Outcome Dimensions Research Articles

Sustainable Public Procurement and Human Rights: Barriers to Deliver on Socially Sustainable Road Infrastructure Projects in Mexico

Public procurement involves a process through which the public sector buys goods, services and works from private suppliers to accomplish its functions, including road infrastructure projects. Sustainability, both within the procurement process and the infrastructure outcome, comprises economic, environmental and social dimensions. Sustainable Public Procurement (SPP) is acknowledged as a core dimension of sustainable development goal 12 (SDG12) on sustainable consumption by States and production by businesses, and as a State-business nexus within Pilar I of the UN Guiding Principles on Business and Human Rights (UNGPs). Clearly, SPP delivering sustainable infrastructure involves broad positive effects and benefits for involved stakeholders and leveraging power over business suppliers to include social sustainable criteria within the procurement process is in the State’s hands. However, SPP has been little implemented in developing States such as Mexico resulting in unsustainable infrastructure outcomes. This article explores, through two case studies, the barriers of socially sustainable public procurement of road infrastructure developed by businesses contracted by the State in Mexico. By identifying such barriers, the Mexican State could be able to implement measures to tackle them and deliver on social sustainable infrastructure aligned with its commitments on sustainable development goals and its international obligations on human rights.

The Impact of Customer Gratitude Expression on Employee Working Outcomes and Its Mechanism

In recent years, research on customer behaviors has raised increasing attention among scholars. Totally, the focus of customer research witnessed a conversion from customer-company relationship to customer-employee interaction. However, existing studies in the customer-employee interaction domain have mostly discussed the negative outcomes of customers’ negative behaviors, and few of them have examined customers’ positive behaviors. In reality, companies, employees, and customers are not enemies; rather, they can create and share value through mutual understanding and civilized interaction. Therefore, it is necessary to deeply explore customers’ positive behavior in addition to customers’ negative behavior. Drawing on the Emotions as Social Information Model, this paper focuses on customer gratitude expression–a positive customer behavior which refers that customers express their gratitude to employees for employees’ service and contribution–and explores its impact on employees. Based on a sample of 304 leader-subordinate dyads, our findings suggested that customer gratitude expression promoted employees’ cognitive crafting, which further helped to improve employees’ working outcomes（i.e., deep acting in behavioral dimension and job performance in outcome dimension）. In addition, employees’ prevention focus–which represented more sensitivity to negative information and more intention to maintain the status quo–weakened the effect of customer gratitude expression on employees’ cognitive crafting and working outcomes. Our research made contributions in several aspects. Firstly, by examining the effect of customer gratitude expression on employees’ working outcomes, our research filled in the blank in customer-employee positive interaction domain, which not only inspired researchers to pay attention to “the other side of the coin”, but also offered practical implications for managers to build civilized customer-employee relationship. Secondly, our paper enriched the research about gratitude. Previous studies mostly identified customer gratitude as emotional states and examined its effect on customer per se. Our research, on the contrast, revealed the interpersonal effect of gratitude by exploring the impact of gratitude expression on receivers. Thirdly, our study answered the call of further investigating cognitive crafting by examining the antecedent（i.e., customer gratitude expression）and outcomes（i.e., employee working outcomes）of cognitive crafting, which also enlarges studies in the job crafting domain.

Emotional regularity: associations with personality, psychological health, and occupational outcomes

ABSTRACT Emotional regularity is the degree to which a person maintains and returns to a set of emotional states over time. The present investigation examined associations between emotional regularity and extant emotion measures as well as psychologically relevant dimensions of personality, health, and real-world occupational outcomes. Participants included 598 U.S. adults who provided daily experience sampling reports on their emotional states for approximately two months. Results suggest that emotional regularity was related to, but distinct from, well-established measures of emotion including emotional intensity, variability, covariation, inertia, granularity, and emodiversity. Furthermore, emotional regularity significantly predicted measures of personality, psychological health, and occupational outcomes even when accounting for extant emotion measures and sociodemographic covariates. Finally, it explained modest (7.5%) improvement (in terms of cross-validated RSq.) over baseline models containing emotional intensity, variability, and sociodemographic covariates. These findings suggest that emotional regularity may provide an important indicator of healthy emotional functioning and may be a promising area for further scientific discovery.

Early, Chronic, and Acute Cannabis Exposure and Their Relationship With Cognitive and Behavioral Harms.

