Societal Circumstances Research Articles

FP5.8 - Bridging the Trust Divide: How Medical AI Outperforms yet Battles to Win Public Confidence - A Study Conducted Among 74 UK Residents

Abstract Background AI is being incorporated into healthcare by major tech companies, but public acceptance remains challenging. The study aims to understand resistance to AI despite its increasing accuracy and potential to improve patient waiting times. Method In partnership with the University of Hull and the Academic Health Science Network (AHSN) in the UK, a study was conducted that involved 111 adult patients or carers. 9 did not respond while 28 demonstrated poor digital literacy and therefore excluded. An interactive user page was designed for the remaining users (n=74) to engage with medical chatbot. The participants were asked whether participants would use an AI-powered medical chatbot or nurse for triage at their nearest A&E. Unstructured open-ended interviews were conducted to understand the participants' reasoning behind their answers. Finding Participants ranged in age from 21 to 74, with a slight female majority (40 female vs 34 male). The majority, 79.8% (n=59) respondents, expressed their comfort with a nurse-led care while a mere 20.2% (n=15) showed readiness to interact with a medical chatbot. Notably, the age group of 20-40 was most open to the idea of consulting a chatbot. The four primary objections were: 90.5% (n = 67) believed that the chatbot fails to justify its decisions, 59.5% (n = 44) doubt its accuracy, 78.4% (n = 58) felt that the chatbot was inflexible, and 79.7% (n = 59) found it unemotional and detached. Conclusion Effective treatment relies on trust, respect and understanding, crucial elements needed when incorporating AI in medicine. It should be introduced progressively, considering patients' emotions and societal circumstances.

Ethnic identity centrality across the adult lifespan: Aging, cohort, and period effects among majority and minority group members.

Ethnic identity is a major area of study across many disciplines including psychology, sociology, anthropology, and political science. Yet, little is known about changes in ethnic identity across the adult lifespan, and whether such changes are driven by normal aging processes (aging effects), unique societal influences linked with one's formative years (cohort effects), or social changes during a specific time frame (period effects). We address these key oversights by utilizing 13 annual waves of longitudinal panel data from a nationwide random sample of both ethnic majority (N = 49,660) and Indigenous ethnic minority (N = 8,325) group members in New Zealand to examine changes in ethnic identity centrality using cohort-sequential latent growth modeling. This approach helps to identify changes in mean levels of ethnic identity centrality over time and whether such changes are driven by aging, cohort, and/or period effects. Our data reveal that, among both ethnic majority and ethnic minority individuals, changes in ethnic identity centrality were informed by a combination of normative aging processes, societal circumstances that reflected the unique historical context in which people grew to maturity, and societal changes during the 13 annual assessments of our study. Collectively, these results demonstrate for the first time that ethnic identity centrality in adulthood is subject to lifelong changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aspirations versus adaptive achievements in the face of climate change in Sri Lanka

This research explores the linkages between threat perception and adaptive behaviour in the face of climate change in Galle, Sri Lanka. We use an analytical framework to analyse the complexity of aspiration versus adaptive practices, centring around the synthesis of threat perception, vulnerability, adaptive capacity and livelihood resilience. Our findings reveal that individual threat perception incentivises climate adaptation strategies, bolstering livelihood resilience. However, unfavourable societal circumstances affecting the participants significantly impede the implementation of these resilience strategies. In addition to a knowledge gap and lack of climate change awareness in popular discourse, we observe a conspicuous discrepancy between individual aspirations and adaptive capacity with the ongoing economic crisis and the need for governmental climate legislation at the time of research. This research, therefore, emphasises a nuanced approach to researching climate change adaptation, considering the gravity of societal circumstances that delimit how individuals can engage in livelihood resilience strategies.

Intergenerational transmission of health inequalities: towards a life course approach to socioeconomic inequalities in health – a review

Adult health inequalities are a persistent public health problem. Explanations are usually sought in behaviours and environments in adulthood, despite evidence on the importance of early life conditions for life...

Testing Sexual Strategy Theory in Norway.

