Choice Response Research Articles

The Ability of Nutrition Warning Labels to Improve Understanding and Choice Outcomes Among Consumers Demonstrating Preferences for Unhealthy Foods

BackgroundGiven growing interest in warning labels as a form of front-of-pack nutrition label, it is important to better understand the mechanisms via which these labels may exert their effects, especially among those making suboptimal food choices. ObjectiveThe study aim was to assess the extent to which consumers with the weakest outcomes for objective understanding and choice in no-label conditions were able to improve their understanding and choices after exposure to warning labels on food product options. DesignPost-hoc analyses of the cross-sectional FOP-ICE (Front-of-Pack International Comparative Experimental) study data generated from an online survey that included simulated food choice and nutritional quality ranking scenarios. Participants/settingParticipants included 3,680 adults from the following 18 countries: Argentina, Australia, Belgium, Bulgaria, Canada, Denmark, France, Germany, Italy, Mexico, Netherlands, Poland, Portugal, Singapore, Spain, Switzerland, United Kingdom, and United States. InterventionSurvey respondents selected their preferred product options and ranked foods according to their healthiness before and after exposure to mock breakfast cereal, cake, and pizza products displaying warning labels. Main outcome measuresObjective understanding and food choice were measured. Statistical analyses performedWithin each product category, analyses were conducted on respondents who initially incorrectly identified the healthiest option and/or selected the unhealthiest option as their preferred choice. Significant differences between proportions selecting each understanding and choice response option were assessed using 2-sample z tests for proportions. ResultsSalience of the warning labels was low; 46% reported noticing the labels while completing the survey. Just over one-third of those aware of the presence of warning labels were able to identify the least healthy option in the post-exposure condition. Approximately one-half reselected the least healthy option post exposure and just over one-fourth switched to the healthiest option. ConclusionsThe results indicated that warning labels can assist some consumers to improve their food quality assessments and choices. However, design improvements could enhance the salience and interpretability of this label format.

Psychological value theory: A computational cognitive model of charitable giving

Charitable giving involves a complex economic and social decision because the giver expends resources for goods or services they will never receive. Although psychologists have identified numerous factors that influence charitable giving, there currently exists no unifying computational model of charitable choice. Here, we submit one such model, based within the strictures of Psychological Value Theory (PVT). In four experiments, we assess whether charitable giving is driven by the perceived Psychological Value of the recipient. Across all four experiments, we simultaneously predict response choice and response time with high accuracy. In a fifth experiment, we show that PVT predicts charitable giving more accurately than an account based on competence and warmth. PVT accurately predicts which charity a respondent will choose to donate to and separately, whether a respondent will choose to donate at all. PVT models the cognitive processes underlying charitable donations and it provides a computational framework for integrating known influences on charitable giving. For example, we show that in-group preference influences charitable giving by changing the Psychological Values of the options, rather than by bringing about a response bias toward the in-group.

Referral pathways for chronic pain patients from Canadian emergency departments: emergency physicians' practices, perspectives, and recommendations.

Patients with chronic pain account for 12-20% of total emergency department (ED) and was the primary presenting concern among 37% of patients who visited the ED > 12 times per year. Despite this, emergency physicians receive little focused training managing these patients, and there is a paucity of effective referral pathways from EDs, despite strong evidence that chronic pain is best treated longitudinally in multidisciplinary clinics. This study sought to explore the practices, perspectives, and recommendations of current Canadians emergency physicians in better serving the chronic pain patient (CPP) population in the ED. An electronic cross-sectional survey was administered to members of the Canadian Association of Emergency Physicians (CAEP), consisting of 16 multiple choice and numerical response questions. Responses were summarized descriptively as percentages and as the median and inter-quartile range (IQR) for quantitative variables. The study was completed by 169/1635 respondents for a response rate of 10%. The most common presentations respondents saw were neuropathic pain and centrally mediated disorders (23% each) and low back pain (19%). 86% of respondents felt that chronic pain patientsdid not get appropriate referrals from the ED, and 70% of respondents were unaware of where they could even refer chronic pain patientsfrom theED. 96% of respondents felt that their ED did not have an effective referral pathway for chronic pain patients. Rapid access clinics for common conditions, reduced pain clinic wait times, and clear ED referral pathways were the commonest recommendationsby respondents. There is a clear need to increase the accessibility to outpatient pain medicine clinics for chronic pain patients presenting to the ED.ED and pain medicine providers must collaborate to establish mutually beneficial referral pathways from EDs, and to advocate for increased funding for rapid access outpatient pain clinics.

