Persuasion or coercion?: An empirical ethics analysis about the use of influence strategies in mental health community care

Background: Influence strategies such as persuasion and interpersonal leverage are used in mental health care to influence patient behaviour and improve treatment adherence. One ethical concern about using such strategies is that they may constitute coercive behaviour ("informal coercion") and negatively impact patient satisfaction and the quality of care. However, some influence strategies may affect patients' perceptions, so an umbrella definition of “informal coercion” may be unsatisfactory. Furthermore, previous research indicates that professionals also perceive dissonance between theoretical explanations of informal coercion and their behaviours in clinical practice. This study analysed mental health professionals’ (MHPs) views and the perceived ethical implications of influence strategies in community care. Methods: Qualitative secondary data analysis of a focus group study was used to explore the conflict between theoretical definitions and MHPs’ experiences concerning the coerciveness of influence strategies. Thirty-six focus groups were conducted in the main study, with 227 MHPs from nine countries participating. Results: The findings indicate that not all the influence strategies discussed with participants can be defined as “informal coercion”, but they become coercive when they imply the use of a lever, have the format of a conditional offer and when the therapeutic proposal is not a patient’s free choice but is driven by professionals. MHPs are rarely aware of these tensions within their everyday practice; consequently, it is possible that coercive practices are inadvertently being used, with no standard regarding their application. Our findings suggest that levers and the type of leverage used in communications with the patient are also relevant to differentiating leveraged and non-leveraged influence. Conclusion: Our findings may help mental health professionals working in community care to identify and discuss influence strategies that may lead to unintended coercive practices

Consumers of flowers and ornamental plants: an eploratory survey in the Italian «Mezzogiorno» regions

This paper aims to provide further knowledge of purchase and consumption behaviours with regard to flowers and ornamental plants in the regions of Italian «Mezzogiorno», as an acknowledgement of the centrality of final demand in the chain process. The knowledge of consumption process is fundamental either to the firm – in order to improve commercial strategies – or to competition authorities – with the purpose of implementing more effective policies. From the analysis carried out it emerges that flowers and ornamental plants consumption in the «Mezzogiorno» regions is characterised by a high penetration index and – just with regard to some commodities – by a low purchase frequency. Purchase – mainly in specialized flower shops – is made both to satisfy personal requirements and as a present for special occasions. With the only exception of flowers, consumption is not tied to specific occasions. In the «Mezzogiorno» regions this sector is actually showing a good growth potential in both productive and consumption terms. It is of primary importance to carry out actions consisting in an improvement of information and awareness among consumers about flowers and ornamentals, and a more diversified supply of products in order to get into the modern distribution chains.Cette étude vise à offrir une connaissance plus approfondie des comportements d’achat et de consommation de fleurs et de plantes ornementales dans les régions du « Mezzogiorno » d’Italie, en reconnaissant l’importance de la demande tout au long de la filière. La compréhension du processus de consommation a une très grande importance soit pour les entreprises, afin d’améliorer leurs stratégies commerciales, soit pour les autorité qui gèrent la concurrence, pour la mise en place de politiques plus efficaces. L’analyse empirique montre que, dans les régions du « Mezzogiorno » d’Italie, la consommation de fleurs et de plantes a un taux élevé de pénétration mais, pour certains produits, une faible fréquence d’achat. En particulier, l’achat, réalisé surtout dans les magasins spécialisés dans la vente de fleurs et de plantes, vise à satisfaire, d’une coté, les besoins des consommateurs, et, de l’autre, les besoins d’achat des cadeaux dans des circonstances spécifiques. Dans les régions étudiées, le secteur des fleurs et des plantes montre des potentialités de développement de plus en plus croissant sur le plan productif mais aussi en termes de consommation. Dans ce scénario, il serait souhaitable de mettre en place des actions et des outils pour à améliorer l’information et la sensibilisation des consommateurs sur les caractéristiques des produits concernés, mais aussi, de diversifier l’offre, de façon à pouvoir accéder aux nouvelles chaînes de la distribution

Stakeholders' Experiences of Research Integrity Support in Universities:A Qualitative Study in three European Countries

Fostering research integrity (RI) increasingly focuses on normative guidance and supportive measures within institutions. To be successful, the implementation of support should be informed by stakeholders’ experiences of RI support. This study aims to explore experiences of RI support in Dutch, Spanish and Croatian universities. In total, 59 stakeholders (Netherlands n = 25, Spain n = 17, Croatia n = 17) participated in 16 focus groups in three European countries. Global themes on RI support experiences were identified by thematic analysis. Themes identified were: ‘RI governance and institutional implementation’, ‘RI roles and structures’, ‘RI education and supervision’, and ‘Infrastructure, technology and tools supporting daily practice’. Experiences of support differed between countries in relation to: the efforts to translate norms into practice; the extent to which RI oversight was a responsibility of RE structures, or separate RI structures; and the availability of support close to research practice, such as training, responsible supervision, and adequate tools and infrastructure. The study reinforces the importance of a whole institutional approach to RI, embedded within local jurisdictions, rules, and practices. A whole institutional approach puts the emphasis of responsibility on institutions rather than individual researchers. When such an approach is lacking, some stakeholders look for intervention by authorities, such as funders, outside of the university. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11948-022-00390-5

Clues to the Formation of Liller 1 from Modeling Its Complex Star Formation History

