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Quality of life (QoL) is vitally important to patients with chronic illnesses such as ulcerative colitis (UC) and has been assessed in observational, cross-sectional, and cohort studies. However, relatively few clinical trials have evaluated the QoL of patients with UC. Recently, greater availability of the necessary tools has facilitated the undertaking of studies showing that QoL of patients with UC is reduced significantly compared with that of the general population. Studies using disease-specific instruments have identified disease severity as the strongest predictor of QoL, with other disease-related predictors including type of medical or surgical treatment and the efficacy, tolerability, and acceptability to patients of particular types of medical or surgical treatments. Other factors, such as comorbid medical or psychosocial problems and adherence to treatment, also affect QoL. Combined use of generic and disease-specific instruments in clinical trials can ensure that all clinically relevant unexpected events (generic instrument) and important improvement or deterioration (disease-specific instrument) are captured. For accurate outcomes assessment, the use of comprehensively validated instruments is critical. The need for the development and evaluation of new instruments will be determined by the mechanisms and targets of novel therapies. Ultimately, QoL assessment of effective therapies will play a strong role in pharmacoeconomic evaluations, providing health policy makers with the evidence to support the treatments that can most effectively normalize QoL through complete symptom resolution, minimal side effects, and convenient administration.

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. Method: Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. Results: The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. Conclusions: These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents’ mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise. Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. Método: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 15,26) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. Resultados: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 37,80%, 48,20% y 36,70%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. Conclusiones: Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular.

Consumer trust is a key prerequisite for establishing a market for credence goods, such as \"green\" products, especially when they are premium priced. This article reports research on exactly how, and how much, trust influences consumer decisions to buy new green products. It identifies consumer trust as a distinct volition factor influencing the likelihood that consumers will act on green intentions and strongly emphasizes the needs to manage consumer trust as a prerequisite for the development of a market for green products. Specifically, based on a mixture of qualitative and quantitative methods, it is found that lack of consumer trust is a barrier for the development of a market for organic food in Thailand. Two focus groups and ten in-depth interviews revealed low knowledge about and low trust in organic food, certification, control, and labeling. Further, a mall-intercept survey (N = 177) revealed that lack of (especially) system trust reduces consumer expectations about benefits of buying organic food, and it makes them less likely to buy organic food. Mistrust in the control system and in the authenticity of food sold as organic has a significant negative impact on self-reported buying behavior. Implications for policy and future research are discussed.

Interruption of work by e-mail and other communication technologies has become widespread and ubiquitous. However, our understanding of how such interruptions influence individual performance is limited. This paper distinguishes between two types of e-mail interruptions (incongruent and congruent) and draws upon action regulation theory and the computer-mediated communication literature to examine their direct and indirect effects on individual performance. Two empirical studies of sales professionals were conducted spanning different time frames: a survey study with 365 respondents and a diary study with 212 respondents. The results were consistent across the two studies, showing a negative indirect effect of exposure to incongruent interruptions (interruptions containing information that is not relevant to primary activities) through subjective workload, and a positive indirect effect of exposure to congruent interruptions (interruptions containing information that is relevant to primary activities) through mindfulness. The results differed across the two studies in terms of whether the effects were fully or partially mediated, and we discuss these differences using meta-inferences. Technology capabilities used during interruption episodes also had significant effects: rehearsing (fine-tuning responses to incoming messages) and reprocessing (reexamining received messages) were positively related to mindfulness, parallel communication (engaging in multiple e-mail conversations simultaneously) and leaving messages in the inbox were positively related to subjective workload, and deleting messages was negatively related to subjective workload. This study contributes to research by providing insights on the different paths that link e-mail interruptions to individual performance and by examining the effects of using capabilities of the interrupting technology (IT artifact) during interruption episodes. It also complements the experimental tradition that focuses on isolated interruptions. By shifting the level of analysis from specific interruption events to overall exposure to interruptions over time and from the laboratory to the workplace, our study provides realism and ecological validity.

Although internal medicine (IM) physicians accept public advocacy as a professional responsibility, there is little evidence that IM training programs teach advocacy skills. The prevalence and characteristics of public advocacy curricula in US IM residency programs are unknown. To describe the prevalence and characteristics of curricula in US IM residencies addressing public advocacy for communities and populations; to describe barriers to the provision of such curricula. Nationally representative, web-based, cross-sectional survey of IM residency program directors with membership in an academic professional association. A total of 276 IM residency program directors (61%) responded between August and December 2022. Percentage of US IM residency programs that teach advocacy curricula; characteristics of advocacy curricula; perceptions of barriers to teaching advocacy. More than half of respondents reported that their programs offer no advocacy curricula (148/276, 53.6%). Ninety-five programs (95/276, 34.4%) reported required advocacy curricula; 33 programs (33/276, 12%) provided curricula as elective only. The content, structure, and teaching methods of advocacy curricula in IM programs were heterogeneous; experiential learning in required curricula was low (23/95, 24.2%) compared to that in elective curricula (51/65, 78.5%). The most highly reported barriers to implementing or improving upon advocacy curricula (multiple responses allowed) were lack of faculty expertise in advocacy (200/276, 72%), inadequate faculty time (190/276, 69%), and limited curricular flexibility (148/276, 54%). Over half of US IM residency programs offer no formal training in public advocacy skills and many reported lack of faculty expertise in public advocacy as a barrier. These findings suggest many IM residents are not taught how to advocate for communities and populations. Further, less than one-quarter of required curricula in public advocacy involves experiential learning.

