Too hard, too easy, or just right? The effects of context on effort and boredom aversion.

Despite people's general desire to avoid cognitive effort, there is a limit to our parsimony: boredom, a state defined by a lack of successful mental engagement, is found to be similarly aversive. The work presented here investigates how context - the alternative tasks present and the environmental context - impacts people's aversion to exerting cognitive effort and avoiding boredom via a demand-selection task. In a population of undergraduate students, we assessed how people's willingness to exert mental effort (in a working memory task) is affected by the presence of an easier alternative (less cognitively demanding) or a boring alternative (doing nothing at all). To manipulate environmental context, we conducted the experiment online, where participants completed the task remotely, and in a controlled laboratory setting. We find people willingly seek out effortful tasks to avoid boredom, despite avoiding high demands when both tasks on offer required some effort. We also find large effects of the participants' environmental context, with preferences for the most demanding task increasing by over 150% in the lab compared to online. These results bear relevance to theories that argue the costs of effort are determined relative to the alternatives available (e.g., opportunity cost theories). Moreover, the results demonstrate that researchers who deliberately (or inadvertently) manipulate effort and boredom must consider the effects context (both choice and environmental) may have on people's behaviour.

The effect of noninstrumental information on reward learning.

Investigations of information-seeking often highlight people's tendency to forgo financial reward in return for advance information about future outcomes. Most of these experiments use tasks in which reward contingencies are described to participants. The use of such descriptions leaves open the question of whether the opportunity to obtain such noninstrumental information influences people's ability to learn and represent the underlying reward structure of an experimental environment. In two experiments, participants completed a two-armed bandit task with monetary incentives where reward contingencies were learned via trial-by-trial experience. We find, akin to description-based tasks, that participants are willing to forgo financial reward to receive information about a delayed, unchangeable outcome. Crucially, however, there is little evidence this willingness to pay for information is driven by an inaccurate representation of the reward structure: participants' representations approximated the underlying reward structure regardless of the presence of advance noninstrumental information. The results extend previous conclusions regarding the intrinsic value of information to an experience-based domain and highlight challenges of probing participants' memories for experienced rewards.

Designing an Informatics Infrastructure for a National Aged Care Medication Roundtable.

In the residential aged care sector medication management has been identified as a major area of concern contributing to poor outcomes and quality of life for residents. Monitoring medication management in residential aged care in Australia has been highly reliant on small, internal audits. The introduction of electronic medication administration systems provides new opportunities to establish improved methods for ongoing, timely and efficient monitoring of a range of medication indicators, made more meaningful by linking medication data with resident characteristics and outcomes. Benchmarking contemporary medication indicators provides a further opportunity for improvement and is most effective when indicator data are adjusted to take account of confounding factors, such as residents' characteristics and health conditions. Roundtables provide a structure for sharing and discussing indicator data in a trusted and supportive environment and encourage the identification of strategies which may be effective in improving medication management. This paper describes a new project to establish, implement and evaluate a National Aged Care Medication Roundtable.

Expectations, opportunities, and awareness: A case for combining i- and s-frame interventions.

We argue that: (1) disappointment in the effectiveness of i-frame interventions depends on realistic expectations about how they could work; (2) opportunities for system reform are rare, and i-frame interventions can lay important groundwork; (3) Chater & Loewenstein's evidence that i-frame interventions detract from s-frame approaches is limited; and (4) nonetheless, behavioural scientists should consider what more they can contribute to systemic reforms.

Mathematical modelling of microneedle-mediated transdermal delivery of drug nanocarriers into skin tissue and circulatory system.

