Esta pesquisa faz parte de um estudo que pretende investigar longitudinalmente a transição da conjugalidade para a parentalidade quanto ao ajustamento diádico e a satisfação conjugal de casais primíparos. O presente relato compreendeu os dados coletados na primeira medida e, portanto, se caracterizo..

In an effort to contain the spread of COVID-19, many states and countries have adopted public health restrictions on activities previously considered commonplace: crossing state borders, eating indoors, gathering together, and even leaving one’s home. These policies often focus on specific activities or groups, rather than imposing the same limits across the board. In this Article, I consider the law and ethics of these policies, which I call tailored policies. In Part II, I identify two types of tailored policies--activity-based and (...) group-based. Activity-based restrictions respond to differences in the risks and benefits of specific activities, such as walking outdoors and dining indoors. Group-based restrictions consider differences between groups with respect to risk and benefit. Examples are policies that treat children or senior citizens differently, policies that require travelers to quarantine when traveling to a new destination, and policies that treat individuals differently based on whether they have COVID-19 symptoms, have tested positive for COVID-19, have previous COVID-19 infection, or have been vaccinated against COVID-19. In Part III, I consider the public health law grounding of tailored policies in the principles of “least restrictive means” and “well-targeting.” I also examine how courts have analyzed tailored policies that have been challenged on fundamental rights or equal protection grounds. I argue that fundamental rights analyses typically favor tailored policies and that equal protection does not preclude the use of tailored policies even when imperfectly crafted. In Part IV, I consider three critiques of tailored policies, centering on the claims that they produce inequity, cause harm, or unacceptably limit liberty. I argue that we must evaluate restrictions comparatively: the question is not whether tailored policies are perfectly equitable, wholly prevent harm, or completely protect liberty, but whether they are better than untailored ones at realizing these goals in a pandemic. I also argue that evaluation must consider indirect harms and benefits as well as direct and apparent ones. (shrink)

Some patients tolerate a given drug well, without adverse reactions. For others, though, an identical dose of the same medication can have toxic effects. Moreover, while a drug can be effective at relieving symptoms for some patients, it may fail to do the same for others suffering with the same disease. With such variability in treatment responses, tailoring medical interventions to individual patients has long been an aspiration of medicine. Until recently, however, medicine lacked a clear understanding of the (...) biological reasons for human variation in drug response. Attempting to adjust treatment to the individual patient, physicians have relied primarily on direct observation, trial-and-error, and, ultimately... (shrink)

We discuss the implementation of Responsible Research and Innovation (RRI) within a project for the development of an AI-supported exergame for assisted movement training, outline outcomes and reflect on methodological opportunities and limitations. We adopted the responsibility-by-design (RbD) standard (CEN CWA 17796:2021) supplemented by methods for collaborative, ethical reflection to foster and support a shift towards a culture of trustworthiness inherent to the entire development process. An embedded ethicist organised the procedure to instantiate a collaborative learning effort and implement RRI (...) in a translational context. Within the interdisciplinary setting of the collaboration and with the support of a technoethicist, we successfully identified relevant, project-specific challenges and developed a roadmap with derived actions, thus meaningfully integrating RRI into the development process. We discuss the methodological procedure in terms of its effectiveness and efficiency, the allocation of responsibilities and roles, particularly regarding potential frictions in the interdisciplinary context with embedded ethics, and the challenges of the translational context. We conclude that the responsibility-by-design standard effectively established a productive workflow for collaborative investigation and work on ethical challenges. We reflect on methodological difficulties and propose possible avenues to our approach. (shrink)

ABSTRACT A key selling point of pharmacogenetics is the genetic stratification of either patients or diseases in order to target the prescribing of medicine. The hope is that genetically ‘tailored’ medicines will replace the current ‘one‐size‐fits‐all’ paradigm of drug development and usage. This paper is concerned with the relationship between difference and justice in the use of pharmacogenetics. This new technology, which facilitates the identification and use of difference, has, we shall argue, the potential to lead to injustice either by (...) the inappropriate use of difference or through the inappropriate failure to use difference. We build on empirical data from a detailed study of the range of options for the development of pharmacogenetics to present a consideration of the ethical issues that surround patient and disease stratification. In it we explore the ways in which the use of pharmacogenetics may lead to the creation of new, genetically stratified, forms of difference and new forms of injustice based on these divisions. We also examine the ways in which existing forms of difference and social stratification may interact with the use of pharmacogenetics. In conclusion, we suggest how an understanding of these ethical issues could usefully inform future policy discussions. (shrink)

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care (...) institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care. (shrink)

We design functional algebras that characterize various complexity classes of global functions. For this purpose, classical schemata from recursion theory are tailored for capturing complexity. In particular we present a functional analog of first-order logic and describe algebras of the functions computable in nondeterministic logarithmic space, deterministic and nondeterministic polynomial time, and for the functions computable by AC 1 -circuits.