Background: Cannabis is the third most consumed drug worldwide. Thus, healthcare providers should be able to identify users who are in need for an intervention. This study aims to explore the relationship of acute, chronic, and early exposure (AE, CE, and EE) to cannabis with cognitive and behavioral harms (CBH), as a first step toward defining risky cannabis use criteria.Methods: Adults living in Spain who used cannabis at least once during the last year answered an online survey about cannabis use and health-related harms. Cannabis use was assessed in five dimensions: quantity on use days during the last 30 days (AE), frequency of use in the last month (AE), years of regular use (YRCU) (CE), age of first use (AOf) (EE), and age of onset of regular use (AOr) (EE). CBH indicators included validated instruments and custom-made items. Pearson correlations were calculated for continuous variables, and Student's t-tests for independent samples were calculated for categorical variables. Effect sizes were calculated for each of the five dimensions of use (Cohen's d or r Pearson correlation) and harm outcome. Classification and Regression Trees (CART) analyses were performed for those dependent variables (harms) significantly associated with at least two dimensions of cannabis use patterns. Lastly, logistic binary analyses were conducted for each harm outcome.Results: The mean age of participants was 26.2 years old [standard deviation (SD) 8.5]. Out of 2,124 respondents, 1,606 (75.6%) reported at least one harm outcome (mean 1.8 and SD 1.5). In our sample, using cannabis on 3 out of 4 days was associated with an 8-fold probability of scoring 4+ on the Severity Dependence Scale (OR 8.33, 95% CI 4.91–14.16, p <0.001), which is indicative of a cannabis use disorder. Also, a start of regular cannabis use before the age of 25 combined with using cannabis at least once per month was associated with a higher probability of risky alcohol use (OR 1.33, 95% CI 1.12–1.57, p = 0.001). Besides, a start of regular cannabis use before the age of 18 combined with a period of regular use of at least 7.5 years was associated with a higher probability of reporting a motor vehicle accident (OR 1.81, 95% CI 1.41–2.32, p < 0.0001). Results were ambiguous regarding the role that age of first use and milligrams of THC per day of use might play regarding cannabis-related harms.Conclusions: The relationship among AE, CE, and EE with CBH indicators is a complex phenomenon that deserves further studies. The pattern of cannabis use should be carefully and widely evaluated—(not just including frequency but also other dimensions of pattern of use)—in research (preferably in longitudinal studies) to assess cannabis-related harms.

Appropriate policy-making for rural regions management in Iran

The development of rural areas, from various aspects, has always been of interest for researchers in less developed communities. These studies, according to the way governments look at development issues, have led the governments to make decisions and implement plans for how to manage rural areas (called politics); the process of studying, planning, as well as making decision and ultimately implementation in the rural environment is called rural policy-making. In Iran, different decisions have always been made to develop rural areas. In this study, we sought to identify the characteristics of policy-making and governance of rural areas and to understand the causes of their inefficiency in order to provide an appropriate model for policy-making and management of rural areas in Iran. Using thematic analysis, the themes of policy-making for managing the rural areas of Iran were investigated. The data were collected through semi-structured interviews and studying the related documents. The findings showed three categories of pervasive themes: contexts; influential factors, and outcome dimensions. These three shape the basic concepts and organize themes for appropriate policy-making. In fact, based on the results, policy is appropriate for managing Iran's rural areas; it pays attention to the context and specific characteristics of the rural identity and environment, considers the role of external factors in decision-making and policy outcomes, is aware of the consequences of the previous policies, and leads to stability in policies.

Enhancing employment and work-life satisfaction through acculturation for international workers

Driven by globalisation trends, self-organised international work is becoming increasingly prevalent around the world. We apply the acculturation theory in exploring employment experiences among previous working holidaymakers, who self-initiated their temporary international work and relocation from Taiwan to Australia. Through in-depth, narrative interviews, we identify four dimensions of work-related outcomes enhanced by acculturation including geographical mobility, increased employment opportunities, enhanced employment conditions and increased work-life satisfaction. Drawing on the model of acculturation strategies, we find that while the separation strategy only contributes towards geographical mobility and increased employment opportunities, the integration strategy can contribute across all four dimensions of enhanced employment and outcomes, particularly work-life satisfaction, which results from emancipating people from their previously socialised cultural values. Moreover, international workers may perceive job quality as a relative concept through comparing work practices experienced in their home and host environments. Our study contributes to the international careers literature by demonstrating how international workers’ experiences of enhanced employment quality may be perceived as a process of accumulating and leveraging sociocultural resources within the host culture.

