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1.
PLoS One ; 16(10): e0258088, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34614004

RESUMO

OBJECTIVES: The Coronavirus disease 2019 (COVID-19) pandemic disrupted medical student education, particularly in New York City (NYC). We aimed to assess the impact of the COVID-19 pandemic on medical students' residency choices. METHODS: The authors conducted a cross-sectional survey of medical students in all years of study at four NYC medical schools (Columbia, Cornell, NYU, and SUNY Downstate). The survey was fielded from 19 Aug 2020 to 21 Sep 2020. Survey questions included items assessing COVID-19 impact on residency choices, personal impact of COVID-19, residency/specialty choices, and factors influencing these choices. RESULTS: A total of 2310 students received the survey, with 547 (23.7%) providing partial responses and 212 (9.2%) providing valid responses for our primary analysis. 59.0% of participants thought that COVID-19 influenced their choice of residency/specialty, with 0.9% saying the influence was to a great extent, 22.2% to some extent, and 35.8% very little. On multivariable analysis, factors that were independently associated with COVID-19 impacting residency choice included low debt ($1 to $99,999: adjOR 2.23, 95%CI 1.02-5.03) compared with no debt and Other race/ethnicity (adjOR 0.26, 95%CI 0.10-0.63) compared with White race/ethnicity. On secondary analysis of all participants answering survey items for logistic regression regardless of survey completion, direct personal impact of COVID-19 was significantly associated with COVID-19 impacting specialty choice (adjOR 1.90, 95%CI 1.04-3.52). Moreover, 24 students (11.6%) reported a change in their top residency choice from before to during/after COVID-19, citing concerns about frontline work, work-life balance, and risk of harm. CONCLUSIONS: Our study found that 3 in 5 (59.0%) participants felt that COVID-19 impacted their residency choice, with 11.6% of respondents explicitly changing their top specialty choice. Investigating the impact of the pandemic on medical student residency considerations is crucial to understand how medical career outlooks may change in the future.


Assuntos
COVID-19/epidemiologia , Comportamento de Escolha , Internato e Residência/estatística & dados numéricos , Cidade de Nova Iorque , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Feminino , Humanos , Masculino , Cidade de Nova Iorque/epidemiologia
2.
Trials ; 22(1): 611, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503552

RESUMO

BACKGROUND: Increasingly, it is argued that clinical trials struggle to recruit participants because they do not respond to key questions or study treatments that patients will be willing or able to use. This study explores how elicitation of patient-preferences can help designers of randomized controlled trials (RCTs) understand the impact of changing modifiable aspects of treatments or trial design on recruitment. METHODS: Focus groups and a discrete choice experiment (DCE) survey were used to elicit preferences of people with scleroderma for autologous hematopoietic stem cell transplant (AHSCT) treatment interventions. Preferences for seven attributes of treatment (effectiveness, immediate and long-term risk, care team composition and experience, cost, travel distance) were estimated using a mixed-logit model and used to predict participation in RCTs. RESULTS: Two hundred seventy-eight people with scleroderma answered the survey. All AHSCT treatment attributes significantly influenced preferences. Treatment effectiveness and risk of late complications contributed the most to participants' choices, but modifiable factors of distance to treatment center and cost also affected preferences. Predicted recruitment rates calibrated with participation in a recent trial (33%) and suggest offering a treatment closer to home, at lower patient cost, and with holistic, multidisciplinary care could increase participation to 51%. CONCLUSIONS: Through a patient engaged approach to preference elicitation for different features of AHSCT treatment options, we were able to predict what drives the decisions of people with scleroderma to participate in RCTs. Knowledge regarding concerns and the trade-offs people are willing to make can inform clinical study design, improving recruitment rates and potential uptake of the treatment of interest.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Preferência do Paciente , Comportamento de Escolha , Grupos Focais , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários
3.
PLoS One ; 16(9): e0257151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34506543