Measuring Cannabis Reinforcement among Young Adults: A Mixed Methods Examination.

Increasing reinforcement received from cannabis-free activities, relative to reinforcement from cannabis-related activities, is one way to reduce harmful cannabis use. Thus, accurate measurement of cannabis reinforcement is important. Using convergent mixed methods, we developed the Adolescent Reinforcement Survey Schedule-Cannabis Use Version (ARSS-CUV). ARSS-CUV, adapted from the alcohol use version, measures cannabis reinforcement by asking individuals how frequently they engaged in, and how much they enjoyed, different activities when using and not using cannabis. Young adults (N = 65; M age = 20.4 years [SD = 1.8]) completed measures of cannabis use, the ARSS-CUV, and provided feedback on included activities, via focus groups. Following Standards for Educational and Psychological Testing framework, this study examined evidence of measurement validity based on item content. Quantitative findings revealed that peer interactions were the most reinforcing activities, whereas activities related to family were least reinforcing. Qualitative findings indicated some confusion with question wording. Participants also indicated the importance of environmental context when using cannabis and noted who they use cannabis with may be more important than the activity they are doing. Changes were made to survey flow and response choices after participant feedback. ARSS-CUV includes revisions in activities solicited and response format. The revised ARSS-CUV provides opportunities to advance measurement of an important construct (i.e., reinforcement) in the study of cannabis use. Psychometric properties of the ARSS-CUV across different populations and contexts of use (e.g., polysubstance use) should be examined.

Value dynamics affect choice preparation during decision-making.

During decision-making, neurons in the orbitofrontal cortex (OFC) sequentially represent the value of each option in turn, but it is unclear how these dynamics are translated into a choice response. One brain region that may be implicated in this process is the anterior cingulate cortex (ACC), which strongly connects with OFC and contains many neurons that encode the choice response. We investigated how OFC value signals interacted with ACC neurons encoding the choice response by performing simultaneous high-channel count recordings from the two areas in nonhuman primates. ACC neurons encoding the choice response steadily increased their firing rate throughout the decision-making process, peaking shortly before the time of the choice response. Furthermore, the value dynamics in OFC affected ACC ramping-when OFC represented the more valuable option, ACC ramping accelerated. Because OFC tended to represent the more valuable option more frequently and for a longer duration, this interaction could explain how ACC selects the more valuable response.

Impact of COVID-19 on clinical practice of UK-based speech and language therapists working with school-aged children with neurodisability and oropharyngeal dysphagia: A survey.

The COVID-19 pandemic and response changed clinical service delivery and practice for speech and language therapists (SLTs) in the United Kingdom. SLTs work with children with neurodisability regarding both difficulties with their communication and eating and drinking skills (oropharyngeal dysphagia). This survey aimed to specifically explore the impact of the COVID-19 pandemic on SLT practice for school-aged children with dysphagia. UK-based SLTs working with school-aged children with neurodisability and oropharyngeal dysphagia were recruited to share their perceptions on the impact of COVID-19 on practice. Four questions focusing on COVID-19 impact were part of a larger online survey exploring SLT clinical practice regarding mealtime management of children with neurodisability and oropharyngeal dysphagia, which included demographic information, service delivery, assessment and intervention practices. COVID-19 impact questions were a mixture of multiple choice and free text responses. The survey was disseminated using professional networks and social media, between 14 May and 30 July 2021. Data were analysed using descriptive statistics and qualitative content analysis. One hundred and two participants answered at least one of the four COVID-19 questions. Eighty-two per cent of SLTs either agreed or strongly agreed that COVID-19 impacted on service delivery to children and families. Negative impacts on service delivery included school absences/closures, home visiting restrictions, families declining input and/or having barriers to telehealth use and the impact of mask wearing on interactions. Positive impacts included increased telehealth access and skills, increased contact with families and focus on children's eating and drinking function within the home environment. Participants aimed to maintain the increased contact with families alongside a hybrid service delivery approach of in-person and virtual appointments. This survey provides novel information capturing SLT practice change across two waves of COVID-19 and return to in-person practice for UK children with neurodisability.

