Sitting knee-flexion angle does not influence endothelial-dependent vasodilation in laboratory or free-living conditions.

INTRODUCTION: Single bouts of prolonged bent-legged sitting attenuate popliteal endothelial-dependent vasodilation (as assessed via flow-mediated dilation [FMD]), which is partially attributed to arterial 'kinking'. However, the impact of knee-flexion angle on sitting-induced popliteal FMD is unknown. The objective of this study was to perform separate laboratory and free-living studies to test the hypotheses that: (1) popliteal FMD impairments would be graded between knee flexions at 90° (bent-legged sitting) > 45° > 0° (straight-legged sitting) following a 3-hour bout of sitting; and (2) more habitual time spent bent-legged sitting (< 45°) would be associated with lower FMD. METHODS: The laboratory study included eight young, healthy adults (24 ± 2 years; four women) who underwent two sitting bouts over 2 days with one leg positioned at a knee-flexion angle of 0° or 90° and the opposite leg at 45° knee flexion. Popliteal FMD was assessed at pre- and postsitting timepoints. RESULTS: Sitting-induced reductions in FMD were similar between all knee-flexion angles (all, p > 0.674). The free-living study included 35 young, healthy adults (23 ± 3 years; 16 women) who wore three activPAL monitors (torso, thigh, shin) to determine detailed sedentary postures. Time spent sedentary (624 ± 127 min/day), straight-legged sitting (112 ± 98 min/day), and bent-legged sitting (442 ± 106 min/day) were not related to relative FMD (5.3 ± 1.8%; all, p > 0.240). CONCLUSION: These findings suggest that knee-flexion angle-mediated arterial 'kinking' during sitting is not a major contributor toward sitting-induced popliteal endothelial-dependent vasodilatory dysfunction.

Clinical impact of non-lying time on hospital-associated functional decline in older patients undergoing transcatheter aortic valve implantation.

The purposes of the present study were: (1) to investigate the relationship between hospital-associated functional decline (HAFD) and non-lying time and (2) to clarify the optimal cut-off value for non-lying time associated with HAFD in older patients undergoing transcatheter aortic valve implantation (TAVI). From January 2021 to December 2022, patients admitted to a university hospital who underwent trans-femoral TAVI were consecutively recruited. We measured short physical performance battery (SPPB) pre and post-TAVI, and non-lying time from post-operative days 3-5. HAFD was defined as at least 1 point decrease in SPPB during pre and post-TAVI. Among 75 patients (47 female, mean age of 84.5 years) enrolled, 14 patients were classified as having HAFD. Non-lying time was significantly shorter in the HAFD group than in the non-HAFD group (371 min vs. 539 min, P < 0.001). Receiver-operating characteristic analysis determined an optimal cut-off value of 477 min for differentiating the patients more likely to experience HAFD (sensitivity, 75%; specificity, 92%; area under the curve, 0.798). The non-lying time could be one of the associated factors of HAFD in older patients with TAVI. Non-lying time of about 480 min (8 h) during hospitalization may be an initial target for preventing HAFD.

Parenting by lying and children's lying to parents: The moderating role of children's beliefs.

How are children socialized about lying? One way is parental modeling of lying given that parents tell various lies to their children for parenting purposes, which is a practice known as parenting by lying. Importantly, how children perceive and interpret the lying behavior around them may be crucial to how they then learn to lie. Yet, we do not know how children's perceptions of different types of parental lies drive this socialization. In a comprehensive birth cohort of parent-child dyads (N = 564; children aged 11 and 12 years) in Singapore, we collected multi-informant reports of instrumental lies (parental lies told for child compliance) and white lies (parental lies told to instill positive emotions), children's belief in parental lies, and children's lying to parents. We found greater consistency in parent and child reports of instrumental lies than of white lies and that children reported greater belief in instrumental lies than in white lies. Children's reported exposure to instrumental lies was associated with greater lying to parents. However, for white lies this relationship was evident only when children had moderate to low beliefs in parental lies. Examining the interplay between parental lies and children's beliefs in those lies, the current study illuminates the potential pathways to children's lying behaviors.

To tell the truth or not: What effortful control, false belief, and sympathy tell us about preschoolers' instrumental lies.

