Ethical, legal, and social implications (ELSI) of virtual agents and virtual reality in healthcare.

Virtual agents (VAs) and immersive virtual reality (VR) applications broaden the opportunities for accessing healthcare by transposing certain processes from the analogue world into a virtual realm. While these innovations offer a number of advantages including improved access for individuals in diverse geographic locations and novel therapeutic options, their implementation raises significant ethical, social, and legal implications. Key considerations pertain to the doctor-patient relationship, privacy and data protection, justice, fairness, and equal access as well as to issues of accountability, liability, and safety. This paper conducts a comprehensive review of the existing literature to analyse the ethical, social, and legal ramifications of employing VAs and VR applications in healthcare. It examines the recommended strategies to mitigate potential adverse effects and addresses current research gaps in this domain.

Predicting physical distancing on recreational trails during COVID-19.

The emergence of Coronavirus 19 led to societal and behavioral changes, including intensified use of many public parks and trails for mental respite and leisure time physical activity. As visitors sought stress-relief in the great outdoors, they also encountered stressful situations as they navigated risk exposure. Recommendations to physically distance between parties was a key component to reduce risk, but compliance is unknown in the outdoor arena. This observational study of more than 10 000 trail user encounters documented distancing and enabled predictive analysis that revealed wider trails, smaller groups and signage led to greater distancing compliance. Managers and planners can integrate these findings immediately and in consideration of future trail designs to minimize risk exposure. Management implications: Select site features increase odds of distancing compliance and can inform management decisions and designs immediately and in addressing future use surges: wider trails, unpaved surfaces, and COVID-19 signage.As distancing compliance waned with time but signage increased compliance, innovative and dynamic signs may sustain compliance and multi-media communications should be considered.Both activity size and group type influence distancing so considering group size recommendations and activity separation are in order.

COVID-19 compliance among urban trail users: Behavioral insights and environmental implications.

Public green spaces provide physical and mental respite, which have become essential and elevated services during the COVID-19 pandemic. As visitation to public parks and recreation areas increased during the pandemic, the challenge of maintaining visitor safety and protecting environmental resources was exacerbated. A key visitor safety practice during the COVID-19 onset was maintaining a physical distance of six feet (1.8 m) between groups. A novel data set documented and compared physical distancing compliance and off-trail behavior on multiple-use trails across multiple states and within select U.S. communities, attending to the impact of select environmental factors. Nearly 6000 observations revealed physical distancing compliance varied and the environmental factors of trail width, density, and signage influenced its variability. Similarly, off-trail movement was related to trail width and density. Clearly the environment matters as people negotiate the 'new normal' of physical distancing during physical activity and outdoor recreation participation. Given the ongoing COVID-19 pandemic and likelihood of future health crises, this project provides important information and insight for trail and other public green space management, monitoring, and modelling moving forward. Management implications: As both trail width and visitor density impacted physical distancing, a combination of trail design that accommodates distancing requirements and density management practices that provide sufficient trail user spacing is essential to retain safe and active trail use.Off-trail movement was influenced by both trail width and density, so ensuring safe off-trail spaces exist and using durable off-trail materials can minimize disturbance and protect visitors.Signage is inconsistently significant to influence trail-compliant distancing behavior, but optimizing its placement and content may improve effectiveness.Compliant trail behavior varied by trail width, visitor density, and trail location; therefore, site-specific information is necessary to understand possible visitor behavior and design/implement mitigation strategies.

Cases and context: Mask-related behaviors among U.S. trail visitors during the COVID-19 pandemic.

