Peripheral oedema as an adverse effect of treatment of secondary progressive multiple sclerosis with siponimod: A case series.

Siponimod is a sphingosine 1-phosphate receptor (S1P) modulator used to treat secondary progressive multiple sclerosis (SPMS). We report 3 SPMS patients treated with siponimod who developed new or worsening peripheral oedema soon after commencing treatment. In one case, peripheral oedema resulted in immobility. Siponimod-related peripheral oedema deserves wider recognition due to the potential for morbidity and over-investigation. Clinicians should assess for pre-existing oedema and coexisting conditions that may predispose to developing peripheral oedema prior to commencing siponimod.

A field experiment on subgoal framing to boost volunteering: The trade-off between goal granularity and flexibility.

Research suggests that breaking overarching goals into more granular subgoals is beneficial for goal progress. However, making goals more granular often involves reducing the flexibility provided to complete them, and recent work shows that flexibility can also be beneficial for goal pursuit. We examine this trade-off between granularity and flexibility in subgoals in a preregistered, large-scale field experiment (N = 9,108) conducted over several months with volunteers at a national crisis counseling organization. A preregistered vignette pilot study (N = 900) suggests that the subgoal framing tested in the field could benefit goal seekers by bolstering their self-efficacy and goal commitment, and by discouraging procrastination. Our field experiment finds that reframing an overarching goal of 200 hr of volunteering into more granular subgoals (either 4 hr of volunteering every week or 8 hr every 2 weeks) increased hours volunteered by 8% over a 12-week period. Further, increasing subgoal flexibility by breaking an annual 200-hr volunteering goal into a subgoal of volunteering 8 hr every 2 weeks, rather than 4 hr every week, led to more durable benefits. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dos and don'ts for achieving managerial diversityGetting to Diversity: What Works and What Doesn't Frank Dobbin and Alexandra Kalev Belknap Press, 2022. 272 pp.

A pair of sociologists turn to data to determine how to diversify organizations' upper ranks.

When seeking help, women and racial/ethnic minorities benefit from explicitly stating their identity.

Receiving help can make or break a career, but women and racial/ethnic minorities do not always receive the support they seek. Across two audit experiments-one with politicians and another with students-as well as an online experiment (total n = 5,145), we test whether women and racial/ethnic minorities benefit from explicitly mentioning their demographic identity in requests for help, for example, by including statements like "As a Black woman…" in their communications. We propose that when a help seeker highlights their marginalized identity, it may activate prospective helpers' motivations to avoid prejudiced reactions and increase their willingness to provide support. Here we show that when women and racial/ethnic minorities explicitly mentioned their demographic identity in help-seeking emails, politicians and students responded 24.4% (7.42 percentage points) and 79.6% (2.73 percentage points) more often, respectively. These findings suggest that deliberately mentioning identity in requests for help can improve outcomes for women and racial/ethnic minorities.

Autonomy in the Operating Room: A Multicenter Study of Gender Disparities During Surgical Training.

BACKGROUND: Gender disparities are prevalent in medicine, but their impact on surgical training is not well studied. OBJECTIVE: To quantify gender disparities in trainee intraoperative experiences and explore the variables associated with ratings of surgical autonomy and performance. METHODS: From September 2015 to May 2019, attending surgeons and trainees from 71 programs assessed trainee autonomy on a 4-level Zwisch scale and performance on a 5-level modified Dreyfus scale after surgical procedures. Multivariable regression models were used to examine the association of trainee gender with autonomy and performance evaluations. RESULTS: A total of 3255 trainees and attending surgeons completed 94 619 evaluations. Attendings gave lower ratings of operative autonomy to female trainees than male trainees when controlling for training level, attending, and surgical procedure (effect size B = -0.0199, P = .008). There was no difference in ratings of autonomy at the beginning of training (P = .32); the gap emerged as trainees advanced in years (B = -0.0163, P = .020). The gender difference in autonomy was largest for the most complex cases (B = -0.0502, P = .002). However, there was no difference in attending ratings of surgical performance for female trainees compared to male trainees (B = -0.0124, P = .066). Female trainees rated themselves as having less autonomy and worse performance than males when controlling for training level, attending, procedure, case complexity, and attending ratings (autonomy B = -0.0669, P < .001; performance B = -0.0704, P < .001). CONCLUSIONS: While there was no significant difference in ratings of operative performance, a small difference between ratings of operative autonomy for female and male surgical trainees was identified.

Forgoing earned incentives to signal pure motives.

Policy makers, employers, and insurers often provide financial incentives to encourage citizens, employees, and customers to take actions that are good for them or for society (e.g., energy conservation, healthy living, safe driving). Although financial incentives are often effective at inducing good behavior, they've been shown to have self-image costs: Those who receive incentives view their actions less positively due to the perceived incompatibility between financial incentives and intrinsic motives. We test an intervention that allows organizations and individuals to resolve this tension: We use financial rewards to kick-start good behavior and then offer individuals the opportunity to give up some or all of their earned financial rewards in order to boost their self-image. Two preregistered studies-an incentivized online experiment (n = 763) on prosocial behavior and a large field experiment (n = 17,968) on exercise-provide evidence that emphasizing the intrinsic rewards of a past action leads individuals to forgo or donate earned financial rewards. Our intervention allows individuals to retroactively signal that they acted for the right reason, which we call "motivation laundering." We discuss the implications of motivation laundering for the design of incentive systems and behavioral change.

The mixed effects of online diversity training.

We present results from a large (n = 3,016) field experiment at a global organization testing whether a brief science-based online diversity training can change attitudes and behaviors toward women in the workplace. Our preregistered field experiment included an active placebo control and measured participants' attitudes and real workplace decisions up to 20 weeks postintervention. Among groups whose average untreated attitudes-whereas still supportive of women-were relatively less supportive of women than other groups, our diversity training successfully produced attitude change but not behavior change. On the other hand, our diversity training successfully generated some behavior change among groups whose average untreated attitudes were already strongly supportive of women before training. This paper extends our knowledge about the pathways to attitude and behavior change in the context of bias reduction. However, the results suggest that the one-off diversity trainings that are commonplace in organizations are unlikely to be stand-alone solutions for promoting equality in the workplace, particularly given their limited efficacy among those groups whose behaviors policymakers are most eager to influence.