The aim of this paper is to explore how children learn to form new relationships with nature. It draws on a longitudinal case study of children participating in a stewardship project involving the conservation of salamanders during the school day in Stockholm, Sweden. The qualitative method includes two waves of data collection: when a group of 10-year-old children participated in the project (2015) and two years after they participated (2017). We conducted 49 interviews with children as well as using participant (...) observations and questionnaires. We found indications that children developed sympathy for salamanders and increased concern and care for nature, and that such relationships persisted two years after participation. Our rich qualitative data suggest that whole situations of sufficient unpredictability triggering free exploration of the area, direct sensory contact and significant experiences of interacting with a species were important for children’s development of affective relationships with the salamander species and with nature in an open-ended sense. Saving the lives of trapped animals enabled direct sensory interaction, feedback, increased understanding, and development of new skills for dynamically exploring further ways of saving species in an interactive process experienced as deeply meaningful, enjoyable and connecting. The behavioural setting instilled a sense of pride and commitment, and the high degree of responsibility given to the children while exploring the habitat during authentic situations enriched children’s enjoyment. The study has implications for the design of education programmes that aim to connect children with nature and for a child-sensitive urban policy that supports authentic nature situations in close spatial proximity to preschools and schools. (shrink)

Fibromyalgia is a chronic pain disorder with a multifaceted nature and its biological, psychological and social aspects are strongly interconnected. Therefore, the integration of the different health disciplines is strongly recommended for its care. There is a growing number of interventions based on this principle but each of them is heterogeneous with regards to how the included disciplines are integrated with each other. With this regards, multidisciplinary and interdisciplinary programs are distinguished. The former are organized in order to treat the (...) various aspects of the syndrome using different perspectives and their various treatment components are usually provided separately by the different care providers. Conversely, interdisciplinary treatments are planned in order to foster a dialogue between the operators by providing a joint conduction of the treatment or scheduling plenary discussions about the cases. In the field of chronic pain, some authors are suggesting to move beyond these approaches and to plan transdisciplinary treatments, which would allow the professionals to move across their disciplinary boundaries. Although no examples of these interventions have been proposed for the treatment of fibromyalgia, there is a visible trend in the literature toward more holistic forms of care. (shrink)

BackgroundChronic airway diseases are prevalent and costly conditions. Interdisciplinary rehabilitation programs that include Acceptance and Commitment-based components could be important to tackle the vicious circle linking progression of the disease, inactivity, and psychopathological symptoms.MethodsA retrospective evaluation of routinely collected data of an interdisciplinary rehabilitation program was performed. The program included group sessions including patient education, breathing exercise, occupational therapy and an ACT-based psychological treatment, and individual sessions of physical therapy. Demographic data, clinical characteristics of the patients and the values of (...) outcome variables before treatment, at discharge, at 3 months, and at 6 months were extracted from medical records. Multiple imputation was employed to address missing data. Linear mixed models were employed to assess changes over time. Multivariable logistic regression was performed to assess predictors of a minimum clinically important change of health status from baseline to the 6-months follow-up.ResultsData from 31 patients with chronic obstructive pulmonary disease and 12 patients with bronchiectasis were extracted. Health status improved from baseline to discharge to the 3 months follow-up, but not to the 6 months follow-up. Anxiety and depression improved across all the time points. Quality of life did not improve over time. Having a worse health status at baseline and fewer depressive symptoms were significantly associated with achieving a minimum clinically important change of health status at 6 months. The effects of the interdisciplinary program were not different for patients with COPD or with bronchiectasis.DiscussionInterdisciplinary programs including ACT-based components are promising treatments for the rehabilitation of patients with chronic airway diseases. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

Managing cardiac illness is not easy because it dramatically disrupts people’s daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping could likely be a moderating factor. The main aim of the present study was to examine the role that dyadic coping (...) plays in moderating the link between patient and partner cardiac illness-related distress and partner support. The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire. We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple’s cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support. With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping. (shrink)

In response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.

