No End in Sight? A Greenwash Review and Research Agenda.

Greenwashing is more virulent than ever. A profusion of environmental, social, and governance and net zero commitments are becoming fraught with questionable and misleading claims. At the same time, we are no closer to solving the pressing environmental and social issues of our time. In this review, we seek to examine this shift and summarize changes in greenwash research into three key phases: (a) 1.0 Static Communication; (b) 2.0 Dynamic Management; and (c) 3.0 Narratives about the Future. We analyze current key areas of developing literature and point to numerous open questions for future research. Next, we go beyond much of the published work to examine emerging tactics and lay out a forward-looking agenda for future research. We also propose a model of Corporate Miscommunication, integrating various streams in greenwash research. In doing so, we seek to lay a pathway for greenwashing researchers to finally find that elusive "end" to greenwashing.

Streamlining orthopaedic trauma surgical care: do all patients need medical clearance?

INTRODUCTION: Preoperative medical optimization is necessary for safe and efficient care of the orthopaedic trauma patient. To improve care quality and value, a preoperative matrix was created to more appropriately utilize subspecialty consultation and avoid unnecessary consults, testing, and operating room delays. Our study compares surgical variables before and after implementation of the matrix to assess its utility. METHODS: A retrospective review of all orthopaedic trauma cases 6 months before and after the use of the matrix (2/2021-8/2021) was conducted an urban, level one trauma centre in collaboration with internal medicine, cardiology, anaesthesia, and orthopaedics. Patients were separated into two cohorts based on use of the matrix during the initial orthopaedic consultation. Logistic regressions were performed to limit significant differences in comorbidities. Independent samples t-tests and Chi-squared tests were used to compare means and proportions, respectively, between the two cohorts. RESULTS: In total, 576 patients were included in this study (281 pre- and 295 post-matrix implementation). Use of the matrix resulted in no significant difference in time to OR, LOS, readmissions, or ER visits; however, it resulted in 18% fewer overall preoperative consults for general trauma, and 25% fewer pre-operative consults for hip fractures. Older patients were more likely to require a consult regardless of matrix use. When controlling for comorbidities, patients with renal disease were at higher risk for increased LOS. CONCLUSION: Use of an orthopaedic surgical matrix to predict preoperative subspecialty consultation is easy to implement and allows for better care utilization without a corresponding increase in complications and readmissions. Follow-up studies are needed to reassess the relationships between matrix use and a potential decrease in ER to OR time, and validate its use.

A review of open pelvic fractures with concurrent genitourinary injuries.

INTRODUCTION: Open pelvic fractures (OPFs) are uncommon but potentially lethal traumatic injuries. Often caused by high energy blunt trauma, they can cause severe injury to abdominal and pelvic structures. We sought to conduct a review of the literature in order to ascertain the rates of genitourinary injury and vaginal laceration after OPF and the rates of resulting infection and mortality. METHODS: A review of PubMed was conducted to identify studies reporting the rates of genitourinary injury from OPF. Study characteristics, patient characteristics, and outcomes were collected. The data were pooled, and descriptive statistics were obtained. RESULTS: Eight studies encompassing 343 patients were included. Average age was 35.1 years (10-85.9), 28% were female, and the average Injury Severity Score was 26.5 (4-75). 95.5% of patients had a blunt mechanism of injury. Motor vehicle collision (23.9%), motorcycle accident (19.7%), and pedestrian struck (19.3%) were the most common etiologies. Overall mortality and infection rates were 31.2% and 18.7%, respectively. 19.7% of patients suffered an injury to the genitourinary system, and 32.4% of females sustained a vaginal laceration. DISCUSSION: OPFs have the potential for extremely high morbidity and mortality. While much research has been done to prevent early mortality from hemorrhage, there is comparatively little research into late mortality stemming from infection and sepsis. Intravenous antibiotics are the mainstay of treatment, and local antibiotics usage has been encouraged. In patients with a vaginal laceration, it is important to provide antibiotic coverage for vaginal flora.

Decreasing Postoperative Opioid Prescriptions After Orthopedic Trauma Surgery: The "Lopioid" Protocol.