Choosing a romantic partner for a long-term relationship is one of the most significant decisions one makes during our lifetime. We have inherited an evolved framework from our ancestors that contains traits, as well as preferences for these traits, to solve this task. We use this framework consciously or unconsciously to choose prospective romantic partners. Following this reasoning, sexual strategy theory (SST) has been proposed for predicting which traits women and men prefer in a romantic partner for a long-term relationship. These predictions were empirically tested in the current work based on a sample of 1193 Norwegian adolescents who responded to an online questionnaire. We implemented the study hypotheses, derived from SST, in three statistical models, which were tested using structural equation modeling. In brief, our results revealed that women only valued resources more than men when we controlled for materialistic traits. This finding contrasts with SST's prediction that women would value resources more than men, independently of other variables. As for the second prediction that men value physical attractiveness more than women, this pattern existed universally and was independent of, for instance, how egalitarian they were. We thus conclude that SST was only partially supported and that variables that may reflect societal circumstances (e.g., wealth, gender, equality) should be considered when examining the mate choice behavior of women and men. The theoretical and practical implications of the study are also discussed.

Psychiatric impact of the novel coronavirus disease 2019 on previously mentally healthy survivors

BackgroundThe prolonged psychiatric disorders rate following coronavirus disease 2019 (COVID-19) could surpass that of severe acute respiratory syndrome (SARS) as well as Middle East Respiratory Syndrome (MERS) as a result of variations in viral disease treatment as well as societal circumstances throughout the outbreaks. This work aimed to investigate the COVID-19 prolonged psychiatric effects on survivors without psychiatric diseases before infection.MethodsThis cross-sectional research was conducted on 1254 patients of which 700 patients (55.8%) were positive for psychiatric complications based on the general health (GHQ-28) questionnaire and 554 patients (44.1%) were negative, aged above 18 years old who had been infected with COVID19 (PCR swab confirmed) and recovered since less than 6 months without previous history of any psychiatric disease.ResultsSmoking, medical comorbidities, hospitalization, and cortisone in treatment were significantly higher in GHQ-28 positive than GHQ-28 negative (p < 0.05). Psychiatric disorders and Beck’s Depression Inventory (BDI) grades showed a significant association between smoking and hospitalization and Taylor Manifest Anxiety scales and smoking, hospitalization, and treatment with cortisone). Smoking, medical comorbidities, hospitalization, and cortisone in treatment were the most significant predictors of positive GHQ-28. However, multivariate analysis demonstrated that medical comorbidities, hospitalization, and cortisone in treatment were the best independent predictors of GHQ-28 positive (p = 7.055, p = 0.007, p = 0.043, p = 0.047, respectively).ConclusionsCOVID-19 cases without pre-existing psychological disorders exhibited a significant increase in psychiatric disorders occurrence 6 months following recovery. Anxiety disorders represented the predominant mental diagnoses documented.

A network of designs: studying Early Lapita exchange networks in the Bismarck Archipelago, Papua New Guinea through Social Network Analysis

ABSTRACTThe application of Social Network Analysis to the study of archaeological networks has become increasingly common around the world, with a proven track record of processing large, complex, spatial and temporal archaeological datasets. This study builds upon previous network‐based analyses of interaction between communities of the Lapita Cultural Complex, with a specific focus on the Early Period (c.3300/3200–3100 calBP) in the Bismarck Archipelago, Papua New Guinea. Employing motif inventories from 13 Early Lapita Period assemblages, motif similarity and Centrality Analysis are undertaken, with the results compared to data from portable material culture, particularly obsidian and pottery, to further define the networks of interaction that linked communities during this period. We conclude that motif similarities and Centrality Analysis scores show good agreement with patterns of interactions established from the analysis of other types of portable material culture, which together support the existence of northern west to east and southern obsidian distribution networks, comprised of communities that employed unique types of interaction tailored towards their own cultural and societal circumstances and needs. Finally, we further conclude that these two networks may have arisen during the initial formation of the Lapita Cultural Complex, as populations established new social connections with other settler communities and incumbent populations across the region to survive in a new and foreign environment.

