OBJECTIVES: Older adults in rural areas with multiple chronic conditions (MCC) generally exhibit poorer medication adherence than the general elderly population. Considering individual heterogeneity helps to design precise subgroup-based interventions. This study aims to identify latent profile types of medication adherence mechanisms among rural older adults with MCC based on the capability-opportunity-motivation-behavior (COM-B) model, and to explore factors influencing medication adherence. METHODS: A multistage sampling method was used to recruit 349 rural older adults with MCC from 10 administrative villages in Jianghua County, Yongzhou City, Hunan Province, between July and September, 2024. Participants were surveyed using a general information questionnaire, the Health Literacy Scale for Chronic Patients, the Beliefs about Medicines Questionnaire-Specific, the Multidimensional Scale of Perceived Social Support, and the Morisky Medication Adherence Scale. Latent profile analysis based on the COM-B model was conducted to identify subgroups of medication adherence mechanisms. Univariate and Logistic regression analyses were used to identify influencing factors associated with different latent profiles and adherence levels. RESULTS: Among the participants, 33.5% demonstrated good medication adherence. The 5 most prevalent chronic diseases were hypertension (86.5%), diabetes (36.7%), arthritis or rheumatism (34.4%), stroke (21.8%), and heart disease (17.5%). Overall, rural older adults with MCC exhibited relatively good medication capability, opportunity, and motivation. Their medication adherence mechanisms were classified into 3 latent profiles: "family-support restrained type" (5.2%), "family-support driven type" (52.1%), and "comprehensive advantage type" (42.7%). Significant differences were observed among the three profiles in terms of education level, marital status, living arrangement, and per capita monthly household income (all P<0.05). Multivariate Logistic regression revealed that higher education level was a protective factor for belonging to the "comprehensive advantage type" rather than the "family-support driven type" [OR=0.277, 95% CI (PL) 0.126 to 0.614, P=0.002]. Furthermore, significant differences in education level, self-rated health status, and latent profile type were found between participants with good and poor adherence (P<0.05). Binary Logistic regression indicated that with each one-level increase in self-rated health status, the risk of poor adherence increased by 293.9% [OR=3.939, 95% CI (PL) 1.610 to 9.636, P=0.003]. Compared with the "family-support restrained type", individuals classified as the "comprehensive advantage type" had a 96.8% [OR=0.032, 95% CI (PL) 0.008 to 0.123, P<0.001] lower risk of poor medication adherence. CONCLUSIONS The mechanisms underlying medication adherence among rural older adults with MCC show clear heterogeneity. Primary healthcare providers should focus on the "family-support restrained type" subgroup, strengthen social support networks, and implement targeted interventions to improve medication adherence.
Humans ; Aged ; Rural Population ; Male ; Female ; China ; Medication Adherence/psychology* ; Surveys and Questionnaires ; Chronic Disease/drug therapy* ; Multiple Chronic Conditions/drug therapy* ; Social Support ; Motivation ; Middle Aged ; Health Literacy ; Aged, 80 and over

OBJECTIVES: To revise and evaluate the psychometric properties of the Chinese version of the Wong and Law's Emotional Intelligence Scale (WLEIS). METHODS: The 11 items of the original WLEIS were modified to form the WLEIS-CR, with the Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), and Flourishing Scale (FS) as the validity criteria. A total of 1546 adult participants were evaluated using all these scales, and a retest was conducted among 192 college students to assess the item discrimination, reliability, validity and measurement invariance of the modified WLEIS-CR. RESULTS: All the 16 items of the modified WLEIS-CR demonstrated good discriminative power (r=0.570 -0.764, P<0.001). The structural equation model from a confirmatory factor analysis showed excellent fit indices (χ²/df=4.610, GFI=0.965, PGFI=0.674, RMR=0.028, NFI=0.975, CFI=0.980, RMSEA=0.048). The criterion-related validity of the modified WLEIS-CR with FS, GAD-7, and PHQ-9 was 0.674, -0.347, and -0.368, respectively (P<0.001). The internal consistency (Cronbach's α) was 0.913 for the total scale and ranged from 0.867 to 0.916 for the subscales. The split-half reliability was 0.956 for the total scale and 0.865-0.924 for the subscales. Test-retest reliability was 0.701 for the total scale and 0.610-0.684 for the subscales. Normative interpretation criteria were established: 7.6% of participants had "low", 19.3% had "below average", 22.3% had "moderate", 34.3% had "above average", and 16.5% had "very high" emotional intelligence. The scale demonstrated a good measurement invariance across gender, identity, and age groups. CONCLUSIONS The modified WLEIS-CR has good reliability, validity and measurement invariance, and is suitable for evaluating emotional intelligence of Chinese adults to assess their emotional health.
Humans ; Psychometrics ; Emotional Intelligence ; Young Adult ; Adult ; Male ; Female ; Surveys and Questionnaires ; Reproducibility of Results ; Adolescent

