprehensive ICF Core Set for rheumatoid arthritis: The perspective of psychologists

The ‘Comprehensive ICF Core Set for rheumatoid arthritis (RA)’ is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with RA. The objective of this study was to validate this ICF Core Set from the perspective of psychologists. Psychologists experienced in RA treatment were asked about the problems of RA patients, treated by psychologists, in a three-round survey using the Delphi technique. Responses were linked to the ICF. Twenty psychologists in five countries gave a total of 303 responses that were linked to 65 different ICF categories. Fifteen responses were linked to the not yet developed ICF component personal factors and nine were not covered by ICF. Overall, 66% of the ICF categories linked to the responses of the psychologists were represented by the Comprehensive ICF Core Set for RA. Several responses that were not covered need to be investigated further.     

Work happiness among teachers: A day reconstruction study on the role of self-concordance

Self-concordant work motivation arises from one's authentic choices, personal values, and interests. In the present study, we investigated whether self-concordant motivation may fluctuate from one work-related task to the next. On the basis of self-determination theory, we hypothesized that momentary self-concordance buffers the negative impact of momentary work demands on momentary happiness. We developed a modified version of the day reconstruction method to investigate self-concordance, work demands, and happiness during specific work-related tasks on a within-person and within-day level. In total, 132 teachers completed a daily diary on three consecutive work days as well as a background questionnaire. The daily diary resulted in 792 reported work activities and activity-related work demands, self-concordance, and happiness scores. Multilevel analysis showed that—for most work activities—state self-concordant motivation buffered the negative association of work demands with happiness. These findings add to the literature on motivation and well-being by showing that the levels of self-concordance and happiness experienced by employees vary significantly on a within-day level and show a predictable pattern. We discuss theoretical and practical implications of the findings to increase employees' well-being.     

Method of Knowledge and the Challenges of the Planetary Society: Edgar Morin's Pedagogical Proposal

Edgar Morin is one of the most important contemporary European philosophers. His name has recently also become well known on the American continent, especially in South America, where his works have given rise to several interesting cultural initiatives. The analysis of his pedagogical proposal can be a stimulating adventure for educators and teachers alike. Morin's proposal to link methodologically what is disjoined suggests re-establishing the connection between thought and action, in order to re-establish on rational and critical bases the ethical principles of solidarity and responsibility and enable us to face the challenges of our times.     

Many-body potential for nitrogen in α-iron

N atom is one of the most frequent foreign interstitial atoms in α-iron along with C atoms. The Fe–C potential has been well-developed and can reproduce many significant interactions of C with point defects present in α-iron. However, there exists no satisfactory Fe–N potential to describe the interactions of N with point defects. Here, we develop a many-body potential for N in α-iron. The potential parameters are determined by fitting to ab initio data, which includes energetics, configurations, and relaxations of Fe atoms close to N atom. This potential successfully describes the interactions of Fe–N across a wide range of defect environments. The potential employs the embedded atom method form and hence is appropriate for large-scale molecular dynamics simulation.     

By-Person Factor Analysis in Clinical Ethical Decision Making: Q Methodology in End-of-Life Care Decisions

Objective: To determine the usefulness of Q methodology to locate and describe shared subjective influences on clinical decision making among participant physicians using hypothetical cases containing common ethical issues.

Design: Qualitative study using by-person factor analysis of subjective Q sort data matrix.

Setting: University medical center.

Participants: Convenience sample of internal medicine attending physicians and house staff (n = 35) at one midwestern academic health sciences center.

Interventions: Presented with four hypothetical cases involving urgent decision making near the end of life, participants selected one of three specific clinical actions offered for each case. Immediately afterward and while considering their decision, each respondent sorted twenty-five subjective self-referent items in terms of the influence of each statement on their decision-making process. By-person factor analysis, where participants are defined as variates, yielded information about the attitudinal background the physicians brought to their consideration of each hypothetical case. We performed a second-order factor analysis on all of the subjective viewpoints to determine if a smaller core of shared attitudes existed across some or all of the four case vignettes. Factor scores for each item and post-sort comments from interviews conducted individually with each respondent guided the interpretation of ethical perspective used by these respondents in making clinical decisions about the cases.

Measurements and Main Results: Second-order factor analysis on seventeen viewpoints used by physicians in the four hypothetical urgent decision cases revealed three moderately correlated (r ² < 40%) subjective core attitudinal guides used broadly among all the cases and among sixteen of the seventeen original factors. Across all the cases, our participants were guided in general by: (1) patient-focused beneficence, (2) a patient- and surrogate-focused perspective that includes risk avoidance, and (3) best interest of the patient guided by ethical values. Economic impact on the physician, expediency in resolution of the situation, and the expense of medical treatment were not found to be influential determinants in this study.

Conclusions: Q sorting and by-person factor analysis are useful qualitative methodological tools to study the complex structure of subjective attitudes that influence physicians in making medical decisions. This study revealed the subjective viewpoints used by our physician participants as they made ethically challenging treatment decisions. The three second-order factors identified here are grounded in current bioethical values as well as the personal traits of physicians. The participants' decision methods appear to resemble casuistry more than principle-based decision making. Generalizability of results will require further studies.