In a series of ten preregistered experiments (N=2043), we investigate the effect of outcome valence on judgments of probability, negligence, and culpability – a phenomenon sometimes labelled moral (and legal) luck. We found that harmful outcomes, when contrasted with neutral outcomes, lead to increased perceived probability of harm ex post, and consequently to increased attribution of negligence and culpability. Rather than simply postulating a hindsight bias (as is common), we employ a variety of empirical means to demonstrate that (...) the outcome-driven asymmetry across perceived probabilities constitutes a systematic cognitive distortion. We then explore three distinct strategies to alleviate the hindsight bias and its downstream effects on mens rea and culpability ascriptions. Not all are successful, but at least some prove promising. They should, we argue, be taken into consideration in criminal jurisprudence, where distortions due to the hindsight bias are likely considerable and deeply disconcerting. (shrink)

In a series of ten preregistered experiments (N=2043), we investigate the effect of outcome valence on judgments of probability, negligence, and culpability – a phenomenon sometimes labelled moral (and legal) luck. We found that harmful outcomes, when contrasted with neutral outcomes, lead to increased perceived probability of harm ex post, and consequently to increased attribution of negligence and culpability. Rather than simply postulating a hindsight bias (as is common), we employ a variety of empirical means to demonstrate that (...) the outcome-driven asymmetry across perceived probabilities constitutes a systematic cognitive distortion. We then explore three distinct strategies to alleviate the hindsight bias and its downstream effects on mens rea and culpability ascriptions. Not all are successful, but at least some prove promising. They should, we argue, be taken into consideration in criminal jurisprudence, where distortions due to the hindsight bias are likely considerable and deeply disconcerting. (shrink)

A coherent practice of mens rea (‘guilty mind’) ascription in criminal law presupposes a concept of mens rea which is insensitive to the moral valence of an action’s outcome. For instance, an assessment of whether an agent harmed another person intentionally should be unaffected by the severity of harm done. Ascriptions of intentionality made by laypeople, however, are subject to a strong outcome bias. As demonstrated by the Knobe effect, a knowingly incurred negative side effect is (...) standardly judged intentional, whereas a positive side effect is not. We report the first empirical investigation into intentionality ascriptions made by professional judges, which finds (i) that professionals are sensitive to the moral valence of outcome type, and (ii) that the worse the outcome, the higher the propensity to ascribe intentionality. The data shows the intentionality ascriptions of professional judges to be inconsistent with the concept of mens rea supposedly at the foundation of criminal law. (shrink)

When two actors have the same mental state but one happens to harm another person (unlucky actor) and the other one does not (lucky actor), the latter elicits a milder moral judgement. To understand how this outcome effect would affect post-harm interactions between victims and perpetrators, we examined how the social role from which transgressions are perceived moderates the outcome effect, and how outcome effects on moral judgements transfer to agentic and communal interpersonal goals. Three (...) vignette experiments (N = 950) revealed similar outcome effects on moral judgement across social roles. In contrast, outcome effects on agentic and communal goals varied by social role: victims exhibited the strongest outcome effects and perpetrators the weakest, with bystanders falling in between. Moral judgement did not mediate the effects of outcome severity on interpersonal goals. We discuss the possibility that outcome severity raises normative expectations regarding post-harm interactions that are unrelated to moral considerations. (shrink)

