The work relative value estimation assessment in China: an empirical research for common surgical procedures.

Objectives: China's National Health Service Items Standard (NHSIS) establishes a relative value system and plays an important role in pricing. However, there are few empirical evaluations of the objectivity of the NHSIS-estimated relative value. Methods: This paper presents a comparison between physician work relative value units (wRVUs) estimates for 70 common surgical procedures from NHSIS and those from the U.S. Medicare Physician Fee Schedule (MPFS). We defined the ratio of the wRVUs for sample procedures to the benchmark procedure (inguinal hernia repair) as a standardized relative value unit (SRVU), which was used to standardize the data for both schedules. We examined the variances in the ranking and quantification of SRVUs across specialties and procedures, as well as how SRVUs impact procedure reimbursement prices between the two schedules. Results: There was no systematic difference between MHSIS-estimated SRVUs and MPFS-estimated, but the dispersion of MPFS-estimated SRVU was greater than that of MHSIS-estimated, and the discrepancies increased with surgical risk and technical complexity. The discrepancies of SRVUs were significant in cardiothoracic procedures. Additionally, whether SRVUs were based on MPFS or MHSIS, there was a positive association between them and payment prices. However, in terms of the impact of SRVUs on payment pricing, the NHSIS system was lower than the MPFS system. Conclusion: China has made incremental progress in estimating the relative value of healthcare services, but there are shortcomings in valuation methods and their impact on pricing. The modular assessment method should be considered as a component to optimize reform.

Nursing science at Mayo Clinic: An alternative model to traditional hospital-based nurse scientist positions.

The role of the Nurse Scientist in clinical settings represents a relatively new career path that has garnered attention in recent literature. Although there is considerable variability in how this role is operationalized across institutions, Mayo Clinic stands out as one of the few health systems in the United States employing nurse scientists who are fully and exclusively engaged in their own programs of research. Given the need for practical information to guide development and implementation of a research-focused nurse scientist role, the purpose of this paper is to describe the infrastructure and resources supporting Mayo Clinic nurse scientists, share role expectations and metrics for success, discuss both the facilitators of success and ongoing challenges, and compare our current practices to those found in the literature.

A Primer for Increasing Competency in Forensic Psychiatry Research.

Empirical research is foundational to the discipline of forensic psychiatry. Candilis and Parker provide a cogent systematic review of the empirical literature on restoration of competence to stand trial using National Institutes of Health quality metrics. Components of the study methodology are highlighted, as they represent current best practices for conducting a systematic review. A discussion of strategies to increase empirical research uptake in forensic psychiatry is pursued alongside concrete examples of how the American Academy of Psychiatry and the Law Research Committee can help facilitate this goal.

Construction and application of the core competence course training system for infectious disease specialist nurses.

OBJECTIVES: This study aims to construct and apply a training course system which was scientific and comprehensive to foster the core competence of infectious disease specialist nurses. DESIGN: A two-round Delphi consultation survey was carried out to collect feedback from experts on constructing the training course system of core competence for infectious disease specialist nurses. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the courses. METHODS: This study adopted a series of methods including group discussion, theoretical analysis and Delphi consultation to draft the training course content of core competence of infectious disease specialist nurses. Twenty-one Chinese experts were invited to participate in the Delphi consultation from November 2021 to December 2021. From October 2022 to January 2023, a total of 105 infectious disease specialist nurses from two training bases were selected by the convenience sampling method, of which the nurses in one training base were the control group and the nurses in the other training base were the observation group. The observation group was trained by the constructed core competence training course. Questionnaire evaluation was used to compare the core competence of infectious disease specialist nurses and the training effect. RESULTS: The experts, regarded as the authorities on the subject, were highly motivated in this study. Besides, they reached a consensus on the results. The final training course system of core competence for infectious disease specialist nurses focused on 5 competence modules and was composed of 12 categories of courses with 66 classes and corresponding objectives. The core competence scores of the observation group were significantly higher than those in the control group after training (P < 0.05), which proved the training system can effectively enhance the core competence of infectious disease specialist nurses. CONCLUSIONS: The research methods embodied scientific and precise properties. The course system was comprehensive in content and reliable in results. It could serve as a reference for training infectious disease specialist nurses.

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.