The challenge of simultaneously providing outdoor recreation opportunities while protecting the public from SARS-CoV-2 virus and COVID-19 transmission, as well as future pandemics, remains foremost on managers' minds. Safe spaces and cultures are paramount for managers and visitors alike. Recommended protective measures against COVID-19 included physically distancing 1.8 m (six-feet) between parties and mask-wearing when distancing is not possible. Adoption of these protective measures is relatively unknown but essential to inform recreation management and planning through future health crises. Such adoption is likely influenced by both the pandemic context and site context, particularly related to visitor density. An observational study assessed mask-wearing behaviors among trail walkers on multiple trails in the United States from November 2020 through May 2021. Trained observers identified if walking groups were prepared to mask or had masks correctly worn as well as if encounters were compliant with the 1.8 m recommendations. Data collected across seven U.S. states enabled comparisons of mask-related behaviors across sites as well as considerations to: the influence of the pandemic context in terms of cases and vaccination rates, mask mandates, and trail density. Results from nearly 3000 encounters revealed significant variance in visible masks, low compliance of mask-wearing in encounters less than 1.8 m, significant influence of both COVID-19 cases and vaccination rates on mask wearing at half the sites, and no impact of state-level mask mandates when controlling for cases and vaccinations. Integrating public health data can inform predictions of compliant behaviors, or lack thereof, and needs exist to advance a safety culture.

What Really Works? Testing Augmented and Virtual Reality Messaging in Terrestrial Invasive Species Management Communications to Impact Visitor Preferences and Deter Visitor Displacement.

Natural resource management is rapidly shifting to incorporate a deeper understanding of ecological processes and functioning, including attention to invasive species. The shift to understand public perceptions of resource management and invasives is much slower. Information influences both landscape preference and behaviors. Theory suggests that increasingly engaging information should have concurrently greater impacts. This research tested the effect of increasingly engaging information on visitor preferences and intentions to return to landscapes treated in response to emerald ash borer (EAB; Agrilus planipennis). Park visitors in a midwestern-U.S. state randomly received one of four messages about forest management in response to EAB (control, photo, augmented reality (AR) and virtual reality (VR)). Messaging impacted preferences for three of the four management approaches, but significant changes in displacement intentions emerged in only one of the four. Specifically, VR and AR increased preferences for complete harvest compared to photos/text, but not differently from those who received no information. VR significantly lowered preferences for select harvest with natural regeneration. The photo/text treatment increased preference for select harvest with planted trees over no information. Any information reduced displacement in response to a photo depicting "select harvest, planted trees." Subsequently judicious use of advanced communications like VR can optimize increasing scarce resources and maintain or optimize ecological services. Future research directions across geographic and content areas are recommended.

Serum Biomarkers are Associated With Atherosclerotic Cardiovascular Disease Among Patients With Nonalcoholic Fatty Liver Disease Undergoing Elective Angiography.

BACKGROUND & AIMS: Cardiovascular disease is the most common cause of death among patients with nonalcoholic fatty liver disease (NAFLD). We assessed select cardiac biomarker associations for existing or future coronary artery disease (CAD) risk in patients with NAFLD. METHODS: Patients with/without NAFLD undergoing elective cardiac angiography were prospectively enrolled. Severe CAD was defined as presence of at least 1 proximal artery >70% stenosis; risk of severe CAD as either existing severe CAD or atherosclerotic cardiovascular disease score ≥20; NAFLD was defined as hepatic fat in the absence of other liver diseases. Cardiac biomarkers (high-sensitivity C-reactive protein, N-terminal pro-brain natriuretic peptide, and high-sensitivity cardiac troponin I [hs-cTnI]) were measured using Atellica Solution assays (Siemens Healthineers). RESULTS: A total of 619 patients were enrolled (mean age, 63 ± 10 years; 80% male; 31% type 2 diabetes; 65% NAFLD); 42% had severe CAD, and 57% had risk of severe CAD. NAFLD prevalence was similar between patients with and without severe CAD (68% vs 62%; P > .05). Patients with NAFLD with severe CAD (44%) or with risk of severe CAD (58%) had higher levels of hs-cTnI than NAFLD controls (both P < .001). Presence of severe CAD or risk of severe CAD in all patients was associated with older age, male, aspects of metabolic syndrome, and elevated hs-cTnI: odds ratio 2.0 (95% confidence interval [CI],1.4-2.9) and 1.8 (95% CI, 1.1-3.0), respectively; 2.3 (95% CI, 1.4-3.8) and 2.2 (95% CI, 1.2-4.2), respectively, in patients with NAFLD (all P < .02). CONCLUSION: CAD is common in patients with NAFLD. High hs-cTnI was associated with an increased risk of CAD. Pending validation, hs-cTnI may be a useful marker for CAD risk prediction in patients with NAFLD.