This study aimed to examine the predictors of instrumental lies in preschool children, specifically focusing on false belief, effortful control, and sympathy. Instrumental lies are intentional falsehoods used to achieve personal goals such as avoiding punishment and obtaining an undeserved reward. A total of 192 preschool children (age range = 32-73 month-olds), along with their mothers and fathers, participated in the study. The Temptation Resistance Paradigm, an experimental task, was employed to elicit instrumental lies from the children. The children also completed first-order false belief measures, and their parents filled out questionnaires assessing their children's effortful control and sympathy skills. Results revealed a positive association between children's effortful control and their decisions to tell instrumental lies. However, no significant relationship was found between false belief and instrumental lying. Age moderated the link between sympathy and the decision to tell instrumental lies, with sympathy being negatively associated with lie-telling behavior among older children but showing no effect among younger children. The study variables did not predict the maintenance of instrumental lies. Overall, this study provides valuable insights into the role of effortful control and sympathy as underlying temperamental and emotional processes influencing children's decisions to engage in instrumental lie-telling.

Lying to recommend unqualified friends: Diverging implications for interpersonal and epistemic trust inferences.

When people are asked to recommend individuals they care about, they often grapple with conflicts regarding the level of honesty they should maintain when being truthful could potentially hinder those individuals' chances of receiving beneficial opportunities. In the current study, we examined how adolescents evaluate people based on how they respond to such dilemmas, with a focus on how it affects judgments of interpersonal and epistemic trustworthiness. We tested a sample of high school students in the southwestern United States (N = 78; Mage = 16.45 years), who were asked about a moral dilemma in which a story character needed to decide whether to recommend an unqualified friend. We experimentally manipulated whether the friend was very close to the standard (requiring a small exaggeration) or was far from the standard (requiring a large exaggeration) between participants. Across both exaggeration conditions, we observed a dissociation in judgments of epistemic and interpersonal trustworthiness: Lie-tellers were judged to be more interpersonally trustworthy than epistemically trustworthy, whereas truth-tellers were judged to be more epistemically trustworthy than interpersonally trustworthy. These results show that adolescents are capable of using information about an individual's lie-telling versus truth-telling decisions to make highly nuanced social inferences.

Infant-parent attachment and lie-telling in young children: The Generation R Study.

Insecure-attached adults are more likely to lie. However, it is unknown whether infant-parent attachment quality relates to lie-telling in early childhood. As in adults, lie-telling in early childhood might be related to attachment insecurity. However, a competing hypothesis might be plausible; lie-telling might be related to attachment security given that lie-telling in early childhood is considered an advancement in social-cognitive development. The current study is the first to investigate the link between insecure/secure and disorganized/non-disorganized attachment and lie-telling behavior in early childhood. Because lie-telling is studied in the context of cheating behavior, the association between cheating and attachment is additionally explored. A total of 560 Dutch children (287 girls) from a longitudinal cohort study (Generation R) were included in the analyses. Attachment quality with primary caregiver (secure/insecure and disorganized/non-disorganized attachment) was assessed at 14 months of age in the Strange Situation Procedure, and cheating and lie-telling were observed in games administered at 4 years of age. The results demonstrated no relationship of attachment (in)security and (dis)organization with cheating and lie-telling. Results are interpreted in light of evidence that lie-telling in early childhood is part of normative development. Limitations are discussed, including the time lag between assessments, the fact that lie-telling was measured toward a researcher instead of a caregiver, and the conceptualization of attachment in infancy versus adulthood. Attachment quality does not affect early normative lie-telling, but how and when it may affect later lying in children remains to be explored.

A mathematical model to predict "low-lying" posterior communicating artery aneurysms in neurosurgical practice.

"Low-lying" posterior communicating artery (PCoA) aneurysms require great attention in surgical clipping due to their distinct anatomical characteristics. In this study, we propose an easy method to immediately recognize "low-lying" PCoA aneurysms in neurosurgical practice. A total of 89 cases with "low-lying" PCoA aneurysms were retrospectively analyzed. All patients underwent preoperative digital subtraction angiography (DSA) examinations and microsurgical clipping. Cases were classified into the "low-lying" and regular groups based on intraoperative findings. The distance- and angle-relevant parameters that reflected the relative location of the aneurysms and tortuosity of the internal carotid artery were measured using 3D-DSA images. The data were sequentially integrated into a mathematical analysis to obtain the prediction model. Finally, we proposed a novel mathematical formula to preoperatively predict the existence of "low-lying" PCoA aneurysms with great accuracy. Neurosurgeons might benefit from this model, which enables them to directly identify "low-lying" PCoA aneurysms and make appropriate surgical decisions accordingly.