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of (...) responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of (...) responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

In their article, A.M. Dorozhkin and S.V. Shibarshina focus on the concepts of problem, task, and features of a creative personality as a single isolated agent. To a certain extent, such view is “opposed” by the socio-epistemic approach, since today it is extremely difficult to consider a person outside the socio-cultural context. In my paper, I discuss the distinctive features of the concepts of tasks and problems in connection with the fields of science and education. As an example of a (...) kind of creative adaptation practice, to which modern scientists are forced to resort (taking into account difficult socio-economic realities), I consider “tayloring” – a type of activity of “creative” written justification of the importance and usefulness of basic research (J. Calvert). The collective and institutional aspects of modern science, which play a role in the possible limitation of the process of generating new (creative) ideas in science, are discussed (P. Stanford). I agree with A.M. Dorozhkin and S.V. Shibarshina, that the method of epistemological randomization is most specific for the field of philosophy. Following C. Rovelli, it is emphasized that philosophy can serve as an important “creative resource” for scientific activity. (shrink)

The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes.

This essay starts by accepting Cécile Fabre's argument in her book Spying through a Glass Darkly that intelligence work, including using incentives and pressures to encourage betrayal and treason, can be morally justified based on the criteria of necessity, effectiveness, and proportionality. However, while assessments of spying tend to be based on Cold War notions, I explore it here in the messier reality of counterinsurgency, counterterrorism, and “new wars.” In addition, I suggest a methodological expansion: adding a sociological perspective to (...) the ethical discussion by exploring the wider effects on society, over longer periods, of the operation of informers. Based on these shifts in perspective and context, I identify additional social harms generated by espionage that should lead to a more restrictive view of ethical espionage than the one emerging from Fabre's work. I argue that many of these social harms are created by the mass recruitment of informers, in asymmetrical conflicts where governments have leverage over suspected communities, and given the (often mistaken) belief that everyone recruited to act as informer is an “asset,” primarily providing advantages. I argue, therefore, that the decisive issue is one of scale: many of the ethical problems created by espionage in these contexts result from the widespread systematic recruitment of informers, while small-scale, targeted, ad-hoc recruitment can more easily avoid such problems. (shrink)

The gap between the Markov blanket and ontological boundaries arises from the former's inability to capture the dynamic process through which biological and cognitive agents actively generate their own boundaries with the environment. Active inference in the free-energy principle (FEP) framework presupposes the existence of a Markov blanket, but it is not a process that actively generates the latter.

This paper is based on an open lecture given at OCMS on Tuesday 21 December 2004.

The prevalence of social production and the increase in User Generated Content destabilize some of the fundamental premises of our current copyright law. Copyright law is primarily designed to regulate the relationships of a single owner with other non-owners and is focused on the sovereignty of the author/owner. Social production, by contrast, requires us to articulate a matrix of relationships between the individual, the facilitating platform and the communities and crowds involved in social production. The transition from industrial production to (...) social production transforms the social relations associated with the production of content and therefore requires adjustment of the institutions that design such relations. This Article closely examines the social dimension of content production and analyzes the consequences for the governance of content in the social web. The Article proceeds as follows: Part I describes social production and analyzes the implications for the stakeholders involved. I focus on three key features of social production which affect why we create, how we create, and what assets are generated by the process of creation. Part II explains why social production might be incompatible with the current copyright regime. In particular, I argue that copyright law mainly defines rights against strangers and fails to provide a framework for managing the rights and interests within a gigantic group of collaborators. Furthermore, the exclusivity offered by copyright law may undermine social motivation and collaborative production. Finally, in Part III, I outline some of the challenges for legal policy. (shrink)

As with other aspects of post-Minoan Crete studies there has been a tendency to accept a pan-Cretan economic model. A Dorian aristocracy, served by pre-Dorian serfs and their descendants, depended upon the produce of their private kleroi for membership in an andreion and citizen status. The elite preserved their political, social, and economic position by discouraging the development of a market economy on Crete in favor of a subsistence economy based upon agriculture, animal husbandry, and hunting. Discouraged were production of (...) coinage, elite display, and manufacture for export . Specialist craftsmen and other kinds of wage earners were either foreigners or members of a dependent population. (shrink)

The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes.

