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Sprague NL, Uong SP, Jacobowitz AL, Packard SE, Quinn JW, Keyes KM, Rundle AG. Examining racial and ethnic heat exposure disparities in New York City (NYC) across different spatial and political scales through geographic effect measure modification. ENVIRONMENTAL RESEARCH 2024; 250:118521. [PMID: 38382663 PMCID: PMC11102848 DOI: 10.1016/j.envres.2024.118521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/02/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
Structural racism in the United States has resulted in neighborhoods with higher proportions of non-Hispanic Black (Black) or Hispanic/Latine residents having more features that intensify, and less that cool, the local-heat environment. This study identifies areas of New York City (NYC) where racial/ethnic heat exposure disparities are concentrated. We analyzed data from the 2013-2017 American Community Survey, U.S Landsat-8 Analysis Ready Data on summer surface temperatures, and NYC Land Cover Dataset at the census tract-level (n = 2098). Four cross-sectional regression modeling strategies were used to estimate the overall City-wide association, and associations across smaller intra-city areas, between tract-level percent of Black and percent Hispanic/Latine residents and summer day surface temperature, adjusting for altitude, shoreline, and nature-cover: overall NYC linear, borough-specific linear, Community District-specific linear, and geographically weighted regression models. All three linear regressions identified associations between neighborhood racial and ethnic composition and summer day surface temperatures. The geographically weighted regression models, which address the issue of spatial autocorrelation, identified specific locations (such as northwest Bronx, central Brooklyn, and uptown Manhattan) within which racial and ethnic disparities for heat exposures are concentrated. Through examining the overall effects and geographic effect measure modification across spatial scales, the results of this study identify specific geographic areas for intervention to mitigate heat exposure disparities experienced by Black and Hispanic/Latine NYC residents.
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Affiliation(s)
- Nadav L Sprague
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA.
| | - Stephen P Uong
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
| | - Ahuva L Jacobowitz
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
| | - Samuel E Packard
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
| | - James W Quinn
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
| | - Andrew G Rundle
- Department of Epidemiology, Columbia Mailman School of Public Health, 722 W 168th St., New York, NY, 10032, USA
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2
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Lederman Z. Loneliness at the age of COVID-19. JOURNAL OF MEDICAL ETHICS 2023; 49:649-654. [PMID: 36600628 DOI: 10.1136/jme-2022-108540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
Loneliness has been a major concern for philosophers, poets and psychologists for centuries. In the past several decades, it has concerned clinicians and public health practitioners as well. The research on loneliness is urgent for several reasons. First, loneliness has been and still is extremely ubiquitous, potentially affecting people across multiple demographics and geographical areas. Second, it is philosophically intriguing, and its analysis delves into different branches of philosophy including phenomenology, existentialism, philosophy of mind, etc. Third, empirical research has shown that loneliness is a significant health risk factor. Loneliness may thus be defined as a (negative) social determinant of health.Having that said, COVID-19 has demonstrated how little we as members of humanity have been prepared to face the loneliness resulting from the global response to the virus. As people worldwide are literally dying from loneliness, we still do not know what makes one feel lonely while making another feel being in solitude, or how is it that one feels lonely in the heart of London.In this essay, I first review loneliness in general and specifically in the context of COVID-19. I then argue that loneliness should be understood as a social determinant of health. Lastly, I argue that individuals have a right not to be lonely. Such right stems in turn from the right to healthcare or even a right to health.
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Affiliation(s)
- Zohar Lederman
- Medical Ethics and Humanities Unit, LKS Medical Faculty, Hong Kong University, Hong Kong, Hong Kong
- International Center of Health, Law, and Ethics, University of Haifa, Haifa, Israel
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3
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Pykett J, Campbell N, Fenton SJ, Gagen E, Lavis A, Newbigging K, Parkin V, Williams J. Urban precarity and youth mental health: An interpretive scoping review of emerging approaches. Soc Sci Med 2023; 320:115619. [PMID: 36641884 DOI: 10.1016/j.socscimed.2022.115619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Circumstances of living are key to shaping emotional and affective experiences, long term health, wellbeing and opportunities. In an era characterised by rapid urbanisation across the majority of the world, there is increasing interest in the interaction between mental health and urban environments, but insufficient attention is paid to how mental health is situated in space and time. Socio-economic inequalities are prevalent in many urban environments globally, making conditions of living highly precarious for some social groups including young people. There remains a large volume of unmet mental health service needs, and young people are impacted by uncertain economic futures. The purpose of this scoping review is to develop an interdisciplinary and globally-informed understanding of the urban conditions which affect youth mental health across a range of scales, and to identify protective factors which can promote better youth mental health. We seek to broaden the scope of urban mental health research beyond the physical features of urban environments to develop an interpretive framework based on perspectives shared by young people. We illustrate how concepts from social theory can be used as an integrative framework to emphasise both young people's lived experiences and the wider cultural and political dynamics of urban mental health.
