Childhood vision impairment and blindness in West Africa: public health measures and implications for systemic health.

Childhood blindness is an issue of global health impact, affecting approximately 2 million children worldwide. Vision 2020 and the United Nations Sustainable Development Goals previously identified childhood blindness as a key issue in the twentieth century, and while public health measures are underway, the precise etiologies and management require ongoing investigation and care, particularly within resource-limited settings such as sub-Saharan Africa. We systematically reviewed the literature on childhood blindness in West Africa to identify the anatomic classification and etiologies, particularly those causes of childhood blindness with systemic health implications. Treatable causes included cataract, refractive error, and corneal disease. Systemic etiologies identified included measles, rubella, vitamin A deficiency, and Ebola virus disease. While prior public health measures including vitamin A supplementation and vaccination programs have been deployed in most countries with reported data, multiple studies reported preventable or reversible etiologies of blindness and vision impairment. Ongoing research is necessary to standardize reporting for anatomies and/or etiologies of childhood blindness to determine the necessity of further development and implementation of public health measures that would ameliorate childhood blindness and vision impairment.

Cutibacterium (Formerly Propionibacterium ) acnes Keratitis: A Review.

ABSTRACT: Infectious keratitis is a devastating cause of vision loss worldwide. Cutibacterium acnes ( C. acnes ), a commensal bacterium of the skin and ocular surface, is an underrecognized but important cause of bacterial keratitis. This review presents the most comprehensive and up-to-date information for clinicians regarding the risk factors, incidence, diagnosis, management, and prognosis of C. acnes keratitis (CAK). Risk factors are similar to those of general bacterial keratitis and include contact lens use, past ocular surgery, and trauma. The incidence of CAK may be approximately 10%, ranging from 5% to 25% in growth-positive cultures. Accurate diagnosis requires anaerobic blood agar and a long incubation period (≥7 days). Typical clinical presentation includes small (<2 mm) ulcerations with deep stromal infiltrate causing an anterior chamber cell reaction. Small, peripheral lesions are usually resolved, and patients recover a high visual acuity. Severe infections causing VA of 20/200 or worse are common and often do not significantly improve even after treatment. Vancomycin is considered the most potent antibiotic against CAK, although other antibiotics such as moxifloxacin and ceftazidime are more commonly used as first-line treatment.

The Endowment Effect and Beliefs About the Market.

The endowment effect occurs when people assign a higher value to an item they own than to the same item when they do not own it, and this effect is often taken to reflect an ownership-induced change in the intrinsic value people assign to the object. However recent evidence shows that valuations made by buyers and sellers are influenced by market prices provided for the individual products, suggesting a role for beliefs about the markets. Here we elicit individuals' beliefs about whole distributions of market prices, enabling us to quantify whether or not a given transaction constitutes a "good deal" and to demonstrate how an endowment effect may reflect such considerations. In a meta-analysis and three laboratory experiments, we show for the first time that ownership has no effect on beliefs about either: (a) the quality of the item or (b) the appropriate market price for the item. Instead, we show that sellers demand a price for the item that matches their beliefs about the item's relative quality and the distribution of market prices in the market. Buyers, in contrast, offer less than what they believe the appropriate market price is. Thus, we argue that the endowment effect may largely reflect "adaptively rational" behavior on the part of both buyers and sellers (given their beliefs about relevant markets) rather than any ownership-induced bias or change in intrinsic preferences.

Anonymized location data reveals trends in legal Cannabis use in communities with increased mental health risks at the start of the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to increases in felt negative affect for many. This is concerning as individuals at increased risk for mental health issues are often more likely to use substances to cope with stressors. OBJECTIVES: The aim of the current study is to examine whether communities reporting an increased risk for developing mental health issues showed differential patterns of legal cannabis use as the pandemic began. A secondary goal is to examine the feasibility of using anonymized location data to uncover community consumption patterns of potential concern. METHODS: Anonymized location data from approximately 10% of devices in the United States provided a count of the number of visitors to 3,335 cannabis retail locations (medical and recreational) each day from December 1st 2019 through April 2020. Visitor counts were merged with the average number of mentally unhealthy days (aMUDs) reported in the Federal Information Processing Standard (FIPS) county the retailer was located along with FIPS county population and poverty rate estimates. A Poisson spline regression predicting visitors by day, aMUDs, as well as their interaction was performed, entering population and poverty rate as covariates. RESULTS: As the pandemic began communities reporting a greater aMUDs showed greater visitation to cannabis retailers. CONCLUSIONS: These results suggest that the COVID-19 pandemic may have led to increased legal cannabis use in at risk communities. They also highlight the value anonymized location data can provide policymakers and practitioners in uncovering community level trends as they confront an increasingly uncertain landscape.