In this article ethical issues are discussed which play a role in pharmacogenetics. Developments in pharmacogenetics have a large impact on many different practices such as clinical trials, the practice of medicine and society at large. In clinical trials, questions rise regarding the exclusion of genetic subgroups that may be non- or poor-responders to the experimental drug. Also, the question is asked how pharmaceutical companies should deal with their growing knowledge about the relations between genetic variation and adverse effects. Moreover, (...) pharmacogenetics may provide disease-specific predictive information which may have a significant impact on the relations between physicians, patients and their relatives in the practice of medicine. Here, issues also arise regarding responsibility of patients and physicians for health and disease. In the society at large, the high costs of new pharmacogenetic possibilities lead to questions concerning solidarity and fair distribution on a national as well as an international level. It is concluded that in the near future, ethical research should be focused on the themes responsibility, inclusion and exclusion and global justice. (shrink)

Tailoring workshop, a school-based teacher training program, has been developed in China on the basis of the Teaching Research Groups to better focus on teacher’s genuine needs, improve their problem-solving ability, and inter-subject collaboration. Literature on teacher workshops predominately roots in western settings whereas scant attention has been paid to those in Asian contexts, especially China. Therefore, a qualitative method was performed with teachers from a middle school in Shanghai to unveil how the TWs were formed, conducted, and how (...) they functioned effectively. Drawing on Dewey’s pragmatic theory as the analysis framework, the findings yielded a formation process with four stages and examined the mechanisms in four dimensions, namely, dynamics mechanism, organizational structure, role of teachers, and learning mechanism. The study argues that, the TWs prioritize teacher’s genuine needs and problems encountered in practice, encourage teachers to identify problems, seek resources and conduct research with collective wisdom for resolutions. These features make it significantly different from the traditional TRGs with ‘top-down’ approach and other training programs in reliance upon short-lived, external lectures. The TW mode, in this sense, can be deemed a promising endeavor to facilitate teacher’s sustainable development in echoing the ever-changing education domain. (shrink)

This paper explores the psychological notion of context as cognitive environment that is part of the Relevance Theory framework and describes the way in which such CEs are constrained during the course of conversation as the conversational partners engage in “conversional tailoring”.

Effective recommendations on healthy food choice need to be personalized and sent out on a large scale. In this paper, we present a model of automatic message selection tailored on the characteristics of the recipient and focused on the reduction of red meat consumption. This model is obtained through the collaboration between social psychologists and artificial intelligence experts. Starting from selected psychosocial models on food choices and the framing effects of recommendation messages, we involved a sample of Italian participants in (...) an experiment in which they: filled out a first questionnaire, which was aimed at detecting the psychosocial antecedents of the intention to eat red/processed meat; read messages differing as to the framing of the hypothetical consequences of reducing versus not reducing red/processed meat consumption; filled out a second questionnaire, which was aimed at detecting participants’ reaction to the messages, as well as any changes in their intention to consume red/processed meat. Data collected were then employed to learn both the structure and the parameters of a Graphical Causal Model based on a Dynamic Bayesian Network, aimed to predicting the potential effects of message delivery from the observation of the psychosocial antecedents. Such probabilistic predictor is intended as the basis for developing automated interactions strategies using Deep Reinforcement Learning techniques. Discussion focuses on how to develop automatic interaction strategies able to foster mindful eating, thanks to considering the psychosocial characteristics of the people involved; sending messages tailored on these characteristics; adapting interaction strategies according to people’s reactions. (shrink)

Conversation analytical methodology was used to specify the new opening practices in Finnish mobile call openings, which differ systematically from Finnish landline call openings. Since the responses to a mobile call orient to the summons identifying the caller, answers have changed and diversified. A known caller is greeted. The self-identification opening that was canonical in Finnish landline calls is mainly used for answering unknown callers, while channel-opener openings involve orientation to ongoing mutual business between the speakers. Some of these changes (...) reflect real-time coordination of the social action that the mobility of mobile phones enables. In all, the adoption of new ways of answering a call shows that people orient themselves to affordances that new technologies allow them. Mobile phone communication opens a salient new area both for the analysis of talk-ininteraction itself and also for understanding communicative behaviour in the era of ubiquitous information technology. (shrink)

