In Theory: Nine Degrees of Uncertainty in Negotiations

Joint decision-making processes such as negotiations play a vital role in diverse societal contexts spanning from business and politics to sustainability-related negotiations. One of the most prominent examples of how negotiations play an important role in overcoming societal challenges was the COVID-19 vaccine supply negotiations. These negotiations have put the spotlight on an aspect of joint decision-making that always has been of great interest to both negotiation researchers and practitioners yet remains empirically understudied- the effect of uncertainty. In the present article, we develop a framework of uncertainty in negotiation using the COVID-19 vaccine supply negotiations between the European Union and pharmaceutical companies as an example. More specifically, we categorize different kinds of uncertainty based both on mathematical considerations (i.e., differentiation between risk, ambiguity, and uncertainty) as well as on more circumstantial factors. To do so, we adapted the nine kinds of uncertainty in environmental governance proposed by Dewulf and Biesbroek to the more general context of negotiations. We first differentiate between three natures of uncertainty (i.e., lack of knowledge, unpredictability, and interpretations) and three objects of uncertainty (i.e., issue- based, strategy- based, and context- based). Second, we illustrate the psychological barriers that negotiators face when handling uncertainty, before concluding with proposals for practitioners on how to manage different kinds of uncertainty. Overall, we aim at stimulating investigations of the effects of uncertainty in mixed- motive decision- making while simultaneously helping negotiation teachers and practitioners better cope with the additional demands created by specific kinds of uncertainty.

Relationship between depression, anxiety, and perceived stress in health professionals and their perceptions about the quality of the health services in the context of COVID-19 pandemic.

BACKGROUND: The health emergency caused by COVID-19 revealed the shortcomings of health services (HS), but little is known about how this has impacted the mental health of health professionals (HP). METHODS: Data were collected through an online survey administered to HP in Lima (Peru) between May and July 2020. Instruments were applied to evaluate anxiety, depression, perceived stress (PS), and perceived quality of health services (PQHS). RESULTS: A total of 507 HP completed the survey. In the multivariate analysis, younger age and female gender were related to anxiety, depression, and PS (all with p < .001). The most relevant unfavorable PQHS associated with anxiety were competence of other HP to care for HP if infected (p = .002) and support for HP or their families in the event of becoming infected (p = .001); the most relevant unfavorable PHQS associated with depression were equipment to care for HP and their families if infected (p = .003); support for HP or their families if infected (p < .001); fear of HP and/or family members being infected or dying (p = .006); and HP' recognition of their competencies (p < .001); and the most relevant unfavorable PHQS associated with PS were support for HP or their families if infected (p < .001) and instability of knowledge (p = .027). CONCLUSIONS: There was an association between impaired mental health and PQHS scores among HP. This study shows the need for HP to express their concerns about how HS are supporting their safety and that of their family during health emergencies.

Caregiver and Youth Mental Health during COVID-19: Risk and Resilience Factors in a Large National Sample in Peru

The present study examined the prevalence and correlates of psychosocial impairment in a large, national sample of Peruvian children and adolescents (ages 5.0–17.9) during the COVID-19 pandemic in late 2020. A sample of 8263 online questionnaires were completed by caregivers in Peru between October 23rd–November 26th, 2020. In addition to sociodemographic and pandemic-related factors, the survey administered the Peruvian Spanish version of the Pediatric Symptom Checklist (PSC-17) to assess child psychosocial risk. The Patient Health Questionnaire (PHQ-9), Kessler-6 (K-6), and Brief Resilience Scale (BRS-6) assessed caregiver depression, psychological distress, and resilience, respectively. In this case, 33% of the children were at overall risk on the PSC-17. In adjusted models, caregiver distress, depression, and low resilience, as well as having a family member with a health risk factor were the strongest predictors of child psychosocial risk, accounting for nearly 1.2 to 2.1 times the likelihood of risk individually and 2.4 to 3.4 times the likelihood of risk when summed. Due to the opt-in sampling method, the obtained sample was likely skewed toward more advantaged families, suggesting that the study's high prevalence of PSC-17 positivity might have been even higher in a more economically representative sample. Given the prevalence of psychosocial problems in Peruvian youth during COVID-19, preventive interventions, with a special focus on family-level approaches that involve and support parents as well as children, are clearly warranted.