OBJECTIVE: To assess the effectiveness of a multimodal analgesic regimen containing "safer" opioid and non-narcotic pain medications in decreasing opioid prescriptions after surgical fixation in orthopedic trauma. DESIGN: Retrospective cohort study. SETTING: One urban, academic medical center. SUBJECTS: Patients with traumatic fracture from 2018 (n=848) and 2019 (n=931). METHODS: In 2019, our orthopedic trauma division began a standardized protocol of postoperative pain medications that included 50 mg of tramadol four times daily, 15 mg of meloxicam once daily, 200 mg gabapentin twice daily, and 1 g of acetaminophen every 6 hours as needed. This multimodal regimen was dubbed the "Lopioid" protocol. We compared patients who received this protocol with all patients from the prior year who had followed a standard protocol that included Schedule II narcotics. RESULTS: Greater mean morphine milligram equivalents were prescribed at discharge from fracture surgery under the standard protocol than under the Lopioid protocol (252.3 vs 150.0; P < 0.001), and there was a difference in the type of opioid medication prescribed (P < 0.001). There was a difference in the number of refills filled for patients discharged with opioids after surgical treatment between the standard and Lopioid cohorts (0.31 vs 0.21; P = 0.002). There were no differences in the types of medication-related complications (P = 0.710) or the need for formal pain management consults (P = 0.199), but patients in the Lopioid cohort had lower pain scores at discharge (2.2 vs 2.7; P = 0.001). CONCLUSIONS: The Lopioid protocol was effective in decreasing the amount of Schedule II narcotics prescribed at discharge and the number of opioid refills after orthopedic surgery for fractures.

Young children's understanding of the epistemic and deontic meanings of ask and tell.

The verbs ask and tell can be used both epistemically, referring to the flow of information, and deontically, referring to obligations through polite requests or commands. Some researchers suggest that children's understanding of deontic modals emerges earlier than their understanding of epistemic modals, possibly because theory of mind is required to understand epistemic modals. In the current study, 184 children aged 3-6 years were presented with vignettes depicting epistemic and deontic asking and telling and were asked whether the speaker asked or told, followed by first-order theory-of-mind tasks. An emergence of both epistemic and deontic understanding was found at 5 years of age, and both were correlated with children's theory-of-mind understanding. These findings are consistent with arguments that both epistemic and deontic understanding implicate theory-of-mind awareness and provide insight into the developmental trajectory of children's understanding.

Police Interviewing Behaviors and Commercially Sexually Exploited Adolescents' Reluctance.

Little is known about the relation between law enforcement interviewing behaviors and commercially sexually exploited children's (CSEC) reluctance. This study examined the relation between officers' use of maximization, (references to) expertise, minimization, and support and adolescent CSEC victims' reluctance in a small sample of police interviews (n = 2,416 question-answer pairs across ten interviews). Twenty-six percent of officers' utterances contained at least one interviewing tactic. When statements were paired with maximization, they were correlated with more reluctance than when they were not paired with an interviewing tactic. Contrary to predictions, support was also related to greater reluctance. Open-ended (recall) questions and statements were associated with greater reluctance than closed-ended (recognition) questions. The results highlight the importance of understanding the context in which interviewing strategies are employed when assessing the relation between interviewer behavior and interviewee reluctance.

Don't know responding in young maltreated children: The effects of wh- questions type and enhanced interview instructions.

OBJECTIVE: Two studies examined 4-7-year-old maltreated children's "I don't know" (IDK) responses to wh- questions after receiving various interview instructions. HYPOTHESES: We predicted (H1) children would be less inclined to give IDK responses and more inclined to guess to color/number questions compared to other wh- questions; (H2) IDK instructions would increase children's IDK responding compared to no instructions, with an increase in accuracy; but (H3) instructions would be less effective in reducing guessing for color/number questions than other wh- questions. In Study 1, we predicted that (H4) verbalizing a commitment to answer IDK would be particularly effective. In Study 2, we predicted that (H5) IDK instructions would reduce children's accurate corrective responses, but that (H6) the negative effect of IDK instructions on corrective responses would be alleviated by a "correct the interviewer" instruction. METHOD: Across 2 studies, 301 four- to seven-year-old (M = 5.60, SD = 1.09) maltreated children viewed videos and answered wh- questions about true and false details. Both studies included a within-subjects manipulation of wh- types (color/number & wh- detail) and a between-subjects manipulation of instructions (Study 1: IDK practice, IDK practice/verbalize, control; Study 2: IDK, correct me, IDK + correct me, control). RESULTS: In both studies, (a) color/number questions elicited more guessing than wh- detail questions, (b) IDK instructions decreased inaccurate responses, but they also decreased accurate responses, including accurate corrective responses, and (c) IDK instructions had a larger effect on wh- detail questions, reducing accurate corrective responses. In Study 1, verbalization failed to enhance the effect of instructions. In Study 2, the negative effect of IDK instructions on accurate corrective responses was not alleviated by instructions to correct the interviewer. CONCLUSIONS: Among young maltreated children, color/number questions elicit higher rates of guessing than other wh- questions. IDK instructions reduced inaccurate responses, but also reduced accurate responses. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Identifying Liars Through Automatic Decoding of Children's Facial Expressions.