Collective trauma refers to psychological effects that are experienced by a group of people in response to shared traumatic conditions. Farmers represent a unique population that is chronically exposed to potentially traumatic events and conditions particular to the agricultural industry. Farming communities in Iowa have experienced the farm crisis of the 1980s, decades of extreme weather events, rapidly fluctuating markets, trade wars, rising input costs, farm bankruptcies and foreclosures, and high rates of farmer suicides. Exposure to such conditions can potentially (...) have dramatic effects on the people who experience them and the communities they live in. While research exists examining the behavioral health aspects of stress in farmers, no studies have examined the lived experiences of farmers within the framework of collective trauma and its effects on decision-making. To investigate how Iowa farmers perceive their own experiences of these potential types of collective trauma, this study conducted in-depth semi-structured interviews with farmers and farmer-oriented behavioral health experts. Particular focus is placed on how collective trauma affects individual farmers, their families, and their farming communities, as well as how this type of trauma impacts farm management decisions and sustainability outcomes. Qualitative data were analyzed using a grounded theory approach to develop a theoretical framework describing how collective trauma, in the form of environmental, financial, and community threats, impacts farm management decisions and, in turn, affects environmental, economic, and social sustainability outcomes. Potential implications for how agricultural policy can potentially address the effects and systemic causes of trauma are discussed. (shrink)

Ethics has been identified as an important factor that potentially affects auditors’ professional skepticism. For example, prior research finds that auditors who are more concerned with professional ethics exhibit greater professional skepticism. Further, the literature suggests that professional skepticism may lead the auditor to more vigilantly resist the client’s position in financial reporting disputes. These reporting disputes are generally resolved through negotiations between the auditor and client to arrive at the final reported amounts. To date, the role that professional skepticism (...) potentially plays in the negotiation process has been relatively unexplored. The literature prior to the enactment of Sarbanes–Oxley (SOX) suggests that auditors are more likely to approve a client position when the matter in dispute is relatively ambiguous and when changing the client’s position will result in the client failing to meet analysts’ expectations. However, changes resulting from SOX have led auditors to be more vigilant and therefore results found in the pre-SOX environment may not hold in the current environment where auditors are held more accountable for their actions. Results from an experiment with experienced audit managers and partners suggest that in the post-SOX climate, auditors’ negotiations do not appear to be substantively influenced by management being able to meet or beat forecasts. Moreover, we find that when auditors exhibit heightened professional skepticism, they are more ethical by being conservative and they stand more resolute than when auditors do not exhibit heightened professional skepticism. Finally, although we do not find a main effect for the influence of earnings forecast, we do find a significant interaction between earnings forecast and heightened professional skepticism. Implications for practice and research are then presented. (shrink)

This study explores the interaction effects of game outcomes and status instability and the moderating role of implicit team identification on spectators’ status-seeking behavior. The current study seeks to contribute to the existing consumer behavior and spectatorship literature by examining the counterintuitive outcomes of winner–loser effects through the application of the biosocial theory of status. In an online experiment, NFL fans’ retrospective spectating experiences were captured and manipulated. This experiment used a 2 × 2 × 2 between-subjects design. The findings (...) indicated that decisive victories and close losses positively influenced spectators’ future attendance as well as their intention to purchase luxury suites and merchandise featuring images of the team mascot. Conversely, decisive losses and close victories had a negative influence. Additionally, the more spectators implicitly identified with a particular team, the more they exhibited status-seeking behavior; even close victories positively influenced the outcomes. By applying a nascent theoretical approach in the field of consumer behavior, our results provide fresh insight into explaining spectators’ status-seeking behavior. Also, the findings identify specific conditions in which spectators’ status-seeking behavior is enhanced, thus suggesting ways for managers to strategically allocate their resources. (shrink)

Over the past few decades, public anxiety about how people interact with science has spawned cycles of discourse across a wide range of media, public and private initiatives, and substantial research endeavors. National and international STEM (science, technology, engineering, and math) education initiatives and research have addressed how students interact with science and pursue careers in STEM fields. Researchers concerned with adult interaction with science have focused on factors that influence how citizens gather and interpret scientific knowledge and form positions (...) on scientific issues, applications, and/or policy in a politicized democratic milieu. Building from research on how the public interacts with science in and outside of formal education, this study focuses on attitudes toward science among students in 4th, 7th, and 10th grades and their parents. Little research to date has paired the STEM experiences of adults with their children. We find that the extent to which parents are positively oriented toward science significantly shapes their children’s attitudes toward science. Furthermore, between 7th and 10th grades, students with parents holding positive orientations toward science are more likely to sustain positive attitudes toward science. Since the foundation for most adults’ interactions with science develops in the K-12 environment, we demonstrate that the foundation, as expressed in adulthood, may directly affect the ways the next generation of students interacts with science. We offer insights into the importance of developing student learning into the social scientific research on public understanding of science and how important scientific issues of today interplay with society. (shrink)