An integrated approach to monitoring and estimating COVID-19 risk exposure among leisure-time physical activity participants.

BACKGROUND: Leisure time physical activity (LTPA) provides both health benefits and risks, particularly during a pandemic. During the COVID-19 pandemic, significant increases in close-to-home LTPA raised concerns for public health and land managers alike. This project illustrates a novel, integrated monitoring approach to estimating COVID-19 risk exposure during trail-related LTPA, with implications for other public spaces. METHODS: COVID-19 risk exposure was conservatively calculated from the integration of in-person observations of LTPA trail groups and automated monitoring of trail traffic volumes in spring 2020. Trained observers tracked 1,477 groups. Traffic volume estimates and observed distance data were integrated, considering occlusion and total trail traffic volume. RESULTS: 70% of groups had one or more encounters. Among individual users, 38.5% were 100% compliant across all events observed but 32.7% were not compliant. Considering trail traffic volumes and annual daily traffic volume, exposure to risk of COVID-19 was conservatively estimated at 61.5% among individual trail users. CONCLUSIONS: Monitoring opportunities and challenges of health risk exposure exist. Adjusted exposure measures based on volume counts can approximate numbers of unique individuals exposed, inform management actions, efficacy and policy decisions.

Identification of High-Risk Patients With Nonalcoholic Fatty Liver Disease Using Noninvasive Tests From Primary Care and Endocrinology Real-World Practices.

INTRODUCTION: We aimed to identify high-risk nonalcoholic fatty liver disease (NAFLD) patients seen at the primary care and endocrinology practices and link them to gastrohepatology care. METHODS: Using the electronic health record, patients who either had the diagnosis of type 2 diabetes or had 2 of 3 other metabolic risk factors met criteria for inclusion in the study. Using noninvasive fibrosis tests (NITs) to identify high risk of fibrosis, patients who met the NIT prespecified criteria were referred to gastrohepatology for clinical assessment and transient elastography. RESULTS: From 7,555 patients initially screened, 1707 (22.6%) met the inclusion criteria, 716 (42%) agreed to enroll, and 184 (25.7%) met the prespecified NIT criteria and eligibility for linkage to GE-HEP where 103 patients (68 ± 9 years of age, 50% men, 56% white) agreed to undergo linkage assessments. Their NIT scores were APRI of 0.38 ± 0.24, FIB-4 of 1.98 ± 0.87, and NAFLD Fibrosis Score of 0.36 ± 1.03; 68 (66%) linked patients had controlled attenuation parameter >248 dB/m, 62 (60%) had liver stiffness <6 kPa, and 8 (8%) had liver stiffness >12 kPa. Liver stiffness for the overall group was 6.7 ± 4.2 kPa, controlled attenuation parameter 282 ± 64 dB/m, and FAST score 0.22 ± 0.22. Linked patients with presumed advanced fibrosis had significantly higher body mass index (36.4 ± 6.6 vs 31.2 ± 6.4 kg/m2, P = 0.025) and higher NIT scores (APRI 0.89 ± 0.52 vs 0.33 ± 0.14, FIB-4 3.21 ± 2.06 vs 1.88 ± 0.60, and NAFLD Fibrosis Score 1.58 ± 1.33 vs 0.25 ± 0.94). DISCUSSION: By applying a simple prespecified multistep algorithm using electronic health record with clinical risk factors and NITs followed by transient elastography, patients with nonalcoholic fatty liver disease seen in PCP and ENDO practices can be easily identified.