An Islamic Crowdfunding Model for the Agricultural Sector: A Proposal Based on Salam and Muzāraʿah-Waqf Scheme

Purpose — This study aims to discuss several examples of temporary Islamic endowments (waqfs) in the modern period, arguing that jurists and Muslim endowment managers should utilise them more widely to adjust to current societal circumstances and open the door for new ways of caring for those in need. Design/Methodology/Approach — It employed textual analysis of legal opinions related to temporary waqfs, outlining the positions of scholars on both sides of the issue, including a presentation and analysis of their evidence. Findings — The research findings show that temporary waqfs are an essential means of renewable and sustainable economic support, where wealthy people endow their money for religious gain and to help others in need. Originality/Value — Unlike some previous studies, this article specifically examines modern and contemporary forms of temporary endowments and demonstrates some of their effects in supporting the economy and the needy in society. Practical Implications — Following this paper’s recommendations, those with funds and everyone who can create an endowment should support endowment institutions in modern ways and in different areas of temporary endowments, which would be very beneficial in eliminating poverty and supporting the economy. Research Limitations/Implications — Due to the limited scope of the study, its findings are limited to contemporary jurisprudential issues related to temporary endowments. Hence, it is related to the Islamic economy and steps for strengthening it in Muslim societies.

Effects of Social Acknowledgment and Interpersonal Shame on Complex Posttraumatic Stress Disorder Symptoms of Sexual Violence Survivors in South Korea.

Sexual violence (SV) survivors face negative social reactions, which can affect their recovery. Based on the socio-interpersonal model of trauma, understanding how societal circumstances impact SV survivors' mental health is important. This study examined conditional indirect effects of interpersonal shame and social acknowledgment on the relationship between perceived SV event severity and complex post-traumatic stress disorder (CPTSD) symptoms. Cross-sectional data from 157 community-based adults who had previously experienced SV were collected from an online panel. Exploratory factor analysis of the Social Acknowledgment Questionnaire was conducted, followed by conditional indirect analyses using Models 1, 4, and 7 of PROCESS macro. First, results showed that a two-factor model of social acknowledgment consisting of "social disapproval" and "social recognition" was more suitable for this study than a three-factor model predominantly used by Western societies. Second, interpersonal shame partially mediated the relationship between perceived SV event severity and CPTSD symptoms. Third, the conditional indirect effect of social disapproval on the mediating effect of interpersonal shame was significant when the social disapproval level was high. This indicates that the indirect effect of interpersonal shame on CPTSD increases when the social disapproval level is high. This study supported the socio-interpersonal perspective of trauma and suggested that increasing social acknowledgment beyond personal-level intervention would be a critical step for recovery of SV survivors to decrease their interpersonal shame and CPTSD.

Effect of COVID-19 Pandemic Lockdowns on Body Mass Index of Primary School Children from Different Socioeconomic Backgrounds

BackgroundChildhood obesity is associated with various health outcomes. Restrictive measures to contain the spread of the Coronavirus Disease 2019 (COVID-19) pandemic, like lockdowns and school closures, affected children’s daily structure, physical activity, dietary habits, and sleep quality, possibly exacerbating risk factors for childhood obesity and higher body mass index (BMI) in children. Poor socioeconomic conditions may have led to relatively higher risk for elevated BMI levels following pandemic measures. In this study, the impact of measures related to the COVID-19 pandemic on the BMI of third graders was investigated regarding children’s socioeconomic background (SEB).MethodsData from 41,728 children (8.84 ± 0.56 years, 20,431 female) were collected in the context of a cohort study. Children were tested either before the pandemic (preCOVID: Sept2017–March2020, n = 26,314), or following the first (postLDI: Aug2020–Dec2020, n = 6657) or second lockdown in Germany (postLDII: Aug2021–Jan2022, n = 8757). SEB was based on the official school type classification of the state of Berlin. Outcome was BMI standard deviation scores (SDS).ResultsSignificant effects of Time and SEB revealed elevated BMIs in postLDI (M = 0.23, p = 0.011) and postLDII (M = 0.22, p = 0.011) compared to preCOVID (M = 0.17) cohorts and higher BMIs for children with lower SEB (b = − 0.13, p < 0.001). A significant Time × SEB interaction indicated that the effect of SEB on children’s BMI increased in response to lockdowns, especially in postLDII (b = − 0.05, p = 0.006). Results suggest that the COVID-19-related measures lead to increased BMI in children, and that children of lower SEB were at particular risk for higher BMIs following lockdowns.ConclusionsThese findings highlight the dependency of children’s BMI on societal circumstances. Over the course of two lockdowns in Germany, children have experienced BMI increments, particularly in low socioeconomic areas. Authorities are called into action to counteract increasing rates of childhood weight by promoting physical activity of children and establishing related post-pandemic offers.

