The emergence of young children's tolerance for inequality: With age, children stop showing numerically sensitive fairness.

One persistent and pernicious feature of outstanding social inequality is that even relatively extreme forms of inequality can be justified with reference to merit-based considerations. One key feature of fairness with respect to resource allocation is that it is numerically sensitive; greater (more extreme) inequalities are generally seen as less fair than less extreme ones. This work sought to document the emergence of numerically sensitive fairness in children aged 4 to 8 years. A total of 81 4- to 8-year-olds completed a series of within-participants fairness judgment trials in which they observed two characters receive either equitable or inequitable shares of resources-ranging from 50/50 (completely fair) to 0/100 (completely unfair)-in two contexts: one in which the two characters were described as working the same amount (equality context) and one in which one character was described as working harder than the other character (merit context). Children of all ages showed numerically sensitive fairness in the equality context. However, whereas younger children continued to show numerically sensitive fairness in the merit context, older children approved even relatively extreme inequalities when one person was described as working harder. This effect emerged with age, suggesting a double-edged sword to acquiring beliefs in merit-based fairness; as children get older, they may begin to accept even relatively extreme forms of inequality when presented in a merit context. Results are discussed with respect to the acquisition of meritocracy as a normative belief of fairness.

Who is chronically obese in Indonesia? The role of individual preferences.

Numerous studies have confirmed the relationship between individual risk and time preference and obesity. Nevertheless, none has studied the effect of these attitudes on chronic (long-term) obesity. This study used Indonesia Family Life Survey (IFLS) data from 16,366 individuals. It tracked their obesity status in 2007 and 2014 by calculating body mass index, the ratio between body weight and square of height. Besides the conventional risk-averse and risk-tolerant behaviour, the IFLS sample includes people who fear uncertainty related to the status quo bias. The ordered logit regression results show that past impatience, risk tolerance, and status quo bias behaviour (in 2007) are associated with transient or chronic obesity, while only current behaviour of status quo bias (in 2014) is associated with obesity. Furthermore, our study confirms that chronic obesity in Indonesia is prevalent among highly educated, high-income, and urban-centric individuals, exacerbated by impatience, risk tolerance, and uncertainty aversion. Thus, providing information on the risk of obesity and food calories, giving the incentive to avoid obesity, and improving the quality of built environments such as public parks, public transportation, and footpath could help prevent the rising obesity prevalence.

Factors affecting the scientific research ability and the corresponding countermeasures in clinical postgraduates.

BACKGROUND: Scientific research ability (SRA) is very important for clinical postgraduates. However, the factors affecting students' SRA are constantly changing with the development of medicine. The aim of this study was to investigate the current situation of SRA in clinical postgraduates and exploring the potential factors and the corresponding countermeasures under the background of new medical science. METHODS: A total of 133 postgraduates (first- or second-year) were investigated by questionnaire in the Second Affiliated Hospital of Fujian Medical University. All results were analyzed by R software. RESULTS: In terms of the SRA, academic-degree postgraduate students (ADPSs) were significantly better than professional-degree postgraduate students (PDPSs) (P = 0.001), the students with scientific research interest were remarkably better than those without scientific research interest (P = 0.004), the students who mastered statistical analysis methods were more prominent than those who did not (P = 0.007), the students with paper-writing skills were obviously superior to those without it (P = 0.003), and the second-year students were notably better than the first-year students (P = 0.003). Stratified analysis by the above factors except the degree type showed no significant difference in the first-year postgraduates. In the second-year postgraduates, the ADPSs were remarkably superior to the PDPSs (P = 0.002), the students with scientific research interest were obviously better than those without scientific research interest (P = 0.014), the students with more time investment in scientific research were more prominent than those with less time investment in scientific research (P = 0.025), the students with paper-writing skills were notably superior to those without it (P = 0.031), and the students with plotting ability were better than those without it (P = 0.013). CONCLUSION: The important factors affecting the SRA of clinical postgraduates include the degree type, the grade of student, scientific research interest, time investment in scientific research, statistical analysis methods, paper-writing skills, plotting ability. In short, earlier systematic SRA training contributes to the improvement of SRA in clinical postgraduates, especially in PDPSs.

An empirical investigation of household's waste separation intention: A dual-factor theory perspective.

