Search

Introduction: Demographic and Health Surveys, widely used for estimation of fertility and reproductive health indicators in developing countries, remain underutilized for the study of pregnancy termination. This is partly due to most surveys not reporting the type of pregnancy termination, whether spontaneous or induced. Reproductive calendar data makes it possible to examine termination patterns according to contraceptive use at the time of pregnancy. Contraceptive failure is expected to increase the likelihood of induced abortion helping in the interpretation of reported termination patterns. Materials and methods: We use individual-level calendar data regarding 623,966 pregnancies to analyze levels and differentials in reported patterns of pregnancy termination by age, union status, and contraceptive use in 107 DHS surveys from 50 countries. From the estimates of the probability of pregnancy termination, we compute derived reproductive health indicators providing an assessment of what is driving the differences by comparison to the few surveys reporting the type of pregnancy termination. Results: From our estimates, 10.9% of pregnancies do not end in live-birth and 63.7% of them are spontaneous terminations. Reported pregnancy termination is higher among women using contraceptives, consistent with expectations. Very low levels of reported PT in some countries, particularly in sub-Saharan Africa, suggests possible underreporting. Differential patterns emerging from cluster analysis and regional rates indicate high rates of pregnancy termination driven by induced abortion in countries from the Former Soviet Union and Asian countries with liberal laws. Most countries with restrictive abortion laws have low levels of reported termination. While the probabilities of pregnancy termination are higher at older ages, termination rates generally peak at younger ages due to higher conception rates. Discussion: This is the first large comparative study of the patterns of reported pregnancy termination in DHS surveys. While we have explored the extent to which differences arise from spontaneous terminations or induced abortion, more research is needed regarding the determinants of reported pregnancy termination. [ABSTRACT FROM AUTHOR]

Background: Culture influences personal health habits and behavior, and healthcare personnel possess different views of cultural perspectives. Currently, an appropriate instrument to assess cultural competence in clinical practice is limited. The present study aimed to develop and examine the psychometric properties of the Nursing Cultural Competence Scale (NCCS) for clinical nurses. Methods: Developing and assessing the scale was carried out in two phases: Phase I involved a qualitative research to explore the themes of nurses’ cultural competence and instrument development; Phase II established construct validity of the scale using a sample of 246 nurses in Taiwan. Data from the questionnaire were analyzed using exploratory factor analysis, confirmatory factor analysis, internal consistency and test-retest reliability. Analysis results were used to determine the reliability and validity of the developed scale. Results: The results showed four factors including cultural awareness ability, cultural action ability, cultural resources application ability, and self-learning cultural ability were generated by exploratory factor analysis, and these factors explained 62.0% of total variance. Cronbach’s α of the Nursing Cultural Competence Scale was .88, and test-retest reliability correlation was .70. Conclusions: The establishment of the tool will facilitate accurate monitoring of the cultural competence among nurses and nursing managers, which can inform the construction of nursing policies aimed at pledge cultural competence expansion. [ABSTRACT FROM AUTHOR]

Introduction: Only a few, large population-based studies, have reported on whiplash-associated disorder (WAD). However, none of them have investigated the influence of crash severity on WAD outcome. In the present study, we aimed to determine whether crash severity predicts outcomes among patients with no-fault government insurance for acute WAD. Methods: We utilized data from a compulsory, no-fault government automobile liability insurance agency in Japan. Individuals involved in a car accident between April 2001 and June 2015 with residual disabilities reported at the end of the treatment between October 2014 and September 2015 were included. Crash severity was assessed based on property damage costs, size of the other vehicle (large car, medium car, small car, or two-wheeled vehicles), and collision types (rear-end collision, contact with vehicle moving in the same direction, or in the opposite direction). Outcomes included the time to claim closure and the number of treatment visits. Results: We analyzed data for a total of 52,251 individuals (28,571 male and 23,680 female) with a median age of 44 years (range: 2–95 years). The median time to claim closure was 220 days (range: 1–4,938 days), and the median number of treatment visits was 102 (range: 1–2,492). There was no significant association between outcomes and property damage costs or size of the other vehicle. Collision types exhibited no consistent association with outcomes. However, older age and affected body parts, in addition to the neck, were independent risk factors for delayed claim closure and a large number of visits, although, all odds ratios were low (often less than 2.0). Conclusions: There was no obvious association of outcomes with property damage costs, size of the other vehicle, or collision types in acute WAD patients. Further studies should investigate the influence of psychological factors, compensation systems, and cultural conditions. [ABSTRACT FROM AUTHOR]