Microneedle-mediated transdermal delivery using nanocarriers can successfully overcome the barrier of the stratum corneum and protect drugs from elimination in skin tissues. However, the effectiveness of drug delivery to different layers of skin tissues and the circulatory system varies considerably, subject to the properties of the drug delivery system and delivery regime. How to maximise delivery outcomes remains unclear. In this study, mathematical modelling is employed to investigate this transdermal delivery under various conditions, using the skin model that is reconstructed based on the realistic skin anatomical structure. Treatment efficacy is evaluated in terms of drug exposure over time. The modelling results demonstrate the complex dependence of drug accumulation and distribution on the nanocarrier properties, microneedle properties and environment in different skin layers and blood. Specifically, delivery outcomes in the entire skin and blood can be improved by increasing the loading dose and reducing microneedle spacing. However, several parameters need to be optimised with respect to the specific location of the target site in the tissue for better treatment; these include the drug release rate, nanocarrier diffusivity in microneedle and skin tissue, nanocarrier transvascular permeability, nanocarrier partition coefficient between tissue and microneedle, microneedle length, wind speed and relative humidity. The delivery is less sensitive to the diffusivity and physical degradation rate of free drugs in microneedle, and their partition coefficient between tissue and microneedle. Results obtained from this study can be used to improve the design of the microneedle-nanocarrier combined drug delivery system and delivery regime.

Is Conviction Narrative Theory a theory of everything or nothing?

We connect Conviction Narrative Theory to an account that views people as intuitive scientists who can flexibly create, evaluate, and modify representations of decision problems. We argue that without understanding how the relevant complex narratives (or indeed any representation, simple to complex) are themselves constructed, we also cannot know when and why people would rely on them to make choices.

Behavioural change interventions encouraging clinicians to reduce carbon emissions in clinical activity: a systematic review.

BACKGROUND: Clinical activity accounts for 70-80% of the carbon footprint of healthcare. A critical component of reducing emissions is shifting clinical behaviour towards reducing, avoiding, or replacing carbon-intensive healthcare. The objective of this systematic review was to find, map and assess behaviour change interventions that have been implemented in healthcare settings to encourage clinicians to reduce greenhouse gas emissions from their clinical activity. METHODS: Studies eligible for inclusion were those reporting on a behaviour change intervention to reduce carbon emissions via changes in healthcare workplace behaviour. Six databases were searched in November 2021 (updated February 2022). A pre-determined template was used to extract data from the studies, and risk of bias was assessed. The behaviour change techniques (BCTs) used in the interventions were coded using the BCT Taxonomy. RESULTS: Six full-text studies were included in this review, and 14 conference abstracts. All studies used a before-after intervention design. The majority were UK studies (n = 15), followed by US (n = 3) and Australia (n = 2). Of the full-text studies, four focused on reducing the emissions associated with anaesthesia, and two aimed at reducing unnecessary test ordering. Of the conference abstracts, 13 focused on anaesthetic gas usage, and one on respiratory inhalers. The most common BCTs used were social support, salience of consequences, restructuring the physical environment, prompts and cues, feedback on outcome of behaviour, and information about environmental consequences. All studies reported success of their interventions in reducing carbon emissions, prescribing, ordering, and financial costs; however, only two studies reported the magnitude and significance of their intervention's success. All studies scored at least one item as unclear or at risk of bias. CONCLUSION: Most interventions to date have targeted anaesthesia or pathology test ordering in hospital settings. Due to the diverse study outcomes and consequent inability to pool the results, this review is descriptive only, limiting our ability to conclude the effectiveness of interventions. Multiple BCTs were used in each study but these were not compared, evaluated, or used systematically. All studies lacked rigour in study design and measurement of outcomes. REVIEW REGISTRATION: The study was registered on Prospero (ID number CRD42021272526) (Breth-Petersen et al., Prospero 2021: CRD42021272526).

The non-unitary nature of information preference.

Factors affecting information-seeking behaviour can be task-endogenous (e.g., probability of winning a gamble), or task-exogenous (e.g., personality trait measures). Various task-endogenous factors affecting non-instrumental information-seeking behaviour have been identified, but it is unclear how task-exogenous factors affect such behaviour, and if they interact with task-endogenous factors. In an online information seeking experiment (N = 279), we focus on the role that outcome probability, as a task-endogenous factor, has on information preferences. We find reliable preference for advance information on highly probable gains and low preference for highly probable losses. Comparisons with individual trait measures of information preference (e.g., intolerance of uncertainty scale, obsessive-compulsive inventory, information preferences scale) reveal minimal association between these task-exogenous factors with choice task performance. We also find minimal interaction between outcome probability and individual trait measures. Despite the choice task and trait measures purportedly tapping the same (or similar) construct, the absence of clear relationships ultimately suggests a multi-dimensional nature of information preference.