Social working memory (SWM)-the ability to maintain and manipulate social information in the brain-plays a crucial role in social interactions. However, research on SWM is still in its infancy and is often treated as a unitary construct. In the present study, we propose that SWM can be conceptualized as having two relatively independent components: "externally oriented SWM" (e-SWM) and "internally oriented SWM" (i-SWM). To test this external-internal hypothesis, participants were tasked with memorizing and ranking either facial expressions (e-SWM) or personality traits (i-SWM) associated with images of faces. We then examined the neural correlates of these two SWM components and their functional roles in empathy. The results showed distinct activations as the e-SWM task activated the postcentral and precentral gyri while the i-SWM task activated the precuneus/posterior cingulate cortex and superior frontal gyrus. Distinct multivariate activation patterns were also found within the dorsal medial prefrontal cortex in the two tasks. Moreover, partial least squares analyses combining brain activation and individual differences in empathy showed that e-SWM and i-SWM brain activities were mainly correlated with affective empathy and cognitive empathy, respectively. These findings implicate distinct brain processes as well as functional roles of the two types of SWM, providing support for the internal-external hypothesis of SWM.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Empathy/physiology* ; Young Adult ; Magnetic Resonance Imaging ; Adult ; Brain/diagnostic imaging* ; Brain Mapping ; Facial Expression ; Social Behavior ; Facial Recognition/physiology* ; Social Perception ; Personality/physiology*

Empathy is crucial for communication and survival for individuals. Whether empathy in pain contagion shows sex differences and its underlying mechanisms remain unclear. Here, we report that pain contagion can occur in stranger female rats, but not in stranger males. Blocking oxytocin receptors in the anterior cingulate cortex (ACC) suppressed pain contagion in female strangers, while oxytocin administration induced pain contagion in male strangers. In vitro, corticosterone reduces neuronal activation by oxytocin. During male stranger interactions, higher corticosterone decreased oxytocin receptor-positive neuronal activity in the ACC, suppressing pain contagion. These findings highlight the role of oxytocin in pain contagion and suggest that sex differences in empathy may be determined by the balance of oxytocin and corticosterone in the ACC. This study suggests an approach for the treatment of certain mental disorders associated with abnormal empathy, such as autism and depression.
Animals ; Oxytocin/pharmacology* ; Gyrus Cinguli/drug effects* ; Male ; Female ; Corticosterone/pharmacology* ; Empathy/drug effects* ; Sex Characteristics ; Receptors, Oxytocin/antagonists & inhibitors* ; Pain/psychology* ; Rats ; Rats, Sprague-Dawley ; Neurons/metabolism*

OBJECTIVE: This study explored the job choice preferences of Center for Disease Prevention and Control (CDC) workers to provide CDC management information and recommendations for optimizing employee retention and motivation policies. METHODS: A discrete choice experiment was conducted in nine provinces across China. Seven key attributes were identified to analyze the job preferences of CDC workers. Mixed logit models, latent class models, and policy simulation tools were used. RESULTS: A valid sample of 5,944 cases was included in the analysis. All seven attributes significantly influenced the job choices of CDC workers. Heterogeneity analyses identified two main groups based on different levels of preference for attribute utility. Income-prioritizers were concerned with income and opportunities for career development, whereas bianzhi-prioritizers were concerned with bianzhi and welfare benefits. The policy simulation analysis revealed that income-prioritizers had a relatively higher sensitivity to multiple job preference incentives. CONCLUSION Income and bianzhi were the two key attributes influencing the job choices and retention preferences of CDC workers. Heterogeneity in job preferences was also identified. Based on the preference characteristics of different subgroups, policy content should be skewed to differentiate the importance of incentives.
China ; Humans ; Male ; Female ; Adult ; Centers for Disease Control and Prevention, U.S. ; Middle Aged ; Choice Behavior ; Career Choice ; Motivation

Stroke remains a leading cause of long-term disability worldwide, demanding extensive and often prolonged rehabilitation. This case report describes the recovery of Mr. Julio, a 60-year-old male, who suffered an ischemic stroke at age 58, resulting in left-sided hemiparesis and balance issues. Even with delays in formal rehabilitation, he made a remarkable recovery over nearly three years. This is because of his strong intrinsic motivation, sustained adherence to therapy, and family support. His symptoms included left-sided weakness, numbness, vertigo, vomiting, and critically high blood pressure. Crucially, his diagnosis was confirmed by MRI only three months later and formal physical therapy started only after six months. Treatment included an emergency TPA, blood pressure control, antiplatelets, and a sustained home- based physical therapy regimen. This case highlights how patient-driven factors can lead to significant recovery even in resource-limited settings, emphasizing the role of motivation and adherence in long-term stroke rehabilitation.

