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Humans operate in groups that are oftentimes nested in multilayered collectives such as work units within departments and companies, neighborhoods within cities, and regions within nation states. With psychological science mostly focusing on proximate reasons for individuals to join existing groups and how existing groups function, we still poorly understand why groups form ex nihilo, how groups evolve into complex multilayered social structures, and what explains fission–fusion dynamics. Here we address group formation and the evolution of social organization at both the proximate and ultimate level of analysis. Building on models of fitness interdependence and cooperation, we propose that socioecologies can create positive interdependencies among strangers and pave the way for the formation of stable coalitions and groups through reciprocity and reputation-based partner selection. Such groups are marked by in-group bounded, parochial cooperation together with an array of social institutions for managing the commons, allowing groups to scale in size and complexity while avoiding the breakdown of cooperation. Our analysis reveals how distinct group cultures can endogenously emerge from reciprocal cooperation, shows that social identification and group commitment are likely consequences rather than causes of group cooperation, and explains when intergroup relations gravitate toward peaceful coexistence, integration, or conflict. [ABSTRACT FROM AUTHOR]

Addressing inequality is a critical challenge for society as a whole and requires sustained efforts to promote fairness and opportunity for all. Filling in the resource gap across social classes is essential in reducing inequality. Previous studies have revealed that ingroup favouritism hinders the rich from cooperating with the poor and expands the wealth gap. Nevertheless, how to find ways of narrowing the gap between the rich and the poor remains an open question. Inducing rich–poor cooperation could be effective in eliciting resource flow across classes. In this study, two experiments using a modified Prisoner's Dilemma game were conducted in Japan (N = 213) and China (N = 150) to examine whether highlighting partners' cooperativeness under permeable group boundaries induces rich–poor cooperation. All participants were allocated to the rich group and participated in the game with programmed rich‐ or poor‐group partner bots, whose cooperation rates were manipulated. Despite the initial resource disparities between participants and the partner bots, participants were more likely to select and cooperate with cooperative poor‐group partners than with non‐cooperative rich‐group partners. Generalized trust played an important role in the enhancement of rich–poor cooperation. The findings shed light on the possibility of reducing inequality and promoting social mobility in society. [ABSTRACT FROM AUTHOR]

Citizens' trust in government is crucial in managing crises that require coordination as it is linked to cooperative behaviour and sociability. Willingness to adopt appropriate health measures plays a decisive role in the effective containment of COVID-19 and other pandemics. Preventive health measures such as physical distancing, avoiding crowded places, wearing masks, and frequent hand washing reduce the spread of the virus. In this study, we examined how trust in government, risk perception, and knowledge were separately and jointly related to compliance with preventive health measures. We focused on young adults who are less prone to the disease than older demographics, who therefore have fewer incentives to protect themselves, and are accordingly pertinent for the study of public health and understandings of risk. Using recent data from a survey completed by 2,455 young people in Luxembourg, we employed structural equation modelling to assess our hypotheses. We found that trust in government, risk perceptions, and COVID-19 knowledge are important predictors of young people's adherence to health measures and prosocial protection. Additionally, these factors are interrelated in several complex and non-linear ways. Our findings provide insights into young people's specific health behaviours, highlighting the roles of risk perception and trust in government in mitigating the spread of COVID-19 and other infectious diseases. [ABSTRACT FROM AUTHOR]

To understand how compliance develops both in everyday and corporate environments, it is crucial to understand how different mechanisms work together to shape individuals' (non)compliant behavior. Existing compliance studies typically focus on a subset of theories (i.e., rational choice theories, social theories, legitimacy theories, capacity theories, and opportunity theories) to understand how key variables from one or several of these theories shape individual compliance. The present study provides a first integrated understanding of compliance, rooted in complexity science, in which key elements from these theories are considered simultaneously, and their relations to compliance and each other are explored using network analysis. This approach is developed by analyzing online survey data (N = 562) about compliance with COVID-19 mitigation measures. Traditional regression analysis shows that elements from nearly all major compliance theories (except for social theories) are associated with compliance. The network analysis revealed groupings and interconnections of variables that did not track the existing compliance theories and point to a complexity overlooked in existing compliance research. These findings demonstrate a fundamentally different perspective on compliance, which moves away from traditional narrow, non-network approaches. Instead, they showcase a complexity science understanding of compliance, in which compliance is understood as a network of interacting variables derived from different theories that interact with compliance. This points to a new research agenda that is oriented on mapping compliance networks, and testing and modelling how regulatory and management interventions interact with each other and compliance within such networks. [ABSTRACT FROM AUTHOR]

Ingroup/outgroup categorisation is a repeatedly found phenomenon. Given the long‐standing caste system, the Indian societal structure provides a unique perspective on such social categorisation. The Indian caste system contains hereditarily inherited identity roles defining profession and status‐based hierarchies. In this preregistered experiment, we investigate the influence of caste‐based identity on cooperation using a (hypothetical) Prisoner's Dilemma. Specifically, Indian participants (N = 685) were paired with a (hypothetical) other in a Prisoner's Dilemma, whose last name reflected either a general caste (i.e., a "high" caste) or a backward ("lower") caste including the scheduled caste, scheduled tribe, and other backward classes. Because participants indicated belonging to a general or a backward caste themselves, they thus played the (hypothetical) Prisoner's Dilemma with either a member of the same or a different caste group. We did not find that the partner's caste group membership in terms of stemming from an ingroup (same caste) or outgroup (different caste) influenced participants' cooperation. Further, we found participants from the general caste to be more cooperative when paired with (hypothetical) backward caste others (outgroup), compared to backward caste participants when paired with (hypothetical) general caste participants (outgroup); however, this difference disappeared once controlling for other demographic characteristics. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the past, the designers used to dominate and conduct user-centered design and research. The findings of such surveys might not reflect the user needs and produce the best design solutions. OBJECTIVE: This project aimed to use PD to introduce the design curriculum to break through the previous user-centered design thinking, as the designer and the user design together, with the user given the right to lead the entire design process. METHODS: The theme of this research design is tableware; 55 students and 11 elderly (over the age of 65) were invited to participate in this study. Questionnaires divided into the beginning, middle and final stages tested the teaching effectiveness of PD. RESULTS: The results showed that PD effectively improves five points: (1) design concepts and attitudes, (2) design methods, (3) problem solving and communication skills, (4) implementing design concepts, and (5) responding to the variety of user needs. CONCLUSION: This PD teaching model employs a well-established practical process to form an effective teaching routine, which is expected to be universally applied to other related design courses. [ABSTRACT FROM AUTHOR]

