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In this issue, Theory & Psychology is trialing a new format for engaging readers and contributors to the journal. In particular, we designated a target article for which we solicited open peer commentaries. Open peer commentaries should reflect engagement from diverse perspectives with the key themes and arguments of the target paper. Future calls for open peer commentaries will focus on different topics. Authors interested in writing commentaries should ensure that they are familiar with the research literature on the topic before submitting proposals. [ABSTRACT FROM AUTHOR]

The author discusses the impact of the changes in humam lifestyle to human microbiome. Topics discussed by the author include the influence of the overexploitation of human to a public resource to the composition of human microbiome, the changes in disease incidence in urbanized Western countries, and the opportunities provided by supporting microbiome conservation and stewardship.

Rationale Asthma is a common respiratory condition with high prevalence rates globally. While there are effective treatments, asthma remains an important health concern as people continue to die from severe attacks. Improving the experiences of, and health outcomes for, people with asthma depends heavily on their interactions with healthcare professionals. Understanding negative clinical encounters will benefit people with asthma and healthcare providers. Objective To examine epistemic tensions in negative clinical encounters from a patient perspective, with an aim to better understand how patients respond to these tensions. Much of the scholarship on patient interactions with healthcare providers examines interpersonal or structural factors. Thus, focusing our analysis on tensions between lay and expert knowledge in negative clinical encounters provides a novel contribution to this body of scholarship. Method As part of a larger qualitative study ( n  = 70) examining the lived experiences of people who have asthma or a child with asthma, semi-structured interviews with 17 participants who described having negative clinical encounters were analyzed for themes. Results Participants responded to epistemic tensions in two main ways: (1) by incorporating expert knowledge; and (2) by resisting/challenging expert knowledge. In both cases, participants also described feeling frustrated and uncertain about their or their child's clinical care. We analyze these responses by drawing on Lindström and Karlsson's (2016) conceptualization of epistemic tensions as arising from 3 characteristics of epistemic asymmetry: access, rights, and responsibility. Conclusion Based on this study, (1) a patient's confidence in claiming epistemic access and asserting epistemic rights when epistemic tensions arise are related to the context and their own history of living with asthma; and (2), epistemic tensions can make visible the power relations in the patient-clinician relationship, which can lead to the exertion of biomedical authority, or the taking up of patient's lay knowledge. [ABSTRACT FROM AUTHOR]

Background: The vaginal microbiome influences quality of life and health. The composition of vaginal microbiota can be affected by various health behaviors, such as vaginal douching. The purpose of this study was to examine the types and prevalence of diverse vaginal/genital health and hygiene behaviors among participants living in Canada and to examine associations between behavioral practices and adverse gynecological health conditions.Method: An anonymous online survey, available in English and French, was distributed across Canada. The sample consisted of 1435 respondents, 18 years or older, living in Canada.Results: Respondents reported engaging in diverse vaginal/genital health and hygiene behavioral practices, including the use of commercially manufactured products and homemade and naturopathic products and practices. Over 95% of respondents reported using at least one product in or around the vaginal area. Common products and practices included vaginal/genital moisturizers, anti-itch creams, feminine wipes, washes, suppositories, sprays, powders, and waxing and shaving pubic hair. The majority of the sample (80%) reported experiencing one or more adverse vaginal/genital symptom in their lifetime. Participants who had used any vaginal/genital product(s) had approximately three times higher odds of reporting an adverse health condition. Several notable associations between specific vaginal/genital health and hygiene products and adverse health conditions were identified.Conclusions: This study is the first of its kind to identify the range and prevalence of vaginal/genital health and hygiene behaviors in Canada. Despite a lack of credible information about the impact of these behaviors on women's health, the use of commercially manufactured and homemade products for vaginal/genital health and hygiene is common. Future research can extend the current exploratory study by identifying causal relationships between vaginal/genital health and hygiene behaviors and changes to the vaginal microbiome. [ABSTRACT FROM AUTHOR]