Review of the determinants contributing to the demographics of Alzheimer’s syndrome: Prevention techniques, risk factors, and insights for public health

Alzheimer's disease (AD) is the leading cause of memory loss, accounting for 80% of cases and severely impacting daily life and social interactions. The prevalence of AD is expected to grow over the globe as life expectancy improves and the population ages in developing countries will result in a costly disease burden. A combination of societal circumstances and inherent sensitivity that extends throughout a person’s lifetime can cause AD, a challenging and varied disorder. This study aims to provide a comprehensive analysis of the factors that shape the demographics of AD, with a focus on prevention measures. risk factors and their public health consequences. Interventions aimed at addressing multiple risk indicators in non-demented older adults, including those in their middle age, can be able to prevent or postpone the development of AD since the illness is thought to begin generations before clinical evidence appears. Addressing the intricate connection between social and psychological characteristics and Alzheimer’s demography is critical for devising effective preventative measures, early treatments and individualized care for at-risk communities. AD is known to be associated with genetic variables, particularly the APOE ε4 allele. Identifying the disease’s genetic causes is essential for specific preventive and early intervention methods. A balanced diet, frequent physical exercise, cognitive stimulation and social involvement are the preventative treatments for AD. Early identification and intervention hold promise for reducing disease development and public health measures that promote knowledge as well as healthy lives are essential.

Scale-up Integrated Care for Chronic Diseases in Belgium: a process evaluation of policy dialogues and roadmap interventions

Background. The goal of more integrated care has been on the Belgium health care policy agenda since 2007 with the start of disease specific care trajectories, reports on chronic care and pilot projects at local level. While there is consensus on what needs to be done, the process of how it should be done is much more uncertain. Scale-up of integrated care is complex, because it requires multi-stakeholder action and intersectoral coordination at individual healthcare practice, organizational, and political/system levels, and tailoring to the context in which it is delivered. There is little research on how to scale-up such complex and adaptive interventions.&#x0D; The SCUBY project aimed to contribute to scale-up of integrated care through development of evidence-based roadmaps and policy dialogues. This evaluation study examines the SCUBY scale-up intervention, by looking at its implementation outcomes, mechanisms of impact and the interaction with the political, policy and societal circumstances in the Belgium context.&#x0D; Methods. The ‘process evaluation for complex interventions’ by the MRC was the evaluation framework. Policy dialogues were defined as the SCUBY-team engagements with key stakeholders to develop and implement roadmaps. They comprised structured formal events, one-to-one interactions with key stakeholders, workshops, consultations, and joining ongoing dialogues of stakeholder networks. The roadmap was a scale-up strategy and included activities, a timeline and a description of the evidence base and key partners/stakeholders involved (change team). Data collection tools included policy dialogue reporting forms and surveys, key informant interviews, policy document review and a project diary. Descriptive and thematic analyses are conducted, together with a policy mapping. &#x0D; Results. The SCUBY team conducted 79 meetings classified as policy dialogues, most of them being small group meetings or network meetings organized by partners. SCUBY organized 6 major policy dialogues and invited a mix of beneficiaries, health system administration representatives, policy makers (from federal and regional level), health care providers and their representative organizations, people involved in organization and coordination of care, care users, and scientific stakeholders. Three themes emerged as being the most important areas for the roadmap: A) primary care practice organization (change management and advocating for primary care nurses); B) data and monitoring (chronic care indicators at primary care practice level and for population health management in Primary Care Zones); and C) healthcare financing (budget for chronic care that stimulates quality and new provider payment models). The roadmap comprised subthemes, with internal objectives (to be reached with our project resources) and external objectives (beyond out sphere of control) and activities. &#x0D; Discussion. Our findings emphasize the importance of adopting a collaborative, networking approach via the organization of various small-size and bigger-size policy dialogues, in order to create real-world impact, by building synergies and coalitions and our researcher team generating boundary spanning skills, as more proximal outcomes. The variation in progress made per roadmap theme was anticipated because of our level of involvement, expertise and resources available. The change team had to find the right balance in the trade-off between relevance and feasibility of certain scale-up strategies.