RESUMO

In the risky-choice framing effect, different wording of the same options leads to predictably different choices. In a large-scale survey conducted from March to May 2020 and including 88,181 participants from 47 countries, we investigated how stress, concerns, and trust moderated the effect in the Disease problem, a prominent framing problem highly evocative of the COVID-19 pandemic. As predicted by the appraisal-tendency framework, risk aversion and the framing effect in our study were larger than under typical circumstances. Furthermore, perceived stress and concerns over coronavirus were positively associated with the framing effect. Contrary to predictions, however, they were not related to risk aversion. Trust in the government's efforts to handle the coronavirus was associated with neither risk aversion nor the framing effect. The proportion of risky choices and the framing effect varied substantially across nations. Additional exploratory analyses showed that the framing effect was unrelated to reported compliance with safety measures, suggesting, along with similar findings during the pandemic and beyond, that the effectiveness of framing manipulations in public messages might be limited. Theoretical and practical implications of these findings are discussed, along with directions for further investigations.


Assuntos
Ansiedade , COVID-19 , Comportamento de Escolha , Pandemias , Assunção de Riscos , COVID-19/epidemiologia , COVID-19/psicologia , Humanos , Inquéritos e Questionários
4.
Sci Rep ; 11(1): 18950, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556687

RESUMO

Theory posits that situations of existential threat will enhance prosociality in general and particularly toward others perceived as belonging to the same group as the individual (parochial altruism). Yet, the global character of the COVID-19 pandemic may blur boundaries between ingroups and outgroups and engage altruism at a broader level. In an online experiment, participants from the U.S. and Italy chose whether to allocate a monetary bonus to a charity active in COVID-19 relief efforts at the local, national, or international level. The purpose was to address two important questions about charitable giving in this context: first, what influences the propensity to give, and second, how is charitable giving distributed across different levels of collective welfare? We found that personal exposure to COVID-19 increased donations relative to those not exposed, even as levels of environmental exposure (numbers of cases locally) had no effect. With respect to targets of giving, we found that donors predominantly benefitted the local level; donations toward country and world levels were half as large. Social identity was found to influence charity choice in both countries, although an experimental manipulation of identity salience did not have any direct effect.


Assuntos
Altruísmo , COVID-19/psicologia , Comportamento de Escolha/ética , Instituições de Caridade/tendências , Feminino , Humanos , Itália , Masculino , Pandemias , SARS-CoV-2/patogenicidade , Comportamento Social , Estados Unidos
5.
Nutrients ; 13(9)2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34579041

RESUMO

The coronavirus disease 2019 pandemic brought changes to almost every segment of our lives, including dietary habits. We present one among several studies, and the first on the Croatian population, aiming at investigating changes of food choice motives before and during the pandemic. The study was performed in June 2021 as an online-based survey, using a 36-item Food Choice Questionnaire applied for both the periods before and during the pandemic. The final sample consisted of 1232 adults living in Croatia. Sensory appeal was ranked as the number one most important food choice motive before, whereas health was ranked as the number one most important food choice motive during the pandemic. Ethical concern was reported as the least important food choice motive both before and during the pandemic. In women, natural content (p = 0.002), health, convenience, price, weight control, familiarity, and ethical concern (all p < 0.001) became more important during the pandemic, while price (p = 0.009), weight control, familiarity, and ethical concern (all p < 0.001) became more relevant for men. All together, these can be considered favorable changes toward optimal diets and may result in beneficial influences on health and lifestyle. Education strategies and efficiently tackling misinformation are prerequisites for informed food choice, which will ensure long-lasting positive effects of such changes.


Assuntos
COVID-19/psicologia , Comportamento de Escolha , Preferências Alimentares/psicologia , Motivação , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Croácia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
6.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34544874

RESUMO

By 2 y of age, children possess expectations about several different moral principles. Building on these results, we asked whether children who observed a wrongdoer violate a principle would draw negative inferences from this violation about how the wrongdoer was likely to behave in other contexts. In four experiments, 25-mo-old toddlers (n = 152) first saw a wrongdoer harm a protagonist. When toddlers judged the wrongdoer's behavior to violate the principle of ingroup support or harm avoidance, they did not find it unexpected if the wrongdoer next violated the principle of fairness by dividing resources unfairly between two other protagonists (Exps. 2 and 3), but they did find it unexpected if the wrongdoer next acted generously by giving another protagonist most of a resource to be shared between them (Exp. 4). When toddlers did not construe the wrongdoer's harmful behavior as a moral violation, these responses reversed: They found it unexpected if the wrongdoer next acted unfairly (Exp. 1) but not if the wrongdoer next acted generously (Exp. 4). Detecting a moral violation thus lowered toddlers' assessment of the wrongdoer's moral character and brought down their expectations concerning the likelihood that the wrongdoer would perform: 1) obligatory actions required by other principles and 2) supererogatory or virtuous actions not required by the principles. Together, these findings expand our understanding of how young children evaluate others' moral characters, and they reveal how these evaluations, in turn, enable children to form sophisticated expectations about others' behavior in new contexts.


