Crisis resolution and home treatment teams have been introduced into mental health care in the UK because, in general, patients do not want to be admitted to hospital, treatment at home is cheaper and in the only randomized controlled trial conducted so far there was no difference in symptomatic outcome. However, because of compulsory gate-keeping by CRHT teams, some patients no longer have the option of going to hospital if they want to. This aspect of the introduction of CRHT teams (...) has not been discussed so far, but it certainly warrants further examination. Intervention through CRHT teams may in fact increase compulsory admissions and serious and untoward incidents, although this is not certain. Sufferers from psychosis are the patient group most likely to be compulsorily admitted to hospital and they are generally considered less responsible for serious and untoward incidents. Therefore, a possible solution could be to offer a choice to some patients, namely those with a psychotic disorder, on whether they want to be admitted or not. At least one should investigate what the consequences of this policy would be, if it were to be adopted in a test region. This example shows that in developing policies for rationing health care, it can be important to look at subgroups and not just at average results when determining the best course of action. (shrink)

This article reflects upon the monopoly and repertoires of violence in the city of Cairo perpetrated in counter-revolutionary moments by the successive military and Islamist regimes, which lack alternative visions and imaginaries. It counters the myth that the Egyptian revolution was non-violent. It also reflects upon some of the debates about the Arab revolutions, the question of militarization, and the return of ‘order’ with the re-emergence of the army in public life. It also reflects upon the multiplication of segregating walls, (...) first as buffer zones to isolate protesters, then as the walls of the gated communities and compounds of the rich, examining the extent to which the supposed revitalization of downtown Cairo actually represents the flight of wealth and capital to isolated areas far from the city center. (shrink)

The COVID-19 pandemic hit healthcare professionals (HCPs) hard, potentially leading to mental health deterioration. This longitudinal study investigated the 1-year evolution of psychological health of acute care HCPs during the COVID-19 pandemic and explored possible differences between high and low resilient HCPs. From April 2020 to April 2021, a convenience sample of 520 multinational HCPs completed an online survey every 3 months, up to five times. We used mixed linear models to examine the association between resilience and the variation of (...) COVID-19-related anxiety, depressiveness, perceived vulnerability, and psychological trauma symptomatology. We demonstrated “u-shaped” trajectories for all mental health symptoms. We also explored differences in the abovementioned variables between front-line and second-line acute care HCPs. In contrast to HCP.s with lower levels of resilience (-1SD), those with higher levels of resilience (+1SD) showed increased COVID-19 anxiety and perceived vulnerability over time. Front-line and second-line HCPs differed in their depressiveness and psychological trauma variation during the 1-year analysis. High and average resilient second-line HCPs showed steeper depressiveness increases with time than high and average resilient front-line HCPs. Acute care HCPs reported their most elevated clinical symptoms of depressiveness (5–7%) and psychological trauma symptomatology (26–46%) in April 2020. During the first year of the COVID-19 pandemic, second-line HCPs with more resilience showed a steeper worsening of their depressiveness than more resilient front-line HCPs. HCPs with low resilience may benefit from interventions at the beginning of a pandemic, whereas HCPs with high resilience might benefit from resilience-enhancing interventions at later phases.Trial RegistrationThe study protocol was pre-registered with the International Standard Randomised Controlled Trial Number (ISRCTN13694948) published (Fuchs et al., 2020). (shrink)

This research provides evidence regarding the causal effect of group conformity on task performance in stable and variable environments. Drawing on studies in cultural evolution, social learning, and social psychology, we experimentally tested the hypotheses that conformity improves group performance in a stable environment (H1) and decreases performance (by hindering adaptability) in a temporally variable environment (H2). We compare the performance of individuals, low conformity groups, and high conformity groups in a four-arm randomized lab experiment (N = 240). High conformity (...) was manipulated by rewarding agreement with the group’s majority and imposing a cost on disagreement. The monetary implications of conformity impaired performance in a variable environment but did not have a significant effect on performance in the stable environment. Intragroup individual-level analyses provide insights into the mechanisms that account for the group-level results by showing that lower conformity in groups facilitates efficient adaptability in the use of social information. (shrink)

The living mycelium networks are capable of efficient sensorial fusion over very large areas and distributed decision making. The information processing in the mycelium networks is implemented via propagation of electrical and chemical signals en pair with morphological changes in the mycelium structure. These information processing mechanisms are manifested in experimental laboratory findings that show that the mycelium networks exhibit rich dynamics of neuron-like spiking behaviour and a wide range of non-linear electrical properties. On an example of a single real (...) colony of _Aspergillus niger_, we demonstrate that the non-linear transformation of electrical signals and trains of extracellular voltage spikes can be used to implement logical gates and circuits. The approaches adopted include numerical modelling of excitation propagation on the mycelium network, representation of the mycelium network as a resistive and capacitive network and an experimental laboratory study on mining logical circuits in mycelium bound composites. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

Evapotranspiration represents the water requirement of plants during their growing season, and its accurate measurement at the farm is essential for agricultural water planners and managers. Field measurements of evapotranspiration have always been associated with many difficulties that have led researchers to seek a way to remotely measure this component in horticultural and agricultural areas. This study aims to investigate an indirect approach for daily rice crop evapotranspiration measurement by machine learning techniques and the least available climatic variables. For this (...) purpose, daily meteorological variables were obtained from three ground meteorological stations in rice cultivation regions of northern Iran during 2003–2016. The ETc rates were calculated by seven meteorological variables, the FAO-56 Penman-Monteith equation, and the regional calibrated rice crop coefficient and considered as the reference data. The MLs, including Multilayer Perceptron, Radial Basis Function, Generalized Regression Neural Network, and Group Method of Data Handling, were utilized for ETc modeling. Different input combinations were applied, based on the use of minimum effective variables as input. Results showed that the models showed the most accurate performances in the input combination of four climatic variables: sunshine duration, maximum temperature, relative humidity, and wind speed. Investigating the accuracy of models in rice growth phases showed that the least estimation error belonged to the initial growing stage, which increased during the mid-season and late-season growing stages. A comparison of the models showed that the GMDH model performed better against the other competitors. For this model, both the Nash-Sutcliffe coefficient and R2 were greater than 0.98, and the Root Mean Square Error ranged between 0.214 and 0.234 mm per day in all stations. The current approach showed promising results in rice evapotranspiration modeling by only four common meteorological variables and can be reliably applied for indirect measurement of this variable over the rice farms. The studied approach will have research value for rice and other crops in similar/different climatic conditions. (shrink)