Dietary supplementation of vitamin D3 and calcium partially recover the compromised time budget and circadian rhythm of lying behavior in lactating cows under heat stress.

Heat stress (HS) impedes cattle behavior and performance and is an animal comfort and welfare issue. The objective of this study was to characterize the time budget and circadian rhythm of lying behavior in dairy cows during HS and to assess the effect of dietary supplementation of vitamin D3 and Ca. Twelve multiparous Holstein cows (42.2 ± 5.6 kg milk/d; 83 ± 27 d in milk) housed in tiestalls were used in a split-plot design with the concentration of dietary vitamin E and Se as main plots (LESe: 11.1 IU/kg and 0.55 mg/kg, and HESe: 223 IU/kg and 1.8 mg/kg, respectively). Within each plot cows were randomly assigned to (1) HS with low concentrations of vitamin D3 and Ca (HS, 1,012 IU/kg and 0.73%, respectively), (2) HS with high concentrations of vitamin D3 and Ca (HS+D3/Ca; 3,764 IU/kg and 0.97%, respectively), or (3) thermoneutral pair-fed (TNPF) with low concentrations of vitamin D3 and Ca (1,012 IU/kg and 0.73%, respectively) in a Latin square design with 14-d periods and 7-d washouts. Lying behavior was measured with HOBO Loggers in 15-min intervals. Overall, cows in HS spent less time lying per day relative to TNPF from d 7 to 14. Daily lying time was positively correlated with milk yield, energy-corrected milk yield, and feed efficiency, and was negatively correlated with rectal temperature, respiratory rate, fecal calprotectin, tumor necrosis factor-α, and C-reactive protein. A treatment by time interaction was observed for lying behavior: the time spent lying was lesser for cows in HS than in TNPF in the early morning (0000-0600 h) and in the night (1800-2400 h). The circadian rhythm of lying behavior was characterized by fitting a cosine function of time into linear mixed model. Daily rhythmicity of lying was detected for cows in TNPF and HS+D3/Ca, whereas only a tendency in HS cows was observed. Cows in TNPF had the highest mesor (the average level of diurnal fluctuations; 34.2 min/h) and amplitude (the distance between the peak and mesor; 17.9 min/h). Both the mesor and amplitude were higher in HS+D3/Ca relative to HS (26.6 vs. 25.2 min/h and 3.91 min/h vs. 2.18 min/h, respectively). The acrophase (time of the peak) of lying time in TNPF, HS, and HS+D3/Ca were 0028, 0152, and 0054 h, respectively. Lastly, a continuous increase in daily lying time in TNPF was observed during the first 4 d of the experimental period in which DMI was gradually restricted, suggesting that intake restrictions may shift feeding behavior and introduce biases in the behavior of animals. In conclusion, lying behavior was compromised in dairy cows under HS, characterizing reduced daily lying time and disrupted circadian rhythms, and the compromised lying behavior can be partially restored by supplementation of vitamin D3 and Ca. Further research may be required for a more suitable model to study behavior of cows under HS.

Genetic relationships between behavioral traits and feed efficiency traits in lactating Holstein cows.

The evaluation of dairy cow feed efficiency using residual feed intake accounts for known energy sinks. However, behavioral traits may also contribute to the variation in feed efficiency. Our objective was to estimate the heritability and repeatability of behavioral traits and their genetic correlations with feed efficiency and its components in lactating Holstein cows. The first dataset consisted of 36,075 daily rumination and lying time records collected using a SMARTBOW ear-tag accelerometer (Zoetis, Parsippany, NJ) and 6,371 weekly feed efficiency records of 728 cows from the University of Wisconsin-Madison. The second dataset consisted of 59,155 daily activity records, measured as number of steps, recorded by pedometers (AfiAct; SAE Afikim, Kibbutz Afikim, Israel) and 8,626 weekly feed efficiency records of 635 cows from the University of Florida. Feed efficiency and its components included DMI, change in BW, metabolic BW, secreted milk energy, and residual feed intake. The statistical models included the fixed effect of cohort, lactation number, and days in milk, and the random effects of animal and permanent environment. Heritability estimates for behavioral traits using daily records were 0.19 ± 0.06 for rumination and activity, and 0.37 ± 0.07 for lying time. Repeatability estimates for behavioral traits using daily data ranged from 0.56 ± 0.02 for activity to 0.62 ± 0.01 for lying time. Both heritability and repeatability estimates were larger when weekly records instead of daily records were used. Rumination and activity had positive genetic correlations with residual feed intake (0.40 ± 0.19 and 0.31 ± 0.22, respectively) and lying time had a negative genetic correlation with this residual feed intake (-0.27 ± 0.11). These results indicate that more efficient cows tend to spend more time lying and less time active. Additionally, less efficient cows tend to eat more and therefore also tend to ruminate longer. Overall, sensor-based behavioral traits are heritable and genetically correlated with feed efficiency and its components and, therefore, they could be used as indicators to identify feed-efficient cows within the herd.