Most studies are inclined to report positive rather than negative or inconclusive results. It is currently unknown how clinicians appraise the results of a randomized clinical trial. For example, how does the study funding source influence the appraisal of an RCT, and do positive findings influence perceived credibility and clinical relevance? This study investigates whether psychiatrists’ appraisal of a scientific abstract is influenced by industry funding disclosures and a positive outcome. Dutch psychiatrists were randomized to evaluate a scientific abstract (...) describing a fictitious RCT for a novel antipsychotic drug. Four different abstracts were created reporting either absence or presence of industry funding disclosure as well as a positive or a negative outcome. Primary outcomes were the perceived credibility and clinical relevance of the study results. Secondary outcomes were the assessment of methodological quality and interest in reading the full article. Three hundred ninety-five psychiatrists completed the survey. Industry funding disclosure was found not to influence perceived credibility nor interpretation of its clinical relevance. A negative outcome was perceived as more credible than a positive outcome 0.43 to 1.18, p?), but did not affect clinical relevance scores. In this study, industry funding disclosure was not associated with the perceived credibility nor judgement of clinical relevance of a fictional RCT by psychiatrists. Positive study outcomes were found to be less credible compared to negative outcomes, but industry funding had no significant effects. Psychiatrists may underestimate the influence of funding sources on research results. The fact that physicians indicated negative outcomes to be more credible may point to more awareness of existing publication bias in the scientific literature. (shrink)

In bargaining environments with uncertain disagreement or “impasse” outcomes (e.g., litigation or labor strike outcomes), there is an identification problem that confounds data interpretation. Specifically, the minimally acceptable settlement value from a risk-averse (risk-loving) but unbiased-belief bargainer is empirically indistinguishable from what one could get with risk-neutrality and pessimistically (optimistically) biased beliefs. This article reports results from a controlled bargaining experiment where data on both risk attitude and beliefs under uncertainty are generated in order to assess their relative importance in (...) bargaining experiment outcomes. The average lab subject is risk-averse, yet optimistic with respect to uncertainty, which is consistent with existing studies that examine each in isolation. I also find that the effects of optimism dominate those of risk-aversion. Optimistic bargainers are significantly more likely to dispute and have aggressive final bargaining positions. Dispute rates are not statistically affected by risk attitude, but there is some evidence that risk aversion leads to a weakened bargaining position. Though additional research is needed to understand the limits of extending these results, a key implication follows. In uncertainty environments where optimism dominates, increased settlement rates are more likely achieved by minimizing impasse uncertainty (to limit the potential for optimism) rather than maximizing uncertainty (to weaken the reservation point of risk-averse bargainers), as has been argued in the dispute resolution literature. (shrink)

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced (...) decision ethicality. Conducting a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes. (shrink)

Differences in perception and potential disagreements between parents and professionals regarding the attitude for resuscitation at the limit of viability are common. This study evaluated in healthcare professionals whether the decision to resuscitate at the limit of viability are influenced by the way information on incurred risks is given or received. This is a prospective randomized controlled study. This study evaluated the attitude of healthcare professionals by testing the effect of information given through graphic fact sheets formulated either optimistically (...) or pessimistically. The written educational fact sheet included three graphical presentations of survival and complication/morbidity by gestational age. The questionnaire was submitted over a period of 4 months to 5 and 6-year medical students from the Geneva University as well as physicians and nurses of the neonatal unit at the University Hospitals of Geneva. Our sample included 102 healthcare professionals. Forty-nine responders were students, 32 paediatricians and 21 nurses in NICU. The received risk tended to be more severe in both groups compared to the graphically presented facts and current guidelines, although optimistic representation favoured the perception of “survival without disability” at 23 to 25 weeks. Therapeutic attitudes did not differ between groups, but healthcare professionals with children were more restrained and students more aggressive at very low gestational ages. Written information on mortality and morbidity given to healthcare professionals in graphic form encourages them to overestimate the risk. However, perception in healthcare staff may not be directly transferable to parental perception during counselling as the later are usually naïve to the data received. This parental information are always communicated in ways that subtly shape the decisions that follow. (shrink)