“Use the Force!” Adaptation of Response Formats

Abstract. The present paper features the adaptation of an existing Big Five questionnaire with a rating scale (RS) response format into a measure using a multidimensional forced choice (MFC) response format. Rating scale response formats have been criticized for their proneness to intentional and unintentional response distortions. Multidimensional forced choice response formats were suggested as a solution to mitigate several types of response sets and response styles by design. The Big Five Inventory of Personality in Occupational Situations (B5PS) is a situation-based questionnaire designed for personnel selection and development purposes which would benefit from fake-proof response formats. MFC response formats require special effort during test construction and calibration which will be laid out here. Changing the response format has severe consequences on item design and scoring. An inherent issue with MFC formats derives from their inability to yield interpersonal comparative results from standard (sum) scoring. This issue can be solved with item response theory (IRT)-based calibration during test construction. The Thurstonian IRT approach (TIRT) was developed by Brown and Maydeu-Olivares (2011) , and aspects of MFC item design and TIRT calibrations are explored in this paper. Evidence on structural and construct validity are presented alongside recommendations on the test development processes. The results support the feasibility of the concept of MFC test construction with TIRT calibration in a contextualized and situation-based item format.

Sound-symbolic association between speech sound and spatial meaning in relation to the concepts of up/down and above/below

AbstractResearch has shown sound-symbolic associations between speech sounds and conceptual and/or perceptual properties of a referent. This study used the choice response time method to investigate hypothesized associations between a high/low vowel and spatial concepts of up/down and above/below. The participants were presented with a stimulus that moved either upward or downward (Experiments 1 and 2), or that was located above or below the reference stimulus (Experiment 3), and they had to pronounce a vowel ([i] or [æ]) based on the spatial location of the stimulus. The study showed that the high vowel [i] was produced faster in relation to the up-directed and the above-positioned stimulus, while the low vowel [æ] was produced faster in relation to the down-directed and the below-positioned stimulus. In addition, the study replicated the pitch-elevation effect showing a raising of the vocalization pitch when vocalizations were produced to the up-directed stimulus. The article discusses these effects in terms of the involvement of sensorimotor processes in representing spatial concepts.

National survey of second opinions for hospitalized patients in need of liver transplantation.

Decisions about patient candidacy for liver transplant (LT) can mean the difference between life and death. We surveyed LT centers across the United States to assess their perceptions of and barriers to second-opinion referrals for inpatients declined for transplant. The medical and surgical directors of 100 unique US LT programs that had done >20 LTs in 2021 were surveyed with a 33-item questionnaire including both multiple-choice and free-response questions. The response rate was 60% (60 LT centers) and included 28 larger-volume ( ≥100 LTs in 2021) and 32 smaller-volume (<100 LTs in 2021) programs. The top 3 reasons for inpatient denial for LT included lack of social support (21%), physical frailty (20%), and inadequate remission duration from alcohol use (11%). Twenty-five percent of the programs reported "frequently" facilitating a second opinion for a declined inpatient, 52% of the programs reported "sometimes" doing so, and 7% of the programs reported never doing so. One hundred percent of the programs reported that they receive referrals for second opinions. Twenty-five percent of the programs reported transplanting these referrals frequently (over 20% of the time). Neither program size nor program location statistically impacted the findings. When asked if centers would be in favor of standardizing the evaluation process, 38% of centers would be in favor, 39% would be opposed, and 23% were unsure. The practices and perceptions of second opinions for hospitalized patients evaluated for LT varied widely across the United States. Opportunities exist to improve equity in LT but must consider maintaining individual program autonomy.