The complex nature of mental well-being is reflected in the great diversity of variables thought to represent aspects of mental flourishing. Discovering the underlying structure of mental well-being is important for a full understanding of this complex construct. Using data from 3 countries (the United States, Japan, and Iran), we performed multi-dimensional scaling to analyze the representation of 9 hedonic and eudaimonic well-being variables in a 2-dimensional psychological space. The analyses revealed 2 interpretable underlying dimensions across cultures and gender groups. The first dimension—eudaimonic well-being versus hedonic well-being—is well-known to well-being researchers. The second dimension—existential relatedness versus Epicurean independence—has not been recognized before. Existential relatedness is the characteristic of being meaningfully interconnected with things other than oneself, and is mainly based on the variables positive relations with others, personal growth, purpose in life, and life satisfaction. Epicurean independence is the characteristic of being relatively free of painful experiences and not feeling the need to have ones’ views accepted by anyone but oneself. Epicurean independence is mainly based on the variables autonomy and absence of negative affect. We explain these dimensions in detail and discuss the implications for well-being research and policy. [ABSTRACT FROM AUTHOR]

Overconfidence is sometimes assumed to be a human universal, but there remains a dearth of data systematically measuring overconfidence across populations and contexts. Moreover, cross-cultural experiments often fail to distinguish between placement and precision and worse still, often compare population-mean placement estimates rather than individual performance subtracted from placement. Here we introduce a procedure for concurrently capturing both placement and precision at an individual level based on individual performance: The Elicitation of Genuine Overconfidence (EGO) procedure. We conducted experiments using the EGO procedure, manipulating domain, task knowledge, and incentives across four populations—Japanese, Hong Kong Chinese, Euro Canadians, and East Asian Canadians. We find that previous measures of population-level overconfidence may have been misleading; rather than universal, overconfidence is highly context dependent. Our results reveal cross-cultural differences in sensitivity to incentives and differences in overconfidence strategies, with underconfidence, accuracy, and overconfidence. Comparing sexes, we find inconsistent results for overplacement, but that males are consistently more confident in their placement. These findings have implications for our understanding of the adaptive value of overconfidence and its role in explaining population-level and individual-level differences in economic and psychological behavior. [ABSTRACT FROM AUTHOR]

Introduction: Instrumental activities of daily living (IADL) are cognitively complex activities related to independent living in the community. Robust IADL scales are needed, however the psychometric properties of instruments have been little evaluated. There is no validated instrument for Sri Lankan older populations. Sri Lanka has the highest proportion of older people in South Asia with rapid population ageing. Therefore, it is essential to have standard instruments to assess activity limitations. We aimed to cross-culturally adapt the original Lawton Instrumental Activities of Daily Living Scale from English to Sinhala and evaluate the psychometric properties of the Sinhala version. Methods: Cross-cultural adaptation of the instrument was performed. The instrument was validated in a sample of 702 community-dwelling older adults aged 60 years and above in Sri Lanka. Reliability (internal consistency and inter-rater reliability) was assessed. Construct validity of the scale was evaluated by performing exploratory and confirmatory factor analysis and testing convergent and divergent validity. Results: The Lawton IADL scale was successfully adapted to Sri Lankan context. Internal consistency of the scale was very high (Cronbach’s alpha = 0.91). Very good inter-rater reliability was observed with very good agreement for all items. Inter-class correlations for overall IADL score ranged from 0.57 to 0.91. Results of the exploratory and confirmatory factor analyses supported the unidimensionality of the scale. Goodness of fit indices in confirmatory factor analysis were in acceptable range (CFI = 0.98, SRMR = 0.06, NNFI = 0.97). Strength of associations were significant and in the expected direction. Results of the known group validity were also significant, confirming the convergent and divergent validity. Conclusion: The Lawton IADL scale was successfully translated and culturally adapted to Sinhala language. The Sinhala version demonstrated excellent reliability and construct validity. Given good psychometric properties, this scale would be recommended for use in future research. [ABSTRACT FROM AUTHOR]