What does it mean to manage effectively? This paper discusses the historical problem of the criterion, stemming from skeptical thinkers, and applies it in a management environment. The aim is to highlight how awareness of criteria in judging outcomes may yield richer and more nuanced views of effectiveness. The argument begins by exploring the characterization of management actions and discusses how a distinguishing quality of those actions is that they’re oriented towards outcomes. The question is then how to assess outcomes (...) associated with effective management. The problem of the criterion, which identifies the multiple criteria used in judgments, is introduced and discussed in connection with outcomes. A guiding question is, What are the criteria used to assess whether outcomes are associated with effective management? A central point in the discussion is that the assessment of outcomes in effective management is contingent upon the criteria that are applied. These criteria function as part of a contextual and complex network. Thus what are seemingly simple and obvious answers may be seen in a different and more nuanced manner once various criteria are identified. The management vision that emerges is one in which management is more layered than simply ‘achieving results.‘ For although results do matter, the network of criteria used to assess outcomes may present those outcomes in new and different lights. Management is seen as the art of recognizing varied possibilities based on the criteria used to assess outcomes. (shrink)

The present study was aimed at investigating whether and how the explicit representation of the decision outcome, framed in terms of lives saved or lost, could affect decision choices, emotional experience, and decision times in the course of a moral dilemma task. Decision outcomes were framed in a between-group design by means of smiling or injured faces depicting, respectively, the lives saved or lost with each choice. A control condition with no frame and no outcome was included. Results (...) showed that behavioral choices were highly resistant to the framing manipulation in both dilemma types. However, an overall reduction in the number of utilitarian choices and in the decision times, associated with an increase in unpleasantness during decision-making, was found, suggesting a progressive increase in aversive emotional activation favoring the rejection of utilitarian resolutions. Interestingly, at the beginning of the task, the POS group showed a delay in decision times as compared with the NOF group, specifically for footbridge-type dilemmas. This result might be interpreted as an interference effect temporarily slowing decision-making during the resolution of dilemmas in which the internal representation is spontaneously focused on the personal cost of causing intentional harm to others. (shrink)

Case-based reasoning has long been used to facilitate instructional effectiveness. Although much remains to be known concerning the most beneficial way to present case material, recent literature suggests that simplifying case material is favorable. Accordingly, the current study manipulated two instructional techniques, incremental case presentation and forecasting outcomes, in a training environment in an attempt to better understand the utility of simplified versus complicated case presentation for learning. Findings suggest that pairing these two cognitively demanding techniques reduces satisfaction and detracts (...) from the effectiveness of the learning approach. Implications regarding the use of instructional techniques in training programs are discussed. (shrink)

Direct effects in mediation analysis quantify the effect of an exposure on an outcome not mediated by a certain intermediate. When estimating direct effects through measured data, misclassification may occur in the outcomes, exposures, and mediators. In mediation analysis, any such misclassification may lead to biased estimates in the direct effects. Basing on the conditional dependence between the mismeasured variable and other variables given the true variable, misclassification mechanisms can be divided into non-differential misclassification and differential misclassification. In (...) this article, several scenarios of differential misclassification will be discussed and sensitivity analysis results on direct effects will be derived for those eligible scenarios. According to our findings, the estimated direct effects are not necessarily biased in intuitively predictable directions when the misclassification is differential. The bounds of the true effects are functions of measured effects and sensitivity parameters. An example from the 2018 NCHS data will illustrate how to conduct sensitivity analyses with our results on misclassified outcomes, gestational hypertension and eclampsia, when the exposure is Hispanic women versus non-Hispanic White women and the mediator is weights gain during pregnancy. (shrink)

