Chaotic cities

We present a model and a narrative on food care to support reflection and dialogue, i.e. the exchange of ideas or opinions between patients, informal caregivers and care professionals, as a way to specifically explore values and perspectives on the use of technologies within care triads. To this end, we used an explorative literature study and an analysis of a care practice. We propose that care professionals have the responsibility to be sensitive to and act on potential dilemmas with the use of technologies in (food) care practice. This requires explicit thinking about one’s own personal perspectives on health and food, care and technologies, and the possible perspectives of others, in achieving a fair balance in care. The ‘Dilemma Model of Technology and Care Relations’ is presented to facilitate dialogue between patients, informal caregivers and professionals, in healthcare as well as in (food) technology. The model can be used both in the workplace and in educational settings. In conclusion, contrasting values and perspectives show that an open dialogue is needed to decide what is good (food) care in each individual care practice.

ABSTRACTThis article proposes a novel urban system equilibrium model for design of a tradable location tax credit scheme to balance traffic congestion and environmental externalities. In the proposed model, the interaction between the location tax credit scheme and households' residential location choices is explicitly considered. It is assumed that the authority initially allocates the credits to all households in a uniform way, and the households pay a certain amount of credits for housing consumptions, relying on the traffic congestion and environmental externalities that they cause. The credits are traded among households through a free market, and the tax revenue due to credit trading is considered as a part of household's income to be redistributed through household's income budget constraint. For a given credit scheme, households' residential location choices and housing market structure in terms of housing prices and space can be endogenously determined by the urban system equilibrium and the price per unit of credit is governed by the credit market equilibrium. A social welfare maximization model is presented to determine the total amount of credits issued. The results show that implementation of the tradable location tax credit scheme can rationalize the urban residential density and promote the efficiency of the urban system in terms of social welfare.

Too much of a good thing: Endogenous business cycles generated by bounded technological progress

Artificial intelligence (AI) and digital technologies are increasingly influencing family life, parenting practices, and pediatric health and mental health services. Applications include AI-enabled parenting support tools, mobile health interventions, digital therapeutics, remote monitoring systems, and algorithm-based platforms for neurodevelopmental and psychiatric assessment. While these technologies offer opportunities to enhance parental support, personalize care, and improve access to services, they also raise concerns related to ethics, equity, data privacy, and parent–child relationships. This narrative review offers an integrative overview of AI and digital technologies in family and parenting contexts, focusing on key domains such as AI-supported parenting interventions, digital health literacy, pediatric and perinatal care, neurodevelopmental and mental health assessment, digital media use, and family communication. Reported benefits, emerging risks, and unintended consequences are discussed with particular attention to parental roles, family-centered design, and implementation challenges. Overall, evidence suggests that AI-enabled tools are most effective when they are transparent, co-designed with parents and clinicians, and integrated into existing health and social care systems. Nonetheless, gaps remain regarding long-term outcomes, equitable access, ethical governance, and sustainable implementation. AI in digital parenting should therefore be viewed as a complementary resource that augments, rather than replaces, parental judgment and professional care.

Introduction: There is widespread interest in the long-term cardiovascular (CV) implications of professional football. Studies have suggested that retired National Football League (NFL) players have a high prevalence of hypertension, which may increase risk for left ventricular hypertrophy (LVH). However, it is unknown if football-specific factors, such as professional football career length (NFLYrs), are associated with long-term CV outcomes, including changes in left ventricle (LV) geometry. Thus, we examined the association of NFLYrs with LV geometry patterns in a retired NFL player cohort. Methods: We analyzed data on 1349 retired NFL players (aged 53.1 ± 12.8 years, 55.1% African-American) that underwent comprehensive health screening with the NFL Player Care Foundation. Echocardiography was used to estimate LV mass, which was then indexed to height 2.7 . Relative wall thickness was computed to classify LV geometry patterns into normal, concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH). Three binary logistic regression models (Model 1: CR; Model 2: EH; Model 3: CH), using normal geometry as reference, were fitted to assess the association of NFLYrs with each LV geometry pattern, adjusting for traditional cardiometabolic risk factors. Results: Increasing NFLYrs was independently associated with CR (odds ratio [OR]: 1.48, 95% confidence interval [CI] 1.03 – 2.11, p = 0.0334), while no associations were observed with EH (OR: 0.49, 95% CI 0.22 – 1.09, p = 0.0801) or CH (OR: 1.04, 95% CI 0.61 – 1.77, p 0.8927). Mean arterial pressure was independently associated with increased odds of CR (OR: 1.03, 95% CI 1.01 – 1.05, p – 0.0017), EH (OR: 1.06, 95% CI 1.02 – 1.09, p = 0.0013), and CH (OR: 1.06, 95% CI 1.04 -1.09, p < 0.0001). Conclusion: NFL career length is not associated with increased odds for EH and CH later in life. In contrast, increased NFLYrs is associated with CR, likely an adaptive response to intense athletic training. Cardiovascular risk factors such as high blood pressure in the retirement period appear to be more important for long-term LVH risk in NFL athletes, underscoring the need for preventive initiatives aimed at decreasing risk for future CV outcomes in athletes transitioning out of professional sports.