Associations of Early-Life Threat and Deprivation With Executive Functioning in Childhood and Adolescence

Many studies have demonstrated an association between early-life adversity (ELA) and executive functioning in children and adolescents. However, the aggregate magnitude of this association is unknown in the context of threat and deprivation types of adversity and various executive functioning domains. To test the hypothesis that experiences of deprivation are more strongly associated with reduced executive functioning compared with experiences of threat during childhood and adolescence. Embase, ERIC, MEDLINE, and PsycInfo databases were searched from inception to December 31, 2020. Both forward and reverse snowball citation searches were performed to identify additional articles. Articles were selected for inclusion if they (1) had a child and/or adolescent sample, (2) included measures of ELA, (3) measured executive functioning, (4) evaluated the association between adversity and executive functioning, (5) were published in a peer-reviewed journal, and (6) were published in the English language. No temporal or geographic limits were set. A 2-reviewer, blinded screening process was conducted. PRISMA guidelines were used to guide data extraction and article diagnostics (for heterogeneity, small study bias, and p-hacking). Article quality was assessed, and data extraction was performed by multiple independent observers. A 3-level meta-analytic model with a restricted maximum likelihood method was used. Moderator analyses were conducted to explore heterogeneity. Primary outcomes included measures of the 3 domains of executive functioning: cognitive flexibility, inhibitory control, and working memory. A total of 91 articles were included, representing 82 unique cohorts and 31 188 unique individuals. Deprivation, compared with threat, was associated with significantly lower inhibitory control (F1,90 = 5.69; P = .02) and working memory (F1,54 = 5.78; P = .02). No significant difference was observed for cognitive flexibility (F1,36 = 2.38; P = .12). The pooled effect size of the association of inhibitory control with deprivation was stronger (Hedges g = -0.43; 95% CI, -0.57 to -0.29) compared with threat (Hedges g = -0.27; 95% CI, -0.46 to -0.08). The pooled effect size of the association of working memory with deprivation was stronger (Hedges g = -0.54; 95% CI, -0.75 to -0.33) compared with threat (Hedges g = -0.28; 95% CI, -0.51 to -0.05). Experiences of both threat and deprivation in childhood and adolescence were associated with reduced executive functioning, but the association was stronger for exposure to deprivation. Efforts to address the consequences of ELA for development should consider the associations between specific dimensions of adversity and specific developmental outcomes.

Updated Review of the Acoustic Modulation of Sleep: Current Perspectives and Emerging Concepts.

With growing interest in the use of acoustic stimuli in sleep research and acoustic interventions used therapeutically for sleep enhancement, there is a need for an overview of the current lines of research. This paper summarizes the various ways to use acoustic input before sleep or stimulation during sleep. It thereby focuses on the respective methodological requirements, advantages, disadvantages, potentials and difficulties of acoustic sleep modulation. It highlights differences in subjective and objective outcome measures, immediate and whole night effects and short versus long term effects. This recognizes the fact that not all outcome parameters are relevant in every research field. The same applies to conclusions drawn from other outcome dimensions, consideration of mediating factors, levels of stimulation processing and the impact of inter-individual differences. In addition to the deliberate influences of acoustic input on sleep, one paragraph describes adverse environmental acoustic influences. Finally, the possibilities for clinical and basic research-related applications are discussed, and emerging opportunities are presented. This overview is not a systematic review but aims to present the current perspective and hence summarizes the most up-to-date research results and reviews. This is the first review providing a summary of the broad spectrum of possibilities to acoustically influence sleep.

The Importance of Outcome Measures in the Management of Inflammatory Rheumatic Diseases.

Rheumatic inflammatory diseases include a diverse and heterogeneous group of multifaceted disorders in which clinical history and physical examination are essential to make treatment choices and for optimizing outcomes. Composite outcome measures have become very relevant in rheumatology to evaluate disease activity as they capture the most important dimensions of the disease into one single measure. Most outcome measures may include disease manifestations, laboratory data, physician examination as well as the patient perspective as different outcome dimensions of the disease into a simple index. These outcome measures have proved their utility for guiding treatment in treat-to- target strategies and personalized medicine, with remission being the ultimate goal. In this narrative review, we go over the most commonly used outcome measures in rheumatoid arthritis, spondyloarthropathies, including psoriatic arthritis, and systemic lupus erythematosus to provide a practical summary for clinicians for everyday routine care.