Although pettiness, defined as the tendency to get agitated over trivial matters, is a facet of neuroticism which has negative health implications, no measure exists. The goal of the current study was to develop, and validate a short pettiness scale. In Study 1 (N = 2136), Exploratory Factor Analysis distilled a one-factor model with five items. Convergent validity was established using the Big Five Inventory, DASS, Satisfaction with Life Scale, and Conner-Davidson Resilience Scale. As predicted, pettiness was positively associated with neuroticism, depression, anxiety and stress but negatively related to extraversion, agreeableness, conscientiousness, openness, life satisfaction and resilience. Also, as predicted, pettiness was not significantly related to physical functioning, or blind and constructive patriotism, indicating discriminant validity. Confirmatory Factor Analysis in Study 2 (N = 734) revealed a stable one-factor model of pettiness. In Study 3 (N = 532), the scale, which showed a similar factor structure in the USA and Singapore, also reflected predicted cross-cultural patterns: Pettiness was found to be significantly lower in the United States, a culture categorized as “looser” than in Singapore, a culture classified as “tighter” in terms of Gelfand and colleagues’ framework of national tendencies to oppose social deviance. Results suggest that this brief 5-item tool is a reliable and valid measure of pettiness, and its use in health research is encouraged. [ABSTRACT FROM AUTHOR]

Culture shapes individuals, but the measurement of cultural differences has proven a challenge. Traditional measures of cultural values focus on individual perceptions. We suggest that values are established and maintained within social communities of proximate others, such as the family and its social environment. Within such communities, values serve to maintain collective harmony whilst preserving individual agency. From a social-dynamic analysis of communities, we infer that community values of loyalty regulate individual commitment, values of honor regulate norm compliance, and values of group hierarchy maintain a division of labor. In addition, communities may regulate the ways in which individuals have independent agency. A new scale to measure these values was validated in four studies (N = 398, 112, 465 and 111) among Dutch (religious and non-religious), Turkish-Dutch, Surinamese and Turkish groups. Values and practices were measured at the level of the individual (‘What do you value?’) and at the level of the perceived community (‘What does your community value?’). Results show that, unlike individual-level measures of individualism/collectivism, this scale has excellent reliability, differentiates between cultural groups, and has predictive validity for future (voting) behavior. This approach provides a new way of conceptualizing culture, a new measure of collectivism and new insights into the role of proximate others in shaping culture. [ABSTRACT FROM AUTHOR]

Current theories of numerical cognition posit that uniquely human symbolic number abilities connect to an early developing cognitive system for representing approximate numerical magnitudes, the approximate number system (ANS). In support of this proposal, recent laboratory-based training experiments with U.S. children show enhanced performance on symbolic addition after brief practice comparing or adding arrays of dots without counting: tasks that engage the ANS. Here we explore the nature and generality of this effect through two brief training experiments. In Experiment 1, elementary school children in Pakistan practiced either a non-symbolic numerical addition task or a line-length addition task with no numerical content, and then were tested on symbolic addition. After training, children in the numerical training group completed the symbolic addition test faster than children in the line length training group, suggesting a causal role of brief, non-symbolic numerical training on exact, symbolic addition. These findings replicate and extend the core findings of a recent U.S. laboratory-based study to non-Western children tested in a school setting, attesting to the robustness and generalizability of the observed training effects. Experiment 2 tested whether ANS training would also enhance the consistency of performance on a symbolic number line task. Over several analyses of the data there was some evidence that approximate number training enhanced symbolic number line placements relative to control conditions. Together, the findings suggest that engagement of the ANS through brief training procedures enhances children's immediate attention to number and engagement with symbolic number tasks. [ABSTRACT FROM AUTHOR]