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1.
Nat Commun ; 12(1): 2044, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33824330

RESUMEN

Simple innate behavior is often described as hard-wired and largely inflexible. Here, we show that the avoidance of hot temperature, a simple innate behavior, contains unexpected plasticity in Drosophila. First, we demonstrate that hot receptor neurons of the antenna and their molecular heat sensor, Gr28B.d, are essential for flies to produce escape turns away from heat. High-resolution fly tracking combined with a 3D simulation of the thermal environment shows that, in steep thermal gradients, the direction of escape turns is determined by minute temperature differences between the antennae (0.1°-1 °C). In parallel, live calcium imaging confirms that such small stimuli reliably activate both peripheral thermosensory neurons and central circuits. Next, based on our measurements, we evolve a fly/vehicle model with two symmetrical sensors and motors (a "Braitenberg vehicle") which closely approximates basic fly thermotaxis. Critical differences between real flies and the hard-wired vehicle reveal that fly heat avoidance involves decision-making, relies on rapid learning, and is robust to new conditions, features generally associated with more complex behavior.


Asunto(s)
Drosophila melanogaster/fisiología , Taxia/fisiología , Animales , Conducta Animal , Conducta de Elección , Drosophila melanogaster/genética , Imagenología Tridimensional , Sensación Térmica/fisiología
2.
BMC Med Educ ; 21(1): 215, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33863332

RESUMEN

BACKGROUND: Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). METHODS: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis. RESULTS: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR = 0.37, 95%CI: 0.17-0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference. CONCLUSION: Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines.


Asunto(s)
Selección de Profesión , Conducta de Elección , Especialización/estadística & datos numéricos , Estudiantes de Medicina/psicología , Adulto , Niño , Estudios Transversales , Educación Médica , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Uganda , Universidades , Adulto Joven
3.
Nutrients ; 13(3)2021 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-33803655

RESUMEN

Impact of parental feeding practices on children's eating behaviors is well-documented in the literature. Nevertheless, little is known about how many of these behaviors might persist into adulthood. There is a lack of a tool measuring childhood feeding experiences recollected by adults, while the Comprehensive Feeding Practices Questionnaire (CFPQ) is used to measure parental feeding practices applied towards children. The aim of the study was to adapt the CFPQ to measure adults' recollections of their childhood (5-10 years old) feeding experiences, to examine its discriminant validity and then to assess if these practices are related to adults' food choices. In 2020, the modified version of CFPQ (mCFPQ) and questions on current food consumption were administered in a group of 500 adults twice over a two-week interval. The analysis included 443 participants whose questionnaires were correctly completed in both stages of the study. The Q-sorting procedure was used to test for discriminant validity of the questionnaire, i.e., confirmatory and exploratory factor analysis (EFA), Cronbach's alpha, correlations coefficients, and the analysis of the differences between groups according to the intake of certain food products. Test-retest reliability was examined by calculating interclass correlation coefficients (ICC) for each obtained factor. As a result of EFA, five subscales were identified: "Restrictions", "Healthy Eating Guidance", "Pressure and Food Reward", "Monitoring", and "Child Control". Items from these subscales created a new tool-Adults' Memories of Feeding in Childhood (AMoFiC). Test for internal consistency, factor correlations, and discriminant validity proved satisfactory psychometric parameters of AMoFiC. "Pressure and Food Reward" and "Child Control" were associated with higher intake of sweets and salty snacks, whereas "Healthy Eating Guidance", "Monitoring", and "Restrictions" were associated with higher consumption of fresh fruits and vegetables. Despite the fact that the AMoFiC questionnaire requires further research, the findings of the study might be of practical use in counseling addressed to the parents.