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Affiliation(s)
- Jessica Pykett
- School of Geography, Earth and Environmental Sciences, Institute for Mental Health and Centre for Urban Wellbeing, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Niyah Campbell
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Sarah-Jane Fenton
- School of Social Policy and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Elizabeth Gagen
- Department of Geography and Earth Sciences, Aberystwyth University, Llandinam Building, Penglais Campus, Aberystwyth, SY23 3DB, Wales, UK.
| | - Anna Lavis
- Institute of Applied Health Research and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Karen Newbigging
- School of Social Policy and Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Verity Parkin
- Liberal Arts and Natural Sciences Alumni, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Jessy Williams
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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4
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Yibo Y, Ziyuan C, Simayi Z, Haobo Y, Xiaodong Y, Shengtian Y. Dynamic evaluation and prediction of the ecological environment quality of the urban agglomeration on the northern slope of Tianshan Mountains. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:25817-25835. [PMID: 36346520 DOI: 10.1007/s11356-022-23794-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
In order to timely determine the dynamic changes of the ecological environment quality and future development laws of the urban agglomeration on the northern slope of the Tianshan Mountains, combined with the actual situation of the urban agglomeration, 11 indicators were selected from the three aspects of natural ecology, social ecology, and economic ecology. To reduce the dimensions of the indicators, principal component analysis, coefficient of variation, and analytic hierarchy process were used based on RS and GIS technology methods, and the ecological environmental quality (EQI) from 2000 to 2018 was dynamically evaluated. Further, the CA-Markov model was introduced to simulate the development status in 2026 for predictive purposes. The main results are as follows: the overall ecological environment of the area exhibited a gradually improving distribution change from southwest to northeast; the proportion of ecological environment classification exhibited a gradually decreasing change pattern; the spatial differentiation of ecological environment quality exhibited a significant spatial positive correlation; from the influencing factors, an observation can be made that natural ecological factors were highly significant; the prediction accuracy verification revealed that the CA-Markov model was suitable for the prediction of the ecological environment quality in the region and had high accuracy; and the comprehensive regional ecological environment quality indexes were 5.7392, 6.1856, and 6.4366, respectively, while the forecasted value for 2026 was predicted to be 6.6285, indicating that the overall ecological environment quality of the region will improve and develop well. The present research results reveal the law of dynamic changes and future development of the ecological environment quality in the region, which can be used as a theoretical reference for the formulation of ecological environmental protection measures.
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Affiliation(s)
- Yan Yibo
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Smart City and Environmental Modelling for General Universities, College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Oasis Ecology, Ministry of Education Laboratory, Xinjiang University, Urumqi, 830046, Xinjiang, China
| | - Chai Ziyuan
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Smart City and Environmental Modelling for General Universities, College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Oasis Ecology, Ministry of Education Laboratory, Xinjiang University, Urumqi, 830046, Xinjiang, China
| | - Zibibula Simayi
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China.
- Key Laboratory of Smart City and Environmental Modelling for General Universities, College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China.
- Key Laboratory of Oasis Ecology, Ministry of Education Laboratory, Xinjiang University, Urumqi, 830046, Xinjiang, China.
| | - Yan Haobo
- School of Civil Engineering and Transportation, North China University of Water Resources and Electric Power, Henan, 450045, China
| | - Yang Xiaodong
- Sino-French Joint College of Ningbo University, Ningbo, 200231, Zhejiang, China
| | - Yang Shengtian
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Smart City and Environmental Modelling for General Universities, College of Resources and Environmental Sciences, Xinjiang University, Urumqi, 830046, Xinjiang, China
- Key Laboratory of Oasis Ecology, Ministry of Education Laboratory, Xinjiang University, Urumqi, 830046, Xinjiang, China
- School of Geography and Remote Sensing Science, Beijing Normal University, Beijing, 100875, China
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Lyu B, Liao X, Yang Y. Relationships Between Temporal Leadership, Transactive Memory Systems and Team Innovation Performance. Psychol Res Behav Manag 2022; 15:2543-2559. [PMID: 36124335 PMCID: PMC9482459 DOI: 10.2147/prbm.s380989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background In recent years, temporal leadership has gradually attracted academic attention. Purpose This paper discussed the impact of temporal leadership on team innovation performance. Methodology Through the sample analysis of 385 team members in 98 teams. The measurements of temporal leadership, team innovation performance, transactive memory system, and team reflection were used to measure the relationships between temporal leadership, transactive memory systems and team innovation performance. Findings/Results It is found that temporal leadership has a positive impact on team innovation performance, which is transmitted through the credibility dimension and coordination dimension of transactive memory systems. Positive team reflection regulates the relationship between temporal leadership and transactive memory systems. Value This paper reveals the specific impact mechanism of temporal leadership on team innovation performance and provides a new perspective on how to improve team innovation performance in limited time resources.