While the study of offline prosocial behavior has a long tradition, much less information is available about how these behaviors manifest and change in the digital environment, and little is known about their background. This paper evaluates differences by age and gender in a variety of attitudes and beliefs during adolescence and studies their influence on the online prosocial behavior emitted and received. A cross-sectional study was performed with 1299 participants aged between 14 and 20 from the Region of Madrid (Spain). The Spanish adaptation of the Online Prosocial Behavior Scale and a selection of items from various studies on attitudes and beliefs regarding altruism, direct and indirect reciprocity, social responsibility, and the perception of the subjective norm were administered. The results suggest that female adolescents maintain higher altruism, social responsibility, and indirect reciprocity than males, and that the older age group (18–20 years old) has higher scores in altruism, social responsibility, and direct reciprocity. Together with altruism, the subjective norm, social responsibility, and indirect reciprocity positively influence the online prosocial behavior emitted by adolescents. Indirect reciprocity, the subjective norm and altruism also influence the feeling of receiving online prosocial behaviors from others. Knowing the extent to which adolescents hold prosocial beliefs and which of these beliefs may favor prosocial online behaviors can be beneficial when promoting such beliefs and fostering more positive online conduct, as well as lessening cyberbullying, online hate and any other manifestation of aggressive behavior online. • Social networks constitute a space for the socialization of prosocial behavior in adolescence. • Beliefs about altruism, social responsibility, and indirect reciprocity favor the emission of online prosocial behavior. • Beliefs about altruism and indirect reciprocity favor greater perception of receiving prosocial behaviors online. • The prosocial subjective norm favors both the emission and reception of online prosocial behaviors. • Direct reciprocity does not seem to influence the emission and reception of online prosocial behaviors. [ABSTRACT FROM AUTHOR]

Background: Collaboration is the way to deliver the desired health outcome for the patients or service users in the healthcare. Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between physicians and pharmacists within the public hospitals of Jigjiga town, Somali National Regional State, Ethiopia, 2020.Methods: A cross-sectional study qualitative was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians.Results: This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals' collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established.Conclusions: The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration.Recommendation: Physicians and pharmacists need to exert more efforts to enhance this collaboration. Further qualitative study might be needed to search for factors affecting, barriers and how to develop collaborative practice. [ABSTRACT FROM AUTHOR]

This study sought to generate new knowledge in the description and comparison of perceived barriers to implementation of mobility programs and practice guidelines as identified through the self-reports of healthcare team members. [ABSTRACT FROM AUTHOR]

According to contesting theory (Shields & Bredemeier, 2011), people conceptualize competition either through a metaphor of partnership or war. These two alternate metaphors suggest differing sociomoral relationships among the participants. In the current study of intercollegiate athletes (n = 610), we investigated the two approaches to contesting in relation to formalist and consequentialist moral frameworks (Brady & Wheeler, 1996) and individualizing and binding moral foundations (Haidt, 2001). Correlational analysis indicated that the partnership approach correlated significantly with all four moral dimensions, while the war approach correlated with formalist and consequentialist frameworks and binding foundations (i.e., appeals to in-group loyalty, authority, and purity). Multiple regressions demonstrated that the best predictors of a partnership approach were formalist thinking and endorsement of individualizing moral foundations (i.e., appeal to fairness and welfare). Among our primary variables, the best predictors of a war orientation were consequentialist thinking and endorsement of binding foundations. [ABSTRACT FROM AUTHOR]

Therapists are faced with the challenge of developing effective ways to advance cross-cultural engagement with a rapidly growing diverse client population. In this qualitative study, we characterized the way clients and therapists described the quality of working alliance during the mental health intake and examined whether these descriptions vary as a function of their social identities. We conducted in-depth interviews with Ashkenazi (socially advantaged group; n = 22) therapists and their Mizrahi (socially disadvantaged group n = 29) or Ashkenazi (n = 26) clients immediately following their intake session in four mental health clinics in Israel. We performed a thematic analysis. Overall, interrater reliability among three raters who coded the narratives was high (kappa = 0.72, therapist; 0.70, client). Across all client and therapist interviews, we identified eight central themes detailing different qualities of the working alliance: (1) feeling understood, (2) feeling comfortable, (3) openness and cooperation, (4) trust, (5) empathy and identification, (6) frustration and disappointment, (7) anger and hostility, and (8) emotional disengagement. On average, clients reported 2.56 (standard deviation = 1.17) and therapists described 2.65 (standard deviation = 1.45) themes in each session. Overall, concordant and discordant dyads described similar themes with few exceptions. In particular, being part of a discordant dyad may affect the client's interpretation of non-verbal communication as well as the therapist's evaluation of the client's openness and trustworthiness. Although less frequent, when anger and hostility were described by therapists, these characterized the interaction with Mizrahi clients. We discuss implications to care including the need to promote a culturally humble approach to providing care for minorities. [ABSTRACT FROM AUTHOR]

New Zealand is a peaceful nation, but ongoing political tensions and inequities between Māori (the indigenous peoples of New Zealand) and Pākehā (the majority group of Europeans) persist as a result of its colonial history. Identifying ways to redress the enduring legacy of colonialism are therefore of critical importance. Accordingly, this paper examines data from 7017 Māori, as well as 37,233 Pākehā, to examine the impact of regional-level Pākehā warmth towards Māori on Māori support for progressive collective action. Results reveal that Pākehā warmth towards Māori varies markedly across 257 regional wards (regional units created for New Zealand electoral purposes). Moreover, multilevel modelling demonstrates that Pākehā warmth towards Māori at the region-level correlates positively with Māori identity and political efficacy at the individual level which, in turn, both correlate positively with collective action support. Collectively, these results demonstrate the impact of the broader social climate on social change, while identifying a previously-unknown facilitator of collective action support (namely, a broader context of warmth towards structurally disadvantaged groups). [ABSTRACT FROM AUTHOR]