Assuntos
Desenvolvimento Infantil , Comportamento de Escolha , Emoções/fisiologia , Julgamento , Comportamento Social , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Princípios Morais
7.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34556580

RESUMO

Names for colors vary widely across languages, but color categories are remarkably consistent. Shared mechanisms of color perception help explain consistent partitions of visible light into discrete color vocabularies. But the mappings from colors to words are not identical across languages, which may reflect communicative needs-how often speakers must refer to objects of different color. Here we quantify the communicative needs of colors in 130 different languages by developing an inference algorithm for this problem. We find that communicative needs are not uniform: Some regions of color space exhibit 30-fold greater demand for communication than other regions. The regions of greatest demand correlate with the colors of salient objects, including ripe fruits in primate diets. Our analysis also reveals a hidden diversity in the communicative needs of colors across different languages, which is partly explained by differences in geographic location and the local biogeography of linguistic communities. Accounting for language-specific, nonuniform communicative needs improves predictions for how a language maps colors to words, and how these mappings vary across languages. Our account closes an important gap in the compression theory of color naming, while opening directions to study cross-cultural variation in the need to communicate different colors and its impact on the cultural evolution of color categories.


Assuntos
Comportamento de Escolha , Percepção de Cores , Cor , Comunicação , Evolução Cultural , Discriminação Psicológica , Idioma , Comparação Transcultural , Humanos
8.
J Nurs Adm ; 51(9): 422-423, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34432735

RESUMO

This month's column highlights why patients are choosing to see nurse practitioners (NPs) as primary care providers, for both urgent and chronic care needs. Nurse practitioners are 1 type of advanced practice RN. Advanced practice RNs are inclusive of NPs, nurse midwives, nurse specialists, and nurse anesthetists. Primary care NPs see patients in the ambulatory and community settings, focusing on disease prevention and health maintenance. Primary care NPs often work in rural communities, providing access to care for many underserved populations.


Assuntos
Comportamento de Escolha , Profissionais de Enfermagem , Participação do Paciente , Atenção Primária à Saúde/organização & administração , Acesso aos Serviços de Saúde , Humanos , Área Carente de Assistência Médica , Serviços de Saúde Rural/organização & administração , Estados Unidos
9.
Elife ; 102021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34342577

RESUMO

Intertemporal choices require trade-offs between short-term and long-term outcomes. Ventromedial prefrontal cortex (vmPFC) damage causes steep discounting of future rewards (delay discounting [DD]) and impoverished episodic future thinking (EFT). The role of vmPFC in reward valuation, EFT, and their interaction during intertemporal choice is still unclear. Here, 12 patients with lesions to vmPFC and 41 healthy controls chose between smaller-immediate and larger-delayed hypothetical monetary rewards while we manipulated reward magnitude and the availability of EFT cues. In the EFT condition, participants imagined personal events to occur at the delays associated with the larger-delayed rewards. We found that DD was steeper in vmPFC patients compared to controls, and not modulated by reward magnitude. However, EFT cues downregulated DD in vmPFC patients as well as controls. These findings indicate that vmPFC integrity is critical for the valuation of (future) rewards, but not to instill EFT in intertemporal choice.


