Lorella Lotto

Background: This prospective observational multicenter cohort study aimed to establish the functional outcomes and quality of life (QoL) of patients with rectal cancer who showed a major (mCR) or complete clinical response (cCR) after neoadjuvant therapy and underwent a rectum-sparing approach (watch and wait, WW, or local excision, LE). Materials and Methods: QoL and functional function were investigated using the EORTC QLQ-30, EORTC QLQ-CR29, the MSKCC bowel function instrument, and the FIQL index. Patients filled these questionnaires at the time of enrollment (T1), and 6 (T2) and 12 months (T3) thereafter. Variation over time for each group and comparisons between cCR patients who underwent WW or LE were performed. Results: Of 161 patients who were enrolled, 112 had a cCR (LE n = 50, WW n = 62) and 49 a mCR (all LE). LE patients showed changes after surgery, WW patients showed more gradual changes. LE patients showed reduced anxiety and depression and improved emotional functioning but also an increased fecal incontinence and reduced sexual function in men after surgery. WW patients showed a significant improvement over time in role functioning and anxiety, while their diarrhea and stool frequency progressively reduced. Among patients with a cCR, LE patients showed a significantly higher incontinence compared to WW patients. However, the two groups did not differ in terms of the impact of incontinence on QoL. Conclusion: Functional outcomes and QoL of patients who underwent WW or LE approach generally improve over time, but LE patients also showed some impact of surgery.

Perspective‐taking (PT) accessibility has been recognized as an important factor in affecting moral reasoning, also playing a non‐trivial role in moral investigation towards autonomous vehicles (AVs). A new proposal to deepen this effect leverages the principles of the veil of ignorance (VOI), as a moral reasoning device aimed to control self‐interested decisions by limiting the access to specific perspectives and to potentially biased information. Throughout two studies, we deepen the role of VOI reasoning in the moral perception of AVs, disclosing personal and contingent information progressively throughout the experiment. With the use of the moral trilemma paradigm, two different VOI conditions were operationalized, inspired by the Original Position theory by John Rawls and the Equiprobability Model by John Harsanyi. Evidence suggests a significant role of VOI reasoning in affecting moral reasoning, which seems not independent from the order in which information is revealed. Coherently, a detrimental effect of self‐involvement on utilitarian behaviours was detected. These results highlight the importance of considering PT accessibility and self‐involvement when investigating moral attitudes towards AVs, since it can help the intelligibility of general concerns and hesitations towards this new technology.

The present study examined the role of the perception of risks and benefits for the mother and her babies in deciding about the COVID-19 vaccination. In this cross-sectional study, five hypotheses were tested using data from a convenience sample of Italian pregnant and/or breastfeeding women (N = 1104, July–September 2021). A logistic regression model estimated the influence of the predictors on the reported behavior, and a beta regression model was used to evaluate which factors influenced the willingness to become vaccinated among unvaccinated women. The COVID-19 vaccination overall risks/benefits tradeoff was highly predictive of both behavior and intention. Ceteris paribus, an increase in the perception of risks for the baby weighed more against vaccination than a similar increase in the perception of risks for the mother. Additionally, pregnant women resulted in being less likely (or willing) to be vaccinated in their status than breastfeeding women, but they were equally accepting of vaccination if they were not pregnant. COVID-19 risk perception predicted intention to become vaccinated, but not behavior. In conclusion, the overall risks/benefits tradeoff is key in predicting vaccination behavior and intention, but the concerns for the baby weigh more than those for the mother in the decision, shedding light on this previously neglected aspect.

In the investigation of moral judgments of autonomous vehicles (AVs), the paradigm of the sacrificial dilemma is a widespread and flexible experimental tool. In this context, the sacrifice of the AV’s passenger typically occurs upon enactment of the utilitarian option, which differs from traditional sacrificial dilemmas, in which the moral agent’s life is often jeopardized in the non-utilitarian counterpart. The present within-subject study (n = 183) is aimed at deepening the role of self-sacrifice framing, comparing autonomous- and human-driving text-based moral dilemmas in terms of moral judgment and intensity of four moral emotions (shame, guilt, anger, and disgust). A higher endorsement of utilitarian behavior was observed in human-driving dilemmas and for self-protective utilitarian behaviors. Interestingly, the utilitarian option was considered less moral, shameful, and blameworthy in the case of concurrent self-sacrifice. The present study collects novel information on how different levels of driving automation shape moral judgment and emotions, also providing new evidence on the role of self-sacrifice framing in moral dilemmas.

The growing interest in the subject of moral judgment in driver and autonomous vehicle behavior highlights the importance of investigating the suitability of sacrificial dilemmas as experimental tools in the context of traffic psychology. To this aim a set of validated sacrificial trolley problems and a new set of trolley-like driving dilemmas were compared through an online survey experiment, providing normative values for rates of participants’ choices; decision times; evaluation of emotional valence and arousal experienced during the decision process; and ratings of the moral acceptability. Results showed that while both sets of dilemmas led to a more frequent selection of utilitarian outcomes, the driving-type dilemmas seemed to enhance faster decisions mainly based on the utilitarian moral code. No further differences were observed between the two sets, confirming the reliability of the moral dilemma tool in the investigation of moral driving behaviors. We suggest that as moral judgments and behaviors become more lifelike, the individual’s moral inclination emerge more automatically and effectively. This new driving-type dilemma set may help researchers who work in traffic psychology and moral decision-making to approach the complex task of developing realistic moral scenarios more easily in the context of autonomous and nonautonomous transportation.