CSR strategy in tourism during the COVID-19 pandemic

Travel and tourism is one of the most affected sectors due to the COVID-19 pandemic, impacting economies, enterprises, and livelihoods worldwide. The pandemic has heavily damaged businesses across the tourism industry, including airlines, transportation, hotels, cruises, and others. Numerous tourism companies went bankrupt or had been struggling to survive, yet other ones have adapted their strategy and seized the crisis to transform their business for the post-pandemic future. This study aims at investigating the TUI Group's CSR strategic adaptability during the COVID-19 pandemic. The case study is based on a documentary analysis including such documents as annual reports, sustainability strategy, sustainability reports, and financial statements. The findings show that the pandemic crisis moved forward the company's transformation into a digital platform and its sustainability transformation. Moreover, the CSR strategy has been constantly adapted to the evolving COVID-19 environment. The company's efforts aimed at maintaining sustainable value have been primarily focused on supporting and engaging employees, ensuring safe holiday packages for customers, and supporting local communities and partners. Several implications are provided based on the study results.

Magnetic Resonance Neurography Reveals Smoking-Associated Decrease in Sciatic Nerve Structural Integrity in Type 2 Diabetes.

OBJECTIVE: It is controversially discussed in how far smoking contributes to diabetic polyneuropathy (DPN) in type 2 diabetes (T2D). Diffusion-weighted magnetic resonance neurography (MRN) at 3 Tesla has been shown to provide objective values for structural nerve integrity in patients with T2D. The aim of this study was to investigate the contribution of cigarette smoking on structural nerve integrity in T2D. METHODS: This cross-sectional prospective cohort study investigated the structural integrity of the sciatic nerve in 10 smokers, 40 never-smokers, and 20 ex-smokers with T2D and 10 healthy control subjects, using diffusion tensor imaging MRN at 3 Tesla and semi-automated nerve fiber tracking. Results were correlated with clinical, electrophysiological, and serological data. RESULTS: The sciatic nerve's fractional anisotropy (FA), a parameter for structural nerve integrity, was significantly lower in smokers with T2D when compared to controls (p = 0.002) and never-smokers (p = 0.015), and lower in ex-smokers when compared to controls (p = 0.015). In addition, sciatic nerve radial diffusivity, a marker of myelin damage, was increased in smokers versus controls and never-smokers (p = 0.048, p = 0.049, respectively). Furthermore, FA in T2D patients was negatively correlated with clinical and electrophysiological markers of DPN. FA also showed negative correlations with the pulse wave velocity, a marker of arterial stiffness and associated microangiopathy, in controls (r = -0.70; p = 0.037), never-smokers (r = -0.45; p = 0.004), ex-smokers (r = -0.55; p = 0.009), and a similar trend in smokers (r = -0.63; p = 0.076). Negative correlations were found between FA and skin auto-fluorescence, a marker of tissue advanced glycation end product accumulation and therefore long-term glycemic stress in T2D, in never-smokers (r = -0.39; p = 0.020) and smokers (r = -0.84; p = 0.004), but not in ex-smokers (r = -0.07; p = 0.765). CONCLUSION: The findings indicate that smoking contributes to sciatic nerve damage in T2D, potentially worsening DPN due to glycemic stress and less microangiopathy-associated myelin damage in active smokers, while angiopathic effects predominate in ex-smokers. To stop smoking may therefore pose a promising preventive measure to slow the progression of DPN in T2D.

Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect?

BACKGROUND: Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19. METHODS: Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE. RESULTS: A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs. CONCLUSIONS: Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.

The impact of COVID-19 on the treatment of obsessive-compulsive disorder.

The COVID-19 pandemic has led to challenges in providing cognitive-behavioral therapy for patients with obsessive-compulsive disorder (OCD). Despite the presence of the pandemic and the risk of contracting illness, therapists can continue to utilize exposure with response prevention (ERP), which is the gold standard psychotherapy treatment for OCD. Therapists can ethically implement ERP by focusing on core treatment tenets while incorporating guidelines recommended by the Centers for Disease Control and Prevention to mitigate risk for COVID-19 exposure. The pandemic has also provided an opportunity to more widely implement ERP through virtual telehealth appointments, which have notable benefits as well as some drawbacks.

Metadata Correction: Patient Empowerment During the COVID-19 Pandemic by Ensuring Safe and Fast Communication of Test Results: Implementation and Performance of a Tracking System.