Résumé Comment quelque chose fait-il événement, surgit-il et fait-il sens massivement? Cela se passe très différemment en Amérique Latine et en Afrique, même s’il y a des emprunts, même si dans le local partout quelque chose se mondialise. Il y a une prise de l’espace à ce moment-là, une occupation, qui fait peur aux autorités. Le modèle en est le carnaval, mais les télévisions communautaires qui surgissent sur les écrans africains sont une autre modalité, comme l’était le théâtre des townships. (...) L’important, ce sont les espaces interstitiels dans lesquels peut surgir une création, une activité à dimension rituelle. L’anthropologie des émergences existe autant que celle qui déterre les traces du passé. Il s’agit d’approcher le monde à partir d’événements ou de situations plus que de structures. Ce qu’il est important de saisir, c’est le mouvement, pas la négociation qui a lieu après et qui réinstalle les structures connues ; ce qui est important, c’est l’image qui reste du changement. Ce qui se passe en Afrique en ce moment c’est le retour d’enfants d’émigrés qui veulent y installer le marché. L’anthropologue fait passer les récits des événements, les descriptions de ces espaces intermédiaires qui se maintiennent entre les camps et les gated communities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban TakeoverAyesha AhmadI work in the capacity of an academic researching conflict in Afghanistan. My commitment is rooted in the firm terrain of friendships that merged into sisterhood of the Afghan terrain spaning decades of war but which is also the home of poetics and legacies that (...) refuse to be clouded by the traumas of the land.As a medical ethicist situated in global health, I perceive the inadequate focus on recognising the mental health needs born from living in war as a moral injustice and a form of silencing the suffering. This injustice should be held by the geopolitical hands that play the chords of conflict.However, such research is all too often concluded before it can develop as too dangerous, or too risky, or even as unethical because potential participants are perceived (often, unjustifiably so) to be too vulnerable.Another peril of research is the boundary drawn between a particular experience of the research objective and the life experience of the research participant. Connecting as a researcher and in a personal capacity, I fell into a chasm unseen in the context from where I work in London, United Kingdom.I remember the evening before Kabul city fell to the forced control of the Taliban. My friends reminisced during a nightfall reflection on the battles where the city walls had barricaded its inhabitants from centuries of invaders trying to access the valley of a city surrounded by mountains. Kabul city is a haven for war. Its geographic location makes it desirable to conquer, but part of its desirability is because of how the mountains envelop where the languages, ethnicities, religions, and stories of the Silk Road have settled and rested. Once conquered, the city protects you. And Kabulis felt safe. And to that end, on that fateful night, we ended our conversation in the confidence of hope; that Kabul city would not fall, and with the heart of the country still intact, Afghanistan would be saved.The dawn arrived and so did the approach of the Taliban to the city gates. There were frantic and rapid whispers that transformed into screams. And then the moment came, the Taliban were within the city walls.The juxtaposition between the regular London traffic heaving and breathing, and the frantic, panicked sounds of horns and vehicles fleeing in Kabul that I heard through WhatsApp audios in the background to friends narrating their journey home, was as stark as the peace and war they both echoed. [End Page 167]Soon the stories started speaking, pleading, paining, pressuring—stories seeking survival. In the dawn, instead of the sun breaking the sky, I broke the morning to a friend during a telephone conversation who had just awoken and had not yet received the news. I told my friend that the Taliban were in Kabul city. The reaction was grief, just like the grief I had heard in their voice a few months prior when their beloved father had passed away and entered the grave before they had breathed the new dawn. In the dusk, instead of the moon shining upon the city, women, families, and children were sheltering from the darkness of the grave closing amid their breathing bodies.Then, the blast came. In the energy of the quest for safety, people, walking like pilgrims, surrounded Kabul airport, queuing like worshippers. Prayers died. Hell rose. The waiting crowd was fired upon. The air did not offer breath; instead, a final moment of the sound of war that had blighted lives.In the crowd was a family who I dedicate this article to. I write the story of the father, the mother, the daughter, and the son of that day. The family was Hazara, a disputed and discriminated ethnic minority in Afghanistan, of a legacy traced to the invasion of Genghis Khan, the founder of the Mongol Empire. Theirs is a story of travellers and a soil of stories; a particularly profound story because the parents had specialised in geology and were experts of the stones of their long heritage. Yet, still, they... (shrink)

In response to concern over the numeracy skills deficit displayed by student nurses, an online computer programme, ?Authentic World??, which aims to simulate a real-life clinical environment and improve the medication dosage calculation skills of users, was developed (Founded in 2004 Authentic World Ltd is a spin out company of Glarmorgan and Cardiff Universities, Cardiff, Wales UK.). Two randomised controlled trials were conducted, each at a UK University, in order to investigate the impact of Authentic World? on student nurses? general (...) numeracy abilities. All first year nursing students who gave consent were randomised equally into an intervention or control group. The intervention group were given access to Authentic World?. The primary outcome measure was the students? scores on a general numeracy test. The Intention to Treat (ITT) analysis in both trials revealed a small negative effect of Authentic World? on general numeracy, which was statistically significant in one trial. However, compliance with the intervention was very low in both trials, with only 24 and 12% of students allocated to the intervention groups spending more than 15 minutes using the programme. Providing nursing students with access to Authentic World? is not an effective use of resources since use of the programme appears to be very low. (shrink)