Organizational Ethics in Healthcare: A National Survey.

Organizational ethics-defined as the alignment of an institution's practices with its mission, vision, and values-is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics' professionalization: while some variability is appropriate to the field's relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners.

Establishment of Comprehensive Protection System for Intellectual Property of Single Herbs by Taking Callicarpa nudiflora of Jiuzhitang as An Example / 中国实验方剂学杂志

The development of single Chinese materia medica is an important direction of technological innovation in the field of Chinese materia medica at present， and the study of its comprehensive intellectual property protection system is of great significance to the intellectual property protection of the whole chain of innovative enterprises of single Chinese materia medica. Based on this， this paper takes the comprehensive protection system of intellectual property of Callicarpa nudiflora constructed by Jiuzhitang Pharmaceutical as a model to conduct empirical research， analyzes the protection forms applicable to intellectual property of Chinese materia medica， such as patents， administrative protection， trademarks， designs and intangible cultural heritages， and discusses the valuable and insufficient aspects of the protection system currently constructed by Jiuzhitang Pharmaceutical and puts forward the following suggestions：①paying attention to patent applications for planting/processing methods of raw medicinal materials， ②emphasizing the protection of geographical indications， authentic medicinal herbs， and new plant varieties， ③actively promoting product and technology upgrades， ④applying for data protection during product iteration， ⑤emphasizing the layout timing of patent and administrative protection， ⑥focusing on improving goodwill， ⑦enhancing awareness of intellectual property protection and promoting deep integration of industry， academia， and research. We hope that innovative enterprises engaged in the development of single Chinese materia medica can learn from the experience of the case， and optimize the strategy to better protect related products.

The Vagueness of Integrating the Empirical and the Normative: Researchers' Views on Doing Empirical Bioethics.

The integration of normative analysis with empirical data often remains unclear despite the availability of many empirical bioethics methodologies. This paper sought bioethics scholars' experiences and reflections of doing empirical bioethics research to feed these practical insights into the debate on methods. We interviewed twenty-six participants who revealed their process of integrating the normative and the empirical. From the analysis of the data, we first used the themes to identify the methodological content. That is, we show participants' use of familiar methods explained as "back-and-forth" methods (reflective equilibrium), followed by dialogical methods where collaboration was seen as a better way of doing integration. Thereafter, we highlight methods that were deemed as inherent integration approaches, where the normative and the empirical were intertwined from the start of the research project. Second, we used the themes to express not only how we interpreted what was said but also how things were said. In this, we describe an air of uncertainty and overall vagueness that surrounded the above methods. We conclude that the indeterminacy of integration methods is a double-edged sword. It allows for flexibility but also risks obscuring a lack of understanding of the theoretical-methodological underpinnings of empirical bioethics research methods.

Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall).

BACKGROUND: The use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue's great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall ("From anxiolysis to deep continuous sedation - Development of recommendations for sedation in palliative care") with the purpose of developing best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care and obtaining feedback and approval from experts in this area. DESIGN: Our stepwise approach entailed drafting the recommendations, obtaining expert feedback, conducting a single-round Delphi study, and convening a consensus conference. As an interdisciplinary group, we created a set of best practice recommendations based on previously published guidance and empirical and normative analysis, and drawing on feedback from experts, including patient representatives and of public involvement participants. We set the required agreement rate for approval at the single-round Delphi and the consensus conference at ≥80%. RESULTS: Ten experts commented on the recommendations' first draft. The Delphi panel comprised 50 experts and patient and public involvement participants, while 46 participants attended the consensus conference. In total, the participants in these stages of the process approved 66 recommendations, covering the topics "indications", "intent/purpose [of sedation]", "decision-making", "information and consent", "medication and type of sedation", "monitoring", "management of fluids and nutrition", "continuing other measures", "support for relatives", and "team support". The recommendations include suggestions on terminology and comments on legal issues. CONCLUSION: Further research will be required for evaluating the feasibility of the recommendations' implementation and their effectiveness. The recommendations and the suggested terminology may serve as a resource for healthcare professionals in Germany on the use of sedative drugs and intentional sedation in specialist palliative care and may contribute to discussion on the topic at an international level. TRIAL REGISTRATION: DRKS00015047 (German Clinical Trials Register).

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.