The impact of natural disasters and epidemics on sexual and reproductive health in low- and middle-income countries: Anarrative synthesis.

Natural disasters and epidemics can strain already-fragile health systems, diverting resources away from essential sexual and reproductive health (SRH) services, threatening supply chains, and adversely impacting access to health facilities. To describe how natural disasters and epidemics affect multiple dimensions of SRH service delivery and outcomes, and identify potential approaches to facilitate resumption of services. Key words searched in Google Scholar, PubMed, and Scopus. Studies published in English between 2005 and 2020 covering events in low- and middle-income countries. This review was developed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2009 checklist. The initial electronic database searching yielded 64345studies, but after screening 13studies were included in the final review. Across contexts, disruptive events worsened the availability of and women's access to SRH services, contributed to decreased utilization of SRH services, and often resulted in lower use of family planning, particularly methods requiring facility-based interaction. SRH in disaster response plans must be prioritized, as women often lose access to these essential services at a time when they are at their most vulnerable. Evidence regarding effective interventions and policies is lacking.

Effective Public Rental Housing governance: tenants’ perspective from the pilot city Chongqing, China

In the past decade, Public Rental Housing (PRH) has become the program of providing affordable rental housing to low- and middle-income households in China. Even though descriptions of the governance results are numerous, the previous studies are not underpinned by a theoretical foundation from a governance perspective, nor have they empirically examined whether PRH governance works on the ground. This explorative and empirical paper aims to fill this gap of an outcome-oriented evaluation of the impacts of governance as perceived by the final user. Central government formulated the objective for PRH governance as maintaining stability in the society. Whether the tenants perceive the goal of social stability as achieved was measured along three governance outcome dimensions: satisfaction with housing quality, satisfaction with housing quantity, and willingness to communicate with the government about PRH governance. Data were collected from questionnaires to PRH-tenants in Chongqing, the most important pilot city of PRH provision in China. The findings show that the perceived governance outcomes were quite mixed as tenants were moderately satisfied with PRH housing quantity, but less satisfied with housing quality, and thought they could relatively easily communicate with local government. In view of these mixed outcomes, to strengthen the effectiveness of PRH governance in the eyes of the tenants, this study suggests local governments: (1) to rethink and redevelop the performance evaluation; (2) to rethink the relations with non-governmental actors and organise a monitoring system that will assist in optimizing housing quality; and (3) to facilitate tenants’ communication with local government.

Wellness and Motivation in a Physical Education Course Over a Semester: Examining the Interaction Effects that Motivation has on Wellness Outcomes

Objective: This study reports the results that physical education classes have on college students' overall wellbeing and motivation over the course of a semester. This study examines the pre/post outcomes of a physical education course on 12 dimensions of wellness and motivation from the start of the semester to the end of the semester.Participants: College students (N = 1193) taking Physical Education 101 (PED101) over the course of a semester.Methods: Beginning (pre) and end (post) of the semester assessments for wellbeing and motivation were conducted using the Wellness Inventory. Quantitative outcomes from the Wellness Inventory were compared pre/post as well as demographic variables (e.g., gender &amp; exercise frequency). Regression analysis was also conducted to examine how motivation may affect wellness. Results: All 12 dimensions of wellness and motivation showed increases from the start of the semester to the end of the semester. Motivation was also positively correlated with increases in wellness scores. The results found statistically significant changes between the pre- and post-assessments for all dimensions of wellness outcomes and motivation scores. There were also significant changes between the pre- and post-assessments when investigating differences based on sex.Conclusion: PED101 courses can be useful interventions to help move college students towards wellness.

Family Business Restructuring: A Review and Research Agenda

AbstractAlthough business restructuring occurs frequently and it is important for the prosperity of family firms across generations, research on family firms has largely evolved separately from research on business restructuring. This is a missed opportunity, since the two domains are complementary, and understanding the context, process, content, and outcome dimensions is relevant to both research streams. We address this by examining the intersection between research on business restructuring and family firms to improve our knowledge of each area and inform future research. To achieve this goal, we review and organize research across different dimensions to create an integrative framework. Building on current research, we focus on 88 studies at the intersection of family firm and business restructuring research to develop a model that identifies research needs and suggests directions for future research.

