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1.
Behav Brain Sci ; 43: e69, 2020 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-32349845

RESUMEN

Social obligation begins far before people establish explicit cooperative relationships. Research on trust suggests that people feel obligated to trust other people even at zero acquaintance, thus trusting complete strangers even though they privately expect to be exploited. Such obligations promote mutually beneficial behavior among strangers and likely help people build goodwill needed for more long-lasting relationships.


Asunto(s)
Amigos , Principios Morales , Humanos , Responsabilidad Social , Confianza
4.
BMC Infect Dis ; 20(1): 263, 2020 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-32245370

RESUMEN

BACKGROUND: The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. METHODS: A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. RESULTS: Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries' populations. CONCLUSIONS: Our findings call for public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence women' willingness and possibility to protect themselves.


Asunto(s)
Epidemias , Gobierno , Confianza/psicología , Poblaciones Vulnerables/psicología , Salud de la Mujer , Infección por el Virus Zika/epidemiología , Virus Zika , Adulto , Brasil/epidemiología , Emociones , Femenino , Humanos , Estilo de Vida , Puerto Rico/epidemiología , Investigación Cualitativa , Apoyo Social , Estados Unidos/epidemiología , Adulto Joven , Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virología
6.
JMIR Public Health Surveill ; 6(2): e19218, 2020 04 24.
Artículo en Inglés | MEDLINE | ID: mdl-32301734

RESUMEN

BACKGROUND: The outbreak of the coronavirus disease (COVID-19) has dramatically changed societies in 2020. Since the end of February, Europe has been hit particularly hard by COVID-19, but there are major country differences in both the spread of the virus and measures taken to stop the virus. Social psychological factors such as institutional trust could be important in understanding the development of the epidemic. OBJECTIVE: The aim of this study was to examine country variations of COVID-19 mortality in Europe by analyzing social risk factors explaining the spread of the disease, restrictions and control measures, and institutional trust. METHODS: The present study was based on a background analysis of European Social Survey data on 25 European countries (N=47,802). Multilevel mixed effects linear regression models focused on 84 days of the COVID-19 epidemic (January 22 to April 14, 2020) and modelled the daily COVID-19 mortality. Analysis focused on the impact of social relations, restrictions, and institutional trust within each country. RESULTS: The spread of the COVID-19 epidemic has been fast everywhere, but the findings revealed significant differences between countries in COVID-19 mortality. Perceived sociability predicted higher COVID-19 mortality. Major differences between the 25 countries were found in reaction times to the crisis. Late reaction to the crisis predicted later mortality figures. Institutional trust was associated with lower COVID-19 mortality. CONCLUSIONS: The analyses demonstrated the importance of societal and social psychological factors in the spread of the COVID-19 epidemic. By considering multiple perspectives, this study showed that country differences in Europe are major, and this will have an impact on how countries will cope with the ongoing crisis in the following months. The results indicated the importance of timely restrictions and cooperation with people.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Coronavirus , Pandemias/estadística & datos numéricos , Neumonía Viral/mortalidad , Confianza , Adulto , Betacoronavirus , Brotes de Enfermedades/prevención & control , Monitoreo Epidemiológico , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Salud Global , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Salud Pública , Cuarentena , Viaje
7.
J Clin Ethics ; 31(1): 89-91, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32213699

RESUMEN

In this comment on Kenneth Iserson's article, "Do You Believe in Magic? Shove, Don't Nudge: Advising Patients at the Bedside," I discuss the definition of and the moral evaluation of nudging. I propose that using persuasive descriptions and intentionally building trust in patients by one's demeanor is a form of nudging. I argue that nudging is not necessarily morally problematic, but that it can be controlling and can limit liberty, despite proponents' claims to the contrary. I agree with Iserson that clinicians should give their patients explicit advice, but add that they should ideally also be aware of the more subtle psychological effects of advice giving.


Asunto(s)
Toma de Decisiones , Principios Morales , Comunicación Persuasiva , Relaciones Médico-Paciente , Humanos , Relaciones Médico-Paciente/ética , Confianza
8.
G Ital Cardiol (Rome) ; 21(4): 309-314, 2020 Apr.
Artículo en Italiano | MEDLINE | ID: mdl-32202565

RESUMEN

BACKGROUND: The request for informed consent to join a clinical trial often creates mistrust and hesitation in the patient who should be enrolled. In our study, we evaluated the reasons for refusing to participate in a clinical trial. METHODS: In the last 10 years of cardiovascular clinical research, we asked an informed consent to 2586 patients for intervention studies. Overall, 59% agreed to join clinical trials, 40% refused. The 1% initially accepted and then withdrew the consent. Those who refused were more frequently women, relatively younger (mean age 62 ± 5 vs 74 ± 9 years) and had a higher level of education and income. We asked all these patients who refused to answer a brief questionnaire about the reasons for rejection. RESULTS: Of 1031 patients, 629 (61%), accepted to answer the interview; 176 (28%) answered they refused on relatives', friends' or other doctors' advices, or after Internet searches; 157 (25%) answered they did not agree about how the trials were carried out (double-blind control procedure, use of placebo); 126 (20%) did not trust official medicine; 63 (10%) could not guarantee their presence at the follow-up visits; 69 (11%) did not want to undergo additional medical examinations; 31 (5%) had previous bad research experiences (feeling like a guinea pig); 7 (about 1%) refused for other reasons. CONCLUSIONS: Recruitment into clinical research studies is still a major challenge. Patients, due to a prevailing humanistic culture, are not fully aware of the importance of participation in clinical research, which is sometimes considered as exclusive economic or prestige interest. In our experience, people who refused participation in the trials were younger, with a high level of education and income, more frequently women. The researcher's task is to motivate the patient by emphasizing that participating in a study means being the actors of a treatment choice and that one is a guinea pig when taking untested therapies.