Is all mental effort equal? The role of cognitive demand-type on effort avoidance.

Humans are often termed "cognitive misers" for their aversion to mental effort. Both in and outside the laboratory people often show preferences for low-effort tasks and are willing to forgo financial reward to avoid more demanding alternatives. Mental effort, however, does not seem to be ubiquitously avoided: people play crosswords, board games, and read novels, all as forms of leisure. While such activities undoubtedly require effort, the type of cognitive demands they impose appear markedly different from the tasks typically used in psychological research on mental effort (e.g., N-Back, Stroop Task, vigilance tasks). We investigate the effect disparate demands, such as tasks which require problem solving (e.g., solve the missing number: 1, 3, 7, 15, 31,?) compared to those which require rule-implementation (e.g., N-Back task), have on people's aversion to or preference for increased mental effort. Across four experiments using three different tasks, and a mixture of online and lab-based settings, we find that aversion to effort remains largely stable regardless of the types of cognitive demands a task imposes. The results are discussed in terms of other factors that might induce the pursuit of mental effort over and above the type of cognitive demands imposed by a task.

Managing Interruptions to Improve Diagnostic Decision-Making: Strategies and Recommended Research Agenda.

Interruptions are an inevitable occurrence in health care. Interruptions in diagnostic decision-making are no exception and can have negative consequences on both the decision-making process and well-being of the decision-maker. This may result in inaccurate or delayed diagnoses. To date, research specific to interruptions on diagnostic decision-making has been limited, but strategies to help manage the negative impacts of interruptions need to be developed and implemented. In this perspective, we first present a modified model of interruptions to visualize the interruption process and illustrate where potential interventions can be implemented. We then consider several empirically tested strategies from the fields of health care and cognitive psychology that can lay the groundwork for additional research to mitigate effects of interruptions during diagnostic decision-making. We highlight strategies to minimize the negative impacts of interruptions as well as strategies to prevent interruptions altogether. Additionally, we build upon these strategies to propose specific research priorities within the field of diagnostic safety. Identifying effective interventions to help clinicians better manage interruptions has the potential to minimize diagnostic errors and improve patient outcomes.

Determinants of early-access to retirement savings: Lessons from the COVID-19 pandemic.

Australian regulations strictly limit early withdrawals from retirement plan accounts. However, in 2020, the Government made otherwise illiquid plan balances temporarily liquid, offering emergency relief during the pandemic. The COVID-19 Early Release Scheme allowed participants in financial hardship easy access to up to $A20,000 of savings over two rounds. We use administrative and survey data from a large retirement plan to describe how and why participants withdrew savings under the scheme. A majority report that they needed the money immediately but around one quarter said they anticipated future needs. Most thought about the decision for less than a week, acted soon after each round opened, and withdrew as much as they could. Many people did not estimate, or appear to have mis-estimated, the impact the withdrawal could have on their retirement savings. Our findings offer insights into preferences for liquidity. They also raise questions about whether the features of the early release scheme, and their implied endorsement by the Government, influenced some withdrawers more than personal deliberations over financial welfare.

Nudge interventions to reduce unnecessary antibiotic prescribing in primary care: a systematic review.

