Next SectionIntensification of poverty and degradation of health infrastructure over recent decades in countries most affected by HIV/AIDS present formidable challenges to clinical research. This paper addresses the overall standard of health care (SOC) that should be provided to research participants in developing countries, rather than the narrow definition of SOC that has characterised the international debate on standards of health care. It argues that contributing to sustainable improvements in health by progressively ratcheting the standard of care upwards for research (...) participants and their communities is an ethical obligation of those in resource-rich countries who sponsor and implement research in poorer ones. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

Objective: Gait adaptation to environmental challenges is fundamental for independent and safe community ambulation. The possibility of precisely studying gait modulation using standardized protocols of gait analysis closely resembling everyday life scenarios is still an unmet need.Methods: We have developed a fully-immersive virtual reality environment where subjects have to adjust their walking pattern to avoid collision with a virtual agent crossing their gait trajectory. We collected kinematic data of 12 healthy young subjects walking in real world and in the VR (...) environment, both with and without the VA perturbation. The VR environment closely resembled the RW scenario of the gait laboratory. To ensure standardization of the obstacle presentation the starting time speed and trajectory of the VA were defined using the kinematics of the participant as detected online during each walking trial.Results: We did not observe kinematic differences between walking in RW and VR/A-, suggesting that our VR environment per se might not induce significant changes in the locomotor pattern. When facing the VA all subjects consistently reduced stride length and velocity while increasing stride duration. Trunk inclination and mediolateral trajectory deviation also facilitated avoidance of the obstacle.Conclusions: This proof-of-concept study shows that our VR/A+ paradigm effectively induced a timely gait modulation in a standardized immersive and realistic scenario. This protocol could be a powerful research tool to study gait modulation and its derangements in relation to aging and clinical conditions. (shrink)

Physical activity counteracts some of the negative consequences associated with chronic neurological diseases. Here, we describe the levels of physical activity and sports activity in patients with multiple sclerosis and chronic stroke and test compliance with the recommendation for health-promoting physical activity of the World-Health Organization. Secondly, we tested for differences between the groups of patients, and thirdly, we examined relationships between PA and Sport with psychological indicators of perceived energy and self-beliefs. Psychological constructs were assessed with validated measures from (...) different disciplines in Psychology. A statistical aim was to describe interpretations gained by parametric Bayesian and Null-Hypothesis-Significance Testing statistics on the example of the conducted tests for differences and relationships. Descriptive analyses revealed that pMS and pStroke complied with recommendations of the WHO, but with large variance indicating that patient groups are not homogenous. Tests for differences showed that the PA difference between pMS and pStroke can be attributed to the higher proportion of women in the pMS sample as they engage more in household chores. Tests for relationships showed that for pStroke, vitality, self-control, and self-efficacy were positively related to the level of sports activity. Furthermore, pStroke who were sport active had lower fatigue and higher self-control and self-efficacy scores than sport inactive people. Although they address slightly different questions, the Bayesian and the NHST approach led to similar general conclusions. (shrink)

The World Health Organization defined COVID-19 as a pandemic on March 11, due to the spread of the new SARS-CoV-2 coronavirus in all continents. Italy had already witnessed a very fast spread that brought the Government to place the entire country under quarantine on March 11, reaching more than 30,700 fatalities in 2 months. We hypothesized that the pandemic and related compulsory quarantine would lead to an increase of anxiety state and protective behaviors to avoid infections. We aimed to investigate (...) whether protective behaviors might have been enhanced or limited by anxiety and emotional reactions to previous experience of stressful conditions. We collected data from 618 Italian participants, by means of an online survey. Participants were asked to rate their level of worry for the pandemic, and to complete two questionnaires measuring the anxiety level: the state-trait anxiety inventory and the Pre-traumatic stress reaction checklist. Finally, the respondents were also asked to report about their compliance with protective behaviors suggested to avoid the spread of the virus. Results show that respondents with higher levels of worry reported higher levels of anxiety and pre-traumatic reactions, with positive correlations among the three measurements, and that higher frequency of the three protective behaviors were put in place by respondents with higher levels of worry. Moreover, regression analysis showed that worry for COVID-19 was most predicted by age, anxiety levels, and Pre-traumatic stress. These results could be interpreted in an evolutionary framework, in which the level of worry leads persons to become more cautious maximizing long-term survival at the cost of short-term dysregulation. (shrink)