Asunto(s)
Niños Adultos/psicología , Encuestas sobre Dietas/normas , Dieta Saludable/psicología , Preferencias Alimentarias/psicología , Encuestas y Cuestionarios/normas , Adulto , Niño , Conducta Infantil/psicología , Preescolar , Conducta de Elección , Análisis Factorial , Femenino , Humanos , Masculino , Recuerdo Mental , Responsabilidad Parental/psicología , Padres/psicología , Psicometría , Reproducibilidad de los Resultados
5.
Rev Infirm ; 70(269): 31-32, 2021 Mar.
Artículo en Francés | MEDLINE | ID: mdl-33742590

RESUMEN

As an individual choice of the mother to feed her newborn and to weave a special bond with him, breastfeeding, whose benefits are multiple, is strongly encouraged by paediatricians and midwives. The return to work at the end of maternity leave is often an obstacle to the continuation of this method of infant feeding. However, adjustments are possible, even for salaried carers who, as one young woman acting as a health executive testifies, wish to combine professional practice with continued breastfeeding in order to remain in line with their choices.


Asunto(s)
Lactancia Materna , Conducta de Elección , Madres , Mujeres Trabajadoras , Lactancia Materna/psicología , Femenino , Humanos , Recién Nacido , Madres/psicología , Reinserción al Trabajo , Mujeres Trabajadoras/psicología
6.
Nat Commun ; 12(1): 1775, 2021 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-33741978

RESUMEN

Human society is cooperative and characterized by spontaneous prosociality. Comparative studies on endotherm vertebrates suggest that social interdependence causes the evolution of proactive prosociality. To test the generality of this hypothesis, we modify a prosocial choice task for application to the convict cichlid, Amatitlania nigrofasciata, a monogamous fish with biparental care and a strong pair bond. We also affirm that male subjects learn to favor prosocial choices when their mates are the recipients in a neighboring tank. When the neighboring tank is empty, males choose randomly. Furthermore, in the absence of their mates, males behave prosocially toward a stranger female. However, if the mate of the subjects is also visible in the third tank, or if a male is a potential recipient, then subjects make antisocial choices. To conclude, fish may show both spontaneous prosocial and antisocial behaviors according to their social relationships with conspecifics and the overall social context.


Asunto(s)
Conducta de Elección/fisiología , Cíclidos/fisiología , Conducta Sexual Animal/fisiología , Conducta Social , Animales , Femenino , Humanos , Masculino , Apareamiento , Reproducción/fisiología
7.
Value Health ; 24(3): 421-430, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33641777

RESUMEN

OBJECTIVES: Recent evidence suggests that e-mental health interventions can be effective at improving mental health but that there is still a notable hesitation among patients to use them. Previous research has revealed that they are perceived by patients as being less helpful than face-to-face psychotherapy. The reasons for this unfavorable perception are, however, not yet well understood. The aim of our study was to address this question by eliciting preferences for individual components of e-mental health interventions in a discrete choice experiment. METHODS: Using a stepwise qualitative approach, we developed the following 5 attributes of eMHIs: introductory training, human contact, peer support, proven effectiveness, content delivery, and price. Additionally, we asked questions about respondents' demographics, attitudes, and previous experience of traditional psychotherapy, as well as their distress level. RESULTS: A total of 1984 respondents completed the survey. Using mixed logit models, we found that personal contact with a psychotherapist in blended care, proven effectiveness, and low price were highly valued by participants. Participants were indifferent toward the mode of content delivery but showed a slight preference for introductory training via phone, as well as for peer support via online forum alongside coach-led group meetings on site. DISCUSSION: Our results suggest a clear preference for blended care that includes face-to-face contact with a psychotherapist. This preference remained stable irrespective of sociodemographics, previous experience of psychotherapy, distress level, and the 2 context scenarios used in our discrete choice experiment. Further investigations looking at the potential benefits and risks of blended care are needed.