Assuntos
Comportamento de Escolha , Desvalorização pelo Atraso/fisiologia , Córtex Pré-Frontal/fisiologia , Recompensa , Idoso , Feminino , Humanos , Imaginação , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
10.
BMC Infect Dis ; 21(1): 879, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454441

RESUMO

BACKGROUND: Choice-based experiments have been increasingly used to elicit preferences for vaccines and vaccination programs. This study aims to systematically identify and examine choice-based experiments assessing (differences in) vaccine preferences of vaccinees, representatives and health advisors. METHODS: Five electronic databases were searched on choice-based conjoint analysis studies or discrete choice experiments capturing vaccine preferences of children, adolescents, parents, adults and healthcare professionals for attributes of vaccines or vaccine settings up to September 2020. Data was extracted using a standardized form covering all important aspects of choice experiments. A quality assessment was used to assess the validity of studies. Attributes were categorized into outcome, process, cost and other. The importance of attributes was assessed by the frequency of reporting and statistical significance. Results were compared between high-quality studies and lower-quality studies. RESULTS: A total of 42 studies were included, with the majority conducted in high-income countries after 2010 (resp. n = 34 and n = 37). Preferences of representatives were studied in nearly half of the studies (47.6%), followed by vaccinees (35.7%) and health advisors (9.5%). Sixteen high-quality studies passed the quality assessment. Outcome- and cost- related attributes such as vaccine effectiveness, vaccine risk, cost and protection duration were most often statistically significant across both target groups, with vaccine effectiveness being the most important. Risks associated with vaccination, such as side effects, were more often statistically significant in studies targeting vaccinees, while cost-related attributes were more often statistically significant in studies of representatives. Process-related attributes such as vaccine accessibility and time were least important across both target groups. CONCLUSION: To our knowledge, this is the first systematic review in which vaccine preferences of different target groups were assessed and compared. The same attributes were most important for vaccine decisions of vaccinees and representatives, with only minor differences in level of evidence for vaccine risk and cost. Future research on vaccine preferences of health advisors and/or among target groups in low-resource settings would give insight into the generalizability of current findings.


Assuntos
Preferência do Paciente , Vacinas , Adolescente , Adulto , Criança , Comportamento de Escolha , Tomada de Decisões , Humanos , Pais , Vacinação
11.
JAMA Netw Open ; 4(8): e2120940, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34410398

RESUMO

Importance: Delaying critical care for treatable conditions owing to fear of contracting COVID-19 in the emergency department (ED) is associated with avoidable morbidity and mortality. Objective: To assess and quantify how people decided whether to present to the ED during the COVID-19 pandemic for care unrelated to COVID-19 using conjoint analysis, a form of trade-off analysis that examines how individuals make complex decisions. Design, Setting, and Participants: This cross-sectional survey study was conducted using a nationwide sample from June 1, 2020, during the initial peak of the COVID-19 pandemic. Included participants were adults aged 18 years or older in the US who self-reported that they had not tested positive for COVID-19. Data were analyzed from July 2020 through May 2021. Exposures: Participants completed a self-administered online survey. Main Outcomes and Measures: Using a choice-based conjoint analysis survey, the relative importance was assessed for the following attributes for individuals in deciding whether to seek ED care for symptoms consistent with myocardial infarction or appendicitis: reduction in chance of dying because of ED treatment, crowdedness of ED with other patients, and chance of contracting COVID-19 in the ED. We also performed latent class analyses using conjoint data to identify distinct segments of the respondent population with similar choice patterns. Logistic regression was then used to explore whether patient sociodemographics and political affiliations were factors associated with decision-making. Results: Among 1981 individuals invited to participate, 933 respondents (47.1%) completed the survey; participants' mean (SD) age was 40.1 (13.0) years, and 491 (52.6%) were women. In latent class analyses, 158 individuals (16.9%) with symptoms of myocardial infarction and 238 individuals (25.5%) with symptoms of appendicitis prioritized avoidance of COVID-19 exposure in the ED (ie, chance of contracting COVID-19 in the ED or crowdedness of ED with other patients) over seeking appropriate care for symptoms. Having a usual source of care was a factor associated with lower odds of prioritizing avoidance of COVID-19 exposure (myocardial infarction scenario: adjusted odds ratio, 0.49 [95% CI, 0.32-0.76]; P = .001; appendicitis scenario: adjusted odds ratio, 0.57 [95% CI, 0.40-0.82]; P = .003), but most sociodemographic factors and political affiliations were not factors associated with decision-making. Conclusions and Relevance: This study found that up to one-quarter of individuals were willing to forgo potentially life-saving ED care to avoid exposure to COVID-19. These findings suggest that health care systems and public health organizations should develop effective communications for patients and the community at large that reassure and encourage timely health care for critical needs during the ongoing COVID-19 pandemic and other scenarios.