OBJECTIVES: Antibiotic prescribing in primary care contributes significantly to antibiotic overuse. Nudge interventions alter the decision-making environment to achieve behaviour change without restricting options. Our objectives were to conduct a systematic review to describe the types of nudge interventions used to reduce unnecessary antibiotic prescribing in primary care, their key features, and their effects on antibiotic prescribing overall. METHODS: Medline, Embase and grey literature were searched for randomised trials or regression discontinuity studies in April 2021. Risk of bias was assessed independently by two researchers using the Cochrane Effective Practice and Organisation of Care group's tool. Results were synthesised to report the percentage of studies demonstrating a reduction in overall antibiotic prescribing for different types of nudges. Effects of social norm nudges were examined for features that may enhance effectiveness. RESULTS: Nineteen studies were included, testing 23 nudge interventions. Four studies were rated as having a high risk of bias, nine as moderate risk of bias and six as at low risk. Overall, 78.3% (n=18, 95% CI 58.1 to 90.3) of the nudges evaluated resulted in a reduction in overall antibiotic prescribing. Social norm feedback was the most frequently applied nudge (n=17), with 76.5% (n=13; 95% CI 52.7 to 90.4) of these studies reporting a reduction. Other nudges applied were changing option consequences (n=3; with 2 reporting a reduction), providing reminders (n=2; 2 reporting a reduction) and facilitating commitment (n=1; reporting a reduction). Successful social norm nudges typically either included an injunctive norm, compared prescribing to physicians with the lowest prescribers or targeted high prescribers. CONCLUSIONS: Nudge interventions are effective for improving antibiotic prescribing in primary care. Expanding the use of nudge interventions beyond social norm nudges could reap further improvements in antibiotic prescribing practices. Policy-makers and managers need to be mindful of how social norm nudges are implemented to enhance intervention effects.

Toward nonprobabilistic explanations of learning and decision-making.

Referring to probabilistic concepts (such as randomness, sampling, and probability distributions among others) is commonplace in contemporary explanations of how people learn and make decisions in the face of environmental unknowns. Here, we critically evaluate this practice and argue that such concepts should only play a relatively minor part in psychological explanations. To make this point, we provide a theoretical analysis of what people need to do in order to deal with unknown aspects of a typical decision-making task (a repeated-choice gamble). This analysis reveals that the use of probabilistic concepts in psychological explanations may and often does conceal essential, nonprobabilistic steps that people need to take to attempt to solve the problems that environmental unknowns present. To give these steps a central role, we recast how people solve these problems as a type of hypothesis generation and evaluation, of which using probabilistic concepts to deal with unknowns is one of many possibilities. We also demonstrate some immediate practical consequences of our proposed approach in two experiments. This perspective implies a shift in focus toward nonprobabilistic aspects of psychological explanations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The mazing race: Effects of interruptions and benefits of interruption lags in a novel maze-like decision-making paradigm.

Interruptions are an inevitable, and often negative, part of everyday life that increase both errors and the time needed to complete even menial tasks. However, existing research suggests that being given time to prepare for a pending interruption-a lag time-can mitigate some of the interruption costs. To understand better why interruption lags are effective, we present a series of three experiments in which we develop and test a novel sequential decision-making paradigm, the mazing race. We find that interruption lags were only beneficial when participants had a clear strategy for how to complete the task, allowing them to avoid specific errors. In the final experiment, we attempted to use what we learned about the kinds of errors introduced by interruptions to develop a feedback-based intervention, aimed at dealing with situations in which interruption lags are not possible. We found that feedback was, only in certain situations, an effective replacement for an interruption lag. Overall, however, because the usefulness of interruption lags depend on the specific strategy a participant adopts, developing generic interventions to replace interruption lags is likely to be difficult. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MEM-EX: An exemplar memory model of decisions from experience.

Many real-world decisions must be made on basis of experienced outcomes. However, there is little consensus about the mechanisms by which people make these decisions from experience (DfE). Across five experiments, we identified several factors influencing DfE. We also introduce a novel computational modeling framework, the memory for exemplars model (MEM-EX), which posits that decision makers rely on memory for previously experienced outcomes to make choices. Using MEM-EX, we demonstrate how cognitive mechanisms provide intuitive and parsimonious explanations for the effects of value-ignorance, salience, outcome order, and sample size. We also conduct a cross-validation analysis of several models within the MEM-EX framework. We compare these to three alternative models; two baseline models built on the principle of expected value maximization, and another employing a suite of choice methods previously shown to perform well in prediction tournaments. We find that MEM-EX consistently outperforms these competitors, demonstrating its value as a tool for making quantitative predictions without overfitting. We discuss the implications of these findings for our understanding of the interplay between attention, memory, and experience-based choice.

Allowing early access to retirement savings: Lessons from Australia.