Asunto(s)
Trastornos Mentales/terapia , Prioridad del Paciente/psicología , Psicoterapia/organización & administración , Telemedicina/organización & administración , Adulto , Anciano , Actitud Frente a la Salud , Conducta de Elección , Técnicas de Apoyo para la Decisión , Femenino , Humanos , Aprendizaje , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Grupo Paritario , Factores Socioeconómicos
9.
Artículo en Inglés | MEDLINE | ID: mdl-33672920

RESUMEN

Background: Since numerical calorie labels have limited effects on less-calorie food ordering, an alternative called physical activity calorie equivalent (PACE) labels, which exhibit calories using visible symbols and the minutes of exercise to burn off the calories, may be more effective in reducing calories ordered. Methods: By using a choice experiment (CE) approach, the aims of this study were to estimate the effects of PACE labels on consumer preferences for healthy and unhealth food. Red date walnuts and potato chips were used as the representatives of healthy and unhealthy foods respectively in this study. Moreover, future time perspective (FTP) is an individual trait variable of consumers, which has been recognized as a significant driver of healthy behaviors. We also included FTP into the interaction with PACE labels. Results: Firstly, the results were opposite between the healthy and unhealthy food groups. Respondents showed significantly more positive attitudes toward red date walnuts (i.e., healthy food) with PACE labels, while they showed significantly more negative preferences for chips (i.e., unhealthy food) with PACE labels. Secondly, people with higher FTP are preferred red date walnuts with PACE labels, while PACE labels on chips could undermine the preferences of respondents with higher FTP. Thirdly, we found that women (vs. men) were less inclined to choose healthy food with standard calorie labels and labels showing the minutes of running to burn off the calories, as well as that the elderly (vs. younger) people in the healthy food group preferred the labels showing the minutes of running to burn off the calories. People with a higher body mass index (BMI) were reluctant to purchase walnuts with the information about the minutes of walking. Conclusions: Results from this study showed that PACE labels have significant effects on consumers' preferences for food products.


Asunto(s)
Comportamiento del Consumidor , Etiquetado de Alimentos , Anciano , Conducta de Elección , Ingestión de Energía , Ejercicio Físico , Femenino , Preferencias Alimentarias , Humanos , Masculino
11.
Ann Afr Med ; 20(1): 46-51, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33727512

RESUMEN

Background: Like many other academic programs, medical education is incomplete without a robust assessment plan. Objective: The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members. Methods: Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test. Results: Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001. Conclusion: There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.


Asunto(s)
Educación de Pregrado en Medicina/métodos , Evaluación Educacional/métodos , Docentes Médicos/educación , Desarrollo de Programa , Escritura/normas , Adulto , Conducta de Elección , Educación Médica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arabia Saudita , Desarrollo de Personal
13.
BMC Psychol ; 9(1): 48, 2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33757601

RESUMEN

BACKGROUND: Many people exercise because they know it is good for their health. Although this is true, it can make us feel deserving of a reward and lead us to eat more indulgent, less healthy food than if we had not done any exercise. Generally, lower energy-dense (LED) foods are recognised as healthier choices than higher energy-dense (HED) options. Despite our intention to make healthy choices, seeing tempting higher-calorie foods on offer often side-tracks us. Priming is a psychological tool that makes specific changes to our environment that remind us of our motivation to be healthy. This makes it easier to choose a healthier option, by nudging us towards it without us even realising. However, it is currently unclear which method of priming achieves the best results. AIMS: Our study explores whether priming people to expect they will receive LED food leads them to make this healthier choice after exercise, even when also offered tempting less healthy HED foods at the moment of selection. METHODS: Our study observed the foods selected by university athletes after their sports matches. Before the match, half of the participants were primed by asking them to choose a LED snack from the options we offered, which they would receive after the match. The remaining half of participants were not asked this same question. To distract the athletes from our observation of their food choices, participants completed a task prior to choosing their snack, which was disguised as a 'thank you' for taking part. RESULTS: Overall, we found the priming group did not choose LED foods significantly more than the control group, hence priming did not increase LED food selection. CONCLUSION: Importantly, our results indicate that priming must be more noticeable to achieve its goal. Additionally, we demonstrated that priming may be less successful for young athletic individuals, compared to older and more overweight adults recruited in other studies. This highlights the importance of studying a broader demographic range of individuals from the general population. We support future research into this area, which will help us to tweak priming to achieve the best outcomes. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN74601698. Date registered: 02/10/2020 (retrospectively registered).