This article attempts a critical conversation between Kafka's _Der Prozess_ (posthumously published in 1925, translated into English as _The Trial_ in 1937) and two novels from the Mediterranean Basin. The Turkish author Bilge Karasu's _Gece_ (1985, translated into English as _Night_ by Güneli Gün in 1994) responds to the national conflicts intensified by the military coup in Türkiye (Turkey) in the 1980s with its dark portrayal of political conspiracies and unhinged violence. Almost thirty years later, Aziz conveys a similar sense (...) of social chaos and political disillusionment: her novel _Al-Ṭābūr_ (2013, translated into English as _The Queue_ Elisabeth Jaquette in 2016) addresses the aftermath of the 2011 Egypt uprising. In addition to the social critique that shapes the dystopian allegories of the novels, Kayı_ş_cı Akkoyun examines the discursive conflicts and gaps through which Kafka, Karasu, and Aziz expose the constructed nature of oppressive structures and the arbitrariness of authority. She argues that the disjointed dystopian narratives of Kafka, Karasu, and Aziz not only portray the horrors witnessed at a particular place and time but also share a common utopian vision that extends to the future through the authors' imaginative struggle against totalizing forces of uneven modernization. (shrink)

Equipoise is advocated as a means of achieving high scientific and ethical standards in randomised trials. As used in the context of research the word describes a state of uncertainty characterised by the belief that in a trial no arm is known to offer greater harm or benefit than any other arm. Clinicians who lack personal equipoise are advised to accept clinical or communal equipoise, based on current unresolved disagreement among the medical profession. Equipoise is mainly discussed in the literature (...) as an issue for senior doctors and research directors. Limitations of professional equipoise are reviewed, and data on the neglected topic of patients' equipoise are reported using the example of breast cancer trials. In theory, a patient who gives informed and voluntary consent to enter a randomised trial has achieved the equilibrium of equipoise. In practice, equipoise among patients ranges from personal to proxy acceptance. (shrink)

Information and communication technologies are increasingly used for development in the Global South, and mHealth plays key role. This paper analyzes the particular relationship to science that characterizes a global maternal mHealth program deployed in Ghana and India. Using science and technology studies, this research relies on qualitative interviews conducted between 2014 and 2016 with funders, implementers, and beneficiaries of this mHealth program. This story begins with a randomized controlled trial, a biomedical experiment with a strong positioning regarding science and (...) the production of evidence. But rapidly the scientific stance disappears to give way to the testing and marketing of a product for the digital economy. From science to market, this paper offers to revisit a classical STS topic through the lens of mHealth. It shows how the various experimental forms taken by this project fundamentally diverge from scientific methods and evidence production and at the same time how it nurtures an ongoing instrumental relationship with science. Thus, from clinical research to product marketing, this paper highlights the tenuous link between evidence-based and market-based mHealth in the Global South. (shrink)

Low heart rate causes a risk of death, heart disease, and cardiovascular diseases. Therefore, monitoring the heart rate is critical because of the heart’s function to discover its irregularity to detect the health problems early. Rapid technological advancement allows healthcare sectors to consolidate and analyze massive health-based data to discover risks by making more accurate predictions. Therefore, this work proposes a real-time prediction system for heart rate, which helps the medical care providers and patients avoid heart rate risk in real (...) time. The proposed system consists of two phases, namely, an offline phase and an online phase. The offline phase targets developing the model using different forecasting techniques to find the lowest root mean square error. The heart rate time-series dataset is extracted from Medical Information Mart for Intensive Care. Recurrent neural network, long short-term memory, gated recurrent units, and bidirectional long short-term memory are applied to heart rate time series. For the online phase, Apache Kafka and Apache Spark have been used to predict the heart rate in advance based on the best developed model. According to the experimental results, the GRU with three layers has recorded the best performance. Consequently, GRU with three layers has been used to predict heart rate 5 minutes in advance. (shrink)

One method for investigating the neurobiology of consciousness is to experimentally manipulate consciousness as a variable and then visualize the resultant functional brain changes with advanced imaging techniques. To begin investigation into this area, healthy volunteers underwent positron emission tomography scanning while listening to randomized word lists in both conscious and unconscious conditions. Following anaesthesia, subjects had no explicit memories. Nonetheless, subjects demonstrated implicit memory on a forced-choice test . These subsequent memory scores were correlated with regional brain metabolism measured (...) during encoding. Conscious recall and unconscious recognition memory demonstrated considerable anatomic overlap in correlating significantly with relative glucose metabolism in auditory verbal memory areas. However, only conscious recall correlated with mediodorsal thalamic nucleus activity; unconscious recognition memory did not. These findings suggest that conscious versus unconscious memory distinctions may depend on the presence or absence of correlated thalamic activity, and directly implicate the thalamus in the neurobiology of consciousness. (shrink)

1. Introduction; Elisabeth A. Lloyd and Eric Winsberg.- Section 1: Confirmation and Evidence.- 2. The Scientific Consensus on Climate Change: How Do We Know We’re Not Wrong?; Naomi Oreskes.- 3. Satellite Data and Climate Models Redux.- 3a. Introduction to Chapter 3: Satellite Data and Climate Models; Elisabeth A. Lloyd.- Ch. 3b Fact Sheet to "Consistency of Modelled and Observed Temperature Trends in the Tropical Troposphere"; Benjamin D. Santer et al..- Ch. 3c Reprint of "Consistency of Modelled and Observed Temperature Trends (...) in the Tropical Troposphere"; Benjamin D. Santer et al..- 4. The Role of ’Complex’ Empiricism in the Debates about Satellite Data and Climate Models; Elisabeth A. Lloyd.- 5. Reconciling Climate Model/Data Discrepancies: The Case of the Trees That Didn’t Bark; Michael Mann.- 6. Downscaling of Climate Information; Linda O. Mearns et al..- Section 2: Uncertainties and Robustness.- 7. The Significance of Robust Model Projections; Wendy S. Parker.- 8. Building Trust, Removing Doubt? Robustness Analysis and Climate Modeling; Jay Odenbaugh.- Section 3: Climate Models as Guides to Policy.- 9. Climate Model Confirmation: From Philosophy to Predicting Climate in the Real World; Reto Knutti.- 10. Uncertainty in Climate Science and Climate Policy; Jonathan Rougier and Michel Crucifix.- 11. Communicating Uncertainty to Policy Makers: The Ineliminable Role of Values; Eric Winsberg.- 12. Modeling Climate Policies: A Critical Look at Integrated Assessment Models; Mathias Frisch.- 13. Modelling Mitigation and Adaptation Policies to Predict their Effectiveness: The Limits of Randomized Controlled Trials; Alexandre Marcellesi and Nancy D. Cartwright. (shrink)