This study explored whether children's (N = 158; 4- to 9 years old) nonverbal facial expressions can be used to identify when children are being deceptive. Using a computer vision program to automatically decode children's facial expressions according to the Facial Action Coding System, this study employed machine learning to determine whether facial expressions can be used to discriminate between children who concealed breaking a toy(liars) and those who did not break a toy(nonliars). Results found that, regardless of age or history of maltreatment, children's facial expressions could accurately (73%) be distinguished between liars and nonliars. Two emotions, surprise and fear, were more strongly expressed by liars than nonliars. These findings provide evidence to support the use of automatically coded facial expressions to detect children's deception.

Children's concealment of a minor transgression: The role of age, maltreatment, and executive functioning.

This study examined the role of age, maltreatment status, and executive functioning on 752 4- to 9-year-old maltreated and nonmaltreated children's recall disclosure of a transgression in which the children appeared to have broken toys while playing with a stranger. Interviewers used narrative practice rapport building and then questioned children with free recall and cued recall questions. Younger and maltreated children were more likely to disclose during rapport building, whereas older and nonmaltreated children were more likely to disclose in response to recall questions. Working memory deficits appeared to mediate the relation between children's characteristics and disclosure during rapport but not during recall. The results demonstrate that how children are questioned affects the relations between deception and age, maltreatment, and executive functioning.

Understanding expert testimony on child sexual abuse denial after New Jersey v. J.L.G.: Ground truth, disclosure suspicion bias, and disclosure substantiation bias.

The New Jersey Supreme Court held in New Jersey v. J.L.G. (2018) that experts can no longer explain to juries why sexually abused children might deny abuse. The court was influenced by expert testimony that "methodologically superior" studies find lower rates of denial. Examining the studies in detail, we argue that the expert testimony was flawed due to three problems with using child disclosure studies to estimate the likelihood that abused children are reluctant to disclose abuse: the ground truth problem, disclosure suspicion bias, and disclosure substantiation bias. Research identifying groups of children whose abuse can be proven without reliance on disclosure reveals that denial of sexual abuse is common among abused children.

Detecting children's true and false denials of wrongdoing: Effects of question type and base rate knowledge.

One common and unfortunately overlooked obstacle to the detection of sexual abuse is non-disclosure by children. Non-disclosure in forensic interviews may be expressed via concealment in response to recall questions or via active denials in response to recognition (e.g., yes/no) questions. In two studies, we evaluated whether adults' ability to discern true and false denials of wrongdoing by children varied as a function of the types of interview question the children were asked. Results suggest that adults are not good at detecting deceptive denials of wrongdoing by children, even when the adults view children narrate their experiences in response to recall questions rather than provide one word answers to recognition questions. In Study 1, adults exhibited a consistent "truth bias," leading them toward believing children, regardless of whether the children's denials were true or false. In Study 2, adults were given base-rate information about the occurrence of true and false denials (50% of each). The information eliminated the adults' truth bias but did not improve their overall detection accuracy, which still hovered near chance. Adults did, however, perceive children's denials as slightly more credible when they emerged in response to recall rather than recognition questions, especially when children were honestly denying wrongdoing. Results suggest the need for caution when evaluating adults' judgments of children's veracity when the children fail to disclose abuse.

Order of Encoding Predicts Young Children's Responses to Sequencing Questions.

We propose that young children exhibit an order of encoding bias, such that they are inclined to report or act out events in the order in which they were originally encoded. This bias helps to explain why children assume that events they first hear described are in chronological order and why they often appear to understand "after" better than "before" when they are questioned about experienced events. Asking children about a sequence of events as a whole (in particular using "first") could avoid order of encoding biases, because children would not have to answer questions about events within the sequence. In the present study, 100 2- to 4-year-old children participated in creating simple stories in which a story child interacted with five objects, thus creating five unrelated events. Children then responded to questions asking them to identify which action occurred "before" and "after" the third event and which action occurred "first" and "last" in the story. We hypothesized that (1) children would exhibit a tendency to answer "before" and "after" questions with the event that occurred after the queried event, thus impairing performance on "before" questions; (2) children would respond more accurately to questions about what occurred "first" and "last" than to questions about "before" and "after"; (3) children would respond more accurately to questions about "first" than questions about "last," and (4) children's performance would improve with age. The hypotheses were supported. Critically, children's errors when responding to "before"/ "after" questions were consistent with an order of encoding bias.