Enormous progress has been made in the field of rheumatology in the past several decades, historically led by publicly funded academic innovators but in more recent times with much greater involvement of the pharmaceutical industry. This shift in resources has created a complex new model for reinvestment in the medical community in which the vast majority of private funds are redirected towards influencing the prescription behaviour of practitioners through 'key opinion leaders', with the main purpose of enhancing and perpetuating profit rather than innovation and critical thinking, and often at the expense of partnerships with scientists (that is, basic and translational researchers) and academic collaborations. This new episteme brings multiple opportunities to rethink approaches to sustaining long-term critical research in the field, ultimately maximizing the return on investment: scientific knowledge for the benefit of patients and society. Central to such strategies should be the rebalancing of academia-industry partnerships towards academic research and the involvement of 'innovation and knowledge leaders', rather than mostly key opinion leaders. [ABSTRACT FROM AUTHOR]

Worldwide, leaders are implementing nonpharmaceutical interventions to slow transmission of the novel coronavirus while pursuing vaccines that confer immunity to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. In this article we describe lessons learned from past pandemics and vaccine campaigns about the path to successful vaccine delivery. The historical record suggests that to have a widely immunized population, leaders must invest in evidence-based vaccine delivery strategies that generate demand, allocate and distribute vaccines, and verify coverage. To generate demand, there must be an understanding of the roots of vaccine hesitancy, involvement of trusted sources of authority in advocacy for vaccination, and commitment to longitudinal engagement with communities. To allocate vaccines, qualified organizations and expert coalitions must be allowed to determine evidence-based vaccination approaches and generate the political will to ensure the cooperation of local and national governments. To distribute vaccines, the people and organizations with expertise in manufacturing, supply chains, and last-mile distribution must be positioned to direct efforts. To verify vaccine coverage, vaccination tracking systems that are portable, interoperable, and secure must be identified. Lessons of past pandemics suggest that nations should invest in evidence-informed strategies to ensure that coronavirus disease 2019 (COVID-19) vaccines protect individuals, suppress transmission, and minimize disruption to health services and livelihoods. [ABSTRACT FROM AUTHOR]

Drawing on data from fieldwork in a Norwegian care home for people diagnosed with dementia, the article focuses on how social ordinariness is produced by professional practices and co‐operation with residents. Through the lens of ethnomethodological and other pragmatist approaches to ordinariness, social agency and identity, the article uses interviews and observations to explore how residents in a care home were given the opportunity to act as ordinary persons and maintain ordinariness despite their illness. The analysis shows that a social and moral norm of ordinariness was central for how professional care work was performed in the care home. To help residents maintaining ordinariness was an essential part of caring work and to accomplish this, residents were regularly involved in activities they recognised from their everyday lives. This helped them holding on to their identities. The activities were regulated by situational rules that avoided stigmatising behaviour and maintained the residents' dignity. [ABSTRACT FROM AUTHOR]

Aims: To explore inter-professional communication and collaboration in guideline-concordant diabetes and periodontitis care.Methods: Qualitative design using iterations of workshops to identify ways to improve multidisciplinary working attended by staff from medical and dental primary care practices, and people with diabetes (n=43). Workshops were semi-structured around a topic guide. Recruitment was via the UK Clinical Research Network, and a patient and public involvement group in the North of England.Results: Medical practice participants were unaware of the bidirectional evidence linking diabetes and periodontitis and stated that they had never received a referral from a dental professional in this context. The patient participants with diabetes reported never having been informed about the links between diabetes and periodontitis from either their family physician or dentist. Medical and dental practice participants gave negative accounts of inter-professional communication, with claims of inappropriate requests and defensive or non-responses that stymied future interaction. Indirect communication through the patient was suggested as an alternative to direct communication.Conclusions: Indirect referral, whereby the patient is signposted to a healthcare professional, was suggested by medical and dental professionals as a useful alternative to the traditional (and time consuming) letter or telephone call, particularly in the case of suspected diabetes or periodontitis. [ABSTRACT FROM AUTHOR]

Background: Many UK GP practices now employ a practice pharmacist, but little is known about how GPs and pharmacists work together to optimise medications for complex patients with multimorbidity.Aim: To explore GP and pharmacist perspectives on collaborative working within the context of optimising medications for patients with multimorbidity.Design and Setting: A qualitative analysis of semi-structured interviews with GPs and pharmacists working in the West of England, Northern England, and Scotland.Method: Thirteen GPs and 10 pharmacists were sampled from practices enrolled in the 3D trial (a complex intervention for people with multimorbidity). Participants' views on collaborative working were explored with interviews that were audiorecorded, transcribed, and analysed thematically. Saturation of data was achieved with no new insights arising from later interviews.Results: GPs from surgeries that employed a pharmacist tended to value their expertise more than GPs who had not worked with one. Three key themes were identified: resources and competing priorities; responsibility; and professional boundaries. GPs valued pharmacist recommendations that were perceived to improve patient safety, as opposed to those that were technical and unlikely to benefit the patient. Pharmacists who were not known to GPs felt undervalued and wanted feedback from the GPs about their recommendations, particularly those that were not actioned.Conclusion: A good working relationship between the GP and pharmacist, where each profession understood the other's skills and expertise, was key. The importance of face-to-face meetings and feedback should be considered in future studies of interdisciplinary interventions, and by GP practices that employ pharmacists and other allied health professionals. [ABSTRACT FROM AUTHOR]

Traditionally, bilateral mastectomy (BM) operations are performed by a single surgeon but a two‐attending co‐surgeon technique (CST) has been described. A questionnaire was sent to members of the American Society of Breast Surgeons to assess national BM practices and analyze utilization and perceived benefits of the CST. Among surgeons responding, most continue to use the single‐surgeon approach for BMs; however, 14.1% utilize the CST and up to 31% are interested in future CST use. Time savings, mentorship, cost savings, and opportunity to learn new techniques were identified as perceived CST advantages. [ABSTRACT FROM AUTHOR]