Waste separation at a household level could facilitate sustainable waste management. However, despite several efforts by the government, the adoption of household waste separation practices is still at a nascent stage. Therefore, we aim to study the factors affecting household waste separation intention (WSI). Drawing on Dual Factor Theory (DFT), two distinct sets of factors (enablers and barriers) were used to explain the WSI at the household level. This study also extended the Self Determination Theory (SDT) and Status Quo Bias (SQB) theory to broadly identify the factors and develop a conceptual model. The main study analyzed data from 494 respondents using a structural equation modeling approach. The result reveals that environmental concern, anticipated guilt, awareness of consequences, and health consciousness have a significant positive effect on WSI. In contrast, perceived inconvenience, information, and infrastructure barriers significantly negatively affect WSI. Additionally, gender and income partially moderated the studied relationships. The results offer key insights and implications for marketers and public policymakers.

[Status Quo and Research Progress in Diagnosis and Treatment of Patients With Diabetes Mellitus and Chronic Kidney Disease].

As the incidence of diabetes mellitus is rapidly increasing worldwide,that of related complications,such as diabetic kidney disease(DKD),also increases,conferring a heavy economic burden on the patients,families,society,and government.Diabetes mellitus complicated with chronic kidney disease(CKD)includes DKD and the CKD caused by other reasons.Because of the insufficient knowledge about CKD,the assessment of diabetes mellitus complicated with CKD remains to be improved.The therapies for diabetes mellitus complicated with CKD focus on reducing the risk factors.In clinical practice,DKD may not be the CKD caused by diabetes.According to clinical criteria,some non-diabetic kidney disease may be misdiagnosed as DKD and not be treated accurately.This review summarizes the status quo and research progress in the assessment,diagnosis,and treatment of diabetes mellitus complicated with CKD and predicts the directions of future research in this field.

The Golden Age Is Behind Us: How the Status Quo Impacts the Evaluation of Technology.

New technology invariably provokes concerns over potential societal impacts. Even as risks often fail to materialize, the fear continues. The current research explored the psychological underpinnings of this pattern. Across four studies (N = 2,454 adults recruited via Amazon Mechanical Turk), we found evidence for the role of status quo thinking in evaluating technology. In Study 1, we experimentally manipulated the reported age of unfamiliar technology and found that people evaluate it more favorably when it is described as originating before (vs. after) their birth. In Studies 2 through 4, participants' age at the time of invention strongly predicts attitudes toward a wide range of real-world technologies. Finally, we found that individual differences in status-quo-based decision-making moderated evaluations of technology. These studies provide insight into how people respond to the rapidly changing technological landscape.

Leveraging behavioral economics to promote treatment adherence: A primer for the practicing dermatologist.

The problem of suboptimal treatment adherence among patients with dermatologic or other diseases has not been adequately addressed in health care. Despite a wide range of efficacious therapies, nonadherence remains a primary driver of suboptimal clinical outcomes. Novel solutions to address this unmet need can be found in behavioral economics. By leveraging our understanding of human decision-making, we may better promote treatment adherence, thereby improving quality of life and decreasing economic burdens. Behavioral economics has been studied extensively in relation to topics such as health policy and health behaviors; however, there is a dearth of research applying this approach to chronic diseases and only a handful within dermatology. We conducted a scoping review in PubMed to identify articles that discuss behavioral economics and its application to treatment adherence in dermatologic patients, with a particular focus on psoriasis, followed by a summary of key ethical considerations. We found that such principles can be employed in cost-effective, scalable interventions that improve patient adherence to a range of medical therapies and lifestyle modifications.

Valuing improved water services and negative environmental externalities from seawater desalination technology: A choice experiment from the Galápagos.

While seawater desalination technologies can improve drinking water supply, they can also generate significant environmental externalities. A choice experiment was implemented to investigate household preferences for potential trade-offs between improved water services and environmental impacts from seawater desalination in the Galápagos Islands. Our results indicate that households are willing to pay for water quality improvements, and for protection of coastal ecosystems and marine organisms. In contrast, households seem indifferent regarding water availability and potential impacts on air quality. Our findings also suggest that respondents who consistently reject the proposed desalination project tend to be less affluent and have stronger environmental preferences than those who support it. It is concluded that stated-preference studies on improved water services should also elicit preferences for potential environmental effects of the proposed water technology.

Critical cultural competence of clinical nurses in China: A cross-sectional survey.

AIM: To determine the level of critical cultural competence (CCC) among Chinese clinical nurses and explore its influencing factors. BACKGROUND: Previous research has only focused on the theoretical model of CCC and the development of assessment tools; however, no large-scale study has been conducted on the level of clinical nurses' CCC and its influencing factors. METHOD: Clinical nurses in 14 Level A tertiary hospitals (n = 3858) were surveyed using Almutairi's critical cultural competence scale (CCCS). Descriptive, univariate and multivariate analyses were performed. RESULTS: The mean score of CCC was 4.44 (SD = 0.33). Critical empowerment (M = 4.85, SD = 0.58) and critical awareness (M = 3.57, SD = 0.99) had the highest and lowest scores, respectively. Female nurses, nurses in the nursing department and nurses with higher positions had higher CCC. CONCLUSION: The CCC of clinical nurses can be strengthened through targeted training, especially considering the fact that male and low-ranking nurses who had the lower level of CCC work in different departments. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators should pay attention to the importance of culture and cultural differences among different countries or ethnic groups. Creating an equal and fair nursing environment and encouraging nurses to provide critical cultural nursing is important.