THE AGING NETWORK AS A CATALYST FOR COMMUNITY GERONTOLOGY AND APPLIED RESEARCH

Abstract The Older Americans Act (OAA) established Area Agencies on Aging (AAAs) fifty years ago as local community-based organizations responsible for planning, coordinating, funding, and delivering nutrition and other supportive services which allow older adults to remain living in their homes and communities. Local control and decision-making, mandated by the OAA, has allowed AAAs to adapt to the evolving needs and demands of their communities The centrality of their role was never more apparent than during the COVID-19 pandemic. As national and societal circumstances have resulted in increased social isolation, housing insecurity, and public health concerns for older adults, AAAs have adapted and expanded beyond traditional OAA services to address the social and health needs of an increasingly diverse older adult population. The Community Gerontology framework provides a useful structure to understand the evolution and impact of AAAs and the broader Aging Network on the health of older adults. Using data from the 2022 National Survey of AAAs and a new qualitative study on Community Care Hubs, academic and Aging Network-based researchers will illustrate the many partnerships and pathways of mutual influence between AAAs and the micro and macro levels to describe how Aging Network services are expanding provision of services for health care partners, public health initiatives, and new housing and homelessness services and partnerships to address emerging needs. The symposium will conclude with an illustration of how applied researchers and Aging Network organizations partnered on research-informed practice to innovate and strengthen services for at-risk older adults.

The democratic offset: Contestation, deliberation, and participation regarding military applications of AI

Authoritarian regimes’ unrestricted collection of citizens’ data might constitute an advantage regarding the development of some types of AI, and AI might facilitate authoritarian practices. This feedback loop challenges democracies. In a critical continuation of the Pentagon’s Third Offset Strategy, I investigate a possible Democratic Offset regarding military applications of AI focussed on contestation, deliberation, and participation. I apply Landemore’s Open Democracy, Hildebrandt’s Agonistic Machine Learning, and Sharp’s Civilian-Based Defence. Discussing value pluralism in AI ethics, I criticise parts of the literature for leaving the fundamental ethical incompatibility of democracies and authoritarian regimes unaddressed. I am focussing on the duty to disobey illegal orders derived from customary international humanitarian law (IHL) and the standard of ‘meaningful human control’, which is central to the partially outdated debate about lethal autonomous weapon systems (LAWS). I criticize the standard of ‘meaningful human control’ following two pathways: First, the ethical and legal principles of just war theory and IHL should be implemented in military applications of AI to submit human commands to more control, in the sense of technological disaffordances. Second, the debate should focus on the societal circumstances for personal responsibility and disobedience to be trained and exerted in deliberation and participation related to military applications of AI, in the sense of societal affordances. In a larger picture, this includes multi-level stakeholder involvement, robust documentation to facilitate auditing, civilian-based defence in decentralized smart cities, and open-source intelligence. This multi-layered approach fosters cognitive diversity, which might constitute a strategic advantage for democracies regarding AI.

“And the Ones that Survived had Hope”: Resilience in Holocaust Survivors

The current study uses a strengths-based lens to explore the resilience narratives of five Holocaust survivors and their perspectives on experiences of resilience during and after the Holocaust. UsingInterpretive Phenomenological Analysis (IPA), transcripts of one to one and a half hour interviews were analyzed by a team of three researchers. Overarching emergent themes included: Definition of Resilience, Adversities, Attitude After Overcoming Adversity, Method of Resilience, Adhering to Cultural Values, and Beliefs About Others’ Experience of Resilience. Subthemes and tertiary categories also evolved and are discussed. Findings are interpreted with the acknowledgement of systemic oppression and overcoming, including participants’ development critical consciousness (Freire, 1975/2000). Implications for current societal circumstances and issues are discussed.

Universities and other Institutions – not Hate Speech Laws – are a threat to Freedom of Political Speech

One of the strongest arguments against hate speech legislation is the so-called Argument from Political Speech. This argument problematizes the restrictions that might be placed on political opinions or political critique when these opinions are expressed in a way which can be interpreted as ‘hateful’ towards minority groups. One of the strongest free speech scholars opposing hate speech legislation is Ronald Dworkin, who stresses that having restrictions on hate speech is, in fact, illegitimate in a liberal democracy. The right to express oneself freely concerning any political decision is, according to Dworkin, a core democratic principle; it is what self-governance – and hence liberal democracies – are built upon. Dworkin and many other free speech scholars based in the United States see hate speech legislation as a threat to expressing oneself freely and critically. I argue that Dworkin and other US-based free speech scholars tend to overlook actual hate speech legislation in countries where such laws have been implemented and have functioned for decades. Furthermore, I argue that the real threat against political speech lies not in hate speech legislation but rather outside of the law, namely, in private institutions such as universities and museums. Restrictions on political speech in various societal circumstances have been on the rise over the last decades – first and foremost in the US. I analyse why these restrictions on political speech are more widespread in the only Western country without laws against hate speech than they are in countries with implemented hate speech laws. Keywords: political speech, hate speech, hate speech legislation, private institu-tions, universities, USA

What If Deliberately Dying Is an Occupation?