Integrating Place Attachment into Management Frameworks: Exploring Place Attachment Across the Recreation Opportunity Spectrum.

The importance of place in landscape management and outdoor recreation has been prominent in the literature since the 1970s. As such, calls to incorporate place into the management of parks, forests, and other protected areas exist. However, little work explores how place attachment may complement existing management frameworks. Hence, the purpose of this investigation was to explore levels of visitors' place attachment intensity across the six classes of the Recreation Opportunity Spectrum (ROS). Survey data collected in North America and Europe indicated there was more similarity in place attachment intensities among areas classified toward the less developed end of the ROS, while greater variation existed among the more developed sites. Observing place attachment across all six ROS classes allowed for a deeper understanding of the correlation between place and the management framework.

The effect of green walking on heart rate variability: A pilot crossover study.

We investigated the effects of regular walking in green and suburban environments on heart rate variability (HRV) and blood pressure (BP) in middle-aged adults. Twenty-three adults participated in a non-randomized crossover experiment comprised of once-weekly 50-min moderate-intensity walking sessions. Separated by a two-week washout period, participants walked for three weeks in each of two treatment conditions (green and suburban) in a local arboretum and suburban sidewalks of Chaska, MN. Eleven participants completed green walking first and 12 suburban walking first. Walks were split into 15-min intra-walk phases, with phases representing each walk's beginning, middle, and final 15-min. Repeated measures linear mixed models evaluated (1) HRV phase differences between treatments and HRV change within treatments, and (2) pre- and post-walk BP differences between treatments and pre-to post-walk BP changes. Intra-walk phase analyses revealed higher HRV during green walking vs. suburban walking during phase 2 (p < 0.0001) and phase 3 (p = 0.02). Less HRV reduction was seen between intra-walk phases 1 and 2 during green vs. suburban walking (p = 0.02). Pre-to post-walk changes revealed decreased mean systolic BP for both green (p = 0.0002) and suburban (p = 0.003) walking conditions, but not for diastolic BP. Post-walk BP results were similar after both green walking and suburban walking. In summary, walking sessions in a green environment elicited greater beneficial HRV responses compared to a suburban environment. Additionally, walking in either environment, green or suburban, promoted reductions in systolic BP.

Changes in Psychological and Cognitive Outcomes after Green versus Suburban Walking: A Pilot Crossover Study.

This study investigated the acute effects of repeated walking sessions within green and suburban environments on participants' psychological (anxiety and mood) and cognitive (directed-attention) outcomes. Twenty-three middle-aged adults (19 female) participated in a non-randomized crossover study comprised of once-weekly 50-min moderate-intensity walking sessions. Participants walked for three weeks in each of two treatment conditions: green and suburban, separated by a two-week washout period. Eleven participants completed green walking first and 12 suburban walking first. For each walk, we used validated psychological questionnaires to measure pre- and post-walk scores for: (1) mood, evaluated via the Positive and Negative Affect Schedule (PANAS); (2) anxiety, assessed by the State-Trait Anxiety Inventory (STAI-S); and (3) directed-attention, measured using the visual Backwards Digit Span test (BDS). Repeated measures linear mixed models assessed pre- to post-walk changes within-treatment conditions and post-walk contrasts between-treatment conditions. Results indicated that anxiety decreased after green walking and increased after suburban walking (-1.8 vs. +1.1 units, respectively; p = 0.001). For mood, positive affect improved after green walking and decreased after suburban walking (+2.3 vs. -0.3 units, respectively; p = 0.004), and negative affect decreased after green walking and remained similar after suburban walking (-0.5 vs. 0 units, respectively; p = 0.06). Directed-attention did not improve from pre- to post-walk for either condition. Our results suggested that green walking may be more effective at reducing state anxiety and increasing positive affect compared to suburban walking.

Visitor Preferences for Visual Changes in Bark Beetle-Impacted Forest Recreation Settings in the United States and Germany.

