Volatility of the COVID-19 vaccine hesitancy: sentiment analysis conducted in Brazil.

Background: Vaccine hesitancy is a phenomenon that can interfere with the expansion of vaccination coverage and is positioned as one of the top 10 global health threats. Previous studies have explored factors that affect vaccine hesitancy, how it behaves in different locations, and the profile of individuals in which it is most present. However, few studies have analyzed the volatility of vaccine hesitancy. Objective: Identify the volatility of vaccine hesitancy manifested in social media. Methods: Twitter's academic application programming interface was used to retrieve all tweets in Brazilian Portuguese mentioning the COVID-19 vaccine in 3 months (October 2020, June 2021, and October 2021), retrieving 1,048,576 tweets. A sentiment analysis was performed using the Orange software with the lexicon Multilingual sentiment in Portuguese. Results: The feelings associated with vaccine hesitancy were volatile within 1 month, as well as throughout the vaccination process, being positioned as a resilient phenomenon. The themes that nurture vaccine hesitancy change dynamically and swiftly and are often associated with other topics that are also affecting society. Conclusion: People that manifest the vaccine hesitancy present arguments that vary in a short period of time, what demand that government strategies to mitigate vaccine hesitancy effects be agile and counteract the expressed fear, by presenting scientific arguments.

Guilt and Regret Experienced by Parents of Children Born Extremely Preterm.

OBJECTIVES: To explore decisional regret of parents of babies born extremely preterm and analyze neonatal, pediatric, and parental factors associated with regret. STUDY DESIGN: Parents of infants born <29 weeks of gestational age, aged between 18 months and 7 years, attending neonatal follow-up were enrolled. Hospital records were reviewed to examine morbidities and conversations with parents about levels of care. Parents were asked the following question: "Knowing what you know now, is there anything you would have done differently?" Mixed methods were used to analyze responses. RESULTS: In total, 248 parents (98% participation) answered, and 54% reported they did not have regret. Of those who reported regret (n = 113), 3 themes were most frequently invoked: 35% experienced guilt, thinking they were responsible for the preterm birth; 28% experienced regret about self-care decisions; and 20% regretted decisions related to their parental role, generally wishing they knew sooner how to get involved. None reported regret about life-and-death decisions made at birth or in the neonatal intensive care unit. Impairment at follow-up, gestational age, and decisions about levels/reorientation of care were not associated with regret. More mothers reported feeling guilt about the preterm birth (compared with fathers); parents of children with severe lesions on ultrasonography of the head were less likely to report regret. CONCLUSIONS: Approximately one-half of the parents of infants born extremely preterm had regrets regarding their neonatal intensive care unit stay. Causes of regret and guilt should be addressed and minimized.

New approaches to maximization: evidence of correlations with malaise and well-being in the chilean adult population / Nuevos enfoques de maximización: evidencia de correlaciones con malestar y bienestar en población chilena adulta

Abstract There is a lack of theoretical consensus about the decision-making process and particularly regarding the maximization construct. Recently, two conceptual approaches to maximization and their respective instruments were proposed. The first defines maximization as consisting of two dimensions, goal and strategy. The second differentiates between the two types of maximization according to the way an individual makes decisions, one is resolute and the other is fearful. Regarding the first approach, empirical goal and strategy relationships with emotional consequences on well-being and discomfort are unknown while deciding, while it is doubt whether the distinction proposed in the second approach also applies to the adult population and in contexts different from the European one. Empirical associations are evaluated here for each approach regarding indicators of malaise and well-being through a set of hypotheses. A sample of 624 Chilean adults of both sexes (20 to 70 years old) answered eight instruments on maximization, its components and types, and well-being and malaise. The results for both approaches show greater associations with rates of malaise than well-being. The results for the first approach show a more intense association with indices of malaise and well-being for strategy than goal. In the second approach, these associations are stronger and greater for fearful maximization than for resolute. The results contribute by increasing the understanding of the maximization construct by simultaneously showing that the increment in the strategy search for alternatives and the fearful style of maximization are directly associated with difficulty in deciding and regret.