In some legal and societal circumstances, people freely and capably plan, organize, and precipitate their own death. Drawing on published literature, we critically reflect on how deliberately ending one's own life fits with the current definitions of the concept of occupation. Using an occupational science and occupational therapy theoretical reflection, we argue that deliberately dying can for some people be considered a purposeful and meaningful occupation. Implications for such an occupational therapy practice are discussed: attending to the occupational needs of specific groups of people, reconsidering definitions and conceptual work, advocating for occupational justice in ending life activities, reflecting on ethical conundrums around self-harm activities within the scope of practice, and exploring deliberate death as a purposeful and meaningful occupation. Because deliberately dying is something that some people do, in this article we aim to open a dialogue within the field of occupational science and occupational therapy about this sensitive and potentially controversial issue.

Reproduction of Spatial Planning Roles

Planning scholars use complexity perspectives to account for unpredictable societal circumstances in an uncertain and changing world. Questions emerge not only about how planning communication and action can transform but more so about the planner’s ability to navigate the complex relational dynamics of planning. To move forward, we use Gilles Deleuze’s concept of assemblage thinking to frame spatial planning as a continually changing multiplicity of diverse entities and emerging dynamic relations among them. Niklas Luhmann’s social systems theory then helps to promote a perspective on planners as a multiplicity of roles grounded in continuously evolving self-descriptions and self-developed meanings. Planners achieve the organisation (navigation) in an uncertain and complex environment through the reproduction of roles. This paper positions planning as a self-reflexive process that uses a multiplicity of role configurations that ultimately defines and transforms the meaning of planning itself.

Multi-methodological Characterisation of Medieval to Early Modern Coral Beads from a Cesspit of the “Fronerei auf dem Schrangen” in Lübeck (Germany)

Eight late medieval to early modern red beads representative of a total of 41 from a cesspit of the “Fronerei auf dem Schrangen” in Lübeck, Germany, were investigated using micro X-ray computed tomography (3D-μXCT), X-ray microdiffraction (μ-XRD2), transmission electron microscopy (HRTEM) and Raman spectroscopy (RS). The microscopic properties of the material were characterised non- destructively or minimally invasively for colouration, mineralogical and chemical composition determination but also with regard to their macroscopic external appearance. The polished beads are spherical with flattered tops and boreholes perpendicular to the flattening and show partially traces of working. As base material for all examined beads, high Mg-Calcite with polyenes could be identified. Combined with density and microstructure data, the beads are undoubtedly red precious corals, identical with modern corallium rubrum from the Mediterranean also confirmed by C- and O-isotopic analyses. The studies provide general criteria for the determination of corallium rubrum, confirming the macroscopically determined identification of other coral artefacts associated with the Hanseatic League, and thus prove their iconographic importance as well as the trade contacts with the Mediterranean region. However, the extent to which the characteristics of the coral beads indicate accidental or intentional individual or collective societal or social circumstances is left to further study.

Cohort differences in the development of civic engagement during adolescence.

Investigating whether changing societal circumstances have altered the development of civic engagement, this study compared developmental changes from mid- to late adolescence (i.e., age 15-18) across two cohorts of representative Swiss samples (born in 1991, N = 1258, Mage T1 =15.30, 54% female, 33% migration background representing diverse ethnicities; born in 2000, N=930, Mage T1 =15.32, 51% female; 33% migration background). Findings from latent multigroup models revealed similar levels in attitudes about social justice in both cohorts, remaining stable over time. Adolescents reported lower levels of political efficacy and informal helping in the cohort born in 2000. Both aspects slightly increased during adolescence. Informal helping had a steeper increase in the 1991 compared to the 2000 cohort, suggesting developmental differences between cohorts.