Indigenous knowledge in climate change adaptation: Choice of indigenous adaptation responses to coastal erosion in Ghanaian communities

Coastal erosion as a threat to Ghana’s coastline is being exacerbated by natural and anthropogenic processes. Adaptation to coastal erosion helps in managing the impacts and the levels of destruction to livelihoods, properties and investments along the coastline. Government intervention in adaptation to coastal erosion has always focused on the development of coastal sea defences without the integration of Indigenous knowledge and initiatives of coastal dwellers. This paper contributes to this gap by examining the Indigenous adaptation responses to coastal erosion in selected coastal communities of Ghana, factors influencing the choice of adaptation responses and the extent to which these Indigenous adaptation responses are addressing coastal erosion. Findings from the explorative qualitative study revealed that coastal dwellers are engaged in different forms of planned and reactive adaptation responses to coastal erosion. It was also found out that most of the Indigenous adaptation responses to coastal erosion were unsustainable in addressing coastal erosion and the choice of Indigenous adaptation response to coastal erosion was shaped by socio-economic and ecological factors or perception. Maladaptation responses by coastal dwellers were contributing to the phenomenon of coastal erosion. Coastal dwellers have survived the impacts of coastal erosion in the absence of support from central and local governments and their unsustainable adaptation responses have become a cyclical ritual over a period of time. The paper contributes to the debates on adaptation to climate change and the consideration of Indigenous knowledge into climate change mitigation and adaptation strategies in coastal zone planning and management.

What are the drivers of sustainable energy transition? Insights from an empirical analysis of household preferences for electric induction cooking in Nepal

Electricity as a clean cooking fuel is economically and environmentally efficient compared to other cooking fuels, and induction stoves are among the most efficient that could contribute to the sustainable energy transition. Nepal is rich in water resources, having resources four times higher than the global average. With increasing hydroelectricity generation, promoting induction stoves for cooking is a viable way to reduce the use of traditional fuels and Liquified Petroleum Gas imported from other countries. This study aims to identify the underlying product-specific factors influencing households’ preference for electric cooking using induction stoves and assess the impact of awareness about the benefits of induction stoves on choice probability. We used a randomized conjoint experiment along with a randomized controlled trial collecting primary data of 9500 choice responses from 950 households in the Nuwakot district of central Nepal to achieve the objective. Among the six product-specific factors considered in the conjoint analysis, monthly expenses and supply of electricity were found to be significant determinants for choosing electric induction cooking, while cooking time, sickness rate, and environmental conditions also had a certain degree of influence, whereas the effect of installation cost was found to be statistically insignificant. The lower bound of households' willingness to pay for electric induction cooking was found to be as high as 4% of their monthly income. The information treatment increases the uptake rate of the induction package by 5% and willingness to pay by 9.58%. This indicates the role of awareness and behavior change in driving a sustainable energy transition, highlighting the need for policymakers to promote cleaner cooking technologies through the effective dissemination of information The results of this study will enable policymakers to make informed decisions to promote the use of induction stoves as the primary cooking fuel, thereby contributing to efforts toward climate change mitigation.

Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients.

Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant injury (CSI) in the abdomen and pelvis among blunt trauma patients presenting to the emergency department (ED). We collected gestalt data on physicians caring for adult blunt trauma patients who received abdominal/pelvic computed tomography (CT) at three Level I and one Level II trauma centers. The primary outcome of CSI was defined as injury on abdominal/pelvic CT requiring hospitalization or intervention. Physicians evaluating trauma patients estimated the likelihood of CSI prior to abdominal/pelvic CT review (response choices: <2%, 2%-10%, 11%-20%, 21%-40%, >40%). We evaluated potential missed injury rates (prevalence of CSI) and sensitivity for prediction categories, as well as calibration and area under the receiver operating characteristic (AUROC) curve for overall physician gestalt. Of 2030 patients, 402 (20%) had an injury on abdominal/pelvic CT and 270 (13%) had CSI. The <2% risk of CSI gestalt cutoff had a potential missed injury rate of 5.6% and a sensitivity of 95.2% (95% confidence interval [CI] 91.7%-97.3%). The 0%-10% cutoff of CSI gestalt had a potential missed injury rate of 6.3% (95% CI, 5.0%-7.9%) and a sensitivity of 75.2% (95% CI 69.5%-80.1%). With an overall AUROC of 0.699 (95% CI 0.679-0.719), physician gestalt was moderately accurate and calibrated for the midranges of predicted risk but poorly calibrated at the extremes. Physician gestalt for the prediction of adult abdominal and pelvic CSI is moderately accurate and calibrated. However, the potential missed CSI rate and low sensitivity of the low perceived risk of injury cutoffs indicate that gestalt by itself is insufficient to direct selective abdominal/pelvic CT use in adult blunt trauma patient evaluation.