Asunto(s)
Preferencias Alimentarias , Bocadillos , Adulto , Conducta de Elección , Humanos , Motivación , Recompensa
14.
Artículo en Inglés | MEDLINE | ID: mdl-33546490

RESUMEN

This study aimed to describe the underlying process, used methods and major recommendations emerging from a comprehensive and prospective health impact assessment of the endorsement of a front-of-pack nutrition labelling (FOP-NL) system by the Portuguese health authorities. A mixed-methods approach was used to gather information on the impact of four FOP-NL schemes on consumers' selection of food products according to the perception of their nutritional quality, combining a systematic literature review, focus groups (FG), in-depth individual interviews, and an open-label crossover randomized controlled study. The relevance of FOP-NL as a public health promotion policy has emerged as a consensual idea among either FGs' participants (i.e., consumers and experts), or interviewed stakeholders. Although all of the evaluated FOP-NLs result better than no system on promoting the choice of the healthiest product, the effectiveness of easy-to-interpret FOP-NL among vulnerable groups raised concerns related to the need of integrating specific nutritional information to promote a better self-management of chronic diseases, and related to the level of literacy of consumers, which could impair the usage of FOP-NL. Educational campaigns addressing skills to use FOP-NL is recommended. Furthermore, a monitoring strategy should be considered to evaluate the long-term effectiveness of this policy in promoting healthier food choices, and in reducing diet-related non-communicable diseases burden.


Asunto(s)
Etiquetado de Alimentos , Salud Pública , Conducta de Elección , Comportamiento del Consumidor , Preferencias Alimentarias , Evaluación del Impacto en la Salud , Humanos , Política Nutricional , Valor Nutritivo , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto
15.
J Stroke Cerebrovasc Dis ; 30(5): 105667, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33631474

RESUMEN

OBJECTIVE: This study aimed to acquire insight into the decision-making processes of healthcare professionals concerning referral to primary care physiotherapy at the time of discharge from inpatient stroke rehabilitation. DESIGN: A generic qualitative study using an inductive thematic analysis was performed. Semi-structured interviews were conducted following an interview guide. SETTING: Secondary care centers in the Netherlands: neurology departments of nine hospitals and (geriatric) rehabilitation centers. PARTICIPANTS: Nineteen healthcare professionals (physiotherapists, specialist in geriatric medicine, physiatrist, physician assistant) participated in the study. All were involved in the decision for referral to primary care physiotherapy. RESULTS: During the inpatient period, healthcare professionals gather information to form a complete picture of the stroke survivor as a basis for decision-making. The decision on referral is influenced by personal factors and home environment of the stroke survivor, organizational factors within the care setting, and the intuition and feeling of social responsibility of the individual healthcare professional. CONCLUSIONS: After inpatient rehabilitation, many elements are considered that may influence referral to primary care physiotherapy. Presently, there is no consensus concerning referrals. The final decision depends on the individual physiotherapist and care setting. Healthcare professionals mentioned the importance of movement behavior, although there is no consensus if secondary prevention is a primary task of the physiotherapist. More research is needed to identify risk factors for functional decline in order to develop a referral policy that addresses primary care physiotherapy to the right group of stroke survivors.


Asunto(s)
Toma de Decisiones Clínicas , Pacientes Internos , Alta del Paciente , Modalidades de Fisioterapia , Atención Primaria de Salud , Derivación y Consulta , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/terapia , Adulto , Actitud del Personal de Salud , Conducta de Elección , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Países Bajos , Investigación Cualitativa , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología
17.
JAMA Netw Open ; 4(2): e2030921, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33566105