In response to the COVID-19 pandemic, many governments around the world introduced policies aiming to provide citizens with financial relief through early access to their retirement savings. In Australia, the Early Release of Super (ERS) scheme allowed eligible citizens to withdraw up to A$20,000 in funds between April and December 2020. Using data provided by a large Australian bank, we examine the characteristics of the individuals who withdrew, how they used the withdrawn funds, and what impact this had on their financial wellbeing. We find that the scheme achieved its intended goal of providing immediate financial support to citizens in need. The scheme was primarily accessed by individuals in poorer financial circumstances, and helped withdrawers to pay down high-interest debts and avoid arrears. Based on our findings, we consider the implications for governments looking to implement similar policies in the future, as well as the opportunities to support individuals who have now withdrawn from their retirement savings.

Adapting to the algorithm: how accuracy comparisons promote the use of a decision aid.

In three experiments, we sought to understand when and why people use an algorithm decision aid. Distinct from recent approaches, we explicitly enumerate the algorithm's accuracy while also providing summary feedback and training that allowed participants to assess their own skills. Our results highlight that such direct performance comparisons between the algorithm and the individual encourages a strategy of selective reliance on the decision aid; individuals ignored the algorithm when the task was easier and relied on the algorithm when the task was harder. Our systematic investigation of summary feedback, training experience, and strategy hint manipulations shows that further opportunities to learn about the algorithm encourage not only increased reliance on the algorithm but also engagement in experimentation and verification of its recommendations. Together, our findings emphasize the decision-maker's capacity to learn about the algorithm providing insights for how we can improve the use of decision aids.

Protection from uncertainty in the exploration/exploitation trade-off.

The exploration/exploitation trade-off (EE trade-off) describes how, when faced with several competing alternatives, decision-makers must often choose between a known good alternative (exploitation) and one or more unknown but potentially more rewarding alternatives (exploration). Prevailing theory on how humans perform the EE trade-off states that uncertainty is a major motivator for exploration: the more uncertain the environment, the more exploration that will occur. The current article examines whether exploratory behavior in both choice and attention may be impacted differently depending on whether uncertainty is onset suddenly (unexpected uncertainty), or more slowly (expected uncertainty). It is shown that when uncertainty was expected, participants tended to explore less with their choices, but not their attention, than when it was unexpected. Crucially, the impact of this "protection from uncertainty" on exploration only occurred when participants had an opportunity to learn the structure of the task before experiencing uncertainty. This suggests that the interaction between uncertainty and exploration is more nuanced than simply more uncertainty leading to more exploration, and that attention and choice behavior may index separate aspects of the EE trade-off. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Consensus-based guidance for conducting and reporting multi-analyst studies.

Any large dataset can be analyzed in a number of ways, and it is possible that the use of different analysis strategies will lead to different results and conclusions. One way to assess whether the results obtained depend on the analysis strategy chosen is to employ multiple analysts and leave each of them free to follow their own approach. Here, we present consensus-based guidance for conducting and reporting such multi-analyst studies, and we discuss how broader adoption of the multi-analyst approach has the potential to strengthen the robustness of results and conclusions obtained from analyses of datasets in basic and applied research.

How top-down and bottom-up attention modulate risky choice.

We examine how bottom-up (or stimulus-driven) and top-down (or goal-driven) processes govern the distribution of attention in risky choice. In three experiments, participants chose between a certain payoff and the chance of receiving a payoff drawn randomly from an array of eight numbers. We tested the hypothesis that initial attention is driven by perceptual properties of the stimulus (e.g., font size of the numbers), but subsequent choice is goal-driven (e.g., win the best outcome). Two experiments in which task framing (goal driven) and font size (stimulus driven) were manipulated demonstrated that payoffs with the highest values and the largest font sizes had the greatest impact on choice. The third experiment added a number in large font to the array, which could not be an outcome of the gamble (i.e., a distractor). Eye movement and choice data indicated that although the distractor attracted attention, it had no influence on option selection. Together with computational modeling analyses, the results suggest that perceptual salience can induce bottom-up effects of overt selection but that the perceived value of information is the crucial arbiter of intentional control over risky choice.