Liller 1 and Terzan 5 are two massive systems in the Milky Way bulge hosting populations characterized by significantly different ages (Delta t > 7-8 Gyr) and metallicities (Delta[Fe/H] similar to 1 dex). Their origin is still strongly debated in the literature and all formation scenarios proposed so far require some level of fine-tuning. The detailed star formation histories of these systems may represent an important piece of information to assess their origin. Here we present the first attempt to perform such an analysis for Liller 1. The first key result we find is that Liller 1 has been forming stars over its entire lifetime. More specifically, three broad star formation episodes are clearly detected: (1) a dominant one, occurring some 12-13 Gyr ago with a tail extending for up to similar to 3 Gyr; (2) an intermediate burst, between 6 and 9 Gyr ago; and (3) a recent one, occurring between 1 and 3 Gyr ago. The old population contributes to about 70% of the total stellar mass, and the remaining fraction is almost equally split between the intermediate and young populations. If we take these results at face value, they would suggest that this system unlikely formed through the merger between an old globular cluster and a giant molecular cloud, as recently proposed. On the contrary, our findings provide further support to the idea that Liller 1 is the surviving relic of a massive primordial structure that contributed to the Galactic bulge formation, similarly to the giant clumps observed in star-forming high-redshift galaxies

Internal kinematics and structure of the bulge globular cluster NGC 6569

In the context of a project aimed at characterizing the properties of star clusters in the Galactic bulge, here we present the determination of the internal kinematics and structure of the massive globular cluster NGC 6569. The kinematics has been studied by means of an unprecedented spectroscopic dataset acquired in the context of the ESO-VLT Multi-Instrument Kinematic Survey (MIKiS) of Galactic globular clusters, combining the observations from four different spectrographs. We measured the line-of-sight velocity of a sample of almost 1300 stars distributed between ~0.8" and 770" from the cluster center. From a sub-sample of high-quality measures, we determined the velocity dispersion profile of the system over its entire radial extension (from ~ 5" to ~ 200" from the center), finding the characteristic behavior usually observed in globular clusters, with a constant inner plateau and a declining trend at larger radii. The projected density profile of the cluster has been obtained from resolved star counts, by combining high-resolution photometric data in the center, and the Gaia EDR3 catalog radially extended out to ~20' for a proper sampling of the Galactic field background. The two profiles are properly reproduced by the same King model, from which we estimated updated values of the central velocity dispersion, main structural parameters (such as the King concentration, the core, half-mass, and tidal radii), total mass, and relaxation times. Our analysis also reveals a hint of ordered rotation in an intermediate region of the cluster (40"<r<90", corresponding to $2 r_c<r<4.5 r_c$), but additional data are required to properly assess this possibility.Comment: Accepted for publication in The Astrophysical Journal; 21 pages, 10 figures, 4 table

Different forms of informal coercion in psychiatry: a qualitative study.

OBJECTIVES: The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion. RESULTS: In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed

Remodeled eX vivo muscle engineered tissue improves heart function after chronic myocardial ischemia

: The adult heart displays poor reparative capacities after injury. Cell transplantation and tissue engineering approaches have emerged as possible therapeutic options. Several stem cell populations have been largely used to treat the infarcted myocardium. Nevertheless, transplanted cells displayed limited ability to establish functional connections with the host cardiomyocytes. In this study, we provide a new experimental tool, named 3D eX vivo muscle engineered tissue (X-MET), to define the contribution of mechanical stimuli in triggering functional remodeling and to rescue cardiac ischemia. We revealed that mechanical stimuli trigger a functional remodeling of the 3D skeletal muscle system toward a cardiac muscle-like structure. This was supported by molecular and functional analyses, demonstrating that remodeled X-MET expresses relevant markers of functional cardiomyocytes, compared to unstimulated and to 2D- skeletal muscle culture system. Interestingly, transplanted remodeled X-MET preserved heart function in a murine model of chronic myocardial ischemia and increased survival of transplanted injured mice. X-MET implantation resulted in repression of pro-inflammatory cytokines, induction of anti-inflammatory cytokines, and reduction in collagen deposition. Altogether, our findings indicate that biomechanical stimulation induced a cardiac functional remodeling of X-MET, which showed promising seminal results as a therapeutic product for the development of novel strategies for regenerative medicine

MIKiS: the ESO-VLT Multi-Instrument Kinematic Survey of Galactic Globular Clusters

Globular clusters are collisional systems, where stars of different masses orbit and mutually interact. They are the best "natural laboratories" in the Universe for studying multi-body dynamics and their (reciprocal) effects on stellar evolution. Although these objects have been studied since the very beginning of modern astrophysics, little is known observationally about their internal kinematics, thus preventing a complete understanding of their dynamical state, and of their formation and evolutionary history. We present the first results from the Very Large Telescope (VLT) Multi- Instrument Kinematic Survey of Galactic globular clusters (MIKiS), which is specifically designed to provide line-of-sight velocities of hundreds of individual stars over the entire radial extension of a selected sample of clusters. The survey allows the first kinematical exploration of the innermost regions of high-density globular clusters. When combined with proper motion measurements, it will provide the full 3D view in velocity-space for each system. Long- running open issues, such as the accurate shapes of the velocity dispersion profiles, the existence of systemic rotation and orbital anisotropy (and thus the level of relaxation), and the controversial presence of intermediate-mass black holes in star clusters can finally be addressed, impacting our understanding of the formation and evolutionary processes of globular clusters and their interactions with the Galactic tidal field. <P /