Construction and application on the training course of information literacy for clinical nurses.

DESIGN: A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of training courses of clinical nursing staff's information literacy. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the training courses. AIMS: This study intended to construct a training course of information literacy for clinical nurses, train nurses in order to improve their information literacy level and provide theoretical reference for the training of information literacy courses for clinical nurses. METHODS: Two rounds of Delphi study were conducted for the study among 26 clinical medical and nursing experts as well as educational experts from 5 different provinces and cities in China. From July 2022 to October 2022, a total of 84 clinical nurses from two hospitals were selected by the convenience sampling method, of which the nurses in one hospital were the control group and the nurses in the other hospital were the observation group. 42 nurses in the observation group were trained by the constructed information literacy training course. Questionnaire evaluation was used to compare the differences in the level of information literacy of nurses and the training effect between the two groups. RESULTS: The results of the Delphi consultation showed that the expert's judgment coefficient was 0.958, the expert's familiarity was 0.946, and the expert's authority coefficient was 0.952. Finally, a training course of information literacy for clinical nurses with 4 course categories and 45 specific course contents was formed. Among them, nursing information awareness included 7 courses, nursing information knowledge 15 courses, nursing information ability 19 courses, and nursing information ethics 4 courses. The results of the empirical study showed that the information literacy level of the nurses in the observation group after the training of the information literacy course was improved, and the scores in nursing information awareness, nursing information knowledge, nursing information ability, and information ethics were significantly higher than those in the control group after training (P < 0.05). CONCLUSIONS: The constructed information literacy training courses for clinical nurses were clearly targeted and systematic. Empirical research showed that the course contents were scientific and reasonable, which could provide reference for the training of clinical nurses' information literacy.

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.

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.

Political views and organizational distrust affect rural residents' willingness to share personal data for COVID-19 contact tracing: A cross-sectional survey study.

Background: We aimed to examine the attitudes of Pennsylvania rural residents toward data sharing in the setting of the COVID-19 pandemic. Specifically, we were interested in better understanding their willingness to provide personal information for contact tracing to public health staff investigating COVID-19 cases, as well as their concerns. We used a validated scale to describe the influence of distrust of healthcare organizations on their attitudes. Methods: We mailed 4000 surveys to rural residents identified from the electronic medical record of a healthcare system in central Pennsylvania. Data were entered into a REDCap database and analyzed using descriptive summaries, and both binomial and multivariable logistic regression. Results: Binomial logistic regression showed that both distrust in healthcare organizations and political values influence respondents' willingness to share information with contact tracers as well as their concerns about sharing personal data. When our multivariable model was applied, political values remained and were consistently associated with willingness to share and concerns about sharing their data. Conclusion: This study is a first step in eliciting rural residents' willingness to share personal data for contact tracing by public health officials. Understanding and addressing rural residents' willingness to share personal data and their concerns about sharing those data will help public health officials identify effective strategies for managing COVID-19 and future pandemics in rural communities. By involving community members at the ground level, public health staff can ensure residents' buy-in for the need to collect their personal data, thereby helping to mitigate the public health crises.

An empirical study of the systemic and technical migration towards microservices.

Context: As many organizations modernize their software architecture and transition to the cloud, migrations towards microservices become more popular. Even though such migrations help to achieve organizational agility and effectiveness in software development, they are also highly complex, long-running, and multi-faceted. Objective: In this study we aim to comprehensively map the journey towards microservices and describe in detail what such a migration entails. In particular, we aim to discuss not only the technical migration, but also the long-term journey of change, on a systemic level. Method: Our research method is an inductive, qualitative study on two data sources. Two main methodological steps take place - interviews and analysis of discussions from StackOverflow. The analysis of both, the 19 interviews and 215 StackOverflow discussions, is based on techniques found in grounded theory. Results: Our results depict the migration journey, as it materializes within the migrating organization, from structural changes to specific technical changes that take place in the work of engineers. We provide an overview of how microservices migrations take place as well as a deconstruction of high level modes of change to specific solution outcomes. Our theory contains 2 modes of change taking place in migration iterations, 14 activities and 53 solution outcomes of engineers. One of our findings is on the architectural change that is iterative and needs both a long and short term perspective, including both business and technical understanding. In addition, we found that a big proportion of the technical migration has to do with setting up supporting artifacts and changing the paradigm that software is developed.