Rationale: Lung-protective ventilation (LPV) improves outcomes in patients with acute respiratory distress syndrome (ARDS) and has also shown benefits in patients without ARDS. Despite this evidence, LPV use remains low.Objectives: To understand clinicians' perceptions of using behavioral economic strategies to improve rates of LPV use.Methods: We conducted semistructured interviews of clinicians across seven intensive care units within a university health system. We purposefully sampled clinicians of different professional backgrounds and experience levels. Each interview included descriptions of three of five strategies grounded in behavioral economic theory designed to facilitate clinicians' use of LPV: 1) an order set autopopulated with LPV settings ("default"), 2) an order set providing a choice between autopopulated LPV settings and open-ended order entry for alternative settings ("active choice"), 3) requirement of written justification if settings other than LPV were ordered or documented ("accountable justification"), 4) automated ARDS identification and clinician prompting ("alert"), and 5) provision of clinicians' and their peers' individual rates of LPV use ("peer comparison"). Descriptions were followed by open-ended questions to elicit perceptions about advantages, disadvantages, and acceptability. Initial interview transcripts were reviewed by two investigators to develop a thematic codebook, which was refined iteratively with the use of constant comparative methods.Results: We completed 17 interviews of physicians, nurse practitioners, and respiratory therapists. Strategies that prepopulated settings (default, active choice, and accountable justification) were perceived as providing benefit by reducing workloads and serving as cognitive prompts. The default and active choice strategies were more acceptable than accountable justification, which was perceived as potentially frustrating due to workflow impedance. The alert strategy was met with concerns about alert accuracy and alarm fatigue. The peer comparison strategy led to concerns about timing and fear of punitive measures. Participants believed that the default and active choice strategies would be highly acceptable, whereas few interviewees thought the alert would be acceptable. The active choice strategy was most consistently identified as potentially highly effective.Conclusions: Behavioral economic strategies have great potential as acceptable and potentially effective strategies to increase the use of LPV. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion. Background: Seclusion should only be used as a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals' decision to seclude. Little is known about factors professionals consider when releasing service users. Design: A qualitative study was undertaken to explore factors which influence decision‐making of mental health professionals when terminating episodes of seclusion. Methods: Semi‐structured face‐to‐face interviews with 21 professionals were undertaken between May 2017–January 2018. Framework analysis was used to systematically manage, analyse, and identify themes, while maintaining links to primary data and providing a transparent audit trail. Results: Six themes were identified where professionals looked for service users to demonstrate cooperation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol. Conclusion: Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involves in decisions regarding seclusion should be explored. Impact: Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded. [ABSTRACT FROM AUTHOR]

Healthcare is increasingly complex and requires the ability to adapt to changing demands. Teamwork is essential to delivering high quality care and is central to nursing. The aims of this study were to identify the processes that underpin nursing teamwork and how these affect the care of older people, identify the relationship between perceived teamwork and perceived quality of care, and explore in depth the experience of working in nursing teams. The study was carried out in three older people's wards in a London teaching hospital. Nurses and healthcare assistants completed questionnaires (n = 65) on known dynamics of teamwork (using the Nursing Teamwork Survey) together with ratings of organisational quality (using an adapted AHRQ HSPS scale). A sample (n = 22; 34%) was then interviewed about their perceptions of care, teamwork and how good outcomes are delivered in everyday work. Results showed that many care difficulties were routinely encountered, and confirmed the importance of teamwork (e.g. shared mental models of tasks and team roles and responsibilities, supported by leadership) in adapting to challenges. Perceived quality of teamwork was positively related to perceived quality of care. Work system variability and the external environment influenced teamwork, and confirmed the importance of team adaptive capacity. The CARE model shows the centrality of teamwork in adapting to variable demand and capacity to deliver care processes, and the influence of broader system factors on teamworking. [ABSTRACT FROM AUTHOR]

Family meetings, which bring together members of a seriously ill patient's family and the interprofessional team (IPT), have been widely recognized as promoting shared decision-making for hospitalized patients, particularly those in intensive care units. The planning and conducting of interprofessional family meetings are hampered, however, by a lack of clarity about who is doing what and when, which in turn can lead to inefficiencies and uncoordinated efforts. This article describes how members of the IPT interact with one another (what we have termed team-team practices), distinguishing these interactions from how the IPT engages directly with family members (team-family practices) in preparing for and conducting family meetings. Although most research and guidelines have focused on team-family practices that directly affect patient- and family-level outcomes (e.g., safety and satisfaction), team-team practices are needed to coordinate team contributions and optimize the skills of the diverse team. Team members' knowledge and attitudes also contribute to patient and family outcomes as well as team outcomes. Yet without attention to team-team practices before, during, and after a family meeting, the family-level outcomes are less likely to be achieved as are team well-being outcomes (e.g., reduced burnout and staff retention). Drawing upon team theory, we present a set of key concepts and corresponding terms that enable a more precise description of team-team practices and team-family practices, aiming to help with team training and evaluation and to enable future research of these distinct yet inter-related practices. [ABSTRACT FROM AUTHOR]

Aim: The aim was to support rich collaborative practice between two professions who frequently work together across both ordered and organic modes of collaboration. Methods: This study uses a qualitative research approach of collaborative dialogical inquiry to explore the question 'From the perspective of dietitians and speech pathologists, "what works well" for developing and maintaining collaborative practice?' We deliberately chose a context where collaborative practice is evident, University Department of Rural Health (UONDRH). Participants in the research were academics and clinicians from dietetics and speech pathology. Data were sourced from our research reflections and focus group transcriptions. Analysis was dialogical and iterative. Results: Beyond shared purpose, knowledge of roles and good communication, the notions of curiosity, willingness and momentum were at the core of 'what works well' for collaborative practice between dietitians and speech pathologists. Participant perspectives related to collaborative practice between these professions and beyond to other professions, and involved collaborative practice within and across healthcare organisations and a university setting. Conclusions: Our interpreted themes of curiosity, willingness and momentum for developing and maintaining collaborative practice highlight the importance of paying attention to the less visible and difficult to measure aspects of patient‐centred care. Questions for reflection are suggested to inform the ongoing process of developing and maintaining our and others' collaborative practice. [ABSTRACT FROM AUTHOR]