Resumen Existe carencia de consenso teórico acerca del proceso de tomar decisiones y particularmente respecto del constructo maximización. Recientemente, se propuso dos enfoques conceptuales sobre maximización y sus respectivos instrumentos de evaluación. El primero considera que el concepto de maximización está constituido por dos dimensiones, meta y estrategia. El segundo diferencia entre dos tipos de maximización según el modo de decidir de un individuo, uno resuelto y otro temeroso. Respecto del primer enfoque se desconocen eventuales relaciones empíricas de meta y estrategia con consecuencias emocionales sobre el bienestar y malestar mientras se decide, mientras existe la duda si la distinción propuesta en el segundo enfoque se aplica también a población de adultos y en contextos diferentes al europeo. En el presente trabajo son evaluadas asociaciones empíricas para cada enfoque respecto de indicadores de malestar y bienestar mediante un conjunto de hipótesis. Una muestra de 624 adultos chilenos de ambos sexos (20 a 70 años) respondió ocho instrumentos sobre maximización, sus componentes y sus tipos, y su bienestar y malestar. Los resultados para ambos enfoques muestran asociaciones mayores con índices de malestar que de bienestar. Los resultados para el primer enfoque muestran asociación con índices de malestar y bienestar más intensos para la dimensión de estrategia que la de meta. En el segundo enfoque estas asociaciones son fuertes y mayores para el tipo de maximización temerosa que para resuelta. Los resultados contribuyen a incrementar la comprensión del constructo de maximización, al mostrar simultáneamente que el aumento en la estrategia de búsqueda de alternativas y el estilo temeroso de maximización, se asocian directamente con dificultad para decidir y con experimentar pesar.

The new Portuguese law on surrogacy - The story of how a promising law does not really regulate surrogacy arrangements.

Since 2006, surrogacy arrangements have been expressly forbidden within the Portuguese legal order, in any one of its forms, and in some situations, it has even been criminalised. However, since August 2016, surrogacy has been allowed under certain restrictive scenarios, providing it follows several prerequisites. In spite of this progress, the 2016 amendment to the law has not been immune to criticism. One of its most debatable aspects is the lack of the surrogate's right to regret, although it is doubtful that surrogacy contracts will be enforced against a surrogate's wishes. But the weakest point of the new law is its failure to address some of the nuclear issues of surrogacy contracts, leaving solutions either to general contract law or to the clauses stipulated by the parties. Furthermore, it is unclear which clauses are allowed and which are forbidden under the law. This study describes the content of the new Portuguese surrogacy law, exposes its main fragilities and suggests solutions for matters not covered by the law. The conclusion is that a law full of promise fails regarding the issues it is supposed to regulate.

Past and future regret and missed opportunities: an experimental approach on separate evaluation and different time frames.

Decisions often imply trade-offs that force people to accept missing an opportunity in the past or in the future. However, it is not fully clear whether a past miss or a future miss elicits more regret. In a direct comparison, previous research had found support for the greater impact of future misses. In an experimental study with 216 participants, we replicated and extended previous research by testing the strength of the future miss in a separate evaluation and with different periods. Results show that, when evaluated separately, future misses caused less regret than past misses. However, future misses made participants change their feelings of regret more intensely than past misses did. Also, regret levels did not decrease when future misses were further away. Our findings support the strength of future misses on regret but also show contrasting effects when evaluated separately.

Past and future regret and missed opportunities: an experimental approach on separate evaluation and different time frames

Abstract Decisions often imply trade-offs that force people to accept missing an opportunity in the past or in the future. However, it is not fully clear whether a past miss or a future miss elicits more regret. In a direct comparison, previous research had found support for the greater impact of future misses. In an experimental study with 216 participants, we replicated and extended previous research by testing the strength of the future miss in a separate evaluation and with different periods. Results show that, when evaluated separately, future misses caused less regret than past misses. However, future misses made participants change their feelings of regret more intensely than past misses did. Also, regret levels did not decrease when future misses were further away. Our findings support the strength of future misses on regret but also show contrasting effects when evaluated separately.