The effects of the putative confession and evidence presentation on maltreated and non-maltreated 9- to 12-year-olds' disclosures of a minor transgression.

The current study examined the influence of the putative confession (in which children are told that the suspect told them "everything that happened" and "wants [the child] to tell the truth") and evidence presentation on 9- to 12-year-old maltreated and non-maltreated children's disclosure (N = 321). Half of the children played a forbidden game with an adult confederate that resulted in a laptop computer breaking (no transgression occurred for the other half of the children), followed by coaching to conceal the forbidden game and to falsely disclose the sanctioned game. Children were then interviewed about the interaction with the confederate. Among the 9- and 10-year-olds, the putative confession led to a higher rate of breakage disclosure (62%) than the control condition (13%) and to a higher rate of leakage of incriminating details during recall (47% vs. 9%). Older children were more likely to disclose than younger children and to be uninfluenced by the putative confession. Among all ages, evidence presentation elicited disclosures from 63% of children who had not previously disclosed without eliciting any false disclosures.

Younger and Older Adults' Lie-Detection and Credibility Judgments of Children's Coached Reports.

Previous research has examined young and middle-aged adults' perceptions of child witnesses; however, no research to date has examined how potential older adult jurors may perceive a child witness. The present investigation examined younger (18-30 years, N = 100) and older adults' (66-89 years, N = 100) lie-detection and credibility judgments when viewing children's truthful and dishonest reports. Participants viewed eight child interview videos where children (9 to 11 years of age) either provided a truthful report or a coached fabricated report to conceal a transgression. Participants provided lie-detection judgments following all eight videos and credibility assessments following the first two videos. Participants completed a General Lifespan Credibility questionnaire to assess credibility evaluations across various witness ages. Lie-detection results indicated that older adults had significantly lower discrimination scores, a stronger truth bias, and greater confidence compared to younger adults. Older adults also rated children as more competent to testify in court, credible, honest, believable, and likeable than younger adults. Participants with greater differences in their credibility evaluations for truth and lie-tellers were significantly more accurate at detecting lies. Responses to the Lifespan Credibility questionnaire revealed significant differences in younger and older adults' credibility evaluations across the lifespan.

Adults' Perceptions of Children's Referentially Ambiguous Responses.

The present study examined adults' (N = 295) interpretations of child witnesses' referentially ambiguous "yes" and "no" responses to "Do You Know/Remember (DYK/R) if/whether" questions (e.g., "Do you know if it was blue?"). Participants were presented with transcripts from child sexual abuse cases modified based on question format (DYK/R vs. Direct) and child response type (Yes, No, I don't know) in a between subjects design. We assessed whether adults recognized that children's ambiguous responses were unclear, and if not, how they were interpreting children's responses compared to the control (Direct) conditions. More specifically, we assessed whether adults interpreted children's responses as answering the explicit (e.g., "No, I don't remember") or implicit (e.g., "No, it wasn't blue") question. Participants virtually never recognized ambiguous responses as unclear, and their interpretations were influenced by the attorney's question and child's response type. In sum, these results suggest that DYK/R questions often lead to misinterpretation, resulting in miscommunication.

The effects of promising to tell the truth, the putative confession, and recall and recognition questions on maltreated and non-maltreated children's disclosure of a minor transgression.

This study examined the utility of two interview instructions designed to overcome children's reluctance to disclose transgressions: eliciting a promise from children to tell the truth and the putative confession (telling children that a suspect "told me everything that happened and wants you to tell the truth"). The key questions were whether the instructions increased disclosure in response to recall questions and in response to recognition questions that were less or more explicit about transgressions and whether instructions were differentially effective with age. A total sample of 217 4- to 9-year-old maltreated and comparable non-maltreated children and a stranger played with a set of toys. For half of the children within each group, two of the toys appeared to break while they were playing. The stranger admonished secrecy. Shortly thereafter, children were questioned about what happened in one of three interview conditions. Some children were asked to promise to tell the truth. Others were given the putative confession, and still others received no interview instructions. When coupled with recall questions, the promise was effective at increasing disclosures only among older children, whereas the putative confession was effective regardless of age. Across interview instruction conditions, recognition questions that did not suggest wrongdoing elicited few additional transgression disclosures, whereas recognition questions that explicitly mentioned wrongdoing elicited some true reports but also some false alarms. No differences in disclosure emerged between maltreated and non-maltreated children. Results highlight the potential benefits and limitations of different interviewing approaches when questioning reluctant children.