We explore Canadian women’s use of vaginal hygiene products including feminine washes, douches, sprays, deodorants, wipes, and powders. Vaginal hygiene products in North America are part of a two billion dollar industry, which focuses on cleanliness and freshness in their advertising toward women. In interviewing women who were currently using or had previously used vaginal hygiene products, we found that vaginal cleanliness and freshness were also frequently brought up as reasons for using these products. Using an inductive thematic analysis informed by Braun and Clarke (2013) we explore how attaining a clean-and-fresh vagina has become a subjective physical need for the participants in our study. In a society where female genitalia are constructed as unclean, we argue the marketing of vaginal hygiene products contributes to the problematization of women’s genitalia by suggesting women need to use these products to attain an ideal (i.e., clean and fresh) vagina. The reliance on vaginal hygiene products reported by participants in attaining sensations of vaginal cleanliness and freshness raises concerns in the context of medical literature suggesting adverse health risks that may result from using some of these products. Potential risks include bacterial vaginosis, pelvic inflammatory disease, and a higher susceptibility to sexually transmitted infections, among others. We believe that companies that advertise these products as beneficial for vaginal health and hygiene can be perceived as not just misinforming women but also profiting from products that are harmful. [ABSTRACT FROM AUTHOR]

Researchers' interest in the use of sex toys has increased in the past 10 years as products become more accepted in mainstream media, and incorporated into individuals' sexual scripts. Though researchers and health educators have emphasized the importance of sex toy use hygiene behaviours, few studies have addressed the extent to which individuals are sharing, cleaning and covering their sex toys. The current research examined 1) the prevalence, frequency, predictors, and types of sex toys use/used, 2) the prevalence/frequency of sex toy use hygiene behaviours (e.g., cleaning, sharing, covering) and 3) whether sex toy use hygiene behaviours were related to vulvovaginal health outcomes among a sample of Canadian participants. As part of a larger survey examining genital health and hygiene practices, 1435 participants across Canada completed an anonymous online survey. Prevalence of sex toy use was 52.3%. Sex toys users were more likely to report a bisexual, lesbian, queer or questioning identity and were more likely to report engaging in additional partnered sexual activities such as oral and anal sex. Participants used a wide variety of sex toys including vibrators, butt plugs, BDSM toys, and household items. Most participants indicated that they cleaned their sex toys regularly using soap and water and 21.7% reported sharing their sex toy(s) with a partner. Sex toy use is common among Canadian women and individuals report using a variety of sexual enhancement products. Implications for educators and medical practitioners working with sexually active clients are also discussed. [ABSTRACT FROM AUTHOR]

Research participants often report wanting to help as a reason for participation, but who they want to help and why is rarely explored. We examined meanings associated with helping among 21 adults with cystic fibrosis (CF)—a group with high participation in research. Meanings included helping to advance research, helping others with CF, helping as their job, helping themselves, helping because they are special, and helping to give back. While some meanings were primarily oriented toward helping others, some also involved hoping for benefits for oneself, and some included feelings of responsibility. Despite indicating that they understood that research is not designed to help them directly, participants nevertheless hoped that it might. We discuss implications for research ethics oversight. [ABSTRACT FROM AUTHOR]

Rationale Traditional perspectives on informed consent assume that when faced with decisions about whether to participate in research, individuals behave according to principles of classical rationality, taking into account all available information to weigh risks and benefits to come to a decision that is optimal for them. However, theoretical and empirical research in psychology suggests that people may not make decisions in this way. Less is known about decision-making processes as they pertain to participating in biomedical research, particularly when the participants are children. Objective We sought to better understand research decision processes especially in children who tend to participate extensively in research due to chronic illness. Methods To learn more about children’s decision-making in this context, we interviewed 19 young patients with cystic fibrosis (male n = 7; female n = 12) aged 8–18 years ( M = 13 years) at a children’s hospital in Canada between April and August 2013. Results We found that participants generally had a default approach to participation decisions, which they attributed to their parents’ attitudes to research, experiences of having grown up participating in research, trusting the researchers, and wanting to help. Most of our participants made the decision to participate in research based on a heuristic with a baseline to say “yes”, subject to change based on aspects of the research or particular preferences. In particular, concerns with the procedure, unwillingness to talk about cystic fibrosis, logistical challenges, and perceptions of risk all influenced the decision, as did the perceived importance or personal relevance of the research. Conclusion Our study illustrates that rather than conducting risk/benefit analyses, participants tended to adopt a heuristic-like approach, consistent with decision theories that view heuristic decision-making as ecologically rational. [ABSTRACT FROM AUTHOR]