In this study, we investigated how empathic neural responses unfold over time in different empathy networks when viewing same-race and other-race individuals in dynamic painful conditions. We recorded magnetoencephalography signals from Chinese adults when viewing video clips showing a dynamic painful (or non-painful) stimulation to Asian and White models' faces to trigger painful (or neutral) expressions. We found that perceived dynamic pain in Asian models modulated neural activities in the visual cortex at 100 ms-200 ms, in the orbitofrontal and subgenual anterior cingulate cortices at 150 ms-200 ms, in the anterior cingulate cortex around 250 ms-350 ms, and in the temporoparietal junction and middle temporal gyrus around 600 ms after video onset. Perceived dynamic pain in White models modulated activities in the visual, anterior cingulate, and primary sensory cortices after 500 ms. Our findings unraveled earlier dynamic activities in multiple neural circuits in response to same-race (vs other-race) individuals in dynamic painful situations.
Adult ; Humans ; Brain Mapping ; Pain ; Empathy ; Racism ; Gyrus Cinguli/physiology* ; Magnetic Resonance Imaging ; Brain/physiology*

BACKGROUND

According to the World Health Organization, in 2016, there were more than 1.9 billion adults who were overweight. Of these, over 650 million were obese. Physical inactivity is one of the major risk factors for several non-communicable diseases. Healthcare workers who have direct contact with patients often influence their behaviors. However, health care workers who educate their patients but they themselves do not practice what they recommend, may be one of the barriers that can affect patient education and influence.

This research paper aimed to investigate the motivation to participate in physical activity among healthcare workers and to determine the association between the profile of respondents with the different types of motivation.

There was a total of 250 randomly selected respondents who were included in the study. Data were gathered through a self-administered questionnaire utilizing the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Behavioral Regulation in Exercise Questionnaire (BREQ-2). Descriptive statistics was used to summarize sociodemographic information, physical activity levels and BREQ-2 profiles. T-test was used to analyze differences in gender while analysis of variance (ANOVA) was used for levels of physical activity and professional category.

Female healthcare professionals have a higher average in amotivation (mean=0.56) while males have a higher average in intrinsic (mean=2.82) motivation. Nurses and ancillary services have higher average amotivation scores than physicians.

Health care workers who have high classification in physical activity have the highest average scores in terms of relative autonomy index, introjected, identified, and intrinsic scores. This demonstrates a positive association between motivation from internal regulation and increased physical activity.

BACKGROUND: The discourse over the relative importance of emotional intelligence (EQ) and cognitive intelligence (IQ) in predicting life success has been a contentious debate over the past few decades. OBJECTIVES: This study examines the interplay between IQ and EQ among gifted Filipino medical students in the University of the Philippines' Integrated Liberal Arts and Medicine (INTARMED) program, who are faced with the dual pressures of being intellectually gifted and coping with the demands of medical education at a young age. METHODOLOGY: Using a sequential explanatory mixed-methods design, 76 participants were administered with standardized tests to measure their EQ and IQ levels. This was followed by in-depth interviews to explore their self-perceptions of intellectual giftedness and emotional competence. RESULTS: Results show that participants have high intellectual ability but with an average level of emotional intelligence, suggesting that while these students excel academically, their emotional competencies might not be as developed. Notably, a weak but significant correlation between IQ and EQ scores was identified, indicating that higher cognitive abilities may be associated with slightly elevated emotional skills. Qualitative findings highlighted the internal conflict between self-perception and societal stereotypes of giftedness, alongside challenges in social interaction and low stress tolerance amidst high adaptability. CONCLUSION Findings of this study emphasize the crucial role of emotional intelligence in coping with stress and social expectations, particularly in high-pressure academic environments like medical school. This study contributes to the ongoing discourse on IQ vs. EQ debate by providing empirical evidence on the complex relationship between cognitive and emotional intelligence. It underscores the need for a more nuanced understanding of success, beyond traditional academic achievements, advocating for the integration of emotional competence training within the medical curriculum to better prepare students for the challenges ahead in their medical profession.
Human ; Emotional Intelligence

OBJECTIVES: To determine the impact of scenario-based lecture and personalized video feedback on anesthesia residents' communication skills during preoperative visits. METHODS: A total of 24 anesthesia residents were randomly divided into a video group and a control group. Residents in both groups took part in a simulated interview and received a scenario-based lecture on how to communicate with patients during preoperative visits. Afterwards, residents in the video group received personalized video feedback recorded during the simulated interview. One week later all the residents undertook another simulated interview. The communication skills of all the residents were assessed using the Consultation and Relational Empathy measure (CARE) scale by two examiners and one standardized patient (SP), both of whom were blinded to the group allocation. RESULTS: CARE scores were comparable between the two groups before training, and significantly improved after training in both groups (all P < 0.05). The video group showed significantly greater increase in CARE score after the training than the control group, especially assessed by the SP (t = 6.980, P <0.001). There were significant correlations between the examiner-assessed scores and SP-assessed scores (both P = 0.001). CONCLUSIONS Scenario-based lectures with simulated interviews provide a good method for training communication skills of anesthesia residents, and personalized video feedback can enhance their performance on showing empathy during preoperative interview.
Humans ; Internship and Residency ; Empathy ; Communication ; Anesthesiology/education* ; Male ; Female ; Adult ; Video Recording ; Feedback ; Clinical Competence