Theatre has been used in psychological intervention and as a metaphor for social life, tendencies that affect the self, highlighting how influential theatrical performance can be for individuals. Their limitations – in terms of the empowerment of the self and its authenticity, respectively - can be overcome by treating theatrical performance as a leisure experience, which considers that freedom and satisfaction play a central role in a more comprehensive understanding and development of the self. With this in mind, we present (...) the conceptual and empirical bases of the leisure experience as an alternative conception of theatrical performance. To do so, we organised a 20-hour theatre exercise workshop with 16 university students (15 women, one man), aged between 18 and 21 years old (M = 19.06 years; SD = 1.06). Qualitative instruments used were: the Time Budget Technique (questionnaire about the activities carried out in the workshop, valued in relation to two items: perceptions of freedom and satisfaction); the Twenty-Statement Test (where people list characteristics of themselves – self-descriptions – related in this case to the theatrical exercises); and, as a third instrument, a combination of the other two – specifying which exercises were more closely related to the self-descriptions. The results showed that group discussion was the activity with the highest perception of freedom, followed by obstacle exercises; as regards the perception of satisfaction, the highest value was observed in the relaxations. In the case of the self-descriptions, the acquisition of practical and intellectual skills was significant, as well as emotional outlook and the expression of self-esteem. In sum, this empirical support - using qualitative instruments that invite an exploration of the self - revealed, on the one hand, which specific characteristics of the self are manifested by doing theatrical exercises and, on the other hand, which exercises – when experienced as leisure – have a more decisive impact on the self. Thus, this paper shows what aspects must be taken into account when deciding which activities to include in a psychosocial intervention addressed to the development of the self from the standpoint of theatrical performance as a leisure activity. (shrink)

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

Neuromarketing is a recent interdisciplinary field which crosses traditional boundaries between neuroscience, neuroeconomics and marketing research. Since this nascent field is primarily concerned with improving marketing strategies and promoting sales, there has been an increasing public aversion and protest against it. These protests can be exemplified by the reactions observed lately in Baylor School of Medicine and Emory University in the United States. The most recent attempt to stop ongoing neuromarketing research in France is also remarkable. The pertaining ethical issues (...) have been continuously attracting much attention, especially since the number of neuromarketing companies has exceeded 300 world-wide. This paper begins with a brief introduction to the field of neurotechnology by presenting its current capabilities and limitations. Then, it will focus on the ethical issues and debates most related with the recent applications of this technology. The French Parliament’s revision of rules on bioethics in 2004 has an exemplary role in our discussion. The proposal by Murphy et al. has attracted attention to the necessity of ethical codes structuring this field. A code has recently been declared by the Neuromarketing Science and Business Association. In this paper, it is argued that these technologies should be sufficiently discussed in public spheres and its use on humans should be fully carried out according to the ethical principles and legal regulations designed in line with human rights and human dignity. There is an urgent need in the interdisciplinary scientific bodies like ethics committees monitoring the research regarding the scientific and ethical values of nonmaleficence, beneficence, autonomy, confidentiality, right to privacy and protection of vulnerable groups. (shrink)

The ideas of face consciousness, group conformity, extended family concept, and crisis consciousness in Confucian culture have a subtle and far-reaching impact on housing consumption decision among the Chinese public, forming a housing consumption model of “preferring to own a house rather than rent one.” The poor interaction between the housing rental market and the sales market caused by the shortage of rental demand and irrational purchasing behaviors has led to soaring house prices and imbalance between supply and demand that (...) prevail in major cities in China. To gain a deeper understanding of public cognitive attitude toward decisions on owning and renting a house, this study divided the subjects into high and low impact groups based on the overall Confucian culture and four subdimensions. It attempts to take a cognitive neuroscience approach for assessing public stereotypes of housing consumption decision with different types based on the analysis of event-related potentials. The results are as follows. First, overall, there is an obvious implicit stereotype of renting a house and explicit stereotype of owning a house among the public. Second, ERPs data show that descriptions of renting a house with positive adjectives could evoke more significant N400 responses. In other words, in the heuristic system, the public perceive that renting a house is restrictive, stressful, unhappy, and crisis. Data from subjective reports show that, after processing information in the analytic system, the public tend to think that owning a house is self-contained, restful, warm, and comfortable. Third, a more negative stereotype of renting a house exists in the high Confucian culture influence group Group than in the low Confucian culture influence group Group, and is more inclined to own a home. Fourth, under the Confucian culture sub-dimension, there are differences in housing consumption stereotypes between high and low groups in terms of extended family concept, group conformity, and crisis consciousness. Fifth, the moderating effect analysis found that perceived usefulness, trust in the rental market, and policy perception can be important factors in guiding public housing consumption stereotypes. (shrink)