Caregivers' perceptions of lying to people with dementia in Denmark: a qualitative study.

OBJECTIVES: This study aims to examine caregivers' perspectives on and justifications for lying when caring for people with dementia. METHOD: The data consisted of interviews and observations of discussions among family and professional caregivers with various educational backgrounds. Thematic analysis was applied to identify key themes related to caregivers' perspectives on lying. RESULTS: The study revealed that lies were frequently employed by caregivers and were seen as effective tools in the caregivers' toolkit. These practices were often labelled 'white lies' and were rationalised based on their potential to enhance the well-being of people with dementia or to facilitate smooth interactions. The potential negative consequences of lying were also acknowledged. In addition, some caregivers suggested that the practice of 'stepping into the person with dementia's reality' might not constitute lying. CONCLUSION: The findings suggest that the caregivers perceived lying to be a legitimate strategy when caring for people with dementia; surprisingly, some did not recognize their practices as constituting acts of lying at all. This finding carries significant clinical relevance, as the varying perceptions of lying underscore the potential need for a consistent approach to deception. Addressing this complexity can lead to more ethical caregiving practices, ultimately enhancing the quality of care provided to people with dementia.

Is therapeutic lying contradictory to person-centred care? Toward understanding the connection.

AIM: There is a lack of clarity about therapeutic lying in the context of everyday dementia care. This study provides conceptual clarity on how the term is used and considers the concept in relation to person-centred care. METHODS: Rodgers' (1989) evolutionary framework of concept analysis was employed. A systematic multiple database search was conducted and supplemented with snowballing techniques. Data were analysed thematically through an iterative process of constant comparison. RESULTS: This study highlighted that therapeutic lying is intended to be used in the person's best interests for the purpose of doing good. However, its potential for doing harm is also evident. Its use in the literature has increased with the general trend towards becoming more accepted in the discourse. A continuum emerged depending on the degree to which a lie departs from the truth. Emerging guidelines were also evident as to when a lie could or could not be justified. CONCLUSION: The term therapeutic lying, was contrasted with aspects of person-centred care and was found to be problematic. We conclude that there may be more pragmatic ways of constructing language around the care of people with dementia which could be less stigmatising.

Is childhood lying shaped by callous-unemotional traits or does lie-telling make children more callous-unemotional? A longitudinal between- and within-person perspective.

The current study aims to advance knowledge on the causal interrelationship between childhood CU traits and lying both at a between- and a within-person perspective across a significant developmental period of mid-childhood to mid-adolescence. Cross-lagged panel models and Random-intercept cross-lagged panel models were used to investigate the prospective associations between lying and the distinct subcomponents of CU traits, including Callousness, Uncaring, and Unemotional in a sample of 719 children (T1; Mage = 10.73 years, SDage = 1.38, range = 7-15 years, 54.4% girls) across four assessment points. Results supported large vulnerability effects at the between-person level across time, indicating that CU traits predominantly influence the subsequent development of lying, with Callousness and Uncaring showing most profound effects on subsequent developmental processes of lying. At the within-person level, fluctuations in CU traits and lying were overall meaningfully related, but no causal relationship could be empirically determined. These findings provide a differentiated etiological viewpoint on the intertwinement of CU traits and lying at a young age, and underscore the importance of an early identification of children with callous and uncaring tendencies in order to prevent more persistent lying in adolescence.

The effect of a hiding space on the behaviour and heart rate variability of dairy calves during temporary separation from the dam.