"In the midst of the world, darkened with many sins and sorrows, in which the majority live, there abides another world, lighted up with shining virtues and unpolluted joy, in which the perfect ones live. This world can be found and entered, and the way to it is by self-control and moral excellence. It is the world of the perfect life, and it rightly belongs to man, who is not complete until crowned with perfection. The perfect life is not the (...) far-away, impossible thing that men who are in darkness imagine it to be; it is supremely possible, and very near and real. Man remains a craving, weeping, sinning, repenting creature just so long as he wills to do so by clinging to those weak conditions; but when he wills to shake off his dark dreams and to rise, he arises and achieves." - JAMES ALLEN - A Complete and Unabridged edition of James Allen's book "The Life Triumphant." Part of The Works of James Allen Series. Other Works by James Allen:- Above Life's Turmoil All These Things Added As a Man Thinketh Byways of Blessedness Entering the Kingdom (Part of- "All These Things Added") From Passion to Peace From Poverty to Power Foundation Stones to Happiness and Success James Allen's Book of Meditations for Every Day in the Year Light on Life's Difficulties Man: King of Mind, Body and Circumstance Men and Systems Morning and Evening Thoughts Out from the Heart (Sequel to "As a Man Thinketh") Poems of Peace The Divine Companion The Eight Pillars of Prosperity The Heavenly Life (Part of-"All These Things Added") The Mastery of Destiny The Path to Prosperity (Part of-"From Poverty to Power") The Shining Gateway The Way of Peace (Part of-"From Poverty to Power") Through the Gate of Good. (shrink)

"The discovery of the law of Evolution in the material world has prepared men for a knowledge of the law of cause and effect in the mental world.... In the realm of thought and deed, the good survives, for it is ''fittest;'' the evil ultimately perishes. To know that the ''perfect law'' of Causation is as all-embracing in mind as in matter, is to be relieved from all anxiety concerning the ultimate destiny of individuals and of humanity-''For man is man (...) and master of his fate'' and the will in man which is conquering the knowledge of natural law will conquer the knowledge of spiritual law.... In this volume I have tried to set down some words indicative of this Law and this Destiny, and the manner of its working and its building." - JAMES ALLEN - A Complete and Unabridged edition of James Allen''s book The Mastery of Destiny. Part of The Works of James Allen Series. Other Books by James Allen:- Above Life''s Turmoil All These Things Added As a Man Thinketh Byways of Blessedness Entering the Kingdom (Part of- "All These Things Added") Foundation Stones to Happiness and Success From Passion to Peace From Poverty to Power James Allen''s Book of Meditations for Every Day in the Year Light on Life''s Difficulties Man: King of Mind, Body and Circumstance Men and Systems Morning and Evening Thoughts Out from the Heart (Sequel to "As a Man Thinketh") Poems of Peace The Divine Companion The Eight Pillars of Prosperity The Heavenly Life (Part of-"All These Things Added") The Life Triumphant The Path to Prosperity (Part of-"From Poverty to Power") The Shining Gateway The Way of Peace (Part of-"From Poverty to Power") Through the Gate of Good. (shrink)

The aim of this paper is to explore the effectiveness of critical thinking for improving the writing skill of undergraduate Arab students who study English Literature at Saudi universities under lockdown circumstances due to the COVID-19 pandemic. At the same time, it explores the impact of implementing Facebook as an online Constructivist tool to improve this skill. A general overview of the status of English language education in Saudi Arabia is briefly presented to shed light on the ongoing English language (...) challenges in learning writing for undergraduate students in the English language and literature departments, which got more manifested due to the current status of education mode with the emergence of the pandemic. Two-group posttest-only randomized experiment was employed to evaluate the effectiveness of the proposed model, using the infusion and constructivism approaches. A total of 40 students enrolled in a literature course at a private university in Saudi Arabia participated in the experiment. The treatment was conducted through utilizing Facebook. The results demonstrated that students’ improvement in English writing was due to the combination of the infusion of a set of critical skills and the constructivist teaching and learning mode. (shrink)

Ako je u antičkom polisu Platona brinulo što se građani samodovoljno oslanjaju na vlastita uvjerenja o vrlinama, ne tragajući za znanjem, današnjeg žitelja globalnog pseudopolisa opčinjavaju simulirane informacije, slike i uvjerenja koja nezamislivim bujanjem kreiraju društvenu svijest. U sjenci masmedijskih pećina uočavaju se obrisi transformirane demokracije koja je sve izloženija silovitim naletima megakorporativnih interesa, dominantnih geopolitičkih utjecaja, kulturnog determinizma i redefiniranog vjerskog fundamentalizma. Usamljenom pojedincu na Agori sve je teže formirati i sačuvati vlastito mišljenje, ideje i vrijednosti. Infoprostor je pokriven (...) globalnom mrežom informacija i podataka, dok čin razmjene simboličkih sadržaja od čovjeka preuzimaju strojevi! Sloboda izražavanja medija je kisik otvorenog, javnog komuniciranja, stup demokratskih građevina, ali problem je u činjenici što čuvari informacijskih ulaza i dalje stražare, ovoga puta pred cyberprostorima.If Plato was upset that people leaned on their own convictions about virtues, without seeking knowledge, present resident of global pseudopolis is obsessed by simulated information, pictures and convictions, which create social consciousness with their hyperproduction. In shadow of massmedia’s caves, contours of transformed democracy can be seen. This democracy is more and more exposed to the interests of megacorporations, dominant geopolitical influence, cultural determinism, and redefined fundamentalism. Under such circumstances, to some lonely individual, “in Athena’s Agora”, is even more difficult to form and keep his or her own opinion, ideas and values. Infospace is covered by global network of information and facts; the process of symbolic exchange is taken off humans by machines. Freedom of speech in media is the air of open, public communication, the pillar of democratic structures, but problem is that watchmen of “information gates” still standing guard, but this time in front of cyber spaces. (shrink)