ObjectiveOverweight and obesity [body mass index ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity among women with breast cancer.MethodsThe sample included 34 post-menopausal women (...) newly diagnosed with Stage 0-IIa breast cancer who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety.ResultsMean BMI was in the obese range. For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex, including ventrolateral PFC, dorsolateral PFC, and superior frontal gyrus. Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety.ConclusionHigher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment and remission. Additional longitudinal research exploring this hypothesis is warranted. (shrink)

It is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred (...) to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters. Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals. Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely lifelogging and self-monitoring, remote monitoring of vital signs, emotional state recognition, food intake monitoring, activity and behaviour recognition, activity and personal assistance, gesture recognition, fall detection and prevention, mobility assessment and frailty recognition, and cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed. (shrink)

Perspective taking has been proposed to be impaired in persons with autism spectrum disorder, especially when implicit processing is required. In narrative texts, language perception and interpretation is fundamentally guided by taking the perspective of a narrator. We studied perspective taking in the linguistic domain of so-called Free Indirect Discourse, during which certain text segments have to be interpreted as the thoughts or utterances of a protagonist without explicitly being marked as thought or speech representations of that protagonist. Crucially, the (...) correct interpretation of text segments as FID depends on the ability to detect which of the protagonists “stands out” against the others and is therefore identifiable as implicit thinker or speaker. This so-called “prominence” status of a protagonist is based on linguistic properties, in other words, the perspective is “hidden” and has to be inferred from the text material. In order to test whether this implicit perspective taking ability that is required for the interpretation of FID is preserved in persons with ASD, we presented short texts with three sentences to adults with and without ASD. In the last sentence, the perspective was switched either to the more or the less prominent of two protagonists. Participants were asked to rate the texts regarding their naturalness. Both diagnostic groups rated sentences with FID anchored to the less prominent protagonist as less natural than sentences with FID anchored to the more prominent protagonist. Our results that the high-level perspective taking ability in written language that is required for the interpretation of FID is well preserved in persons with ASD supports the conclusion that language skills are highly elaborated in ASD so that even the challenging attribution of utterances to protagonists is possible if they are only implicitly given. We discuss the implications in the context of claims of impaired perspective taking in ASD as well as with regard to the underlying processing of FID. (shrink)

Five experiments investigated the role of spatial connectedness between a pair of objects presented in the change detection task for the actual capacity of visual working memory (VWM) in healthy young adults (total N = 405). Three experiments yielded a surprising nonlinear relationship between the proportion of pair-wise connected objects and capacity, with the highest capacity observed for homogenous displays, when either all objects were connected or disjointed. A drop in capacity, ranging from an average of a quarter of an (...) object out of three objects maintained in VWM, was noted when only some objects were connected while others were disjointed. As indicated by another two experiments, this effect was specific to double-feature encoding, but disappeared when single visual features had to be memorized. No existing theoretical model of VWM can directly explain this novel effect. Overall, the nonlinear effect of spatial connectedness implies that representations in VWM possess hierarchical structure defined by wholes, parts, features, and their relations, and the heterogeneity of such a structure hinders VWM performance, while homogeneity facilitates it. (shrink)

Although remote working can involve positive outcomes both for employees and organizations, in the case of the sudden and forced remote working situation that came into place during the COVID-19 crisis there have also been reports of negative aspects, one of which is technostress. In this context of crisis, leadership is crucial in sustainably managing and supporting employees, especially employees with workaholic tendencies who are more prone to developing negative work and health outcomes. However, while research on the role of (...) the positive aspects of leadership during crises does exist, the negative aspects of leadership during the COVID-19 crisis have not yet been studied. The present study aimed to explore the role of authoritarian leadership in a sample of 339 administrative university employees who worked either completely from home or from home and the workplace. The study examined the moderating effect of a manager on this relationship and the connections between workaholism and technostress through conditional process analysis. Results pointed out that high authoritarian leadership had an enhancing effect, whereas low authoritarian leadership had a protective effect on the relationship between workaholism and technostress, only in the group of complete remote workers. Thus, authoritarian leadership should be avoided and training leaders to be aware of its effect appears to be essential. Limitations, future directions for the study, and practical implications are also discussed. (shrink)