Impact of the COVID-19 Pandemic on Unhealthy Eating in Populations with Obesity.

OBJECTIVE: This study aimed to examine the impact of the coronavirus disease (COVID-19) pandemic on patronage to unhealthy eating establishments in populations with obesity. METHODS: Anonymized movement data accounting for roughly 10% of devices in the United States at 138,989 unhealthy eating locations from December 1, 2019, through April 2020 and the percentage of adults with obesity, the poverty rate, and the food environment index in 65% of United States counties were collected and merged. A cluster corrected Poisson spline regression was performed predicting patronage by day, the percentage of adults with obesity in the establishment's county, the county's poverty rate, and its food environment index, as well as their interactions. RESULTS: Patronage to unhealthy eating establishments was higher where there was a higher percentage of the adult population with obesity. A similar pattern was observed for counties with a lower food environment index. These disparities appear to have increased as the COVID-19 pandemic spread. CONCLUSIONS: These results suggest unhealthy eating patterns during the COVID-19 pandemic are higher in already at-risk populations. Policy makers can use these findings to motivate interventions and programs aimed at increasing healthy food intake in at-risk communities during crises.

Choice rates are independent from perceived patterns (when patterns are not obvious): A reply to Plonsky and Teodorescu.

In Ashby, Konstantinidis, and Yechiam (2017) we argued that the variance in people's choices in decisions from experience stems from uncertainty about preferences. This was confirmed by high correlations between the variance in experiential choices and subsequent one-shot policy decisions: both showing considerable diversification. In the present paper we address a comment regarding our paper by Plonsky and Teodorescu (2020). These authors suggested that variance in experiential choices is driven by responses to perceived patterns in prior outcomes (rather than individuals' preferences), and that these responses can also drive subsequent policy decisions. This was supported by an apparent "wavy recency" effect in our data indicatory of responses to patterns, and by an experiment showing that outcome patterns affected subsequent policy decisions. We demonstrate that our study results do not in fact show a significant wavy recency. We do find positive recency but it is very poorly correlated with the overall choice rates. Hence, we contend that the variance in choice rates mostly reflects one's preferences when there are no obvious patterns. Moreover, we argue that because Plonsky and Teodorescu's experimental manipulation was confounded with the frequency of relatively positive/negative outcomes, their results do not conclusively show an effect of response to patterns on subsequent policies.

The effect of switching costs on choice-inertia and its consequences.

In two studies we provide a novel investigation into the effects of monetary switching costs on choice-inertia (i.e., selection of the same option on consecutive choices). Study 1 employed a static decisions-from-feedback task and found that the introduction of, as well as larger, monetary switching costs led to increases in choice-inertia. While experience and decreases in the similarity of options average payouts (expected value: EV) increased choice-inertia for the option with a higher EV (the EV maximizing option), switching costs increased choice-inertia for the inferior option (the lower EV option): The proportion of total participants showing choice-inertia for the EV maximizing option also increased with switching costs. Study 2 employed a dynamic decisions-from-feedback task where halfway through the task the EV maximizing option became the inferior option. The effect of switching costs increasing choice-inertia for both the EV maximizing and the inferior option was replicated with little impact of the change in options values being detected. In sum, decision makers appear to be sensitive to switching costs, and this sensitivity can bias them towards inferior or superior options, revealing the good and the bad of choice-inertia.

Are we attracted by losses? Boundary conditions for the approach and avoidance effects of losses.

The majority of the literature on the psychology of gains and losses suggests that losses lead to an avoidance response. Several studies, however, have shown that losses can also lead to an approach response, whereby an option is selected more often when it produces losses. In five studies we examine the boundary conditions for these contradictory approach and avoidance effects. The results show that an approach response emerges only when losses are produced by a highly advantageous choice alternative and when participants have ample unbiased direct or vicarious experience with this alternative. Additionally, the avoidance response to losses is also not ubiquitous and emerges when alternatives producing losses are experienced as disadvantageous. Thus, the findings suggest that both the approach and avoidance effects of losses exist and can be accounted for by increased investment of cognitive resources with losses (i.e., loss attention). Additionally, the findings clarify the loss attention account in indicating that losses increase exploitative behavior based on experienced outcomes, a process which can be locally optimal. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The acute effect of Hypericum perforatum on short-term memory in healthy adults.