Extensive outbreaks of tree-killing insects are increasing across forests in Europe and North America due to climate change and other factors. Yet, little recent research examines visitor response to visual changes in conifer forest recreation settings resulting from forest insect infestations, how visitors weigh trade-offs between physical and social forest environment factors, or how visitor preferences might differ by nationality. This study explored forest visitor preferences with a discrete choice experiment that photographically simulated conifer forest stands with varying levels of bark beetle outbreaks, forest and visitor management practices, and visitor use levels and compositions. On-site surveys were conducted with visitors to State Forest State Park in Colorado (n = 200), Lake Bemidji State Park in Minnesota (n = 228), and Harz National Park in Germany (n = 208). Results revealed that the condition of the immediate forest surrounding was the most important variable influencing visitors' landscape preferences. Visitors preferred healthy mature forest stands and disliked forests with substantial dead wood. The number of visitors was the most important social factor influencing visitor landscape preferences. Differences in the influence of physical and social factors on visual preferences existed between study sites. Findings suggest that both visual forest conditions and visitor use management are important concerns in addressing landscape preferences for beetle-impacted forest recreation areas.

Association of outdoor recreation availability with physical activity and weight status in Minnesota youth.

OBJECTIVE: Examine macro-level associations of youth physical activity (PA) and weight status with availability of outdoor recreation resources (i.e., parkland, forestland, natural preserves, nonmotorized trails, and motorized trails) across counties in Minnesota. METHODS: Hierarchical regression models examined if availability of recreation resources significantly improved prediction of PA and weight status of 9th and 12th grade boys and girls (2010) across Minnesota counties. RESULTS: The inclusion of county-level densities of recreational land variables did not produce a significant increase in R(2) for any of the models predicting 9th grade outcomes, yet county-level densities of recreational trails did significantly increase R(2) for both levels of PA and weight status. In contrast, the inclusion of recreational trails did not produce any significant increases in R(2) for 12th grade outcomes, although the inclusion of recreational land did significantly increase the R(2) for 12th grade girls achieving 30min of PA 5 or more days of the week. CONCLUSION: Findings indicate that various recreational land and trail types may have different impacts on and associations with PA and health outcomes. As such, it is important that future studies focus not only on parks, but also on other types of recreational lands and trails as well.

Determinação do tempo de apresentação a emergência de pacientes com infarto agudo do miocárdio / Determining the time of presentation to emergency of patients with acute myocardial

Objetivo: identificar o tempo entre a apresentação dos sintomas do paciente com Infarto Agudo do Miocárdio (IAM) até a apresentação a um serviço de emergência, descrevendo as características clínico-demográficas destes pacientes atendidos no serviço de emergência de um Hospital Universitário em Porto Alegre. Método: estudo descritivo transversal, os pacientes foram selecionados em amostra consecutiva após confirmação de infarto agudo do miocárdio e responderam a um questionário estruturado. Resultados: dos dezesseis pacientes estudados 9 (56,3%) eram homens, com idade média de 64,7±13,2 anos. Dor precordial foi o sintoma mais prevalente ocorrendo em 62,5% (10) dos casos. A mediana de tempo para procurar assistência foi de 4h30 minutos com intervalo interquartil de (3:10 a 9:45). Oito pacientes haviam recebido informação prévia sobre sintomas do infarto agudo do miocárdio. Conclusão: o tempo de demora até a procura de ajuda ainda é longo, o desconhecimento das manifestações do infarto pode ser um fator contribuinte.

Objective: to identify the time between the onset of symptoms of the patient with Acute Myocardial Infarction (AMI) to the presentation to an emergency department, describing the demographic and clinical characteristics of these patients seen in a university hospital in Porto Alegre. Methods: cross-sectional study, patients were selected in consecutive sample after confirmation of acute myocardial infarction and answered a structured questionnaire. Results: of the sixteen patients 9 (56.3%) were men, mean age 64.7 ± 13.2 years. Chest pain was the most prevalent symptom occurring in 62.5% (10) of the cases. The median time to seek assistance was 4 hours and 30 minutes with interquartile range (3:10 to 9:45). Eight patients had received prior information about symptoms of acute myocardial infarction. Conclusion: time delay before seeking help is still long, the lack of manifestations of infarction may be a contributing factor.