With increased urbanization, ecological challenges such as climate change and loss of biodiversity, and stress-related disorders globally posing a major threat to public health and wellbeing, the development of efficient multiple-use strategies for urban green spaces and infrastructures is of great importance. In addition to benefits such as climate and water regulation, food production, and biodiversity conservation, green spaces and features have been associated with various health and wellbeing outcomes from a psychological perspective. Research suggests links between exposure to green (...) environmental qualities and restoration from psycho-physiological stress and attention fatigue, promotion of physical activity, increased neighborhood satisfaction and even reduced mortality. Especially strong associations have been observed in urban and socio-economically challenged areas. Usually such salutogenic, i.e. health-promoting, effects are explained through theories related to the notion of biophilia, i.e. the idea that humans share innate tendencies to attend to natural environments and features that have been beneficial during evolution. This paper assumes an ecological approach to perception and behavior to be fruitful in order to analyze the salutogenic potential of environments such as urban green spaces and to step beyond the “green vs. gray” dichotomy that has been prevalent through much of the research on health-promoting environments. Through an analysis of environmental affordances for certain perceived qualities such an approach is explored through a proposed concept for urban green space use and management, the edible forest garden. Such gardens, based on agroecological principles, have emerged as one of the most promising models regarding ecologically sustainable food production. In addition to potential contributions of importance for urban sustainability and biodiversity, we argue that the inclusion of edible forest gardens in urban green spaces – today globally dominated by lawns – also potentially could reinforce several affordances of salutogenic importance, both in terms of e.g. social cohesion but also in regard to restoration from psycho-physiological stress and attention fatigue. Increased opportunities for contact with nature and processes of food production may also reinforce pro-environmental behaviors in the population and thus also affect long-term sustainability. (shrink)

Modern computer-based applications often require the user to interact with avatars. Depending on the task at hand, spatial dissociation between the orientations of the user and the avatars might arise. As a consequence, the user has to adopt the avatar's perspective and identify herself/himself with the avatar, possibly changing the user's self-representation in the process. The present study aims to identify the conditions that benefit this change of perspective with objective performance measures and subjective self-estimations by integrating the idea of (...) avatar-ownership into the cognitive phenomenon of spatial compatibility. Two different instructions were used to manipulate a user's perceived ownership of an avatar used in otherwise identical situations. Users with the high-ownership instruction reported higher levels of perceived ownership of the avatar and showed larger spatial compatibility effects from the avatar's point of view in comparison to the low ownership instruction. This supports the hypothesis that perceived ownership benefits perspective taking. (shrink)

Evaluating the risks and anticipated benefits of medical, behavioral and, social research is a central function of institutional review boards. The calculation that IRBs undertake ultimately determines whether a particular research project involving human participants is permitted to proceed. In medical research the physical harms and even the anticipated benefits of a new procedure or drug are often apparent and quantifiable. In contrast, for social/behavioral research that may involve probing the most intimate feelings, thoughts, and actions of participants, the weighing (...) of risks and anticipated benefits, the calculation of possible harms and the acceptability of that harm require a more intense level of scrutiny.Even the early step of identifying and recruiting participants for a research endeavor may potentially cause harm, making participant selection a focus of IRB analysis. (shrink)

In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM (...) are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship. (shrink)

This overview describes the breadth of topicscovered in this volume devoted to children inresearch. It summarizes how these articles areinterrelated and how they all respond to thechallenge proposed by the Children's Health Actof 2000: to consider what modifications, ifany, are necessary to current regulations ``toensure the adequate and appropriate protectionof children participating in research.''.

BackgroundAlcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied.ObjectiveThe aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador.MethodsA total of 7,905 college students were surveyed using the following (...) standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire. Macro Process for SPSS was used to analyze mediation and moderation effects.ResultsReported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women.DiscussionResults of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective. (shrink)

The COVID-19 epidemic is associated with negative mood, which has the potential to be a powerful driver of creativity. However, the influence of negative mood on cognitive creativity and emotional creativity remains elusive. Previous research has indicated that self-focused attention is likely to be related to both negative mood and creativity. The current study introduced two self-focused attention variables to explore how negative mood might contribute to cognitive creativity and emotional creativity. Based on a sample of 351 participants, our study (...) found that negative mood during the outbreak of COVID-19 was associated with cognitive creativity and emotional creativity. Meanwhile, there were significant serial mediation effects of rumination and reflection in the relationship between negative mood and creativity and the psychological impact after exposure to the COVID-19 epidemic was positively correlated with emotional creativity but not with cognitive creativity. These results suggested that individuals, in real life and work, could achieve better creative performance through moderate self-focus. Moreover, individuals with different mood states can be induced to enhance their creativity in times of crisis through intervention training to promote reflection. (shrink)