Each technology—and also biotechnology—relates to and is developed within a certain context. Besides a technical dimension (the techniques) biotechnology also contains asocial dimension, such as the social relations that reflect themselves in the technology-development, and the aims for which the technology is used.The Center for Agriculture and Biotechnology (CAB), the research department of the Western Farming and Horticultural Organization, is attempting to relate the socio-economic contents of biotechnological developments more to the interests of farmers and sustainable farming styles.

The use of epithets was a fundamental component of Greek polytheism. The present study brings attention to a small subgroup of such divine bynames, referred to as individual epithets because they stem from the names of mortal individuals. The function of these epithets is to designate a deity specifically concerned with the individual in question, thereby providing a close relationship and personal benefits for the eponymous worshipper and his or her close kin. The article exemplifies the phenomenon through the investigation (...) of a goddess Isis Aphrodite Dikaia identified in Hellenistic Delos. Through the epithet Dikaia, two Athenian brothers, Dikaios and Asklepiades, sons of Dikaios, intimately tie the deity to themselves and their family. It is moreover proposed that a positioning of the epithet in its historical and physical context furthers our understanding of its origins and significance.L’usage des épithètes était une composante fondamentale du polythéisme grec. Cet article se penche sur un petit groupe de surnoms de ce genre, que l’on appelle des épithètes individuelles, dans la mesure où elles dérivent du nom d’individus mortels. Ces épithètes ont pour fonction de montrer qu’une divinité est particulièrement concernée par l’individu en question, fournissant dès lors une relation étroite et des bienfaits personnels pour le fidèle éponyme et sa famille proche. L’étude illustre le phénomène en investigant la déesse Isis Aphrodite Dikaia que l’on rencontre dans la Délos hellénistique. Par l’épithète Dikaia, deux frères athéniens, Dikaios et Asklépiadès, fils de Dikaios, associent intimement la divinité à eux-mêmes et à leur famille. Il est en outre proposé qu’un replacement de l’épithète dans son contexte historique et physique approfondit notre compréhension de ses origines et de sa signification. (shrink)

platform, whose design concepts are described. Furthermore, a concrete example for the application of the approach to the design of a tailorable distributed coordination tool is given. We discuss related work, summarise the current state of the component-based tailorability approach and propose venues of further research.

When people engage in conversation, they tailor their utterances to their conversational partners, whether these partners are other humans or computational systems. This tailoring, or adaptation to the partner takes place in all facets of human language use, and is based on a mental model or a user model of the conversational partner. Such adaptation has been shown to improve listeners' comprehension, their satisfaction with an interactive system, the efficiency with which they execute conversational tasks, and the likelihood of (...) achieving higher level goals such as changing the listener's beliefs and attitudes. We focus on one aspect of adaptation, namely the tailoring of the content of dialogue system utterances for the higher level processes of persuasion, argumentation and advice-giving. Our hypothesis is that algorithms that adapt content for these processes, according to a user model, will improve the usability, efficiency, and effectiveness of dialogue systems. We describe a multimodal dialogue system and algorithms for adaptive content selection based on multi-attribute decision theory. We demonstrate experimentally the improved efficacy of system responses through the use of user models to both tailor the content of system utterances and to manipulate their conciseness. (shrink)

When people engage in conversation, they tailor their utterances to their conversational partners, whether these partners are other humans or computational systems. This tailoring, or adaptation to the partner takes place in all facets of human language use, and is based on a mental model or a user model of the conversational partner. Such adaptation has been shown to improve listeners' comprehension, their satisfaction with an interactive system, the efficiency with which they execute conversational tasks, and the likelihood of (...) achieving higher level goals such as changing the listener's beliefs and attitudes. We focus on one aspect of adaptation, namely the tailoring of the content of dialogue system utterances for the higher level processes of persuasion, argumentation and advice‐giving. Our hypothesis is that algorithms that adapt content for these processes, according to a user model, will improve the usability, efficiency, and effectiveness of dialogue systems. We describe a multimodal dialogue system and algorithms for adaptive content selection based on multi‐attribute decision theory. We demonstrate experimentally the improved efficacy of system responses through the use of user models to both tailor the content of system utterances and to manipulate their conciseness. (shrink)