Assuntos
COVID-19 , Tomada de Decisões , Emergências/psicologia , Serviços Médicos de Emergência , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Comportamento de Escolha , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pesquisa Qualitativa , SARS-CoV-2 , Estados Unidos
12.
Nutrients ; 13(7)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34371832

RESUMO

Limited research has examined athletes' food and health beliefs and decisions and the congruence of these decisions with recommendations from nutrition professionals. This study aimed to improve understanding of athletes' food-related beliefs and practices to enable nutrition professionals to more effectively enhance performance while protecting athletes' health. Division I college athletes (n = 14, 64% female) from a variety of sports were recruited to participate in 20-min semi-structured phone interviews about food and nutrition-related behaviors and cognitions. Data were content analyzed to identify themes and trends. Prominent factors influencing athletes' food choices were potential benefits to health and performance, availability of foods, and recommendations from sports dietitians. Foods commonly consumed by athletes, including fruits, vegetables, and lean protein, were generally healthy and aligned with sports nutrition recommendations. Athletes avoided energy-dense nutrient-poor foods, such as fast food and fried foods, with the goal of improving performance. Some athletes took supplements (i.e., multivitamin, iron, protein) on the premise that they would improve health and enhance performance or recovery. While athletes' nutrition behaviors are generally congruent with current recommendations, findings highlighted misconceptions held by athletes related to the benefits of some supplements and the belief that packaged/processed foods were inherently less healthy than other options. Nutrition misconceptions held by athletes and incongruities between athletes' nutrition knowledge and behaviors suggest that dietitians should aim to dispel misconceptions held by athletes and provide additional guidance and information to support athletes' current healthful behaviors to ensure these behaviors extend beyond their college athletic career.


Assuntos
Atletas/psicologia , Desempenho Atlético/psicologia , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Estudantes/psicologia , Adulto , Comportamento de Escolha , Dieta Saudável/estatística & dados numéricos , Suplementos Nutricionais , Feminino , Fidelidade a Diretrizes , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Necessidades Nutricionais , Pesquisa Qualitativa , Ciências da Nutrição e do Esporte/normas , Universidades , Adulto Jovem
13.
Nutrients ; 13(7)2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34371839

RESUMO

The obesity pandemic is associated with increased consumption of restaurant food. Labeling of menus is an intervention used to provide consumers with kilocalorie (calorie) information in hopes of them making healthier food choices. This study evaluated the relationship between young adults' calorie choices on restaurant menus and menu design, dietary behaviors, and demographic characteristics. A 3 (fast-casual restaurants) × 4 (menu-designs based on menu engineering theories) between-subjects (n = 480, 18-24-year olds) experimental design was used. The relationship between the participants' calorie choices (high versus low) and menu design, stage of change, gender, race, educational level and weight status was evaluated using logistic regression. All independent variables had at least one category that had greater odds (CI 95% ± 5%) of subjects choosing a lower calorie entree, except education level and race/ethnic group. Normal weight and overweight subjects had greater odds of choosing lower calorie entrees than those that were obese. In addition, subjects that had started to control their calorie intake for less than six months or had sustained this change for at least six months, had greater odds of choosing lower calorie entrees compared to others. Including a green symbol and calories on fast casual restaurant menus may influence some young adults to choose lower calorie entrees.


Assuntos
Comportamento de Escolha , Dieta Saudável/psicologia , Fast Foods/análise , Rotulagem de Alimentos/métodos , Preferências Alimentares/psicologia , Adolescente , Comportamento do Consumidor , Ingestão de Energia , Fast Foods/efeitos adversos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Valor Nutritivo , Obesidade/etiologia , Obesidade/psicologia , Restaurantes , Adulto Jovem
14.
Neurosci Biobehav Rev ; 129: 307-329, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34358579