Processing the motivational relevance of a visual scene and reacting accordingly is crucial for survival. Previous work suggests the emotional content of naturalistic scenes affects response speed, such that unpleasant content slows responses whereas pleasant content accelerates responses. It is unclear whether these effects reflect motor-cognitive processes, such as attentional orienting, or vary with the function/outcome of the motor response itself. Four experiments manipulated participants’ ability to terminate the picture and, thereby, the response’s function and motivational value. Attentive orienting (...) was manipulated via picture repetition, which diminishes orienting. A total of N = 81 participants completed versions of a go/no-go task, discriminating between distorted versus intact pictures drawn from six content categories varying in positive, negative, or neutral valence. While all participants responded faster with repetition, only participants without offset control exhibited slower responses to unpleasant and accelerated responses to pleasant content. Emotional engagement, measured by the late positive potential, was not modulated by attentional orienting, suggesting that the interaction between repetition and offset control is not due to altered emotional engagement. Together, results suggest that response time changes as a function of emotional content and sensitivity to attention orienting depends on the motivational function of the motor response. (shrink)

This paper investigates whether the impact of PCAOB Rule 3211 on the quality and cost of audit services differs between female and male audit partners. We find that the improvement of audit quality is more pronounced for female audit partners than male partners after Rule 3211 adoption. Female audit partners are also associated with higher increases in fees and report lags than male counterparts after the adoption of Rule 3211. Further, we find that the presence of female CFOs attenuate the (...) audit fees and report lag increases in the post-adoption periods. Overall, our findings confirm the importance of the gender effect on audit outcomes, which needs further consideration by standard setters. Our study also provides empirical evidence of the benefits of gender equality in the workplace. (shrink)

Infections and deaths associated with COVID-19 show a high degree of heterogeneity across different populations. A thorough understanding of population-level predictors of such outcomes is crucial for devising better-targeted and more appropriate public health preparedness measures. While demographic, economic, and health-system capacity have featured prominently in recent work, cultural, and behavioral characteristics have largely been overlooked. However, cultural differences shape both the public policy response and individuals' behavioral responses to the crisis in ways that can impact infection dynamics and key (...) health outcomes. To address this gap, we used meta-analytic methods to explore the global variability of three public health outcomes during the first wave of the pandemic. This set of analyses identified several cultural/behavioral attributes as independent predictors of public health outcomes after adjusting for key demographic, political, economic, and health-system-related predictors; which were robust in sensitivity analyses. In conclusion, this study clearly demonstrates that cultural attributes do in fact account for some of the global disparities in COVID-19-attributed health outcomes. As a consequence, policymakers should more explicitly consider a society's cultural attributes alongside other important parameters such as demographic characteristics and health system constraints in order to develop better tailored and more effective policy responses. (shrink)

The aim of this study was to explore the relationship between the protein S100B level, cognitive dysfunction, and Glasgow Outcome Scale (GOS) in moderate traumatic brain injury patients. Thirty patients suffering from head injuries undergoing neurosurgery in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, and who were considered eligible based on the inclusion and exclusion criteria participated in this double-blind experimental Randomized Controlled Trial (RCT). The treatment groups (COX-2) were assigned as COX2-I, COX2II, and COX3-IV, six patients in each (...) group. The treatment group was given another dose of sCOX-2 inhibitor 12 hours, 12 and 24 hours after the first dose, and 12, 24 and 36 hours after pre-induction sCOP-2 inhibitor was administered. The GOS score was obtained during the before the surgery and 1 month, 1.5 months, and 2 months postoperative days. The MMSE was performed preoperatively and then on the first to seventh day after the surgery. The results showed that there was a significant decrease in the protein level in all treatment groups including the control group, where the resulting p-value was less than 0.05. Moreover, the treatment group showed a faster time in reaching GOS 5 or be discharged from the hospital compared to the control. In conclusion, it has been demonstrated that the provision of 3 or 4 times of the sCox-2 inhibitor leads to the achievement of a score of 5, while the recovery of the cognitive dysfunction into the normal level is obtained when the SCox2 inhibitor is given 4 times. (shrink)