In natural settings, newborn calves hide for several days before joining the herd. It is unclear whether dairy calves housed indoors would show similar hiding behaviour. This study aimed to describe the use of an artificial hide provided to calves during temporary separation from the dam and assess the effect it has on lying and sleep-like behaviour, as well as heart rate variability (HRV). Twenty-eight cow-calf pairs were randomly assigned to having a hide (n = 14), or no hide (n = 14). Hide use (n = 14), as well as lying and sleep-like behaviour (n = 28), were recorded continuously via video camera during the first hour after the dam was removed for morning milking on day three to seven. Heart rate and R-R intervals were recorded using Polar equine monitors for a subsample of 12 calves (n = 6 per treatment) on day six. Descriptive statistics were calculated for hide use. Wilcoxon Signed Rank tests were used to evaluate whether having a hide affected lying and sleep-like behaviours as well as HRV. Hide use decreased over days and was highly variable between calves. Lying behaviour did not differ between treatments. Duration of sleep-like behaviour was higher for calves without a hide compared to those with a hide. Calves with a hide tended to show signs of higher HRV and parasympathetic activity compared to calves without a hide. Results suggest that providing a hiding space to young calves may be beneficial during periods when the cow is removed from the pen for milking.

Voluntariness, timing, and consistency in adolescent routine disclosure and lying to parents.

INTRODUCTION: Whether adolescents' routine disclosure to parents is voluntary is assumed but rarely assessed. Researchers also have not examined whether disclosure and lying are premeditated, occurring before rather than after disclosure or lying, and whether adolescents use a single strategy consistently rather than applying multiple strategies when deciding whether to disclose or lie about their activities. This study investigated these significant gaps in the literature and tested whether voluntariness (for disclosure), timing, consistency, and parental psychological control are associated with lessons learned from disclosure and lying. METHODS: Narrative interviews were conducted in 2014-2015 with 131 primarily middle-class, mostly White US early and middle adolescents and college students (M's = 12.74, 15.81, 20.41 years). Narrated disclosure and lying interviews were reliably coded for voluntariness, timing, consistency, and lessons learned. Parental psychological control was assessed using an online survey. RESULTS: Disclosure was primarily strategic or voluntary and less often involuntary. Lying occurred more often before the narrated event, whereas disclosure occurred more often after. Youth typically reported using other strategies besides the elicited one. Disclosing after was associated with lessons learned. Voluntary disclosure was associated with psychological growth, and psychological control was associated with negative self-lessons. CONCLUSIONS: Disclosure and lying are complex and nuanced, varying in their timing, consistency, and voluntariness. These features contribute to adolescents' meaning-make from disclosure and lying. The findings have implications for future research on disclosure and secrecy.

Low placenta at the mid trimester anomaly scan-A cause for concern?

OBJECTIVE: This study was aimed to assess the predictive validity of internal os distance (IOD) in mid-trimester scan for the prediction of third-trimester low-positioned placenta, and to define a cut-off of IOD at which third-trimester low-positioned placenta could be identified, see the association of placental site (anterior/posterior), previous history of cesarean section with abnormal location of placenta in third trimester and see the maternal and neonatal outcomes. METHODS: It was a prospective cohort study of women with low-positioned placenta (IOD < 20 mm) at mid-trimester anomaly scan followed up in third trimester till birth. Relative risks for a low-positioned placenta in the third-trimester were calculated for women with posterior versus anterior, low-lying placenta versus placenta previa and positive versus negative history of cesarean section. Multilevel likelihood ratios and corresponding ROC curves for different ranges of IOD were calculated. RESULTS: Women with posterior placenta had a high risk of low positioned placenta compared to anterior placenta (9.28% vs. 0.74%); RR 1.45, similarly women with placenta previa had high risk compared to low lying placenta (68.57% vs. 1.69%); RR 6.51, so did the women with previous cesarean section (9.41% vs. 5.87%); RR 1.47. CONCLUSIONS: 93.42% placenta which were low positioned in mid trimester were normally situated in third trimester. The cut-off for IOD in anterior placenta was -40 mm and in posterior placenta was 14.3 mm. IOD measurement and interpretation seems promising.

The Ideal Proportion of the Auricle Exposure via a Morphometric Analysis in Asian Women.