Background/Objective: Despite the great interest that bullying and cyberbullying have received during the last decades, the problem of defining these phenomena is still debated. Recently, this discussion has also been articulated in terms of how young people who are directly involved in bullying and cyberbullying understand these notions. This study aimed at investigating the operational definitions of both bullying and cyberbullying provided by adolescent victims and perpetrators, by inquiring the weight of traditional criteria (i.e., frequency, deliberateness, imbalance of power, and harm) as well as dominance in the perception of these phenomena. Method: A total of 899 students aged between 11 and 16 years filled out the Student Aggression and Victimisation Questionnaire. Results: Common traits and differences between the operational definition of bullying and cyberbullying and between the perspectives of victims and perpetrators of aggression were found. The most relevant criterion for the perception of both these phenomena was clearly the presence of dominance. By contrast, the imbalance of power showed no significant relationship with the perception of being bullied or bullying others both offline and online. Conclusions: Findings emphasise that young people conceptualise bullying with a clear reference to relational and group processes, rather than to individual differences. Antecedentes/Objetivo: A pesar del gran interés que el bullying y el cyberbullying han despertado durante las últimas décadas, el problema de la definición de estos fenómenos es todavía motivo de debate. Recientemente, la literatura ha abarcado esta controversia a partir de la comprensión que los jóvenes tienen del bullying y cyberbullying. Este artículo investiga las definiciones operativas, proporcionadas por víctimas y agresores, tras analizar la envergadura que tienen estos factores: frecuencia, intencionalidad, desequilibrio de poder, daño y dominancia. Método: Un total de 899 alumnos entre 11 y 16 años rellenaron el Student Aggression and Victimisation Questionnaire. Resultados: Los resultados evidenciaron rasgos comunes y diferencias entre las definiciones operativas de bullying y cyberbullying, al igual que entre las perspectivas de víctimas y perpetradores. El criterio más relevante para la definición de ambos fenómenos fue la percepción de la dominancia. En cambio, el desequilibrio de poder no mostró relaciones significativas con la definición de bullying y cyberbullying. Conclusiones: Estos hallazgos hacen hincapié en cómo los jóvenes interpretan el bullying, con un enfoque en los procesos relacionales y grupales, más que en las diferencias individuales.

Background Considering the chronic and debilitating nature of HIV infection, health-related quality of life (HRQoL) is an important patient-reported clinical outcome to better understand the effects of this infection and its treatment on patients’ lives. The purpose of this study was to assess the HRQoL and its association with sociodemographic, behavioural, clinical, nutrition-related factors and social support in an Irish HIV cohort. Methods A cross-sectional, prospective study using the Medical Outcomes Study HIV Health survey assessed the 10 dimensions of HRQoL and summarised as Physical Health Summary (PHS) and Mental Health Summary (MHS) scores. Participants were categorised as having good or poor PHS and MHS using the standardised mean score of 50. The variables independently associated with PHS and MHS were identified using multivariable logistic regression models. Results Overall, 521 participants completed the HRQoL questionnaire. The median (IQR) PHS and MHS scores were 56 (47–60) and 51 (41–58) respectively. All the covariate groups had lower MHS than PHS. Participants with symptoms of HIV reported the lowest median (IQR) PHS score 44.7 (32.–54.5) and MHS score 36.1 (28.6–48.4). Of the 10 dimensions of HRQoL, the lowest scores were for the energy level and general health. Symptoms of HIV, co-morbidities, social support, employment and ethnicity had independent association with both PHS and MHS. Gender, education, alcohol intake and HIV-complications were associated with PHS. Age, illicit drugs, BMI and malnutrition were associated with MHS. However, CD4 count and viral load were not independently associated with PHS and MHS in multivariable regression models. Conclusion Overall, HIV-infected people in this cohort had an average level of HRQoL. However, it is impaired in people with symptoms and co-morbidities, and not independently associated with CD4 and viral load. Alleviating HIV symptoms and preventing co-morbidities are important in managing HIV. Providing psychosocial supports for behaviour modification and return to work or exploring new opportunities will help to improve HRQoL. Healthcare providers and policy makers need to plan and implement programs to routinely assess the HRQoL in a systematic method to facilitate a holistic management of HIV.