Factors Influencing Farmers’ Choices of Responses to Climatic Stressors in Tanzania

The viability of food production by smallholder farmers in Tanzania's semi-arid regions is threatened by climate variability and change. This study's main goal was to comprehend the available options for farmers in Tanzania's Great Ruaha River Sub-Basin and the factors that influenced their decisions. We used both quantitative and qualitative data collection methods. Primary data were gathered through focus groups and household questionnaire surveys, while secondary data came from records collected by government organizations. A logistic regression analysis was undertaken so as to determine factors that influence smallholder farmers’ perceptions and choice of response measures during dry years. Smallholder farmers mostly relied on their prior knowledge and locally accessible resources when developing their response strategies. Findings indicate that climate awareness, gender, age, education level, village location, wealth rank, and farmer experience are factors that have a substantial impact on farmers' decisions regarding choice of adaptation strategies to climate change. Therefore, decision-makers at all levels of government, from local authorities to the national level, should play a crucial role in improving adaptation strategies appropriate for a given climatic shock on the research area. The study suggests that GRRB farmers increase their knowledge and understanding of climate change. In order to successfully adapt to climate change, farmers should also work to create associations that will operate as a forum for knowledge exchange about indigenous farming techniques.

ROLE OF INTEREST ACTORS IN THE DEVELOPMENT POLICY OF THE DONGGI-SENORO LNG REFINERY, BATUI DISTRICT, BANGGAI DISTRICT, CENTRAL SULAWESI PROVINCE

Indonesia opened a new gas field in Kab. Banggai Province of Central Sulawesi withthe project name Donggi-Senoro. This LNG field project is the first project that uses adifferent system by separating owners and managers of the downstream and upstreamsections with an investment capital of $28 billion, where for the upstream regionIndonesia is represented by Pertamina also managing and owning a share capital of29%.In this study the authors tried to analyze the roles of the actors involved in the DSLNGproject development policy using policy response and public choice theory. This studyuses a case study approach in reconstructing the analysis based on data obtained inthe field, both primary and secondary data by conducting interviews and observations.The results of the study concluded that there were 3 major groups that became actorsand played a role in DSLNG project development activities, namely the governmentas policy makers and policy makers, the private sector as owners of capital and thecommunity and NGOs which were divided into groups that were pro and those whowere resistant to development policies. DSLNG project. The emergence of a responsethat is mostly resistant is a manifestation of the injustice of the policies and decisionsmade by the local government. The response given by the community was in theform of demonstrations, blocking roads and burning tires as a form of protest againstpolicies related to the construction of a DSLNG plant.&#x0D; Keywords: public policy, public choice, policy response

Mechanisms in Emotional Information Processing in Individuals with Major Depressive Disorder: An Event-Related Potential Study of an Information Processing Model.