Asunto(s)
Ensayos Clínicos como Asunto , Consentimiento Informado , Participación del Paciente , Adulto , Toma de Decisiones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Participación del Paciente/psicología , Selección de Paciente , Sujetos de Investigación , Encuestas y Cuestionarios , Confianza
11.
World Neurosurg ; 136: xx, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32204300
13.
PLoS One ; 15(2): e0224761, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32069295

RESUMEN

The United States has experienced prolonged severe shortages of vital medications over the past two decades. The causes underlying the severity and prolongation of these shortages are complex, in part due to the complexity of the underlying supply chain networks, which involve supplier-buyer interactions across multiple entities with competitive and cooperative goals. This leads to interesting challenges in maintaining consistent interactions and trust among the entities. Furthermore, disruptions in supply chains influence trust by inducing over-reactive behaviors across the network, thereby impacting the ability to consistently meet the resulting fluctuating demand. To explore these issues, we model a pharmaceutical supply chain with boundedly rational artificial decision makers capable of reasoning about the motivations and behaviors of others. We use multiagent simulations where each agent represents a key decision maker in a pharmaceutical supply chain. The agents possess a Theory-of-Mind capability to reason about the beliefs, and past and future behaviors of other agents, which allows them to assess other agents' trustworthiness. Further, each agent has beliefs about others' perceptions of its own trustworthiness that, in turn, impact its behavior. Our experiments reveal several counter-intuitive results showing how small, local disruptions can have cascading global consequences that persist over time. For example, a buyer, to protect itself from disruptions, may dynamically shift to ordering from suppliers with a higher perceived trustworthiness, while the supplier may prefer buyers with more stable ordering behavior. This asymmetry can put the trust-sensitive buyer at a disadvantage during shortages. Further, we demonstrate how the timing and scale of disruptions interact with a buyer's sensitivity to trustworthiness. This interaction can engender different behaviors and impact the overall supply chain performance, either prolonging and exacerbating even small local disruptions, or mitigating a disruption's effects. Additionally, we discuss the implications of these results for supply chain operations.


Asunto(s)
Toma de Decisiones , Preparaciones Farmacéuticas/provisión & distribución , Confianza/psicología , Simulación por Computador , Equipos y Suministros de Hospitales/tendencias , Humanos , Modelos Organizacionales , Preparaciones Farmacéuticas/economía , Estados Unidos
14.
PLoS One ; 15(2): e0228911, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078645

RESUMEN

OBJECTIVES: To explore parents' experiences of seeking health care for their children and instead being accused by healthcare professionals of Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT), being reported to Social Services, undergoing judiciary processing, and the impact of these events on family (dis)integration. METHODS: Design: A qualitative study based on qualitative content analysis. Participants: Twelve parents in Sweden, mothers and fathers, seeking health care for their infants, encountering allegations of SBS/AHT, losing custody of their infants, and being subjected to a judiciary process, and finally regaining custody of their children. Data collection: In-depth interviews. RESULTS: An overarching theme 'Fighting for protection of their child after being trapped by doctors' and four sub-themes were developed to reflect the parents' experiences, reactions and interpretations. The first sub-theme, 'Being accused of injuring the child', illuminated the shock experienced when seeking care and instead being accused of being a perpetrator. The second, 'Chaos and powerlessness', refers to the emotions experienced when losing custody of the child and being caught in the enforcement of legislation by the authorities. The third, ´The unified fight against the doctors' verdict´, illustrates the parents' fight for innocence, their worry for the lost child, and their support and resistance. The fourth, 'The wounded posttraumatic growth', describes the emotions, grief, panic, anxiety, and challenges in reuniting the family, but also the parents' reflections on personal growth. Unanimously, they had experienced the authorities' inability to reconsider, and expressed a deep mistrust of paediatric care. CONCLUSIONS: Being wrongly accused of child abuse and alleged SBS/AHT evoked emotions of intense stress, but parents endured because of a successful fight to regain custody of their child. However, the trauma had a long-term impact on their lives with residual posttraumatic stress symptoms and mistrust towards healthcare services and the authorities. The results provide important inferences for restoring system failures within child protection services.