Daily stressors, compared to traumatic events, are increasingly recognized as important risk factors for mental health. The role of general self-efficacy on the relationship between daily stress and aspects of mental health has not yet been examined. Taking into account the dual factor model of mental health, which postulates that mental health is more than the absence of psychopathological symptoms, we tested mediation effects of self-efficacy separately for positive and negative mental health. Total, direct and indirect effects were estimated using data from a large nationally representative German population sample (N = 1,031) by bootstrapped mediation analyses providing 95% bias corrected bootstrap confidence intervals. Results indicated self-efficacy as a mediator of the effects of daily stressors on mental health, with superior effect sizes for positive compared to negative mental health. Mediation effects were replicated in student samples from Germany (N=394), Russia (N=604) and China (N=8,669). Findings suggest that self-efficacy operates as a buffer of daily stress. However, a full mediation model was not supported as multiple psychological resources can have protective effects. This study provides the first transnational evidence for different stress-buffer effects for the two dimensions of mental health. El estrés cotidiano, en comparación con acontecimientos traumáticos, es reconocido cada vez más como un importante factor de riesgo para la salud mental. El papel de la autoeficacia general en la relación entre estrés diario y aspectos de la salud mental todavía no se ha examinado. Teniendo en cuenta el modelo de dos factores, que postula que la salud mental es más que la ausencia de síntomas psicopatológicos, examinamos la mediación de la autoeficacia separadamente para la salud mental positiva y negativa. Efectos totales, directos e indirectos fueron evaluados, utilizando datos de una muestra de la población alemana representativa (N=1.031). La autoeficacia es un mediador de los efectos del estrés cotidiano, con efectos superiores para la salud mental positiva. Los resultados fueron replicados en muestras de estudiantes de Alemania (N=394), Rusia (N=604) y China (N=8.669). La autoeficacia actúa como un búfer para el estrés cotidiano. Un modelo de mediación completo no fue apoyado con múltiples recursos psicológicos que pueden tener efectos protectores. Es la primera evidencia transnacional para diferentes efectos del búfer-estrés para las dos dimensiones de salud mental.

Machine learning is part of the daily life of people and companies worldwide. Unfortunately, bias in machine learning algorithms risks unfairly influencing the decision-making process and reiterating possible discrimination. While the interest of the software engineering community in software fairness is rapidly increasing, there is still a lack of understanding of various aspects connected to fair machine learning engineering, i.e., the software engineering process involved in developing fairness-critical machine learning systems. Questions connected to the practitioners’ awareness and maturity about fairness, the skills required to deal with the matter, and the best development phase(s) where fairness should be faced more are just some examples of the knowledge gaps currently open. In this paper, we provide insights into how fairness is perceived and managed in practice, to shed light on the instruments and approaches that practitioners might employ to properly handle fairness. We conducted a survey with 117 professionals who shared their knowledge and experience highlighting the relevance of fairness in practice, and the skills and tools required to handle it. The key results of our study show that fairness is still considered a second-class quality aspect in the development of artificial intelligence systems. The building of specific methods and development environments, other than automated validation tools, might help developers to treat fairness throughout the software lifecycle and revert this trend.

A more comprehensive understanding of the relationship between the positive and negative factors of professional quality of life and the emergency nurse’s caring ability is imperative as the care a nurse gives has lasting effects on their patients. The purpose of this study was to examine the effects of professional quality of life constructs on caring ability in emergency nurses. A sample of emergency nurses (n=238) in the US participated. Using a convergent mixed method approach with quantitative priority. Bivariate associations were explored, and a model of caring ability was obtained via multiple regression analysis incorporating the independent variables to answer the research questions. A final regression model of caring ability was obtained using the independent variables in conjunction with adjustment for significant demographic characteristics. Using a qualitative descriptive design, the qualitative data were subjected to content analysis. Themes were derived and qualitative data was quantitized for better understanding of the phenomena under study. Most participants reported low levels of compassion satisfaction, secondary traumatic stress, burnout, and caring ability. A multiple regression analysis identified compassion satisfaction as the strongest predictor for caring ability in emergency nurses. Content analysis revealed 3 themes: 1) I Love My Job but…, 2) Quantity versus Quality: I Want What Is Best, but I Cannot Provide it, and 3) The Abuse: Make it Stop. The results from the qualitative strand in this study confirmed the quantitative findings. As compassion satisfaction had the highest predictive value for caring ability, this variable was quantized from the qualitative strand with 30% of participants endorsing feeling compassion satisfaction in their qualitative information. This novel study concludes that promoting the nurse’s purpose in their work, meaning and joy in their work, and feelings of pleasure in their work has the potential to augment their caring ability resulting in a greater likelihood of quality outcomes for patients in the emergency department.