En este trabajo analizamos cómo se articula la justificación estadística de las conclusiones obtenidas en los ensayos clínicos aleatorizados con sus condiciones de aceptabilidad ética y política. Pretendemos mostrar cómo varía tal justificación dependiendo de nuestra concepción de la probabilidad y, correlativamente, qué argumentos éticos se pueden ofrecer sobre cada una de ellas. Veremos cómo los enfoques frecuentista y bayesiano resultan defendibles en el ámbito de los ensayos clínicos y defenderemos que, para su aceptación pública, se les debe exigir garantías (...) de imparcialidad cuyo mejor ejemplo es la propia técnica de aleatorización. /// This paper analyses how to combine the statistical justification of the results obtained in a randomised clinical trial and the ethical and social arguments that support its implementation. It aims at showing how this justification varies according to the view on probability we adopt and the different ethical cases that can be made to sustain it. Both the frequentist and the Bayesian approaches to the design of clinical trials will be seen as equally defensible on these grounds. To be socially acceptable both approaches must meet an impartiality requirement, which is best served by the technique of randomisation. (shrink)

Introduction: Many individuals and families are currently experiencing a high level of COVID-19-related stress and are struggling to find helpful coping mechanisms. Mindfulness-based interventions are becoming an increasingly popular treatment for individuals experiencing depression and chronic levels of stress. The app draws from scholarly evidence on the efficacy of mindfulness meditations and builds on the pre-existing apps by incorporating techniques that are used in some therapies such as cognitive behavioral therapy and mindfulness-based cognitive therapy.Methods: Participants were randomly assigned to a (...) 4-week mindfulness and self-compassion-based cognitive smartphone intervention or a wait-list control group. They were instructed to engage in self-compassion and mindfulness practices and a cognitive restructuring task. They also completed measures that evaluated their levels of depression, stress, anxiety, self-compassion, wisdom, psychological well-being, and subjective well-being. The intervention group was also instructed to track their weekly engagement with the app. Standardized effect sizes for between-group differences were calculated using Cohen's d for complete case analyses.Results: Complete case analyses from baseline to the end of this randomized controlled trial demonstrated significant moderate between-group differences for depressive symptoms and decisiveness. Moderate between-group differences were also found for self-compassion such that significant improvements in self-kindness, common humanity, mindfulness and decreases in self-judgement, isolation, and overidentification were observed. A small between-group difference was found for emotional regulation. Moreover, a significant moderate within-group decrease in stress and anxiety symptoms was also observed in the intervention group.Conclusions: Serene is an effective intervention that promotes increased levels of self-compassion and emotional regulation. Engaging with Serene may help reduce depressive symptoms through mindfulness, self-compassion, and cognitive restructuring which help reduce overidentification with one's negative emotions. As individuals rebalance their thinking through cognitive restructuring, they can identify the varying stressors in their life, develop action plans and engage in adaptive coping strategies to address them. Serene may promote greater self-understanding which may provide one with a more balanced perspective on their current upsetting situations to positively transform their challenges during the pandemic. (shrink)

Background and aimsExcessive pain during medical procedures is a worldwide medical problem. Most scald burns occur in children under 6, who are often undermedicated. Adjunctive Virtual Reality distraction has been shown to reduce pain in children aged 6–17, but little is known about VR analgesia in young children. This study tests whether desktop VR can reduce the just noticeable pressure pain of children aged 2–10.MethodsA within-subject repeated measures design was used. With treatment order randomized, each healthy volunteer pediatric participant underwent (...) brief cutaneous pressure stimuli under three conditions: no distraction, a verbal color naming task, and a large TV-based desktop VR distraction. A hand-held Wagner pressure pain stimulation device was used to generate just noticeable pain sensations. Participants indicated when a steadily increasing non-painful pressure stimulus first turned into a painful pressure sensation.ResultsA total of 40 healthy children participated. Compared to the no distraction condition, the 40 children showed significant VR analgesia, t = 9.83, p < 0.001, SD = 6.24. VR was also significantly more effective at reducing pain sensitivity vs. an auditory color naming task, t = 5.42, p < 0.001, SD = 5.94. The subset of children aged 2–5 showed significant reductions in pain during VR. Children under 6 showed greater sensitivity to pain during no distraction than children aged 6–10.ConclusionDuring no distraction, children under 6 years old were significantly more sensitive to pain than children aged 6–10. Virtual reality significantly reduced the “just noticeable” pressure pain sensitivity of children in both age groups. (shrink)

BackgroundImplementation of recommendations from clinical practice guidelines is essential for evidence based clinical practice. However, the most effective methods of implementation are unclear. We conducted a national, cluster-randomised, blinded implementation trial to determine if midwife or doctor local implementation leaders are more effective in implementing a guideline for use of oral dextrose gel to treat hypoglycaemic babies on postnatal wards. To prevent any conscious or unconscious performance bias both the doctor and midwife local implementation leaders were kept unaware of the (...) trial. This paper reports the ethical dilemmas and practical challenges of ensuring clinicians remained unaware of their involvement in an implementation trial.MethodsWe sought approval from the National Health and Disability Ethics committee to keep clinicians unaware of the trial by waiving the standard requirement for locality approval usually required for each district health board. The ethics committee did not approve a waiver of consent but advised that we approach the chief executive of each district health board to ask for provisional locality approval. Ultimately it was necessary to seek ethics approval for three separate study designs to keep clinicians unaware of the trial.ResultsThe median time for chief executive approval was 16 days and for locality approval was 57 days. We completed 21 different locality approval forms for 27 hospitals.ConclusionsKeeping clinicians unaware of their involvement in a national implementation cluster-randomised trial is feasible. However, despite a national ethics committee, significant logistical challenges were time consuming and delayed trial completion. Co-ordination of the locality approval process would help facilitate multi-centre trials. (shrink)