BackgroundInternational consensus definitions of Advance Care Planning (ACP) typically capture well the scope and purpose of ACP, and central characteristics of the ACP conversation. At an operational level, however, the...

The Gastroenterology Core Curriculum, Third Edition

Recent contributions on intertemporal decision-making and self-control have focused on the impact of cognitive constraints on the way people behave over time. In particular there is evidence on the fact that exerting cognitive effort on the job, adhering to some specific behavioral plan and self-regulating behavior is fatiguing so that, unless sufficient rest is allowed for, the performance on these tasks degrades over time. In this paper I propose an intertemporal decision-making model to determine the optimal path of effort that a worker should exert on a cognitively demanding task. In this environment the worker trades-off current performance with the endogenous accumulation of fatigue; consequently multitasking or exogenous cognitively demanding factors (like stress or noise) play a critical role, and they can induce the decision-maker to optimally take rest-breaks in order to save on the cognitive resources to be used in the future. In the model multiple equilibria and thresholds can emerge, with the consequence that the long-term outcome toward which the agent converges critically hinges on the initial condition of fatigue of the worker. When this is the case, it can be optimal to force the agent to take a rest break, or a holiday, in order to allow her to recover and to converge toward the desirable long-term outcome in which she is more productive and more rested. These results highlight the importance of cognitive constraints in the study of intertemporal behavior and they suggest an alternative explanation for the evidence of preferences for improving consumption profiles and the evidence of (apparent) time-inconsistent behavior. More generally, this paper shows that the assessment of how people evaluate intertemporal utility profiles, on which the economic literature has mainly focused, should be complemented by considering also cognitive constraints, since they may limit the set of feasible paths of behavior that people can implement over time much in a way as a budget constraint limits the set of feasible alternatives in a standard decisionmaking model.

University students have high rates of mental health problems; however, most delay or fail to seek help altogether. Tertiary settings can offer educational and social programmes to increase mental health awareness and in turn increase the number of students seeking help for their problems. This study aimed to explore students' and staffs' knowledge of mental health issues, confidence to intervene and application of skills following Mental Health First Aid (MHFA) training. Students and staff at an Australian university who had completed MHFA training in the previous 24 months were invited to complete a validated online questionnaire. Of the 566 eligible participants, 107 (19%) completed the questionnaire. The majority (65%) had applied their skills to someone in need, with the highest number applying it to students. Notably, of those who had applied their skills 23 participants (33%) had applied them in a crisis situation, the most common being panic attacks followed by suicidal thoughts. Although most (98%) applied their skills in a face-to-face capacity, 53% also reported assisting someone via electronic mediums and social media. The mean score for the literacy test was considered high, 12/16 (SD = 1.7) for students and 13/16 (SD = 2.5) for staff. The majority (94%) reported more confidence in providing support following training. This study demonstrated that MHFA training on a university campus is associated with a high level of knowledge, confidence to intervene and apply MHFA skills to assist a student or friend in need, potentially impacting their long-term health outcomes and future professional careers.

A common and important feature within models of career management is the career goal, yet relatively little is known about the factors influencing career goals and when and how career goal setting occurs. Drawing from Ashforth's (2001) model of role transitions we propose and test a model wherein mentoring experiences of early career professionals relate to short- and long-term career goals through professional identification. Using survey data collected at three points in time from 312 early career professionals, we find that psychosocial mentoring, but not career mentoring, positively relates to professional identification. For short-term goal outcomes, professional identification positively relates to extrinsic goals, intrinsic goals, and goals that are high quality (i.e., specific, difficult, to which one is committed). For long-term goal outcomes, professional identification positively relates to extrinsic and intrinsic goals, but not to goal quality. Instead, in the long-term goal model, psychosocial mentoring is directly related to goal quality. The theoretical and practical implications of this study for professional identification, career goals, and how mentors can facilitate career goals are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).