Individuals with major depressive disorder have a cognitive bias toward emotional stimuli, which influences the quality and speed of emotional information processing. This study aimed to understand the factors underlying this bias by identifying when it occurs during information processing using an information processing model. A total of 57 participants-19 each [ (16 (84.21%) females and 3 (15.79%) males per group)], for the first-episode MDD (FMDD), recurrent episodes MDD (RMDD), and healthy controls (HCs) - matched for sex and hand preference, completed event-related potentials (ERP) to perform psychological function and a choice response time task. Results revealed that recurrent episodes major depressive disorder participants had decreased N2b and P3b amplitudes but increased contingent negative variation during the processing of happy and neutral facial stimuli, relative to their counterparts. Both recurrent episodes major depressive disorder and first-episode major depressive disorder participants used a parallel information processing strategy for happy information at P3a latency, while healthy controls used a linear information processing strategy. The use of a parallel processing strategy among individuals with major depressive disorder may have led to impaired "happy" information processes, possibly explaining why individuals with major depressive disorder are less efficient than healthy controls. The results suggest the possibility that biases related to the processing of "happy" information among individuals with major depressive disorder may be related to a tendency for these individuals to engage in superficial decision-making. Future research is needed to examine the processes contributing to people with major depressive disorder having challenges with inhibition-facilitation of emotional stimuli.

Charging Station Location and Sizing for Electric Vehicles Under Congestion

This paper studies the problem of determining the strategic location of charging stations and their capacity levels under stochastic electric vehicle flows and charging times taking into account the route choice response of users. The problem is modeled using bilevel optimization, where the network planner or leader minimizes the total infrastructure cost of locating and sizing charging stations while ensuring a probabilistic service requirement on the waiting time to charge. Electric vehicle users or followers, on the other hand, minimize route length and may be cooperative or noncooperative. Their choice of route in turn determines the charging demand and waiting times at the charging stations and hence, the need to account for their decisions by the leader. The bilevel problem reduces to a single-level mixed-integer model using the optimality conditions of the follower’s problem when the charging stations operate as M/M/c queues and the followers are cooperative. To solve the bilevel model, a decomposition-based solution methodology is developed that uses a new logic-based Benders algorithm for the location-only problem. Computational experiments are performed on benchmark and real-life highway networks, including a new eastern U.S. network. The impact of route choice response, service requirements, and deviation tolerance on the location and sizing decisions are analyzed. The analysis demonstrates that stringent service requirements increase the capacity levels at open charging stations rather than their number and that solutions allowing higher deviations are less costly. Moreover, the difference between solutions under cooperative and uncooperative route choices is more significant when the deviation tolerance is lower. History: This paper has been accepted for the Transportation Science Special Issue on 2021 TSL Workshop: Supply and Demand Interplay in Transport and Logistics. Funding: This research was supported by the Ontario Graduate Scholarship when Ö. B. Kınay was a PhD candidate at the University of Waterloo, and this support is acknowledged. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2021.0494 .

Patient perspectives on post-bariatric surgery nutritional supplementation.

Bariatric procedures increase patient risk of long-term metabolic complications primarily due to nutrient deficiencies. The mainstay of prevention includes routine vitamin and mineral supplementation; however, patient-reported barriers to daily compliance are poorly understood. Post-bariatric surgery patients electively participated in an 11-point outpatient survey at a single academic institution. Surgical procedures included either laparoscopic sleeve gastrectomy (SG) or gastric bypass (GB). At the time of survey, patients ranged from 1-month to 15years from surgery. Survey items consisted of dichotomous (yes/no), multiple choice, and open-ended free response questions. Descriptive statistics were evaluated. Two hundred and fourteen responses were collected, 116 (54%) underwent SG and 98 (46%) underwent GB. Of these, 49% of samples were during short-term postoperative follow-up visits (0-3months), 34% intermediate follow-up (4-12months), and 17% long-term follow-up (> 1year). A total of 98% of patients reported that insurance did not cover their supplement cost. Most patients reported current vitamin use (95%), with 87% reporting daily compliance. Daily compliance was observed in 94%, 79%, and 73% of SG patients at short-, intermediate-, and long-term follow-up visits, respectively. While GB patients reported daily compliance in 84%, 100%, and 92% of short, intermediate, and long-term responses. Of those who were unable to take vitamins daily, non-compliance was attributed most to forgetting (54%), and less often to side effects (11%), or taste (11%). Patient-reported strategies for remembering to take vitamins included tying into daily routine (55%), use of a pill box (7%), and alarm reminders (7%). Daily compliance with post-bariatric surgery vitamin supplementation does not appear to vary based on postoperative time-period or surgical procedure. While a minority of patients struggle with daily compliance, factors associated with non-compliance include patient forgetting, side effects, and taste. Widespread utilization of patient-reported daily reminder strategies may lead to improved overall compliance and reduce incidence of nutritional deficiencies.