In this article we present a new kind of computing device that uses biochemical reactions networks as building blocks to implement logic gates. The architecture of a computing machine relies on these generic and composable building blocks, computation units, that can be used in multiple instances to perform complex boolean functions. Standard logical operations are implemented by biochemical networks, encapsulated and insulated within synthetic vesicles called protocells. These protocells are capable of exchanging energy and information with each other through transmembrane (...) electron transfer. In the paradigm of computation we propose, protoputing, a machine can solve only one problem and therefore has to be built specifically. Thus, the programming phase in the standard computing paradigm is represented in our approach by the set of assembly instructions that directs the wiring of the protocells that constitute the machine itself. To demonstrate the computing power of protocellular machines, we apply it to solve a NP-complete problem, known to be very demanding in computing power, the 3-SAT problem. We show how to program the assembly of a machine that can verify the satisfiability of a given boolean formula. Then we show how to use the massive parallelism of these machines to verify in less than 20 min all the valuations of the input variables and output a fluorescent signal when the formula is satisfiable or no signal at all otherwise. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Bodyheartminding” (xin 心): Reconceiving the Inner Self and the Outer World in the Language of Holographic Focus and FieldRoger T. Amesin body consciousness: a philosophy of mindfulness and somaesthetics, Richard Shusterman expands upon a professional oeuvre in which his exploration of the phenomenon of “body consciousness” has effected nothing less than a somatic turn in the contemporary Western philosophical narrative.1 But his contribution does not end there. Over the (...) past two decades, the reach and influence of his “somaesthetics” has been extended to the gates of China. Indeed, it has become a theme engaged by scholars of China’s indigenous philosophical traditions, thus providing an opportunity for a further edifying conversation between the Chinese and Western philosophical traditions.2 And it is this conversation, as it has been inspired by Shusterman’s work, that I propose to join in this short essay.In Body Consciousness, Shusterman tells the story of how John Dewey advances the pragmatic project of not only understanding the body better, but indeed of applying the Alexander Technique as his way of using his own body properly.3 Just as Dewey has been a prominent resource for Shusterman in his development of somaesthetics, for Dewey in turn, it was William James’s Principles of Psychology that was a self-confessed inspiration for the development of his own evolving interpretation of pragmatism.4 Indeed, one way of reading Dewey’s philosophical career and his thirty-seven-volume opus is that it is a sustained effort to take the radical “stream-of-consciousness” insights developed in James’s Principles to their logical, systematic conclusion. In pursuing this project, while appreciative, Dewey is at times impatient with James’s dualistic lapses in which he continues to separate individuals from community, mind from body, emotions from intellect, agents from actions, and theory from practice. Dewey takes these unfortunate reversions to old ways of thinking as serving only to confound James’s holistic doctrines of pure experience and radical empiricism. Given Dewey’s own postulate of [End Page 100] immediate and continuous empiricism, one way of tracking his journey from having been inspired by James’s biological naturalism to achieving his own philosophical coherence is to register his unrelenting aversion to dualism in any form.But Dewey himself was not always consistent in this respect. Shusterman gives an account of the early neo-Hegelian Dewey who, affirming the familiar transcendent conception of soul we associate with idealism, unsurprisingly embraces a clear soul and body dualism. And in spite of the philosophically mature Dewey’s best efforts to think “process,” he has no choice but to use both a language and a grammar freighted with substance ontology that resists his more holistic insights. On occasion, even while trying to remain consistent in his thinking, Dewey seems to fall victim to terminology that if not dualistic is at best ambiguous. Dewey’s struggle against this problem of equivocation is particularly apparent in some of the language he appeals to in attempting to put the Humpty Dumpty of mind and body together again. In his effort to register the irreducible continuity and inseparability of the nonanalytic abstractions we differentiate as body and mind—the ontological givenness or “hadness” of “bodyminding”—Dewey still at times invokes terms such as “combination,” “integration,” “unity,” and so on, that take as their suppressed premise “two things becoming one.” By way of contrast, in the correlative vocabulary of Chinese process cosmology, expressions such as yinyang 陰陽, the natural/cultural and the human (tianren 天人), and knowing and doing (zhixing 知行), primacy is given to vital relationality and the continuity it entails. It is not putting two things together that is referenced with these binomials, but the deepening of the horizon of constitutive, internal relationships that transforms the two aspects of the same phenomenon qualitatively into harmonics (he 和) for yinyang, sagacity (sheng 聖) for tianren, and acting wisely (zhi 智) for zhixing. In each instance, the two aspects themselves are simply conceptual abstractions from a complex relational process. The proper and effective measure (du 度) sought in this Confucian cosmology is not quantitatively more or less of two distinct things—taking mind and body as our example—but rather a qualitative and transformative change that... (shrink)

Informed by interviews conducted with members of a local research ethics committee, this article reflects upon how RECs can act to improve the quality of patient consent to clinical trials. Two emergent narratives which trial participants have drawn upon to account for their experiences are explored: the narrative of the clinical trial itself and a narrative of individualized treatment. Informed consent requires participants to recognize that only the first of these narratives is relevant to the design, and their experience, of (...) randomized controlled trials. Improving the clarity of patient information is argued to be a relevant, but insufficient, strategy for increasing patient familiarity with the methodology of clinical trials. In the concluding sections of the article, other approaches, and the role of RECs, are considered. (shrink)

This paper addresses the methodological problem of analysing what it is to explain observed behaviours of engineered computing systems, focusing on the crucial role that abstraction and idealization play in explanations of both correct and incorrect BECS. First, it is argued that an understanding of explanatory requests about observed miscomputations crucially involves reference to the rich background afforded by hierarchies of functional specifications. Second, many explanations concerning incorrect BECS are found to abstract away from descriptions of physical components and processes (...) of computing systems that one finds below the logic circuit and gate layer of functional specification hierarchies. Third, model-based explanations of both correct and incorrect BECS that are provided in the framework of formal verification methods often involve idealizations. Moreover, a distinction between restrictive and permissive idealizations is introduced and their roles in BECS explanations are analysed. (shrink)

