Well‐paid nurses are good nurses

Some recent articles suggest that increasing wage in the nursing market with the aim of reducing shortage can negatively impact on the average ability and motivation of applicants attracted and, in turn, on the average quality of care. This finding is at odds with empirical evidence and has been criticized on the grounds that nurses' motivation is modeled in an overly simplistic way. This paper provides a novel theoretical framework where the orientation of nurses' motivation—intrinsic versus extrinsic—is taken into account, and the precise distinction between intrinsic and extrinsic motivation is delineated on the basis of self‐determination and person–environment fit theories. Conditions are derived under which high wages attract able and motivated individuals, thus maximizing the average quality of care.     

Assessing college students’ ego-identity status and their use of motivational regulation strategies

Using correlational analyses and structural equation modeling, this study tests three hypotheses: students’ reported use of motivational strategies is 1) correlated with their ego-identity status; 2) positively correlated with their reported use of learning strategies and negatively associated with their level of procrastination; and 3) related to their existing motivational beliefs and attitudes. Participants were American college students (N?=?113). The findings support all three hypotheses.

The study computed Pearson product moment correlations (listwise) among the ego identity and motivation measures; significant correlations ranged from 0.19 to 0.29. To test the hypothesized conceptual model, the study subjected the correlations to a confirmatory factor analysis. The five model varimax solution had excellent loadings on 16 variables; their standardized path coefficients were highly significant (p?df?=?161, p?=?0.0003; goodness of fit (GFI)?=?0.913; RMSEA?=?0.056).

The findings support the existence of a positive relationship between college students’ identity status and their use of motivational regulation strategies. They also suggest students’ use of motivational strategies is closely related to their use of cognitive and metacognitive strategies, but not to their level of academic procrastination. This article discusses practical applications for mental health providers and educators.     

Paradoxical brain embolism shadowing massive pulmonary embolism

Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagnosis of massive pulmonary embolism that was lately confirmed by a multidetector CT-angiography. Anticoagulation therapy was rapidly complicated by a hemorrhagic transformation of the ischemic stroke leading to a fatal outcome. This case illustrates the double-edged circulatory effect of shunting across a patent foramen ovale in case of massive pulmonary embolism: it may have limited circulatory failure but caused in the meanwhile a fatal paradoxical brain embolism.     

Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory

Background: Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. Objective: This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. Method: The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. Results: The variables of perceived vulnerability (β = 0/137, P < 0.001), fear (β = 0/149, P < 0.001), self-efficacy (β = 0/249, P < 0.001), perceived intrinsic reward (β = ?0.285, P < 0.001), threat appraisal (β = ?0.25, P < 0.001), and coping appraisal (β = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (β = ?0.158, P < 0.001), fear (β = ?0.172, P < 0.001), self-efficacy (β = ?0.288, P < 0.001), perceived intrinsic reward (β = 0.329, P < 0.001), threat appraisal (β = 0.265, P < 0.001), and coping appraisal (β = ?0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (β = ?1.156, P < 0.001). Conclusions: The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.