Objetivo: identificar el tiempo entre el inicio de los síntomas del paciente con infarto agudo de miocardio (IAM) para la presentación de un servicio de urgencias,describiendo las características clínicas de los pacientes atendidos en el servicio de un hospital universitario de Porto Alegre. Métodos: estudio descriptivo transversal, los pacientes fueron seleccionados en la muestra consecutiva después de la confirmación del IAM y respondieron un cuestionario estructurado. Resultados: dieciséis pacientes 9 (56,3%) eran hombres, edad 64,7 ± 13,2 años. El dolor de pecho es el síntoma más frecuente que ocurre en el 62,5% (10) de los casos. La media de tiempo para buscar ayuda fue 4h30m con un intervalo intercuartil (3:10-9:45). Ocho pacientes habían recibido información previa acerca de los síntomas del IAM. Conclusión: el retraso del tiempo antes de buscar ayuda aún es demorado, el desconocimiento de las manifestaciones del infarto puede ser un factor contribuyente.

To Be or not IP? Exploring limits within patent law for the constitutionalization of intellectual property rights and the governance of synthetic biology in human health

El artículo se adentra en los límites establecidos por la ley de patentes para la constitucionalización de los derechos de propiedad intelectual y la gobernanza de la biología sintética para la salud humana. Con este fin, comienza por explicar las bases inherentes de dos límites fundamentales dentro de la ley de patentes europea, concretamente (1) la frontera entre el descubrimiento y la invención (Artículo 52 EPC); (2) la cláusula de ley y orden público (Art. 53 (a) EPC). Ambas exclusiones para reunir los requisitos necesarios para constituir patente conservan una función normativa pero se basan en lógicas inherentes, funciones y objetivos reguladores opuestos. Mientras que en el primer tipo de lógica "permitir el acceso para todos" es el principio fundamental, en el segundo, la lógica de opuestos, nadie debería tener acceso al conocimiento tecnológico en cuestión. La segunda parte del artículo se enfrenta a determinar si las decisiones sobre si se debe y, en caso afirmativo, cómo se otorgan las patentes en biología sintética no son independientes de los marcos institucionales: el ámbito en el que se trate el asunto de las patentes biológicas sintéticas será decisivo para determinar si deben establecerse límites y cómo hacerlo. Desde la perspectiva de las ciencias políticas, puede realizarse la distinción entre el terreno de lo administrativo, lo legislativo y lo judicial. Si la biología sintética se negociara en el terreno de lo legislativo, concretamente en el Parlamento Europeo, las probabilidades de aplicar la cláusula de descubrimiento administrativo, los juzgados y oficinas de patentes han, al menos durante las últimas décadas, utilizado una limitada interpretación de estas excepciones absolutas de la patentabilidad y casi nunca han hecho uso de ellas. La tercera parte del artículo reafirma que la elaboración metafórica de la biología sintética es otro factor crucial para las cuestiones de patentabilidad. El encuadramiento semántico podría estar relacionado con la articulación y movilización del consentimiento o disentimiento y, por tanto, de la aceptación pública de la biología sintética. Tanto si las aplicaciones de biología sintética se consideran "naturales" como "sintética", el ADN puede influir sobre si la patente podría refutarse como "vida patentada" o aceptarse como novedosa, al igual que para superar el paso inventivo y las pruebas de aplicación industrial. El proceder de dicho modo puede considerarse como ética "ascendente", evaluación anticipatoria del impacto y análisis de políticas en las biociencias, así como una herramienta para la constitucionalización de los derechos de propiedad intelectual (AU)