Rationale Living with a chronic illness poses many challenges, especially during the adolescent stage of development. Few studies have explored young people’s experiences of talking about their illness and how they go about deciding if and when they should tell others about their condition. Objective Our study sought the perspectives of Canadian children and adolescents living with inflammatory bowel disease (IBD) to determine how they go about deciding if and when to tell others about their illness. Methods Twenty-five participants with IBD, ranging in age from 10 to 17 years old, were interviewed about their experiences. Results Our participants highlighted that they generally preferred to conceal their illness. However, when they did disclose, they drew on a diverse range of contextual factors such as their knowledge of the illness as well as the severity of their illness, to make the decision. They also highlighted that one of the main challenges they experience is dealing with negative reactions to the news of their illness. This paper presents a decision-making model describing how children decide whether to disclose or conceal their IBD. Conclusion Our study illustrates that for children and adolescents, managing others’ knowledge about their illness has important implications for illness identity management. We argue that knowledge of how children with IBD make disclosure decisions is an important part of understanding the social experience of having IBD, and in creating environments that allow them to adapt to life with IBD. Our study clearly highlights the need for specific programs to be implemented to normalize IBD and to create supportive environments for children and adolescents diagnosed with IBD. [ABSTRACT FROM AUTHOR]

This article identifies and examines a tension in mental health researchers' growing enthusiasm for the use of computational tools powered by advances in artificial intelligence and machine learning (AI/ML). Although there is increasing recognition of the value of participatory methods in science generally and in mental health research specifically, many AI/ML approaches, fueled by an ever-growing number of sensors collecting multimodal data, risk further distancing participants from research processes and rendering them as mere vectors or collections of data points. The imperatives of the "participatory turn" in mental health research may be at odds with the (often unquestioned) assumptions and data collection methods of AI/ML approaches. This article aims to show why this is a problem and how it might be addressed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Governments are increasingly interested in measuring quality of life (QoL) among older adults to inform policy. We demonstrate the advantages of situating an investigation of QoL in local contexts through a thematic analysis of focus group data collected in Chatham-Kent, Ontario, Canada. Local and broader factors relating to QoL among older adults were explored. We examine three themes: Natural Environment considers how participants derive aspects of their sense of QoL from the unique natural environment in Chatham-Kent; Amalgamation's Influence on Identity explores how participants' sense of belongingness and place-based identity were shaped by the amalgamation of townships and communities that now constitute Chatham-Kent; and Ease of Travel and Independence examines how older adults' conceptions of QoL are closely connected to their ease of travel, which they connect with a sense of independence. Our findings provide further support for the importance of engaging directly with older adults to understand their perspectives of QoL in a local context, particularly when seeking to inform policy changes.

Faecal microbiota transplantation is an effective therapy for recurrent Clostridioides difficile infection, with potential therapeutic applications in other health conditions. As research uncovers potential associations between the intestinal microbiome and various disease states, stool donor screening has become increasingly stringent, leading to low donor acceptance. Many stool banks have opted to recruit universal stool donors, who are encouraged to donate frequently over a prolonged period and whose stool is used to treat multiple patients. However, various ethical concerns arise when recruiting universal stool donors, which need to be addressed to mitigate harm to donors. In this Personal View, we describe the major ethical issues with universal stool banks across six domains: informed consent, privacy, the imposing of restrictions on autonomy, stewardship of microbiome information, financial incentives, and preventing a sense of obligation. We also suggest several priorities for future research that should be pursued to address these crucial issues and develop more donor-centric stool banks., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Biobanking of human tissues is associated with a range of ethical, legal, and social (ELS) challenges. These include difficulties in operationalising informed consent protocols, protecting donors' privacy, managing the return of incidental findings, conceptualising ownership of tissues, and benefit sharing. Though largely unresolved, these challenges are well documented and debated in academic literature. One common response to the ELS challenges of biobanks is a call for strong and independent governance of biobanks. Theorists who argue along these lines suggest that since fully informed consent to a single research project is often not feasible, research participants should be given the additional protection of being allowed to consent to the governance framework of the biobank. Such governance therefore needs to be transparent and ethically sustainable. In this paper we review the governance challenges of establishing and maintaining human tissue biobanks. We then discuss how the creation of a biobank for eggs and embryos, in particular, may introduce additional or unique challenges beyond those presented by the biobanking of other human tissues. Following previous work on biobank governance, we argue that ethically sustainable governance needs to be participatory, adaptive, and trustworthy.