Reducing the Uncertainty of the Moving Object Location Measurement with the Method of Quasi-Multiple Measurement in GNSS Technology in Symmetrical Arrangement.

The article presents a solution to the problem of limited accuracy of dynamic measurements performed with GNSS receivers. The proposed measurement method is a response to the needs related to the assessment of the measurement uncertainty of the position of the track axis of the rail transport line. However, the problem of reducing the measurement uncertainty is universal for many different situations where high accuracy of positioning of objects is required, especially in motion. The article proposes a new method to determine object's location using geometric constraints of a number of GNSS receivers arranged in symmetric configuration. The proposed method has been verified by comparing signals recorded by up to five GNSS receivers during stationary and dynamic measurements. The dynamic measurement was made on a tram track within the framework of a cycle of studies upon effective and efficient methods to catalogue and diagnose tracks. A detailed analysis of the results obtained with the quasi-multiple measurement method confirms remarkable reduction in their uncertainty. Their synthesis shows the usability of this method in dynamic conditions. The proposed method is expected to find application in measurements requiring high accuracy, and in case of deterioration of the signal quality from satellites by one or more of GNSS receivers due to the appearance of natural obstacles.

An Overview of the Fundamentals of Data Management, Analysis, and Interpretation in Quantitative Research.

OBJECTIVES: To provide an overview of three consecutive stages involved in the processing of quantitative research data (ie, data management, analysis, and interpretation) with the aid of practical examples to foster enhanced understanding. DATA SOURCES: Published scientific articles, research textbooks, and expert advice were used. CONCLUSION: Typically, a considerable amount of numerical research data is collected that require analysis. On entry into a data set, data must be carefully checked for errors and missing values, and then variables must be defined and coded as part of data management. Quantitative data analysis involves the use of statistics. Descriptive statistics help summarize the variables in a data set to show what is typical for a sample. Measures of central tendency (ie, mean, median, mode), measures of spread (standard deviation), and parameter estimation measures (confidence intervals) may be calculated. Inferential statistics aid in testing hypotheses about whether or not a hypothesized effect, relationship, or difference is likely true. Inferential statistical tests produce a value for probability, the P value. The P value informs about whether an effect, relationship, or difference might exist in reality. Crucially, it must be accompanied by a measure of magnitude (effect size) to help interpret how small or large this effect, relationship, or difference is. Effect sizes provide key information for clinical decision-making in health care. IMPLICATIONS FOR NURSING PRACTICE: Developing capacity in the management, analysis, and interpretation of quantitative research data can have a multifaceted impact in enhancing nurses' confidence in understanding, evaluating, and applying quantitative evidence in cancer nursing practice.

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.

Moving forward to achieve the ambitions of the European Water Framework Directive: Lessons learned from the Netherlands.

The restoration and preservation of freshwater ecosystems is one of the prerequisites for a sustainable and fair future for all and therefore part of the United Nations Sustainable Development Goals (SDG 6). However, countries worldwide are facing a challenge to achieve this ambition by 2030. This paper focuses on the legal and governance challenges faced in the European context with regard to achieving water quality ambitions, using experiences from the Netherlands as a case study. Although many EU Member States (MS) are facing a challenge to meet the ambitions set by the Water Framework Directive (WFD) in 2027, literature on effectiveness of governance approaches in terms of actual water quality improvement, seems to be scarce. Based on interviews, a survey, expert panel discussions and literature we show that in the Netherlands, an important problem is that stakeholders, also within organisations, have different views on ambitions, achievements and necessary follow-up actions. This is problematic because for realising the water quality ambitions, cross-sectoral cooperation (e.g. from agriculture and spatial development) as well as strengthened interlinkages between these related policy fields is crucial. Moreover, there is a tendency to stick to the status quo. In order to increase effectiveness, a better understanding of the underlying mechanisms for this lock-in will be necessary. This will enable the development of practical tools and instruments to support cross-sectoral and multi-level collaboration. The sectoral implementation of the WFD in the Netherlands was chosen by many other MS, resulting in similar cross-sectoral challenges as we found in the Netherlands. Insight into how other MS deal with lock-in situations is needed to develop pathways to achieving WFD ambitions.