Decision-making and challenges within the evolving treatment algorithm in spinal muscular atrophy: a clinical perspective

ABSTRACT Introduction The clinical application of disease modifying therapies has dramatically changed the paradigm of the management of people with spinal muscular atrophy (SMA), from sole reliance on symptomatic care directed toward the downstream consequences of muscle weakness, to proactive intervention and even preventative care. Areas covered In this perspective, the authors evaluate the contemporary therapeutic landscape of SMA and discuss the evolution of novel phenotypes and the treatment algorithm, including the key factors that define individual treatment choice and treatment response. The benefits achieved by early diagnosis and treatment through newborn screening are highlighted, alongside an appraisal of emerging prognostic methods and classification frameworks to inform clinicians, patients, and families about disease course, manage expectations, and improve care planning. A future perspective of unmet needs and challenges is provided, emphasizing the key role of research. Expert opinion SMN-augmenting therapies have improved health outcomes for people with SMA and powered the practice of personalized medicine. Within this new proactive diagnostic and treatment paradigm, new phenotypes and different disease trajectories are emerging. Ongoing collaborative research efforts to understand the biology of SMA and define optimal response are critical to refining future approaches.

Ontarians' Perceptions of Public Health Communications and Misinformation During the COVID-19 Pandemic: Survey Study.

Clear, accurate, and transparent risk communication is critical to providing policy makers and the public with directions to effectively implement public health strategies during a health emergency. We aimed to explore the public's preferred sources of obtaining COVID-19 information, perceptions on the prevalence and drivers of misinformation during the pandemic, and suggestions to optimize health communications during future public health emergencies. We administered a web-based survey that included Likert scale, multiple choice and open-ended response questions to residents of Ontario, Canada. We aimed to recruit a sample that reflected population diversity with respect to age and gender. Data were collected between June 10, 2020, and December 31, 2020, and were analyzed using descriptive statistics; open-ended data were analyzed using content analysis. Subgroup analyses to explore perceptions by age and gender were conducted using ordinal regression. A total of 1823 individuals participated in the survey (n=990, 54% women; n=703, 39% men; n=982, 54% aged 18-40 years; n=518, 28% aged 41-60 years; and n=215, 12% aged ≥61 years). Participants most commonly obtained COVID-19 information from local television news (n=1118, 61%) followed by social media (n=938, 51%), national or international television news (n=888, 49%), and friends and family (n=835, 46%). Approximately 55% (n=1010) of the participants believed they had encountered COVID-19-related misinformation; 70% (n=1284) of the participants reported high levels of trust in health authority websites and health care providers; 66% (n=1211) reported high levels of trust in health ministers or public health organizations. Sources perceived to be less trustworthy included friends and family, talk radio, social media, as well as blogs and opinion websites. Men were more likely to report encountering misinformation and to trust friends or family (odds ratio [OR] 1.49, 95% CI 1.24-1.79) and blogs or opinion websites (OR 1.24, 95% CI 1.03-1.50), compared to women. Compared to those aged 18-40 years, participants aged ≥41years were more likely to trust all assessed information sources, with the exception of web-based media sources, and less likely to report encountering misinformation. Of those surveyed, 58% (n=1053) had challenges identifying or appraising COVID-19 information. Over half of our participants perceived that they had encountered COVID-19 misinformation, and 58% had challenges identifying or appraising COVID-19 information. Gender and age differences in perceptions of misinformation and trust in information sources were observed. Future research to confirm the validity of these perceptions and to explore information-seeking patterns by population subgroups may provide useful insights on how to optimize health communication during public health emergencies.

The Problem with the Anthropocene: Kainos, Not Anthropos

The Problem with the Anthropocene: <i>Kainos</i>, Not <i>Anthropos</i>