Recently, public concerns have been expressed regarding the non-consented storage and secondary research uses of residual newborn bloodspot (RBS) samples. The purpose of this paper is to examine public responses to the storage and secondary uses of RBS that can be identified through analysis of media, legal cases, and documented public engagement activities. Coverage in the examined print media confirmed the importance of RBS to journalists and those people who expressed their concerns to these journalists. Several lawsuits, brought by parents concerned about the storage of newborn bloodspots, placed the practice of storing NBS into the spotlight. This resulted in controversial debates and the mandatory destruction of millions of samples. Analysis of public engagement activities across several jurisdictions indicated that across (inter)national boundaries there are common elements to what is perceived as inappropriate governance of RBS. Public concerns were grouped into five main themes: trust, transparency, confidentiality, ownership, and stigmatization/discrimination. The results of our analysis help to make a compelling case for placing citizens at the center of the debate and developing policy about the storage and secondary uses of newborn bloodspots.

This paper reports on the design, implementation, and results of a structured public deliberation on human tissue biobanking conducted in Vancouver, Canada, in 2009. This study builds on previous work on the use of deliberative democratic principles and methods to engage publics on the social and ethical implications of human tissue biobanking. In a significant refinement of methods, we focus on providing public input to institutional practice and governance of biobanks using a tailored workbook structure to guide participants' discussion. Our focus is on the local context and practices of a particular institution, the BC BioLibrary. However, elements of both the methodological innovations and the ethical guidance implied by our findings are generalisable for biobanking internationally. Recommendations from the deliberative forum include issues of informed consent, privacy protections, collection of biospecimens, governance of biobanks, and how to manage the process of introduction between biobanks and potential donors. Notable findings include public support for research use of anonymised un-consented tissue samples when these come from archived collections, but lack of support when they are collected prospectively., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Biobanks are increasingly hailed as powerful tools to advance health research. The social and ethical challenges associated with the implementation and operation of biobanks are equally well-documented. One of the proposed solutions to these challenges involves trading off a reduction in the specificity of informed consent protocols with an increased emphasis on governance. However, little work has gone into formulating what such governance might look like. In this paper, we suggest four general principles that should inform biobank governance and illustrate the enactment of these principles in a proposed governance model for a particular population-scale biobank, the British Columbia (BC) Generations Project. We begin by outlining four principles that we see as necessary for informing sustainable and effective governance of biobanks: (1) recognition of research participants and publics as a collective body, (2) trustworthiness, (3) adaptive management, and (4) fit between the nature of a particular biobank and the specific structural elements of governance adopted. Using the BC Generations Project as a case study, we then offer as a working model for further discussion the outlines of a proposed governance structure enacting these principles. Ultimately, our goal is to design an adaptive governance approach that can protect participant interests as well as promote effective translational health sciences., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

We begin with the premise that human tissue biobanking is associated with ethical ambiguities and regulatory uncertainty, and that public engagement is at least one important element in addressing such challenges. One is then confronted with how to achieve public engagement that is both meaningful and effective. In particular, how can public engagement on the topic of biobanking be implemented so that (a) it is perceived broadly as legitimate and (b) the results of the engagement are relevant and useful to the institutional and regulatory context? In this paper we build on previous work that has addressed the former point and focus primarily on the latter. We argue that one way to increase the likelihood of results of public engagement being taken up in policy is through framing the issues that are deliberated by members of the public based in part on the practical policy questions for which input is sought. In this approach, we move discussion on the social and ethical implications of biobanking from abstract principles, to their consideration in the context of local biobanking practices. This is illustrated using a practical example involving a public engagement conducted to inform institutional policy for biobanking in British Columbia, Canada., (Copyright 2010 S. Karger AG, Basel.)