This study examines the effects of transformational, transactional, and non-transactional leadership on hotel employees’ outcomes including extra effort, perceived efficiency, and satisfaction with managers. Employees from eleven 4-star hotels in Spain provided the collected data. A series of statistical analyses identify the elements of three leadership styles using a multi-factor leadership questionnaire ; examine the effect of leadership styles on employees’ outcomes. The results of this study indicate that “idealized attributes” of transformational leadership and “contingent reward” from transactional leadership (...) are the most important factors that positively affect all three outcomes ; and to assess the moderating effect of different types of ownership of hotel properties on the relationship between styles of leadership and outcomes of employees’ activities other than these two elements, the significant factors indicating positive or negative relationships vary depending on the types of individual outcomes as well as ownership of hotel properties. The discussion sections indicate theoretical and practical implications of the findings. (shrink)

In order to investigate patients’ experience of healthcare, repeated assessments of patient-reported outcomes are increasingly performed in observational studies and clinical trials. Changes in PRO can however be difficult to interpret in longitudinal settings as patients’ perception of the concept being measured may change over time, leading to response shift and possibly to erroneous interpretation of the observed changes in PRO. Several statistical methods for response shift analysis have been proposed, but they usually assume that response shift occurs in the (...) same way in all individuals within the sample regardless of their characteristics. Many studies aim at comparing the longitudinal change of PRO into two groups of patients. The group variable could have an effect on PRO change but also on response shift effect and the perception of the questionnaire at baseline. In this paper, we propose to enhance the ROSALI algorithm based on Rasch Measurement Theory for the analysis of longitudinal PRO data to simultaneously investigate the effects of group on item functioning at the first measurement occasion, on response shift and on changes in PRO over time. ROSALI is subsequently applied to a longitudinal dataset on change in emotional functioning in patients with breast cancer or melanoma during the year following diagnosis. The use of ROSALI provides new insights in the analysis of longitudinal PRO data. (shrink)

Causal mediation analysis is complicated with multiple effect definitions that require different sets of assumptions for identification. This article provides a systematic explanation of such assumptions. We define five potential outcome types whose means are involved in various effect definitions. We tackle their mean/distribution’s identification, starting with the one that requires the weakest assumptions and gradually building up to the one that requires the strongest assumptions. This presentation shows clearly why an assumption is required for one estimand (...) and not another, and provides a succinct table from which an applied researcher could pick out the assumptions required for identifying the causal effects they target. Using a running example, the article illustrates the assembling and consideration of identifying assumptions for a range of causal contrasts. For several that are commonly encountered in the literature, this exercise clarifies that identification requires weaker assumptions than those often stated in the literature. This attention to the details also draws attention to the differences in the positivity assumption for different estimands, with practical implications. Clarity on the identifying assumptions of these various estimands will help researchers conduct appropriate mediation analyses and interpret the results with appropriate caution given the plausibility of the assumptions. (shrink)

Several allocation rules allow for possible violations of the ‘independence of irrelevant alternatives’ axiom in cooperative bargaining game theory. Nonetheless, there is no conclusive evidence on how contractions of feasible sets exactly affect bargaining outcomes. We have been able to identify a definite behavioral channel through which such contractions actually determine the outcomes of negotiated bargaining. We find that the direction and the extent of changes in bargaining outcomes, due to contraction of the feasible set, respond to the level of (...) agent asymmetry with a remarkable degree of regularity. Alongside, we conclude that the validity of the IIA axiom is only limited to symmetric games. (shrink)