Nurses' responses to requests for forgiveness at the end of life.

CONTEXT: Patients or family members facing serious illness often express regrets over life events or the need for forgiveness. Professionals, including nurses as the prominent discipline at the bedside, witness these expressions of regret or needs for forgiveness but may not be adequately prepared to optimally address patient concerns regarding forgiveness. OBJECTIVES: The objectives of this descriptive study were to 1) identify contexts in which nurses have witnessed expressions of regret or the need for forgiveness and 2) describe nurses' responses to these clinical experiences related to forgiveness. METHODS: Nurses attending palliative care educational programs shared narratives of their experiences in caring for patients who expressed regret or the need for forgiveness. Study narratives were analyzed qualitatively, using content analysis. Themes were identified. RESULTS: Narratives were provided by 339 nurses from courses throughout the U.S. and Belize, India, the Philippines, and Romania. CONCLUSION: Nurses provide clinical care for patients with advanced illness who struggle with issues of forgiveness. Nurses would benefit from additional education regarding how best to address these concerns.

Bienestar subjetivo en maximizadores y satisfacedores / Subjective well being in maximizers and satisfecers

El propósito aquí es evaluar una tendencia decisional cuyos polos son la simple satisfacción hasta la maximización, y sus efectos eventuales sobre el bienestar subjetivo (B.S.), en sus componentes afectivo (felicidad) y cognitivo (satisfacción vital). Una muestra de 209 estudiantes de la Facultad de Psicología de la Universidad de Talca, respondió un cuestionario con cuatro instrumentos para medir maximización-satisfacción y B.S. Los resultados muestran diferencias significativas entre los participantes para el componente cognitivo -satisfacción vital- del B.S., donde quienes son satisfacedores tienen una mejor valoración de sus vidas que los maximizadores (t[194] = 3.28, p < .05). También se encuentra una relación positiva entre la maximización y el pesar (r = .393). Se discuten estos resultados en relación a los hallazgos obtenidos internacionalmente y a algunas características de la sociedad chilena.

The purpose of this research was to evaluate the decision making using maximal and satisficing approaches and their effects on subjective well-being, according to its emotional component (happiness) and its cognitive dimension (satisfaction with the life). A total of 209 undergraduate students answered four questionnaires to asses maximization, satisfaction, regret and subjective well-being. The result shows that there are significant differences between maximizers and satisficers as for the subjective well-being just in its cognitive component of vital satisfaction. The satisficers presents a better evaluation of their lives than the maximizers (t[194] = 3.28, p < .05) Finally a positive relation was found between maximizers and the tendency to express regret (r= .393). These finds are discussed in based to internationally ones.

Risk factors for tubal sterilization regret, detectable before surgery.

Brazil has one of the highest prevalence rates of female surgical sterilization in the world. At the same time there is an increased demand for sterilization reversal. In order to understand which women tend to later request reversal of the procedure, a case-control study was carried out comparing 216 women who requested reversal with sterilized women who did not, paired by year of surgery. The relative risk of requesting reversal for women sterilized before age 25 was 18 times that of women sterilized after age 29. The elevated risk remained even after controlling for a number of variables present at the time of surgery. Multiple regression analysis showed that request for reversal was associated with younger age, less information about the procedure, and fewer contraceptive methods known before sterilization. These results support the recommendation that women should be fully informed about the tubal ligation procedure and have access to other contraceptive options before being sterilized.

Sterilization regret in the Dominican Republic: looking for quality-of-care issues.