Objective: To understand primary care patients' and clinicians' experiences with diagnosis and treatment of patients with bipolar disorder in primary care.Methods: We conducted a qualitative study using thematic content analysis of individual interviews with nine primary care clinicians and six patients from Federally Qualified Health Centers to understand their experiences with the diagnosis and treatment of bipolar disorder.Results: Themes of bipolar disorder detection, referral to specialty mental health care and medication treatment emerged from individual interviews with primary care patients and clinicians. Clinicians and patients faced challenges deciding to continue with care in primary care that is easier to access, but less intensive, than specialty care that can be harder to access but at times of higher quality.Conclusions: Potential next steps in research include identifying ways to support primary care clinicians in detection of patients with bipolar disorder, and strategies to support treatment of patients in primary care with easier access to specialty care including consultation in primary care or co-management with specialty care. [ABSTRACT FROM AUTHOR]

This article reports on a cluster randomized trial of cooperative learning (CL) as a way to prevent escalation in alcohol use during middle school (N = 1,460 seventh-grade students, age 12-13, seven intervention and eight control schools). We hypothesized that CL, by bringing students together in group-based learning activities using positive interdependence, would interrupt the process of deviant peer clustering, provide at-risk youth with prosocial influences, and in turn, reduce escalations in alcohol use. Results indicated that CL significantly reduced growth in deviant peer affiliation and actual alcohol use, and effects for willingness to use alcohol were at the threshold of significance (p = .05). CL also attenuated the link between willingness to use alcohol and later alcohol use. [ABSTRACT FROM AUTHOR]

Full integration of oncology and palliative care relies on the specific knowledge and skills of two modes of care: the tumour-directed approach, the main focus of which is on treating the disease; and the host-directed approach, which focuses on the patient with the disease. This Commission addresses how to combine these two paradigms to achieve the best outcome of patient care. Randomised clinical trials on integration of oncology and palliative care point to health gains: improved survival and symptom control, less anxiety and depression, reduced use of futile chemotherapy at the end of life, improved family satisfaction and quality of life, and improved use of health-care resources. Early delivery of patient-directed care by specialist palliative care teams alongside tumour-directed treatment promotes patient-centred care. Systematic assessment and use of patient-reported outcomes and active patient involvement in the decisions about cancer care result in better symptom control, improved physical and mental health, and better use of health-care resources. The absence of international agreements on the content and standards of the organisation, education, and research of palliative care in oncology are major barriers to successful integration. Other barriers include the common misconception that palliative care is end-of-life care only, stigmatisation of death and dying, and insufficient infrastructure and funding. The absence of established priorities might also hinder integration more widely. This Commission proposes the use of standardised care pathways and multidisciplinary teams to promote integration of oncology and palliative care, and calls for changes at the system level to coordinate the activities of professionals, and for the development and implementation of new and improved education programmes, with the overall goal of improving patient care. Integration raises new research questions, all of which contribute to improved clinical care. When and how should palliative care be delivered? What is the optimal model for integrated care? What is the biological and clinical effect of living with advanced cancer for years after diagnosis? Successful integration must challenge the dualistic perspective of either the tumour or the host, and instead focus on a merged approach that places the patient's perspective at the centre. To succeed, integration must be anchored by management and policy makers at all levels of health care, followed by adequate resource allocation, a willingness to prioritise goals and needs, and sustained enthusiasm to help generate support for better integration. This integrated model must be reflected in international and national cancer plans, and be followed by developments of new care models, education and research programmes, all of which should be adapted to the specific cultural contexts within which they are situated. Patient-centred care should be an integrated part of oncology care independent of patient prognosis and treatment intention. To achieve this goal it must be based on changes in professional cultures and priorities in health care. [ABSTRACT FROM AUTHOR]

Publicly insured children needing referral to mental health (MH) services often do not access or receive services. The objective of this study was to identify gaps in communication and coordination between primary care providers (PCPs) and MH providers during the MH referral and care process for publicly insured children. Thirteen semi-structured interviews were conducted with 10 PCPs and staff from a federally qualified health center (FQHC) and 6 MH providers and staff from two local MH clinics. Interview participants identified multiple gaps in communication throughout the care process and different phases as priorities for improvement. PCPs described primary care-MH communication challenges during early phases, while MH providers described coordination challenges in transferring patients back to primary care for ongoing mental health management. Strategies are needed to improve primary care-specialty MH communication and coordination throughout all phases of the referral and care process, particularly at initial referral and transfer back to primary care. [ABSTRACT FROM AUTHOR]

This study identified how the manipulation in the number of goal targets affects the tactical behaviour of players from different age groups (U9, U11, U15 and U17). Forty youth futsal players performed two small-sided games based on Gk + 4vs4 + Gk situation with one regular and two small targets. TACTO software was used to capture players and ball displacements. The following variables were computed and presented as absolute values, coefficient of variation and regularity (approximate entropy): (i) distance from each player to the team centre (DtC); (ii) distance from each player to the ball (DtB); (iii) distance between team centres (DbTC); and (iv) distance from team centre to the ball (DCtB). The team dispersion increased with two goal targets (mainly the DbTC, U9 and U17, large effects; U11 and U15, very large effects). Also, the use of two goal targets condition increased the variability in the DbTC (U9, small effects; U11 and U15 moderate effects; U17, very large effects) and DCtB (U9 and U17 moderate effects and U11 and U15 small effects). Overall, the approximate entropy values showed higher regularity in the condition with two targets. All age groups were sensitive to the manipulation of goal targets, however, the U9 were the most sensitive to the changes, as seen by the dispersion of players in the field. Thus, coaches can use one target to promote movement irregularity of players and two targets to increase the team dispersion, mainly in younger age groups that tend to be agglomerated around the ball. [ABSTRACT FROM AUTHOR]