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Affiliation(s)
- Bei Lyu
- Business School, Henan University, Kaifeng, People's Republic of China.,School of Economics and Management, Huaibei Normal University, Huaibei, People's Republic of China.,Chinese Graduate School, Panyapiwat Institute of Management, Nonthaburi, Thailand
| | - Xiaoyu Liao
- School of Humanities and Management, Guizhou University of Traditional Chinese Medicine, Guiyang, People's Republic of China
| | - Yanchao Yang
- Faculty of Education, University of Macau, Macau, People's Republic of China
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6
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Sprague NL, Bancalari P, Karim W, Siddiq S. Growing up green: a systematic review of the influence of greenspace on youth development and health outcomes. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:660-681. [PMID: 35614136 PMCID: PMC9482936 DOI: 10.1038/s41370-022-00445-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 05/05/2023]
Abstract
Youth growing up in places with more greenspaces have better developmental outcomes. The literature on greenspace and youth development is largely cross-sectional, thus limited in terms of measuring development and establishing causal inference. We conducted a systematic review of prospective, longitudinal studies measuring the association between greenspace exposure and youth development outcomes measured between ages two and eighteen. We searched Cochrane, PubMed, CINAHL, Scopus, and Environment Complete, and included prospective cohort, quasi-experimental, and experimental studies on greenspace and youth development. Study quality was assessed using a 10-item checklist adapted from a previously published review on greenspace and health. Twenty-eight studies met criteria for review and were grouped into five thematic categories based on reported outcomes: cognitive and brain development, mental health and wellbeing, attention and behavior, allergy and respiratory, and obesity and weight. Seventy-nine percent of studies suggest an association between greenspace and improved youth development. Most studies were concentrated in wealthy, Western European countries, limiting generalizability of findings. Key opportunities for future research include: (1) improved uniformity of standards in measuring greenspace, (2) improved measures to account for large latency periods between greenspace exposure and developmental outcomes, and (3) more diverse study settings and populations.
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Affiliation(s)
- Nadav L Sprague
- Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Pilar Bancalari
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Wasie Karim
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shabnaz Siddiq
- Columbia University Mailman School of Public Health, New York, NY, USA
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7
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Bonhomme M, Alfaro A. 'The filthy people': Racism in digital spaces during Covid-19 in the context of South-South migration. INTERNATIONAL JOURNAL OF CULTURAL STUDIES 2022; 25:404-427. [PMID: 37519849 PMCID: PMC9096011 DOI: 10.1177/13678779221092462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Notions of 'race' and disease are deeply imbricated across the globe. This article explores the historical, complex entanglements between 'race', disease, and dirtiness in the multicultural Chilean context of Covid-19. We conducted a quantitative content analysis and a discourse analysis of online readers' comments (n = 1233) in a digital news platform surrounding a controversial news event to examine Chileans' cultural representations of Haitian migrants and explore online racism and anti-immigrant discourse. Drawing on a decolonial approach, we argue that Covid-19 as a crisis has been fabricated at the expense of a constructed 'other'. We show how colonial racist logics not only endure in digital spaces, but are made viral in new ways by representing Haitian migrants as 'filthy' and 'disease carriers'. We identified two contemporary forms of racism - online cultural racism and online aggressive racism - through which people construct imaginaries of racial superiority in digital spaces.
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Anthony R, De Paula Vieira A. One Health Animal Disaster Management: An Ethics of Care Approach. J APPL ANIM WELF SCI 2022; 25:180-194. [PMID: 35272545 DOI: 10.1080/10888705.2022.2040360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this article, we consider the One Health framework for orienting guidance for animal disaster management through an ethics of care approach. While One Health was created at the beginning of the 21st century in response to the persistence of emerging infectious diseases and the view that the health of humans and other animals are contiguous, it can be a useful tool for promoting animal welfare and considering animals' experiences during a disaster. However, implementing One Health strategies into animal disaster management is not without its challenges, since ethical judgments are implicit in all decisions and recommendations made about how to conceptualize a "disaster" and their impact on animals and their welfare. Our discussion is divided into three sections. First, we consider the significance of a One Health framework for animal disaster management. Here, we highlight how One Health strategies can be employed in disaster health and natural disaster. Next, we use an ethics of care approach to lay the contours for an interspecies account of relational solidarity, thus offering a vision for how One Health strategies can reimagine the ethical dilemmas involving human-animal conflicts during a disaster. Lastly, we consider the textured nature of our relationship with animals, the moral weight of common vulnerability and interdependency and illuminating insights from animal welfare science.