BackgroundFrontal brain dysfunction is a major challenge in neurorehabilitation. Neurofeedback (NF), as an EEG-based brain training method, is currently applied in a wide spectrum of mental health conditions, including traumatic brain injury.ObjectiveThis study aimed to explore the capacity of Infra-Low Frequency Neurofeedback (ILF-NF) to promote the recovery of brain function in patients with frontal brain injury.Materials and methodsTwenty patients hospitalized at a neurorehabilitation clinic in Switzerland with recently acquired, frontal and optionally other brain lesions were randomized to either receive NF (...) or sham-NF. Cognitive improvement was assessed using the Frontal Assessment Battery (FAB) and the Test of Attentional Performance (TAP) tasks regarding intrinsic alertness, phasic alertness and impulse control.ResultsWith respect to cognitive improvements, there was no significant difference between the two groups after 20 sessions of either NF or sham-NF. However, in a subgroup of patients with predominantly frontal brain lesions, the improvements measured by the FAB and intrinsic alertness were significantly higher in the NF-group.ConclusionThis is the first double-blind controlled study using NF in recovery from brain injury, and thus also the first such study of ILF NF. Although the result of the subgroup has limited significance because of the small number of participants, it accentuates the trend seen in the whole group regarding the FAB and intrinsic alertness (p = 0.068, p = 0.079, respectively). We therefore conclude that NF could be a promising candidate promoting the recoveryfrom frontal brain lesions. Further studies with larger numbers of patients and less lesion heterogeneity are needed to verify the usefulness of NF in the neurorehabilitation of patients with frontal brain injury (NCT02957695 ClinicalTrials.gov). (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

The goal of this study was to determine if the level of preservice teachers’ economic literacy might serve as a gatekeeper to teaching economics competencies. The participants ( n=84) were teacher candidates in an elementary education program in their final methods courses prior to their teacher internship. The findings supported the intuitive belief that elementary teachers lack the economic literacy and confidence needed to teach economics concepts in the elementary curriculum. This deficit can serve as a gatekeeper to teaching economics (...) competencies leading to curricular disjuncture between the established curriculum and actual practice in the classroom. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 7.2 (2002) 194-196 [Access article in PDF] The Body Toxic: An Environmental Memoir by Suzanne Antonetta. Washington, D.C.: Counterpoint, 2001. Pp. 242. Hardback $26; paper $15.00. ISBN 1-5824-3209-0. Memoirs rely on the power of recollection to reproduce the inward texture of experience. Autobiographies cast their authors as historians of the self, combing through documents and old letters, checking facts. In her first prose work, the (...) accomplished poet Suzanne Antonetta crosses the boundary between memoir and autobiography. Interweaving the rough textures of memory with slick surfaces of corporate data, she gives us a lyric meditation on the struggle to become undeceived. Recounting both the facts of corporate malfeasance and our fantastic capacity to filter our reality, she captures the relation between failures of understanding and failures of responsibility. She shows us how difficult it is to accept an unofficial truth. The Body Toxic is a thoughtful and obsessively readable contribution to environmental ethics.Antonetta tells us of childhood exposure to toxic wastes in a penurious and neglected corner of Barnegat Bay. She writes in retrospect, with painfully acquired knowledge of cancer clusters and disease-ridden families. [End Page 194] Her own body's malformed reproductive organs, riddled with tumors, prove spectacularly and tragically infertile when quadruplets spontaneously abort. Sharp backward glances at childhood pleasures; crabbing, berrying, and running through the sweet-smelling spray of DDT, twist us around. Children of the 1960s trail through pesticide as if the weekly truck brought some poisonous ice cream. The mosquitoes thrived: what happened to the children? We revisit these scenes obliquely. Denzer-Schaefer empties its effluent into the bay, cost-efficient Ciba-Geigy rids their chemical wastes through a pipe running straight into the woods, the local farm has become an illegal toxic dump for an unscrupulous contractor. Fire at a nearby nuclear weapons silo has hapless firemen spraying radioactive water into the air. The government responds: they build a chain link fence around the site. A nuclear power plant of the 'old-school' emanates levels of radioactivity to rival Chernobyl. The plant managers assiduously cover it up. This is not some national catalogue of Superfund sites: all take place within a dozen or so miles of a childhood summer house in New Jersey. These shards of a case study are scattered throughout Antonetta's non-linear narrative, piecing together experience, cause and effect.But this work is more ethically and artistically ambitious than the artificial clarity of case studies. Powerfully, Antonetta shows us the inner tangle of toxic mental life: the depression, listlessness, confusion, and self-medication of barely cognized symptoms. Self-clouding toxicity affects both the body and the mind. She fears that she and other family members are not right in the head. How far can she trust herself, and how far can she trace the causes? Is it heredity? Is it toxicity? Has toxic exposure potentiated some family trait? She reads out strings of hazardous chemicals like a rosary, overdetermining all of her symptoms. The distance between cause and effect shields the guilty. Strong toxicity undermines the ability of its victims to understand and act. The Body Toxic is part case study, part phenomenology of altered consciousness, and all too human. A course in environmental ethics could make imaginative use of its insights into a wide range of anthropocentric concerns. Antonetta considers questions of environmental justice, religious beliefs about the natural order, environmental responsibility and property rights, nuclear risk, and cost-benefit analysis in multi-dimensional form, an entry point for philosophical reflection. The Body Toxic is stimulating, controversial, and beautifully written.Many great works of literature signal their ethical intent by fostering a sense of identification with their subjects or protagonists. Antonetta's deft [End Page 195] blunt portraiture expands our moral sensibility by showing us how to be concerned for people with whom we are not meant to identify. The story begins before the beginning, with Antonetta's immigrant family. They are strangely familiar and not entirely sympathetic people, isolated between first generation immigrant cultures and fantasies of prosperous America, clinging to islands of... (shrink)

The role of mechanistic evidence tends to be under-appreciated in current evidencebased medicine (EBM), which focusses on clinical studies, tending to restrict attention to randomized controlled studies (RCTs) when they are available. The EBM+ programme seeks to redress this imbalance, by suggesting methods for evaluating mechanistic studies alongside clinical studies. Drug approval is a problematic case for the view that mechanistic evidence should be taken into account, because RCTs are almost always available. Nevertheless, we argue that mechanistic evidence is central (...) to all the key tasks in the drug approval process: in drug discovery and development; assessing pharmaceutical quality; devising dosage regimens; assessing efficacy, harms, external validity, and cost-effectiveness; evaluating adherence; and extending product licences. We recommend that, when preparing for meetings in which any aspect of drug approval is to be discussed, mechanistic evidence should be systematically analysed and presented to the committee members alongside analyses of clinical studies. (shrink)