Children's Conversational Memory Regarding a Minor Transgression and a Subsequent Interview.

Children's memories for their conversations are commonly explored in child abuse cases. In two studies, we examined conversational recall in 154 4- to 9-year-old children's reports of an interaction with a stranger, some of whom were complicit in a transgression and were admonished to keep it a secret. Immediately afterwards, all children were interviewed about their interaction. One week later, children were asked recall questions about their interaction with the stranger, their conversations with the stranger, and their conversations with the interviewer. Overall, interaction recall questions elicited few details about children's conversations, whereas conversation recall questions were effective in doing so. Accuracy was high in response to both the interaction and conversation recall questions, with no differences observed. Questions explicitly inquiring about coaching elicited higher error rates, as well as apparent attempts to maintain secrecy. Source errors were rare. Conversation recall questions elicited new transgression disclosures among a substantial percentage of children. The results provide tentative support for the use of recall questions in eliciting conversational information from children.

Spatial language, question type, and young children's ability to describe clothing: Legal and developmental implications.

Children's descriptions of clothing placement and touching with respect to clothing are central to assessing child sexual abuse allegations. This study examined children's ability to answer the types of questions attorneys and interviewers typically ask about clothing, using the most common spatial terms (on/off, outside/inside, over/under). Ninety-seven 3- to 6-year-olds were asked yes/no (e.g., "Is the shirt on?"), forced-choice (e.g., "Is the shirt on or off?"), open-choice (e.g., "Is the shirt on or off or something else?"), or where questions (e.g., "Where is the shirt?") about clothing using a human figurine, clothing, and stickers. Across question types, children generally did well with simple clothing or sticker placement (e.g., pants completely on), except for yes/no questions about "over," suggesting children had an underinclusive understanding of the word. When clothing or sticker placement was intermediate (e.g., pants around ankles, and therefore neither completely on nor off), children performed poorly except when asked where questions. A similar task using only stickers and boxes, analogous to forensic interviewers' assessments of children's understanding, was only weakly predictive of children's ability to describe clothing. The results suggest that common methods of questioning young children about clothing may lead to substantial misinterpretation. (PsycINFO Database Record

Pragmatic Failure and Referential Ambiguity when Attorneys Ask Child Witnesses "Do You Know/Remember" Questions.

"Do you know" and "Do you remember" (DYK/R) questions explicitly ask whether one knows or remembers some information while implicitly asking for that information. This study examined how 104 4- to 9-year-old children testifying in child sexual abuse cases responded to DYK/R wh- and yes/no questions. When asked DYK/R questions containing an implicit wh- question requesting information, children often provided unelaborated "Yes" responses. Attorneys' follow-up questions suggested that children usually misunderstood the pragmatics of the questions. When DYK/R questions contained an implicit yes/no question, unelaborated "Yes" or "No" responses could be responding to the explicit or the implicit questions resulting in referentially ambiguous responses. Children often provided referentially ambiguous responses and attorneys usually failed to disambiguate children's answers. Although pragmatic failure following DYK/R wh- questions decreased with age, the likelihood of referential ambiguity following DYK/R yes/no questions did not. The results highlight the risks of serious miscommunications caused by pragmatic misunderstanding and referential ambiguity when children testify.

Challenging the Credibility of Alleged Victims of Child Sexual Abuse in Scottish Courts.

This study examined the effects of credibility-challenging questions (n = 2,729) on 62 5- to 17-year-olds' testimony in child sexual abuse cases in Scotland by categorizing the type, source, and content of the credibility-challenging questions defense lawyers asked and assessing how children responded. Credibility-challenging questions comprised 14.9% of all questions asked during cross-examination. Of defense lawyers' credibility-challenging questions, 77.8% focused generally on children's honesty, whereas the remainder referred to specific inconsistencies in the children's testimony. Children resisted credibility challenges 54% of the time, significantly more often than they provided compliant responses (26.8%). The tendency to resist was significantly lower for questions focused on specific rather than general inconsistencies, and peripheral rather than central content. Overall, children resisted credibility challenges more often when the aim and content of the question could be understood easily. As this was a field study, the accuracy of children's responses could not be assessed. The findings suggest that credibility-challenging questions that place unrealistic demands on children's memory capacities (e.g., questions focused on peripheral content or highly specific details) occur frequently, and that juries should be made aware of the disproportionate effects of such questioning on the consistency of children's testimony.