Background Healthcare is provided by a variety of different professionals, including pharmacists who are integral members of the team, and all are expected to work collaboratively to provide quality care. Little is known about the perceptions of pharmacists in Qatar towards interprofessional collaboration. Positive attitudes towards interprofessional education are essential to successful implementation of interprofessional collaboration. Therefore, to develop effective collaboration strategies in practice settings, it was essential to survey the attitudes of practising pharmacists towards collaboration. Objective To explore the awareness, views, attitudes and perceptions of practising pharmacists in Qatar towards interprofessional education and collaborative practice. Setting Community, hospital and primary healthcare settings in Qatar. Methods This was a two-staged sequential explanatory mixed method design. It utilised a quantitative survey (Stage 1), based on a modified version of the Readiness for Interprofessional Learning Scale. This was followed by a qualitative stage, utilising focus groups (Stage 2). Main outcome measures (1) Qatar pharmacists' attitudes towards interprofessional education and collaborative practice; (2) Practising pharmacists' perspectives in relation to enablers, barriers and recommendations regarding interprofessional education and collaborative practice. Results 63% of the practising pharmacists (n = 178) responded to the survey. Three focus groups followed (total n = 14). High scores indicating readiness and positive attitudes towards interprofessional education were reported for pharmacists working in hospital, community and primary healthcare settings. Qualitative analysis identified three overarching themes in relation to the enablers, barriers and recommendations for practising pharmacists working collaboratively. The enabling themes were: professional and patient related benefits, and current positive influences in Qatar; the barriers were patients' negative perceptions; the status of the pharmacy profession and current working practices and processes; the recommendations related to improving patients' perceptions about pharmacists and enhancing the status of pharmacy profession in Qatar. The findings from this study highlighted two major observations: the lack of existence of collaborative practice and hierarchy and power play. Conclusion Pharmacists demonstrated willingness and readiness to develop interprofessional learning and collaborative practice with significant steps already taken towards improving collaborative working practices in different care settings. [ABSTRACT FROM AUTHOR]

Background: Participation in the rescue effort after the terror attacks of 22 July 2011 was challenging, unprecedented and unpredictable. Work related to major events can be stressful, but can also lead to a sense of personal growth. However, there are few studies that elucidate the experience of gaining confidence in carrying out your own role. Objective: To investigate the extent to which rescue workers are better equipped to master similar situations in the future. We also wanted to identify what factors are associated with a heightened perception of mastery. Method: Ten months after the terror attacks on 22 July 2011, healthcare personnel, the police and the fire and rescue service, as well as voluntary groups, participated in a cross-sectional study on professional challenges, perceived support and personal reactions after the events. Qualitative data from healthcare personnel enabled a more in-depth analysis of the findings. Results: The response rate was 62 per cent (1734/2801). All groups reported that they were now better equipped to master similar situations in the future (average value 3.5-3.7; scale 1-5). Early response (OR 1.5, CI 1.2-1.9), several witnessing experiences (OR 1.5, CI 1.2-1.9) and a greater degree of role clarity (OR 1.5, CI 1.2-1.9) were associated with a heightened perception of mastery. Compared with the under 30s, the perception of mastery was lower in the 30-49 age group (OR 0.7, CI 0.5-0.9 (p = 0.05) and the group aged 50 years and over (OR 0.5, CI 0.3-0.7, p < 0.001). Conclusion: Real events provide a learning opportunity that cannot be gained from studying theory or through simulation exercises. High stress levels were associated with a heightened perception of mastery. Supportive management, the perception of cooperation and pride in their efforts may also have contributed to the healthcare personnel's heightened perception of mastery. [ABSTRACT FROM AUTHOR]

Two experiments were conducted to test the generality of the door-in-the-face compliance technique from nonbusiness to business contexts. Results indicate that the compliance-gaining procedure generalizes if a concession is emphasized by making the second request a smaller version of the first request rather than a new request, and if the second request is made large enough to avoid ceiling effects. [ABSTRACT FROM AUTHOR]

The relative effectiveness of the foot-in-the-door and door-in-the-face techniques in inducing subjects to comply with a commercial request for information was assessed in a field experiment. Although foot-in-the-door was found to be more effective than door-in-the-face, contrary to expectations the behavioral compliance rate was not significantly different from control outcomes. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

From authors' responses to open-ended questions, this theory-building study developed a framework to explain conflict over credit for joint research. Regression analysis of quantitative items provided evidence for the influence of motives and power on attitudes toward the value of author tasks and the criteria for ordering names in publications. The resulting model identifies four collaborative approaches and the sources of conflict appearing in each. [ABSTRACT FROM AUTHOR]

Six behavioral influence strategies of inducing people to comply with a request to donate money were investigated in a field experiment. The findings, replicated with a different subject population, demonstrate the efficacy of several alternatives to a direct request for compliance. Possible processes that could explain the results are discussed. [ABSTRACT FROM AUTHOR]

Objectives South Asian migrant populations have a high risk of non-communicable diseases, such as type 2 diabetes (T2D). The aim of this study is to provide in-depth insight into key success factors and challenges in developing culturally adapted lifestyle interventions to prevent T2D within South Asian migrant populations. Study design The study has a qualitative research design. Methods In-depth interviews, using a semi-structured interview guide, were conducted with eight researchers and project leaders from five studies of culturally adapted lifestyle interventions for South Asian migrant populations. Data were analysed using a grounded theory approach. Results Four main themes emerged as key factors for success: 'approaching the community in the right way', 'the intervention as a space for social relations', 'support from public authorities' and 'being reflexive and flexible'. Two themes emerged as challenges: 'struggling with time' and 'overemphasising cultural differences'. Conclusions Our findings augment existing research by establishing the importance of cooperation at the organisational and institutional levels, of fostering the creation of social networks through interventions and of acknowledging the multiplicity of identities and resources among individuals of the same ethnic origin. [ABSTRACT FROM AUTHOR]

Programs that serve transition-age youth with serious mental health conditions typically reside in either the child or the adult system. Good service provision calls for interactions among these programs. The objective of this research was to discover programmatic characteristics that facilitate or impede collaboration with programs serving dissimilar age groups, among programs that serve transition-age youth. To examine this "cross-age collaboration," this research used social network analysis methods to generate homophily and heterophily scores in three communities that had received federal grants to improve services for this population. Heterophily scores (i.e., a measure of cross-age collaboration) in programs serving only transition-age youth were significantly higher than the heterophily scores of programs that served only adults or only children. Few other program markers or malleable program factors predicted heterophily. Programs that specialize in serving transition-age youth are a good resource for gaining knowledge of how to bridge adult and child programs. [ABSTRACT FROM AUTHOR]