Quantitative research studies examining the effects of literacy instruction set in social studies classrooms (grades 6-12) on students’ academic content learning and reading comprehension are synthesized using meta-analytic techniques. An extensive search of the scholarly literature between 1983 and 2013 yielded a total of twelve intervention studies that provided literacy instruction to secondary students within social studies classes and quantitatively measured content learning outcomes, reading comprehension, or both. Findings revealed that content learning outcomes were consistently improved with instruction that included (...) text-processing activities such as summarizing and generating questions. While many social studies teachers do not provide explicit reading supports, in part because they perceive that the time needed to do so is prohibitive, the findings of this synthesis suggest that sound reading practices hold promise as a means through which teachers can help students better access social studies content, thus improving student learning outcomes. More rigorous quantitative research is needed to further understand the causal effects of literacy practices in social studies settings. Highlights • Literacy instruction supports both reading comprehension and academic content • Literacy instruction does not negatively affect content knowledge acquisition. • Few studies investigate the effects of literacy instruction in social studies. • More research is needed to explore the effects of literacy instruction in social studies. (shrink)

Recently, achievement emotions have attracted much scholarly attention since these emotions could play a pivotal role in online learning outcomes. Despite the importance of achievement emotions in online education, very few studies have been committed to a systematic review of their effects on online learning outcomes. This study aimed to systematically review studies examining the effects of achievement emotions on online learning outcomes in terms of motivation, performance, satisfaction, engagement, and achievement. According to the selection process of Preferred Reporting Items (...) for Systematic Review and Meta-analysis principles, a total of 23 publications were included in this review. It was concluded that positive achievement emotions, such as enjoyment, pride, and relaxation, could generally exert a positive effect on online learning motivation, performance, engagement, satisfaction, and achievement. It should be noted that excessive positive emotions might be detrimental to online learning outcomes. On the other hand, it has been difficult to determine the effects of negative achievement emotions on online learning outcomes because of disagreement on the effects of negative achievement emotions. In order to improve online learners' learning outcomes, instructors should implement interventions that help online learners control and regulate their achievement emotions. Teaching interventions, technological interventions, and treatment interventions could benefit online learners emotionally and academically. Future studies could examine the moderating roles of contextual factors and individual variables in the effects of achievement emotions on online learning outcomes. (shrink)

With the increasing level of internationalization in higher education, the number of international students in mainland China is rapidly increasing. However, limited research has considered that student results may be affected by a reduced motivation to learn. Therefore, the aim of this research is to explore the effect of the learning motivation on the learning outcomes of international students and the moderating role of learning experience. A sample of 130 international students from 23 countries studying in mainland China was (...) analyzed. The study found a significant correlation between the learning motivations and international students' learning outcomes. It was also determined that learning experience has significantly enhances the relationship between learning motivation and the learning outcomes of international students. This study contributes to the higher education literature of on learning motivation by students and learning outcomes. (shrink)

Imagination as the key to the creative process is one of the key components of design education that affects students' problem-solving skills and innovation. The purpose of this research is to determine the impact of creative imagination on the academic performance of students enrolled in design courses. It intends to obtain a measure of the way creative imagination affects or influences students’ performance as well as their achievements. However, there is a lack of understanding regarding the correlation between creativity and (...) performance among university students. The study collected data on creative imagination and academic performance through a survey of 350 participants drawn from five universities. Self-administered questionnaires were distributed to 350 participants, of which 320 were 176 males and 144 females. The research included quantitative techniques such as linear regression, correlation analysis, and structural equation modeling-partial least squares (SEM-PLS). Further, the result of the analysis showed that imagination level has the most significant impact on academic outcomes in design programs with a strong positive effect (β=0.35, p-value = 0.04). Higher creative imagination scores had a positive correlation with grades and students' involvement. This underscores the importance of forecasting to enhance students’ performance and engagement in design programs. The strategies used in education should be utilized to supplement creativity to raise the performance and satisfaction of students. (shrink)