This article explores limits within patent law for the constitutionalization of Intellectual Property Rights and the governance of synthetic biology in human health. To this end, it starts by explaining the inherent rationales of two fundamental limits within European patent law, namely (1) the boundary between discovery and invention (Art. 52 EPC); (2) the order public and public policy clause (Art. 53 (a) EPC). Both these exclusions from patent eligibility bear a normative function by rely on opposing inherent logics, functions, and regulatory aims. While in the first type of logics, "enabling access for all" is the guiding principle, in the second, converse logics, no one should have access to the technological knowledge in question. The second part contends that decisions on whether and how to grant patents in synthetic biology are not independent from institutional frameworks: The arena in which synthetic biology patenting will be dealt with will be decisive for whether and how boundaries will be deployed. From a political science perspective, the administrative, legislative and judicial arena can be distinguished. If synthetic biology will be negotiated in the legislative arena, in particular in the European Parliament, the probabilities will be higher that either the discovery clause or the order public clause will be applied. In contrast, patent offices and courts have, at least in the past decades, employed a narrow interpretation of these absolute exemptions from patentability and hardly ever used them. The third part asserts that metaphoric framing of synthetic biology is another crucial factor for patentability questions. Semantic framing may relate to the articulation and mobilization of consent or dissent, and thus public acceptance of synthetic biology. Whether applications of synthetic biology are conceived as "natural" or "synthetic" DNA may have an influence on whether patenting might become contested as "patenting life" or accepted as novel, and also on passing the inventive step and industrial application test. Proceeding in such a manner can be regarded as "upstreaming" ethics, anticipatory impact assessment, and policy analysis in the biosciences and as a tool for constitutionalizing intellectual property rights (AU)

To be or not IP? Exploring limits within patent law for the constitutionalization of intellectual property rights and the governance of synthetic biology in human health.

The article explores limits within patent law for the constitutionalization of Intellectual Property Rights and the governance of synthetic biology in human health. To this end, it starts by explaining the inherent rationales of two fundamental limits within European patent law, namely (1) the boundary between discovery and invention (Art. 52 EPC); (2) the ordre public and public policy clause (Art. 53 (a) EPC). Both these exclusions from patent eligibility bear a normative function but rely on opposing inherent logics, functions, and regulatory aims. While in the first type of logics, "enabling access for all" is the guiding principle, in the second, converse logics, no one should have access to the technological knowledge in question. The second part contends that decisions on whether and how to grant patents in synthetic biology are not independent from institutional frameworks: The arena in which synthetic biology patenting will be dealt with will be decisive for whether and how boundaries will be deployed. From a political science perspective, the administrative, legislative and judicial arena can be distinguished. If synthetic biology will be negotiated in the legislative arena, in particular in the European Parliament, the probabilities will be higher that either the discovery clause or the ordre public clause will be applied. In contrast, patent offices and courts have, at least in the past decades, employed a narrow interpretation of these absolute exemptions from patentability and hardly ever used them. The third part asserts that metaphoric framing of synthetic biology is another crucial factor for patentability questions. Semantic framing may relate to the articulation and mobilization of consent or dissent, and thus public acceptance of synthetic biology. Whether applications of synthetic biology are conceived as "natural" or "synthetic" DNA may have an influence on whether patenting might become contested as "patenting life" or accepted as novel, and also on passing the inventive step and industrial application tests. Proceeding in such a manner can be regarded as "upstreaming" ethics, anticipatory impact assessment, and policy analysis in the biosciences and as a tool for constitutionalizing intellectual property rights.

Parks and health: differences in constraints and negotiation strategies for park-based leisure time physical activity by stage of change.