RESUMO

Although obesity is a result of processes operating at multiple levels, most forms result from decision-making behavior. The aim of this review was to examine the candidacy of temporal discounting (TD) (i.e. the reduction in the value of a reinforcer as a function of the delay to its receipt) as a behavioral marker of obesity. For this purpose, we assessed whether TD has the ability to: identify risk for obesity development, diagnose obesity, track obesity progression, predict treatment prognosis/outcomes, and measure treatment effectiveness. Three databases (Pubmed, PsycINFO, and Web of Science) were searched using a combination of terms related to TD and obesity. A total of 153 papers were reviewed. Several areas show strong evidence of TD's predictive utility as a behavioral marker of obesity (e.g., distinguishing obese from non obese). However, other areas have limited and/or mixed evidence (e.g., predicting weight change). Given the positive relationship for TD in the majority of domains examined, further consideration for TD as a behavioral marker of obesity is warranted.


Assuntos
Desvalorização pelo Atraso , Comportamento de Escolha , Humanos , Obesidade , Inquéritos e Questionários
15.
Nutrients ; 13(8)2021 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-34444855

RESUMO

The concept of sustainable nutrition considers different fields: from human health to environmental, economic and socio-cultural aspects. Currently, in Europe, the diets that reflect the assumptions of the sustainable diet are the Mediterranean Diet and the New Nordic Diet. They both encourage the consumption of vegetable, organic and minimally processed foods, as well as regional, seasonal and Fair-Trade products, reducing the ecological impact of the production chain. These eating habits could be established starting from the prenatal period and from infancy during the complementary feeding stage, aiding children to accept of a more variable diet in terms of flavor, taste and texture. In particular, the positive parental role model is an effective method for improving a child's diet and behaviors. Two healthy plates representing a sustainable diet in early infancy, at 6 and 24 months, are here proposed, in line with the "Planetary Health Diet" approved by the EAT-Lancet Commission. Our work aims to highlight how a sustainable diet is possible since infancy, since the introduction of solid foods.


Assuntos
Dieta Saudável/métodos , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Fenômenos Fisiológicos da Nutrição do Lactente , Paladar , Comportamento de Escolha , Feminino , Humanos , Lactente , Alimentos Infantis , Masculino , Desenvolvimento Sustentável
16.
Nutrients ; 13(8)2021 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-34444877

RESUMO

Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained-stores, full-service restaurants, quick-services restaurants, and schools-and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003-2004 to 2017-2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003-2004 to 7 out of 10 points in 2017-2018. In 2017-2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted.


Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Dieta Saudável/estatística & dados numéricos , Preferências Alimentares , Serviços de Alimentação/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Comportamento de Escolha , Estudos Transversais , Feminino , Abastecimento de Alimentos/métodos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Política Nutricional , Inquéritos Nutricionais , Valor Nutritivo , Restaurantes , Serviços de Saúde Escolar/estatística & dados numéricos , Supermercados , Estados Unidos , Adulto Jovem
17.
PLoS One ; 16(8): e0255543, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34339481

RESUMO

Since the outbreak of the global COVID-19 pandemic, social distancing has been known to everyone and recommended almost everywhere everyday. Social distancing has been and will be one of the most effective measures and sometimes, the only available one for fighting epidemics and saving lives. However, it has not been so clear how social distancing should be practiced or managed, especially when it comes to regulating everyone's otherwise normal social activities. The debate on how to implement social distancing often leads to a heated political argument, while research on the subject is lacking. This paper is to provide a theoretical basis for the understanding of the scientific nature of social distancing by considering it as a social dilemma game played by every individual against his/her population. From this perspective, every individual needs to make a decision on how to engage in social distancing, or risk being trapped into a dilemma either exposing to deadly diseases or getting no access to necessary social activities. As the players of the game, the individual's decisions depend on the population's actions and vice versa, and an optimal strategy can be found when the game reaches an equilibrium. The paper shows how an optimal strategy can be determined for a population with either closely related or completely separated social activities and with either single or multiple social groups, and how the collective behaviors of social distancing can be simulated by following every individual's actions as the distancing game progresses. The simulation results for populations of varying sizes and complexities are presented, which not only justify the choices of the strategies based on the theoretical analysis, but also demonstrate the convergence of the individual actions to an optimal distancing strategy in silico and possibly in natura as well, if every individual makes rational distancing decisions.