Healthy aging in India: evidence from a panel study

PurposeRecent public health policy emphasizes the achievement of healthy aging as average life expectancy increases worldwide. Evidence for healthy aging from low- and middle-income countries (LMIC) is limited. The purpose of this paper is to assess the prospects of healthy aging and its associated factors in the Indian context.Design/methodology/approachThe study was based on a national-level panel survey, the Indian Human Development Survey (IHDS) conducted in 2004-05 and 2011-12. The analytical sample consists of 10,218 elderly individuals who were 60 years old and above at the baseline. Change in health status was assessed based on disability and disease incidence at the follow-up. A generalized estimating equation (GEE) model was performed to assess health status change.FindingsIncreasing age was a risk factor for all dimensions of health outcomes. Elderly from the lowest wealth quintiles were more likely to lose health due to short-term morbidity, whereas the highest wealth quintiles were more likely to lose health due to long-term and multi-morbidity, indicating evidence for the presence of the “disease of affluence”. Social capital, such as living in a joint family acted as a protective factor against health risks.Originality/valueWith the results showing the evidence of the “disease of affluence” and “disease of poverty” in different health outcomes, there should be a health policy focus that copes with undergoing epidemiological transition. It is also important to pay attention to health-protecting factors such as social and familial support to achieve healthy aging.

Patient perceived quality of nursing care in hemodialysis: A meta-synthesis

This study was done with the purpose of clarifying the concept of patient perceived quality of nursing care in hemodialysis. In this meta-synthesis study, qualitative studies was searched in the four interntional databases from January 1st, 2000 to December 30th, 2019. The keywords used were: nursing care quality, and hemodialysis. Studies which had been done with the purpose of understanding the patient perceived quality of nursing care concept aomg hemodialysis patients were included. Two researchers were evaluate the quality of included studies separately using JBI tool, required information were extracted using the designed table. The main themes in the structure dimension include Sufficient Human resource, quality of equipment, financial support from patient and quality of the patient care environment. Process dimension consisted of continuous monitoring of the syndromes, effective patient education, efficient care, effective therapeutic relationship, and patient’s empowerment and participation in the process, and in the outcome dimension included high dialysis adequecy, patient burnout reduction, and increased patient satisfaction from services. The results of the study indicated a comprehensive, deep and interactive dimensions about the concept of nursing quality of care.

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study.

Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients' socio-economic gradient. We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users' characteristics. In the qualitative component, we synthesized users' and providers' narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. The quality of ANC in Nepal's primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

The functioning of dynamic capabilities: explaining the role of organizational innovativeness and culture

PurposeUsing the knowledge-based view of the firm, dynamic capability literature and known dimensions of organizational innovativeness (OI), this article develops two testable models that attempt to explain: (1) how innovativeness functions as a source of capability dynamization and (2) how organizational culture (OC) critically determines this function of innovativeness.Design/methodology/approachThe study uses a cross-sectional design and maximum variation sampling to identify organizations from the population of formal Indian business firms with the aim of controlling the effects of moderating variables such as their size, age, nature of business and ownership. Measurement instruments are borrowed from the literature. The cleaned dataset (n = 453 cases from 13 organizations) is randomly split into two-halves, which are used separately for extracting and confirming underlying factors. Rigorous procedure for assessing scale psychometric properties has been followed. The hypotheses are tested using structural equation modelling (SEM).FindingsExcept for a couple of paths that turned out insignificant, the data by and large support the study hypotheses. While market innovativeness failed to emerge as a factor, the capability dynamizing dimensions of innovativeness significantly predict its outcome dimensions of product and process innovativeness. Barring the effect of “trust”, they also fully mediate the effect of the rest of the culture factors on these outcome dimensions. Importantly, they are substantively determined by the culture factors, suggesting that the capability dynamizing dimensions are embedded in culture.Originality/valueThe primary contribution of this study is that besides accounting for how firm innovativeness can possibly explain the dynamism in dynamic capabilities, the results indicate a critical influence of culture in determining the potency of the dynamizing mechanisms. This has important implications for theory and practice.