[Chinese medicine dispensing granules: history, status quo, and development prospect in "post-pilot era"].

Chinese medicine dispensing granules, the result of the efforts to transform Chinese medicinal decoction pieces in China, features portability and ease of storage. Thus, it is destined to be an indispensible dosage form in the modernization drive of Chinese medicine. The Announcement on Ending the Pilot Project of Chinese Medicine Dispensing Granules was released in February 2021 and relevant regulations went into force in November 2021, which marks the a new journey for the development of Chinese medicine dispensing granules and the beginning of the "post-pilot era". However, it faces the challenges in quality and standard. This study reviewed the history of Chinese medicine dispensing granules, analyzed the technical progress, market, and main problems in development, and proposed suggestions and prospects for its development in the "post-pilot era", which is expected to serve as a reference for its industry development and rational use.

The Status quo and way forwards on the development of Tibetan medicine and the pharmacological research of tibetan materia Medica.

Tibetan medicine (TM), the second largest traditional Chinese medicine system in China, boasts a long history and an integrated theoretical system. It abounds with classical medical works constituing a unique corpus of Tibetan materia medica (TMM). China has now conceived a modern education system of TM, and Tibetan medical hospitals at different levels have been set up. Many enterprises are granted the privileges to produce preparations of TM in compliance with Good Manufacturing Practices (GMP) regulations. However, there still exist unsolved issuess in TMM research as to the mechanism of action and the active constituents of TMM which are now been tackled through pharmacology and modern science and technology. Up till now, the mechanism of action and the active constituents of 141 medicines as well as 230 preparations of TM have been preliminarily revealed. This paper reviews in detail the development of TM and the status quo of TM's pharmacological research, in hope of serving a reference value for the promotion of the modernization of TM and understanding of TM among the medical scholars.

When accountability meets power: realizing sexual and reproductive health and rights.

This paper addresses a critical concern in realizing sexual and reproductive health and rights through policies and programs - the relationship between power and accountability. We examine accountability strategies for sexual and reproductive health and rights through the lens of power so that we might better understand and assess their actual working. Power often derives from deep structural inequalities, but also seeps into norms and beliefs, into what we 'know' as truth, and what we believe about the world and about ourselves within it. Power legitimizes hierarchy and authority, and manufactures consent. Its capillary action causes it to spread into every corner and social extremity, but also sets up the possibility of challenge and contestation.Using illustrative examples, we show that in some contexts accountability strategies may confront and transform adverse power relationships. In other contexts, power relations may be more resistant to change, giving rise to contestation, accommodation, negotiation or even subversion of the goals of accountability strategies. This raises an important question about measurement. How is one to assess the achievements of accountability strategies, given the shifting sands on which they are implemented?We argue that power-focused realist evaluations are needed that address four sets of questions about: i) the dimensions and sources of power that an accountability strategy confronts; ii) how power is built into the artefacts of the strategy - its objectives, rules, procedures, financing methods inter alia; iii) what incentives, disincentives and norms for behavior are set up by the interplay of the above; and iv) their consequences for the outcomes of the accountability strategy. We illustrate this approach through examples of performance, social and legal accountability strategies.

Progress bias versus status quo bias in the ethics of emerging science and technology.

How should we handle ethical issues related to emerging science and technology in a rational way? This is a crucial issue in our time. On the one hand, there is great optimism with respect to technology. On the other, there is pessimism. As both perspectives are based on scarce evidence, they may appear speculative and irrational. Against the pessimistic perspective to emerging technology, it has been forcefully argued that there is a status quo bias (SQB) fuelling irrational attitudes to emergent science and technology and greatly hampering useful development and implementation. Therefore, this article starts by analysing the SQB using human enhancement as a case study. It reveals that SQB may not be as prominent in restricting the implementation of emergent technologies as claimed in the ethics literature, because SQB (a) is fuelled by other and weaker drivers than those addressed in the literature, (b) is at best one amongst many drivers of attitudes towards emergent science and technology, and (c) may not be a particularly prominent driver of irrational decision-making. While recognizing that SQB can be one driver behind pessimism, this article investigates other and counteracting forces that may be as strong as SQB. Progress bias is suggested as a generic term for the various drivers of unwarranted science and technology optimism. Based on this analysis, a test for avoiding or reducing this progress bias is proposed. Accordingly, we should recognize and avoid a broad range of biases in the assessment of emerging and existing science and technology in order to promote an open and transparent deliberation.