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Affiliation(s)
- Raymond Anthony
- Department of Philosophy, University of Alaska Anchorage, Anchorage, AK, USA
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9
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Shu R, Liu C, Liang H, Liang Y. Potential mediators of the relationship between vision impairment and self-rated health in older adults: A comparison between long-term care insurance claimants in residential care institutions versus those living in the community. Geriatr Nurs 2022; 44:259-265. [DOI: 10.1016/j.gerinurse.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/24/2023]
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10
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Magan IM, Padgett DK. "Home Is Where Your Root Is": Place Making, Belonging, and Community Building among Somalis in Chicago. SOCIAL WORK 2021; 66:101-110. [PMID: 33842957 DOI: 10.1093/sw/swab007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
This qualitative study examines the notion of home as it relates to place making, belonging, and community building. Using a phenomenological method of inquiry, data were gathered through in-depth qualitative interviews with 15 Somali Americans and subjected to transcendental phenomenological analyses. Three major themes were found: (1) the meaning of community: being Somali and Muslim; (2) "We help each other. We are connected"; and (3) "Home is where your root is." The study findings highlight how Somali participants drew on their faith and culture as foundational to community building and drew on acts of mutual giving and receiving to bind them together even as subjective feelings of "home" could be place based or could transcend geography. Although sometimes disrupted by bias and discrimination, Somalis persevered in defining themselves and pursuing a sense of belonging both within their own community and in the city at large. This study offers an expansive and dynamic view of the meaning of place making, community building, and belonging (home) in the lives of displaced refugees. Both research and practice can benefit from special attention given to the "natural" formation of refugee communities and their role in enhancing adjustment to life in a new land.
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Abstract
Social innovation has been gaining attention as an alternative method for defining socially constructed problems and their solutions in times of failure of more conventional methods. This study focused on the potential of undergraduate architecture students for social innovation in public space production. A novel collaborative educational method was proposed based on a conceptual framework of social extrapreneurs’ platforms of exploration, experimentation and execution, and problem-based learning. The method was designed for 90 h synchronous and 90 h asynchronous work, in a remote teaching mode. The benefit of the method was foreseen in improving the social processes of public space production, especially in areas with pronounced discrimination. Social innovation in planning is crucial for the capacity of imagining better futures in the context of a system’s evolutionary resilience and has the potential for democratization of public place design. Preliminary results show that the proposed method enables critical thinking, sets the base of action on social justice, and turns students into active agents of social change; thus, it provides an important contribution to the necessary, but still uncharted, paradigm shift in architectural education from an object- to people-driven design.
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12
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Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review. ACTA ACUST UNITED AC 2021; 6:464-485. [PMID: 33688575 PMCID: PMC7934124 DOI: 10.1007/s41347-021-00195-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.
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Abstract
COVID-19 deeply affects many spheres of life. Lockdown measures implemented worldwide have accentuated mental wellbeing changes in the population from the perspectives of space and social relations. These changes leave lasting imprints on individuals and communities. This article draws upon solidarity and care ethics in exploring their role in rebuilding mental wellbeing in the light of constraints arising from lockdown. The diversity of responses to physical and social isolation during the pandemic illuminates the distinctly relational nature of human beings, offering the opportunity for care and solidarity to respond to mental wellbeing challenges in an inclusive and context-sensitive way.
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Affiliation(s)
- Hui Yun Chan
- Department of Law, University of Huddersfield, Huddersfield, HD1 3DH UK
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14
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Kaye DK. Lay persons' perception of the requirements for research in emergency obstetric and newborn care. BMC Med Ethics 2021; 22:1. [PMID: 33388052 PMCID: PMC7777394 DOI: 10.1186/s12910-020-00568-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons' understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. METHODS This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6-8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. RESULTS Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. CONCLUSIONS Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent.
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Affiliation(s)
- Dan Kabonge Kaye
- Department of Obstetrics and Gynecology, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
- Berman Institute of Bioethics, Johns Hopkins University, Deering Hall, 1809 Ashland Avenue, Baltimore, MD, 21205, USA.
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15
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Eckenwiler LA. A Global Ecological Ethic for Human Health Resources. JOURNAL OF BIOETHICAL INQUIRY 2020; 17:575-580. [PMID: 33169247 PMCID: PMC7651803 DOI: 10.1007/s11673-020-10039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
COVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sustains and even worsens injustice, including health injustice, and that has profound consequences for global health, a global ecological ethic would have us see health as interdependent and aim at "ethical place-making" across health ecosystems to enable people everywhere to have the capability to be healthy.
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