Large-scale inference of correlation among mixed-type biological traits with phylogenetic multivariate probit models

Inferring concerted changes among biological traits along an evolutionary history remains an important yet challenging problem. Besides adjusting for spurious correlation induced from the shared history, the task also requires sufficient flexibility and computational efficiency to incorporate multiple continuous and discrete traits as data size increases. To accomplish this, we jointly model mixed-type traits by assuming latent parameters for binary outcome dimensions at the tips of an unknown tree informed by molecular sequences. This gives rise to a phylogenetic multivariate probit model. With large sample sizes, posterior computation under this model is problematic, as it requires repeated sampling from a high-dimensional truncated normal distribution. Current best practices employ multiple-try rejection sampling that suffers from slow-mixing and a computational cost that scales quadratically in sample size. We develop a new inference approach that exploits: (1) the bouncy particle sampler (BPS) based on piecewise deterministic Markov processes to simultaneously sample all truncated normal dimensions, and (2) novel dynamic programming that reduces the cost of likelihood and gradient evaluations for BPS to linear in sample size. In an application with 535 HIV viruses and 24 traits that necessitates sampling from a 12,840-dimensional truncated normal, our method makes it possible to estimate the across-trait correlation and detect factors that affect the pathogen’s capacity to cause disease. This inference framework is also applicable to a broader class of covariance structures beyond comparative biology.

The reward positivity reflects the integrated value of temporally threefold-layered decision outcomes.

In reinforcement learning, adaptive behavior depends on the ability to predict future outcomes based on previous decisions. The Reward Positivity (RewP) is thought to encode reward prediction errors in the anterior midcingulate cortex (aMCC) whenever these predictions are violated. Although the RewP has been extensively studied in the context of simple binary (win vs. loss) reward processing, recent studies suggest that the RewP scales complex feedback in a fine graded fashion. The aim of this study was to replicate and extend previous findings that the RewP reflects the integrated sum of instantaneous and delayed consequences of a singular outcome by increasing the feedback information content by a third temporal dimension. We used a complex reinforcement-learning task where each option was associated with an immediate, intermediate and delayed monetary outcome and analyzed the RewP in the time domain as well as fronto-medial theta power in the time-frequency domain. To test if the RewP sensitivity to the three outcome dimensions reflect stable trait-like individual differences in reward processing, a retesting session took place 3months later. The results confirm that the RewP reflects the integrated value of complex temporally extended consequences in a stable manner, albeit there was no relation to behavioral choice. Our findings indicate that the medial frontal cortex receives fine graded information about complex action outcomes that, however, may not necessarily translate to cognitive or behavioral control processes.

Personal Accounts of Young-Onset Colorectal Cancer Organized as Patient-Reported Data: Protocol for a Mixed Methods Study.

BackgroundYoung-onset colorectal cancer is a contemporary issue in need of substantial research input. The incidence of colorectal cancer in adults younger than 50 years is rising in contrast to the decreasing incidence of this cancer in older adults. People with young-onset colorectal cancer may be at that stage of life in which they are establishing their careers, building relationships with long-term partners, raising children, and assembling a financial base for the future. A qualitative study designed to facilitate triangulation with extant quantitative patient-reported data would contribute the first comprehensive resource for understanding how this distinct patient population experiences health services and the outcomes of care throughout the patient pathway.ObjectiveThe aim of this study was to undertake a mixed-methods study of qualitative patient-reported data on young-onset colorectal cancer experiences and outcomes.MethodsThis is a study of web-based unsolicited patient stories recounting experiences of health services and clinical outcomes related to young-onset colorectal cancer. Personal Recollections Organized as Data (PROD) is a novel methodology for understanding patients’ health experiences in order to improve care. PROD pivots qualitative data collection and analysis around the validated domains and dimensions measured in patient-reported outcome and patient-reported experience questionnaires. PROD involves 4 processes: (1) classifying attributes of the contributing patients, their disease states, their routes to diagnosis, and the clinical features of their treatment and posttreatment; (2) coding texts into the patient-reported experience and patient-reported outcome domains and dimensions, defined a priori, according to phases of the patient pathway; (3) thematic analysis of content within and across each domain; and (4) quantitative text analysis of the narrative content.ResultsRelevant patient stories have been identified, and permission has been obtained for use of the texts in primary research. The approval for this study was granted by the Macquarie University Human Research Ethics Committee in June 2020. The analytical framework was established in September 2020, and data collection commenced in October 2020. We will complete the analysis in March 2021 and we aim to publish the results in mid-2021.ConclusionsThe findings of this study will identify areas for improvement in the PROD methodology and inform the development of a large-scale study of young-onset colorectal cancer patient narratives. We believe that this will be the first qualitative study to identify and describe the patient pathway from symptom self-identification to help-seeking through to diagnosis, treatment, and to survivorship or palliation for people with young-onset colorectal cancer.International Registered Report Identifier (IRRID)DERR1-10.2196/25056