RESUMEN

Importance: Many factors are associated with food choice. Personalized interventions could help improve dietary intake by using individual purchasing preferences to promote healthier grocery purchases. Objective: To test whether a healthy food incentive intervention using an algorithm incorporating customer preferences, purchase history, and baseline diet quality improves grocery purchase dietary quality and spending on healthy foods. Design, Setting, and Participants: This was a 9-month randomized clinical crossover trial (AB-BA) with a 2- to 4-week washout period between 3-month intervention periods. Participants included 224 loyalty program members at an independent Rhode Island supermarket who completed baseline questionnaires and were randomized from July to September 2018 to group 1 (AB) or group 2 (BA). Data analysis was performed from September 2019 to May 2020. Intervention: Participants received personalized weekly coupons with nutrition education during the intervention period (A) and occasional generic coupons with nutrition education during the control period (B). An automated study algorithm used customer data to allocate personalized healthy food incentives to participant loyalty cards. All participants received a 5% grocery discount. Main Outcomes and Measures: Grocery Purchase Quality Index-2016 (GPQI-16) scores (range, 0-75, with higher scores denoting healthier purchases) and percentage spending on targeted foods were calculated from cumulative purchasing data. Participants in the top and bottom 1% of spending were excluded. Paired t tests examined between-group differences. Results: The analytical sample included 209 participants (104 in group 1 and 105 in group 2), with a mean (SD) age of 55.4 (14.0) years. They were predominantly non-Hispanic White (193 of 206 participants [94.1%]) and female (187 of 207 participants [90.3%]). Of 161 participants with income data, 81 (50.3%) had annual household incomes greater than or equal to $100 000. Paired t tests showed that the intervention increased GPQI-16 scores (between-group difference, 1.06; 95% CI, 0.27-1.86; P = .01) and percentage spending on targeted foods (between-group difference, 1.38%; 95% CI, 0.08%-2.69%; P = .04). During the initial intervention period, group 1 (AB) and group 2 (BA) had similar mean (SD) GPQI-16 scores (41.2 [6.6] vs 41.0 [7.5]) and mean (SD) percentage spending on targeted healthy foods (32.0% [10.8%] vs 31.0% [10.5%]). During the crossover intervention period, group 2 had a higher mean (SD) GPQI-16 score than group 1 (42.9 [7.7] vs 41.0 [6.8]) and mean (SD) percentage spending on targeted foods (34.0% [12.1%] vs 32.0% [13.1%]). Conclusions and Relevance: This pilot trial demonstrated preliminary evidence for the effectiveness of a novel personalized healthy food incentive algorithm to improve grocery purchase dietary quality. Trial Registration: ClinicalTrials.gov Identifier: NCT03748056.


Asunto(s)
Conducta de Elección , Comportamiento del Consumidor , Dieta Saludable , Motivación , Valor Nutritivo , Adulto , Anciano , Estudios Cruzados , Dietoterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto
18.
JAMA Netw Open ; 4(2): e2037880, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33616665

RESUMEN

Importance: Ten percent of the Medicare Part B budget is spent on aflibercept, used to treat a myriad of ocular neovascular diseases. A substantial portion of these costs can be attributed to a few hundred ophthalmologists, raising concerns regarding the influence of pharmaceutical companies on the choice of medication by a relatively small group of clinicians. One approach to protect patients' health care interests is to include them in deliberations on the choice of therapy for their eye disease. Objective: To examine factors associated with patients' choice between an effective and less expensive off-label drug or a more effective, but also more expensive, US Food and Drug Administration (FDA)-approved drug. Design, Setting, and Participants: This retrospective cohort analysis used data from the satellite office of a tertiary referral center from August 2, 2013, to April 9, 2018. Insured patients initiating treatment with anti-vascular endothelial growth factor were included in the analysis. Data were analyzed from March 26, 2018, to June 10, 2020. Interventions: Patients were asked to choose between bevacizumab (approximately $100 per dose), a chemotherapy that is effective, but not FDA approved, for the treatment of ocular vascular disease, or aflibercept (approximately $2000 per dose), an FDA-approved drug for ocular vascular disease that may be more effective than bevacizumab in some patients. Independent of this choice, patients were separately asked by a study coordinator to participate in an invasive clinical study for which they would not be compensated, there was a small risk for an adverse event, and they would not personally benefit from participating (a surrogate marker for altruism). Main Outcomes and Measures: Factors associated with patients' choice of medication, including age, sex, ocular disease, race, and participation in an invasive clinical study. Results: A total of 189 patients were included in the analysis (106 women [56%]; mean [SEM] age, 74.6 [0.8] years). Despite being told that it may not be as effective as aflibercept, 100 patients (53%) selected bevacizumab for their own eye care. An act of altruism (ie, participation in an invasive clinical study) when the patient was making a choice between the 2 drugs was associated with a patient's choice of bevacizumab (odds ratio [OR], 7.03; 95% CI, 2.27-21.80; P < .001); the OR for selecting bevacizumab for patients who never agreed to participate in the clinical study was 0.45 (95% CI, 0.25-0.83; P = .001). Age (OR, 1.00; 95% CI, 0.97-1.03; P = .86), race (OR, 0.70; 95% CI, 0.41-1.22; P = .21), sex (OR, 0.72; 95% CI, 0.39-1.35; P = .31), presence of diabetes (OR, 1.52; 95% CI, 0.59-3.93; P = .39), and type of eye disease (OR, 0.56; 95% CI, 0.30-1.04; P = .07) were not associated with choice of therapy. Conclusions and Relevance: These findings suggest that clinicians must consider the ethical implications of the influence of altruism when patients participate in the decision between cost-effective vs the most effective medicines for their own health care.