[This corrects the article DOI: 10.2196/27348.].

Patient Empowerment During the COVID-19 Pandemic by Ensuring Safe and Fast Communication of Test Results: Implementation and Performance of a Tracking System.

BACKGROUND: Overcoming the COVID-19 crisis requires new ideas and strategies for online communication of personal medical information and patient empowerment. Rapid testing of a large number of subjects is essential for monitoring and delaying the spread of SARS-CoV-2 in order to mitigate the pandemic's consequences. People who do not know that they are infected may not stay in quarantine and, thus, risk infecting others. Unfortunately, the massive number of COVID-19 tests performed is challenging for both laboratories and the units that conduct throat swabs and communicate the results. OBJECTIVE: The goal of this study was to reduce the communication burden for health care professionals. We developed a secure and easy-to-use tracking system to report COVID-19 test results online that is simple to understand for the tested subjects as soon as these results become available. Instead of personal calls, the system updates the status and the results of the tests automatically. This aims to reduce the delay when informing testees about their results and, consequently, to slow down the virus spread. METHODS: The application in this study draws on an existing tracking tool. With this open-source and browser-based online tracking system, we aim to minimize the time required to inform the tested person and the testing units (eg, hospitals or the public health care system). The system can be integrated into the clinical workflow with very modest effort and avoids excessive load to telephone hotlines. RESULTS: The test statuses and results are published on a secured webpage, enabling regular status checks by patients; status checks are performed without the use of smartphones, which has some importance, as smartphone usage diminishes with age. Stress tests and statistics show the performance of our software. CTest is currently running at two university hospitals in Germany-University Hospital Ulm and University Hospital Tübingen-with thousands of tests being performed each week. Results show a mean number of 10 (SD 2.8) views per testee. CONCLUSIONS: CTest runs independently of existing infrastructures, aims at straightforward integration, and aims for the safe transmission of information. The system is easy to use for testees. QR (Quick Response) code links allow for quick access to the test results. The mean number of views per entry indicates a reduced amount of time for both health care professionals and testees. The system is quite generic and can be extended and adapted to other communication tasks.

Examining the longitudinal effects and potential mechanisms of hope on COVID-19 stress, anxiety, and well-being.

Hope is a cognitive trait that predicts both resilience to and recovery from anxiety and stress-related disorders. The present study examines the prospective associations of hope with subsequent anxiety, stress, and well-being during the COVID-19 pandemic. Perceived emotional control, a transdiagnostic vulnerability factor, was also examined as a potential mediator of these relationships. American adults (N = 822) were recruited during the COVID-19 pandemic using Amazon mTURK and structural equation modeling was used to examine how trait hope predicted outcomes approximately one month later. Higher hope was associated with greater well-being and perceived emotional control, as well as lower levels of anxiety and COVID-19 perceived stress. Results also indicated an indirect effect of hope with all outcomes via perceived emotional control. These findings suggest that hope may associated with resilience to the chronic stressors associated with the COVID-19 pandemic.

A secure and rapid query-software for COVID-19 test results that can easily be integrated into the clinical workflow to avoid communication overload (preprint)

Overcoming the COVID-19 crisis requires new ideas and strategies. Rapid testing of a large number of subjects is essential to monitor, and delay, the spread of SARS-CoV-2 to mitigate the consequences of the pandemic. People not knowing that they are infected may not stay in quarantine and, thus, are a risk for infecting others. Unfortunately, the massive number of COVID-19 tests performed is challenging for both laboratories and the units that take the throat swab and have to communicate test results. Here, we present a secure tracking system (CTest) to report COVID-19 test results online as soon as they become available. The system can be integrated into the clinical workflow with very modest effort and avoids excessive load to telephone hotlines. With this open-source and browser-based online tracking system, we aim to minimize the time required to inform the tested person but also the test units, e.g. hospitals or the public healthcare system. Instead of personal calls, CTest updates the status of the test automatically when the test results are available. Test reports are published on a secured web-page enabling regular status checks also by patients not using smartphones with dedicated mobile apps which has some importance as smartphone usage diminishes with age. The source code, as well as further information to integrate CTest into the IT environment of other clinics or test-centres, are freely available from https://github.com/sysbio-bioinf/CTest under the Eclipse Public License v2.0 (EPL2).