A substantial proportion of undergraduate men report compliance with unwanted, noncoercive sexual activities. This study used thematic analysis of interviews with 12 undergraduate men to understand how they conceptualized compliance with unwanted sex. Themes emerging within the context of casual sexual encounters were: compliance with unwanted sex is socially beneficial; alcohol modifies one's sexual receptivity to unwanted sex; and men rarely anticipate negative consequences from sexual compliance. Themes emerging within the context of committed relationships were: being compliant with unwanted sex for altruistic reasons and to build intimacy; and it is okay to say no to sex. Within the context of casual relationships, men's understanding and expectations of compliance with unwanted, noncoercive sex were complex and deeply rooted in their conceptualization of masculinity on a personal and social level. [ABSTRACT FROM AUTHOR]

This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise. [ABSTRACT FROM AUTHOR]

The current article aims to offer an informational basis for creating an adaptable model of spiritual support provision for Estonian health care institutions. The study addresses Estonian medical staff's knowledge about and attitudes towards spiritual support. The data originate from a quantitative research conducted in 19 Estonian hospitals during 2015-2016. The results show a good will for interdisciplinary co-operation, and pastoral caregiver is expected to be a part of the staff. The fact that spiritual support is not financed by the state budget funds raises the question about explaining the benefits of spiritual support to the hospital's or clinic's management. [ABSTRACT FROM AUTHOR]

The article presents results of a study that examined the influence of gender role orientations on gaming motivations, game genre preferences, and different play styles. Applying social role theory, it was hypothesized that femininity and masculinity influence gender-typed motivations (social interaction, competition, and challenge) and preferences (role-playing and action games) as well as gender-typed behavior (cooperative play and competitive play). After collecting empirical data through an online survey, hypotheses were tested by structural equation modeling. Moreover, moderating effects of sociodemographic characteristics (biological gender, age, and educational level) were examined. Findings provide evidence for the existence of gender-typed motives of play, genre preferences, and – mediated by motivations and preferences – gaming behavior. Group analyses support a biosocial model of gender-typed gaming behavior because gender-typing of motives, preferences, and play styles varies in strength and direction by biological gender, age, and educational level. [ABSTRACT FROM PUBLISHER]

Allport's (1954) contact theory states that our stereotypical associations and biases will decrease as we get to know and understand the experiences of others through meaningful, equal status, and collaborative contact. Contact theory is particularly relevant to inclusive education settings and adapted physical activity, as it supports an equitable school culture, and forms the basis of awareness and education programs. This article examines the four components of contact theory, and offers theory to practice considerations. [ABSTRACT FROM AUTHOR]

Background: Improving medication management is an important component of comprehensive care coordination for health systems. The Managing Your Medication for Education and Daily Support (MyMeds) medication management program at the University of California Los Angeles addresses medication management issues by embedding trained clinical pharmacists in primary care practice teams.Objectives: The aim of this work was to examine and explore physician opinions about the clinical pharmacist program and identify common themes among physician experiences as well as barriers to integration of clinical pharmacists into primary care practice teams.Methods: We conducted a mixed quantitative-qualitative methods study consisting of a cross-sectional physician survey (n = 69) as well as semistructured one-on-one physician interviews (n = 13). Descriptive statistics were used to summarize survey responses, and standard qualitative content-analysis methods were used to identify major themes from the interviews.Results: The survey response rate was 61%; 13 interviews were conducted. Ninety percent of survey respondents agreed or strongly agreed that having the pharmacist in the office makes management of the patient's medication more efficient, 93% agreed or strongly agreed that pharmacist recommendations are clinically helpful, 71% agreed or strongly agreed that having access to a pharmacist has increased their knowledge about medications they prescribe, and 75% agreed or strongly agreed that having a pharmacist as part of the primary care team has made their job easier. Qualitative interviews corroborated survey findings, and physicians highlighted the value of the clinical pharmacist's communication, team care and expanded roles, and medication management.Conclusion: Primary care physicians valued the integrated pharmacy program highly, particularly its features of strong communication, expanded roles, and medication management. Pharmacists were viewed as integral members of the health care team. [ABSTRACT FROM AUTHOR]

Background: Protecting human subjects from being exploited is one of the main ethical challenges for clinical research. However, there is also a responsibility to protect and respect the communities who are hosting the research. Recently, attention has focused on the most efficient way of carrying out clinical research, so that it benefits society by providing valuable research while simultaneously protecting and respecting the human subjects and the communities where the research is conducted. Collaboration between partners plays an important role and that is why we carried out a study to describe how collaborative partnership and social value are emerging in clinical research.Methods: A supra-analysis design for qualitative descriptive secondary analysis was employed to consider a novel research question that pertained to nurse leaders' perceptions of ethical recruitment in clinical research and the ethics-related aspects of clinical research from the perspective of administrative staff. The data consisted of two separate pre-existing datasets, comprising 451 pages from 41 interviews, and we considered the research question by using deductive-inductive content analysis with NVivo software. A deductive analysis matrix was generated on the basis of two requirements, namely collaborative partnership and social value, as presented in An Ethical Framework for Biomedical Research by Emanuel et al.Results: The findings showed that collaborative partnership was a cornerstone for ethical clinical research and ways to foster inter-partner collaboration were indicated, such as supporting mutual respect and equality, shared goals and clearly defined roles and responsibilities. In addition, the social value of clinical research was an important precondition for ethical clinical research and its realisation required the research partners to demonstrate collaboration and shared responsibility during the research process. However, concerns emerged that the multidimensional meaning of clinical research for society was not fully recognised. Achieving greater social value for clinical research required greater transparency, setting research priorities, shared responsibility for the dissemination and use of the findings and stronger community awareness of the ethics-related aspects of clinical research.Conclusions: Collaborative partnership and social values are essential for protecting the human subjects and communities involved in clinical research. [ABSTRACT FROM AUTHOR]