Asunto(s)
Altruismo , Inhibidores de la Angiogénesis/economía , Bevacizumab/economía , Conducta de Elección , Toma de Decisiones , Oftalmopatías/tratamiento farmacológico , Participación del Paciente , Proteínas Recombinantes de Fusión/economía , Afroamericanos , Anciano , Inhibidores de la Angiogénesis/uso terapéutico , Americanos Asiáticos , Bevacizumab/uso terapéutico , Estudios de Cohortes , Análisis Costo-Beneficio , Retinopatía Diabética/tratamiento farmacológico , Costos de los Medicamentos , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Degeneración Macular/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Neovascularización Patológica/tratamiento farmacológico , Oportunidad Relativa , Uso Fuera de lo Indicado , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual
19.
Behav Processes ; 186: 104355, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33571612

RESUMEN

Spatial discounting is a largely underexplored area of decision-making research, both theoretically and empirically, especially when compared to intertemporal choice, which has received significant attention in psychology and animal behaviour. Spatial decision problems seem to share some of the same features of a temporal decision problem (namely, the risk of reward objects disappearing and the opportunity cost of waiting), but there are several additional factors that affect the appropriate discount function for distant rewards. These include more significant opportunity costs, changes in the distances to all the other available opportunities, the post-reward costs of getting back home, the complex energetics associated with locomotion and all the additional risks faced by travelling itself. This paper organises and explores these factors and suggests some normative models that should predict the adaptive behaviour of animals and humans.


Asunto(s)
Descuento por Demora , Animales , Atención , Conducta Animal , Conducta de Elección , Humanos , Recompensa
20.
Poult Sci ; 100(2): 643-653, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33518118

RESUMEN

Gender determination in incubated eggs (in ovo) has the potential to substitute the highly discussed practice of culling male layer chicks. The aim of this study was to investigate the effect pictures have on peoples' preferences toward in ovo sexing at different stages of embryonic development and chick culling. For this purpose, an online survey was conducted with a representative sample of 482 respondents in Germany. A within-subject design with 2 choice experiments was used to investigate the influence pictures have on respondents' preferences and willingness to pay. The first-choice experiment contained plain text only; the second contained also pictures of a chick or the incubated eggs at the corresponding stages of development. Findings reveal that in ovo gender determination at each proposed day of incubation (d1, d4, and d9) was preferred to chick culling. In ovo screening on d1 and d4 was significantly preferred to d9. This preference for early gender determination increased significantly as a consequence to the provision of pictures. Results furthermore reveal that a high error rate of gender determination or the lack of a meaningful utilization of incubated eggs can decrease approval for in ovo gender determination to an extent, where no positive willingness to pay remains. Findings of this study are useful for stakeholders in poultry production when considering the implementation of in ovo gender determination as a morally admissible substitute to chick culling.


Asunto(s)
Sacrificio de Animales/métodos , Pollos , Conducta de Elección , Comportamiento del Consumidor , Animales , Femenino , Alemania , Masculino , Modelos Econométricos , Óvulo , Fotograbar , Factores Socioeconómicos , Encuestas y Cuestionarios
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