ABSTRACT Objectives: the purpose of this study is to explore laypersons’ attitudes towards and experiences of medical research, and to compare them with those of physicians in Japan. Designs and Participants: fourteen Japanese adults from the general public and seven physicians participated in one of three focus interviews. Setting: Osaka, Japan. Results: trust and distrust in the physician by whom the participants were invited to participate in research played a considerable role in their decisions about participation. That the participants felt (...) an obligation to participate was also expressed. The lay participants perceived medical research as something entirely outside of their world. A greater willingness to volunteer for research was expressed if there were direct benefits to themselves or their families. Research methods such as use of placebos, double blinds, and randomisations seemed to cause negative attitudes to medical research. All physicians were convinced of the need for medical research, including double‐blinded randomised control trials, and its significant role in medical progress. Most physicians thought that the greater awareness of the need for medical research in the community and a better understanding of the psychology of potential research participants were necessary and urgent. Conclusions: there is a good possibility that the lay public and medical professionals have sharply different beliefs about and attitudes towards every aspect of medical research. Building up a better and equal patient‐doctor relationship based on trust is a key issue in medical research, and it is mandatory to fill the gap in perception regarding medical research between them through fully informed debates. (shrink)

People with learning disability sometimes display challenging behaviour. This can be managed by use of antipsychotic medication or behavioural therapy or both. There is no solid evidence, however, that these therapies are safe and effective. A randomised controlled trial of antipsychotic medication has been proposed to deliver such evidence. However, this presents difficult issues in the ethics of research with learning disabled people. In particular, is a trial the most efficient and fairest way to evaluate practice in this area? This (...) paper reviews the clinical situation, gives the rationale for the trial, and analyses the ethical arguments for and against such a trial. (shrink)

Clinical trials and other forms of evaluation of medical treatment are held to give an objective assessment of the ‘clinical effectiveness’ of the medical treatments under evaluation. This kind of evaluation is central to the evidence-based medicine movement, as it provides a basis for the rational selection of treatment. The ethical status of randomised clinical trials is widely agreed to depend crucially upon the state of equipoise regarding which of two (or more) treatments is more (or most) effective in a (...) defined population. However, the meaning and nature of ‘clinical effectiveness’ are unclear. in this paper, I discuss the proposals to define clinical effectiveness as a relational property and as an intrinsic property, and the way effectiveness may supervene upon more fundamental physical properties of treatments. I discuss whether effectiveness is a single property or a family of properties; the types of outcome which can be explained by effectiveness properties; and the relationship between ‘objective’ and ‘preference’ outcomes. This paper suggests that while it may be possible to put clinical effectiveness on a proper metaphysical footing, in practice the language of clinical effectiveness is more properly a topic of the human sciences than of the natural sciences. (shrink)

The principle of clinical equipoise has been variously characterized by ethicists and clinicians as fundamentally flawed, a myth, and even a moral balm. Yet, the principle continues to be treated as the de facto gold standard for conducting randomized control trials in an ethical manner. Why do we hold on to clinical equipoise, despite its shortcomings being widely known and well-advertised? This paper reviews the most important arguments criticizing clinical equipoise as well as what the most prominent proposed alternatives are. (...) In the process, it evaluates the justification for continuing to use clinical equipoise as the gold standard for randomized control trials. (shrink)

Uncertainties about how to achieve sustainable and reliable biobased value chains can be remedied by inclusion of local biomass producers. Such inclusion implies that the knowledge, values, interests and skills of these local producers are integrated into the set-up, design, development and associated distribution of risk and benefits of the specific value chain. To make sure that this inclusion is both fair and effective, capabilities of relevant actors need to be taken into account, i.e. the capabilities of biomass producers and (...) of companies and local governments. Building on these capabilities can lead to context sensitive design of biorefineries that allow for true inclusion of local stakeholders. We support this claim with reference to the case of sugarcane production in Jamaica. (shrink)

In this study, I examine the institutional model of data science as a nascent profession undergoing an occupational founding phase. Drawing on interviews with sixty data scientists, senior managers, and professors from Israel as well as observations at the local professional community’s events, I argue that data scientists endorse an open institutional model, upholding largely internet-based institutions focusing on knowledge sharing, networking, and collaboration. This model grants data scientists expertise, autonomy, and authority vis-à-vis clients, employers, and states; provides them with (...) continued credentialing independent of employing organizations; encourages the wide entry of new members; and helps them deal with the accelerated temporality of their field. This open model enables an omnivorous spreading of data science expertise and is used to challenge professionalization as an occupational-institutional model in other professions. Still, this model faces many challenges. (shrink)

BackgroundAcrophobia is a specific phobia characterized by a severe fear of heights. The purpose of the present study was to investigate the efficacy of two therapies that may ameliorate symptoms of acrophobia and anxiety sensitivity, i.e., virtual reality exposure therapy (VRET) and eye movement desensitization and reprocessing (EMDR) therapy with a Waiting List Control Condition (WLCC).MethodsWe applied a three-armed randomized controlled pre-post-test design with 45 female adolescent students. Students who met DSM-5 criteria for acrophobia were randomly assigned to either VRET (...) (N = 15;Mage = 17.26; SD = 1.32), EMDR (N = 15;Mage = 17.15; SD = 1.57), or a WLCC (N = 15;Mage = 17.50; SD = 1.26). The study groups were evaluated one week before the intervention and one week after the last intervention session regarding symptoms of acrophobia (Severity Measure for Acrophobia) and anxiety sensitivity (Anxiety Sensitivity Index).ResultsThe data showed that both the application of VRET and EMDR therapy were associated with significantly reduced symptoms of acrophobia (d = 1.03 for VRET and d = 1.08 for EMDR) and anxiety sensitivity (d = 1.15 for VRET and d = 1.13 for EMDR) in comparison to the Waiting List.LimitationsThe sample consisted only of adolescent women. Due to the recognizable differences between the two interventions, the therapists and the participants were not blind to the conditions.ConclusionThe results suggest that both VRET and EMDR are interventions that can significantly improve symptoms of acrophobia and anxiety sensitivity in female adolescents.Clinical Trial Registrationhttps://www.irct.ir/trial/57391, identifier: IRCT20210213050343N1. (shrink)