RATIONALE: Over-the-counter drugs containing Hypericum perforatum (H. perforatum) have been argued to improve memory and sustained attention. So far, these claims have not been supported in human studies. However, previous studies used rather high dosages, and little is known about the acute effect of small dosages. OBJECTIVE: We evaluated whether an acute treatment with Remotiv 500 and Remotiv 250 (500 or 250 mg of H. perforatum quantified to either 1 or 0.5 mg of hypericin) improved memory and sustained attention, as well as mood and state anxiety in healthy adults. METHOD: A single dosage, randomized, double-blind, placebo-controlled trial was conducted with 82 student participants (33 women). Each participant received placebo in one session and one of two dosages in the other session. Order of the sessions and dosage conditions were randomized between subjects. Participants completed a battery of tasks assessing short-term memory capacity and sustained attention. RESULTS: A significant positive effect of Remotiv 250 on digit span (mean Cohen's d = 0.58; p = .01) was observed. By contrast, Remotiv 500 had a negative effect on digit span (mean d = - 0.48, p = 0.04). A similar effect emerged when factoring across tests of short-term memory. Both dosages improved mood (d = 0.60, p = .03). CONCLUSIONS: The results indicate that acute treatment with small (250 mg) dosages of H. perforatum has a positive effect on the capacity of short-term verbal memory, and stress the importance of maintaining small dosages in nootropic applications. TRIAL REGISTRATION: www.clinicaltrials.gov NCT02862236.

The consistency of visual attention to losses and loss sensitivity across valuation and choice.

Sensitivity to losses has been found to vary greatly across individuals. One explanation for this variability is that for some losses garner more visual attention and are subsequently given more weight in decision-making processes. In three studies we examined whether biases in visual attention toward potential losses during valuation and choice were related to loss sensitivity, as well as the valuations provided and the choices made. In all studies, we find a positive relationship between estimated loss sensitivity and attention to losses for valuation, with increased attention to losses predicting decreased valuations. For choices, however, there was no robust relationship between attention and loss sensitivity or the choices made. In addition, preferences were not strongly consistent across tasks (i.e., valuations and choices did not robustly align), nor was the distribution of attention robustly related across tasks. Study 3 involved testing across separate sessions and found significant consistency in loss sensitivity and attention to losses across sessions for both choice and valuation. In sum, it appears that loss sensitivity varies across individuals, is differentially related to attention across tasks, and shows some consistency across time. Attention to losses also shows consistency across time, and its relationship with valuations appears much more robust than with choices; patterns of results that add to research suggesting that different cognitive processes underlie valuations and choices. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

On the relation between economic bubbles and effort gaps between sellers and buyers: An experimental study.

Economic bubbles are an empirical puzzle because they do not readily fit the notion of an efficient market. We argue that bubbles are associated with a conflict and a gap in the allocation of effort during negotiation by sellers and buyers. We examined 21 experimental asset markets where in one condition players could buy and sell and in the other they could either buy or sell. The results indicated that when making concurrent buying and selling decisions the mean number of asks for sellers was 71% higher than the number of bids for buyers. Similar findings emerge in a re-analysis of data from Lei et al. (2001). Importantly, bubbles only emerged in markets where the number of asks was larger than that of bids. These findings indicate that bubbles are associated with increased negotiation effort when acting as a seller and diminished effort when acting as a buyer.

Who's biased? A meta-analysis of buyer-seller differences in the pricing of lotteries.