Occupant behavior is one of the most significant contributors to building energy consumption. Employing communication systems to enable buildings to interact with their occupants and influence the way they behave could significantly reduce energy consumption. We investigated the effectiveness of different delivery styles (i.e., avatar, voice, and text), as well as the impact of communicator’s persona (i.e., building facility manager and building itself) and gender (i.e., male and female) on occupants’ compliance with pro-environmental requests. The results showed that avatar is more effective than voice and voice is more effective than text on promoting compliance with persuasive pro-environmental requests. In addition, results showed greater compliance with requests made by the persona of a building facility manager than the persona of the building itself. Finally, participants were more likely to comply with the female communicator than the male communicator. Accordingly, this new interaction between buildings and their occupants could impact human behavior. [ABSTRACT FROM AUTHOR]

Health research participants want the results of the studies in which they participate but do not typically receive them. Researchers generally express support for sharing results with participants but, in practice, may be unprepared or unwilling to do so. Many funders call for increased dissemination of research results beyond academic and clinical audiences, but few funders sponsor research to improve result sharing with participants. Although the solution appears straightforward (e.g., funders could incentivize researchers to share results with participants), there are critical gaps in knowledge that suggest the need for a more deliberate approach. For example, what ethical or practical concerns discourage researchers from returning results to participants? What exactly do participants plan to do with the results that they would like to receive? What are the best channels of communication for sharing results with particular participant populations? To address these knowledge gaps, we argue for a collaborative process to develop a research agenda related to result sharing with participants. With support and encouragement by funders, such research should evaluate the effects of different types of results (and results from different types of studies) on participants' behaviors, attitudes, and emotions; it should also examine the researchers' ethical, financial, logistical, methodological, and skill-related concerns and constraints related to sharing results with participants. Over time, collaborative research between researchers and participants can yield an evolving set of evidence-based guidelines for ethical, effective result sharing with participants. [ABSTRACT FROM AUTHOR]

Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment combines evidence from the international literature on CHW programmes with research outcomes from the 5-year REACHOUT consortium, undertaking implementation research to improve CHW performance in six contexts (two in Asia and four in Africa). A conceptual framework on CHW performance, which explicitly conceptualizes the interface role of CHWs, is presented. Various categories of factors influencing CHW performance are distinguished in the framework: the context, the health system and intervention hardware and the health system and intervention software. Hardware elements of CHW interventions comprise the supervision systems, training, accountability and communication structures, incentives, supplies and logistics. Software elements relate to the ideas, interests, relationships, power, values and norms of the health system actors. They influence CHWs' feelings of connectedness, familiarity, self-fulfilment and serving the same goals and CHWs' perceptions of support received, respect, competence, honesty, fairness and recognition.The framework shines a spotlight on the need for programmes to pay more attention to ideas, interests, relationships, power, values and norms of CHWs, communities, health professionals and other actors in the health system, if CHW performance is to improve. [ABSTRACT FROM AUTHOR]

“Réflexions pour 1985”, a prospective report published in 1964, envisaged what France might look like in 1985. This essay argues the blend of “probable” and “desirable” in its imagined vision of the future reveals an agenda of enforcing social compliance with its techno-scientific assumptions. To test such an assessment of the text, this essay offers a study of the shaping factors and shaping actors of the report, before analysing the language of the report itself. [ABSTRACT FROM AUTHOR]

Background: For decades hospitals have been "vertically" organized, with the risk that specialization leads to fragmented and one-sided views of patient care and treatment that may cause poor communication and coordination of care and treatment. Two years after the introduction of an orthogeriatric unit for elderly patients admitted with fragility fractures, we studied the involved healthcare professionals' perspectives and experiences with working in an interprofessional organization.Methods: We performed four focus groups interviews with 19 healthcare workers representing different professions. The interviews were analysed using systematic text condensation (STC).Results: Three themes were identified: 1) A patient-centred approach, 2) An opportunity for professional growth and 3) The benefits of interprofessional collaboration. The interviewees emphasized in particular the systematic and frequent face-to-face communication enabled by the interprofessional team meetings as essential to their feeling of enhanced collegial solidarity. All groups expressed their respect for other groups' competences and their vital contributions to good orthogeriatric care. However, collaboration was challenged by the groups' divergent views of the patients and of the relevance of the information given in the weekly meetings. Heavy workloads were also mentioned. The opportunity for professional growth was also felt to be imperilled by some professionals.Conclusions: All participants indicated their view that the orthogeriatric organization had improved the quality of care and treatment. Furthermore, good communication, mutual respect for other professional competences and shared goals were found to have enhanced interprofessional collaboration and improved the sense of having a shared mission. However, differences in approaches and expectations continued to challenge the orthogeriatric model after 2 years. Neither did all professionals find orthogeriatric care professionally challenging. [ABSTRACT FROM AUTHOR]

Background: Medical schools have a major impact on future doctors' ethics and their attitudes towards cooperation with the pharmaceutical industry. From childhood, medical students who are related to a physician are exposed to the characteristics of a medical career and learn its professional ethics not only in school but also in the family setting. The present paper sought to answer the research question: 'How does growing up with a physician influence medical students' perceptions of conflicts of interest in their relationships with industry?'Methods: An anonymous questionnaire was completed by 451 medical students from four Philadelphia medical schools and 554 medical students from Warsaw Medical University during 2013. Medical schools in these two cities were chosen because they are both university cities with similar population sizes. Students who had and who did not have a family member working as a physician were compared using chi-square analysis. Data were analysed for each country separately.Results: For both the US and Poland, there were statistically significant differences (p < .05) between medical students with a physician as a family member and other students with respect to views regarding relationship with the pharmaceutical industry. In both groups, this difference occurred for three important dimensions: students' relationship with the pharmaceutical industry; students' views on physicians' rights to cooperate with the pharmaceutical industry; trust in the pharmaceutical industry. In the US, students related to a doctor were characterized by more restrictive opinions on all three dimensions than other students (e.g., 27.8% of the former students vs. 31.4% of the latter students thought doctors had unrestricted rights to cooperate with the industry). However, the contrary was observed in Poland: students with a physician in the family had less strict views than their colleagues (e.g., 56.8% of the former vs. 39.7% of the latter thought that doctors should have unrestricted rights of cooperation).Conclusions: In Poland, a former communist country, physicians transmit a more liberal approach towards collaboration with the pharmaceutical industry to their student relatives than those in the US. [ABSTRACT FROM AUTHOR]