This report approaches the concept of quality of care by looking at the covariates of sterilization regret in the Dominican Republic according to the results from the 1991 Demographic and Health Survey. The main variables observed are the women's satisfaction with sterilization, their decisionmaking process, sterilization experience, use of family planning, and socioeconomic characteristics. The more detailed measurement and analysis of the outcomes of care point to a need for improvement in the public program effort with regard to sterilization. Substantial proportions of women were sterilized who were younger than 30, who had three or fewer living children, and who had the operation before they had used any other method of contraception. Because a greater proportion of sterilization regret is observed among these groups, women must be enabled to make a free and informed decision about sterilization by means of programs that offer a more balanced choice of methods, as well as better counseling, education, and access to high-quality services.

PIP: A quality of care study examined the covariates of sterilization regret by analyzing data from the 1991 Demographic and Health Survey for the Dominican Republic. The leading contraceptive method was female sterilization (about 40% of women in union) followed by oral contraceptives (10%). Over time, an increasing number of younger women chose sterilization. In fact, 60% of all sterilized women underwent sterilization when they were younger than 30. Almost 40% of women in union who underwent sterilization when they were younger than 30 had no more than three living children. Sterilization was the first and only contraceptive method that 34% of sterilized women in union had ever used. 56% of them were younger than 30. 44% had fewer than four children. These women were more likely to report regret, dissatisfaction with their decision to undergo sterilization, and to not choose sterilization again than did all respondents (11% vs. 5%). Some variables significantly associated with dissatisfaction and regret were: age; no other modern family planning methods used; reasons for sterilization (recommended by medical/family planning worker and side effects/health concerns); a less than 6 month interval between last birth and sterilization; sterilization was first method used; family size less than four; sterilized at delivery; and sterilization was discussed with husband. These findings suggest a need for the family planning program to provide information about all contraceptive methods and their effective use, quality counseling, and access to high quality services to optimize levels of satisfaction among clients.

[Voluntary sterilization]. / La esterilizacion voluntaria.

PIP: Voluntary sterilization is the chosen family planning method of more couples worldwide than any other, evidence of its acceptability and lack of serious shortcomings. This work offers observations on training, counseling, supervision, cost-effectiveness, and acceptability of voluntary sterilization programs, and presents some results of Profamilia's program. Training of qualified medical personnel in the available techniques is a relatively simple. Profamilia has trained almost 1000 medical professionals, nearly half of whom were from other countries, but a legal technicality has forced Profamilia to curtail training of foreign professionals. It is much more difficult to train personnel to identify and inform potential clients about sterilization, promote the procedure, and provide follow-up, yet these program activities are crucial to a successful sterilization program. Counseling of couples is necessary and should include discussion of the greater convenience of vasectomy compared to tubal ligation. Sterilization should be presented as a permanent method. This permanence, often viewed as a disadvantage, has a positive side in freeing couples of the need for further consideration of family size or contraception and in protecting them against family and social pressures to have more children. Raising marriage age or family size requirements in the hope of avoiding regret does not appear justified. Assuring that sterilization is truly voluntary is a preoccupation of donors, but has not been a problem in Profamilia programs. All clients are required to make some payment and to sign a detailed consent form. Profamilia has been persuaded to discourage mental defectives from undergoing sterilization because of possible legal problems. Periodic, unannounced visits to clinics are recommended for quality control and supervision. Profamilia employs salaried medical personnel for sterilization when careful supervision is available to ensure that they do not unjustifiably reject applicants, and pays on a per-case basis otherwise. It is estimated that each Profamilia sterilization provides 12.5 couple-years of protection. Each sterilization costs US $ 33.20 on average, 60% of it for personnel costs. Profamilia offer highly subsidized services for its lower middle class clients and almost free services for its poorest 40% of clients. The financial strain is considerable for Profamilia, which carries out some 70,000 sterilizations each year at a cost of US $ 2.25 million, only 1/7 of it directly paid for by clients. Since 1973, Profamilia has performed over 700,000 tubal ligations. There have been 19 deaths, 9 attributed to surgical and 5 to anesthetic problems. There are minor complications in about 1% of cases. 26,401 vasectomies were performed through 1990, with 2 cases requiring hospitalization.^ieng