A large body of empirical research has examined the impact of trading perspective on pricing of consumer products, with the typical finding being that selling prices exceed buying prices (i.e., the endowment effect). Using a meta-analytic approach, we examine to what extent the endowment effect also emerges in the pricing of monetary lotteries. As monetary lotteries have a clearly defined normative value, we also assess whether one trading perspective is more biased than the other. We consider several indicators of bias: absolute deviation from expected values, rank correlation with expected values, overall variance, and per-unit variance. The meta-analysis, which includes 35 articles, indicates that selling prices considerably exceed buying prices (Cohen's d = 0.58). Importantly, we also find that selling prices deviate less from the lotteries' expected values than buying prices, both in absolute and in relative terms. Selling prices also exhibit lower variance per unit. Hierarchical Bayesian modeling with cumulative prospect theory indicates that buyers have lower probability sensitivity and a more pronounced response bias. The finding that selling prices are more in line with normative standards than buying prices challenges the prominent account whereby sellers' valuations are upward biased due to loss aversion, and supports alternative theoretical accounts. (PsycINFO Database Record

Choice in experiential learning: True preferences or experimental artifacts?

The rate of selecting different options in the decisions-from-feedback paradigm is commonly used to measure preferences resulting from experiential learning. While convergence to a single option increases with experience, some variance in choice remains even when options are static and offer fixed rewards. Employing a decisions-from-feedback paradigm followed by a policy-setting task, we examined whether the observed variance in choice is driven by factors related to the paradigm itself: Continued exploration (e.g., believing options are non-stationary) or exploitation of perceived outcome patterns (i.e., a belief that sequential choices are not independent). Across two studies, participants showed variance in their choices, which was related (i.e., proportional) to the policies they set. In addition, in Study 2, participants' reported under-confidence was associated with the amount of choice variance in later choices and policies. These results suggest that variance in choice is better explained by participants lacking confidence in knowing which option is better, rather than methodological artifacts (i.e., exploration or failures to recognize outcome independence). As such, the current studies provide evidence for the decisions-from-feedback paradigm's validity as a behavioral research method for assessing learned preferences.

Finding the right fit: A comparison of process assumptions underlying popular drift-diffusion models.

Recent research makes increasing use of eye-tracking methodologies to generate and test process models. Overall, such research suggests that attention, generally indexed by fixations (gaze duration), plays a critical role in the construction of preference, although the methods used to support this supposition differ substantially. In 2 studies we empirically test prototypical versions of prominent processing assumptions against 1 another and several base models. We find that general evidence accumulation processes provide a good fit to the data. An accumulation process that assumes leakage and temporal variability in evidence weighting (i.e., a primacy effect) fits the aggregate data, both in terms of choices and decision times, and does so across varying types of choices (e.g., charitable giving and hedonic consumption) and numbers of options well. However, when comparing models on the level of the individual, for a majority of participants simpler models capture choice data better. The theoretical and practical implications of these findings are discussed. (PsycINFO Database Record

Forgetting the past: individual differences in recency in subjective valuations from experience.

Recent research investigating decisions from experience suggests that not all information is treated equally in the decision process, with more recently encountered information having a greater impact. We report 2 studies investigating how this differential treatment of sequentially encountered information affects subjective valuations of risky prospects when observations of past outcomes must be used to estimate the prospect's payoff distribution, and examine how individual differences in cognitive capacities influence information usage. In Study 1 we found that a sliding window of information model that averages a subset of (only) the most recently encountered outcomes (samples) fit the subjective valuation data for a portion of individuals better than models that integrate all observed outcomes. This pattern of results is replicated in Study 2, in which we also found that the amount of information used to form valuations varies greatly between individuals, and that individual difference in memory span explains a portion of this variation. Combined, these results suggest a process in which information usage is in part reliant on cognitive capacity, and where information aggregation appears to be memory based rather than online, providing new insight into the processes involved in the construction of valuation in experiential decisions.

Conscious and unconscious thought in risky choice: testing the capacity principle and the appropriate weighting principle of unconscious thought theory.

Daily we make decisions ranging from the mundane to the seemingly pivotal that shape our lives. Assuming rationality, all relevant information about one's options should be thoroughly examined in order to make the best choice. However, some findings suggest that under specific circumstances thinking too much has disadvantageous effects on decision quality and that it might be best to let the unconscious do the busy work. In three studies we test the capacity assumption and the appropriate weighting principle of Unconscious Thought Theory using a classic risky choice paradigm and including a "deliberation with information" condition. Although we replicate an advantage for unconscious thought (UT) over "deliberation without information," we find that "deliberation with information" equals or outperforms UT in risky choices. These results speak against the generality of the assumption that UT has a higher capacity for information integration and show that this capacity assumption does not hold in all domains. Furthermore, we show that "deliberate thought with information" leads to more differentiated knowledge compared to UT which speaks against the generality of the appropriate weighting assumption.