The inhibiting effects of resistance to change of disability determination system: a status quo bias perspective.

BACKGROUND: Information systems implementation projects have been historically plagued by failures for which user resistance has consistently been identified as a salient reason. Most prior studies investigated either the causes or the consequences of Resistance to Change (RTC) of medical related Information Systems. In this study, we simultaneously explore the causes and impacts of RTC of Disability Determination System (DDS). METHODS: This study adopts the Status Quo Bias perspective and combines the information systems usage model and Technology Acceptance Model (TAM) as theoretical foundation to investigates the causes and impacts of users' RTC on their intention to use the DDS. Data were obtained through internet questionnaire survey. Totally, 326 respondents from 22 local governments and 142 hospitals were collected, of which 252 were valid samples and were analyzed using structure model analysis. RESULTS: The research model is proved with eight out of 11 hypotheses being supported. The antecedents of RTC can explain 21.4% of the RTC variation, and the RTC impacts can explain 57.5% of the variation of intention to use DDS. CONCLUSIONS: Combining the Status Quo Bias perspective and key component of TAM provides an adequate explanation of adopting intention of changing systems and extend the existing knowledge of information systems adoption. The results provide as a reference for managing users' RTC and enhance the effects and efficiency of new systems adoption.

Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps?

Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.

[Single-use Medical Devices Re-processing: Regulatory Status Quo].

Some single-use medical devices are reprocessed and reused in some countries in the world, but the regulatory approach is different, and in some countries it isn't regulated yet. In this article, the regulatory status quo of single-use medical devices is reviewed. The regulatory development, important regulatory documents and regulatory approaches of single-use medical device reprocessing in the United States, Germany and the UK are introduced. And how to perform scientific risk assessment and effective risk control is discussed. The information is useful to establish China-specific regulations, and to develop relevant standards, guidelines or specifications and the risk control strategies.

Fortifying the Corrective Nature of Post-publication Peer Review: Identifying Weaknesses, Use of Journal Clubs, and Rewarding Conscientious Behavior.

Most departments in any field of science that have a sound academic basis have discussion groups or journal clubs in which pertinent and relevant literature is frequently discussed, as a group. This paper shows how such discussions could help to fortify the post-publication peer review (PPPR) movement, and could thus fortify the value of traditional peer review, if their content and conclusions were made known to the wider academic community. Recently, there are some tools available for making PPPR viable, either as signed (PubMed Commons) or anonymous comments (PubPeer), or in a hybrid format (Publons). Thus, limited platforms are currently in place to accommodate and integrate PPPR as a supplement to traditional peer review, allowing for the open and public discussion of what is often publicly-funded science. This paper examines ways in which the opinions that emerge from journal clubs or discussion groups could help to fortify the integrity and reliability of science while increasing its accountability. A culture of reward for good and corrective behavior, rather than a culture that protects silence, would benefit science most.

[Research progress on Chinese medicines with topical administration in umbilical region].

Based on the Chinese medicines with topical administration in umbilical region approved by China Food and Drug Administration (CFDA), this paper would comb and analyze their dosage forms, varieties and clinical applications. On the other hand, through consulting literature materials, the research progress was reviewed and the main challenges faced by the medicines were discussed in detail as well. This paper elaborates that the preparations with topical administration in umbilical region, as an important branch in Chinese medicine external therapy, have unique advantages. However, there are still some problems such as rough workmanship, lacking internationally accepted quality control standards, scarcity of pharmacological and clinical evidences and biopharmaceutical researches. Meanwhile, proper measures and suggestions are put forward.

Normal human variation: refocussing the enhancement debate.

This article draws attention to several common mistakes in thinking about biomedical enhancement, mistakes that are made even by some supporters of enhancement. We illustrate these mistakes by examining objections that John Harris has recently raised against the use of pharmacological interventions to directly modulate moral decision-making. We then apply these lessons to other influential figures in the debate about enhancement. One upshot of our argument is that many considerations presented as powerful objections to enhancement are really strong considerations in favour of biomedical enhancement, just in a different direction. Another upshot is that it is unfortunate that much of the current debate focuses on interventions that will radically transform normal human capacities. Such interventions are unlikely to be available in the near future, and may not even be feasible. But our argument shows that the enhancement project can still have a radical impact on human life even if biomedical enhancement operated entirely within the normal human range.