Genome editing with engineered nucleases (GEENs) introduce site‐specific DNA double‐strand breaks (DSBs) and repairs DSBs via nonhomologous end‐joining (NHEJ) pathways that eventually create indels (insertions/deletions) in a genome. Whether the features of indels resulting from gene editing could be customized is asked. A review of the literature reveals how gene editing technologies via NHEJ pathways impact gene editing. The survey consolidates a body of literature that suggests that the type (insertion, deletion, and complex) and the approximate length of indel edits (...) can be somewhat customized with different GEENs and by manipulating the expression of key NHEJ genes. Structural data suggest that binding of GEENs to DNA may interfere with binding of key components of DNA repair complexes, favoring either classical‐ or alternative‐NHEJ. The hypotheses have some limitations, but if validated, will enable scientists to better control indel makeup, holding promise for basic science and clinical applications of gene editing. Also see the video abstract here https://youtu.be/vTkJtUsLi3w. (shrink)

Thanks to developments in genomics,dietary recommendations adapted to genetic riskprofiles of individual persons are no longerscience fiction. But what are the consequencesof these diets? An examination of possibleimpacts of genetically tailor-made diets raisesmorally relevant concerns that are analogous to(medical-ethical) considerations aboutscreening and testing. These concerns oftengive rise to applying norms for informedconsent and for the weighing of burdens andbenefits. These diets also have a broaderimpact, especially because food patterns arefull of personal, social and cultural meanings.Diets will change one's food patterns (...) and one'sattitude towards food, and this may implychanges in one's identity. We argue that suchan impact does not necessarily raise moralproblems. Moral concerns are, however, relevantif collective values and shared meanings infood practices are at issue. Therefore, thedevelopment of genetically tailor-made dietsdoes not merely require emphasis on weighingpersonal benefits and burdens and on informedconsent. It also asks for attention to andmoral reflection on the collective valuesinvolved in food practices. (shrink)

Currently, there is no authoritative credentialing process for individuals engaged in ethics practice, no accreditation system that sets minimum education standards for programs aiming to prepare these individuals for their work, and little evidence available that any particular training model is actually achieving its pedagogical goals. At the same time, a number of healthcare organizations and universities now routinely offer post-graduate programs, clinical fellowships and in-house training specifically devised to prepare graduates for ethics practice. However, while their numbers appear to (...) be growing, information about these programs is limited. In this paper, we describe the goals, content and strategies of three educational programs offered in Ontario, Canada. These case studies highlight the diversity of ethics education available to those who engage in ethics practice and underscore the need to take this variety into account in the development of future education standards that would specify minimally acceptable educational requirements. (shrink)

The role of software architecture in large-scale Agile development is important because several teams need to work together to release a single software product while helping to maximise teams’ autonomy. Governing and aligning Agile architecture across autonomous squads, when using the Spotify model, is a challenge because the Spotify model lacks practices for addressing Agile architecture governance. To explore how software architecture can be governed and aligned by scaling the Spotify model, we conducted a longitudinal embedded case study in a (...) multinational FinTech organisation. Then, we developed and evaluated an approach for architectural governance by conducting an embedded case study. The collected data was analysed using Thematic Analysis and informed by selected Grounded Theory techniques such as memoing, open coding, constant comparison, and sorting. Our approach for architectural governance comprises an organisational structure change and an architecture change management process. The benefits reported by the practitioners include devolving architectural decision-making to the operational level, enhancing architectural knowledge sharing among squads, minimising wasted effort in architectural refactoring, and other benefits. The practitioners in our case study realised an improved squad autonomy by the ability to govern and align architectural decisions. We provide two key contributions in this paper. First, we present the characteristics of our proposed architectural governance approach, its evaluation, benefits, and challenges. Second, we present how the novel Heterogeneous Tailoring model was enhanced to accommodate our architectural governance approach. (shrink)

BackgroundIndividuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues. The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial -design and methods. The main hypothesis is that participants receiving PIPCI will increase their (...) psychological flexibility compared to participants in the active control group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health compared to participants in the active control group and the waiting list control group.Materials and MethodsThis three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group, an active control group or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers and health care costs. Assessments will be performed at pre- and post-intervention, as well as at a 6-month follow-up.DiscussionThe development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia.Clinical Trial RegistrationClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924. (shrink)