Assuntos
COVID-19/epidemiologia , Comportamento de Escolha , Pandemias/prevenção & controle , Distanciamento Físico , Comportamento Social , Teoria do Jogo , Humanos , Modelos Estatísticos
18.
Behav Neurosci ; 135(4): 550-570, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34460275

RESUMO

Reversal learning paradigms are widely used assays of behavioral flexibility with their probabilistic versions being more amenable to studying integration of reward outcomes over time. Prior research suggests differences between initial and reversal learning, including higher learning rates, a greater need for inhibitory control, and more perseveration after reversals. However, it is not well-understood what aspects of stimulus-based reversal learning are unique to reversals, and whether and how observed differences depend on reward probability. Here, we used a visual probabilistic discrimination and reversal learning paradigm where male and female rats selected between a pair of stimuli associated with different reward probabilities. We compared accuracy, rewards collected, omissions, latencies, win-stay/lose-shift strategies, and indices of perseveration across two different reward probability schedules. We found that discrimination and reversal learning are behaviorally more unique than similar: Fit of choice behavior using reinforcement learning models revealed a lower sensitivity to the difference in subjective reward values (greater exploration) and higher learning rates for the reversal phase. We also found latencies to choose the better option were greater in females than males, but only for the reversal phase. Further, animals employed more win-stay strategies during early discrimination and increased perseveration during early reversal learning. Interestingly, a consistent reward probability group difference emerged with a richer environment associated with longer reward collection latencies than a leaner environment. Future studies should systematically compare the neural correlates of fine-grained behavioral measures to reveal possible dissociations in how the circuitry is recruited in each phase. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Reversão de Aprendizagem , Recompensa , Animais , Comportamento de Escolha , Aprendizagem por Discriminação , Discriminação Psicológica , Feminino , Masculino , Ratos , Reforço Psicológico
19.
Nat Commun ; 12(1): 4830, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376663

RESUMO

Choice-relevant brain regions in prefrontal cortex may progressively transform information about options into choices. Here, we examine responses of neurons in four regions of the medial prefrontal cortex as macaques performed two-option risky choices. All four regions encode economic variables in similar proportions and show similar putative signatures of key choice-related computations. We provide evidence to support a gradient of function that proceeds from areas 14 to 25 to 32 to 24. Specifically, we show that decodability of twelve distinct task variables increases along that path, consistent with the idea that regions that are higher in the anatomical hierarchy make choice-relevant variables more separable. We also show progressively longer intrinsic timescales in the same series. Together these results highlight the importance of the medial wall in choice, endorse a specific gradient-based organization, and argue against a modular functional neuroanatomy of choice.


Assuntos
Comportamento de Escolha/fisiologia , Macaca mulatta/fisiologia , Neurônios/fisiologia , Córtex Pré-Frontal/fisiologia , Potenciais de Ação/fisiologia , Algoritmos , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Mapeamento Encefálico , Imageamento por Ressonância Magnética/métodos , Modelos Neurológicos , Córtex Pré-Frontal/citologia
20.
Nutrients ; 13(8)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34444780

RESUMO

While the food environment has been implicated in diet-related health disparities, individuals' ability to shape the food environment by limiting attention to a subset of products has not been studied. We examine the relationship between BMI category and consideration set-the products the individual considers before making a final choice-in an online hypothetical shopping experiment. Specifically, we focus on the healthiness of the consideration set the individual selected. Secondly, we examined the interaction of a health prompt (versus a no-prompt control) with BMI category on the healthiness of the consideration set. We used linear probability models to document the relationship between weight status and consideration set, between prompt and consideration set, and the effect of the interaction between prompt and weight status on consideration set. We found that (1) obese individuals are 10% less likely to shop from a consideration set that includes the healthy options, (2) viewing the prompt increased the probability of choosing a healthy consideration set by 9%, and (3) exposure to the prompt affected individuals in different BMI categories equally. While obese individuals are more likely to ignore healthier product options, a health-focused prompt increases consideration of healthy options across all BMI categories.


Assuntos
Atenção , Índice de Massa Corporal , Alimentos , Adulto , Comportamento de Escolha , Comportamento do Consumidor , Dieta , Feminino , Preferências Alimentares , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas On-Line , Estados Unidos
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