Asunto(s)
Custodia del Niño/ética , Padres/psicología , Aceptación de la Atención de Salud/psicología , Confianza/psicología , Adulto , Niño , Maltrato a los Niños/prevención & control , Traumatismos Craneocerebrales/prevención & control , Decepción , Emociones , Padre/psicología , Femenino , Humanos , Lactante , Masculino , Madres/psicología , Investigación Cualitativa , Síndrome del Bebé Sacudido , Suecia
16.
PLoS One ; 15(1): e0228193, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32004336

RESUMEN

BACKGROUND: Anxiety can create serious disruption in the life and mind of youth who are affected. Youth living with anxiety suffer a wealth of physical and psychological challenges, yet little is known about how anxiety influences the sense of the self. The purpose of this research was to explore the experience of the self in a sample of Canadian youth living with anxiety. MATERIALS AND METHODS: The qualitative research approach of hermeneutic phenomenology was used. The sample consisted of 58 Canadian youth with anxiety, 44 females and 14 males between the ages of 10 and 22. Youth took part in open-ended interviewing, ecomaps, and photovoice. Data analysis followed a staged process, informed by Max van Manen. All sources of data were included in the analysis to form thematic statements. RESULTS: Entering into the lifeworld of youth revealed that they suffered deeply. A fractured sense of self underlined their experience, setting up for a great deal of self-scrutiny and a lack of self-compassion. They experienced a profound sense of responsibility for others at the loss of being-there-for-oneself. Navigating their social sphere presented an additional challenge. However, youth were genuinely interested in self-discovery through awareness and reflection. CONCLUSIONS: The phenomenological accounts by youth on living with anxiety reinforce the challenges they experienced within themselves that give rise to a great deal of inner turmoil. Care and support to youth with anxiety requires an understanding of the ways in which the self may be fractured by their experiences with anxiety. Providing young people with an opportunity to share with others who had similar lived experiences can serve to contribute to a sense of healing for youth, while also providing a safe space in which young people can let down their guard and openly acknowledge or share their experiences without fear of stigmatization.


Asunto(s)
Ansiedad/epidemiología , Investigación Cualitativa , Adolescente , Ansiedad/psicología , Canadá/epidemiología , Niño , Emociones , Femenino , Humanos , Masculino , Estrés Psicológico , Confianza , Adulto Joven
19.
PLoS One ; 15(1): e0228379, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32004352

RESUMEN

BACKGROUND: Lack of conceptual clarity and measurement methods have led to underdeveloped efforts to measure experience of participation in care by next of kin to older people in nursing homes. OBJECTIVE: We sought to assess the measurement properties of items aimed at operationalizing participation in care by next of kin, applied in nursing homes. METHODS: A total of 37 items operationalizing participation were administered via a questionnaire to 364 next of kin of older people in nursing homes. Measurement properties were tested with factor analysis and Rasch model analysis. RESULTS: The response rate to the questionnaire was 81% (n = 260). Missing responses per item varied between <0.5% and 10%. The 37 items were found to be two-dimensional, and 19 were deleted based on conceptual reasoning and Rasch model analysis. One dimension measured communication and trust (nine items, reliability 0.87) while the other measured collaboration in care (nine items, reliability 0.91). Items successfully operationalized a quantitative continuum from lower to higher degrees of participation, and were found to generally fit well with the Rasch model requirements, without disordered thresholds or differential item functioning. Total scores could be calculated based on the bifactor subscale structure (reliability 0.92). Older people (≥ 65 years) reported a higher degree of communication and trust and bifactor total scores than younger people (p < 0.05 in both cases). People with a specific contact person experienced a higher degree of participation in the two subscales and the bifactor total score (p < 0.05 in all three instances). CONCLUSION: Psychometric properties revealed satisfactory support for use, in nursing home settings, of the self-reported Next of Kin Participation in Care questionnaire, with a bifactor structure. Additional research is needed to evaluate the effectiveness of the scales' abilities to identify changes after intervention. TRIAL REGISTRATION: The KUPA project has Clinical Trials number NCT02708498.


Asunto(s)
Familia/psicología , Enfermería Geriátrica/métodos , Hogares para Ancianos , Casas de Salud , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Suecia , Confianza
20.
PLoS One ; 15(2): e0225818, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092084

RESUMEN

Low levels of trust in government have potentially wide-ranging implications for governing stability, popular legitimacy, and political participation. Although there is a rich normative and empiricial literature on the important consequences of eroding trust in democratic societies, the causes of political trust are less clear. In this article we estimate the effect that changing Americans' views about the perceived honesty and integrity of political authorities (or "political probity") has on their trust in government using randomized survey experiments. In one experiment on a convenience sample and a direct replication on a more representative sample, we find that a single Op-Ed article about political probity increased trust in government by an amount larger than the partisan gap between Democrats and Republicans. These results complement prior observational studies on trust in government by demonstrating that political probity plays an important causal role in shaping Americans' judgments about the trustworthiness of their government and politicians.


Asunto(s)
Gobierno , Condición Moral , Política , Confianza/psicología , Democracia , Humanos , Opinión Pública , Encuestas y Cuestionarios , Estados Unidos
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