BACKGROUND: Public parks are increasingly recognized as important places that facilitate physical activity. Despite the presence of parks, constraints to recreation and physical activity at parks exist. As the health benefits identified with physical activity require long-term and regular activity, it is important to examine factors pertaining to physical activity participation beyond initiation. This study explored differences in reported constraints to park based physical activity and negotiation strategies by physical activity stage of change. METHODS: Data were collected among visitors to one Minnesota state park via onsite and follow-up questionnaires. RESULTS: The average visitor had a healthier weight than the average U.S. and Minnesota adult and the majority of visitors were meeting the physical activity recommendations (86.4%). Respondents in the inactive/insufficient stages were more constrained and used fewer negotiation strategies than respondents in the maintenance stage. CONCLUSIONS: Results both support and expand on previous research findings. Specifically, this study supports research which indicates the adoption and maintenance of physical activity are influenced by different individual, social and environmental factors, and expands the research base by examining constraints and negotiation at different physical activity stages in a park setting. Implications of these findings provide directions for future stage-based intervention efforts.

Parks and Health: Differences in Constraints and Negotiation Strategies for Park-Based Leisure Time Physical Activity by Stage of Change.

BACKGROUND: Public parks are increasingly recognized as important places that facilitate physical activity. Despite the presence of parks, constraints to recreation and physical activity at parks exist. As the health benefits identified with physical activity require long-term and regular activity, it is important to examine factors pertaining to physical activity participation beyond initiation. This study explored differences in reported constraints to park based physical activity and negotiation strategies by physical activity stage of change. METHODS: Data were collected among visitors to one Minnesota state park via onsite and follow-up questionnaires. RESULTS: The average visitor had a healthier weight than the average U.S. and Minnesota adult and the majority of visitors were meeting the physical activity recommendations (86.4%). Respondents in the inactive/insufficient stages were more constrained and used fewer negotiation strategies than respondents in the maintenance stage. CONCLUSIONS: Results both support and expand on previous research findings. Specifically, this study supports research which indicates the adoption and maintenance of physical activity are influenced by different individual, social and environmental factors, and expands the research base by examining constraints and negotiation at different physical activity stages in a park setting. Implications of these findings provide directions for future stage-based intervention efforts.

Crowding and experience-use history: a study of the moderating effect of place attachment among water-based recreationists.

Effective recreation resource management relies on understanding visitor perceptions and behaviors. Given current and increasing pressures on water resources, understanding crowding evaluations seems important. Beyond crowding, however, variables that possibly relate to or influence crowding are of interest and in particular, place attachment and experience-use history (EUH). As EUH is related to place attachment and likely affects crowding, this study explored the moderating effect of place attachment dimensions on the relationships between EUH and visitor crowding evaluations. Water based recreationists at a U.S. Army Corps of Engineers site were contacted onsite and asked questions related to experience-use history, crowding evaluations, place attachment, and activity participation. Anglers and campers at the site identified similar crowding perceptions and place attachments. Only one of eight models tested revealed a moderating effect. Specifically, place identity moderated the relationship between the total times visited in the past twelve months and expected crowding among anglers. As such, the quest continues to understand the relationship among these important variables.

Physical activity patterns and preferences among Latinos in different types of public parks.

BACKGROUND: Centers for Disease Control (CDC) data suggest that Latinos are less likely to be physically active and more likely to be overweight and suffer from resulting complications than are Whites and that within the Latino population, Latina women are especially at risk. Therefore, promoting physical activity among Latinos, and understanding gender participation patterns within that population, is particularly important. One strategy for encouraging physical activity is to promote active uses of public parks. METHODS: A national, multiyear, multisite study funded by the USDA Forest Service sought to understand use of public parks by Latinos and Latinas in Los Angeles, Minneapolis, and Chicago. RESULTS: More than 50% of our sample visited parks to engage in physical activity, and in part, activity choice was related to gender. Furthermore, nearly half of all respondents walked to city park sites, whereas few or none walked to state or regional park sites. CONCLUSIONS: Our data suggest that Latinos are using some parks repeatedly and, in the case of city parks, are using them for physical as well as social activity. Therefore, we suggest specific ways that parks could be managed to encourage more physical activity while taking into account gender variations.