BACKGROUND: Ears are an important aesthetic feature that is vital to the overall attractiveness of the face. Although there have been many studies on the aesthetics of the auricle, there is currently a lack of consensus on the ideal proportion of auricle exposure for Asian women in frontal view. OBJECTIVES: This study aimed to investigate ideal proportion of auricle exposure in Asian women. METHODS: An observational study was carried out on the photographs of 84 women on the list of the 100 most beautiful faces in Asia (published by TCC Asia in 2020). The proportion of the distance between the outer canthus and the outermost point of auricle to the distance between the inner canthus and the outermost point of auricle was calculated as the auricle exposure proportion. Evaluators were asked to rank a set of photographs of the volunteer with varying auricle exposure proportions from most attractive to least attractive. RESULTS: Measurements of the photographs of the 84 women showed a mean ear exposure proportion of 0.600. With 487 questionnaire responses received, the proportion of auricle exposure that the evaluators considered most attractive was 0.600. People with aesthetic experience considered 0.625 the most attractive proportion, while the general group considered 0.600 the most attractive. CONCLUSIONS: The ideal proportion of the auricle exposure for Asian women is in the range of 0.60-0.625, which may help surgeons reconstruct aesthetically pleasing ears. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Monocular Vision Loss After Ear Filler Injection.

Ophthalmic artery occlusion caused by facial hyaluronic acid filler injection has always been a rare but devastating complication. With the pursuit of beauty, people have become more interested in ears and hyaluronic acid fillers. Herein, we report the case of a more serious rare complication of ophthalmic artery occlusion caused by ear filler injection. A 45-year-old woman developed vision loss on the left side immediately after receiving cosmetic hyaluronic acid injection in the ear, with only the visual field at the inferior temporal side remaining. She was diagnosed with central retinal artery occlusion in the left eye. After treatment with hyaluronidase injection, dexamethasone, hyperbaric oxygen, and oral alprostadil, blood flow was partially restored in the left ophthalmic artery, and her vision improved. Vascular complications after ear injections are rare. However, as the demand for ear filler injections increases, the probability of serious vascular complications is predicted to increase. The potential mechanism by which occlusion occurred involved the filler reaching the superficial temporal artery system through the superior auricular artery, thus occluding the ophthalmic artery. Having an understanding of anatomy is an important measure to avoid complications.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

Unveiling the Low-Lying Spin States of [Fe3S4] Clusters via the Extended Broken-Symmetry Method.

Photosynthetic water splitting, when synergized with hydrogen production catalyzed by hydrogenases, emerges as a promising avenue for clean and renewable energy. However, theoretical calculations have faced challenges in elucidating the low-lying spin states of iron-sulfur clusters, which are integral components of hydrogenases. To address this challenge, we employ the Extended Broken-Symmetry method for the computation of the cubane-[Fe3S4] cluster within the [FeNi] hydrogenase enzyme. This approach rectifies the error caused by spin contamination, allowing us to obtain the magnetic exchange coupling constant and the energy level of the low-lying state. We find that the Extended Broken-Symmetry method provides more accurate results for differences in bond length and the magnetic coupling constant. This accuracy assists in reconstructing the low-spin ground state force and determining the geometric structure of the ground state. By utilizing the Extended Broken-Symmetry method, we further highlight the significance of the geometric arrangement of metal centers in the cluster's properties and gain deeper insights into the magnetic properties of transition metal iron-sulfur clusters at the reaction centers of hydrogenases. This research illuminates the untapped potential of hydrogenases and their promising role in the future of photosynthesis and sustainable energy production.

Validation of the Attitudes toward Lying to People with Dementia (ALPD) Questionnaire among Social Workers in Spain.

Gerontological interventions should address the various geriatric syndromes suffered by the elderly, such as neurodegenerative diseases. Therapeutic lying is an effective and humanizing strategy to deal with dementia, used by various disciplines in the social and healthcare fields. This intervention strategy is made up of all the different responses to reality that are given to a person with cognitive impairment. This study analyzes the validity of the Spanish adaptation of the Attitudes toward Lying to People with Dementia (ALPD) questionnaire, given to 253 social workers who directly and indirectly intervened with older people suffering from cognitive impairment in public and private centers in Spain during the year 2022. The results of the validity and reliability analyses support the psychometric quality of ALPD for use in Spanish social workers. The statistical results indicate a good fit of the bifactor model (person-focused and lie-focused) and show the questionnaire to be reliable, with adequate psychometric properties. The article concludes with a discussion of practical, formative, and ethical challenges for social work in the field of geriatric services.

"I Do Not Believe We Should Disclose Everything to an Older Patient": Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia.

Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients' religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.