The aim of this cross-sectional study is to investigate the role of psychological inflexibility in the relationship between anxiety and depression and emotional eating in a sample of 123 inpatient Italian adult individuals with obesity. Participants completed the Anxiety and Depression subscales of the Psychological General Well-Being Inventory, the Acceptance and Action Questionnaire, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess anxiety and depression, psychological inflexibility, and emotional eating, respectively. Results showed that the indirect effect (...) of PGWBI-A on DEBQ-EE through AAQ-II was significant [b = −0.0155; SE = 0.076; 95% BC-CI ]. Similarly, the indirect effect of PGWBI-D on DEBQ-EE through AAQ-II was significant [b = −0.0383; SE = 0.0207; 95% BC-CI ]. These findings may help to plan and develop specific psychological interventions aimed at addressing emotional eating through targeting psychological inflexibility to be included in obesity treatment programs. (shrink)

The Fibromyalgia Survey Questionnaire was self-administered by a sample of 207 Italian individuals with obesity to screen for fibromyalgia. We aimed to investigate the inter-rater reliability and the agreement in the detection of FM symptomatology between the self-administered FSQ and the clinical interview conducted by a rheumatologist. All the patients were divided randomly into two groups : a rheumatologist first interviewed patients of group A and after 48 h, the patients completed the self-report FSQ. Patients of group B first completed (...) the FSQ and 48 h later were interviewed by a rheumatologist. The agreement between the measurements was good with the Bland-Altman analysis showing low bias scores for the two subscales of the FSQ. Results showed that 33% of the sample satisfied the criteria for a diagnosis of fibromyalgia. The FSQ is a self-reporting measure that showed substantial reliability providing fast screening for FM symptomatology. (shrink)

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

Foundation models such as GPT-4 are fine-tuned to avoid unsafe or otherwise problematic behavior, so that, for example, they refuse to comply with requests for help with committing crimes or with producing racist text. One approach to fine-tuning, called reinforcement learning from human feedback, learns from humans' expressed preferences over multiple outputs. Another approach is constitutional AI, in which the input from humans is a list of high-level principles. But how do we deal with potentially diverging input from humans? How (...) can we aggregate the input into consistent data about "collective" preferences or otherwise use it to make collective choices about model behavior? In this paper, we argue that the field of social choice is well positioned to address these questions, and we discuss ways forward for this agenda, drawing on discussions in a recent workshop on Social Choice for AI Ethics and Safety held in Berkeley, CA, USA in December 2023. (shrink)

This paper examines the effects of a decrease in auditor litigation risk in a setting that isolates a change in auditor litigation risk from changes in auditor reputation. _StoneRidge Investment Partners v. Scientific Atlanta_ is a 2008 U.S. Supreme Court ruling that restricted secondary actor liability in class action suits, resulting in a decrease in class actions that listed auditors as defendants. We document that the _StoneRidge_ decision is associated with a negative CAR for clients of Big 4 auditors and (...) industry specialist auditors, in particular those associated with high-litigation risk, low cash, and past incidences of modified going concern opinions. These findings are consistent with investor perception of lower potential payoffs from secondary defendants in class action suits, in particular auditors, following the _StoneRidge_ decision. We also document that auditors are more (less) likely to accept (reject) risky clients and charge lower audit fees to risky clients after _StoneRidge_, consistent with a decrease in auditor litigation risk that increases auditor risk tolerance. Finally, we provide evidence that audit firms issue fewer going concern opinions following _StoneRidge_, consistent with a decrease in litigation risk leading to lower audit quality_._ Our results are relevant to policy makers as they consider the disciplinary role of litigation on audit markets. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Epigenetic research has brought several important technological achievements, including identifying epigenetic clocks and signatures, and developing epigenetic editing. The potential military applications of such technologies we discuss are stratifying soldiers’ health, exposure to trauma using epigenetic testing, information about biological clocks, confirming child soldiers’ minor status using epigenetic clocks, and inducing epigenetic modifications in soldiers. These uses could become a reality. This article presents a comprehensive literature review, and analysis by interdisciplinary experts of the scientific, legal, ethical, and societal issues (...) surrounding epigenetics and the military. Notwithstanding the potential benefit from these applications, our findings indicate that the current lack of scientific validation for epigenetic technologies suggests a careful scientific review and the establishment of a robust governance framework before consideration for use in the military. In this article, we highlight general concerns about the application of epigenetic technologies in the military context, especially discrimination and data privacy issues if soldiers are used as research subjects. We also highlight the potential of epigenetic clocks to support child soldiers’ rights and ethical questions about using epigenetic engineering for soldiers’ enhancement and conclude with considerations for an ethical framework for epigenetic applications in the military, defense, and security contexts. (shrink)