Among medical researchers and clinicians the dominant view is that it is unethical to deceive patients by prescribing a placebo. This opinion is formalized in a recent policy issued by the American Medical Association (AMA [Chicago, IL]). Although placebos can be shown to be always safe, often effective, and sometimes necessary, doctors are now effectively prohibited from using them in clinical practice. I argue that the deceptive administration of placebos is not subject to the same moral objections that face other (...) forms of deception in clinical practice and medical research. Although deception is normally objectionable on the grounds that it limits autonomy and breaches trust, these grounds do not apply to placebos when they are prescribed within appropriate ethical limits. Patients have reason to prefer that doctors can prescribe placebos in ethically responsible ways. Hence, the AMA has an obligation to endorse and to promote the responsible use of deceptive placebos in clinical practice. (shrink)

Evaluating the risks and anticipated benefits of medical, behavioral and, social research is a central function of institutional review boards. The calculation that IRBs undertake ultimately determines whether a particular research project involving human participants is permitted to proceed. In medical research the physical harms and even the anticipated benefits of a new procedure or drug are often apparent and quantifiable. In contrast, for social/behavioral research that may involve probing the most intimate feelings, thoughts, and actions of participants, the weighing (...) of risks and anticipated benefits, the calculation of possible harms and the acceptability of that harm require a more intense level of scrutiny.Even the early step of identifying and recruiting participants for a research endeavor may potentially cause harm, making participant selection a focus of IRB analysis. (shrink)

The practice of physical activity (PA) contributes to the prevention of chronic diseases such as obesity, metabolic syndrome or cardiovascular diseases, being also directly related to the individual’s physical fitness. Therefore, it is necessary to measure and monitoring the levels of PA in childhood and adolescence, since it may be useful to describe their current health status and the association with physical fitness, as well as to reveal putative consequences in the future. Within the educational field, it has been shown (...) that physical education (PE) classes are a favorable context for the creation of healthy physical-sports habits and self-determined motivation could be a key for explaining the level of PA practice. For this reason, the purpose of this research was to study the mediating role of integrated regulation (IR) on the relationship between PA and physical fitness in children and adolescents. A total of 325 students between 11 and 14 years old participated in the study. The level of PA was estimated through the specific Physical Activity Questionnaire for Children (PAQ-C), while motivation and IR were measured by using the Perceived Locus of Causality scale (PLOC-2). In addition, physical fitness was measured through the Eurofit fitness battery of tests, composed of three body composition measures and seven tests of different physical capacities. The physical fitness score showed no differences when genders were compared. After regression analysis, the resulti... (shrink)

Risks and burdens in the study participation, as well as an adequate risk-benefit balance, are key concepts for the evaluation of clinical studies by research ethics committees. An adequate assessment and continuous monitoring to ensure compliance of risks and burdens in clinical trials have long been described as a central task in research ethics. However, there is currently no uniform and solid theoretical approach to risk assessment by RECs. Regulatory standards of research ethics such as the Declaration of Helsinki provide (...) only minimal guidance on how risk decisions are considered. Due to discrepancies in the existing literature and guidance documents, adequate risk assessment by RECs remains to be elusive. In this article, we address current definitions of risk and present our own concept of aggregate risk definition. Moreover, we highlight the concept of benefit, the standard of reasonableness with respect to ethics literature and different approaches of risk-benefit assessment. In order to present a comprehensive theoretical approach of risk assessment by RECs, further understanding of the definitions of risk may improve adequate decision-making tasks by RECs. To improve the process of risk assessment by RECs, a dynamic framework will be illustrated, showing step-by-step risk assessment functions. This approach may be a promising tool to ensure adequacy in risk assessment by RECs. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

The emotional experience and the type of communication about cancer within the family are important factors for successful coping with pediatric oncology. The main purpose is to study mother’s and children’s emotional experiences concerning cancer, whether they communicate openly about the disease, and relationships between the type of communication and the different emotions expressed by the children. Fifty-two cancer patients aged 6–14 years and their mothers were interviewed in separate sessions about the two central themes of the study: emotional experiences (...) and type of communication. Analyses of response categories were performed to subsequently compare the age-groups and the mother–child responses. According to the results, mothers expressed emotions such as fear, sadness, or anxiety, while children report sadness, pain, but also happiness. Significant positive correlations were observed between mothers’ sadness and older children’s sadness, mothers’ anxiety and children’s fear, and mothers’ anxiety and children’s happiness. Regarding communication type, mothers tend to hide information about the disease from younger children and to provide direct information to the older children. Children usually prefer to communicate their concerns to parents; however, children whose mothers convey anxiety are more likely to prefer to communicate with others. These results support the idea that parents should talk honestly with their children, explaining their illness in an age-appropriate way, and encouraging them to share their emotional experiences. Further studies are needed from a developmental perspective to understand the disease management of children and families. (shrink)