The unsustainable growth in U.S. health care costs is in large part attributable to the rising costs of pharmaceuticals and medical devices and to unnecessary medical procedures. This fact has led health reform advocates and policymakers to place considerable hope in the idea that increased government support for research on the comparative effectiveness of medical treatments will eventually help to reduce health care expenses by informing patients, health care providers, and payers about which treatments for common conditions are effective and (...) which are not. Comparative effectiveness research has shown in some cases that expensive but commonly used treatments are significantly less effective than relatively inexpensive alternatives. Critics warn, however, that CER will homogenize patient care, limit patient choices, and lead to improper health care rationing and even to the denial of lifesaving treatments. (shrink)

BackgroundThe aim of this study was to investigate the effectiveness of psychotherapeutic interventions for clinically referred adolescents, as well as to examine whether sociodemographic, clinical, or treatment-related variables and patients’ role expectations predict treatment outcome or are possible predictors of treatment dropout.MethodThe study comprised 58 adolescents suffering from diverse psychiatric disorders referred to psychotherapeutic interventions conducted in outpatient care. The outcome measures, The Beck Depression Inventory, and the Clinical Outcomes in Routine Evaluation – Outcome Measure were filled (...) in at baseline and at 3-, 6-, and 12-month follow-ups. Possible predictors were assessed at baseline.ResultsThe results indicate that the mean level of symptoms and psychological distress decreased during the treatment, most reduction occurring in the first 6 months. The frequency of treatment sessions was the strongest predictor of good outcome. Adolescents with a higher level of externalizing problems or lower level of expectations for their own active role in treatment seem to have a higher risk of dropping out.ConclusionOffering intensive treatment for a shorter period might be the most efficient way to gain symptom reduction and decrease psychological distress in psychotherapeutic interventions with adolescents. Being aware of externalizing behavior and increasing the adolescents’ own agency during the assessment could strengthen commitment and result in the adolescent benefiting more from treatment. (shrink)

We examined if cancer patients' health-related quality of life (HRQoL) scores on the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 are affected by the specific time point, before or during treatment, at which the questionnaire is completed, and whether this could bias the overall treatment comparison analyses. A 'completion-time window' variable was created on three closed EORTC randomised control trials in lung (non-small cell lung cancer, NSCLC) and colorectal cancer (CRC) to indicate when the QLQ-30 was completed (...) relative to chemotherapy cycle dates, defined as 'before', 'on' and 'after'. HRQoL mean scores were calculated using a linear mixed model. Statistically significant differences (P < 0.05) were observed on 6 and 5 scales for 'on' and 'after' comparisons in the NSCLC and two-group CRC trial, respectively. As for the three-group CRC trial, several statistical differences were observed in the 'before' to 'on' and the 'on' to 'after' comparisons. For all three trials, including the 'completion-time window' variable in the model resulted in a better fit, but no substantial changes in the treatment effects were noted. We showed that considering the exact timing of completion within specified windows resulted in statistical and potentially clinically significant differences, but it did not alter the conclusions of treatment comparison in these studies. (shrink)

Entrepreneurship education is increasingly becoming a focal strategy for promoting entrepreneurship, particularly to foster entrepreneurial intentions and startups. However, learning and support are equally important after startup for novice entrepreneurs to gain a good level of confidence to manage their business and achieve the desired outcomes. Using a sample of 189 young self-employed individuals in Uganda, this study examines the differential impact of mentoring and self-efficacy on the achievement of intangible outcomes of entrepreneurship including satisfaction of need for autonomy, work (...) satisfaction and the intention to stay in self-employment. We found self-efficacy to mediate the effects of mentoring on these intangible outcomes. In addition, the results showed substantial gender differences. Whereas women’s satisfaction of the need for autonomy and intention to stay in self-employment were strongly associated with the direct effects of mentoring, their male counterparts seemed to benefit more if mentoring resulted in increased self-efficacy. Overall, our findings suggest that whereas mentoring improves the competence of small business owners and consequently achievement of superior outcomes, mentoring should also focus on boosting self-efficacy which in turn is essential for the application of the entrepreneurial competencies. (shrink)